RESUMO
BACKGROUND: This study examines the frequency of problematic internet use and sleep problems in adolescents aged 14-18 years during the COVID-19 pandemic and identifies the impact of factors such as sociodemographic characteristics, internet habits, changes in daily life, and perceived social support on these problems. METHODS: This multicentre study was a questionnaire-based online survey study. The questionnaire included the Young Internet Addiction Scale, the Pittsburgh Sleep Quality Index, and the Multidimensional Scale of Perceived Social Support, as well as questions about demographic information, internet habits, and changes in daily life during pandemic. Several multivariate Backward logistic regression models were run to determine the variables that predicted problematic internet use and poor sleep quality. RESULTS: It was determined that the frequency of problematic internet use was 15.5%, and the frequency of poor sleep quality was 47.8%. Poor sleep quality was found 2.5 times higher in problematic internet users. The perceived social support was found insufficient in adolescents with problematic internet use and poor sleep quality. Various factors such as the excessive use of internet and social media, low school success, lack of physical activity, lack of rules for internet use at home, and worsening of relationships with parents were found to be predictive factors for these problems. CONCLUSIONS: Problematic internet use during the pandemic is associated with worsening sleep quality in adolescents. It is important to create special interventions for problematic internet use and sleep problems that develop in adolescents as a result of restrictions during the pandemic.
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Comportamento do Adolescente , Comportamento Aditivo , COVID-19 , Distúrbios do Início e da Manutenção do Sono , Humanos , Adolescente , Pandemias , Uso da Internet , Estudos Transversais , Apoio SocialRESUMO
Studies describing paediatric sleep patterns are needed by taking culture into consideration. The aim of this study was to identify parent-reported sleep-wake patterns in young children and explore possible factors influencing sleep problems. The mothers of 2,434 young children enrolled from well-child outpatient clinics in Turkey completed an online survey including sociodemographic variables, Brief Infant Sleep Questionnaire, Edinburgh Postnatal Depression Scale and Generalised Anxiety Disorder scales. Overall, young children in Turkey go to bed late (10:00 p.m.), awaken twice per night for 30 min, and obtain 11.5 h of total sleep, showing no sex-specific differences. Distinct night-time sleep patterns emerged after 18 months of age. Importantly, although currently breastfed healthy children were 3.8-times less likely to sleep through the night, total sleep duration and exclusive breastfeeding duration were higher in children who were not sleeping through the night. Overall, bedsharing was identified in 11.5%, and only room sharing was reported in 52.9%. Parental perception of a child's sleep as problematic was 35.8%. Mothers with higher educational attainment were more likely to perceive their children's sleep as a problem. Maternal depressive and anxious symptoms and a history of excessive infant crying were the determinants predicting the likelihood of both parent-perceived sleep problems and poor sleepers. The present analysis of sleep structure in infancy and toddlerhood provides reference data for well-child visits. These findings highlight the importance of considering maternal anxiety, depression and behaviour management techniques to cope with fussy infants in addressing childhood behavioural sleep problems.
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Transtornos do Sono-Vigília , Sono , Lactente , Feminino , Criança , Humanos , Pré-Escolar , Estudos Transversais , Mães , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/diagnóstico , Atenção Primária à SaúdeRESUMO
SIGNIFICANCE: We determined decreases in choroidal thickness and retinal nerve fiber layer (RNFL) thickness in all quadrants. Our findings show that the choroid and RNFL are affected before the emergence of ocular symptoms in malnourished children. PURPOSE: We aimed to determine whether the RNFL, a component of the neuronal structure, and the choroid, supplying the retina, are affected in children with malnutrition using spectral-domain optical coherence tomography. METHODS: One hundred twenty-six malnourished patients without ocular symptoms, aged between 5 and 10 years, and 116 healthy children were included in the study. Age, sex, weight-for-age (WFA) z score, height-for-age z score, body mass index-for-age z score, and spectral-domain optical coherence tomography data were recorded. RESULTS: Average RNFL thickness was 96.5 µm (82.0 to 128.0 µm) in the malnutrition group and 111.0 µm (95.0 to 128.0 µm) in the control group (P < .001). Retinal nerve fiber layer thickness was statistically significantly lower in all quadrants in malnourished patients compared with the control group. Median choroidal thickness in the foveal center was 304.0 µm (250.0 to 375.0 µm) in the malnutrition group and 345.0 µm (280.0 to 403.0 µm) in the control group (P < .001). Choroidal thickness in all quadrants was also statistically significantly lower in malnourished patients. Positive correlation was determined between average RNFL thicknesses and WFA z score. Average RNFL thickness decreased as WFA z score decreased (r = 0.730 and P < .001). Positive correlation was also observed between choroidal thickness in the foveal center and WFA z score. Foveal center choroidal thickness decreased in line with WFA z score (r = 0.786 and P < .001). CONCLUSIONS: Our results show that the retinal nerve fiber layer and choroidal thickness decreased in malnourished children without clinically reported ocular symptoms. A decreased retinal nerve fiber layer and choroidal thickness may be an important clue to the prevention of retinal pathologies that may develop at later ages if the malnutrition is not addressed.
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Transtornos da Nutrição Infantil/diagnóstico por imagem , Corioide/patologia , Oftalmopatias/diagnóstico por imagem , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica , Índice de Massa Corporal , Criança , Pré-Escolar , Corioide/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Masculino , Tamanho do Órgão , Estudos ProspectivosRESUMO
INTRODUCTION: Considerable advances have been made in hospital appointment systems in the past 60 years. In Turkey, the Central Physician Appointment System (CPAS) is used together with appointments made through direct presentations to the hospital. This study evaluated CPAS data. MATERIALS AND METHODS: CPAS data for the previous 2 years (2015, Group 1; 2016, Group 2) were evaluated retrospectively. Department-based analysis was also performed. Total number of clinics, CPAS capacity, number of appointments through CPAS, and numbers of patients keeping appointments and "no shows" and ratios calculated from these were investigated. RESULTS: Overall, 1,704,594 patients were examined in 20 departments during the 2-year period (January 1, 2015-December 31, 2016). Mean CPAS capacity per department was 12,831 ± 7,691 in Group 1 and 11,573 ± 6,849 in Group 2 (p = 0.588). Ratios of appointments made through CPAS to CPAS capacity were 0.7 in Group 1 and 0.84 in Group 2 (p = 0.009). The ratio of patients keeping appointments made through CPAS to the number of appointments made through CPAS was 0.772 in Group 1 and 0.775 in Group 2 (p = 0.831). The departments with the highest number of appointments made through CPAS to CPAS capacity were Neurosurgery in Group 1 (0.99) and Ophthalmology in Group 2 (0.99). The department with the lowest ratio was Infectious Disease and Clinical Microbiology in Group 1 (0.28) and Group 2 (0.45). CONCLUSIONS: The use of CPAS has increased. However, some CPAS vacancies remain unfilled, and some appointments are not kept. CPAS capacities must be adjusted in line with take-up rates through regular department-based analysis.
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Agendamento de Consultas , Centros de Atenção Terciária/organização & administração , Centros de Atenção Terciária/estatística & dados numéricos , Humanos , Medicina/estatística & dados numéricos , Pacientes não Comparecentes/estatística & dados numéricos , Estudos Retrospectivos , TurquiaRESUMO
BACKGROUND: Urinary tract infection (UTI) is common in children. The aim of this study was therefor to construct a guide for the empirical antibiotic treatment of community-acquired UTI by investigating the etiology and antimicrobial resistance patterns of uropathogens and analyzing the epidemiological and clinical patient characteristics. METHODS: A total of 158 children with positive urine culture were included in the study. Antibiotic susceptibility testing was performed with Vitek 2 Compact for 28 commonly used antimicrobials. RESULTS: Mean age was 3.36 ± 3.38 years (range, 45 days-15 years). Escherichia coli (60.1%), and Klebsiella spp. (16.5%) were the most common uropathogens. For all Gram-negative isolates, a high level of resistance was found against ampicillin/sulbactam (60.1%), trimethoprim/sulfamethoxazole (44.2%), cefazolin (36.2%), cefuroxime sodium (33.5%), and amoxicillin/clavulanate (31.5%). A low level of resistance was noted against cefepime (8.7%), ertapenem (4.6%), norfloxacin (1.3%), and meropenem (0.7%). There was no resistance against amikacin. CONCLUSIONS: There is high antibiotic resistance in children with UTI. The patterns of uropathogen antimicrobial resistance vary in susceptibility to antimicrobials depending on region and time. Thus, the trends of antibiotic susceptibility patterns should be analyzed periodically to select the appropriate regimen for UTI treatment.
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Farmacorresistência Bacteriana , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções Urinárias/microbiologia , Adolescente , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/epidemiologia , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Turquia/epidemiologia , Infecções Urinárias/diagnóstico , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologiaRESUMO
Patients with ß-thalassemia major (ß-TM), a disease that emerges due to disorder of hemoglobin (Hb) synthesis, require life-long erythrocyte transfusion. The purpose of this study was to evaluate skin color and iron levels of patients with ß-TM using a visual skin color chart. Each patient's skin color was matched on a skin color chart under a fluorescent lamp by the same physician on each occasion. Iron, iron binding capacity, ferritin and complete blood count (CBC) were studied for each patient enrolled. Colors marked on the visual skin color chart were compared with the laboratory results. Thirty-five patients being monitored at our hospital were included, 19 (54.3%) males and 16 (45.7%) females. The colors marked on the chart darkened as patients aged (p = 0.002, r = 0.49), the frequency of annual transfusions (p = 0.022, r = 0.385), ferritin levels (p < 0.001, r = 0.72) and iron levels increased (p = 0.001, r = 0.538) and as total iron binding capacity (TIBC) decreased (p < 0.001, r = -0.709). On the basis of this study, iron deposition in patients with ß-TM was correlated with the colors on the chart.
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Ferro/sangue , Pigmentação da Pele , Talassemia beta/sangue , Talassemia beta/diagnóstico , Biomarcadores/sangue , Criança , Pré-Escolar , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: A new age in communications began with the entry into use of cell phones and their applications. Cell phones and their various applications must be actively used in patient monitoring in the healthcare system. INTRODUCTION: The purpose of this study was to determine the length of stay in the pediatric emergency department observation unit (PEDOU) based upon the notification of abnormal laboratory results (ALRs) via the short message service (SMS). MATERIALS AND METHODS: Patients with ALRs notified through the SMS (April-May-June 2015: study period) were evaluated retrospectively, and those admitted to hospital after such notification were enrolled as the study group (SG). Patients presenting to the pediatric emergency department (April-May-June 2014: control period), whose ALRs were not notified through the SMS, and who were hospitalized for treatment, were enrolled as the control group (CG). Age, sex, length of stay in the PEDOU (min), admission diagnosis, and receiving department were recorded for both groups. RESULTS: Number of patients monitored in the PEDOU was 8584 during the study period and 8507 during the control period (p = 0.27). Length of stay of patients monitored in the PEDOU during the control period (n = 8507) and study period (n = 8584) was 136.4 and 133.5 min, respectively (p = 0.92). One hundred forty-seven patients were enrolled as the SG and 154 as the CG. Length of stay in the PEDOU was 221.1 ± 86.9 (65-542) min in the CG and 154.8 ± 76.6 (15-442) min in the SG (p < 0.001, 95% confidence interval: 47.5-84.8). CONCLUSIONS: Notification of ALRs through the SMS does not affect length of stay in the PEDOU. Use of this method reduces length of stay of patients who require more rapid hospitalization.
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Registros Eletrônicos de Saúde/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Hospitalização/estatística & dados numéricos , Laboratórios Hospitalares/organização & administração , Tempo de Internação/estatística & dados numéricos , Medicina de Emergência Pediátrica/métodos , Envio de Mensagens de Texto , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos RetrospectivosRESUMO
PURPOSE: This study aimed to evaluate the risk factors for falls in hospitalized children in relation to their caregivers. METHODS: This was a case control study to evaluate the risk factors for falls in hospitalized children in relation to their caregivers. The children included in our study were at the hospital between June 2014 and June 2015. Demographic data of patients, caregivers, some habits; education level; and number of siblings were recorded. RESULTS: The data of 117 patients were evaluated, and there were 39 patients with a fall event and 78 patients who did not experience a fall. The mean age for the fall group and the non-fall group were 14.71±9.36 and 15.62±10.65months, respectively. The mean age for the caregivers of the fall group and the non-fall group were 29.33±5.89 and 29.53±5.56years, respectively. There was a statistically significant difference in fall risk related to the caregivers' education level (p<0.01) and caregivers' habit of smoking (p<0.01). The analysis of risk factors related to caregivers for pediatric inpatient falls, by multivariate logistic regression, showed that low educational level of caregivers (OR=0.361; CI=0.196-0.665; p<0.01), caregivers' smoking (OR=4.863; CI=1.058-22.358; p<0.05) and increased length of stay for the children (OR=1.994; CI=1.475-2.696; p<0.01) carried a higher risk for pediatric inpatient falls. CONCLUSIONS AND PRACTICE IMPLICATIONS: The data obtained in our study have shown that caregivers play a key role in fall events in hospitalized children. Nurses and other health workers should consider children's caregivers educational level and habits for prevention of hospitalized children falls.
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Acidentes por Quedas/estatística & dados numéricos , Cuidadores/estatística & dados numéricos , Criança Hospitalizada/estatística & dados numéricos , Hospitais Pediátricos , Gestão da Segurança , Cuidadores/psicologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Avaliação em Enfermagem/métodos , Medição de RiscoRESUMO
PURPOSE: The purpose of this study was to determine whether there are differences in choroidal thickness in children with beta thalassemia major (ß-TM). METHODS: Thirty-five patients with ß-TM and 38 healthy children aged between 3 and 16 years participated in the study. After complete eye examinations were conducted on the participants, choroidal thickness measurements were performed using optical coherence tomography. Correlations between choroidal thickness and laboratory and clinical parameters, such as age, sex, hemoglobin and ferritin levels, duration of disease, type and duration of chelating therapy, visual acuity, intraocular pressure, central corneal thickness, and axial length were also evaluated. RESULTS: The mean ages for the study group and for the control group were 8.2 ± 2.7 and 7.9 ± 2.4 years, respectively. There were no statistical differences between groups in terms of visual acuity, intraocular pressure, central corneal thickness, or axial length (p > 0.05). Choroidal thicknesses at the foveal center were 286 ± 33 µm in ß-TM patients and 335 ± 423 µm in the healthy control children. Choroidal thicknesses at each point within the horizontal nasal and temporal quadrants were thinner in the ß-TM group. There was a positive correlation between choroidal thickness and hemoglobin levels and a negative correlation between choroidal thickness and ferritin levels (r = 0.924, p < 0.001 and r = -0.947, p < 0.001, respectively). There was no correlation between clinical or ocular characteristics and choroidal thickness. CONCLUSIONS: Choroidal thickness was significantly thinner in all quadrants in children with ß-TM. This thinning of the choroid may be the reason for the development of eye disorders in older patients with ß-TM.
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Corioide/patologia , Talassemia beta/patologia , Adolescente , Comprimento Axial do Olho/anatomia & histologia , Criança , Pré-Escolar , Corioide/diagnóstico por imagem , Córnea/anatomia & histologia , Paquimetria Corneana , Feminino , Ferritinas/sangue , Hemoglobinas/metabolismo , Humanos , Pressão Intraocular/fisiologia , Masculino , Tomografia de Coerência Óptica/métodos , Tonometria Ocular , Acuidade Visual/fisiologiaRESUMO
BACKGROUND: For children under 5 years of age, 1700 000 000 episodes of diarrhea are seen worldwide, and death occurs in 700 000 of these cases due to diarrhea. Rotavirus is an important cause of diarrhea in this age group, and many studies have shown that vitamin D plays a pivotal role in the immune system, as well as in antimicrobial peptide gene expression. In addition, lower vitamin D has been correlated with higher rates of infectious diseases such as respiratory tract infection, tuberculosis, and viral infection. METHODS: Seventy patients with rotaviral diarrhea and 67 healthy patients were enrolled in this study. Serum 25-hydroxy vitamin D(3) (25(OH)D(3)), parathormone, calcium, phosphate, alkaline phosphatase, complete blood count parameters, and C-reactive protein were compared between pre-school children hospitalized due to rotaviral diarrhea and healthy children. Additionally, birthweight, feeding habits in the first 6 months of life, vitamin D and multivitamin supplements, and rotaviral vaccinations were also evaluated in each group. RESULTS: There were no differences between the groups with regard to gender and age, but 25(OH)D(3) was significantly different: 14.6 ± 8.7 ng/mL in the rotaviral diarrhea patients versus 29.06 ± 6.51 ng/mL in the health controls (P < 0.001), and serum 25(OH)D(3) <20 ng/mL (OR, 6.3; 95%CI: 3.638-10.909; P < 0.001) was associated with rotaviral diarrhea. CONCLUSIONS: Low vitamin D is associated with rotaviral diarrhea. This is the first study in the literature to show this, and this result needs to be repeated in larger controlled clinical studies.
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Diarreia/sangue , Infecções por Rotavirus/sangue , Rotavirus , Deficiência de Vitamina D/complicações , Vitamina D/farmacologia , Pré-Escolar , Diarreia/etiologia , Diarreia/virologia , Suplementos Nutricionais , Feminino , Seguimentos , Humanos , Lactente , Masculino , Estudos Prospectivos , Infecções por Rotavirus/virologia , Fatores de Tempo , Deficiência de Vitamina D/sangue , Vitaminas/farmacologiaRESUMO
AIM: Here we present the patients whose body mass index is in the normal range and who visited with the complaint of headache. The differences in lipid profile in this group compared to healthy children and the risk factors that may be associated with this were investigated. MATERIALS AND METHODS: 195 patients who applied to the Pediatric Neurology outpatient clinic with headache complaints between April 2021 and October 2022 were retrospectively examined. 201 healthy children were included as the control group. The gender, age, headache type, lipid profile blood test after at least 8 h of fasting [total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and TG/HDL ratio], and body mass index (BMI) were recorded. Those patients who had a BMI range of 18.5-24.9 kg/m2 were included in the study. RESULTS: The study group had 195 patients; 118 girls (60.5%). The average age was 12,57 ± 3,48 years, and 114 patients (58.5%) had tension-type headaches and 81 (41.5%) had migraine-type headaches. There was no significant difference in age and gender between the two groups. Blood pressure, folate, and thyroid function tests were normal. In the lipid profile, a significant difference was observed between total cholesterol, LDL, HDL, and TG in the study group compared to the control group (p < 0.05). However, there was no difference in the TG/HDL ratio between those two groups. No significant statistical difference was observed in the lipid profile and other laboratory findings between headache types. CONCLUSION: In children presenting with headache complaints, which can be both worrying for families and cause significant loss of functionality, it is detectable (obviously) that headache is an important marker for dyslipidemia; even if BMI is in a normal range. The lipid profile should be seen both to control the complaint with an appropriate diet and to observe the risk of future atherosclerotic processes.
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Biomarcadores , Dislipidemias , Cefaleia , Humanos , Feminino , Masculino , Criança , Dislipidemias/sangue , Dislipidemias/complicações , Adolescente , Biomarcadores/sangue , Estudos Retrospectivos , Cefaleia/sangue , Cefaleia/etiologia , Triglicerídeos/sangue , Índice de Massa CorporalRESUMO
Brucellosis which is a zoonotic infection, is an important public health problem in Turkey and all over the world. The disease may involve many organs and systems. Since the symptoms of brucellosis are non-specific, difficulties in differential diagnosis and misdiagnosis are frequent. In this case report we present a case of brucellosis, misdiagnosed as Crimean-Congo hemorrhagic fever (CCHF). A 13-year-old boy was referred from another medical center with preliminary diagnosis of CCHF and admitted to our clinic with fever and a history of presence of a tick on his back. His physical observation only included splenomegaly. The laboratory results on admission were anemia, thrombocytopenia, elevation of acute phase reactants and liver transaminase levels. Abdominal ultrasonography revealed splenomegaly. Since the patient had anemia, epistaxis, fever and thrombocytopenia, he was initially diagnosed as CCHF. Meantime serum sample of the patient had been sent to Refik Saydam National Public Health Agency for CCHF PCR test. The fever of the patient could not be controlled. His detailed medical history revealed stockbreeding and consumption of raw milk products. Patient's signs and symptoms were also compatible with brucellosis and standard tube agglutination test for brucellosis was positive at 1/1280 titer in serum. The patient was diagnosed as brucellosis and the treatment was started with combination of rifampicin (1 x 600 mg/day) and doxycycline (2 x 100 mg/day). Blood cultures yielded negative result. The PCR tests for CCHF was found also negative. His fever and other complaints improved with treatment which was completed in six weeks and the follow-up was without complications. Turkey is endemic both for brucellosis and CCHF. This case was reported to emphasize that the cases of brucellosis could mimic other diseases and brucellosis should also be considered in the differential diagnosis of CCHF.
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Brucelose/diagnóstico , Erros de Diagnóstico , Doenças Endêmicas , Febre Hemorrágica da Crimeia/diagnóstico , Proteínas de Fase Aguda/análise , Adolescente , Testes de Aglutinação , Anemia , Brucelose/epidemiologia , Diagnóstico Diferencial , Febre Hemorrágica da Crimeia/epidemiologia , Humanos , Fígado/enzimologia , Masculino , Reação em Cadeia da Polimerase , Esplenomegalia/diagnóstico por imagem , Trombocitopenia , Transaminases/sangue , Turquia/epidemiologia , UltrassonografiaRESUMO
Children are exposed to large amounts of information and high levels of stress and anxiety from adults around them, the media, and social communication networks during the Covid-19 period. The purpose of this study was to compare the anxiety and depression levels of the children of health workers following the declaration by the World Health Organization (WHO) of Covid-19 as a global pandemic with those of age-matched children of non-health worker parents. This prospective, case-controlled, cross-sectional study was performed between July and September 2020. One hundred forty-six participants were enrolled, 71 children of health worker parents in the study group, and 75 age- and sex-matched children of non-health worker parents in the control group. While no significant difference was determined between the children of health workers and non-health workers in terms of CDI scores, total STAI-C scores were higher among children of health workers (70.36 ± 12.43) than in children of non-health worker parents (65.62 ± 11.83) (p = .02). This study shows that since their parents work in intensive and high-risk environments during the Covid-19 pandemic, the children of health workers may be at greater psychological risk than other children.
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COVID-19 , Pandemias , Adulto , Ansiedade , Criança , Estudos Transversais , Depressão , Pessoal de Saúde , Humanos , Saúde Mental , Estudos Prospectivos , SARS-CoV-2RESUMO
BACKGROUND: A significant number of children are injured by or die from firearm-related incidents every year, although there is a lack of global data on the number of children admitted to pediatric emergency departments (PEDs) and pediatric intensive care units (PICU) with firearm injuries. This study is the most comprehensive analysis of firearm injuries sustained by children in Turkey to date. METHODS: This multicenter, retrospective, cohort study was conducted between 2010 and 2020 with the contributions of the PEDs, PICUs, intensive care units, and surgery departments of university hospitals and research hospitals. RESULTS: A total of 508 children were admitted to hospital with firearm-related injuries in the research period, although the medical records of only 489 could be obtained. Of the total admissions to hospitals, 55.0% were identified as unintentional, 8.2% as homicide, 4.5% as self-harm, and 32.3% as undetermined. The Glasgow Coma Scale (GCS) and ventilation support were found to be the most significant predictors of mortality, while head/neck injury, length of stay (LOS) in the hospital and surgical interventions were found to be the most significant predictors of disability. The overall mortality of firearm-related injuries was 6.3%, and the mortality for children admitted to the PICU was 19.8%. The probability of disability was calculated as 96.0% for children hospitalized with firearm injuries for longer than 75 days. CONCLUSIONS: Head/neck injury, LOS in the hospital, and surgical interventions were found to be the most significant parameters for the prediction of disability. Hospitalization exceeding 6 days was found to be related to disability.
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Armas de Fogo , Lesões do Pescoço , Ferimentos por Arma de Fogo , Criança , Humanos , Lactente , Ferimentos por Arma de Fogo/epidemiologia , Ferimentos por Arma de Fogo/terapia , Estudos de Coortes , Estudos Retrospectivos , Turquia/epidemiologia , Unidades de Terapia Intensiva PediátricaRESUMO
INTRODUCTION: Health care workers (HCWs) are disproportionately exposed to infectious diseases and play a role in nosocomial transmission, making them a key demographic for vaccination. HCW vaccination rates are not optimal in many countries; hence, compulsory vaccination policies have been implemented in some countries. Although these policies are effective and necessary under certain conditions, resolving HCWs' hesitancies and misconceptions about vaccines is crucial. HCWs have the advantage of direct contact with patients; hence, they can respond to safety concerns, explain the benefits of vaccination, and counter antivaccine campaigns that escalate during pandemics, as has been observed with COVID-19. METHOD: A short survey was carried out in May-June 2020 on the vaccination status of HCWs working with pediatric patients with COVID-19. The survey inquired about their vaccination status (mumps/measles/rubella [MMR], varicella, influenza, and diphtheria/tetanus [dT]) and willingness to receive hypothetical future COVID-19 vaccines. The respondents were grouped according to gender, age, occupation, and region. RESULTS: In total, 4927 HCWs responded to the survey. Most were young, healthy adults. The overall vaccination rates were 57.8% for dT in the past 10 years, 44.5% for MMR, 33.2% for varicella, and 13.5% for influenza. Vaccination rates were the highest among physicians. The majority of HCWs (81%) stated that they would be willing to receive COVID-19 vaccines. CONCLUSION: Although vaccination rates for well-established vaccines were low, a majority of HCWs were willing to receive COVID-19 vaccines when available. Education and administrative trust should be enhanced to increase vaccination rates among HCWs.
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COVID-19 , Varicela , Vacinas contra Influenza , Influenza Humana , Sarampo , Adulto , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Criança , Pessoal de Saúde , Humanos , Influenza Humana/prevenção & controle , Sarampo/prevenção & controle , SARS-CoV-2 , VacinaçãoRESUMO
Objective: COVID-19 since the reporting of the first case of infection and its declaration as a pandemic, it caused morbidity and mortality in hundreds of thousands of people. In the early stages of the COVID-19 pandemic, the number of confirmed cases among children was relatively low, and therefore, data were limited. However, the number of pediatric cases has also risen markedly among children in the later stages of the pandemic. Methods: Forty patients from 1 month to 18 years of age who presented to the Division of Pediatric Infectious Diseases of a tertiary research and training hospital between March 10, 2020, and May 31, 2020, with symptoms suggestive of COVID-19 infection and whose combined oropharyngeal and nasopharyngeal swab specimens tested positive on real-time reverse transcription polymerase chain reaction (rRT-PCR) were included in the study. Results: Forty pediatric patients with a mean age of 109.1±66.1 months were included in the study. Among patients, 62.5% (25/40) were girls and 37.5% (15/40) were boys. The most presentation symptom was cough in 19 (47.5%) patients. Hydroxychloroquine (HQ) therapy was given as part of combination treatment to 15 symptomatic patients older than 72 months of age (72-143 months of age: 4 patient, 144-216 months of age: 11 patients). The mean time to a rRT-PCR negative test was 7.2±1.69 (4-10) days for the group receiving an HQ treatment protocol and 8.2±1.44 (6-11) days for the group receiving a non-HQ treatment protocol with no significant difference between the groups (p=0.054). Conclusion: In this study, it was shown that the use of HQ had no effect on the length of hospital stay and that there was no significant difference between patients in terms of epidemiological data.
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STUDY OBJECTIVE: In this study we explored the level and severity of issues related to self-concept, depression, and anxiety in adolescents with polycystic ovary syndrome (PCOS). DESIGN: Cross-sectional and case-control study. SETTING: The research was conducted in the outpatient Pediatric Endocrinology Clinic of Adiyaman University School of Medicine in Turkey. PARTICIPANTS: The study population comprised 153 patients with PCOS and 161 healthy adolescents. INTERVENTIONS AND MAIN OUTCOME MEASURES: The Personal Information Form, State-Trait Anxiety Inventory for Children, Children's Depression Inventory, and Piers-Harris Children's Self-Concept Scale were administered to all of the participants who took part in the study. RESULTS: The Piers-Harris Children's Self-Concept Scale scores were lower in the PCOS group than in the control group (P < .001). In addition, the scores for the Children's Depression Inventory were also significantly higher in the PCOS group (P < .001). The State-Trait Anxiety Inventory for Children scores showed statistically significant higher levels of state anxiety and trait anxiety in the PCOS group (P < .001). CONCLUSION: Adolescents with PCOS had lower self-concept scores, greater anxiety levels, and increased depressive symptoms than the healthy controls. Future studies are needed to examine the psychiatric problems in adolescents with PCOS.
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Ansiedade/etiologia , Depressão/etiologia , Síndrome do Ovário Policístico/psicologia , Autoimagem , Adolescente , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Síndrome do Ovário Policístico/complicações , Índice de Gravidade de Doença , Turquia/epidemiologiaRESUMO
BACKGROUND: Changes have occurred in children's sleep habits during the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this study was to compare the sleep patterns during the COVID-19 pandemic of school age children of health worker parents (Group 1) and non-health worker parents (Group 2). METHOD: One hundred twenty-two participants were included in Group 1 and 250 in Group 2. The families' sociodemographic characteristics (education levels and occupations of mothers and fathers, parental shift-working status, monthly family income, number of children in the family, and place of residence), general information for the children taking part (diagnosis of COVID-19 or COVID-19 related isolation, distance education, participation in sporting activities, time spent watching TV, time devoted to reading, time spent on telephones/tablets/computers, and time spent on indoor activities), and the responses given to the Children's Sleep Habits Questionnaire (CSQH)-abbreviated form were all examined. RESULTS: Group 1 consisted of 122 individuals, 66 (54.1%) female and 56 (45.9%) male, and Group 2 of 250 individuals, 129 (51.6%) female and 121 (48.4%) male. Statistically significant differences were determined between the groups in terms of parental education levels and occupations, family monthly income, number of children in the family, place of residence, parental shift-working status, and length of time spent on indoor activities. Total CSHQ scores were 41.57 ± 7.57 (20-60) in Group 1 and 39.6 ± 8.47 (17-68) in Group 2 (p:0.03). CONCLUSION: Greater impairment of sleep habits of school age children of health workers compared to those of non-health workers in the COVID-19 pandemic is proved for the first time in this study. Further assessment of the effects of the COVID-19 pandemic on children's sleep habits is now required, and appropriate measures must be taken in the light of the results obtained.
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COVID-19 , Transtornos do Sono-Vigília , Criança , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2 , Sono , Transtornos do Sono-Vigília/epidemiologia , Inquéritos e QuestionáriosRESUMO
Background Anxiety and caregiver burden increase among caregivers for individuals with chronic disease. The purpose of this study was to compare the anxiety levels and caregiver burden among caregivers for cases with pediatric celiac disease (CD) before and during the COVID-19 pandemic. Materials The Zarit Burden Interview (ZBI) and the Beck Anxiety Inventory (BAI) were applied to 29 parents caring for pediatric CD patients in January 2020, when COVID-19 cases had not yet been seen in Turkey. The study was designed prospectively. The scales were also reapplied to the same study group online during the COVID-19 pandemic (May 2020). The results were then compared. Results Parents caring for 29 cases of pediatric CD; 21 mothers (72.4%), six fathers (20.7%), and two aunts (6.9%) took part in the study. Mean ZBI scores before and during the COVID-19 pandemic were 27.51 ± 14.12 (8-73) and 38.68 ± 10.95 (21-57), respectively ( p < 0.01). Mean BAI scores before and during the COVID-19 pandemic were 13.27 ± 7.65 (1-27) and 23.48 ± 12.40 (2-48), respectively ( p < 0.01). Conclusion Increased anxiety and caregiver burden among caregivers of pediatric CD cases during the COVID-19 pandemic were identified for the first time in the literature in this study.
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BACKGROUND: Understanding SARS-CoV-2 seroprevalence among health care personnel is important to explore risk factors for transmission, develop elimination strategies and form a view on the necessity and frequency of surveillance in the future. METHODS: We enrolled 4927 health care personnel working in pediatric units at 32 hospitals from 7 different regions of Turkey in a study to determine SARS Co-V-2 seroprevalence after the first peak of the COVID-19 pandemic. A point of care serologic lateral flow rapid test kit for immunoglobulin (Ig)M/IgG was used. Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. RESULTS: SARS-CoV-2 seropositivity prevalence in health care personnel tested was 6.1%. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19-positive co-worker increased the likelihood of infection. The least and the most experienced personnel were more likely to be infected. Most of the seropositive health care personnel (68.0%) did not suspect that they had previously had COVID-19. CONCLUSIONS: Health surveillance for health care personnel involving routine point-of-care nucleic acid testing and monitoring personal protective equipment adherence are suggested as important strategies to protect health care personnel from COVID-19 and reduce nosocomial SARS-CoV-2 transmission.