What do children aged 12-18 think about COVID-19 vaccines?

OBJECTIVES: Vaccines are crucial for preventing the spread of the coronavirus pandemic and controlling its effects. We aimed to determine the desire of children aged 12-18 to be vaccinated with the current vaccines, the reasons for wanting or not wanting to be vaccinated, where they had learned about the vaccine, how many of the children with a history of chronic disease want to be vaccinated, and which factors affect them. METHODS: A questionnaire form was completed for children aged 12-18 years who applied to Gazi University Pediatric Emergency Department and the Child Health and Diseases Polyclinic between April 1, 2022, and September 30, 2022. RESULTS: A total of 924 children participated in the study. The mean age of the participants was 14.64±1.77 years. The willingness to be vaccinated was 83.1%. Being older, living in the city, having a mother, father, or sibling who was vaccinated, information about vaccines obtained from health personnel, a completed national vaccination program, and the presence of a first-degree relative in the healthcare field significantly increased the probability of the child being vaccinated. The most important factors affecting the desire to be vaccinated in children were the vaccination status of the mother, father, or sibling and the completed national vaccination program. CONCLUSION: We found that the immunization status of the parents is the most important factor guiding the child's desire to be vaccinated and that the most common reason for vaccine hesitancy is the side effects of the vaccine.

Identification of subclinical iron deficiency using new erythrocytes, leukocytes, and reticulocytes parameters during nonsevere acute infection in pediatric outpatients.

BACKGROUND: This study aims to investigate the diagnostic utility of new erythrocytes, leukocytes, and reticulocytes parameters for the identification of subclinical iron deficiency (ID) in children under 6 years with nonsevere acute infection in pediatric outpatients. METHODS: The study included 102 children with acute infections and 31 true ID. Traditional and new hematology parameters were measured in a Sysmex-XN®, along with C-reactive protein level, and iron parameters. Participants' ID were categorized as: the ferritin < 100 ng/mL, transferrin saturation < 20% was defined as "subclinical or functional ID (FID) in Group 1"; ferritin < 30 ng/mL, transferrin saturation < 20%, as "absolute-ID (AID)" in Group 2; ferritin < 12 ng/mL without anemia and infection, as "true ID" in Group 3. RESULTS: The frequencies of FID and AID among the 102 children with acute infection were 24% and 76%, respectively. Compared with the Group 2 patients, Group 1 had a significantly higher mean percentage of hypochromic erythrocytes (Hypo-He), and significantly lower levels of hemoglobin (Hb) and Hb content of reticulocytes (RET-He) (p < 0.05 for all). Compared with Group 2 and Group 3 patients, Group 1 had a significantly higher mean percentage of immature reticulocyte fraction (IRF) and immature granulocyte (IG) values (p < 0.05 for all). The RET-He, IRF%, Hypo-He%, and IG% cut-off values for predicting FID during infection were 27.0 pg, 10.6%, 2.5%, and 0.35% respectively. DISCUSSION: The RET-He, Hypo-He, IRF, and IG may be useful parameters for identifying subclinical ID in small children with nonsevere acute infection in pediatric outpatients.

Evaluation of parental knowledge, attitudes and practices regarding antibiotic use in acute upper respiratory tract infections in children under 18 years of age: a cross-sectional study in Turkey.

BACKGROUND: Upper respiratory tract infections (URTIs) are common in children. Antibiotics still continue to be prescribed although most URTIs are of viral origin. This is inappropriate use and this unnecessary administration contributes or may cause antibiotic resistance. The problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and middle-income developing countries. This study aims to evaluate the knowledge and attitudes of parents of children with upper respiratory tract infections regarding antibiotic use and their antibiotic administration practices in a tertiary care hospital in Turkey. METHODS: Our study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April 2021 for parents over 18 years of age with a child under 18 years' old who applied to the general pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics. RESULTS: Five hundred fifty-four parents responded to the questionnaire (93.2% rate of response). A total of 15.7% of parents stated to use antibiotics in any child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of parents declared that they put pressure on pediatricians to prescribe antibiotics. While 28% of the parents who thought that the use of inappropriate antibiotics would not change the effect and resistance of the treatment, 41% thought that new antibiotics could be developed continuously. 85.6% of the parents stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9% of them declared that they never used past antibiotics in the presence of a new infection. CONCLUSION: According to the results of our study of parents' lack of knowledge about antibiotics in Turkey, though generally it shows proper attitude and practices. It shows that some of the restrictions imposed by the National Action Plan are partially working. However, it is still necessary to continue to inform parents, pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent unnecessary antibiotic prescriptions.

The prevalence of low serum levels of Vitamin D, Vitamin B12, folate and ferritin in adolescents: Single center experience.

BACKGROUND: In this study, the aim was to evaluate the prevalence of vitamin D, vitamin B12, ferritin, and folate deficiencies in adolescence to clarify the need for early diagnosis and therapy. METHODS: The medical records of adolescents between 10 and 18 years of age between 01 September 2018 and 28 February 2019 as healthy with non-specific complaints, or due to well-child care visits, were analyzed retrospectively. RESULTS: A total of 1847/2507 (73.6%) adolescents were included in the study. The prevalence of vitamin D deficiency was 25.7% (n: 178/691). Vitamin B12 deficiency prevalence was 69.2% (n: 753/1088). The prevalence of anemia and ferritin deficiency was 4.8% and 13.26%. The prevalence of folate deficiency was 37.9% (n: 413/1088). VDD prevalence was statistically significantly higher in females than males (F/M:116/62). VB12D prevalence, the number and mean age of females with hemoglobin deficiency, and low ferritin levels was found to be statistically significantly higher in females than males. CONCLUSIONS: The prevalence of vitamin D, vitamin B12, folate deficiency and low ferritin levels was found to be high among adolescents. In particular, adolescents admitting with non-specific complaints and for control purposes in big cities must be considered to be at risk for the deficiency of these vitamins and low level of ferritin.

May rotavirus vaccine be affect food allergy prevalence?

Incidence of food allergy (FA) during nursing period is 6-8% globally and It is reported %5,7 in Turkey. In our study, the aim is to determine whether the prevalence of food allergy (FA) increases in children vaccinated against rotavirus. The files of 681 infants who are still followed-up were retrospectively evaluated. Children who did not come to our clinic for all of their well-child follow-up visits were excluded from the study. Moreover, children diagnosed with allergy before vaccination and children with known gastrointestinal system disease were excluded from the study. The number of patients diagnosed with food allergy after being vaccinated against rotavirus was 12 (1.76%). Three children had a family history of allergy. Of 12 patients who were diagnosed after vaccination, 3 (n:104) were vaccinated with pentavalent vaccine and 9 (n:507) with monovalent vaccine. In the monovalent vaccination group, food allergy was found in 9 children (1.55%), and in the pentavalent vaccination group, food allergy was found in 3 children (2.88%). The difference between the two vaccination groups in terms of food allergy prevalence was not significant (p > .05). Although it is believed that food allergy, and even cow's milk protein allergy (CMPA) prevalence increases in infants vaccinated against rotavirus, in this study, no significant increase was observed in the prevalence of food allergy after rotavirus vaccination. Both types of vaccine had similar rates to each other.

The importance of attachment in infant and influencing factors.

Attachment is a pattern of interaction and communication established and developed between mother and baby. For the growth of mentally and physically healthy individuals, the mother is expected to create a suitable attachment starting before the birth and to maintain it afterwards. It is also necessary for the baby to establish appropriate and safe attachment towards the mother in a similar manner. There are several factors that affect the attachment. Also, some studies show that children with attachment problems also have problems in their future lives. Healthcare professionals need to be aware of these factors and evaluate the child in terms of healthy parental communication and child development in well-child visits. As a result of these evaluations, multidisciplinary approaches to the mother-child pair can be established and the child's health is protected mentally and physically for healthy generations.

Baglanma, anne ve bebegi arasinda her iki yönde gelisen ve kurulan bir iletisim ve etkilesim örüntüsüdür. Ruhen ve bedenen saglikli bireylerin yetismesi için, annenin bebegi ile dogum öncesinden baslayan ve dogum sonrasi da devam eden uygun baglanma olusturmasi ve sürdürmesi beklenirken, benzer sekilde bebegin de annesi ile uygun ve güvenli baglanma kurmasi gerekmektedir. Baglanmayi etkileyen birçok etmen bulunmaktadir. Baglanmada sorun yasayan çocuklarin ileriki yasamlarinda sorunlar oldugunu gösteren çalismalar da bulunmaktadir. Saglik çalisanlarinin, bu etmenlerin farkinda olmasi ve saglikli çocuk izlemlerinde, çocugu saglikli ebeveyn iletisimi ve gelisimi açisindan degerlendirilmesi gerekmektedir. Bu degerlendirme sonucunda, anne-çocuk ikilisine çok disiplinli yaklasimlar yapilabilir ve saglikli nesiller için çocugun sagligi ruhen ve bedenen korunmus olur.

Congenital Hypothyroidism and Bone Remodeling Cycle.

OBJECTIVE: The present study aimed to evaluate the biochemical markers of bone turnover in children with congenital hypothyroidism during the course of treatment as compared to healthy children selected as controls. METHODS: The study included 31 children with congenital hypothyroidism and 29 healthy children. In both groups, we evaluated serum procollagen type-1 N-terminal propeptide (PINP) and tartrate-resistant acid phosphatase type 5b isoform (TRACP 5b) levels as bone turnover markers. RESULTS: In both groups, thyroid hormone levels were within normal limits. The levels of vitamin D were significantly higher in the cases with congenital hypothyroidism. Although PINP levels were not found to be different, TRACP 5b levels which are related to osteoclastic activities were significantly higher in the control group. CONCLUSION: We did not detect an increase in bone resorption in patients with congenital hypothyroidism, despite long-term treatment with LT4. Our results suggest that with effective vitamin D treatment and thyroxin replacement, congenital hypothyroidism is not a deleterious factor for bone turnover.

Pain Syndrome and Ventricular Arrhythmia Induced by Sirolimus and Resolved by Dosage Adjustment in a Child After Heart Transplant: A Case Report.

For patients with late congenital heart diseases and advanced heart failure, heart transplant is the one of the most effective known treatment methods. With the development of immunosuppressive medicines, it is possible to prevent and treat rejection, and survival after organ transplant has increased rapidly. Calcineurin inhibitors (tacrolimus and cyclosporine), mycophenolate mofetil, and corticosteroids are used together in many centers as immunosuppressive medications. Although the use of calcineurin inhibitors is essential, therapy is switched to sirolimus in some specific cases and when significant adverse effects occur. The most seen sirolimus-based adverse effects are diarrhea, constipation, vomiting, nausea, abdominal pain, leg pain, acne, headache, and sleep problems. Here, we present a patient who had abdominal pain, nausea, vomiting, and ventricular extrasystole attacks due to sirolimus toxicity, which improved with dose adjustment during follow-up after heart transplant. Pain associated with the use of calcineurin inhibitors improving with sirolimus has been previously reported before; however, because we did not encounter pain syndrome associated with use of sirolimus, we chose to report our experience with this patient.

Serum Vitamin D Levels in Children with Recurrent Respiratory Infections and Chronic Cough.

OBJECTIVES: To evaluate serum vitamin D levels in cases of recurrent respiratory infections and chronic cough and to investigate the effect of vitamin D therapy on recurrence of the diseases. METHODS: This prospective observational study was performed by comparing serum vitamin D levels in children with recurrent respiratory infections, chronic cough and healthy children. One-hundred-one children with chronic cough, ninety-eight children with recurrent respiratory infections and one-hundred-twenty-four healthy children were enrolled in the study. A structured questionnaire was completed to collect data on demography, diet, duration of breastfeeding, vitamin D supplementation and family history for allergic diseases. In patients with low serum vitamin D levels (<20 ng/ml), vitamin D therapy was administered in addition to conventional treatment for the diseases. Patients were followed up for 6 mo and their complaints were evaluated. RESULTS: Mean serum 25(OH) vitamin D level in the recurrent respiratory infections group was 11.97 ± 4.04 ng/ml, chronic cough group was 13.76 ± 4.81 ng/ml and control group was 31.91 ± 18.79 ng/ml. Comparison of serum 25(OH) vitamin D levels between the study groups revealed a statistically significant difference (p < 0.05). 25(OH)D deficiency in children was associated with increased frequency of recurrent respiratory infections and chronic cough. CONCLUSIONS: To conclude, administration of supplementary vitamin D may be useful in the treatment and preventation of recurrent respiratory infections and chronic cough.

Maternal-fetal proinflammatory cytokine gene polymorphism and preterm birth.

Association between maternal-fetal proinflammatory cytokine genotype and preterm birth was studied. Isolated genomic DNA from maternal and cord blood samples of 100 preterm and 101 term labors were used for TNFα (-238G/A, -308G/A), IL-1α (4845G/T), and IL-1ß (-511C/T) genotyping. TNFα -238 GA genotype in term neonates was significantly higher than the premature neonates (p<0.05). Maternal-fetal TNFα -238 heterozygosity was associated with term labor (p<0.05). TNFα -308 GA and AA genotypes were associated with term labor (mothers and neonates, respectively; p<0.05 and p<0.001). The incidence of term labor was significantly increased in TNFα -308 GA genotype. If a -308GA carrier has a fetus with GG genotype, the incidence of preterm labor increases (p<0.01). The 4845 T allele was significantly higher in preterm mothers and neonates (p<0.001 and p<0.001). The effect of maternal-fetal genotype for the pregnancy outcome reveals that maternal 4845GG and GT genotypes increase term labor incidence, whereas fetal 4845 TT genotype was a significant independent risk factor for preterm birth (p<0.01). IL-1ß -511 TT genotype was significantly higher in preterm neonates. The preterm labor risk was significantly increased in maternal -511 TT genotype and fetal CT genotypes, whereas with maternal -511 CT or TT genotypes or a -511 TT fetus, the incidence of term pregnancy increases (p<0.01).