Iron deficiency anemia (IDA) is frequent in childhood. Inadequate nutrition and gastrointestinal malabsorption are the frequent causes of IDA in children. But reduced iron absorption and insidious blood loss from the gastrointestinal tract has been identified as the most frequent causes of IDA in older children and adolescents. Therefore the authors evaluated the frequency and etiologies of the upper gastrointestinal system pathologies causing IDA in older pediatric population. Patients with known hematological or chronic diseases, heavy menstrual flow, and obvious blood loss were excluded from the study. Forty-four children between the ages of 9.5 and 17.5 years and diagnosed with IDA were enrolled. They underwent upper gastrointestinal endoscopy and biopsy from esophagus, stomach, and duodenum. Mean age and hemoglobin (Hb) levels of study group (32 boys, and 12 girls) were 14.6 ± 2.0 years and 7.9 ± 1.8 g/dL, respectively. Only 1 patient had a positive serology testing with anti-tissue transglutaminase and small bowel biopsy correlating with celiac disease. Endoscopy revealed abnormal findings in 25 (56.8%) patients (21 endoscopic antral gastritis, 2 active duodenal ulcers, and 2 duodenal polyps). Helicobacter pylori (HP) infection was identified by using antral histopathological evaluation in 19 of 44 children (43.2%). In 2 of duodenal samples, one patient had celiac disease, and the other one was diagnosed as giardiasis. In conclusion, there are different etiologies resulting in IDA in older children and adolescents. When older children and adolescents are found to have iron deficiency, HP infection and other gastrointestinal pathologies should be ruled out before iron deficiency treatment.

Objective:Late neonatal hypocalcemia (LNH) is a common metabolic problem associated with hypoparathyroidism, high phosphate intake and vitamin D deficiency, often presenting with seizures. In this cross-sectional study, we aimed to evaluate the role of vitamin D deficiency in LNH in Turkey and to describe the characteristics of affected newborns.Methods:Conducted with a cross-sectional design and with the participation of 61 neonatal centers from December 2015 to December 2016, the study included term neonates with LNH (n=96) and their mothers (n=93). Data were registered on the FAVOR Web Registry System. Serum samples of newborns and mothers were analyzed for calcium, phosphate, magnesium, albumin, alkaline phosphatase, intact parathyroid hormone (iPTH) and 25 hydroxyvitamin D [25(OH)D] levels.Results:The median (range) onset time of hypocalcemia was 5.0 (4.0-8.0) days of age, with a male preponderance (60.4%). The median (range) serum 25(OH)D levels of the neonates and their mothers were 6.3 (4.1-9.05) and 5.2 (4.7-8.8) ng/mL, respectively. The prevalence of vitamin D deficiency (<12 ng/mL) was high in both the neonates (86.5%) and mothers (93%). Serum 25(OH)D levels of the infants and mothers showed a strong correlation (p<0.001). While the majority (93.7%) of the neonates had normal/high phosphorus levels, iPTH levels were low or inappropriately normal in 54.2% of the patients.Conclusion:Vitamin D deficiency prevalence was found to be high in LNH. Efforts to provide vitamin D supplementation during pregnancy should be encouraged. Evaluation of vitamin D status should be included in the workup of LNH.

Advances in diagnostic and therapeutic methods have led to a paradigm shift in the management of bronchopulmonary dysplasia (BPD). The lack of evidence-based data in this area has led to variations in clinical practice. The aim of this study was to identify these differences and compare them with recommendations based on pathophysiology. The study was designed as an observational online survey of neonatologists from level 3 to 4 neonatal intensive care units caring for premature infants at increased risk of BPD and born before 28 weeks’ gestation. Respondents were invited to participate in the study through the portal of the Turkish Neonatal Society. Participants were surveyed online about preferred ventilation modes, settings and clinical management of these patients through each respiratory distress syndrome, evolving BPD and severe BPD phases. A total of 39 centers involved in the study. Pressure-control assist-control volume-guaranteed was the most commonly preferred ventilation mode in respiratory distress syndrome and evolving BPD, while high frequency oscillatory ventilation was most commonly used in severe BPD. The use of synchronized intermittent mandatory ventilation volume-guaranteed pressure support ventilation increased with disease progression. Ventilation settings were found to be changed according to pathophysiological recommendations, but not to the extent recommended. The study shows that early ventilation strategies are predominantly maintained in the later phases of BPD, although there are notable differences between centers.

Objective: This study aimed to explore the impact of environmental factors, specifically adverse weather conditions, on the rate of pediatric emergency department visits. Methods: A retrospective analysis was performed at a tertiary care hospital specializing in pediatric and emergency medicine. Data on environmental factors, including particulate matter (PM10) and nitrogen oxide (NOX) levels, temperature, wind speed, and precipitation, were collected from official Turkish sources and correlated with pediatric emergency department admissions over a year. Admissions were categorized seasonally, and analyzed variables included patient demographics, visit details, diagnosis, and outcomes, utilizing ICD-10 codes for a broad range of conditions. Results: A retrospective study from 2019 to 2022 investigated 126,364 pediatric patients aged < 15 years. Seasonal variation was noted, with the highest number of admissions in the fall of 2022. Admissions significantly decreased during periods of water and air pollution, with the most substantial decline seen during the pandemic year of 2021. During the post-pandemic period, there was a sharp increase in the number of visits. Upper respiratory tract infections (URTIs) constitute 47% of all cases and are the leading cause of emergency department visits. The majority of patients (99%) walked, whereas only 1% arrived by ambulance. (0.2%) required referral to higher-level care, and 3% of emergency visits resulted in hospital admissions, of which 5% required intensive care. The frequency of visits was correlated with environmental factors, with fewer visits occurring during adverse weather conditions (P<.001). URTIs remained the predominant diagnosis, even during extreme weather or pollution events, suggesting that such environmental factors did not diminish the urgency of these conditions. Conclusion: This study found that environmental factors influence child emergency room visits, particularly during summer when children engage in more outdoor activities due to warmer weather. Based on the results obtained, health systems are able to allocate resources and formulate response strategies that enhance the provision of care for children, thereby increasing the resilience of the emergency health services infrastructure.