Rotavirus infections in children in Turkey: A systematic review.

We aimed to describe rotavirus epidemiology and clinical findings including extraintestinal manifestations in a setting that has yet to introduce rotavirus vaccines in the national immunization program. A literature search was performed by using the key words "Turkey" and "rotavirus." Ninety-eight studies published between 1987 and 2016 including epidemiological, clinical, and genotypical data at least 1 year duration were included. There were a total of 117 741 children with diarrhea and 26 566 rotavirus gastroenteritis with a median detection rate 31.8% (95% CI, 31.3-32.4) under 5 years of age. The rate of dehydration was 47% (95% CI, 23.4-91.6). There were 328 cases reported to be presenting with a various complication related to rotavirus in 2750 children in eight studies. The overall complication rate was 11.7% (95% CI, 10.7-12.9). The cumulative incidence of the most common genotypical combinations circulating worldwide was only 59.7% (G9[P8], 25%; G1[P8], 22%; G2[P4], 5.6%; G3[P8], 2.6%; G4[P8], 4.5%) whereas mixed, untypeable, and other genotypes were 2.4%, 15%, and 22.9% respectively. Our results point out the importance of rotavirus vaccination by presenting that rotavirus may cause severe complications besides severe gastroenteritis. The role of strain diversity in the variability of clinical presentations of rotavirus infections needs to be further investigated.

The Scintigraphic Findings of Gastroesophageal Reflux in Children is Related to Body Weight?

BACKGROUND: Gastroesophageal reflux disease (GERD) is the most common cause of children admissions to pediatric gastroenterology unit and affects about 30% of pediatric population. Body weight and height percentiles of children with GERD and their relationship between presence and the severity of reflux on scintigraphic images were studied. METHODS: Patients who underwent reflux scintigraphy between 2005 - 2012 were retrospectively reviewed. Among 200 patients, 49 patients were involved that their ages were ranging from 0 to 18 years old and body weight and height percentiles were recorded. Accurately 37 MBq (1 mCi) 99mTc-MAA in 100 - 150 mL of milk was ingested by the patient. Presence, number, duration and level of reflux were evaluated on the dynamic images. Presences of reflux within last ten minute were also recorded. Region-of-interests were drawn on esophagus and stomach and reflux ratio (RR) was calculated. RESULTS: The ratio of the presence of reflux which occurred within the last ten minutes was significantly higher in children with low body weight percentile. High-level reflux frequency was higher in these children than in normal's. Presence of reflux which occurred within the last ten minutes was related with low body weight percentile. CONCLUSIONS: If reflux is shown within the last ten minutes and there is high level of reflux, the clinician should be warned about possible low body weight percentile in the future and scintigraphic study should be a guide or a reference for the assessment of more effective treatment methods.

Vitamin D status in children with attention-deficit-hyperactivity disorder.

BACKGROUND: Attention-deficit-hyperactivity disorder (ADHD), one of the most common psychiatric disorders of childhood, has an early onset, affecting 2-18% of children worldwide. The etiopathogenesis of ADHD is obscure. In recent studies, a low level of vitamin D has been found in association with many disorders as well as in neuropsychiatric diseases. The aim of this study was therefore to investigate serum vitamin D level in pediatric ADHD patients. METHODS: A total of 60 ADHD patients and 30 healthy controls were included in the study. The age of both groups was in the 7-18-year-old range. Serum 25-OH-vitamin D, calcium, phosphorus and alkaline phosphatase were investigated. RESULTS: Serum 25-OH-vitamin D was found to be significantly lower in children and adolescents with ADHD compared to healthy controls, and no significant differences were found between the groups in terms of other variables. 25-OH-vitamin D level in the ADHD group and control group was, respectively, 20.9 ± 19.4 ng/mL and 34.9 ± 15.4 ng/mL (P = 0.001). CONCLUSION: There is an association between lower 25-OH-vitamin D concentration and ADHD in childhood and adolescence. To the authors' knowledge this is the first study to investigate the relationship between vitamin D and ADHD in children.

The relationship between internet addiction and body mass index in Turkish adolescents.

The purpose of this study was to investigate Internet use patterns and Internet addiction among adolescents and to examine the correlation between Internet addiction and eating attitudes and body mass index (BMI). The study was conducted among 1,938 students, aged between 14 and 18 years. The Internet Addiction Test (IAT), the Eating Attitudes Test (EAT), and a sociodemographic query form were used to collect data. According to the IAT, 12.4% of the study sample met the criteria for Internet addiction. A significant positive correlation between BMI and the IAT (r=0.307; p<0.01) and weekly Internet use (r=0.215; p<0.01) was found. Nine students with Internet addiction (3.8%) and 90 with average Internet use (5.3%) were found to have a possible eating disorder (p>0.05). No relationship was found between the EAT and the IAT and duration of weekly Internet use. Linear regression analysis revealed a significant independent association of the IAT with BMI (r=0.235; p<0.001). These results indicate an association between Internet addiction and BMI. Further studies are needed to describe the causality of this association.

Case of isolated thrombocytopenia due to cobalamin deficiency.

The most common form of isolated thrombocytopenia is idiopathic thrombocytopenic purpura (ITP) in childhood. Hence, pediatricians consider a possible diagnosis of ITP in patients with isolated thrombocytopenia who are admitted to hospital with complaints of skin findings such as petechiae, purpura, and ecchymosis. It is well known that cobalamin deficiency may also cause thrombocytopenia together with anemia and leukopenia in children. However, isolated thrombocytopenia due to cobalamin deficiency has rarely been reported in literature. In this case report, we present a 7-year-old female patient with isolated thrombocytopenia that was improved by cyanocobalamin therapy.

Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study.

AIM: Mean platelet volume (MPV) in the healthy population has not been studied before. Therefore, the aim of the study was to measure MPV in normal subjects in a large cohort of Turkish adults. METHODS: A total of 2298 subjects with a mean age of 50 (age range 18 to 92) were interviewed. Subjects who had smoking habit, diabetes, hypertension, coronary artery disease, dyslipidemia, chronic obstructive pulmonary disease, cancer, chronic use of any drugs including antiplatelets, heavy drinkers, metabolic syndrome, ejection fraction <55%, creatinine >1.4 in men and >1.1 in women, abnormal liver function tests and an abnormal TSH were excluded in a in a stepwise manner. Complete blood counts were done on the same day within 6 hours by a CELL-DYN 3700 SL analyzer (Abbott Diagnostics). RESULTS: Three hundred twenty-six participants (204 females (63%) and 122 males (37%) with a mean age of 41 ± 16) constituted the final healthy cohort. Mean MPV of the cohort was 8.9 ± 1.4 fL. There was no significant difference among age groups regarding MPV. CONCLUSION: Ninety-five percent of the individuals had a MPV between 7.2 and 11.7 fL. A patient having a MPV beyond this range should be evaluated carefully especially for occlusive arterial diseases.