INTRODUCTION: We aimed to analyze changes in vital parameters and assess behavioral response to lung ultrasound (LUS) in preterm and term newborns hospitalized in the neonatal intensive care unit (NICU).
METHODS: Three groups of neonates (term, 370/7–416/7 weeks; moderate to late preterm, 320/7–366/7; and very preterm, <320/7) were included. Response to LUS was assessed using heart rate (HR), blood oxygen saturation (SpO2), and Neonatal Infant Pain Scale (NIPS). Reactions to LUS, blood sampling, and nappy change were compared.
RESULTS: Seventy-one infants were enrolled: 30 term, 21 moderate to late preterm, and 20 very preterm. An increase in mean HR and decrease in median SpO2 during LUS were observed (p < 0.001), in all analyzed groups, whereas the median NIPS score was 3. During LUS, 38% term infants experienced pain according to NIPS. The same was observed for 47% and 35% of infants in the moderate to late preterm and very preterm groups. The trend of NIPS increased along with the higher intensity of the stimulus. The highest NIPS values were related to blood sampling, moderate to LUS, and lowest to nappy change (p < 0.001).
DISCUSSION AND CONCLUSION: As LUS affects vital parameters and may be perceived as potentially painful in >1/3 newborns, indications for each examination and adequate pain management should be always considered.

INTRODUCTION: To examine the relationship between children's oral health-related quality of life and academic achievement and school attendance.

METHODS: Data was gathered from the answers of 150 children aged 7-12 years to the structured questionnaire. Demographic data, children's/parents’ oral health conditions, academic performance/school absenteeism of the children, and intraoral examination outcomes were recorded in the structured questionnaire. Sillness & Löe plaque index was used to assess the dental plaque scores and DMFT/DMFS, dfmt/dfms indices according to WHO criteria were used to determine the dental caries scores.


RESULTS: The mean age of the 150 pediatric patients (72 girls (48%) and 78 boys (52%)) were 9.23 ± 1.44 years. Due to dental care-related issues, 82% of schoolchildren missed less than two weeks, and 18% missed more than two weeks. Furthermore, 21% of these missed days were related to toothache or infections, and 34% were due to going to a dental treatment appointment. The association between nail biting and hard object biting and school achievement was shown to be statistically significant (p=0.02 and p=0.03, respectively). According to the results of the present study, it was determined that school absenteeism was higher in children who needed dental treatment. It was also observed that there was a negative correlation between school absenteeism and academic success (p=0.01).
DISCUSSION AND CONCLUSION: Dental problems can cause school-age children to be absent from school and affect their school performance negatively.

INTRODUCTION: Beside the increased survival rates systemic complications that can impair the quality of life have been seen in 25-30% at childhood and adolescent cancer. Respiratory system is one of the severely affected systems. We aimed to evaluate late respiratory complications and risk factors in pediatric and adolescent cancers.
METHODS: We examined the pulmonary complications of 50 cancer patients and 40 control cases. We asked about environmental exposures, performed physical examination, and pulmonary function tests (PFT) (spirometry, DLCO). X-ray was performed on all patients in the patient group and on patients with indication in the control group
RESULTS: In the patient group there was impairment of pulmonary function in 52%, (24% small airway disease, 14 % diffusion disorders (DD) and 14% combined disorder(CD) compared to 22,5% in the control group (p: 0,007). There was a higher risk of restrictive disorder and/or small airway disease (SAD) in cancer patients who were diagnosed prior to 2 years of age. Besides thare was a higher rate of SAD in patients with soft tissue sarcomas and a higher rate of restrictive disease in patients who had received high-dose alkylating agents. No significant PFT impairment was observed in other patient groups.
DISCUSSION AND CONCLUSION: There is a high incidence of respiratory impairment in childhood and adolescent cancer survivors. They need to be followed-up by a multidisciplinary team and be informed about additional risk factors which may cause lung function loss.

INTRODUCTION: This study aims to analyze the trends in the prophylaxis of febrile convulsions (FC) in childhood by comparing two cohorts in the last decade (2007-2008 versus 2017-2018).
METHODS: The cohort consisted of 272 children with FC who were followed up during the 2007-2008 (n=105) and 2017-2018 (n=167) periods in XXX Children’s Hospital. The following clinical parameters were analyzed: demographic data, FC types, prophylaxis type, selected antiseizure medications, recurrence risk factors, and EEG characteristics
RESULTS: We defined two secular trends for the prophylaxis of FC in children in the last decade: (1) a reduced rate of FC prophylaxis (22.1%) in the period of 2017-2018 compared with a rate of 63.8% in 2007-2008, p<0.01, (2) no impact of recurrence risk factors for initiation of prophylaxis for complex FC in the last decade (p=0.028). The mean number of previous seizures at the initiation of the antiseizure medication (ASM) prophylaxis increased from 2.8±1.13 to 3.4±2 for simple FC and from 1.9±0.24 to 3.1±0.31 for complex FC (p<0.01) in the period of 2017-2018.
DISCUSSION AND CONCLUSION: Prophylaxis rates were defined to be lower in recent decades in children with FC. There was no impact of recurrence risk factors for initiation of prophylaxis in children with simple and complex FC.

INTRODUCTION: In juvenile idiopathic arthritis (JIA), systemic corticosteroids are reserved for cases with serious organ involvement, those with macrophage activation syndrome, and in the presence of high disease activity in oligo- and polyarticular JIA. However, systemic steroids may lead to serious side effects linked to adrenal insufficiency (AI). This study aimed to investigate factors related to AI in children with JIA who received systemic steroids.
METHODS: Twenty-five children with AI (serum cortisol <18 µg/dL, 30 minutes after ACTH stimulation) and 25 children without AI were included in this study. Subjects’ characteristics, type of JIA, arthritis location, laboratory measurements, and number of joints involved were recorded. Type of glucocorticoid administered, treatment protocol, and cumulative steroid dose were recorded. The primary endpoint was the difference in clinical characteristics, laboratory measurements and systemic corticosteroid dose in children with and without AI.
RESULTS: Median cumulative steroid dose was significantly higher in patients with AI compared to those without [2500 (1370–4400) mg vs. 963 (650–2500) mg, p=0.010]. Patients with oligoarticular JIA had a 6.7-fold lower risk of AI compared to those with other JIA types (OR: 0.149, 95% CI: 0.035–0.643, p=0.011). Patients with higher cumulative steroid dose (>1000 mg) had a 7.5-fold higher risk of AI than patients with lower dose (OR: 7.500, 95% CI: 1.634–34.416, p=0.010).
DISCUSSION AND CONCLUSION: Our findings show that non-oligoarticular JIA and high cumulative steroid dose are predictive for AI development in this patient subset; thus, systemic corticosteroids should be reserved for more aggressive JIA types and cumulative dose should be limited to 1000 mg.

INTRODUCTION: The aim of our study was to compare clinical severity scores and classic spirometry with impulse oscillometry (IOS) results and thoracic high-resolution computed tomography (HRCT) scores in children with Cystic fibrosis (CF) in order to determine the utility of the latter approach in patient follow-up.
METHODS: CF patients over 6 years of age were included. Swachman Kulczycki score, underclassical spirometry and IOS were performed when not in acute exacerbation. Thoracic HRCT images obtained within the previous 6 months were evaluated using the Bhalla scoring system.
RESULTS: The mean age of the children studied (n=30) was 12.1±4.2 years and 40% were female. Pseudomonas aeruginosa (P.aeroginosa) was isolated from sputum cultures of 40% of the patients. Patients with forced expiratory volume in 1 s (FEV1) below 80% exhibited significantly higher (resistance)R5, R10 values and significantly lower (reactance) X5 values on IOS (p=0.03, 0.027, 0.006, respectively). Patients with P.aeruginosa had significantly lower FEV1, FVC, and FEF25-75 values in classic spirometry when compared with patients without P.aeruginosa (p=0.002, p=0.002, and p=0.005, respectively). P. aeruginosa-positive patients showed significantly higher R5 and lower X5 values (p=0.047, 0.046, respectively). Bhalla scoring, bronchiectasis weight, peribronchial thickening, mucous plaques, saccularization, bronchial division, mosaic pattern parameters in groups with P.Aeroginosa growth and / or FEV1 <80%; was found to be significantly more serious than the non-reproductive group (p <0.005, respectively). Again, in the group with P. Aeroginosa growth, Swachman Kulczycki score was found to be significantly lower (p = 0.001). No significant correlation was found between thoracic score data such as bronchiectasis weight and mosaic pattern presence and impulse oscillometry values. In addition, in the group with high clinical score of swachman Kulczycki, resistance values such as R5 R10 R15, which are IOS parameters, and FEV1 were found above 80%. (p = 0.016, p = 0.037, p = 0.042, 0.004, respectively).
DISCUSSION AND CONCLUSION: Impulse oscillometry and tomographic scoring can be used safely in early detection of impairment in lung function. Further studies are needed to evaluate the utility of impulse oscillometry in the clinical monitoring of children with cystic fibrosis who are not compliant with spirometry maneuvers.

INTRODUCTION: Painful procedures in the newborn begin with injections. Controlling painful practices in the newborn is of great importance. Nurses should be familiar with evidence-based nonpharmacological methods to reduce pain. This study was performed to compare the effect of white noise, facilitated tucking, and their concerted application during heel-stick sampling on pain in term babies.
METHODS: A randomized controlled trial was conducted. The study was conducted on 90 newborns. Using stratification and the blocking method, 30 newborns were included in the white noise group (Group 1), 30 in the facilitated tucking group (Group 2), and 30 in the white noise + facilitated tucking group (Group 3). Pain scores of the newborns in all groups before, during, and after the procedure were evaluated by two nurses independent of each other using the Neonatal Infant Pain Scale (NIPS).
RESULTS: When the NIPS scores of the neonates during the heel-stick sampling procedure were compared, a significant difference was detected between the groups (p<0.001).
DISCUSSION AND CONCLUSION: The pain score of the group that was made to listen to white noise and had been placed in the facilitated tucking position during the application was significantly lower than in the other two groups.

INTRODUCTION: In this study, we aimed to evaluate the etiological, clinical, and laboratory characteristics of children with pancreatitis and the changes in these data over the years.


METHODS: Children, hospitalized with the diagnosis of pancreatitis between January 2011 and January 2021 were evaluated retrospectively. The etiology, demographic characteristics, laboratory findings, and changes over the years were analyzed.

RESULTS: : A total of 111 cases were enrolled, 72 (64.9%) in acute pancreatitis (AP) group and 39 (35.1%) in the acute recurrent pancreatitis and chronic pancreatitis (ARP-CP) group. The most common causes of AP were idiopathic (27.8%), cholelithiasis (26.4%), and infections (8.4%). In ARP and CP assessments, idiopathic (35.9%), trauma (15.4%), and drugs (10.3%) were the most frequent etiologies.
During the first five years, only 14 and 97 patients were diagnosed with pancreatitis in the second five years. In both, periods, the most frequent diagnosis was idiopathic pancreatitis (42.9% and 28.9%, respectively). While trauma (14.3%) and infections (14.3%) were the most common etiology in the first five years, cholelithiasis (20.6%) and drugs (9.3%) were the most common in the second five years.

DISCUSSION AND CONCLUSION: There was a significant increase between the first and the second five years in pancreatitis-related hospitalizations. The most common cause of pancreatitis in all groups was still unknown. The cholelithiasis ratio increased from 7.1% to 20.6% in the second five years. Also, drugs played a bigger role in pancreatitis at a high rate of 9.3% over the years. Moreover, it was emphasized that the administration of octreotide treatment has decreased over the years.

INTRODUCTION: Existential Breastfeeding Difficulty Scale (ExBreastS) evaluates mothers who interrupt or terminate breastfeeding because of existential difficulties. Aim of the study was to adapt the scale for Turkish.
METHODS: This methodological study was carried out between December 2021 and February 2022 in the obstetrics and gynecology clinic of a hospital in the west of Turkey. The study sample consisted of 139 mothers who fulfilling the study inclusion criteria. The data were obtained using a breastfeeding experience information form and the ExBreastS - Turkish form. Language adaptation and content validity, exploratory factor analysis, and confirmatory factor analysis were performed to determine the validity of the scale, and internal consistency coefficient, item–total score correlation, split-half reliability, and test-retest analyzes were carried out to establish the reliability of the scale.
RESULTS: An exploratory factor analysis showed that the instrument had a 3-factor construction with appropriate factor loads of the items (0.58–0.85). In addition, results of confirmatory factor analysis showed that model fit indices of the instrument met the target values. Cronbach’s alpha coefficient of the scale was 0.87, and the item–total score correlations ranged from 0.35 to 0.77. The test-retest correlation coefficient was 0.90 (p < 0.001) and the Spearman–Brown reliability coefficient was 0.79.
DISCUSSION AND CONCLUSION: The Turkish version of the ExBreastS evaluated in Turkish women showed that it was a valid and reliable measurement instrument after necessary corrections.

INTRODUCTION: Vaccine hesitancy has recently grown worldwide, caused by misinformation generally. The study aimed to determine parental intention to vaccinate children against coronavirus disease (COVID-19) and factors associated with vaccination hesitancy.
METHODS: The cross-sectional survey study was conducted in Ege University General Pediatrics Outpatient Clinic. The parents of 12-18 years-old children were admitted to the clinic between June and December 2021 (n=819) included in the study. They were asked about their intention to vaccinate themselves and their children. The vaccination status against COVID-19, hesitancy or willingness to vaccinate their children, and factors affecting parents’ thoughts regarding COVID-19 vaccines were measures of the study.
RESULTS: The vaccination rate of the parents was 70.3%, while parents' intention to vaccinate their children was 69.0%. Most parents had awareness regarding COVID-19 vaccines (88.3%), and most parents (89.4%) stated that the vaccination was necessary for the COVID-19 pandemic. Parents who have a male child or younger child were intended to be hesitant. Parents’ beliefs about the necessity of vaccines, awareness about COVID-19 vaccines, and their vaccination status against COVID-19 were identified as decreasing factors in parents’hesitancy.
DISCUSSION AND CONCLUSION: Parents' attitudes and vaccination status play a key role in children's vaccination. Providing reliable information to parents regarding the COVID-19 vaccines should be considered a priority to increase childhood immunization.

INTRODUCTION: This study aims to understand how the pandemic affects the mental health of adolescents with a previous psychiatric diagnosis during the pandemic.
METHODS: Fifty-nine patients aged 12-18 years, who were previously followed up in the Adolescent Mental Health Unit were included in the study. The participants were interviewed via telephone between June-July,2020 and December2020-January2021. Sociodemographic-data, psychiatric diagnoses and the previous CGI scores were obtained from the patient file. The Clinical Global Follow-up Scale was scored by the interviewing physician.
RESULTS: Past CGI scores before the pandemic was significantly greater for the participants with greater than one psychiatric condition(p=.024). For participants with more than one psychiatric condition the difference between CGI scores previous to the pandemic and during the early stages of the pandemic was significant(p=.004). The total satisfaction scores for telepsychiatry services assessed via the Telemedicine Evaluation Form were statistically higher for the participants with a single psychiatric disorder(p=.023). The past and early pandemic CGI scores were found to be inversely correlated with Telemedicine Evaluation Form with r=-.338 p=.019, r=-.353 p=.014 respectively.
DISCUSSION AND CONCLUSION: The present study offers a perspective for adolescent mental health across the pandemic, underlining the importance and caveats of healthcare delivery to youth with mental health problems during lockdown.

INTRODUCTION: Familial Mediterranean fever (FMF) is the most frequent monogenetic autoinflammatory disorder. It is characterized by fever and serositis. The first line treatment of FMF is colchicine. Adherence to colchicine is one of the main factors affecting colchicine response. In this study, we aimed to evaluate drug adherence in children with FMF using the Medication Adherence Scale in FMF (MASIF). We also assessed the clinical characteristics of drug-adherent patients and factors affecting drug adherence.
METHODS: Eighty-two children with FMF under colchicine therapy were included in this cross-sectional observational study. The patients were divided into two groups according to medication adherence and compared according to their demographic and clinical data.
RESULTS: According to MASIF, 31 (38%) patients had non-adherence to colchicine. There was a significant difference between the colchicine-adherent and non-adherent groups in terms of age, disease severity according to the International Severity Score for FMF, attack rate, colchicine dosage, M694V homozygosity, and family type (p = 0.005, p = 0.04, p = 0.025, p = 0.045, p = 0.04, and p = 0.046, respectively).
DISCUSSION AND CONCLUSION: Patients with FMF should be questioned about their medication adherence at every visit, and children with a high risk of colchicine non-adherence should be followed up more closely.

Neonatal lupus erythematosus (NLE) is an uncommon disease; frequently undiagnosed, produced by transplacental passage of autoantibodies such as anti-Ro/SSA and anti-La/SSB. Here we discuss a case of a preterm baby with intracardiac calcification and right ventricular dysfunction detected antenatally and managed successfully with steroid and intravenous immunoglobulins.