Investigation of anxiety, depression, obsessive-compulsive disorder, and quality of life of children of healthcare workers during the COVID-19 pandemic.

BACKGROUND: This study aimed to evaluate the anxiety, depression, obsessive-compulsive disorder symptoms, and quality of life of children whose parents were healthcare workers during the coronavirus disease 2019 (COVID-19) pandemic period. METHODS: The participants completed a sociodemographic questionnaire, the depression inventory for children (CDI), the screening for anxiety disorders in children (SCARED), the Maudsley obsessive compulsive question list (MOCQL), and the pediatric quality of life inventory (PedsQL) using online applications. A total of 153 children and adolescents whose parents were healthcare workers and 356 children and adolescents whose parents were not healthcare workers were included in the study. RESULTS: One tenth of all children participating in our study had a high level of depression, and nearly half of them had a high level of anxiety. There was no significant difference in CDI (p = 0.306), SCARED (p = 0.841), and PedsQL (p = 0.863) scale scores between the two groups. The MOCQL scale scores were higher in the group whose parents were not health professionals for cleanliness (p<0.001), slowness (p = 0.001), and total score (p<0.001). CONCLUSION: It was found that all participants were affected by anxiety, depression, and quality of life decline; moreover, obsessive-compulsive symptoms were more common in children whose parents were healthcare workers. In this context, our findings could help determine possible mental health problems of children and adolescents whose parents are or are not healthcare workers.

Evaluation of the risk factors for recurrence and the development of epilepsy in patients with febrile seizure.

BACKGROUND: Although febrile seizure (FS) is generally considered benign and self-limiting, there are differences regarding the risk factors, the prognosis, and the development of epilepsy. OBJECTIVE: To examine the clinical and sociodemographic characteristics of patients diagnosed with FS, and to determine the risks of recurrence and the development of epilepsy. METHODS: Between 2015 and 2019, we performed a retrospective evaluation of 300 patients with FS followed for at least 24 months. RESULTS: The first episode of FS was simple in 72.7% of the patients and complex in 27.3%, and it recurred in 40%. Age under 12 months in the first FS, complex FS, and neurodevelopmental delay were found to statistically increase the risk of recurrence (p < 0.05). A total of 7% of the patients developed epilepsy, and this rate was found to be higher in patients with neurodevelopmental delay and long-term use of antiepileptic drugs (p < 0.001). The development of epilepsy was also observed in 77.8% of the patients with abnormal electroencephalogram (EEG). Epilepsy developed more frequently in those with abnormal EEG (p<0.001). CONCLUSIONS: Neurodevelopmental delay was an important risk factor for FS recurrence and the development of epilepsy. Abnormality in the EEG is an important risk factor for the development of epilepsy. We found that the long-term prophylactic treatment did not cause decreases in the recurrence of FS nor in the development of epilepsy.

ANTECEDENTES: Embora a convulsão febril (CF) seja geralmente considerada benigna e autolimitada, existem diferenças nos fatores de risco, prognóstico e desenvolvimento de epilepsia. OBJETIVO: O objetivo foi examinar as características clínicas e sociodemográficas de pacientes diagnosticados com CF e determinar os riscos de recorrência e desenvolvimento de epilepsia. MéTODOS: Trezentos pacientes com CF, acompanhados por pelo menos 24 meses, foram avaliados retrospectivamente entre 2015 e 2020. RESULTADOS: A primeira CF foi simples em 72,7% dos pacientes e complexa em 27,3%. CS foi recorrente em 40% dos pacientes. Encontrou-se que a idade da primeira CF inferior a 12 meses, CF complexa e atraso no neurodesenvolvimento aumentaram estatisticamente o risco de recorrência (p < 0,05). Epilepsia se desenvolveu em 7% dos pacientes. A epilepsia foi maior em pacientes com atraso no desenvolvimento neurológico e uso prolongado de drogas antiepilépticas (p < 0,001). A epilepsia se desenvolveu em 77,8% dos pacientes com eletroencefalograma (EEG) anormal. Uma diferença estatisticamente significativa foi determinada em pacientes com EEG anormal em risco de epilepsia (p < 0,001). CONCLUSõES: O atraso no neurodesenvolvimento foi um importante fator de risco para recorrência de CF e epilepsia. A anormalidade do EEG é um importante fator de risco para o desenvolvimento de epilepsia. O tratamento de profilaxia a longo prazo não diminuiu a recorrência de CS e o desenvolvimento de epilepsia.

A Comparison Between Rome III and Rome IV Criteria in Children with Chronic Abdominal Pain: A Prospective Observational Cohort Study.

BACKGROUND: The Rome IV includes a redefinition of functional gastrointestinal disorders and diagnostic criteria. The present study aimed to compare the Rome III and Rome IV classification results and to reveal their differences in children with chronic abdominal pain. METHODS: The present study is a prospective observational cohort study. Three hundred forty-four children, who were admitted to the pediatric gastroenterology clinic, had abdominal pain for more than 2 months, and were not diagnosed with an organic disease, were included in our study. RESULTS: In children with chronic abdominal pain, Rome IV criteria did not cause a change in the number of patients diagnosed with functional abdominal pain disorders according to Rome III (89.8% vs 89.2%, P >.05). Functional abdominal pain and functional abdominal pain syndrome were the most common diagnoses in Rome III and functional abdominal pain, not otherwise specified in Rome IV. When compared to Rome III, while the diagnosis of functional dyspepsia increased in Rome IV, irritable bowel syndrome decreased. CONCLUSION: In children with chronic abdominal pain, Rome IV criteria did not cause a change in the number of patients diagnosed with functional abdominal pain disorders according to Rome III, but it caused a diagnostic shift. It was seen that some of the children diagnosed with irritable bowel syndrome in Rome III shifted to functional dyspepsia diagnosis in Rome IV.

Evaluation of the risk factors for recurrence and the development of epilepsy in patients with febrile seizure / Avaliação de fatores de risco para recorrência e desenvolvimento de epilepsia em pacientes com convulsões febris

Abstract Background Although febrile seizure (FS) is generally considered benign and self-limiting, there are differences regarding the risk factors, the prognosis, and the development of epilepsy. Objective To examine the clinical and sociodemographic characteristics of patients diagnosed with FS, and to determine the risks of recurrence and the development of epilepsy. Methods Between 2015 and 2019, we performed a retrospective evaluation of 300 patients with FS followed for at least 24 months. Results The first episode of FS was simple in 72.7% of the patients and complex in 27.3%, and it recurred in 40%. Age under 12 months in the first FS, complex FS, and neurodevelopmental delay were found to statistically increase the risk of recurrence (p< 0.05). A total of 7% of the patients developed epilepsy, and this rate was found to be higher in patients with neurodevelopmental delay and long-term use of antiepileptic drugs (p< 0.001). The development of epilepsy was also observed in 77.8% of the patients with abnormal electroencephalogram (EEG). Epilepsy developed more frequently in those with abnormal EEG (p<0.001). Conclusions Neurodevelopmental delay was an important risk factor for FS recurrence and the development of epilepsy. Abnormality in the EEG is an important risk factor for the development of epilepsy. We found that the long-term prophylactic treatment did not cause decreases in the recurrence of FS nor in the development of epilepsy.

Resumo Antecedentes Embora a convulsão febril (CF) seja geralmente considerada benigna e autolimitada, existem diferenças nos fatores de risco, prognóstico e desenvolvimento de epilepsia. Objetivo O objetivo foi examinar as características clínicas e sociodemográficas de pacientes diagnosticados com CF e determinar os riscos de recorrência e desenvolvimento de epilepsia. Métodos Trezentos pacientes com CF, acompanhados por pelo menos 24 meses, foram avaliados retrospectivamente entre 2015 e 2020. Resultados A primeira CF foi simples em 72,7% dos pacientes e complexa em 27,3%. CS foi recorrente em 40% dos pacientes. Encontrou-se que a idade da primeira CF inferior a 12 meses, CF complexa e atraso no neurodesenvolvimento aumentaram estatisticamente o risco de recorrência (p< 0,05). Epilepsia se desenvolveu em 7% dos pacientes. A epilepsia foi maior em pacientes com atraso no desenvolvimento neurológico e uso prolongado de drogas antiepilépticas (p< 0,001). A epilepsia se desenvolveu em 77,8% dos pacientes com eletroencefalograma (EEG) anormal. Uma diferença estatisticamente significativa foi determinada em pacientes com EEG anormal em risco de epilepsia (p< 0,001). Conclusões O atraso no neurodesenvolvimento foi um importante fator de risco para recorrência de CF e epilepsia. A anormalidade do EEG é um importante fator de risco para o desenvolvimento de epilepsia. O tratamento de profilaxia a longo prazo não diminuiu a recorrência de CS e o desenvolvimento de epilepsia.

Elevated blood carboxyhemoglobin levels as an early predictor of phototherapy requirement in moderate and late preterm infants.

Objective: Preterm infants are prone to increased bilirubin burden and display adverse outcomes if left unmonitored; therefore, predicting an increased bilirubin production is of paramount importance.Methods: We aimed to evaluate carboxyhemoglobin (COHb) levels in moderate (GA: 320/7-336/7) and late preterm (GA: 340/7-366/7) infants to assess whether this molecule could be used as an early predictor of phototherapy requirement.Results: A total of 221 infants were enrolled in the study. On admission, carboxyhemoglobin levels of infants who received phototherapy were significantly higher than that of infants who did not require this treatment, and this difference persisted in the consecutive hours (median (min-max): 1.2% (0.3-1.7) versus 0.8% (0.4-1.1); p < .001). The initial and consecutive COHb levels showed positive correlation (r = 0.77, p < .001). In the post-hoc analysis, direct antiglobulin test positivity significantly affected phototherapy requirement (p < .001). Receiver operating characteristics analysis showed that a COHb level of ≥0.95% was found to have a sensitivity of 90% and a specificity of 88%. Multinomial logistic regression analysis demonstrated that high COHb levels on admission significantly increased the likelihood of phototherapy requirement when adjusted for covariants (adjusted odds ratio: 2.2; 95% confidence interval: 1.4-3.5; p < .001).Conclusion: Carboxyhemoglobin measurement can be simply used to predict preterm infants who will require phototherapy.

Red blood cell distribution width as a useful marker for severity in pediatric acute gastroenteritis.

BACKGROUND: Acute gastroenteritis (AGE) in children is still one of the most important causes of mortality and morbidity in developing countries. Therefore, it is very important for clinicians to detect the presence and severity of acute gastroenteritis. Red cell distribution width (RDW) is thought to have the potential for AGE evaluation in children. We sought to investigate the value of RDW for severity assessment in children with AGE. METHODS: A total of 97 AGE patients were included in a prospective observational study. Complete blood count, serum C-reactive protein, and stool examinations were carried out. Modified Vesikari score (MVS) was evaluated to determine severity. RESULTS: Median age was 19 months (min-max, 1-198 months). The male/female ratio was 1.55 (59/38). Rotavirus was detected in 31 of 97 children (32%). median MVS was 9 points (min-max, 5-24 points). A total of 32 (33%), 43 (44%) and 22 patients (23%) were classified in the mild-, moderate-, and high-severity groups, respectively. There were no significant differences between rotavirus-positive and rotavirus-negative children. Hemoglobin, mean corpuscular volume, and RDW differed significantly according to severity. RDW had the highest area under the curve when the high-severity group was compared with the combination of low- and moderate-severity groups on receiver operating characteristic analysis. CONCLUSIONS: Red cell distribution width increased with the increase in severity of AGE. RDW may offer additional severity stratification in children with AGE.

The GABAA receptor γ2 subunit (R43Q) mutation in febrile seizures.

BACKGROUND: Febrile seizure is the most common form of childhood seizure. Although its exact cause is unclear, many researchers emphasize the importance of its genetic predisposition. Recent genetic studies revealed the importance of the mutations of the gamma-aminobutyric acid A receptor as the etiology of the febrile seizures. R43Q mutation affecting the γ2-subunit N-terminal domain has been related to childhood absence epilepsy and febrile seizure. METHODS: We investigated R43Q mutations of the GABRG2 gene, located on the long arm of chromosome 5 encoding the γ2-subunit of the gamma-aminobutyric acid A receptor. We studied 44 patients with febrile seizure and 49 children without any febrile seizure who were admitted to our clinic. RESULTS: We found that 36% of our patient group, the children who experienced febrile convulsions, had heterozygous R43Q mutation. Statistical studies revealed that heterozygous R43Q mutation of gamma-aminobutyric acid A receptor γ2 subunit was higher in the study group than in the control group (P < 0.01). CONCLUSIONS: Heterozygous gamma-aminobutyric acid A receptor γ2 subunit (R43Q) mutation may have an effect in the development of febrile seizures.