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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.

Objective: Increased systemic inflammatory response during intrauterine period or period before the age of 3 is associated with cerebral palsy (CP) pathogenesis; however, effects of inflammatory processes involving mast cell activation in elder children with CP remain unclear. We aimed to investigate the role of mast cells and proinflammatory cytokines in children with CP at 3-18 years of age. Methods: In this cross-sectional study, venous blood samples were obtained from 30 volunteers with CP and 26 healthy volunteers at 3-18 years of age. Plasma levels of proinflammatory cytokines (IL-1β, IL-6 and IL-9) and mast cell biomarkers (histamine and tryptase beta-2) were determined using ELISA. Results: IL-1β, IL-6 and histamine levels were higher in individuals with CP compared to healthy controls. Likewise, IL-1β, IL-6, IL-9 and histamine levels were higher in the female patients with CP compared to the male patients, and in the female patients in adolescence compared to the female patients in pre-adolescence. Conclusion: Our findings indicate that the increased inflammatory response contributes to the pathogenesis of the disease in children with CP who are older than 2 years of age. Moreover the increased inflammatory response is more effective in female patients than in male patients, suggesting that there may be a gender difference in CP. Additionally mast cell activation contributes to the exacerbation of systemic inflammatory response in children with CP at 3-18 years of age.

Aim: To examine the maternal and other factors affecting the clinical course of newborn infants in Bolu province and to reveal the possible relationships between them. Methods: A total of 1592 newborns and their mothers were retrospectively included in the study between 2022-2023 at the Maternity and Child Unit of Bolu İzzet Baysal State Hospital. Clinical data of neonates and their mothers' pregnancy data were retrieved from the hospital data system. The categorical data were analyzed by chi-square test. Mann-Whitney U test was used to compare two independent groups. Spearman's rank correlation was employed to test if there was correlation between the variables. Results: The rate of intensive care unit admission for caesarean deliveries (21.8%) was significantly higher than for normal deliveries (15%, p<0.01). The rate of ventilator requirement was significantly higher in early-term (27%), late-preterm (49%) and moderately-preterm (100%) neonates compared to term ones (12%), respectively (p<0.01). The most common risk factor for expectant mothers was thyroid disorder (27.7%). The rate of hospitalization for infection was higher than that due to congenital pneumonia in both caesarean section (45.6% vs 23.5%) and normal births (46.8% vs 18.3%, p< 0.05). The rate of cesarean delivery was significantly higher in those with late preterm (67.3%) than in those with term (49.7%, p<0.01). Conclusions: Expectant mothers should be encouraged to have a normal birth unless medically necessary. Factors that may cause prematurity should be kept under control as it causes many health problems after birth. More health precautions need to be taken for newborns under 1 year of the health of expectant mother should be closely monitored for the mother and her newborn. Awareness about the common causes of infant disorders is important in forward health planning and precautions to be taken.

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.