An Overview on Child Health Care in Turkey

The general health status of the Turkish people has improved significantly in recent years. Improvements in the health status of the child population followed the introduction of health reforms, such as the Health Transformation Program. Presently, Turkey is undergoing further important changes concerning its medical system. The changes introduced during 2005-2015 have provided almost complete health insurance coverage and increased accessibility to primary health care givers. However, health providers realize that there are ongoing inefficiencies and deficiencies in both the health care system and health education. There is a need for continuous improvement; challenges lie ahead for improving services beyond primary care. The main criticism of previous health care reforms has come mainly from professionals in the health care sector because of their privileged position as inside observers being able to analyze pros and cons of the system. Quality and sustainability of future reform programs will rely not only on the economic support of the public health and health care sector, but also on the high standards of service pathways and satisfaction of both patients and providers of care by multifactorial quality assurance and continuous quality improvement analyses of basic elements of health care

Yenidoğan ve süt çocukluğunda kolestaz

During the newborn and infancy period, it is an important to demonstrate the condition which causes cholestatic liver diseases. If direct bilirubin level is more than 20% of total bilirubin, it is defined as cholestasis. Especially early diagnosis of diseases including biliary atresia, tyrosinaemia, galactosaemia is crucial for prevention of permanent damage in the future and for benefit from early treatment. Therefore, total, direct and indirect bilirubin levels should be measured in all newborns with jaundice lasting more than two weeks. If 20% of total bilirubin is direct bilirubin, liver-related disorders should be questioned. In this review, we aimed to show which clinical and laboratory features should be considered to demonstrate the cause of cholestatic diseases. (Turk Arch Ped 2012; 47: 1-7

Kronik karaciğer hastalığı olan çocukluklarda doğal antikoagülan düzeyleri

Aim: The aim of this study was to evaluate the serum levels of natural anticoagulants and their possible role as a marker in determining the severity of liver disease

Importance of the Human Leukocyte Antigen Tissue Type in Detecting Celiac Disease in Two Families

Celiac disease (CD) is strongly related to human leukocyte antigens (HLA) genes. The incidence of CD is very low in patients without the HLA-DQ2.5 and HLA-DQ8 leukocyte antigens. This study presents two families with CD and shows that the disease might be familial. The determination of HLA tissue groups is important and family screening tests may lead to early diagnose of the disease. In both of the families, the patients' siblings and fathers were asymptomatic, but diagnoses were made after family screening tests. HLA tissue typing was performed in all family members. The patients, siblings and fathers carried the HLADR3-DQA1*0501-DQB1*0201 tissue groups in both two families while this tissue group was not present in the mothers. As CD is strongly related to certain HLA groups and has a genetic predisposition, all members of a family must be screened when a case of CD is diagnosed in any family member. On the other hand, the determination of the HLA tissue type in patients with both symptoms and very positive serologic tests is important in terms of suspicion of the disease

Long-Term Follow-Up of Children with Inflammatory Bowel Disease: Evaluation of 53 Cases

Introduction: In this study it was aimed to determine the long-term demographic, clinical and laboratory characteristics, together with the responses to therapy, in children diagnosed with inflammatory bowel disease (IBD)

Maternal Psychopathology and Psychomotor Development of Children With GERD

Objectives: The relation between gastroesophageal reflux disease (GERD) and maternal psychopathology as well as the role of impairments in mother child interactions in the perpetuation of feeding problems in children with GERD was previously implicated but not confirmed. The present study aimed to study the relation between maternal psychopathology and feeding problems in children with GERD and the effects of GERD on the psychomotor development of children