A digital movement in the world of inactive children: favourable outcomes of playing active video games in a pilot randomized trial.

This parallel randomized controlled trial was aimed to evaluate whether parameters as physical fitness, reaction times, self-perception and enjoyment levels, as well as parental and children perspectives, were affected by active video games in inactive and technologically preoccupied children. Data were collected in a laboratory setting from four randomly selected urban public schools. All 1300 children in grades 3-6 were surveyed for the study. Among the 918 responders, 106 children were determined to be inactive and preoccupied with technology. Children in 3 schools (n = 53) allocated to active video game and in one school (n = 53) allocated to control group were compared by univariate covariance analyses for primary outcomes such as weight, body mass index and fat ratios at the end of 12 weeks. Active video game group significantly showed favourable responses for weight, body mass index and corresponding z scores as well as reaction times and self-perception controlling for age and baseline scores. In addition, enjoyment of the children in the game group by qualitative analysis was high indicating a motivational aspect for the continuation of the games. Diverse contributions of games to physical, social, intellectual and personal development were revealed.Conclusion: Active video games by promoting enjoyment levels and physical activity, as well as contributing to agility, alertness, socializing, and striving, led to a reduction in weight gain. They may be used as beneficial tools diverting children from inactivity and subsequent obesity.Trial registration: This study called AVGAME is registered with the number NCT03720938 in Clinicaltrials.gov . The trial protocol can also be retrieved from the archives of Abant Izzet Baysal University. What is Known: • Nowadays, children prefer sedentary video games that are known to induce weight gain and obesity-related comorbidities. • Active video games were shown to decrease weight in overweight and obese children. What is New: • Active video games decrease weight increment and reaction times, thus could be used to prevent obesity in inactive non-obese children. • Active video games raise self-esteem, induce enjoyment, improve the personal and intellectual development of children in addition to socializing and is a safe alternative to indoor sedentary video games.

Zinc deficiency and its predictive capacity for anemia: Unique model in school children.

BACKGROUND: Zinc deficiency is thought to be common in children, but its predictive capacity for anemia is unclear. Thus, this study identified zinc deficiency in school children, and investigated the association between zinc status and hemoglobin, together with other estimates of anemia. METHODS: For this case-control study, 349 of 483 children between 6.5 and 14.8 years old were included from primary schools in Bolu, Turkey. We measured weight, length, body mass index, and complete blood count with serum zinc, ferritin, vitamin B12 and folate. We investigated the differences between the groups and the effects of independent predictors such as age, gender, ferritin, zinc, vitamin B12 and folate on hemoglobin, on hierarchical multiple regression analysis. RESULTS: Thirty-eight (10.9%) of 349 children had low serum zinc concentration, and 21 (6.0%) were anemic. There were 12 anemic children in the zinc-deficient group and nine in the zinc-sufficient control group (31.5% vs 2.9%) with similar ferritin levels. On regression analysis, zinc had the strongest association with hemoglobin. On receiver operating characteristic analysis, the cut-off for serum zinc for prediction of anemia was 71.5 µg/dL. CONCLUSIONS: The strongest association of zinc with hemoglobin suggests that low zinc contributed the most to the observed anemia in children.

Pegylated interferon therapy during early pregnancy for hepatitis B infection: does it prevent vertical transmission?

In general, interferon (IFN) is avoided during pregnancy due to the possibility of fetal side effects. We, herein, reported two child-bearing women with chronic hepatitis B (HB) infection who used pegylated interferon alfa 2b (PEG IFNα 2b) in first trimester unintentionally. We compared HB contracting rates of gestations in which IFN was used and not used. The cases are unique in that they could highlight the importance of IFN use in early gestation for preventing vertical transmission particularly if combined with antiviral therapy for the rest of pregnancy.

Unique variant of Adams-Oliver syndrome with dilated cardiomyopathy and heart block.

Reported herein is the case of a 2-year-old boy with Adams-Oliver syndrome who presented with dilated cardiomyopathy and complete atrioventricular block. The patient had aplasia cutis congenita with partial aplasia of the skull bones, and terminal transverse limb malformations characteristic of the disease. Although congenital cardiac malformations may be associated with the syndrome, dilated cardiomyopathy has not been previously reported to be associated with the syndrome.

Identification of an Alu-mediated 12.2-kb deletion of the complete LPAR6 (P2RY5) gene in a Turkish family with hypotrichosis and woolly hair.

Hypotrichosis is a rare form of progressive hair loss characterized by sparse and occasionally woolly hair that is curly and breaks easily. Disease-causing mutations in LIPH, LPAR6 and KRT74 have recently been identified. We describe a four-generation pedigree from Turkey following an autosomal recessive pattern, in which the four affected members had hypotrichosis and woolly hair. By sequencing LPAR6 and the use of SNP arrays, we revealed a homozygous loss of the entire LPAR6 gene in the affected individuals. We hypothesize that the 12-kb deletion resulted from illegitimate recombination secondary to slip-replication. The orientation of three Alu repeats around LPAR6 may have provoked the formation of a 'triple-barrel' structure during replication, thereby allowing strand slipping. This first report of complete LPAR6 loss expands the spectrum of known LPAR6 mutations and suggests a novel mechanism for this gene and for the formation of DNA rearrangements in general.

Cochlear involvement in Familial Mediterranean Fever: a new feature of an old disease.

OBJECTIVES: In this study we first aimed to assess the cochlear functions in children with Familial Mediterranean Fever. The second aim was to investigate the correlation between the hearing levels and some clinical features of Familial Mediterranean Fever including the duration of the disease, age at onset, genetic analysis and colchicine use. METHODS: Thirty-four children with Familial Mediterranean Fever and 27 age matched children were included in the study. Following otologic examination, all children underwent audiometric evaluation, including Pure Tone Average measurements and Distortion Product Otoaoustic Emission testing. Audiological results of the two groups were compared and correlation between the audiologic status and clinical parameters of the disease like the duration of disease, age at onset, mutations and colchicine treatment were studied. RESULTS: Pure tone audiometry hearing levels were within normal levels in both groups. Hearing thresholds of Familial Mediterranean Fever patients were found to be increased at frequencies 8000, 10,000, 12,500 and 16,000 (p<0.05). In otoacoustic emission evaluation, distortion products and signal-noise ratio of FMF children were lower in the tested frequencies, from 1400 Hz to 4000 Hz (p<0.05). Interaction of the disease duration and age of disease onset was found to predict hearing levels, distortion products and signal-noise ratios of children with Familial Mediterranean Fever (F value=2.034; p=0.033). CONCLUSIONS: To our knowledge this is the first study demonstrating cochlear involvement in children with Familial Mediterranean Fever which showed increased hearing thresholds at higher frequencies in audiometry together with decreased distortion products and signal-noise ratios demonstrated by distortion product otoacoustic emission testing. Similar studies must be carried out on adult patients to see if a clinical hearing impairment develops. The possible mechanisms that cause cochlear involvement and the effect of colchicine treatment on cochlear functions must be enlightened.

Submandibular gland pleomorphic adenoma in a seven-year-old child: a case report.

Salivary gland neoplasms are rare in the pediatric age group. Pleomorphic adenomas in the submandibular gland are rarer. In this article, we present a seven-year-old female with a slowly growing mass in her right submandibular area. The firm, mobile and painless mass was about 2x3 cm in size and with bimanual palpation it was indiscriminated from the submandibular gland. Magnetic resonance imaging with contrast revealed a heterogeneous and minimally lobulated mass within the submandibular gland with clearly defined borders. Fine needle aspiration biopsy revealed a diagnosis of pleomorphic adenoma and we performed right submandibular gland excision under general anesthesia. The histopathological diagnosis was pleomorphic adenoma with sparse mitotic figures that may be interpreted as having a potential of malignant transformation. This patient who was followed up for one year without any complication is to our knowledge the youngest case cited in the English-language literature.

Screening of family members of children with Familial Mediterranean Fever: true-autosomal and pseudo-autosomal inheritance.

OBJECTIVES: Screening of family members of children with Familial Mediterranean Fever (FMF) has been carried out to detect new potential patients and to analyze the type of inheritance other than autosomal recessive. METHODS: Marenostrin encoding fever gene mutational analysis has been performed in 83 subjects - including 19 newly diagnosed children with FMF and their family members. RESULTS: Fourteen additional patients with FMF were diagnosed by screening family members. Pseudo-dominant and true dominant inheritances were detected in two families respectively, while the rest of the patients exhibited autosomal recessive mode of inheritance. CONCLUSION: Screening the family members of newly diagnosed FMF patients provides the opportunity to reveal undiagnosed new cases and to understand the mode of inheritance.