The use of the novel inflammatory indicator—systemic immune-inflammatory index (SII)—in pediatric patients with bronchiolitis remains unreported. Therefore, this study investigated the relationship between the SII and neutrophil-to-lymphocyte ratio (NLR) in patients with respiratory syncytial virus (RSV) and non-RSV bronchiolitis and clinical severity prediction. This study analyzed the data of 155 patients aged <2 years hospitalized with viral bronchiolitis due to RSV and/or other viral pathogens. The SII [platelet count×(neutrophil/lymphocyte)] value was calculated and compared among patients with RSV monoinfection, other viral monoinfections, and RSV coinfections. Severity was defined according to the number of days of supplemental oxygen treatment. The NLR and SII values were significantly higher in the non-RSV monoinfection group than in the RSV monoinfection group; the number of days of supplemental oxygen therapy was significantly increased in the RSV monoinfection group. No significant differences in the NLR, SII, and days of supplemental oxygen therapy were found between the RSV monoinfection and RSV coinfection groups. Although patients with RSV monoinfection showed more severe clinical findings than those with non-RSV monoinfection, the NLR and SII values were significantly higher in the non-RSV monoinfection group. Therefore, the NLR and SII do not appear to be very useful measurements for determining the severity of acute bronchiolitis attacks, but lower NLR and SII values in RSV group compared to non RSV group may be potential biomarker for RSV infection. Additional studies are required.

Background: Multisystem inflammatory syndrome in children (MIS-C) is a novel pediatric disorder associated with coronavirus disease 2019. However, no laboratory parameters can diagnose MIS-C. This study aimed to determine the changes in mean platelet volume (MPV) and investigate its relationship with cardiac involvement in MIS-C. Methods: In this single-center retrospective study, 35 children with MIS-C, 35 healthy children and 35 febrile children were enrolled. Patients with MIS-C were further subdivided depending on the presence of cardiac involvement. For all patients, the white blood cell, absolute neutrophil, absolute lymphocyte, platelet counts, MPV and C‐reactive protein levels were recorded. Ferritin, D-dimer, troponin and CK-MB levels and the day when IVIG was administered were recorded and compared between groups. Results: Thirteen patients with MIS-C had cardiac involvement. The mean MPV of the MIS-C group was significantly higher than those of the healthy (P = 0.0001) and febrile (P = 0.027) groups. Using a cutoff of >7.6 fL, the MPV had a sensitivity of 82.86% and specificity of 82.75%, and the area under the MPV receiver operating characteristics curve was 0.896 (0.799–0.956). The MPV was significantly higher in patients with cardiac involvement than in those without (P = 0.031). Logistic regression analysis revealed that the association between the MPV and cardiac involvement was significant (odds ratio, 2.28; 95% confidence interval, 1.04–2.95; P = 0.039). Conclusions: The MPV may indicate cardiac involvement in patients with MIS-C. Large cohort studies are needed to define an accurate cutoff value for the MPV.

This study aimed to determine parental knowledge and behavior about oral health and dental care. For this purpose, we also examined the relationship between demographic characteristics and the oral-dental health behavior of parents. This study consisted of 269 parents who visited the pediatric outpatient clinic of the hospital between December 2017-January 2019. Data were collected using the researchers' prepared oral health and dental care assessment form. To determine the parents' level of knowledge and behavior regarding oral and dental health, a total of 45 questionnaires were administered with face-to-face interview technique, including demographic characteristics (4 questions), knowledge (19 questions), oral-dental behavior (18 questions), and personal opinion (4 questions). 269 parents (231 females and 38 males) participated in the study. The average age of the parents was 30.6±6.9 years (range: 18-62 years). 118 parents (43.9%) graduated from middle-high school, 109 parents (40.5%) were primary school graduates, 33 parents (12.3%) were university graduates, and five parents were illiterate people (1.9%). The parents did not have enough information about nutrition, fluoride therapy, and dental flossing. There was no statistically significant difference between education level and the number of correct answers (p=0.133). As a result, providing accurate and appropriate knowledge to children by their parents will affect oral-dental health positively. Whether it is a child or adolescent, regular periodic education programs for the protection and development of oral and dental health, as well as the contribution of the school and the family, are essential.

In this study, it was aimed to compare the levels of serum endocan with commonly used markers, and also to define the suitability for determination of disease severity in patients with community-acquired pneumonia (CAP). The study included 60 patients and 28 healthy subjects. Pneumonia severity was determined according to British Thoracic Society guidelines for the management of CAP in children. Serum levels of endocan and C-reactive protein (CRP) and white blood cell (WBC), and neutrophil count were measured. Serum endocan levels were increased in patients with CAP. CRP levels, WBC count, neutrophil count and neutrophil lymphocyte ratio were also higher in the CAP group than healthy control group. Endocan was correlated with CRP and WBC count and disease severity. For the identification of CAP, the area under the receiver operating characteristic (ROC) curve of CRP was acceptable for CRP, but not for endocan (0.812 and 0.649, respectively). ROC analysis for endocan to differentiate between severe CAP ( n = 29) and mild–moderate CAP ( n = 31) gave an area under the curve of 0.769 compared to 0.667 for CRP. Serum endocan levels increase in patients with CAP and can therefore be a useful marker in diagnosis and as a particular indicator of the treatment in the clinical assessment of CAP disease severity. Serum endocan levels of patients with severe CAP were higher compared with patients with mild–moderate CAP. These results revealed that endocan might be a useful indicator of severity of CAP.