The Turkish journal of pediatrics最新文献

Background: The ongoing conflict in Gaza continues to take an unbearable toll, with particularly severe impacts on children. Measuring the burden of conflict-related disease in Gaza in terms of disability-adjusted life years (DALYs) is important in terms of showing this effect. The aim of this study was to calculate the conflict-related DALY in Gaza among children aged 0-14 years, following the October 7 events and compare these values with global and expected values.

Methods: We estimated the age and gender distribution of individuals killed or injured in Gaza, and calculated the DALYs, including Years of Life Lost (YLL) and Years Lived with Disability (YLD), attributable to the conflict. These estimates were then compared to the Institute for Health Metrics and Evaluation data for Palestine and global averages. The study also evaluated the DALY/YLD ratio and excess mortality rate.

Results: The DALY per 100,000 population was 160,745.01 (156,986.01-164,503.99) for males, 175,784.51 (170,812.52-180,756.50) for females, and 168,111.39 (164,009.17-172,213.62) overall. The daily DALY burden experienced by Gaza due to conflict indicates an increase of 181.05% compared to Palestinian estimates. The increase was calculated as 115.39% for YLL and 4,268.25% for YLD. Compared to global data for conflict and terrorism, the increases in daily DALY, YLL, and YLD values in Gaza were 1,918.08%, 1,316.32%, and 8,537.50%, respectively. The data calculated in our study indicate that the daily DALY/YLD ratio for the 0-14 age group in Gaza was 333.21 with a p-score of 6,952.0%.

Conclusion: To reduce the devastating effects of violence, such as conflict and terrorism, on children's health, more effective measures should be taken at the international level and preventive strategies should be developed.

Background: Food addiction has been increasingly recognized as a contributing factor to obesity and eating disorders. Compulsive eating, characterized by an uncontrollable urge to consume food despite adverse consequences, shares behavioral similarities with substance addiction. This study aims to adapt the Brief Measure of Eating Compulsivity (MEC) into Turkish and evaluate its validity and reliability in the adolescent population.

Methods: The study included a sample of 89 adolescents aged 12-18 years. Participants without chronic medical or psychiatric conditions affecting eating behaviors were included. The adaptation process involved translation, back-translation, and expert evaluations to ensure cultural and linguistic appropriateness. The psychometric properties of the Turkish MEC were assessed through internal consistency, exploratory factor analysis, and criterion validity using the Yale Food Addiction Scale (YFAS).

Results: The internal consistency of the Turkish MEC was 0.89, with item-total correlations ranging from 0.56 to 0.72. Factor analysis supported a single-factor structure explaining 52.6% of the variance. Convergent validity was established through a significant positive correlation with YFAS scores (r = 0.57, p < 0.001). Criterion validity analysis demonstrated significantly higher MEC scores in individuals classified as food addicts by YFAS (p = 0.025). Additionally, significant differences in MEC scores were observed across body mass index categories (p = 0.010), with higher scores in adolescents with obesity compared to the normal-weight group.

Conclusions: The Turkish version of the MEC demonstrated strong reliability and validity among adolescents, supporting its use in assessing compulsive eating behaviors. Given the increasing prevalence of obesity and eating disorders in Turkish youth, this tool provides a valuable resource for early detection and intervention in research and clinical settings.

Background: Autism spectrum disorder (ASD) is more frequently diagnosed in boys than in girls, possibly due to gender-based differences in symptom presentation or referral patterns. This study investigates gender-related variations in symptom severity and clinical presentation among preschool children referred for suspected ASD.

Methods: This study included 125 children (boys: n=103; girls: n=22) aged 2-5 years suspected of having ASD. The Childhood Autism Rating Scale (CARS) was used to evaluate autism-related symptoms, focusing on presenting complaints and gender-specific differences in nonverbal communication and social interaction.

Results: Girls had a significantly younger median age at assessment (28 months) compared to boys (33 months, p=0.03). In the minimal to no symptoms group, girls had significantly higher total CARS scores (median 26 vs. 22.5, p < 0.001) and elevated ratings in domains such as nonverbal communication (p=0.03), relationship to people (p=0.01), imitation (p < 0.001), and visual response (p < 0.001). In the severe group, girls also showed significantly higher scores in adaptation to change, taste, smel, and touch response and use, and fear or nervousness. Effect sizes ranged from small to strong. A negative correlation was found between assessment age and total CARS score (r= -0.45, p < 0.01), particularly among girls.

Conclusion: This study highlights that girls may exhibit more prominent symptoms by the time they are referred for clinical evaluation, raising concerns about missed or delayed recognition of milder symptom profiles.

Background: Intractable paroxysmal sneezing is a rare and diagnostically challenging condition in children, often mimicking organic diseases. While it is often addressed as psychogenic in the literature, our case presented findings suggestive of a tic disorder, highlighting the need for a broader diagnostic perspective.

Case presentation: An 11-year-old girl was referred to the child and adolescent psychiatry clinic with a one-year history of persistent and fluctuating sneezing episodes. Despite comprehensive evaluations by pediatric neurology, allergy, and otolaryngology services, no significant pathology was identified. While the symptoms initially appeared psychogenic due to their onset following a school change and exacerbation during periods of heightened stress, a detailed assessment revealed findings suggestive of a tic disorder, including the fluctuating nature of the symptoms, their absence during sleep, and transient suppressibility. Partial symptomatic relief observed with metoclopramide, a dopamine antagonist, led to the initiation of risperidone therapy (0.25-0.5 mg/day), which resulted in significant clinical improvement.

Conclusions: This case illustrates the complex interplay between psychogenic stressors and tic-like manifestations in pediatric intractable paroxysmal sneezing. The positive response to risperidone underscores the potential role of dopamine antagonist treatments in managing such cases. A multidisciplinary approach is crucial for accurate diagnosis and effective management, ultimately enhancing patient quality of life.

Background: The expression and clinical correlation of BRAFV600E mutation and programmed cell death-1 ligand 1 (PD-L1) in children with Langerhans cell histiocytosis (LCH) have been reported, but the conclusions of previous studies are inconsistent. In addition, it has been reported that elevated cathepsin S (CTSS) expression is associated with various cancers. However, there is currently no research on the correlation between CTSS and LCH. The aim of this study was to reassess the clinical correlation of BRAFV600E mutation and PD-L1 in pediatric LCH and to investigate the expression and clinical correlation of CTSS in children with LCH.

Methods: A total of 35 tissue samples were analyzed for the BRAFV600E gene mutation using droplet digital polymerase chain reaction, and 31 tissue samples were examined for CTSS and PD-L1 by immunohistochemistry. In addition, the clinical characteristics and prognosis of these 35 pediatric patients were analyzed and summarized.

Results: The incidence of BRAFV600E gene mutation was 34.3% (12/35). The occurrence of BRAFV600E gene mutation was significantly associated with age ≤ 2 years and involvement of central nervous system risk sites (66.7% and 72.7%, respectively). The expression rate of PD-L1 was 35.5% (11/31), and it was significantly correlated with cutaneous involvement (100%, 3/3). PD-L1 expression was unrelated to BRAFV600E gene mutation. Neither BRAFV600E gene mutation nor PD-L1 expression had a significant impact on disease progression/reactivation and initial 6-week treatment response. CTSS was expressed positively in the lesion tissues of all 31 children with LCH. The H-scores of CTSS were significantly associated with age ≤ 2 years. CTSS had no significant effect on the initial 6-week treatment response, disease progression/reactivation, BRAFV600E gene mutation, or PD-L1 expression.

Conclusions: CTSS is positively expressed in LCH, and its expression level is associated with onset age ≤ 2 years. BRAFV600E gene mutation, PD-L1, and CTSS may not be associated with the prognosis of LCH.

Aim: This study aimed to describe barriers and facilitators of the adherence of children with human immunodeficiency virus (HIV) to antiretroviral therapy (ART) from the perspectives of their caregivers.

Methods: In-depth interviews were held with the caregivers of 15 children. The collected data were analyzed using thematic analysis procedures. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were followed in the study.

Results: The perspectives of caregivers were categorized under four themes and subthemes. Barriers and facilitators of the adherence of children with HIV to ART were categorized into 4 main themes: (1) medication-related, (2) child-related, (3) caregiver-related, and (4) health system-related. The results indicated that understanding the factors that influence pediatric ART adherence is critical to the development of adequate strategies. In addition, disclosure of HIV status to the child is also an important factor affecting drug administration in the social environment.

Conclusions: To ensure adherence to lifelong ART, targeted caregiver support through continuous supervision, clear guidance on drug preparation, and strategies for effective administration should be integrated into context-specific interventions that address the combined influence of factors related to the child, medication, healthcare, and of the sociocultural environment.

Background: With the development of technology, easier access to the internet and its excessive use have led to problematic internet use (PIU). The prevalence of PIU and its association with lifestyle behaviors in adolescents have become subjects of increasing academic interest. This study aimed to determine the prevalence of PIU among Turkish high school students and to investigate its association with sleep, physical activity and dietary habits.

Methods: This cross-sectional study was conducted on high school students between October 2019 and March 2020. Participants completed a questionnaire regarding demographic characteristics, internet use, lifestyle habits and the "Young Internet Addiction Test-Short Form (YIAT-SF)".

Results: Among the total 951 participants, the mean age was 15.3±1.0 years, 42.3% were female, and the prevalence of PIU was determined as 12.1%. It was shown that having daily internet usage time ≥2 hours on weekdays, having at least one type of sleep problem, having breakfast less than 3 days per week, eating salty snacks ≥3 days per week, consuming sugary-carbonated drinks ≥3 days per week were associated with PIU.

Conclusions: PIU is a widespread public health problem that is negatively associated with the daily health habits of adolescents. There is a need for nationwide school screening programs for this problem and rehabilitation of adolescents diagnosed with PIU.

Background: Glucocorticoids remain the primary treatment for acute lymphoblastic leukemia (ALL) in children. However, glucocorticoid-resistant ALL exhibits increased mortality rates. To overcome resistance and improve management strategies, alternative therapeutic agents are required. Ivermectin (IVM), widely used as an anthelmintic agent, has been reported to possess anticancer properties through various mechanisms. These properties suggest IVM as a potential alternative treatment for ALL. This study aims to evaluate the role of IVM in inducing cytotoxic effects in the ALL cell line SUP-B15.

Methods: The ALL cell line SUP-B15 was examined following treatment with IVM at concentrations of 5, 10, and 20 μM. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to assess cytotoxic effects of IVM, including measurements of optical density, cell inhibition, and cell viability.

Results: IVM demonstrated inhibitory effects on SUP-B15 cells starting at a low dose of 5 μM. The half maximal inhibitory concentration (IC50) of IVM was 5 µM, showing an inhibitory effect of 54.18 ± 0.03% (95% confidence interval: 54.11-54.25%; p < 0.001). Treatment with 10 μM IVM demonstrated the most significant inhibitory effect (59.05 ± 0.1%) and the lowest cell viability (40.95 ± 0.01%).

Conclusions: IVM holds potential as a promising alternative therapeutic agent for the treatment of ALL.