INTRODUCTION: We aimed to determine the frequency of autoantibody (ANA, pANCA, ASCA, PAb, GAb) positivities in children with the complaint of chronic diarrhea and inflammatory bowel disease (IBD). We also purposed explore the role of these autoantibodies in the differential diagnosis of IBD.
METHODS: In our study, serum samples of 51 patients with the complaint of chronic diarrhea and 35 healthy controls were analyzed. Clinical and laboratory data at the time of serum sampling were collected and differential diagnosis was made as the results of performed tests were recorded. For all patients, ANA, pANCA, ASCA, GAb, PAb positivities were evaluated by indirect immunofluorescence. Chronic diarrhea group was divided into two groups as IBD and non-IBD group.
RESULTS: In chronic diarrhea group, 11 (21.6%) patients had ANA, 3 (5.9%) had pANCA, 1 (2%) had PAb, 1 (2%) had GAb, 1 (2%) had ASCA positivity. From the 35 cases of the control group, 8 (22.9%) had ANA, 7 (20%) had ASCA positivity. In the control group, ASCA was found to be high (p=0.007). Six cases were diagnosed as IBD; 1 (16.7%) had ANA, 1 (16.7%) had pANCA, 1 (2%) had GAb, 1 (2%) had ASCA positivity. ASCA and GAb positivities were significantly more frequent in the IBD group (p=0.006, p=0.006, respectively).
DISCUSSION AND CONCLUSION: ASCA was determined to be significantly higher in the control group. High positivity in the control group showed that the percentage of nonspecific positivity may be high for this test. Anti-saccharomyces cerevisiae antibody ASCA and GAb of patients with diagnosis of IBD were found significantly higher. The serologic tests which are depending on pANCA, ASCA, PAb, GAb can be supportive of diagnosis and differential diagnosis of IBD. Autoantibodies in IBD may be used as a supportive diagnostic tool in selected cases, rather than in the diagnosis of IBD as a routine practice.

INTRODUCTION: Oral care is a standard practice used to reduce ventilator-associated pneumonia in intensive care units and in the treatment of chemotherapy-induced oral mucositis. This research examines the oral care practices of pediatric nurses.
METHODS: This is a descriptive and cross-sectional study. Its sample was composed of 90 nurses working in the pediatric services of a university hospital in western Turkey from March to December 2016. The research data was collected using a sociodemographic data form and the Oral Care Practices Information Form.
RESULTS: Of the nurses, 62.2% had received oral care education. There were statistical differences in oral diagnosis by clinic, work shift, doing an oral diagnosis before each oral care practice, oral care frequency and number of patients with impaired oral mucosal integrity (p<.05).
DISCUSSION AND CONCLUSION: Nurses need training about oral care that is current with the literature to manage oral care practices more effectively.

INTRODUCTION: In this study, the correlation of faecal calprotectin (FC) levels with endoscopic and histopathological findings was evaluated in children who underwent upper gastrointestinal system (UGIS) endoscopy.
METHODS: The patients aged 4–18 years admitted to our endoscopy unit were included in the study. Faecal samples were collected on the day participants presented for the study. A calprotectin assay was performed on faecal samples using enzyme-linked immunosorbent assay kits. FC levels were compared with those of children with normal histopathology.
RESULTS: FC levels of 112 children included in the study were evaluated according to their histopathological diagnoses. FC levels were not found to be significantly higher than those in healthy children. No significant difference was found in FC levels of participants with and without signs of inflammation in the esophagus, stomach and duodenum. In participants with chronic gastritis, Helicobacter pylori gastritis, reflux esophagitis and celiac disease, FC levels above cut-off values were observed. However, no significant difference was found in participants with normal endoscopic findings. There was no significant difference in FC levels between similar regions of the UGIS with and without signs of inflammation. A positive correlation was discovered between eosinophil counts and FC levels in patients with Helicobacter pylori gastritis and esophagitis.
DISCUSSION AND CONCLUSION: The diagnostic value of FC levels in UGIS diseases was not sufficient to establish a definitive diagnosis in our study.

INTRODUCTION: Acute appendicitis is the condition that most commonly requires a surgical procedure in children presented with acute abdominal pain to the emergency department. Alvarado and Pediatric Appendicitis Scores (PAS) are the most widely used scoring systems in the diagnosis of acute appendicitis in children. This study aims to evaluate the effectiveness of Alvarado and PAS scores in the diagnosis of acute appendicitis in children.
METHODS: One hundred and two patients aged 3-17 years, who admitted to the pediatric emergency department with acute abdominal pain and had a clinical suspicion of acute appendicitis were included in the retrospective study. The demographic characteristics, laboratory and radiological findings, and Alvarado and PAS scores were obtained from the records of the patients, retrospectively. According to the results of pathology, n = 48 patients for acute appendicitis group (AA) and n = 54 patients for non-acute appendicitis group (non-AA) have been found. AA and non-AA groups were compared in terms of PAS and Alvarado scores.
RESULTS: The mean age of 102 patients was 9.38±3.90, and 62 (60.85%) of them were male. The median PAS score was 7.79±1.2 (8) and 5.52±1.34 (6), and the median Alvarado score was 7.98±1.14 (8) and 5.89±1.53 (6) in AA and N-AA groups, respectively (p<0.001, p<0.001). For the PAS, the cut-off score was >7 with sensitivity 66.7%, specificity 94.4%, positive predictive value (PPV) 91.4%, and negative predictive value (NPV) 76.1% (p<0,001). For the Alvarado score, the cut-off was >7, with sensitivity 77.1%, specificity 85.2%, PPV 82.2%, and NPV 80.7% (p<0,001).

DISCUSSION AND CONCLUSION: Although both PAS and Alvarado scores provide useful diagnostic information in patients suspected of acute appendicitis, none of them is enough diagnose acute appendicitis alone.

INTRODUCTION: Although breastfeeding is common in Turkey, the proportion of breastfed infants in the first hour after birth is not the desired level. The aim of the study was to explore the difficulties in the early initiation of breastfeeding encountered by maternity nurses.
METHODS: Phenomenology model of the qualitative research design was used in the study. The data were collected by in-depth interview method. Content analysis was used to analyze the data, and findings were categorized into themes.
RESULTS: Barriers related to the early initiation of breastfeeding was into four main themes: delivery, culture, hospital environment and health care staff. Delivery mode, pain and the perception of insufficient milk were included theme of delivery. Theme of culture was consist of traditional practices, patriarchal family structure, and language sub-themes. Theme of the hospital environment was involved lack of privacy and chaos. Finally understaffing, insufficient knowledge and employee turn rates were inclusived health care staff theme.
DISCUSSION AND CONCLUSION: Interviewing about barriers of the early initiation breastfeeding with nurses provided understanding deeper this critical period. The findings suggest that delivery related factors, cultural and environmental elements were obstacles in initiating early breastfeeding. To support and counseling given in the early postpartum period is important for the initiation of breastfeeding. To eliminate the barriers in this process it is recommended to improve the education and health care policy.

INTRODUCTION: This study was carried out to analyze the effect of fatigue-reducing interventions on fatigue levels of children with cancer.
METHODS: The quantitative studies carried out in the literature related to the interventions to reduce fatigue in children with cancer were investigated. No time limits were defined for the literature review; instead, all available studies published until February 2019 were reviewed. Data were collected from Pubmed, Cochrane, EBSCO Host, ScienceDirect, Embase/Elsevier, and Web of Science databases. The keywords “child”, “cancer”, and “fatigue” were used during the search process. The effect sizes and group comparisons of each study were analyzed using The Comprehensive Meta-Analysis statistical software package for the meta-analysis.
RESULTS: The total sampling number of the five studies included in the study was 500. As a result of the heterogeneity test, it was determined that the studies involving interventions to reduce the fatigue of children with cancer had heterogeneous characteristics. The result of publication bias test found no publication bias. The average effect size at 95% significance level was calculated as 1.452 for Li et al. (2018) study, 0.560 for Ramezani et al. (2018) study, 7.606 for Kudubeş et al. (2019) study, -0.995 for Lam et al. (2018) study, and 0.544 for Viera et al. (2015) study.
DISCUSSION AND CONCLUSION: In this study, fatigue-reducing interventions were found to affect fatigue level.

INTRODUCTION: The aim of this study was to compare the levels of iron, ferritin levels in children with ADHD and ADHD-NOS and to assess the relationship between ADHD symptom severity, anxiety symptom severity and iron, ferritin levels.
METHODS: The study was planned as a cross-sectional, retrospective study. The records of patients who applied to the study center in between January 2012 and January 2013 were screened and 205 ADHD and ADHD-NOS cases’ records were evaluated. Patients were diagnosed clinically according to DSM-IV-TR criteria. ADHD symptom severity was assessed by Turgay DSM-IV–Based Child and Adolescent Behavior Disorders Screening and Rating Scale. Anxiety symptom severity was assessed by The Screen for Anxiety Related Emotional Disorders (SCARED).
RESULTS: Among the whole sample, 99 (48.3%) patients had ADHD and 106 (51.7%) had ADHD-NOS. The average age of the children in the ADHD group was 10.88 ± 3.02 years, while that of the children in the ADHD-NOS group was 9.93±2.49 years. Iron and ferritin were detected in 81 of 205 patients participating in the study. No statistically significant difference was determined between two groups in terms of iron, ferritin levels (p> 0.05). Statistically significant negative correlations between ADHD hyperactivity symptom severity and iron levels, and ADHD attention deficit symptom severity and ferritin levels were found. Ferritin levels correlated statistically with the total number of psychiatric diagnoses in children.
DISCUSSION AND CONCLUSION: Iron and ferritin levels may be differentially affected in children with ADHD. Our results should be supported with future studies.

INTRODUCTION: The aims of this study were to explore the infantile colic in infants from 1-6 months of age, and the mother’s practices to eliminate colic and the relationships between infantile colic scores and sample characteristics.
METHODS: This descriptive study included 232 mothers of infants who were admitted to the hospital for child monitoring at two university hospitals in the Aegean region. Information on demographics, colic characteristics, and practices of mothers to eliminate colic was collected.
RESULTS: According to reports of the mothers, 67.2% of the infants had colic, and 28.5% of the infants met all of the Wessel criteria. The average scale score of infantile colic was 65.2±12.6. To eliminate the colic, 67.6% of the mothers held their infants on their lap, 68.7% rocked them, 63.2% changed the position of their infants, 57.4% massaged the infants’ bellies, and 37.1% stated that they used a warm application.
DISCUSSION AND CONCLUSION: One out of every three-four babies in the study met the diagnosis of infantile colic according to Wessel criteria’s. The average score obtained from the infantile colic scale is quite high. Mothers usually use behavioral methods to prevent and reduce colic symptoms, they also use pharmacological and traditional methods in this study.

INTRODUCTION: Vesicoureteral reflux (VUR) and urinary tract infection (UTI) are common problem in children. Our goal is to use different models for the clinical decision of differential diagnosis of VUR and UTI in children.
METHODS: This was a retrospective cross-sectional study enrolled 611 pediatric patients. Detailed information for the patients was obtained from hospital records and patient files. Three models including different variables were evaluated via artificial neural network for differential diagnosis of VUR and recurrent UTI. Clinical findings were included in Model 1, clinical and laboratory findings were included in Model 2, and clinical, laboratory and detailed urinary USG findings were included in Model 3. Cross-validation technique was used to evaluate predictive models by partitioning the original sample into a training set to train the model, and a test set to evaluate it.
RESULTS: Of the 611 children, 425 (69.6%) had VUR and 186 (30.4%) had UTI. Sensitivity of Model 1 and Model 2 were 0.682 and 0.856, respectively. Also, Model 3 showed the best performance and high sensitivity with 0.939 for differential diagnosis.
DISCUSSION AND CONCLUSION: Differential diagnosis between VUR and UTI in children can predict with using clinical, laboratory and USG variables via Artificial Neural Network. The model 3 which was including clinical, laboratory and USG variables together is shown the highest performance and sensitivity.

INTRODUCTION: Childhood obesity is associated with psychosocial and medical comorbidities. While children affected by obesity have significantly lower self-esteem than children with normal weight, families have an important role in the development of body image and body dissatisfaction. It is aimed to examine the relationship between body esteem of obese children with the parents’ body esteem and their weight status.
METHODS: The study was carried out in Ankara, capital city of Turkey, and was rolled out to 9 and 11 years old children and their parents in 46 schools (2066 parent-child dyad). The data were collected by using parent and children questionnaires. Anthropometric measurements were conducted by the project team. Four different logistic regression models were performed seperately; parental body esteem and BMI for fathers and sons, fathers and daughters, mothers and sons, and mothers and daughters.
RESULTS: Mothers obesity was associated with their daughters’ and their sons’ obesity status. Fathers’ obesity status appears to be positively associated with their daughters’ status only but not their sons’. Body esteem of the obese boys was adversely affected only by their BMI in the models with fathers and mothers. Compared to boys, girls adversely were affected by their own BMI, their body esteem, and their mothers’ and fathers’ body esteem.
DISCUSSION AND CONCLUSION: Strong association between both mothers and fathers role in the body esteem of daughters was found. Further research should be conducted to better understand the socio-cultural dynamics that may be unique to the development of childhood obesity.

INTRODUCTION: The purpose of this study is to evaluate effectiveness of a bullying prevention program, developed using an integrated approach, in the short-term and long-term, in primary schools.
METHODS: This study was made using quasi-experimental control group pretest-posttest design; one of the experimental research methods.; one of the experimental research methods. The study comprised 113 students receiving 6th grade education at 2 randomly selected schools in the counties of Konak and Karabağlar, in Izmir, Turkey. The data were gathered using the Demographic Data Questionnaire and The Peer Bully Adolescent Form. In the experimental group, the students attended a bullying prevention program and their parents and teachers attended seminars for 5 weeks. The data were collected before the training, 2 weeks after the training, at the 6th month, and at 1 year after the training. In the analysis of the data, ANOVA was used in repetitive measurements and t-tests were used in dependent and independent groups with Bonferroni correction.
RESULTS: A statistically significant difference was found among the control and experimental group victim subdimension point averages in the group (F = 68.28,p = 0.001), time (F = 7.39,p = 0.001), and group-time (F = 14.04,p = 0.001). A statistically significant difference was found between the control and experimental group bully subdimension point averages in the group (F = 7.63,p = 0.007) and time (F = 20.21, p = 0.001). No significant difference was determined in the group and time (F = 1.10, p = 0.349) interaction.
DISCUSSION AND CONCLUSION: It was found that the bullying prevention program based on the Social Cognitive Theory is effective after the training in decreasing the rate of students that are bullies or are victims of bullying, and this effect continues in victims in the 6th month and 1st year; however, it becomes nonsignificant in the bullies in the 1st year.

INTRODUCTION: We aimed to investigate the rate of brain death (BD) determinations and organ donations in our tertiary paediatric intensive care unit (PICU), and to report the data on demographic pattern and supplementary descriptive data on the BD declarations.
METHODS: Age and gender of the cases were recorded, and also clinical conditions causing BD were grouped and recorded under six headings including; traumatic brain injury (TBI), brain neoplasm, cardiac arrest, intracranial haemorrhage, central nervous system infection and other causes. The time from the PICU admission to the diagnosis of BD, the time from suspicion of BD to final diagnosis, duration of survival after diagnosis of BD, confirmatory tests used, whether apnea test is performed, and inherent alterations (diabetes insipidus, hyperglycaemia, hypothermia) that occurred following diagnosis of BD were recorded. Organ donation rate, the name and number of organs harvested were determined.
RESULTS: Twenty-three patients were diagnosed with BD.The mean age of the patients diagnosed with BD was 5.5 ± 4.9 years. The causative mechanism leading to BD was classified into six groups, out of which the most common diagnosis was TBI with a rate of 39.3%. The meantime from PICU admission to BD diagnosis was 5.7 ± 5.5 days. The time perion from suspicion of BD to the final diagnosis was 1.6 ± 0.7 days and the meantime to develop cardiac arrest after diagnosis of BD was 13.1 ± 21.6 days in non-donor cases. The most commonly used confirmation test was brain computed tomography angiography with 82.6%. The most common alteration that follow BD was diabetes insipidus (56.5%). Four patients became organ donors (17.4%).
DISCUSSION AND CONCLUSION: Patients with severe TBI are the most likely candidates for BD declaration and suitable for organ donation for children in need. Early diagnosis and good donor care are of great importance, especially for paediatric patients waiting for organ transplants.

INTRODUCTION: In this study, we aimed to compare the levels of vitamin B12 and folate in children with Attention Deficit and Hyperactivity Disorder and Attention Deficit and Hyperactivity Disorder-Not Otherwise
METHODS: The study was planned as a cross-sectional, retrospective study. Patients were recruited between January 2012 and January 2013 and 205 cases’ records were evaluated. Both groups were compared according to vitamin B12 and folate levels. Symptom severity was evaluated by Turgay DSM-IV–Based Child and Adolescent Behavior Disorders Screening and Rating Scale. Anxiety symptom severity was assessed by The Screen for Anxiety Related Emotional Disorders.
RESULTS: The average age of the children in the Attention Deficit and Hyperactivity Disorder group was 10.88±3.02 (n=99) years, and the average age of the children in the and Attention Deficit and Hyperactivity Disorder-Not Otherwise Specified group 9.93±2.49 (n=106) years. There was no statistically significant difference between two groups in terms of Vitamin B12 level and folate (p> 0.05). A statistically significant negative correlation between the total number of diagnoses of a child and vitamin B12 levels was found. Folate levels correlated significantly with anxiety total scores generalized anxiety subscale.
DISCUSSION AND CONCLUSION: Vitamin B 12 levels may be affected in children with impairing Attention Deficit and Hyperactivity Disorder symptoms and increased comorbidities. The results of the study should be supported by future studies.

Eosinophilic gastroenteropathies are rare disorders. 18-year-old girl presents to the hospital abdominal pain and distension. Abdominal tenderness and grade 2 ascite, serious peripheral eosinophilia and high IgE level were found. Laparoscopic antrum biopsy showed subserosal eosinophilic infiltration. Eosinophilic gastroenteropathy was thought, diet elimination was given, any steroid treatment wasn’t used.