Miyokardit miyokard dokusunun enflamasyonu ve miyokard fibrillerinin hasari ile seyreden bir hastaliktir. Asemptomatik seyirden, kalp yetersizligi ve ani olume kadar degisken bulgular gosterir. Tedavinin kose tasi, antikonjestif ilaclar ve gerektiginde mekanik ventilasyonu da kapsayan destekleyici tedavidir. Miyokardit duzeldikten sonra ilac tedavisinin kesilmesi icin en uygun zaman belirsizdir. Burada, izleminin besinci ayinda kalp yetersizligi bulgulari duzelen ancak ilaclari kesildikten sonra kalp yetersizligi bulgulari tekrarlayan hastayi sunarak antikonjestif tedavinin kesilmesi konusunda temkinli olunmasi gerektigini vurgulamak istedik.

BACKGROUND:The aim of this study was to investigate the experiences of Turkish mothers in teething period and the factors affecting teething.METHODS:This study was performed by filling in questionnaire forms with a face-to-face interview technique with the mothers of 792 patients presenting to the outpatient clinics of pediatrics of Fatih (Turgut Ozal) University Faculty of Medicine between 1 April and 31 July 2012.RESULTS:This study was conducted in a total of 792 children (mean age: 24.2±7.9, range 12-42 months; 430 males). Of the study population, 6.1% had a family history of premature teething, 9.7% had a family history of delayed teething, 98% had been breastfed, 91.9% had used vitamin D, 67.6% had used iron supplements, and 3.9% had fluorine use. The first teething was at 7.8±2.5 months and the first teeth to appear was the anterior lower incisor (58.7%). The symptoms the patients had during teething were irritability (64.9%), fever (64.1%), increased mastication (61.6%), increased salivation (58.2%), and diarrhea (45.6%). The rate of admission to a physician with these complaints was 19.6%. The factors affecting the teething time were a family history of premature or delayed teething and birth with natal tooth, and male gender.CONCLUSIONS:In this study we found that nutritional or local factors were not effective on teething time. Teething period was characterized by nonspecific symptoms including irritability, subfebrile fever, increased mastication and salivation, and diarrhea. Linear regression analysis revealed that male gender and a family history of premature teething were the factors responsible from a shortening in teething time.

Objective: In this study, we investigated socio-demo­graphic characteristics of adolescents living in our region. Methods: Were analyzed, retrospectively, patients admit­ted Dicle University Faculty of Medicine’ adolescent out­patient clinic. Demographic data, body mass index (BMI), medical history and family background, school status, academic achievement, habits, trauma and psychosocial status were recorded. Results: Of the 244 adolescents, 124/%) were females. The average age of cases was 12.99 ± 1.89 years (10-18 years). 48.3% of adolescents were low BMI. The smoking rate of 32.4% (n=79) and was higher in men. In smok­ers, school performance was lower (p = 0.002), and the rate of suicidal idea was higher (p < 0.001). In those with family history of suicide, the rate of suicidal thoughts or attempted suicide was higher (p = 0.005, p = 0.022, re­spectively). Similarly, in cases exposed to physical vio­lence, the rates of attempted suicide or suicidal thoughts were higher (p=0.011, p=0.001, respectively). In addition, in cases exposed to psychological violence the rates of attempted suicide or suicidal thoughts were higher (p<0.001, p<0.001, respectively). Conclusion: Adolescents, for they can complete this period in a healthy way, health-care services, education units, especially their parents, should be made aware of the adolescence period-specific problems. Additionally, special centers customized adolescents, should be cre­ated and supported by state and private institutions.

Background Depression, a challenging disorder, affects 1–6% of adolescents and early onset often predicts more serious manifestations in later life. Elevated Parathyroid hormone (PTH), parathormone levels have reported among adults with depression. In this study, the roles of 25(OH) D (vitamin D) and parathormone during adolescence, in which the frequency of depression is high, were studied. Materials and Methods Patients who were followed-up jointly at both clinics and whose 25(OH) D and PTH levels were evaluated and questioned "Depression Scale for Children" for depression at the same time, were included in the study. Cases’ socio-demographic data, 25(OH) D and PTH levels and Depression Scale’ scores were recorded. Results Depression was diagnosed in 35 (25.3%) of the 138 patients. No differences were found between vitamin D and parathormone in terms of age and gender in groups either with or without depression. Negative correlation was found between the vitamin D levels and depression score in the group with depression (r=-0.368; P=0.03). A significant and positive correlation was found between the PTH levels and depression score (r=0.399; P=0.018). A significant and negative correlation was found between 25(OH) D and PTH levels. Conclusion Even if clinical depression is absent, the frequency of depressive symptoms is increased with decreased vitamin D levels and increased PTH levels, independent of other factors. The prevention of depression, specifically in adolescents, is important to decrease possible suicidal and homicidal thoughts that might arise during adulthood, and substance abuse. Maintaining vitamin D support during adolescence, as with the first year of life, is necessary for both the prevention and treatment of depression.

Aim Over the past 2 decades, transcatheter occlusion of patent ductus arteriosus (PDA) with coils and the duct occluders evolved to be the procedure of choice. A new device, the Occlutech PDA® occluder (ODO) device has been designed. Herein, we aimed to evaluate the characteristics and short‐term results of patients who underwent transcatheter closure of PDA using the ODO. Methods We reviewed the clinical records of 60 patients from different centers in Turkey between December 2013 and January 2016. The medical records were reviewed for demographic characteristics and echocardiographic findings. Device size was selected on the narrowest diameter of PDA. Results The median patient age was 2.5 years (6 months–35 years), and median PDA diameter was 2.5 mm (1.2–11 mm). Fifty‐eight of 60 patients (96.6%) had successful ODO implantation. The occlusion rates were 37/58 (63.7%) at the end of the procedure, 51/58 (87.9%) at 24–48 hours post‐procedure, and 57/58 (98.2%) on echocardiography at a median follow‐up of 7.6 months. Conclusion Our results indicate that transcatheter closure of PDA using the ODO is effective. Larger studies and longer follow‐up are required to assess whether its shape and longer length make it superior to other duct occluders in large, tubular, or window‐type ducts. (J Interven Cardiol 2016;29:325–331)

Aim: Acute poisoning is an important health problem in pediatric patients. The aim of this study is to evaluate the epidemiological and clinical signs and treatment results of the children with acute poisoning.Methods: All of the cases that admitted to the children hospital between September 2012 and June 2014 enrolled to the study. File records of cases was retrospectively evaluated. Age, gender, admission season, intended purpose of agent, feature of agent, ingested route, symptoms, physical examination findings, mental state, applied treatments and intensive care needs were recorded.Results: 65 males, 63 girls were included to the study. 57.8% of patients were under the age of 5. The most admission seasons were autumn (50.8%) and summer (26.6%). Ten cases, mostly girls, had suicidal ingestion. In all cases, except one, oral poisoning had occurred. Three patients were mentally handicapped. The most frequent symptoms and signs during admission were nausea and vomiting (10.9%) and lethargy (7.8%). Before admission, the majority of patients (68.0%) had undergone gastric lavage and activated charcoal. Intensive care was required in 21 (16.4%) patients. Pharmacological or non-pharmacological intoxication were not related with intensive care need. Hospitalization duration was significantly longer in patient hospitalized in intensive care unit. The age of the patients who need intensive care were lower than those without. Nine (7.0%) patients died during follow-up in intensive care. Death mostly had occurred as a result of non-pharmacological intoxication.Conclusion: Acute poisoning cases among the important reasons for emergency visits, and can result in significant morbidity and mortality. Therefore, this issue of parents and health professionals to increase their level of knowledge in daily practice is important to consider acute intoxication.

The objective of this study was to determine the rate, independent risk factors, and outcomes of healthcare-associated infections in pediatric patients. This study was performed between 2011 and 2014 in pediatric clinic and intensive care unit. 86 patients and 86 control subjects were included in the study. Of 86 patients with nosocomial infections (NIs), there were 100 NIs episodes and 90 culture growths. The median age was 32.0 months. The median duration of hospital stay of the patients was 30.0 days. The most frequent pathogens were Coagulase-negative Staphylococcus , Acinetobacter spp., Klebsiella spp., and Candida spp. Unconsciousness, prolonged hospitalization, transfusion, mechanical ventilation, use of central venous catheter, enteral feeding via a nasogastric tube, urinary catheter, and receiving carbapenems and glycopeptides were found to be significantly higher in NIs patients. Multivariate logistic regression analysis showed prolonged hospitalization, neutropenia, and use of central venous catheter and carbapenems as the independent risk factors for NIs. In the univariate analysis, unconsciousness, mechanical ventilation, enteral feeding, use of enteral feeding via a nasogastric tube, H 2 receptor blockers, and port and urinary catheter were significantly associated with mortality. In the multiple logistic regression analysis, only mechanical ventilation was found as an independent predictor of mortality in patients with NIs.

BACKGROUND:The aim of this study was to investigate the urine levels of human kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP) in children with iron-deficiency anemia (IDA). MATERIAL AND METHODS:Thirty-five children with IDA and 32 matched healthy controls were recruited. We assessed complete blood count, serum iron, iron-binding capacity, ferritin, serum levels of urea, creatinine (Cr), sodium (Na), potassium (K), calcium (Ca), and glucose levels. Estimated glomerular filtration rate (eGFR) was calculated. Urinary NAG, NGAL, KIM-1, and L-FABP were measured and divided by urine creatinine for comparisons. RESULTS:There were no significant differences in serum urea, Cr, or eGFR between the IDA group and the control group (p>0.05, for all). IDA patients had significantly higher urine NGAL/Cr, L-FABP/Cr, KIM-1/Cr, and NAG/Cr compared with the control group (p<0.05). There were significant negative correlations between hemoglobin, hematocrit, red blood cell count, and urine NGAL/Cr, NAG/Cr, L-FABP/Cr, KIM-1/Cr levels (p<0.05). CONCLUSIONS:Higher urinary kidney injury molecule levels in IDA patients suggest a possible subclinical renal injury in pediatric IDA patients whose renal functions and serum electrolytes were normal.

BACKGROUND:Chronic hepatitis B virus (HBV) infection is common worldwide. Follow-up of patients by the use of non-invasive techniques may be valuable in clinical practice. The aim of this study was to investigate serum galectin-3 (GAL-3) levels for monitoring disease status in children with chronic HBV infection. MATERIAL/METHODS:Thirty-two patients with chronic hepatitis B (CHB), 30 inactive HBV carrier patients, and 30 matched healthy controls were enrolled in the study. We performed basic laboratory tests: serum glucose, albumin, alanine aminotransferase (ALT), aspartate aminotransferase, gamma-glutamyl transferase (GGT), total bilirubin, prothrombin time, and activated partial thromboplastin time. In addition, serum GAL-3 levels were measured by ELISA technique. RESULTS:Significantly higher serum GAL-3 levels (16.5±3.6, 1.1±0.3, 0.7±0.5 ng/ml, respectively, p<0.001) and ALT levels (80.2±30.6, 26.8±12.6, 28.1±4.4 IU/L, respectively, p<0.001) were found in the CHB group compared with the inactive carriers and the control groups. There were no significant differences in ALT levels and GAL-3 levels or between inactive HBV carriers and the control groups (p>0.05, for each). Significantly higher GGT levels were found in the CHB group (51.3±27.5 IU/L) compared with the inactive HBV carriers (35.7±10.1 IU/L) and the control group (31.3±9.5 IU/L) (p<0.001, and p=0.004, respectively). A significant correlation was found between GAL-3 and ALT levels in the CHB group (r=0.82, p<0.001). CONCLUSIONS:Our results suggest that serum GAL-3 level may be a beneficial indicator of chronicity in hepatitis B infection in children.

Familial Mediterranean fever (FMF) is an inflammatory disease, which is suggested to be associated with increased risk of atherosclerosis. Epicardial adipose tissue (EAT) thickness and the mean platelet volume (MPV) are parameters used in prediction of atherosclerotic risk in various conditions. These parameters were evaluated in children with FMF and compared with healthy controls.

In these case series, we report on six children (3 girls, 3 boys) aged 5-13 years with Henoch-Schönlein purpura (HSP) who developed severe gastrointestinal (GI) bleeding resistant to both 2 mg/kg or pulse (10-30 mg/kg) i.v. methylprednisolone. All patients responded to single-dose (500 mg/m(2) ) i.v. cyclophosphamide (CPA) and none of them developed new GI bleeding after CPA treatment. No patients required surgical intervention. Single high-dose CPA may be beneficial in HSP with severe GI involvement, in which bleeding is non-responsive to high-dose steroids.

Background: Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent attacks of serositis, fever, and rash. Clinical and subclinical inflammatory processes may contribute to atherosclerosis in FMF patients, with mean platelet volume (MPV) as a potential indicator for atherosclerosis risk and neutrophil-tolymphocyte ratio (NLR) as a marker for subclinical inflammation in these patients. In this study, we investigated whether MPV can be used as an indicator for atherosclerosis risk and if NLR is a marker for subclinical inflammation in FMF patients.Material/Methods: The study consisted of 75 FMF patients in attack, 157 attack-free patients, and 77 healthy controls. White blood cell count neutrophil-to-lymphocyte ratio, platelet count, MPV, PDW C-reactive protein levels, and erythrocyte sedimentation rate were recorded.Results: There were no significant differences between attack, attack-free, and control groups in terms of mean MPV and PDW value. NLR value was higher in the attack group. NLR value was similar in attack-free and control groups.Conclusions: We found that MPV and PDW values are similar in FMF patients and healthy controls. NLR was higher in FMF patients in the attack period. Therefore, our results suggest that MPV and PDW values do not predict atherosclerosis risk in pediatric FMF patients, and NLR may be an indicator for attack period but not attack-free period.

AIM In this study, we aimed to evaluate complementary and alternative methods of medicine, determine the frequencies of usage of these methods and investigate the factors which have an impact on their usage. MATERIAL AND METHODS The study was conducted between October, the 15(th) and November, the 15(th) 2012. Approval was obtained from the local ethics committee (08.10.2012/732). The study form prepared was applied to the mothers of the children who presented to our general outpatient clinic and had no chronic disease. The data were recorded in SPSS for Windows v.16 program. Descriptive statistics, chi-square, Mann-Whitney U and logistic regression analyses were applied. A p value of <0.05 was considered significant. RESULTS Two hundred and six children were included in the study. Complementary and alternative medicine was used in 83% of the patients. Wearing an evil eye (45%) bead and prayer (35%) to protect from the evil eye were the most commonly used methods. The most common medical conditions which caused to use of complementary and alternative medicine included anemia, diarrhea, constipation and cough. Belief-based application were being used in 73% of the patients and herbal methods were being used in 57%. In 18% of the patients, interventional methods including cutting had been performed. No difference was found between the patients in whom these methods were used and not used in terms of familial income, education levels of the parents, family type and residence (p>0.05). CONCLUSIONS Complementary and alternative methods of medicine are applied substantially frequently in children. Physicians should have information about these methods in terms of their effects and side effects and warn families and especially mothers about potential risks.

This study aimed to investigate the clinical and laboratory features of children with juvenile idiopathic arthritis (JIA) that followed up at Dicle University Hospital Department of Pediatrics. Totally, 121 (64 male, 57 female) children with the mean age of 10.0±4.1 (range, 1.5-1.8) years were included. The mean disease onset age was 7.9±3.8 (range, 0.8-15.4) years and the mean follow up period was 2.1±1.9 years. The percentages of JIA subtypes were as follows: Oligoarticular JIA 67 (55.4%), polyarticular 45 (37.2%), enthesitis related arthritis 5 (4.1%) and systemic JIA 4 (3.3%). The most common complaints were arthralgia (91.7%), fever (57.0%), fatigue (38.8%) and malaise (34.7%) and the most frequently involved joints were knee (74.4%), ankle (57.9) and wrist (48.8%). Complete remission were achieved in 28 (23.1%) and partial remission in 56 (46.3%), however 27 (21.3%) cases not responded to treatment satisfactorily. Significant risk factors for poor response to treatment with logistic regression were found as delay in treatment ≥6 months (Odds ratio, OR:11.1; p=0.006), existence of thrombocytosis (OR: 7.5; p=0.009) and early disease onset (age<5 years) (OR:18.1; p=0.004). In conclusion, JIA is a heterogeneous childhood disease with varied clinical manifestations. Early onset disease, delay in treatment and existence of thrombocytosis were the risk factors for an unfavorable outcome.

Acute myeloblastic leukemia (AML) is originating from hematopoietic precursor cells. CD7 is expressed in 30% of AML cases and is associated with poor prognosis in myeloid malignancies [1,2]. Perica...

INTRODUCTION:In children, coughs lasting longer than 4 weeks are considered to be chronic, with etiological factors varying widely.OBJECTIVE:This study included children with chronic cough who were followed for 1 year. All cases were evaluated with the guidance of the American College of Chest Physicians (ACCP), and etiological factors were analyzed.METHODS:The study included 270 children between the ages of 2 months and 14 years. Their presenting symptoms, physical examination findings and laboratory data were recorded. All patients underwent laboratory tests including direct chest X-ray and spirometric measurements. Several patients required additional advanced examinations such as a sweat test, determination of immunoglobulin levels and bronchoscopy. Patients were reevaluated according to ACCP recommendations, and etiological factors were investigated.RESULTS:The total of 270 patients were included in the study included 43.3% (n=153) females with a mean age of 6.5 ± 2.3 years (7 months to 17 years). After a 1-year follow-up of patients, we determined that the most common etiologic factors were asthma (27%), asthma-like syndrome (15.5%) and gastroesophageal reflux (10%). Other etiological factors included upper airway cough syndrome and protracted bronchitis, respectively.CONCLUSION:The use of a standardized clinical approach such as the ACCP increases the possibility for fast and accurate diagnosis during the treatment of children with chronic cough, and the use of these guidelines should be required.