INTRODUCTION: The main objective of this study was to predict upper urinary tract damage utilizing novel approaches, such as machine learning models, by incorporating simpler predictors alongside established radiological and clinical factors.
METHODS: In this retrospective study, a total of 191 patients who underwent blood tests, urine analysis, imaging, and urodynamic studies (UDS) to assess nephrological and urological status were included. Basic statistical analyses were conducted using IBM SPSS Version 25. A significance level of p<0.05 was employed to establish statistical significance. The machine learning analyses were performed on Ddsv4-series Azure Virtual Machines, equipped with 32 vCPUs and a memory capacity of 128 GiB.
RESULTS: In the model where clinical and imaging data were jointly assessed, the k-nearest neighbor (KNN) model demonstrated the highest performance, achieving values of 0.813 AUC and 0.854 Accuracy. For KNN Model, the best predictors for kidney function loss were as follows: Neutrophil/Lymphocyte (1.0577), abnormal bladder in ultrasound (1.054), Vesicoureteral reflux (0.901), Ferritin (0.898), Neutrophil/Albumin (0.678), Platelet/Lymphocyte (0.619), increased detrusor leakage pressure (0.435), Age (0.3505), decreased Bladder Capacity in urodynamics (0.3009), and WBC (0.266).
DISCUSSION AND CONCLUSION: Based on our findings, initial patient evaluation through basic blood and urine tests, ultrasonography, urodynamic study, and VCUG is crucial for identifying risk factors and preventing renal damage. CBC-derived inflammatory biomarkers offer cost-effective and accessible alternatives to other radiological tools in primary care settings. These machine learning models may hold clinical relevance in pre-clinical or resource-limited hospitals, guiding clinicians in implementing preventative measures.

INTRODUCTION: Dental caries is one of the most common chronic diseases that affect oral health. Brushing the teeth regularly is considered the most effective method of preventing dental caries. Providing this motivation and ensuring this habit can be difficult, especially in children. Novel methods for gaining tooth brushing habits are attractive. This study aimed to investigate a mobile application's effectiveness in improving oral health in children.
METHODS: Two hundred children between 5-12 years old who applied to the Department of Pedodontics, Faculty of Dentistry, University of ……, for routine dental examination were included in the study after ethical approval. Children who have any systemic, physical, and/or mental disorders and have emergency dental complaints were not included in the study. A structured questionnaire including the child's oral hygiene habits was completed by the parents. In the clinical examination, caries indices (DMFT/dmft and DMFS/dmfs), dental plaque, and gingival index scores of the children were recorded. Following the clinical examination, the “Brush DJ” mobile application was introduced to the children and their parents. After the first examination, the children were referred for their dental treatment and all were recalled after three months. At the recall examination, a second questionnaire was completed by the parents. Dental caries index (DMFT/dmft and DMFS/dmfs) scores, dental plaque, and gingival index scores were recorded again. A parental satisfaction questionnaire was administered to the parents. Statistical analysis was carried out using SPSS 25.0 software program. The compliance of the parameters with normal distribution was evaluated with the Shapiro-Wilk test. Mann-Whitney U and Kruskal-Wallis tests were used for comparisons between the groups. For intra-group comparisons Wilcoxon test, chi-square test, Fisher's exact test, and t-test were used. The results were evaluated at a 95% confidence interval and a statistical significance level of p<0.05.
RESULTS: It was determined that 56.5% (n=113) of the children participating in the study were girls and 43.5% (n=87) were boys. One hundred seventy-one of the 200 children were reported using the mobile application. It was observed that the tooth brushing frequency was increased in 97 children with the use of the mobile application. It was also observed that the tooth brushing duration was increased in 143 of 171 children with the use of the application. Initial plaque and gingival index scores (1.59±0.40; 1.18±0.40, respectively) were statistically higher than the recall examination scores (1.29±0.46; 1.09±0.49 respectively) (p<0.05). Based on the parental satisfaction survey data, it was observed that the use of the mobile app was effective in gaining tooth brushing habits, and brushing became regular and enjoyable in all children.
DISCUSSION AND CONCLUSION: It has been concluded that using the "Brush DJ" mobile tooth brushing app is effective in gaining oral hygiene habits and making it a regular behavior in children. Long-term follow-up studies with a larger number of subjects comparing different oral hygiene education methods will be planned.

INTRODUCTION: Although indirect hyperbilirubinemia is the most common neonatal problem in term newborns, we have rarely observed it in newborns with some inherited metabolic diseases. Therefore, we aimed to compare the frequency of indirect hyperbilirubinemia in newborns with these diagnoses and compare it with healthy newborns.
METHODS: In the study group, term newborns with inherited metabolic diseases characterized by metabolic acidosis and/or hyperammonemia were included retrospectively and prospectively between January 1, 2001, and December 31, 2014. Healthy-term newborn infants were prospectively included in the control group.
RESULTS: In the study group (n=106), 63.2% of the patients had organic acidemia, 20.8% urea cycle disorders, 4.7% mitochondrial disease, 5.7% fatty acid oxidation disorders, and 5.7% other diseases while the control group included 126 healthy term newborns. Mean serum indirect bilirubin levels were significantly lower in the study group compared to the control group (5.8±5.4 mg/dl vs13.9±4.1 mg/dl, p<0.00, respectively). The frequency of phototherapy was 11.3% in the study group and 23.8% in the control group (p<0.05). While the incidence of jaundice was significantly lower in organic acidemia, urea cycle disorder, and fatty acid oxidation disorders (p<0.05), there was no difference in the mitochondrial disease compared to the control group (p>0.05).
DISCUSSION AND CONCLUSION: This is the first epidemiological study that determined a very low incidence of indirect hyperbilirubinaemia in newborns with inherited metabolic diseases characterized by metabolic acidosis and/or hyperammonemia. The exact pathophysiological mechanism of this strikingly low incidence of indirect hyperbilirubinaemia in these newborns should be investigated with prospective biochemical, enzymatic, molecular, and genetic studies.

INTRODUCTION: The goal of this study was to investigate the expression levels of micro RNAs (miRNAs) (miR-196b, miR-10a, miR-31-5p, and miR-338-3p) that regulate genes involved in the proliferation and function of cells functioning in inflammatory processes in Celiac patients' blood and tissue samples. Celiac disease (CD) is an inflammatory disease that affects people who are genetically predisposed to gluten consumption. The only treatment for this disease is a gluten-free diet.
METHODS: The miRNA expressions were determined in blood and tissue samples from 12 pediatric patients with CD and from 8 healthy children using quantitative real-time PCR (qRT-PCR) and SybrGreen dye. The gene expression levels of miRNAs such as miR-196b, miR-10a, miR-338-3p, and miR-31-5p was compared between two groups.
RESULTS: There was a significant difference only in miR-10a gene expression levels between control and patient blood samples. The greatest difference in between tissue and blood samples within the CD group were found in expression of miR-31-5p and miR-338-3p. It was seen that the patients' HLA tissue type was not associated miRNA expression profiles. Besides, there was no significant correlation between Marsh classification and gene expression levels.
DISCUSSION AND CONCLUSION: The significantly low level of miR-10a may be related to the CD due to its effect on the immune response. However, miR-10a may have a potential for the non-invasive diagnosis of CD.

INTRODUCTION: Hypothermia is a common and serious problem during anesthesia. Because the ratio of skin surface area to body volume is higher in neonates than in adults, heat loss and ultimately hypothermia are more common in the intraoperative period. This study aims to determine the incidence and independent risk factors of hypothermia in the neonatal period.
METHODS: This retrospective observational cohort study included 63 patients who underwent neonatal surgery within one year. Hypothermia (HT) was defined as body temperature <36 °C and patients were divided into two groups: Group I (body temperature ˂36°C) and Group II (≥36°C). Demographic data, ASA score, operative diagnosis, duration of surgery and anesthesia, amount of fluid, inotrope and vasopressor therapy, amount of bleeding, amount of blood transfusion, preoperative and postoperative temperature, and heating methods of the patients were recorded.
RESULTS: The median age of the patients was 5 days (0-28 days) and their mean weight was 2792±782 grams. The esophageal method was used for temperature monitoring in 88.9% (56 patients) and the rectal method in 10.1% (7 patients). Hypothermia developed in 54% of all patients. Caps and socks were used to prevent hypothermia in 96.8% of patients, forced-air warming blankets in 95.2%, warming gel mattresses in 27%, and fluid and blood warming devices in 17.5%. In the logistic regression model, only operating room temperature was identified as an independent risk factor associated with neonatal hypothermia.
DISCUSSION AND CONCLUSION: Despite the use of active and passive warming methods, the incidence of hypothermia in the neonatal period was found to be high. Cold operating rooms were found to be the only independent factor associated with neonatal hypothermia.

INTRODUCTION: Premature ventricular contractions are a prevalent arrhythmia in children, with the majority of cases exhibiting normal cardiac function and no anatomical abnormalities. The objective of this study was to assess the clinical course of premature ventricular contractions in children who do not have any structural heart abnormalities.
METHODS: In this study, 60 patients younger than 18 years of age who were diagnosed with premature ventricular contractions in our clinic and who did not have any structural cardiac abnormalities on echocardiography were included. Demographic data, 12-channel standard resting electrocardiography, 24-hour Holter electrocardiography monitoring, and exercise test records of the patients were retrospectively analyzed from the follow-up files.
RESULTS: The study assessed 60 patients diagnosed with premature ventricular contraction, of which 55% were male. Out of the total number of patients, 28 (46.7%) were asymptomatic, whereas the most often reported symptom was palpitations. Additionally, it was stated that five children had syncope. Medical treatment was given to 40 patients (66.7%). Beta-blockers (52.2 %)were the most commonly prescribed drugs. Malignant arrhythmia or sudden cardiac death did not occur in any of the patients throughout the follow-up period. According to all patients' follow-up Holter electrocardiography results, a 61.6% decrease in premature ventricular contraction rates was observed. Complete recovery was observed in 16.7 % of patients.
DISCUSSION AND CONCLUSION: Premature ventricular contractions in children generally have a good prognosis. Most cases are asymptomatic, and regardless of the origin, spontaneous regression rates over time are quite substantial. Determining the origin may help predict the prognosis.

INTRODUCTION: The autonomic nervous system has a direct or indirect effect on motor speech and its development. The results of studies evaluating autonomic functions in stuttering individuals show that research is needed in different age groups. In this study, the aim was to evaluate autonomic function by analysing heart rate variability (HRV) in children with stutter.
METHODS: In the study, a total of 41 stutterers (11 females, 30 males) between the ages of 6-18 years, diagnosed with stuttering were evaluated. The control (healthy/normal) group comprised 41 individuals (12 female, 29 male) between the ages of 6-18 years, who did not have any speech disorder complaints and no family history. The level of stuttering was designated by applying the Turkish version of the Stuttering Severity Instrument Fourth Edition (SSI-4TR) to the diagnosed group. All cases were tested for HRV and analysed using the 24-hour Holter electrocardiography recording method. The correlation between stuttering severity and HRV parameters of the stuttering group, and the correlation of HRV parameters in both groups were examined.
RESULTS: A positive significant correlation was found between secondary behaviours in the stuttering group and standard deviation of the mean NN intervals in 5-minute recordings (SDANN) of the HRV test. Additionally, when the correlation of HRV parameters between groups was examined, the SDANN parameter in the stuttering group was statistically significantly higher (p<0.05). The other parameters were not statistically significantly different between the groups.
DISCUSSION AND CONCLUSION: In this study, when the HRV parameters of stuttering children were compared with non-stuttering children, no significant differences were found to prove autonomic nervous system dysregulation.

INTRODUCTION: Premature adrenarche has been associated with metabolic and polycystic ovarian syndrome and, thus, with an increased risk for type 2 diabetes and cardiovascular diseases in later life. Mean platelet volume, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio are parameters used to show inflammation. This study planned to evaluate systemic inflammation in children with premature adrenarche using mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR).
METHODS: The study included 40 female patients diagnosed with PA and 40 healthy female individuals as a control group, retrospectively. The patient and control groups' MPV, NLR, and PLR values were compared.
RESULTS: The mean age of the PA group was 7.18±0.66, and the mean age of the control group was 7.09±1.08. The mean MPV and PDW values were significantly higher than those in the control group (10.25±0.87 vs 9.52±0.79, p<0.001 and 15.43±1.31 vs 14.35±1.84, p=0.04, respectively). However, in the PA group, NLR and PLR were not significantly different from the values in the control group (p>0.05). The results of the multivariate logistic regression analysis revealed that the mean platelet volume [Odds ratio (OR); 95% confidence interval (CI) 0.331 (0.174-0.630); p=0.001], and platelet distribution width [OR; 95% CI 0.612 (0.425-0.884); p=0.008] were associated with PA in the patient group.
DISCUSSION AND CONCLUSION: Our results demonstrated that premature adrenarche patients had significantly higher mean platelet volume levels and platelet distribution width than healthy controls. Hence, recognition of early markers in adolescence might reveal primary pathogenetic alterations predictive of the later development of PCOS and metabolic syndrome.

INTRODUCTION: The children of healthcare workers(HCWs) constitute a highly vulnerable group to anxiety disorders during the COVID-19 pandemic. This study aimed to compare the prevalence and severity of anxiety between children of HCWs and non-HCWs while identifying factors contributing to anxiety.
METHODS: A cross-sectional study was conducted involving 334 children aged between 6 and 17 years to assess their anxiety levels. The risk factors related to anxiety were determined using binary logistic regression analysis.
RESULTS: Significant risk factors for anxiety included having parents who were HCWs, having parents with psychiatric disorders, changes in household members, and following news updates (p: 0.045, 0.022, 0.021, and 0.024, respectively). Children of HCWs working in COVID clinics exhibited a higher prevalence of moderate to severe anxiety than other groups (p: 0.036). Additionally, prolonged screen time and changes in sleep duration were more common in children with moderate to severe anxiety.
DISCUSSION AND CONCLUSION: The results suggest that children of HCWs may be more prone to anxiety symptoms than children of parents in other professions.

INTRODUCTION: Childhood cancers are life-threatening diseases that are universally distressing and potentially traumatic for children and their families at diagnosis, treatment, and beyond.
METHODS: Thirty-nine child patients between the ages of 0-18 receiving treatment in a pediatric oncology hospital for various pediatric cancers consenting to participate in the study were recruited. The participants were assessed with Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS-PL-DSM5) for ages 6-18 by a trained and certified child and adolescent psychiatrist. Clinical assessments of patients aged 0-5 years were completed by a trained child and adolescent psychiatrist in agreement with the DSM-5 and standard principles of the psychiatric interview with the pediatric population. The previous and current psychiatric diagnoses of the participants were recorded. The Quality of Life Scale for Children (PedsQL) was administered to the participants and their caregivers in the first interview and at the 6th month of follow-up.
RESULTS: While no significant differences in the quality of life of children with a novel diagnosis of pediatric cancer and children with cancer recurrence/ongoing treatment were observed per their own reports, the parents reported significant improvement in the quality of life of their children with a novel cancer diagnosis after six months. The parents’ and their children’s reports were highly correlated, and this association remained significant in multiple linear regression analyses for both the initial interview and the follow-up.
DISCUSSION AND CONCLUSION: The parents’ reports of their children’s quality of life appear to be reliable in the clinical setting to accurately predict the children’s quality of life.