Turkish archives of pediatrics最新文献

Objective: One-third of extremely low birth-weight newborns develop chronic lung disease. Early corticosteroid therapy may reduce this risk, but questions remain about the possible adverse effects, especially on neurodevelopment. Materials and Methods: A bibliographic search of papers recorded in the PubMed, Scopus, and Google Scholar databases was conducted in November 2023. Articles that included the expressions "prenatal and postnatal corticotherapy" and "neurodevelopmental" and "infant, very low birth weight" and published between 2013 and 2023 in Spanish, English, or French were selected for analysis. Those that did not meet the selection criteria or did not refer to meta-analyses, systematic reviews, or experimental or observational studies were excluded. The PRISMA methodology was used for this search. Results: After applying the inclusion and exclusion criteria, 21 articles remained for analysis, which revealed no solid evidence of a relationship between prenatal corticosteroid therapy and neuropsychiatric disorders. However, dose-dependent negative effects on neurodevelopment have been observed, and postnatal corticosteroid therapy is associated with a higher risk of gross motor impairment, with greater side effects when administred early and at high cumulative doses. There is no evidence of postnatal inhaled corticosteroid therapy on neurodevelopment. Conclusion: Evidence suggests that prenatal betamethasone adminisration is not associated with negative effects on neurodevelopment. For very-low-birth-weight newborns, most studies recommend postnatal corticosteroid therapy from 7 days of life, when mechanical ventilation cannot be withdrawn. The review findings suggest that the cumulative effect of corticosteroids on this group of newborns may be considered.

Despite several articles that in recent years have highlighted the work of the Russian child psychiatrist and researcher Grunya Efimovna Sukhareva (Kiev, 1891 - Moscow, 1981), even today the prevailing opinion, at least in the Western world, does not attribute to this author the merit of the original clinical description of autism spectrum disorder. In fact, this credit is still attributed today first to Leo Kanner and second to Hans Asperger, who in 1943 and 1944 respectively described some cases of children who today would certainly be diagnosed with autism spectrum disorder. In reality, almost 20 years earlier than Kanner and Asperger, that is in 1925, Sukhareva published a paper in which she described with great accuracy and in a modern way the cases of 6 children affected, using current terminology, by autism spectrum disorder, that today would be defined as "high-functioning." Later, in 1927, Sukhareva described 5 girls affected, emphasizing the sex-related differences in autistic features, which today represent a very current and still debated topic. Over the next few decades, her work remained largely unknown to most of the Western scientific world. In this paper, the intention is to pay tribute to Sukhareva's work in particular (but not only) in the field of autism and discuss some possible hypotheses as to why it has been ignored by most for decades.

Objective: Acute rheumatic fever (ARF) is a non-suppurative, inflammatory disease. Various arrhythmias, the pathogenesis of which is unknown but thought to be immunological, are observed in ARF. This study aimed to detect the frequency of rhythm and conduction disorders, and to evaluate their relation with clinical findings in ARF patients diagnosed according to the updated Jones criteria, using 24-hour electrocardiography (ECG) recordings. Materials and Methods: This study included patients who applied between 2018 and 2021 and were diagnosed with ARF. Rhythm and conduction abnormalities were determined by examining their surface ECG and 24-hour ECG recordings (Holter). The relationship between rhythm and conduction abnormalities and clinical findings were also investigated. Results: Thirty-two patients with ARF with a mean age of 11.5 ± 2.9 years were included in this study. On the surface ECG, accelerated junctional rhythm (AJR) was detected in 2 patients. In Holter recordings, 7 patients had a prolonged PR interval, and a second-degree atrioven tricular (AV) block was observed in 1 patient. In addition, 5 patients had AJR, and 1 patient had accelerated nodal beats (6/32, 18.7%), 2 patients had rare ventricular premature beats, 2 patients had rare, 3 patients had frequent supraventricular premature beats, 1 patient had nonsustained, and 1 patient had sustained supraventricular tachycardia. Accelerated junctional rhythm was more prevalent among patients with carditis + polyarthralgia (33%). Conclusion: The frequency of AJR detected on ECG and Holter monitoring in ARF is similar to that of other minor findings. Therefore, the presence of AJR could be used as a minor finding in the diagnosis of ARF.

Objective: The aim of the study is to evaluate the clinical and laboratory features of pediatric patients with immunoglobulin A vasculitis (IgAV) according to Mediterranean fever (MEFV) gene variant status and to identify possible clinical indicators that may guide selective genetic testing. Materials and Methods: A total of 176 pediatric IgAV patients who underwent MEFV gene analysis were retrospectively reviewed. Patients were classified into 2 groups based on the presence or absence of MEFV variants. Demographic, clinical, and laboratory parameters assessed at diagnosis were compared between groups. Results: Among the 176 patients, 75 (42.6%) carried at least 1 MEFV variant. Compared to those without MEFV variants, patients with MEFV variants had a significantly higher rate of family history of Familial Mediterranean fever (FMF) (42.6% vs. 5.9%, P < .001). In addition, arthralgia (76% vs. 58%, P= .02) and arthritis (36% vs. 20.8%, P= .03) were more frequently observed in patients with MEFV variants. Serum amyloid A levels were significantly elevated in patients with MEFV variants (median 15 [IQR 4-150] vs. 5 [2-33] mg/L, P < .001). No significant differences were observed in renal or gastrointestinal involvement between groups. C-reactive protein and erythrocyte sedimentation rate values were higher in patients with MEFV variants but did not reach statistical significance. Conclusion: The presence of MEFV variant in pediatric IgAV patients is associated with increased systemic inflammation and higher rates of musculoskeletal symptoms. Selective MEFV genetic testing and SAA measurement may be beneficial in IgAV patients presenting with marked inflammatory responses, joint involvement, or positive family history of FMF.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a recent update in defining fatty liver disease, emphasizing its strong connection to metabolic factors and reflecting a shift in understanding its causes and progression. The principal aim of this investigation was to scrutinize the conceivable association between the poverty income ratio (PIR) and the incidence of MASLD, specifically focusing on liver fibrosis. Materials and Methods: In this study, a cross-sectional analysis was carried out utilizing data obtained from the National Health and Nutrition Examination Survey dataset covering the period from 2017 to 2020. To explore the relationship between the PIR and the prevalence of MASLD as well as liver fibrosis, a robust multivariable analytical method was adopted. This approach integrated a wide range of variables, such as sociodemographic characteristics, lifestyle habits, and individual health conditions. Results: In this study, a comprehensive analysis was conducted using logistic regression models and found a significant decline in the likelihood of MASLD in the highest PIR quartile (Q4) (odds ratio [OR] = 0.634, 95% CI: 0.446-0.903, P = .012) as well as liver fibrosis (OR = 0.682, 95% CI: 0.503-0.925, P = .014). Conclusion: The findings obtained from this research strongly demonstrate that higher PIR levels are significantly associated with a reduced prevalence of both MASLD and liver fibrosis, suggesting that higher socioeconomic shighertatus, as reflected by higher PIR, may decrease the risk of these conditions. These findings underscore the need for targeted interventions, such as better nutrition education, lifestyle support, and healthcare access to reduce the MASLD burden in low-income populations.

Background/Aims: Colorectal cancer (CRC) is the third most common cancer, and its progression to advanced diagnosis leads to a dismal prognosis. The long non-coding RNA (lncRNA) GUSB Pseudogene 11 (GUSBP11) can act in a variety of cancers. Nevertheless, the potential mechanism of GUSBP11 in CRC has not been reported. The purpose of this study is to investigate the relationship between the role of GUSBP11 expression in CRC progression as well as prognosis. Materials and Methods: Two hundred and fifty-nine CRC patients were recruited. Expression levels of GUSBP11 and downstream target genes in CRC cell lines were evaluated by quantitative reverse transcription polymerase chain reaction. The influence of clinical characteristics and GUSBP11 on prognosis was evaluated by the proportional hazards model. Cell-Counting-Kit-8 and transwell assays were conducted for detection of CRC cell proliferation, migration, and invasion. Dual luciferase and correlation analyses were used to validate GUSBP11 with predicted genes. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed to analyze downstream gene function and signaling pathways. Results: The expression of GUSBP11 was upregulated in CRC and relevant to the deterioration of prognosis. The CRC cell proliferation, migration, and invasion were inhibited by GUSBP11 silencing. miR-605-3p was the downstream target gene of GUSBP11, and its expression is negatively regulated by GUSBP11. Conclusion: Taken together, this study highlights that the inhibition of miR-605-3p by GUSBP11 to regulate the downstream signaling pathway leads to prognostic malignancy and promotes tumor growth in CRC.

Objective: Premature babies have a fragile circulatory system balance; therefore, rapid inter- vention may be needed in patients with patent ductus arteriosus (PDA). Echocardiography performed by a neonatologist can help to choose the best treatment option for newborns in a timely manner. The aim is to evaluate the performance of neonatologists in ductus assessment. Materials and Methods: Among the neonates born at the hospital, those diagnosed with PDA (n=40) under 32 weeks of gestational age were evaluated with echocardiography by a neo- natologist and a pediatric cardiologist. Interobserver variability analysis was done using the intraclass coefficient value and Cohen's kappa test results. Results: An excellent interobserver agreement was found in the peak systolic-to-end diastolic flow velocity ratio, a good agreement in the narrowest diameter of the ductus, peak systolic and diastolic velocities, and mitral A velocity. Raters had moderate to poor agreement in the rest of the variables such as left atrium/aorta ratio, ampulla diameter, length of the ductus, and left pulmonary artery diameter. Conclusion: It is suggested that neonatologists perform echocardiography to measure the nar- rowest diameter of the ductus and ductal flow velocities for PDA evaluation.

Objective: There are numerous athletes under 18 years of age in our country, whose physical, psychosocial and athletic developments have become more of an issue. The aim was to deter- mine challenges confronted by coaches of pediatric athletes in the referral of pediatric athletes for preparticipation medical clearance, management of injuries, pre- and postparticipation follow-up, and opinions of coaches about whether establishment of Pediatric Sports Medicine (PSM) would be warranted. Materials and Methods: This questionnaire addressed coaches' age, sex, the sport branch they were dealing with, physicians to whom they refer pediatric athletes, challenges experienced with the athlete and his/her parents during preparticipation evaluation (PPE), challenges experienced by parents during PPE, suggested branch for referral, awareness of coaches on PSM abroad, and their opinions on interests of PSM and establishment of PSM in our country. Results: A total of 352 coaches were included. The most common branch of coaching was foot- ball (21.4%). The most common physicians they were referring to were sports medicine special- ists (52.0%), family medicine specialists (44.9%), general pediatricians (33.8%), and pediatric cardiologists (29.3%). Of the participants, 69.0% had never heard about PSM. Regarding areas of interest of PSM, 55.1% stated they had no idea, 37.5% routine follow-up and 25.0% physical examination of pediatric athletes. Of the participants, 90.1% stated that establishment of PSM in our country would definitely contribute to PPE, and 94.9% stated that it should definitely be established. Conclusion: It was concluded that awareness on PSM is low among coaches and that the establishment of PSM would definitely make contribution in Türkiye.