Objective: This study examined the sociodemographic and clinical characteristics of female adolescents with eating disorders receiving inpatient treatment, compared anorexia nervosa (AN) and non-AN eating disorder groups, evaluated changes in depressive symptoms, and identified factors associated with the duration of inpatient treatment. Method: This single-center retrospective study reviewed the records of 45 female adolescents with eating disorders treated in a child and adolescent psychiatry inpatient unit between July 2021 and May 2026. Patients were categorized into AN and non-AN eating disorder groups. Sociodemographic data, psychiatric comorbidities, risk behaviors, indications of hospitalization, comorbid medical conditions, pharmacological treatment, depressive symptom severity and duration of inpatient treatment were analyzed. Results: The mean age of the patients was 15.13±1.71 years, and 48.9% had AN. The AN group had lower body mass index and higher rates of amenorrhea/menstrual irregularity, comorbid medical conditions, need for nutritional support, and hospitalization due to weight loss or medical instability. The non-AN group had higher rates of psychiatric comorbidities, cigarette and alcohol use, non-suicidal self-injury, suicide attempts, and hospitalization due to suicidality or non-adherence to treatment. Depressive symptom severity decreased from admission to discharge in both groups. In an exploratory hierarchical regression analysis, depressive symptom severity at admission and indication for hospitalization were associated with the duration of inpatient treatment, whereas diagnostic group was not. Conclusion: Female adolescents receiving inpatient treatment for eating disorders presented with substantial clinical complexity. Duration of treatment was associated with severity of depressive symptoms and the indication for hospitalization rather than with diagnostic category. These findings provide real-world data from Türkiye and underscore the need for larger-scale prospective studies examining factors associated with treatment course and prognosis.
Objective: Complications such as irritant dermatitis, infection, hypergranulation tissue should not occur involving the peristomal area to maintain skin integrity. Correct stoma creation techniques and appropriate nursing care are essential to prevent complications. This study aimed to compare the effectiveness of two different skin care solutions on peristomal skin integrity. Method: Twenty-six children with an ostomy hospitalized in the pediatric surgery intensive care unit were randomized. Stoma care of the children was performed using saline solution in Group 1, and distilled water + pH 5.5 baby shampoo in the standard care group for 7 days. On the 3rd and 7th days of the study, the peristomal skin integrity of the patients was evaluated using the peristomal integrity follow-up form and the Pittman ostomy complication severity index. The CONSORT checklist was used for the study. Results: Concerning the measurements made on the 3rd and 7th day of the study, there was no difference between both groups in terms of peristomal temperature or Pittman ostomy complication severity index scores, but skin moistures measured on the 7th day differed (p=0.01). Conclusion: The findings suggest that the use of distilled water + pH 5.5 baby shampoo as part of peristomal skin care may help maintain better skin moisture by the 7th day compared to saline solution, although no significant differences were observed between both groups in terms of skin temperature or complication severity.
Objective: This study aimed to examine the effect of a web-based double check program, developed as a computerised decision support system, on preventing high-risk medication errors among pediatric nurses. Method: This quasi-experimental study was conducted using a single-group pretest-posttest design in the pediatric surgery clinics of a university hospital. The sample consisted of all high-risk medication administrations performed by 24 nurses. Medication error rates were determined through direct observation before the intervention. Subsequently, nurses administered medications using the web-based double check program, and medication error rates were reassessed after the interventions. Data were analysed using IBM Statistical Package for the Social Sciences software program. Ethical approval, institutional permission, and informed consent were obtained. Results: The average rates of medication error were 47.8% before and 19.4% after the interventions, indicating a substantial reduction in medication error rates following implementation of the web-based double check program. The overall medication error rate was calculated as the arithmetic mean of stage-specific (preparation, administration, patient monitoring, and documentation). Conclusion: The use of the web-based double check program significantly reduced medication error rates among pediatric nurses. Integration of computerized decision support systems into clinical practice may contribute to improved medication safety in pediatric settings.
Objective: The aim of this investigation is to construct and psychometrically evaluate a novel measurement instrument designed to capture maternal perceptions and attitudes regarding donor milk services. Method: An instrument development investigation was undertaken among mothers between 18-49 years of age with their offspring under sixty months who presented to the pediatric department of Izmir Bakir & ccedil;ay University & Ccedil;i & gbreve;li Training and Research Hospital. Information about study participants was gathered using a demographic information form and the newly constructed "Perceptions and Attitudes Toward Human Milk Banking". Results: Psychometric evaluation encompassed content validity assessment, dimension reduction through principal axis factoring, structural verification via latent variable modeling, and homogeneity assessment through estimation of coefficient alpha with item-scale correlation analysis. Upon completion of item refinement procedures, the finalized eighteen-item version exhibited superior homogeneity (coefficient alpha=0.925). Sampling adequacy assessment yielded a Kaiser-Meyer-Olkin coefficient of 0.789, while the Bartlett sphericity examination reached the level of statistical significance (p<0.001). Dimension reduction revealed a tripartite structure accounting for 70.089% of score variability including Communal Encouragement and Behavioral Inclination (alpha=0.943), Informational and Security Consciousness (alpha=0.874), and Personal Evaluations and Reservations (alpha=0.655). Confirmatory factor analysis demonstrated satisfactory correspondence between the hypothesized model and observed data (chi & sup2;/df=1.818; Comparative Fit Index=0.965; Root Mean Square Error of Approximation=0.064). Time-dependent consistency assessment through repeated applications yielded intraclass correlation coefficients ranging from 0.91-0.93. Conclusion: This scale constitutes a psychometrically sound 18 item-ratng instrument featuring three constituent domains appropriate for capturing mothers' perceptions and attitudes concerning donor milk services.
Objective: Teeth that priorly and urgently require emergency dental care (SOS teeth) are evaluated through clinical and radiographic exams and primarily treated with root canal therapy and/or extraction in pediatric patients. It is important both to determine the prevalence and distribution of SOS teeth in children with primary and permanent dentition and to develop an appropriate treatment plan. This study assesses the prevalence of SOS teeth among the pediatric population based on gender, as well as types of teeth and their locations in the jaw. Method: A total of 1391 patients without systemic diseases at the end of primary (ages 5-6; n=215) and the beginning of permanent dentition (ages 11-12; n=169) who visited the Pediatric Dentistry Clinic of Dokuz Eyl & uuml;l University, between November 1, 2022, and April 30, 2023, were included in the study. To identify SOS teeth, the Caries Assessment Spectrum and Treatment code 6 were used. Results: SOS teeth were found in 62.3% of 5-6, and 19.5% of 11-12 year-old children. While no statistically significant difference was observed between gender and the presence of SOS teeth in terms of primary teeth, a significant difference was found regarding permanent teeth (p<0.017). SOS teeth appeared statistically significantly more often in the mandible than in the maxilla in terms of both primary and permanent molar teeth, (p=0.003, p=0.001, respectively). Conclusion: SOS teeth were detected at a high rate in permanent and primary molar teeth. Therefore, the detection of SOS teeth and treatment planning should be included in the agenda of dentists.
Recurrent 16p13.11 microdeletion syndrome is a rare genetic condition with variable clinical manifestations. This report aims to highlight the craniofacial and dental features of a pediatric patient with this syndrome, emphasizing the importance of early dental evaluation in children with genetic disorders. A 7-year-old girl diagnosed with recurrent 16p13.11 microdeletion syndrome, who had no previous dental examination, was evaluated. Clinical and radiographic findings revealed microcephaly, retrognathic maxilla, Class III appearance, oligodontia, delayed tooth eruption, and malformations in crown and root morphology. Dental caries in molars were restored with glass ionomer, compomer, and composite resin. Due to mental retardation and poor cooperation of the patient, removable prosthetic rehabilitation was not planned. Oral hygiene education was provided, and follow-up visits were scheduled. This case underlines the significance of early dental assessment in patients with genetic syndromes and emphasizes the need for multidisciplinary management and long-term follow-up.
Objective: Our aim was to investigate the therapeutic efficacy of intravenous immunoglobulin (IVIG) in pediatric patients with elevated cardiac troponin T (cTnT) levels and diagnosed with myocarditis confirmed by cardiac magnetic resonance imaging or clinically assessed as probable myocarditis (PM). Method: We retrospectively reviewed 105 children (mean age 13.4 +/- 3.1 years; 81% male) hospitalized with PM between January 2013 and April 2025. Patients were classified as those whose diagnosis of myocarditis was confirmed using cardiovascular magnetic resonance (CMR-confirmed) or PM based on Lake Louise diagnostic criteria. Data concerning demographic features, electrocardiography (ECG), echocardiography, CMR, baseline and follow-up cTnT (Roche high-sensitivity assay; 99th-percentile 0.014 ng/dL), time to normalization of cTnT levels, and IVIG therapy (400 mg/kg/day up to 5 days) were analyzed. Results: CMR abnormalities were found in 44 (41.9%) patients. Median baseline cTnT level was 0.135 ng/dL (range 0.016-9.057) and median normalization of cTnT levels was achieved within median period of 5 days (range: 2-42 days). IVIG was administered to 38 (36.2%) patients and more often patients with confirmed myocarditis (CM) received IVIG therapy ratherthan cases with PM (50% vs. 24.5%). Pathologic ECG findings were detected in 32% of all study participants and more frequently in IVIG-treated patients. Troponin normalization rate was slower in IVIG-treated patients (median: 10 vs 6 days), especially in patients with CM. Echocardiographic outcomes and recovery of left-ventricular systolic function had not shown any significant differences between IVIG-treated and untreated groups. Conclusion: Serum cTnT is a useful adjunct for diagnosis and follow-up of patients with pediatric myocarditis. IVIG was more often used in clinically severe cases but showed no significant effect on recovery of ventricular function or on fluctuations in troponin levels. Larger multicenter studies should be conducted to clarify therapeutic benefit of IVIG.
Objective: Syncope is a transient, sudden and reversible loss of consciousness caused by cerebral hypoperfusion. The most common type of childhood syncope is neurally mediated syncope, with more than 50% of cases suffer from vasovagal syncope (VVS). Although VVS is commonly seen during both childhood and adulthood, its underlying pathogenesis and prognosis are still unclear. We have aimed to evaluate both left ventricular (LV) and left atrial myocardial function in children with VVS using two-dimensional speckle-tracking echocardiography (2D-STE) during the non-syncopal period. Method: The study population included patients under the age of 18 years diagnosed with VVS based on patient history and physical examination findings. Cases with structural heart disease, arrhythmia, or syncope due to metabolic or neurological causes were excluded. The control group consisted of healthy children without systemic diseases. Results: A total of 36 children with VVS and 36 healthy controls were included. No significant differences were found between the groups regarding age, gender, body mass index, systolic/diastolic blood pressure and heart rate. Conventional echocardiographic measurements showed no differences between both groups in terms of LV volume, systolic and diastolic functions. However, LV global longitudinal and circumferential strain, left atrial peak strain values were lower in the VVS group. LV global longitudinal strain, circumferential strain, and left atrial strain were significantly associated with the presence of syncope. Conclusion: The study demonstrated that myocardial performance parameters are affected in children with VVS. In addition to conventional echocardiography, evaluation of cardiac functions with 2D-STE imaging will provide important information for these patients.
Objective: The central tegmental tract (CTT) is an extrapyramidal pathway located in the brainstem. CTT hyperintensity (CTTH) is a neuroimaging finding of uncertain etiology, considered either part of the normal maturation process or a finding that can be seen in various neurological conditions. This study aims to investigate its relationship with age and the associated disorders of CTTH observed in the pediatric population. Method: All brain magnetic resonance imagings (MRIs) performed between July 2023 and November 2025 at a tertiary pediatric hospital were retrospectively reviewed. Eighty-one pediatric patients with CTTH were included in the study. Clinical data, additional MRI findings, and available follow-up scans were examined. Results: CTTH was detected in 1.4% of all cranial MRIs, while the median age of the cases was 17 months. The most common complaints at admission were seizures (35.8%) and developmental delay (28.4%). Additional MRI findings (most commonly periventricular leukomalacia) were observed in 51.9% of the cases. The age of patients in this group with additional MRI findings was significantly lower than those without (median ages: 15 vs. 23 months). CTTH resolved in 36.7%, and persisted in 63.3% of the patients who underwent follow-up MRI. It was determined that CTTH resolved significantly in older children compared to the persistent cases among younger patients (median: 26 vs. 14 months). Conclusion: CTTH is a finding that can be seen in pediatric cranial MRI examinations, and its clinical significance should be interpreted by considering the patients' age and associated neurological conditions.
Objective: Outpatient parenteral antimicrobial therapy (OPAT) has been developed as an alternative approach to hospital stay for the effective treatment of infections requiring long-term therapy. The aim of this study is to evaluate the clinical outcomes and hospital readmission rates of pediatric patients receiving OPAT. Method: Pediatric patients aged between 1 month and 18 years who received antimicrobial treatment under the OPAT program were included in this retrospective study. The duration of OPAT, the antimicrobial treatments used, bed-days saved by OPAT, OPAT-related complications, and readmission rates were examined. Results: A total of 21 patients were included in the study, and the median age of these patients was 85 months. The most common diagnosis was leishmaniasis, observed in 33.3% of cases. OPAT shortened hospital stays for a median of 6 days (interquartile range: 2-12.5) per case. However, 14.3% (n=3) of the patients required readmissions to the hospital. No infusion-related side effects were observed in any patients receiving OPAT. Conclusion: Our data suggest that OPAT could be a good option for selected pediatric patients. However, further research and increased awareness are needed to promote the widespread use of OPAT for pediatric patients.
Objective: Neuroblastoma (NB) is a common childhood tumour, affecting telomerase enzyme activity. Expression of telomerase reverse transcriptase (TERT) protein is crucial for the fu & imath;nctioning of telomerase activity, but its association with risk stratification and prognosis is unclear. The adenosine triphosphatedependent helicase alpha-thalassemia/mental retardation x-linked (ATRX) protein, a chromatin remodeling protein, accumulates H3.3 histone variants. The study aimed to assess the correlation between expression levels of ATRX and TERT with the NB risk group and its prognosis. Method: Immunohistochemical expressions of TERTand ATRX proteins in tumourtissue samples of54 NB cases at different stages and risk groups were evaluated. Results: Immunohistochemical expression rates of TERT and ATRX proteins in tissues were 55.8% and 61.2%, respectively, with ATRX positively expressed at a rate of 50%, and 69% in early and in advanced stages of NB, and rates of 67.7%, and 50% in high and low-risk groups, respectively. TERT expression varies in early and advanced stages of NB, with higher levels in high-risk groups. ATRX expression is significantly higher in NB patients with Neuroblastoma myc (NMYC) gene amplification. Conclusion: High expression of ATRX in NB patients with NMYC gene amplification suggests that ATRX may be used as a potential immunohistochemical prognostic marker in NB patients.
Objective: This study aims to examine how structural, social, and economic inequalities influence the rights of children with disabilities to access, participate, and be protected in digital environments in T & uuml;rkiye. Method: A cross-sectional mixed-methods study design was adopted. The sample consisted of 82 children with disabilities aged 12-15 years living in & Idot;zmir, T & uuml;rkiye. Quantitative data were collected using a Socio-Demographic Information Form, the Cyber Victimization Scale, and the Social Exclusion Scale for Children (SESC). Qualitative data were obtained through semi-structured interviews with 20 children and 15 parents. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed through thematic content analysis. Results: Most children owned a smartphone (88.6%), whereas 38.6% had a computer and 37.1% had a tablet; while 38.0% of households lacked fixed internet access. Among visually impaired children, 40.0% reported that screen readers were outdated, non-functional, or insufficient, whereas children with hearing impairments frequently reported a lack of subtitles. According to the SESC, 35.4% lacked financial access to healthcare services, 23.2% could not access safe housing, and 25.6% were unable to regularly participate in social activities. Online risks included receiving insulting (30.5%) or sexually explicit (8.5%) messages, offensive nicknames (24.4%), being mocked or excluded from games or chats (20.7%), unauthorized sharing of private content (17.1%). More than half (57.3%) of the children were unable to assess online information reliability, 21.4% were unaware of digital opportunities, and 32.1% had never produced digital content. Additionally, 52.4% of parents did not approve of their children sharing content on social media. Themes emerging from the qualitative analysis included access to digital technologies, digital development and literacy, disability-specific content, participation rights, experiences of digital rights violations, responsibilities, complaint mechanisms, and privacy and safety. Conclusion: Digital access among children with disabilities is restricted by device, connectivity, and accessibility gaps; participation is constrained by material deprivation; and cyber risks remain prevalent. These findings highlight that digital participation is a multidimensional rights issue requiring strengthened digital literacy, standardized accessibility, and effective protection and reporting mechanisms.
Objective: The aim of this study was to evaluate sleep quality and internet use behaviours in children with pediatric migraine, focusing on their associations with anxiety, internet gaming disorder (IGD), and daytime functional impairment. Method: The study included 38 pediatric patients aged 10-18 years with migraine and 35 age-matched controls without migraine or psychiatric complaints. Migraine characteristics were systematically assessed, and sociodemographic data were collected. Comorbid psychiatric symptoms were evaluated using the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. All participants completed the Pittsburgh Sleep Quality Index (PSQI), the IGD Scale-Short-Form (IGDS9-SF), and the Screen for Child Anxiety Related Disorders (SCARED). Results: The migraine patients comprised 65.8% females and 34.2% males. Of these, 26 reported a positive family history of migraine, 12 were diagnosed with migraine with aura, and 26 without aura. The SCARED and IGDS9-SF scores were significantly higher in the migraine group than in the control group (p=0.001, p=0.011). Total PSQI scores indicated poorer sleep quality in migraine patients (p=0.001). Sleep latency (p=0.579) and duration (p=0.882) did not differ between the groups but subscale analyses revealed significant impairments in subjective sleep quality (p=0.001), daytime dysfunction (p=0.018), sleep disturbances (p=0.001), and habitual sleep efficiency (p=0.001) in the migraine patients. Conclusion: Pediatric migraine is associated with heightened anxiety, problematic gaming, and impaired sleep quality, contributing to daytime dysfunction. These results underscore the importance of a multidisciplinary approach addressing both migraine symptoms and co-existing psychological factors.
Objective: Isotonic fluids are recommended for parenteral maintenance fluid therapy because they reduce morbidity and mortality due to iatrogenic hyponatremia in children. However, there is still an ongoing debate regarding the ideal fluid therapy to be used in children. This study aims to provide insight into the development of hyponatremia in patients using hypotonic and isotonic fluids for maintenance and the comparative effects of these fluid regimens. Method: The study included hospitalized patients aged 1 to 83 months between January 2021 and June 2022, with normal serum sodium levels and given maintenance fluid therapy. Patients were categorized into three maintenance fluid groups: 0.3% saline (0.3% saline in 3.3% dextrose), 0.45% saline (0.45% saline in 5% dextrose), and normal saline (0.9% saline in 5% dextrose). The groups were further stratified based on control sodium level measurement times (8-16 hours, 17-32 hours, and 33-48 hours), and data were compared with baseline sodium levels. Results: The study involved 215 patients aged 1-83 months. There was no significant difference between the groups in terms of initial serum sodium levels. However, comparing control sodium levels revealed significant distinctions between each group (respectively, 0.3% saline and 0.45% saline groups (p=0.009), 0.45% saline and normal saline (p=0.003), 0.3% saline and normal saline groups (p<0,001). Significantly, the difference between baseline and control sodium values varied across fluid groups (p<0.001). Treatment duration did not impact the sodium level change. Conclusion: Using hypotonic fluids in pediatric maintenance fluid therapy elevates the risk of hospital-acquired hyponatremia. Opting for isotonic fluids in parenteral maintenance therapy is safer.
Objective: This study aims to compare the dental caries, plaque accumulation, gingival health, and oral hygiene habits of children with hemophilia to those of systemically healthy children of the same age group. Method: Our study consists of a study group of 54 male children with hemophilia, with a mean age of 7.80±3.18 years, and a control group of 55 healthy male children, with a mean age of 8.20±2.63 years. A case report form was used to assess patients’ demographics, medical and dental history, and oral hygiene habits. In addition to an intraoral examination, data related to oral hygiene, including caries indices [decayed, missing, filled teeth (DMFT/dmft) gingival index (GI), and plaque index (PI), were recorded in the case report form. Results: The dmft score of the control group was found to be significantly higher than that of the study group. However, the DMFT score did not show a significant difference between the groups. The GI score did not exhibit a significant difference between the groups either. The PI score of the control group was found to be significantly higher than that of the study group. No significant difference was observed between the two groups in terms of oral hygiene habits. Conclusion: Children with hemophilia are a special patient group at risk in terms of oral and dental health. Awareness should be raised among patients and their parents to ensure preventive dental treatments and regular dental check-ups from an early age.
Objective: Allergy is a hypersensitivity reaction triggered by various factors through immunological mechanisms. Elevated serum total immunoglobulin E (IgE) and peripheral blood eosinophil levels are commonly observed in allergic diseases; however, these biomarkers are not specific to allergy. This study aimed to evaluate the diagnostic value of serum total IgE, eosinophil, and basophil levels in predicting atopy. Method: Atopic and non-atopic patients under 18 years of age diagnosed with atopic dermatitis, food allergy, allergic rhinitis, or asthma were compared in terms of serum total IgE levels, eosinophil, and basophil counts. Results: A total of 673 patients including 406 (60.3%) atopic and 267 (39.7%) non-atopic cases constituted the study population. Most frequently sensitization developed to egg in atopic dermatitis, and food allergy, to tree pollens in allergic rhinitis, and to house dust mite in asthma. Elevated total IgE levels were significantly associated with atopy in patients with allergic rhinitis and asthma, with odds ratios of 3.33 and 16.37, respectively (p<0.001). The optimal predictive cut-off value of serum total IgE for atopic asthma was calculated as 108.5 kU/L, with a sensitivity of 85.6% and specificity of 76.6%. Similarly, a significant association was observed between eosinophilia and atopy in allergic rhinitis and asthma, but not in atopic dermatitis. Conclusions: Our findings suggest that serum total IgE is a sensitive and specific biomarker for predicting atopy in patients with asthma.
Objective: This study aims to identify key clinical and laboratory indicators that differentiate between severe and mild presentations of Multisystem Inflammatory Syndrome in Children (MIS-C), facilitating early recognition and application of targeted treatment strategies. Method: A retrospective, single-center analysis was conducted, reviewing clinical data of patients with MIS-C to identify factors associated with disease severity. The study assessed demographic, clinical, laboratory, and echocardiographic parameters, comparing patients with severe MIS-C (requiring inotropic support or prolonged intensive care unit stay) to those with mild MIS-C. Statistical analyses were performed to determine significant intergroup differences. Results: The group with severe MIS-C exhibited a longer duration of fever, presence of shock, tachycardia, and hypotension. Inflammatory markers such as lymphopenia, hypoalbuminemia, and elevated ferritin levels were significantly more pronounced in the severe MIS-C group. Elevated N-terminal pro-B-type natriuretic peptide and troponin levels were also significantly associated with severe MIS-C, indicating myocardial involvement. Echocardiographic findings of reduced ejection fraction and valve insufficiency were significant indicators of worsening clinical conditions. Coronavirus disease 2019 polymerase chain reaction and serological tests were not useful in differentiating between severe and mild forms of MIS-C. Conclusion: Early recognition of clinical features of MIS-C and classification based on disease severity can guide clinicians in diagnosis and treatment of MIS-C. Prolonged fever, shock, elevation of specific inflammatory, and cardiac markers, and echocardiographic abnormalities should raise suspicion for severe disease, prompting rapid intervention and tailored treatment strategies to improve patient outcomes and reduce potential mortality and long-term sequelae.
Objective: Advancements in the treatment of hemophilia have extended life expectancy of the patients, while leading to the emergence of new comorbidities, including obesity, among them. This study aimed to evaluate the prevalence of obesity and overweight in patients with hemophilia while examining their associations with the clinical characteristics of the disease. Method: Hemophilia patients were included in this single-center cross-sectional study. To assess joint health and functionality, the Functional Independence Score in Hemophilia and the Hemophilia Joint Health Score (HJHS) were applied. Patients were grouped according to their body mass indexes (BMIs). Differences in the number of bleeding episodes, prophylactic doses, and joint scores among BMI groups were evaluated. Results: A total of 35 hemophilia patients aged between 4 and 20 years were included in the study. Based on their BMIs, 8 patients (22.9%) were obese, and 11 patients (31.4%) were obese/overweight. Patients in the obese/overweight group were significantly younger than those in the other group. No significant difference was found between the groups in terms of annual bleeding episodes and HJHS. Interestingly, although obese/overweight patients received significantly lower prophylaxis doses per kilogram of body weight, did not show any difference in clinical scores. Conclusions: Our findings suggest that dose adjustments based on ideal body weight may lead to similar treatment outcomes. Additionally, younger age and parental protective behaviors may contribute to occurrence of fewer bleeding episodes in obese/overweight patients.
Objective: Bladder-bowel dysfunction (BBD) is a clinical condition in which both bladder and bowel functions are impaired. Constipation is often associated with BBD. This study aimed to estimate nutritional parameters and anemia in patients with BBD. Method: The study included 189 patients aged between 60 months and 18 years who were admitted to Bakırçay University Çiğli Training and Research Hospital. Their bladder symptom scores, iron parameters, and hemoglobin levels were evaluated. Results: It was determined that levels of blood hemoglobin and iron parameters were deficient in patients with constipation complaints who were particularly consuming unhealthy diets. Conclusion: It is important to evaluate nutritional status, fluid intake, constipation management, anemia, and iron parameters in patients with BBD. With appropriate treatment, we can improve their quality of life and prevent complications.
Objective: The aim of the study is to compare the mortality rates in cases with esophageal atresia/tracheoesophageal fistula (EA/TEF) using Spitz and Okamoto prognostic classifications as the predictive power of the presence of major cardiac anomalies alone, and to reveal specific risk factor indicators predicting early-stage postoperative morbidities. Method: Archive files of the patients with the diagnosis of EA/TEF admitted between between January 2000 and May 2020 were retrospectively reviewed. Archive files of the patients were reviewed in terms of their demographic information, disease characteristics, the surgeries they had undergone, postoperative outcomes, early complications, and morbidities developed during follow-up and secondary surgical interventions. Morbidities were divided into three groups as gastrointestinal, respiratory, and developmental complications. Results: The Okamoto and Spitz classifications were valid in predicting mortality, but the Okamoto classification provided statistically more significant prognostic data. The presence of major cardiac anomalies alone was not significant in predicting mortality. All morbidities were found to be at a higher rate in cases with prematurity and in the presence of accompanying congenital syndrome. The time to removal of postoperatively inserted thoracic and nasogastric tubes, length of hospital stay, and duration of postoperative mechanical ventilation were positively correlated with the development of all morbidities. Anastomotic leakage and development of recurrent fistula were found to worsen especially respiratory morbidities. However, among all morbidities, long-gap EA was not a significant risk factor. Conclusion: The presence of a major cardiac anomaly, regardless of birth weight, is insufficient to predict mortality. Although Okamoto and Spitz classifications remain valid for predicting mortality, Okamoto classification was a more powerful predictor of mortality. Knowing morbidity-specific risk factors for each of them will guide the follow-up of EA/TEF patients in order to reduce the incidence rates of gastrointestinal, respiratory, and developmental morbidities.
