The Turkish journal of pediatrics最新文献

Background: To investigate the diagnostic and pathological staging value of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 levels in retinopathy of prematurity (ROP).

Methods: A total of 70 infants with ROP (140 eyes) treated at our hospital from October 2018 to October 2023 were enrolled as the ROP group, while 70 healthy preterm infants (140 eyes) of the same gestational age without ROP were selected as the control group. The relative expression levels of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 were detected by quantitative real-time PCR. Logistic regression analysis was used to identify factors influencing ROP occurrence. The diagnostic efficacy of the three circular RNAs (circRNAs) was evaluated using receiver operating characteristic (ROC) curve analysis.

Results: The relative expression levels of hsa_circ_0061346 in serum were significantly higher in the ROP group than in the control group (6.27 ± 3.60 vs. 0.72 ± 0.31, P < 0.05), whereas the levels of hsa_circ_0000095 (1.98 ± 1.38 vs. 3.90 ± 1.75) and hsa_circ_0068606 (1.18 ± 0.51 vs. 7.71 ± 4.45) were significantly lower (all p < 0.05). Multivariate logistic regression showed that abnormal expression of these circRNAs was an independent risk factor for ROP. Notably, the combined diagnostic performance of the three circRNAs yielded an area under the ROC curve of 0.983, with a sensitivity of 100% and a specificity of 97.14%.

Conclusion: The combined detection of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 may provide a novel approach for the early diagnosis and severity assessment of ROP.

Background: Electronic cigarettes (e-cigarettes) are rapidly infiltrating youth culture under the guise of safety and social acceptance. Despite their prohibition in Türkiye, anecdotal reports suggest widespread access and experimentation among adolescents. This study aimed to determine the prevalence and predictors of e-cigarette use among adolescents attending a tertiary pediatric clinic, using the validated E-Cigarette Attitudes and Beliefs in Adolescents (ECABA) Scale to explore how beliefs shape behavior.

Methods: A cross-sectional design with consecutive sampling was employed. A total of 547 adolescents aged 14-18 years without psychological or organic illness participated. Data were collected using the 18-item ECABA Scale, along with demographic, cigarette, and e-cigarette use information. Logistic regression models were used to identify independent predictors of ever and current e-cigarette use.

Results: E-cigarette use was alarmingly common: 18.5% had ever tried, and 9.2% were current users. Males and those with peers who smoked or vaped were significantly more likely to use e-cigarettes (p.

Background: The relationship between sleep disturbances and exposure to environmental tobacco smoke (ETS) in children is a growing health concern. This study aimed to evaluate the association between ETS exposure and sleep disorders in healthy children, and to determine whether there is a difference in this relationship between secondhand smoke (SHS) and thirdhand smoke (THS) exposure.

Methods: Healthy children aged 4-12 years who presented to the pediatric outpatient department were consecutively enrolled in this cross-sectional study. Plasma cotinine levels were measured to validate the exposure. The Children's Sleep Habits Questionnaire was used to assess sleep disorders in all children.

Results: Of the 203 children we evaluated, with a median (Q1-Q3) age of 8.3 (6-10) years, 99 (49.8%) were female. Children exposed to ETS had significantly more sleep disturbances than children who were not exposed to ETS (p = 0.042). However, there was no significant difference in the plasma cotinine levels (p = 0.239) or the prevalence of sleep disorders (p = 0.648) between children exposed to SHS and those exposed to THS.

Conclusions: Exposure to both SHS and THS is associated with an increase in plasma cotinine and a higher prevalence of sleep disorders in children. These findings highlight the importance of reducing children's exposure to all forms of ETS to promote healthy sleep and overall well-being.

Background: Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm of intermediate malignant potential, commonly arising in the lungs and intra-abdominal organs. Involvement of the urinary bladder is exceptionally rare, particularly in children, and may clinically and radiologically mimic malignant tumors.

Case presentation: We report the case of a 10-year-old girl who presented with painless macroscopic hematuria and syncope, necessitating blood transfusion. Initial imaging revealed a bladder mass, and biopsy initially suggested rhabdomyosarcoma. Definitive histopathological evaluation, however, confirmed IMT. Partial cystectomy was performed, but due to positive surgical margins and recurrent hematuria, targeted therapy with crizotinib was initiated based on anaplastic lymphoma kinase (ALK) positivity. At 12-month follow-up, the patient remained symptom-free with no evidence of recurrence on imaging.

Conclusion: Pediatric IMT of the bladder is a rare but important differential diagnosis for bladder masses. Accurate histological diagnosis is essential, as this tumor may mimic malignancy and influence the treatment plan. Complete surgical excision remains the cornerstone of treatment, while targeted therapies such as ALK inhibitors offer valuable options in cases with residual disease or risk of recurrence. This case highlights the importance of a multidisciplinary approach involving surgery, pathology, and oncology. Further pediatric-focused studies are warranted to refine treatment strategies and define long-term outcomes.

Background: Urinary tract infection (UTI) is a significant issue in childhood due to its high prevalence and potential long-term complications. Several studies have suggested that vitamin D deficiency is an influential factor in the progression of infection. This study aims to determine the value of serum vitamin D levels in predicting renal scarring among children with febrile UTIs.

Methods: This study was conducted through a census sampling method from September 2019 to November 2021, with a 6-month follow-up period to survey children with their first febrile UTI who were referred to the nephrology clinic of a tertiary academic hospital. Out of 193 referred children, 55 met the inclusion criteria. Patients were excluded if they had a previous history of UTI, recurrent or breakthrough infection, delay in treatment initiation, hospitalization, ultrasonographic abnormality, hypertension, neurogenic bladder, or renal failure. Five additional cases were excluded due to incomplete follow-up. The study was completed with 50 participants, aged between 3 and 98 months. The main outcomes were measuring serum vitamin D levels during the acute phase of UTIs and conducting dimercaptosuccinic acid (DMSA) scans four to six months later. Logistic regression was used to determine the correlation between vitamin D levels and DMSA findings.

Results: Levels of 25-hydroxyvitamin D were significantly associated with renal scarring (p = 0.0001); mean serum concentrations were significantly lower in patients with renal scarring (20.7 ± 7.8 ng/mL) than in those without renal scarring (37.1 ± 11.4 ng/mL). A serum vitamin D concentration of less than 30 ng/mL was determined as the best predictor of post-UTI renal scarring (positive LR 4.25, Youden's j index 0.676).

Conclusions: The study showed a negative correlation between renal scarring and serum vitamin D levels. It has been found that serum vitamin D level is a good predictor of renal scarring.

Background: Endocan (endothelial cell-specific molecule-1) is a soluble dermatan sulfate proteoglycan of the extracellular matrix released into the circulation by vascular endothelial cells and involved in vascular processes in which endothelial cell activation occurs. In this study, we aimed to evaluate serum and urinary endocan levels in children with hemolytic uremic syndrome (HUS) during the acute disease and follow-up period, compared with controls, and to evaluate associated clinical and laboratory parameters.

Methods: Children were evaluated in three groups: HUS patients in the active stage (Group 1, HUS-active stage, n=15), HUS patients followed until the resolution of active disease (Group 2, HUS-follow-up, n=10) and healthy controls (Group 3, n=15). Clinical parameters and renal outcomes were compared between the groups based on serum and urinary endocan levels.

Results: The pairwise group comparisons of the urinary endocan levels (median; Q1-Q3) revealed statistically significant differences between Group 1 (2148; 1592-3068 ng/gCr) and Group 2 (1274; 733-1565 ng/gCr), and between Group 1 and Group 3 (954; 517-1966 ng/gCr) (P0.05). The serum endocan level showed no statistically significant difference between the groups (p>0.05). When all groups were evaluated together, urinary endocan level showed positive correlations with white blood cell counts (r= 0.63, P.

Background: Anemia in infancy is a frequent clinical challenge, often attributed to nutritional deficiencies. However, persistent or unexplained anemia warrants further investigation. In this case report, we describe an infant in whom anemia was first identified at six months of age; however, the underlying etiology became apparent only after the development of elevated serum creatinine and hyperuricemia.

Case presentation: We present a 1.7-year-old boy with persistent normocytic anemia, hyperuricemia, and elevated creatinine, initially evaluated for hematologic causes without a clear diagnosis. Despite normal growth, laboratory findings revealed hypouricosuria, hyposthenuria, and mildly decreased kidney function. Imaging and immunologic work-up were unremarkable. Due to multisystem involvement, genetic testing was performed and identified a heterozygous variant in REN gene, suggesting a potential link to autosomal dominant tubulointerstitial kidney disease (ADTKD). Due to persistent anemia refractory to iron therapy, erythropoietin was initiated at a dose of 0.50 µg/kg/week, resulting in a 1.9 g/dL increase in hemoglobin after one month. The family was appropriately informed about the chronic nature of the kidney disease, and a lifelong follow-up strategy was established.

Conclusion: This case underscores the importance of considering ADTKD in pediatric patients presenting with unexplained anemia and mild kidney impairment, even in the absence of a family history. Early diagnosis can prevent unnecessary procedures such as kidney biopsy, allow the timely initiation of supportive treatments, and improve long-term outcomes. Pediatricians, pediatric hematologists and pediatric nephrologists should be aware of this diagnostic possibility, particularly when anemia is accompanied by hyperuricemia and elevated creatinine in infancy.