Turkish archives of pediatrics最新文献

Self-efficacy is important in supporting breastfeeding behaviors and enhancing breastfeeding practices. This study aimed to explore research trends, identify knowledge gaps, and provide a comprehensive overview of breastfeeding self-efficacy. Data were retrieved from the Scopus online database on March 20, 2024, encompassing articles published in English between 2000 and 2023. The search strategy focused on articles containing the keywords "self-efficacy," "breastfeeding," and "mother." VOSviewer version 1.6.19 was then used to map the data and visually identify research clusters. The analysis yielded a significant increase in breastfeeding self-efficacy research over the past 2 decades. The United States led in publication numbers (117 documents), while Canada dominated citations (2792 citations). Furthermore, the analysis identified 8 critical themes in 8 different clusters, encompassing various aspects of breastfeeding, including determinants, behaviors, interventions, and mental health considerations during lactation, and employed research methodologies. One crucial gap identified in this study pertains to low breastfeeding social support. This includes a lack of support from peer groups, social networks, and social media platforms. Addressing this gap can be a valuable reference point for developing future interventions to bolster breastfeeding self-efficacy. Bibliometric analysis contributes to exploring research trends, identifying knowledge gaps, and providing a comprehensive overview of breastfeeding self-efficacy.

The aim of the study was to evaluate respiratory syncytial virus (RSV) infections in cases followed in the pediatric intensive care unit (PICU). The study was designed as a prospective cohort in 6 PICUs. There were 3 groups: only RSV (+), RSV (v+) who were positive for another viral agent(s) in addition to RSV, and RSV (b+) who were positive for a bacterial agent(s) in addition to RSV. A total of 119 cases were included in the study, 67 (56.3%) of whom were male. The RSV (+) group had a lower pH compared to the other groups and a higher rate of acute bronc hiolitis/bronchitis diagnoses compared to the RSV (v+) group. The RSV (v+) group had higher bicarbonate levels, higher creatinine levels, longer hospital stays, and higher Pediatric Risk of Mortality-3 scores (PRISM-3) compared to the RSV (+) group. Cases with RSV (b+) were younger and also had lower body weight compared to the other groups. Furthermore, the RSV (b+) group had higher C-reactive protein and Procalcitonin (PCT) levels and higher rates of High Flow Nasal Cannula-Oxygen Therapy (HFNC-OT) use. Multiple linear regression analysis revealed that PRISM-3 score, PCT levels, Pediatric Acute Respiratory Distress Syndrome diagnoses, inhaled steroid use, chronic illness status, and heart rate on admission were associated with the length of stay in the PICU. High flow nasal cannula-oxygen therapy continues to be the most frequently preferred respiratory support method in RSV infections. Viral infections accompanying RSV can increase the severity of the disease.

Staphylococcus aureus is one of the leading causes of bacteremia in children. In this study, we aimed to evaluate our center's experience on the etiology, management, and outcomes of pediatric Staphylococcus aureus bacteremia (SAB) with particular focus on transitioning to oral antibiotic therapy. This retrospective cohort study included children aged ≤ 19 years diagnosed with SAB over a 5-year period. The main outcome was poor clinical outcome related to SAB defined as (1) recurrence of SAB within 30 days after discontinuation of SAB treatment and (2) any-cause mortality within 30 days after detection of SAB. Over a 5-year period, 88 SAB episodes of 76 unique patients were included. The most common source of SAB attributed to central line (n = 34), followed by osteoarticular (n = 24), infections. All patients received at least one day of intravenous (IV) antibiotics and treatment was switched to an oral agent in 45.5% of SAB episodes. Sources of SAB in the oral switch group were osteoarticular (n = 21), skin and soft tissue (n = 7), central line (n = 3), thrombophlebitis (n = 2), head and neck infection (n = 1), and unknown (n = 6). 30-day mortality and SAB recurrence within 30 days after initial treatment completion occurred in 3 and 5 SAB episodes, respectively. None of the patients in oral switch group had poor clinical outcomes. Our study results indicate that 30-day any-cause mortality and SAB-related mortality is low in children. Similar to growing adult literature, oral switch in SAB treatment was not associated with poor SAB outcomes in selected patients.

In our study, we aimed to share the clinical experiences of our center regarding osteosarcoma cases, the most common primary malignant bone tumor in children and adolescents. With approval from the Clinical Research Ethics Committee of our center, the data of 59 pediatric patients who were followed up in our center with the diagnosis of osteosarcoma between 2007 and 2021 were evaluated retrospectively. The mean time between the onset of symptoms and diagnosis was 3 months. Although not statistically significant, patients with a diagnostic delay of 3 months or less had a higher rate of recurrence and mortality. 59.3% of patients had metastatic disease, and the presence of metastases was associated with higher rates of recurrence and mortality. Significant number of patients had multiple surgical operations. Amputation as the first operation and the need for multiple surgeries were associated with higher mortality. Pathologically poor response to chemotherapy is associated with mortality. 42.4% of patients died, and the 5-year overall and disease-free survival rates were 47.5% and 30.5%, respectively. Survival rates were highest in non-metastatic and non-relapsed patients, and lowest in metastatic patients and patients with poor response to chemotherapy. Renal problems and cardiotoxicity were most frequently treatment-related complications. Significant improvements have been achieved in the survival and quality of life in osteosarcoma cases compared to previous years; however, there is still a long way to go, and more multicenter and multidisciplinary studies are needed on osteosarcoma.

Several studies have reported outbreaks of Kawasaki disease among children amid the coronavirus disease 2019 (COVID-19) pandemic. Vitamin D possesses high utility in modulating the immune system to repair and prevent severe inflammation in COVID-19. This study aims to explore the association between Kawasaki disease and vitamin D levels in pediatric patients and describe the potential role of vitamin D in promoting recovery and preventing complications associated with Kawasaki disease in pediatric patients with COVID-19. The association between Kawasaki disease and vitamin D was explored adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, utilizing databases such as PubMed, Google Scholar, and ScienceDirect. The association between COVID-19 and Kawasaki disease was also assessed by reviewing relevant literature.Most studies indicated that patients with Kawasaki disease had lower vitamin D levels. Vitamin D supplementation was also found to be deficient in the pediatric population with Kawasaki disease. Inflammation of the endothelium, cytokine storms, and endothelial dysfunction in patients suffering from COVID-19 may contribute to the development of Kawasaki disease. Vitamin D is believed to have protective potential for Kawasaki disease outcomes by modulating the inflammatory response. Administering vitamin D to pediatric patients with viral infections like COVID-19 is expected to accelerate clinical improvement and prevent complications from Kawasaki disease.

Coronavirus disease 2019 pandemic caused many changes in the social behaviors of individuals and the provision of health systems. Many studies revealed reductions in the number of diagnoses and delays in diagnosis time during the pandemic. This study aimed to evaluate the effect of the pandemic on the time to diagnosis of major diseases of pediatric pulmonology. Newly diagnosed patients with cystic fibrosis (CF), childhood interstitial lung disease (chILD), tuberculosis (TB), and primary ciliary dyskinesia (PCD) were grouped into pandemic (group 1) and 2 consecutive pre-pandemic periods divided into equal intervals (groups 2 and 3). For each disease group, the time to diagnosis was compared between the specified periods. A total number of patients were 171 in this study. In the CF group, there was no statistically difference in time to diagnosis between periods. In the chILD group, there was a statistically significant difference in time to diagnosis (P = .036) between groups (group 1: 2 months, group 2: 4 months and group 3: 10.5 months) that was not originated from pandemic period. In TB group there was no statistically significant difference between groups. In the PCD group, the impact of the pandemic on the time to diagnosis could not be clarified because the time interval to diagnosis (minimum: 2 years, maximum: 16 years) exceeded the studied periods (21 months). In our study, no effect found between the pandemic and age at diagnosis or time to diagnosis in patients with PCD, chILD, CF, and TB at our center.

This comprehensive review explores the integration of artificial intelligence (AI) in the field of social pediatrics, emphasizing its potential to revolutionize child healthcare. Social pediatrics, a specialized branch within the discipline, focuses on the significant influence of societal, environmental, and economic factors on children's health and development. This field adopts a holistic approach, integrating medical, psychological, and environmental considerations. This review aims to explore the potential of AI in revolutionizing child healthcare from social pediatrics perspective. To achieve that, we explored AI applications in preventive care, growth monitoring, nutritional guidance, environmental risk factor prediction, and early detection of child abuse. The findings highlight AI's significant contributions in various areas of social pediatrics. Artificial intelligence's proficiency in handling large datasets is shown to enhance diagnostic processes, personalize treatments, and improve overall healthcare management. Notable advancements are observed in preventive care, growth monitoring, nutritional counseling, predicting environmental risks, and early child abuse detection. We find that integrating AI into social pediatric healthcare aims to enhance the effectiveness, accessibility, and equity of pediatric health services. This integration ensures high-quality care for every child, regardless of their social background. The study elucidates AI's multifaceted applications in social pediatrics, including natural language processing, machine learning algorithms for health outcome predictions, and AI-driven tools for health and environmental monitoring, collectively fostering a more efficient, informed, and responsive pediatric healthcare system.

The complete role of factors contributing to the pathogenesis of childhood obesity remains to be fully elucidated. Limited research has addressed trace elements in the context of child obesity. Our objective was to assess trace element and lead (Pb), copper (Cu) (are toxic metal) levels in both healthy and obese children, and to investigate the potential correlations between these elements and obesity-related anthropometric measurements, lipid profiles, as well as insulin and glucose levels. Furnace atomic absorption spectrophotometry was employed to measure the concentrations of trace elements in the serum. Additionally, fasting glucose, insulin, and lipid levels were determined in obese children (body mass index ≥ 95th percentile for age and sex), along with 50 healthy children. Only the obesity group underwent an oral glucose tolerance test (OGTT). Significantly reduced levels of Fe, Mg, Zn, and Co were observed in obese children, whereas Cu, Pb, and Mn levels were elevated (P < .001, P <.001, P = .002, P = .008, P <.001, P = .001, P = .007, respectively). Significant positive correlations were found between the 2-hour glucose level in OGTT and Mn (P = .013), as well as between peak insulin and insulin levels at the 30th and 60th minutes, and Fe (P = .001, P = .025, P = .001). This study indicates that an imbalance in trace element levels and the accumulation of Pb may be associated with obesity, while levels of Mn and Fe may be linked to glucose intolerance.