Prevalence of COVID-19 infection in asymptomatic school children.

BACKGROUND: With the onset of the COVID-19 pandemic, discussions regarding the prevalence of COVID-19 in children and the association of this with education have started. This study aimed to determine the prevalence of COVID-19 infection in asymptomatic school children within a limited period while face-to-face education continued. METHODS: This is a descriptive and retrospective study. Screening was carried out in the schools in the three major districts of the metropolitan municipality when face-to-face education was practiced. COVID-19 RT-PCR swab samples were collected from 4,658 students from 46 schools at preschool, primary, secondary, and high school levels by using the stratified sampling method. Screening results were retrospectively analyzed by the researchers. RESULTS: The mean age of the children included in the study was 10.6±3.2 (5-17). Only 46 students` COVID-19 RT-PCR results were positive; the positivity rate was higher in male students than in female students (p > 0.05); the students living in the third region had a higher positivity rate than the other students, there was a statistical difference between them (p < 0.001); there were no positive cases in 26 (56.7%) schools, and the spreader rate of the school children was 0.98%. CONCLUSIONS: We determined in the study that the prevalence of COVID-19 infection was not high in asymptomatic school children in the period when schools were open. This may play a role in directing the education and training during the pandemic.

Death and COVID-19 Anxiety in Home-Quarantined Individuals Aged 65 and Over During the Pandemic.

Urgent measures were taken for those at the age of 65 and over who were at the risk group all over the world due to the COVID-19 pandemic. It is known that many individuals at the age of 65 and over have experienced anxiety due to the uncertainties.This study aimed to determine the anxiety and death anxiety in individuals aged 65 and over who were isolation at home due to being diagnosed with COVID-19 or being in contact during the pandemic process.The study is descriptive and cross-sectional. It was performed with 656 home-quarantined individuals aged between 65-80 years with positive or negative real-time polymerase chain reaction (RT-PCR) test result. A form including questions about the death anxiety and the Coronavirus Anxiety Scale Short Form prepared by the researchers were administered to the individuals by phone call.Of the participants, 49.5% were male. Median COVID-19 anxiety score was 4 (0-18). Anxiety scores of the male and female participants were similar. Participants with negative polymerase chain reaction (PCR) results and those with death anxiety had higher COVID anxiety scores. Death anxiety has increased by 1.661 times in male gender, 1.983 times in RT-PCR positivity and 0.146 times in the presence of symptoms.Individuals with positive COVID-19 test results or those aged 65 and over who had death anxiety and negative COVID-19 test result but who were in home-isolation due to being a contact had higher anxiety score. For this reason, those with death anxiety can be supported in line with their religious beliefs to reduce anxiety.Those with negative PCR test results in quarantine can be adequately informed about the COVID-19.

The Effect of Chronic Diseases, Age and Gender on Morbidity and Mortality of COVID-19 Infection.

BACKGROUND: We aimed to reveal how chronic diseases, age and gender affected morbidity and mortality in patients with Coronavirus disease of 2019 (COVID-19). METHODS: Medical records of all reverse transcription polymerase chain reaction (RT-PCR) positive COVID-19 patients followed up in hospital and home isolation between 13th of Mar 2020 and 12th of May 2020 were retrospectively reviewed. The patients were from Kayseri Province, Turkey. Patients' demographic and clinical characteristics and the factors associated with morbidity and mortality were analyzed. RESULTS: Of all the patients, 773 (95.8%) were alive and 34 (4.24%) died. The fatality rate was 4.2%. There were differences between the age groups in terms of fatality rate (P<0.001). The fatality rate in patients above the age of 65 yr was significantly higher. The fatality rate in the male gender was 2.44 times higher (P<0.05). It was 1.104 times higher in advanced age (P<0.001) and 10.893 times higher in patients with at least one comorbid disease (P<0.05). Hypertension increased mortality by 3.635 times (P<0.05) and chronic pulmonary diseases by 2.926 times (P<0.05). CONCLUSION: Advanced age, male gender and accompanying chronic diseases have adverse effects on the course and severity of the disease and hospitalization. They also increased the rate and risk of mortality.

Reduced antioxidant capacity in children with iron deficiency and iron-deficiency anemia.

OBJECTIVE: This study aimed to assess the relationship between antioxidant enzymes such as glutathione peroxidase (GSH-Px), glutathione reductase (GSH-R), and paraoxonase (PON1) and carotid intima-media thickness (CIMT) and investigate susceptibility to atherosclerosis with decreasing antioxidant capacity in adolescent patients with iron deficiency (ID) and irondeficiency anemia (IDA). MATERIAL AND METHODS: Twenty-five patients with IDA (14.9±1.8 years; 14 female and 11 male patients), 25 patients with ID (14.1±2.24 years; 13 female and 12 male patients) and 21 healthy controls (14.04±2.01 years; 11 female and 10 male individuals) were included in the study. Serum PON1, GSH-Px, GSH-R, and CIMT were measured in all cases. After 3-month oral iron therapy for the group with IDA, the same measurements were performed again. RESULTS: CIMT was statistically significantly higher in patients with ID and IDA than in the control group (p<0.05). PON1, GSH-Px, and GSH-R activities decreased and were statistically significantly low in patients with IDA compared to the control group (p<0.05). Serum PON1 activity was statistically significantly lower in patients with ID than in the control group (p<0.05). Post-treatment PON1, GSH-Px, and GSH-R activities in patients with IDA got back to normal and were statistically significantly higher compared to pre-treatment values. CONCLUSIONS: Antioxidant capacity decreases in patients with IDA and ID, which causes atherosclerotic changes. Therefore, patients with iron deficiency must be treated without the development of iron-deficiency anemia.

The relationship between immature platelet fraction and severity of acute bronchiolitis.

BACKGROUND AND OBJECTIVES: Acute bronchiolitis is one of the most common reasons for hospitalization in infants. Although patients with acute bronchiolitis generally have a good prognosis, death can also occur. In this study, we evaluate the immature platelet fraction (IPF) as an indicator of the severity of acute bronchiolitis. METHODS: In our study, 179 patients diagnosed with acute bronchiolitis were divided into three groups as mild (n: 48; 26.8%), moderate (n: 104; 58.10%) and severe (n: 27; 15.1%) bronchiolitis. There were 80 healthy children in the control group. The diagnostic capacity of IPF and hematological parameters (platelet distribution width (PDW), mean platelet volume (MPV), white blood cell count (WBC), and platelet count (PLT)) values to predict severity of acute bronchiolitis was evaluated using receiver operating characteristic (ROC) curves and their respective areas under the curves (AUCs) calculated with 95% confidence intervals. RESULTS: The IPF value of patients with acute bronchiolitis was significantly higher than the healthy group (p < 0.001). In addition, a positive correlation was observed between clinical severity of bronchiolitis and IPF. The ROC curve analysis indicated that the IPF cut-off point for predicting severity of acute bronchiolitis was > 3.2% (Sensitivity of 84%, specificity of 97%). We found that the AUCs for IPF, MPV, PDW, WBC and PLT were statistically significant for bronchiolitis relative to the healthy control group. The parameter with the greatest AUC value was IPF. CONCLUSION: The IPF may present for diagnosing and evaluating the clinical severity of acute bronchiolitis in children.

Assessment of Hair Zinc in the School Children in Kayseri, Turkey.

Zinc is an essential micronutrient for the organism and is critical for the functional and structural integrity of cells. Determination of the amount of trace element concentrations in tissues such as hair samples have been used for the evaluation of the metabolic status especially in children. Unlike serum zinc, concentrations of zinc in hair are more stable and indicative of variations over time. The purpose of this study is to assess the zinc status of healthy school-age children in Kayseri (Turkey) by measuring the zinc level in hair samples and its association with BMI and the frequency of intake of zinc-rich foods. A total of 527 healthy children, including preadolescent (n = 360) aged 6-10 years and adolescent (n = 167) aged 11-15 years were included in this study. Hair samples were analyzed for zinc content by the inductively coupled plasma-mass spectrophotometry. Analysis of 527 healthy children showed that the mean hair zinc level was 186 ± 77 µg/g. Mean hair zinc level was lower in preadolescent age group than adolescents. There was no significant relationship between the monthly income of the family and the zinc-rich food intake and the zinc level of the hair. Our study shows that samples for analysis of zinc can be obtained with a noninvasive method for determining cases of deficiency during periods of rapid growth. However, further studies are needed to determine the normal tissue zinc level in healthy children, especially in our country and including different geographical regions.

High Doses of Boron Have No Protective Effect Against Nephrolithiasis or Oxidative Stress in a Rat Model.

Boron plays roles in the metabolism of calcium, vitamin D, steroid hormones, healthy bone development, and maintenance of cell membranes. The biological effects of boron are dose-dependent but follow a U-shaped pattern, rendering it important to define the active range. The studies of Bahadoran et al. on rats and Naghii et al. on humans showed that low doses of boron (3 and 10 mg/day) prevented kidney stone formation. The aim of this study was to determine whether high doses of boron have an anti-urolithiatic or antioxidant effect on nephrolithiasis in an experimental rat model. The study was conducted on 50 adult male Wistar rats randomized to five groups. Nephrolithiasis was induced with water containing 0.75% ethylene glycol (EG) and 2% ammonium chloride (AC). This treatment was given to animals in all groups for 10 days, except the positive and negative controls. Simultaneously, groups 2, 3, and 4 were given boric acid via gavage at doses of 25, 50, and 100 mg/kg/day (equivalent to 4/8/16 mg boron respectively) as the source of boron. Animals in the negative and positive control groups were given 6 µL/g distilled water without boric acid. At day 10, intra-cardiac blood samples were drawn from all animals. The right and left kidneys were removed for biochemical and histopathological examinations, respectively. The groups were compared with respect to serum urea, creatinine, calcium, phosphorous, total antioxidant status (TAS), total oxidant status (TOS), serum paraoxonase (PON1) activity, tissue calcium and oxalate levels, and stone burden as determined by histopathological examination. Serum urea and creatinine levels were significantly higher (p < 0.001 and p < 0.05, respectively), while serum calcium and phosphorous levels were significantly lower (p < 0.001 and p < 0.001, respectively), in animals given EG/AC compared to negative controls. No significant differences were detected in serum calcium, phosphorous, urea, or creatinine levels between animals treated with boron and positive controls (p > 0.05). Serum PON1 activity was significantly lower in animals given EG/AC than in negative controls (p < 0.001), while no significant difference in serum PON1 level was detected between rats treated with boron and positive controls. No significant differences were detected in vitamin D, TAS, TOS, tissue calcium, or tissue oxalate levels among groups. No stone formation was detected on histopathological examination in negative controls. No significant differences were found in stone formation between rats treated with boron and positive controls. Based on this study, high doses of boron had no protective effect against nephrolithiasis and oxidative stress.

Diagnostic role of mean platelet volume and neutrophil to lymphocyte ratio in childhood brucellosis.

BACKGROUND/AIMS: Brucellosis patients present various non-specific clinical symptoms, such as fever, fatigue, sweating, joint pain, arthritis, myalgia, and headache. Based on the nonspecifity of its clinical signs and symtoms, we decided to evaluate whether mean platelet volume (MPV) , neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) will contribute to the diagnosis. METHODS: In this retrospective study, we reviewed hospital-records of 60 children with a confirmed diagnosis of brucellosis in Kayseri between January 2013 and January 2016, and compared the hematological parameters; white blood cell (WBC) count, hemoglobin (Hb), neutrophil count, lymphocyte count, platelet count, MPV, NLR, and PLR with 55 healthy age and gender matched children. Also, the well known inf lammation markers; erytrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were compared between the patient and control group. RESULTS: We found significant difference among the Hb, platelet count, MPV and NLR values between the patient and control group (p < 0.05). There was no difference between WBC, neutrophil count, lymphocyte count and PLR between the patient and control group (p > 0.05). When the patients were divided into groups as arthritis positive and arthritis negative and compared to the control group; we found that the NLR is more significant in between the arthritis positive and control group (p = 0.013). Also, we found significant difference among the ESR and CRP values between the patient and control group (p < 0.001). CONCLUSIONS: The results of this study indicates that MPV and NLR values can be used as markers of inflammation in childhood brucellosis. Also, NLR is more valuable in children with brucella arthritis.

Reduction in mean platelet volume in children with acute bronchiolitis.

AIM: Platelets which are known to play a role in inflamation change their shapes when they are activated and this change is reflected in mean platelet volume and platelet distribution width values. Therefore, the mean platelet volume and platelet distribution width values are considered to be beneficial parameters for the diagnosis and treatment of many inflammatory diseases. The aim of the study was to evaluate platelet volume indices in children with acute bronchiolitis. MATERIAL AND METHODS: A total of 514 infants who were below the age of 2 years old were evaluated in this study. Three hundred thirteen of these infants were diagnosed with acute bronchiolitis patients and 201 were healthy children. The patients were separated into four groups as mild, moderate, severe bronchiolitis and the control patient group. The groups were evaluated in terms of significant differences in the values of mean platelet volume and platelet distribution width. A p value of <0.05 was considered statistically significant for all results. RESULTS: The mean platelet volume was found to be 6.8±0.6 fL in the patients with mild bronchiolitis attack, 6.7±0.6 fL in the patients with moderate bronchiolitis attack, 6.5±0.5 fL in the patients with severe bronchiolitis attack and 7.3±1.1 fL in the control group. The mean platalet volume was statistically significantly lower in the mild, moderate and severe bronchiolitis attack groups compared to the control group (p=0.000). The platelet distribution width was found to be 17.2%±0.83 in the mild bronchiolitis attack group, 17.1%±0.96 in the moderate bronchiolitis attack group, 17.3%±0.87 in the severe bronchiolitis attack group and 16.9±1.6% in the control patient group. This difference was not statistically significant (p=0.159). The platelet count was statistically significantly higher in the mild, moderate and severe bronchiolitis attack groups compared to the control group (p=0.000). CONCLUSIONS: The mean platalet volume is decreased in patients with acute bronchiolitis. It is not a useful criterion in determining the severity of bronchiolitis attack. It is important that clinicians evaluating hemogram results to also interprete this variable.

Bullous Dermatitis and Skin Necrosis Developing after Adrenalin Extravasation.

Extravasation of vasopressors can have serious complications varying from simple local reactions to skin necrosis and compartment syndrome. Here, we presented bullous dermatitis and skin necrosis which developed due to extravasation of adrenalin infusion in a Hodgkin lymphoma patient with septic shock who was admitted due febrile neutropenia.