Explore the vast range of titles available.

Introduction: Pro-inflammatory/anti-inflammatory cytokine and oxidant/antioxidant imbalances develop in acute respiratory distress syndrome cases, a significant cause of morbidity and mortality in childhood. This study aims to investigate whether Achillea millefolium, with its antioxidant and anti-inflammatory effects, can be used in the treatment of acute lung injury. Methods: A total of 36 male Wistar rats were divided into four groups. Acute lung injury was induced by cecal ligation and puncture (CLP). Serum samples were analyzed for TNF-α, IL-10, native thiol, total thiol, and disulfide levels. Lung samples were examined using hematoxylin-eosin staining. Results: A significant difference was observed in TNF-α values among groups (p=0.003). CLP group showed higher TNF-α values compared to the control group (50.88±5.21 vs. 34.13±9.89 pg/mL, p=0.002), and histologically demonstrated increased scores of lymphocytes, fibroblasts, histiocytes, neutrophils, hemorrhage, and congestion (p=0.006, p<0.001, p=0.007, p=0.001, and p=0.001, respectively). TNF-α values in the CLP+AM group showed a statistically significant decrease compared to the CLP group (50.88±5.21 vs. 38.59±11.65 pg/mL, p=0.035), and histologically, scores of lymphocytes, fibroblasts, histiocytes, neutrophils, hemorrhage, and congestion were reduced (p=0.017, p=0.005, p=0.007, p=0.001, and p=0.02, respectively). CLP+D group also showed a non-significant decrease in TNF-α values compared to the CLP group (50.88±5.21 vs. 39.31±5.09 pg/mL, p=0.055), but histologically, congestion, fibroblast, and histiocyte scores were significantly reduced (p=0.015 and p=0.002, respectively). There was no statistically significant difference among other groups (p>0.05). Conclusion: This study suggests that Achillea millefolium, with its anti-inflammatory effect, may be used in the treatment of acute lung injury. However, clinical studies are needed to support these findings.

Hepcidin is a regulator of iron balance that is increased in obesity. It reduces the absorption of iron, reduces the transfer of iron from macrophages to the plasma and/or prevents mobilisation of stored iron. Obese patients with non-alcoholic fatty liver disease (NAFLD) demonstrate adipokine and cytokine release promoting inflammatory response. We aimed to analyse the hepcidin levels and iron metabolism in obese children with and without NAFLD and non-obese healthy controls. The study population consisted of 110 children aged 7–18 years in three groups: 50 obese patients without NAFLD, 30 obese patients with NAFLD, and 30 non-obese healthy controls. Serum hepcidin, ferritin, and iron levels, iron-binding capacity, lipid profile, and liver function tests were measured, and hepatic ultrasonography was performed in all participants. Obese patients’ white blood cell counts, total cholesterol, triglyceride levels, and homeostatic model assessment of insulin resistance (HOMA-IR) were significantly higher than those of the control group. Iron-binding capacity was significantly higher in obese patients without NAFLD compared with obese patients with NAFLD ( p  = 0.002). Hepcidin levels were not significantly different between obese patients and the control group. However, hepcidin levels in obese patients with NAFLD were significantly higher than those in obese patients without NAFLD ( p  < 0.001). Conclusions : Hepcidin levels were significantly higher in obese children with NAFLD than those without NAFLD. Obese children with NAFLD should receive attention regarding iron metabolism disorders. Serum hepcidin could be a marker of iron metabolism status and NAFLD in these groups of patients.

Neurogenic inflammation is involved in the development and progression of respiratory inflammatory diseases. However, its role in community-acquired pneumonia (CAP) remains unclear. We therefore aimed to investigate plasma levels of neurogenic inflammation-related neuropeptides, calcitonin gene-related peptide (CGRP), substance P (SP), vasoactive intestinal peptide (VIP) and neuropeptide Y (NPY), and procalcitonin (PCT) in pediatric patients with CAP and to assess their diagnostic value in viral and bacterial/mixed pneumonia. A total of 124 pediatric patients with CAP (1 month-18 years old) and 56 healthy children of similar ages were prospectively enrolled. The patients were classified as viral (n = 99) and bacterial/mixed (n = 25) pneumonia. Plasma levels of the peptides were quantified by ELISA. ROC analysis was performed to evaluate possible diagnostic value of the peptides. While plasma levels of CGRP, VIP and PCT were significantly higher in patients with CAP than in the control group, respectively, NPY levels were significantly lower. Moreover, plasma levels of all neuropeptides and PCT were significantly higher in bacterial pneumonia patients compared to viral pneumonia patients. ROC analysis revealed that CGRP, SP and NPY had a diagnostic value in distinguishing viral and bacterial/mixed pneumonia. Conclusions : Our findings suggest that these neuropeptides may be implicated in pediatric CAP. CGRP, SP and NPY together may be a promising candidate in distinguishing viral and bacterial/mixed pneumonia, however, for this, further studies are needed. What is Known: • Neurogenic inflammation contributes to the development and progression of respiratory inflammatory diseases such as chronic obstructive pulmonary disease and bronchial asthma. What is New: • Plasma levels of neurogenic inflammation related neuropeptides calcitonin gene-related peptide, substance P, vasoactive intestinal peptide and neuropeptide Y are changed in pediatric community-acquired pneumonia. Calcitonin gene-related peptide, substance P and neuropeptide Y are promising candidates in distinguishing viral and bacterial/mixed pneumonia.

Aim: Preterm infants encounter hyperoxia relatively early on as they leave the intrauterine environment earlier than expected, while also being exposed to a higher level of hyperoxic stress due to insufficiencies in their antioxidant defense mechanisms. With that in mind, we investigate whether running exercises performed during pregnancy can contribute to the development of tolerance to neonatal hyperoxic brain damage. Method: While two female rats maintained a sedentary pregnancy, one female rat performed the mandatory running exercise for 30 minutes for five days a week throughout the pregnancy. Following delivery, the sedentary rats and the exercised rat were kept together with their offspring for five days at oxygen concentrations above 80 percent in order to induce brain damage. The offspring were sacrificed on postnatal Day 7 and brain/body ratio measurements were obtained. Results: The brain/body ratios in the control, hyperoxia and exercise-hyperoxia groups were found to be median (IQR) 0.074(0.68-0.77), 0.065(0.06-0.067) and 0.064(0.060-0.068), respectively. The brain/body ratios of the offspring of the mothers in the hyperoxia group were found to be significantly lower than the control group (p=0.002), irrespective of exercise (p=0.007). No statistically significant difference was noted between the offspring of the sedentary and the exercised mothers in the hyperoxia group (p=0.94). Conclusion: Hyperoxia was found to result in lower brain mass relative to total body mass. This finding, which indicates the presence of microcephaly, reflects the negative effects of hyperoxia on brain development. Contrary to expectations, exercises performed during pregnancy had no significant effect on the brain/body weight ratio of the offspring.

Aim: Research into the different treatment methods based on the intrauterine lipopolysaccharide (LPS)-induced periventricular leukomalacia (PVL) model, as one of the main causes of morbidity in preterm infants still continues to be relevant. The present study investigates the effect on PVL of salidroside obtained from Rhodiola Rosea (golden root, orpin rose), which is a plant with known for its medicinal qualities. Method: To develop an induced PVL model, a 500 microgram/kg dose of LPS (Escherichia coli, serotype 055:B5, Sigma) was applied to two pregnant rats intraperitoneally on day 18, day 19 and day 20 of gestation. One of the LPS applied rats was given 25 mg/kg salidroside (250 mg Rhodiola root extract capsules, which include 3 mg salidroside) by oral gavage (LPS+Salidroside), and a physiological saline solution was given to the control group. After delivery, 10 offspring of the LPS-applied mother, nine offspring of the LPS+Salidroside-applied mother and seven offspring of the control mother were sacrificed on postnatal day 7 with ether anesthesia. The caspase enzyme located in apoptosis pathways of 10 percent neutral-buffered formalin fixed brain tissue was stained immunohistochemically, and apoptotic cells were counted. Results: No statistically significant difference was noted between the LPS+Salidroside group and the control group, while a statistically significant difference was noted between the LPS and LPS+Salidroside groups. It was observed that salidroside reduced LPS induced apoptosis. Conclusion: The intended experimental neuroprotective effect of salidroside usage was provided through the inhibition of apoptosis in a PVL-damaged brain.

Aim: Celiac disease (CD) is a common immune-mediated enteropathy caused by gluten. These patients may apply with many different clinical forms. The aim of this study is to determine the association of serological tests and type of anemia in CD. Methods: Totally117 biopsy proven CD patients aged between 1-17 years were included. Serological and hematological parameters of all patients were studied. Results: Anemia was identified in 71 (60.7%) cases. Patients with anemia were diagnosed earlier than other patients (5.2±4.5 vs. 15.3±33.8 years, p=0.012). Among CD patients with anemia 39 (54.9%) were having iron deficiency, 22 (30.9%) were having folate deficiency and 10 (14%) were having vitamin B 12 deficiency. In patients with tissue transglutaminase (tTG) seropositivity serum iron levels and ferritin levels were significantly lower compared to anti-gliadin antibody (AGA) or anti-endomysium antibody (EMA) seropositivity (35±23.5 vs. 57.5±33.3, p=0.007 and 12.4±21.9 vs. 24.2±18.5, p=0.026, respectively). Low serum folate levels were more frequent in the presence of tTG seropositivity compared with AGA+EMA seropositivity (81.8% vs. 25%, p=0.015). Conclusions: Anemia is an important cause of admission in CD. These patients are diagnosed earlier as a result of anemia. Alone tTG seropositivity is more valuable to demonstrate anemia associated with iron or folate deficiencies.

Aim: To investigate the effects of SAR-CoV-2 infection on nutritional status in patients who underwent percutaneous endoscopic gastrostomy (PEG) for neurological disorders. Methods: The clinical and laboratory follow-up data of the patients who underwent PEG in our clinic between 2002 and 2018 were evaluated before and during the pandemic. The results were analyzed statistically. Results: Twenty patients were included. They were 70.9±64.4 months old at the time of PEG, 97.9±67.8 months before the pandemic, and 105.5±60.8 months during the pandemic (p=0.048). Weight for age at the time of PEG increased from 10.7±4.6 kg to 15.6±7.2 kg before the pandemic. Hemoglobin was 12.3±1.4 g/dl at the time of PEG, 13.5±1.6 g/dl before the pandemic (p=0.045). Vitamin D was 24.1±8.9 ng/ml at the time of PEG and increased to 45.7±9.7 ng/ml during the pandemic (p=0.018). The annual number of visits before the pandemic was 9.8±5.7 and decreased to 2±1.7 during the pandemic (p=0.003). Twelve (%60) of the patients developed PEG complications, 6(30%) had their PEG replaced. Those who had developed PEG complications had low levels of albumin (3.3±0.4 vs 4±0.4 g/dl, p=0.022) and vitamin B12 (578±199 vs 1299±533 pg/ml, p=0.007). Conclusions: Even if PEG is applied late, it provides a partial improvement in patients, but the COVID-19 pandemic reversed these benefits and caused an increase in PEG complications. In order for the patient to get the maximum benefit from PEG, close follow-up is essential.

Aim: Migralepsy is a clinical entity that occasionally represents a diagnostic problem. An apparent history and clinical manifestation of migraine may mask the epileptic attack accompanying migralepsy. The aim of this study is to present our experience with clinical and electroencephalography (EEG) findings and treatment of our patients diagnosed with childhood migralepsy disease. Methods: We documented six patients who were initially followed-up with a diagnosis of migraine, subsequently observed to have epileptic seizures, and then diagnosed with migralepsy. Result: Our patients became asymptomatic by giving good responses to antiepileptic therapy based on clinical and electroencephalography (EEG) findings. Conclusions: This case series shows that EEG recording can be useful in all stages of migraine for long-term, safe monitoring. Identifying patients with possible migralepsy will enable them to receive antiepileptic treatment.

Aim: To evaluate the predictive roles of biochemical and complete blood count parameters in the diagnosis of febrile seizures by comparing these between patients with simple febrile seizures and febrile patients without seizures. Methods: One hundred fifty-two children (66 girls and 86 boys), aged 6-60 months presenting with fever symptoms presenting to our hospital’s pediatric emergency department between January 2015 and January 2020 were included in the study. Demographic data, complete blood count parameters and biochemical parameter levels were compared between the two groups. These were divided into a patient group with simple febrile seizures (n = 74) and a febrile control group without seizures (n = 78). Results: Comparison of biochemical parameters revealed significantly higher glucose, CRP, and ALT levels in the febrile seizure group, while Ca and Na were significantly lower. Comparison of complete blood count parameters revealed significantly higher white blood cell (WBC), neutrophil, red cell distribution width, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values in the febrile seizure group, while hemoglobin, hematocrit, mean corpuscular volume, lymphocytes, and mean platelet volume were significantly lower. Conclusions: We think that in addition to markers such as WBC, leukocytes, and CRP for evaluating inflammation in patients with febrile seizures, simple, easily available, and inexpensive tests such as NLR and PLR can also be useful for assessing inflammation.