Assesment of bone mineral density and markers of bone turnover in normal short stature children

Yapısal büyüme ve puberte gecikmesi (YBPG) olan çocuklarda osteopeni ve kemik kırık riski olup olmadığı halen tartışmalı bir konudur. YBPG ve ailevi boy kısalığı (ABK) olan prepubertal erkek çocuklarda, kemik metabolizmasının biyokimyasal göstergelerini ve kemik mineral yoğunluğunu değerlendirmek amacı ile bu çalışma planlandı. Yaşları 6-11 yaş arasında olan YBPG tanısıyla izlenmekte olan 31 çocuk, ailevi boy kısalığı tanısıyla ile izlenmekte olan 22 çocuk ve kontrol grubunda 27 sağlıklı çocuk çalışmaya dahil edildi. Tüm hastalar erkek ve prepubertal evredeydi. Serum kalsiyum (Ca), fosfor (P), alkalen fosfataz (ALP), osteokalsin (OC), parathormon (PTH), 25 OH Vitamin D, osteoprotegerin (OPG), idrarda deoksipiridinolin (D-pyd) seviyesi, DEXA yöntemiyle lumbar vertebra seviyesinde kemik mineral yoğunluğunun YBPG, ABK ve kontrol grubu arasındaki ilişkisi araştırıldı. Laboratuar parametrelerinden Kalsiyum, Fosfor, Alkalen fosfataz, Parathormon ve Osteoprotogerin ortalama ya da ortancaları ABK, YBPG ve kontrol çalışma gruplarında istatistiksel olarak anlamlı farklılık göstermemektedir (p>0.05). 25 OH Vit D düzeyi ABK olan grupta kontrol grubundan anlamlı olarak yüksek iken (p=0.040), Ailevi ile YBPG (p00.887) ve YBPG ile Kontrol (p=0.311) grupları arasındaki farklılıklar anlamlı değildir. Kontrol grubundaki çocukların osteokalsin ortancası Ailevi ve Yapısal boy kısalığı olan çocukların ortancasından daha küçüktür. Ailevi ile Yapısal (Z=1.826; p=0.068) ve Ailevi ile Kontrol (Z=0.628; p=0.530) grupları arasında idrar deoksipiridinolin düzeyi açısından farklılık yokken, YBPG olan grupta Kontrol grubundan anlamlı olarak yüksektir (Z=2.582; p=0.010).Yapısal büyüme ve puberte gecikmesi olan grupta KMD Z skoru Kontrol grubuna göre anlamlı şekilde düşüktür. (p<0.001), Ailevi ile Kontrol (p=0.111) grupları arasındaki kemik mineral yoğunluğu Z skoru ortalaması benzerdir. Yapısal büyüme ve puberte gecikmesi olan çocuklarda günlük kalsiyum alımı ile kemik mineral yoğunluğu Z skoru (r=0.758; p<0.001) arasında doğrusal bir ilişkinin varlığı gözlenmiştir. Ailevi boy kısalığı olan çocuklarda kemik mineral yoğunluğu Z skoru ile osteoprotogerin arasındaki ilişkiler ters yönde iken (r=-0.593; p=0.006), YBPG ve kontrol grubunda kemik mineral yoğunluğu Z skoru ile osteoprotogerin arasında ilişki saptanmamıştır. Hiçbir çalışma grubunda kemik mineral yoğunluğu Z skoru ile idrar deoksipiridinolin ve 25 OH Vit D arasında ilişki saptanmamıştır. Kemik yaş grubu &#8805; 8 yaş olan çocuklarda, Kemik mineral yoğunluğu Z skoru ortancası Ailevi boy kısalığı olan grupta YBPG olan gruptan istatistiksel olarak önemli miktarda yüksek bulundu (Z=2.188; p=0.026). Diğer parametreler arasında ABK ve YBPG olan gruplarda anlamlı farklılık saptanmadı. YBPG olan grupta < 8 kemik yaş grubunda yer alan çocuklarda da osteoprotegerin değerleri ile idrar deoksipiridinolin değerleri arasında ters yönde ve orta derecede bir korelasyon bulunmuştur (r=-0.528; p=0.008). Sonuç olarak; YBPG olan grupta kemik mineral yoğunluğu ABK ve kontrol grubundaki çocuklara göre düşük bulundu. YBPG olan grupta Ca alımlarının diğer gruplar ile karşılaştırıldığında daha az olması, VKİ lerinin düşük olması nedeniyle bu çocuklara nutrisyonel boy kısalığı da eşlik edebilir mi? sorusunu aklımıza getirdi. Ayrıca idrar deoksipridinolin seviyesinin yüksek olması da puberte öncesi dönemde başlayan osteoporoza yatkınlığın, puberte gecikmesi ile daha da derinleşebileceği düşündürmektedir.It is still being discussed if there is a risk of osteopenia and broken bone children who have constitutional delay of growth and puberty (CDGP). This project has been planned to evaluate the density of bone minerals and biochemical indicators of bone metabolism of prepubertal male boys who have familial short stature(FSS) and CDGP. 31 children between 6-11 years who have been observed as CDGP, 22 children who have been observed as familial short stature and 27 healthy boy in control group have been included in this research. All patients were male and in prepubertal stage. Serum calcium (Ca) , phosphore (P), alkaline phosphatase (ALP) , osteocalcin (OC), parathormone (PTH) , 25 OH Vitamin D, osteoprotegerin (OPG) , level of deoksipiridinolin (D-pyd) in urinary relation have been researched via DEXA method in the level of lumbar vertebra density of bone minerals between CDGP, FSS and control group. There is no meaningful difference in average and median of calcium phosphore, alkaline phosphatase , parathormone and osteoprotogerin of FSS, CDGP and control group according to parameters from laboratory (p>0.05). While level of 25 OH Vit D in FSS is meaningfully higher than that in control group, differences between FSS and CDGP (p 00.887) and between CDGP and control (p=0.311) are not meaningful. Median of osteokalsin of the children in control group is smaller than the ones in familial and structural short stature. While there is no difference in the level of deoksipiridinolin in urine in FSS and CDGP (z=1.826; p=0.068) and familial and control (Z=0.628; p=0.530) groups; it is higher meaningfully in the CDGP group (Z=2.582; p=0.010). Bone mineral density(BMD) Z score is meaningfully quite low in CDGP when compared with control group (p<0.001). Average Z score of density of bone mineral is similar in the groups of familial and control(p=0.111). It has been observed that there is a direct relation between Z score density of mineral of bone and daily calcium intake (r=0.758; p<0.001). While the link between osteoprotogerin and Z score of bone mineral density children who have familial short stature is reverse, and there is no link found between CDGP and Z score of bone mineral density in control group. There is no link found between Z score of bone mineral density and deoxypyridinoline of urine and 25 OH Vit D. In the children whose bone age is &#8805; 8, Z score median of bone mineral density has been found quite high when compared with familial short stature group statistics. (Z=2.188; p=0.026) Among other parameters , there is no difference in FSS and CDGP. There has beeen found a medium and reverse relation between levels of deoksipiridinolin of urine and osteoprotegerin in the age group of above bone age 8 in the CDGP group. (r=-0.528; p=0.008). As a consequent; bone mineral density in CDGP group has been found low when compared with FSS and control group. The question May there be also an effect of nutritional short stature? has been raised in minds because Ca intake in CDGP group was lower than others. Also since level of deoxypyridinoline in urine is so high; inclination to osteoporosis which starts in prepuberty stage , is believed to be increased with delay of puberty

Education of Healthcare Personnel Working with Pediatric Patients During COVID-19 Pandemic within the Framework of Infection Control

Objective: In the early stages of any epidemic caused by new emerg-ing pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precau-tions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare per-sonnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depend-ing on age, sex, occupation and region.Results: Among four thousand nine hundred twelve healthcare person-nel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theo-retical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions.Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic

Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy

Background: Antibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region. Methods: The prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre. Results: A result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarrhea. In the analysis of antibiotic-associated diarrhea occurrence according to different geographical regions of Turkey, antibiotic-associated diarrhea episodes differed significantly (p = 0.014), particularly higher in The Eastern Anatolia and Southeastern Anatolia. Though most commonly encountered with cephalosporin use, antibiotic-associated diarrhea is not a frequent side effect. Conclusion: This study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region

Education of healthcare personnel working with pediatric patients during covid-19 pandemic within the framework of infection control Covid-19 pandemisinde enfeksiyon kontrol çalışmaları çerçevesinde çocuk hastalarla çalışan sağlık personeli eğitimi

© 2020, AVES. All rights reserved.Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic

SARS-CoV-2 seropositivity among pediatric health care personnel just after the first peak of pandemic: A nationwide surveillance.

BACKGROUND: COVID-19 pandemic affected every single person on earth one way or the other. The healthcare personnel were no exception, their responsibilities as well as their risks being immense. METHODS: 4927 healthcare personnel all working in pediatric units at 32 hospitals from seven different regions of Turkey enrolled to the study to determine the seroprevalence of SARS Co-V-2 after the first peak wave. Point of care serologic lateral flow rapid test kit for IgM/IgG was used (Ecotest CE Assure Tech. Co. Ltd.). Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. RESULTS: Nearly 6.1% of healthcare personnel were found to be seropositive for SARS Co-V- 2. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19 co-worker increased the likelihood of infection. The least and the most experienced personnel affected more. Most of the seropositive healthcare personnel (68%) did not have any suspicion that they had COVID-19 previously. CONCLUSIONS: Health surveillance for healthcare personnel involving routine point-of-care nucleic acid testing as well as monitoring PPE adherence would be important strategies to protect healthcare personnel from COVID-19 and to reduce nosocomial SARS-CoV-2 transmission

Evaluation of vaccination status of health care workers for recommended vaccines and their acceptance of SARS-CoV-2 vaccines

© 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.Introduction: Health care workers (HCWs) are disproportionately exposed to infectious diseases and play a role in nosocomial transmission, making them a key demographic for vaccination. HCW vaccination rates are not optimal in many countries; hence, compulsory vaccination policies have been implemented in some countries. Although these policies are effective and necessary under certain conditions, resolving HCWs’ hesitancies and misconceptions about vaccines is crucial. HCWs have the advantage of direct contact with patients; hence, they can respond to safety concerns, explain the benefits of vaccination, and counter antivaccine campaigns that escalate during pandemics, as has been observed with COVID-19. Method: A short survey was carried out in May–June 2020 on the vaccination status of HCWs working with pediatric patients with COVID-19. The survey inquired about their vaccination status (mumps/measles/rubella [MMR], varicella, influenza, and diphtheria/tetanus [dT]) and willingness to receive hypothetical future COVID-19 vaccines. The respondents were grouped according to gender, age, occupation, and region. Results: In total, 4927 HCWs responded to the survey. Most were young, healthy adults. The overall vaccination rates were 57.8% for dT in the past 10 years, 44.5% for MMR, 33.2% for varicella, and 13.5% for influenza. Vaccination rates were the highest among physicians. The majority of HCWs (81%) stated that they would be willing to receive COVID-19 vaccines. Conclusion: Although vaccination rates for well-established vaccines were low, a majority of HCWs were willing to receive COVID-19 vaccines when available. Education and administrative trust should be enhanced to increase vaccination rates among HCWs