Turkish archives of pediatrics最新文献

Simple renal cysts are not commonly found in children. They occur in a small percentage of cases, with an incidence of 0.2%-0.5%. These cysts are typically solitary and develop in the renal cortex. Pain, infection, hematuria, hypertension, or obstruction of the collecting system are indications for treatment. When intervention is necessary, there are several ways to reduce cyst volume. In this report, we discuss the pediatric case of a solitary giant renal cyst and its therapeutic approach. We present a symptomatic pediatric renal cyst patient treated with a sclerosing agent. A simple renal cyst is a rare condition in children, and its treatment includes conservative management, percutaneous sclerosing agent injection, and surgical approach. Choosing the appropriate treatment according to the patient's condition and clinical symptoms is essential. We think that sclerotherapy should be the first-line therapy before surgery in symptomatic simple renal cysts.

Thirdhand smoke (THS) is defined as the harmful substances in cigarette smoke that are absorbed into objects, people, and surfaces after smoking. This study aimed to determine the level of awareness of pediatricians working in a tertiary healthcare institution about THS exposure. In this cross-sectional study, participants were asked to fill out an information form in which we questioned the participant's age, sex, occupation in the institution, the exposure of pediatric patients to cigarette smoke during daily healthcare, tobacco product use status, smoking status in their home and car, behavior in case of smoking in closed areas where smoking is prohibited, and whether they knew the term of THS. Also, the Turkish version of The Beliefs About Third-Hand Smoke was used. Eighty-one participants, with a mean age of 34.2 ± 7.6 years, were included in the study. Fifty-six (69.1%) participants said they had never used tobacco products. Participants who had never used tobacco products (P = .005), never allowed smoking in their homes (P = .017) and cars (P = .001), had heard the definition of THS before (P = .013), and thought they knew it (P = .005) had higher total scale scores. There was no significant difference between the THS awareness levels of pediatricians who questioned children's exposure to cigarette smoke in their daily practice and those who did not (P = .491). Determining the awareness levels of pediatricians about THS will be an important step in preventing THS exposure in children.

The complete blood count (CBC) parameters and the ratios regarding these parameters have been demonstrated to be useful diagnostic biomarkers for many infectious diseases. Herein, we aimed to evaluate and compare the usefulness of the predictive role of the CBC in the differential diagnosis of pulmonary tuberculosis (TB) from community-acquired pneumonia (CAP) in children. We also compared serum electrolyte levels between the 2 diseases. In this retrospective study, we analyzed the efficacy of CBC parameters and neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), plateletto-lymphocyte ratio (PLR), neutrophil-to-monocyte-plus-lymphocyte ratio (NMLR), and serum electrolyte levels in the differential diagnosis of pulmonary TB from CAP in children. We also classified patients with TB into 2 groups according to the microbiologic confirmation. We investigated whether there is any difference regarding these parameters in patients with positive microbiologic results. A total of 163 patients diagnosed with TB and CAP were included in this study. The WBC, neutrophil and monocyte counts, NLR, MLR, NMLR, mean platelet volume (MPV), and C-reactive protein (CRP) values were higher in CAP. There was statistical significance among serum sodium and phosphorus (P) levels between the 2 groups. Microbiologic confirmation was determined in 37 (35.5%) patients with the diagnosis of TB. The NLR, MLR, NMLR, CRP, and P values were significantly higher in patients with microbiologic confirmation. The results of the present study suggest that complete blood count parameters, NLR, MLR, NMLR, and CRP can be useful and cost-effective markers in differentiating pulmonary TB from CAP in the early stages of diagnosis.

The aim of this study was to investigate the use of whole-body magnetic resonance imaging (WBMRI) in cases where we suspected rheumatic disease in our pediatric rheumatology clinic. We conducted a retrospective analysis of demographic, clinical, laboratory, and imaging data pertaining to pediatric patients who presented at our clinic and underwent WBMRI over the last 5 years. Our investigation targeted children experiencing diffuse musculoskeletal pain, where precise localization was challenging and suspicion of rheumatological pathology persisted despite inconclusive results from conventional diagnostic modalities. A total of 87 patients (33 female) underwent WBMRI at our clinic, with a median age (minimum-maximum) of 11.3 (0.5-18) years. Whole-body magnetic resonance imaging was performed in 4 patients suspected with dermatomyositis (DM) where muscle biopsy was not feasible, revealing muscle involvement and myositis. Additionally, WBMRI was utilized in 4 patients diagnosed with chronic nonbacterial osteomyelitis (CNO) to assess recurrence, identifying new active lesions in 3 patients. Among the remaining 79 patients, 34 received a new diagnosis of CNO. Clinically, supported by additional findings in laboratory and WBMRI, 18 were diagnosed with juvenile idiopathic arthritis (JIA), 5 with protracted febrile myalgia syndrome (PFMS), 5 with acute osteomyelitis, and 1 with viral myositis. The results were normal for 17 patients. Most of the WBMRIs conducted at the clinic under study were primarily performed on patients suspected of having CNO. Additionally, WBMRI was found to be supportive and beneficial in cases of suspected DM, PFMS, and JIA during the diagnosis.

Natural disasters present a significant and growing threat to the well-being of children. Every year 175 million children globally are expected to be affected by natural disasters, including floods, cyclones, droughts, heatwaves, severe storms, and earthquakes. In emergencies, children of all age groups, especially those under 5, are the most affected part of the community, with child mortality rates 2-70 times higher than average. Clean water, sanitation and hygiene measures, vaccination to prevent infectious diseases, providing psychological support to vulnerable children in an age-appropriate approach, and paying particular attention to children with special needs are extremely important. Healthcare personnel and families should have adequate information and preparation to do what is necessary before, during, and after emergencies to minimize the negative effects on children. In this review, we aim to discuss the effects of emergencies on children and the prevention methods.

Fetal growth is known to be affected by ethnic and environmental factors; therefore, intrauterine growth references for each community vary and need to be determined individually. This study aimed to construct intrauterine growth references for Turkish infants. This prospective, multicenter, cross-sectional study was performed in collaboration with the Turkish Ministry of Health and the Turkish Neonatology Society, in coordination with Mersin University. The study included 33 healthcare centers from all regions of Türkiye. The study included singleton infants who were born alive at 24-42 weeks of gestation. Weight, length, and head circumference were measured within the first 4 hours of delivery. The Lambda-Mu-Sigma method and penalized likelihood were used to establish the curves and construct percentiles. In all, data from 10 286 infants were analyzed and 552 cases that did not meet the inclusion criteria were excluded. The intrauterine growth curves and tables for Turkish infants were constructed using the data for 9734 singleton infants born at 24-42 weeks of gestation. To the best of our knowledge this is the first study to establish intrauterine growth references for Turkish infants, based on a cohort of infants from all regions of Türkiye. Using these new references, the intrauterine growth of Turkish infants and postnatal growth of those born prematurely can be followed-up more effectively, and it will be possible to more accurately determine if Turkish infants are small for gestational age or large for gestational age.

Early diagnosis of biliary atresia (BA) and the timing of Kasai hepatic portoenterostomy are associated with improved survival rates of the native liver. Acholic stool is a major and earliest sign of BA. We evaluated the awareness and recognition of medical students and primary health care professionals (PHCPs) about neonatal cholestasis and acholic stool as a marker of BA. The knowledge of students and PHCP about prolonged jaundice and acholic stool was evaluated through a questionnaire. In the first step, 5 questions evaluating the knowledge of prolonged jaundice were asked. The sixth question was "Have you ever seen acholic stool before?" Following this question, stool color cards with 9 colors were shown, and participants were asked "Which of the following stool pictures would you define as acholic?" A total 724 students and 88 PHCPs were included in the study. In both groups, about half of the participants could not answer the first 4questions related to prolonged jaundice and cholestasis correctly. Twenty-four percent of the students and 11.4% of PHCP answered correctly to all of the stool colors. The rate of correct answers to acholic stool colors were approximately 43.9%-87.6% and 23.9%-86.4% for students and PHCP, respectively. Whitish acholic stool colors were better known than mild yellowish pale stool colors. The percentages of recognition were less than about 50% for these stool colors. This study showed that recognition and awareness of prolonged jaundice are low, and acholic stool is not well known. This may lead to delay in diagnosis. Considering the international success of stool color cards, using stool color cards will improve the outcomes of biliary atresia in our country as well.

This study aims to assess the neurodevelopmental progress of high-risk infants 2 years post implementation of the Neurodevelopmental Follow-Up Unit (NFU) program at our hospital and explore implementation challenges for insights. Infants were assessed using the Hammersmith Infant Neurological Examination (HINE), The Alberta Infant Motor Scale (AIMS), and Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). A multidisciplinary team provided comprehensive parent education covering neurologic cues, postural advice, and developmental instructions in accordance with the children's assessment findings. In addition, a pediatric physical therapist provided motor development training emphasizing age-appropriate milestones and functional independence, while child development specialists addressed delays identified through BSID-III assessments. A total of 121 high-risk babies were enrolled during a 2-year period. Results revealed that 9 infants exhibited suboptimal HINE scores at 3-4 months, with only 2 maintaining suboptimal scores at 12-15 months. Similarly, 2 infants with suboptimal AIMS scores at 3-4 months reached normal values at 12-15 months. Comparable improvements were observed in BSID-III scores. While no correlation between HINE and AIMS scores was found at the 3-4-month mark, a significant correlation emerged between AIMS and HINE scores at 6-9 months (r = 0.643, P < .001) and 12-15 months (r = 0.820, P < .001). Encouraging early family education alongside regular monitoring of high-risk newborns appears to have a positive impact on their motor and cognitive development. Consideration of clinical recommendations, such as tailored interventions and periodic assessments, may contribute to optimizing developmental outcomes.