The Evaluation Of The Effects Of Passive Smoking On Children's Health With Detection Of Urine Cotinine Levels

Background: Passive smoking exposure is an important public health problem that causes pneumonia, bronchiolitis, bronchopneumonia, asthma formation and exacerbation, middle ear inflammation, tooth decay, growth retardation and development in children.Objectives: In this study, it was aimed to evaluate passive smokers objectively by cotinine level in urine.Method: Eighty children with at least one active smoker at home and 80 children who were not active smoker at home were admitted to the Ankara Education and Research Hospital . Parents were asked a questionnaire to the sociodemographic characteristics of their children and their families, the habits of smoking and the illnesses they had in a year. To assess passive smoking exposures, the first urine of children was collected and the level of cotinine, the main metabolite of nicotine in the urine, was measured using the solid phase competitive chemiluminescence immunoassay method on the Immulite 2000 Analyzer. A cut-off value of 10 ng / ml was obtained for diagnosis of passive smoking. Patients with cotinine levels above this value were assessed as "exposed to passive smoking".Results: In passive smoking exposures, the number of illnesses and wheezing has increased in the last year. The preterm birth and wheezing frequency of the smokers were significantly higher in the pregnant women (p <0, 05). Median cotinine level was found to be 10 ng / ml in the passive smoking group but median cotinine level was found to be 20,8 ng / ml in the cigarette group (p <0,01). The group with only mother smokers had significantly increased incidence of tooth decay compared with other groups (p <0.05). No relationship was found between birth weigth of infant and smoking behaviour during pregnancy (p=0,53), however the frequency of prematurity was found to be higher  (p=0.03).The cotinine level of 68.7% of patients in the passive smoking group and 25% of the control group was above the threshold value of 10 ng / ml. The most sensitive and specific threshold level of cotinine was found as 14.75 ng/ml. Conclusions: Our study showed that 25% of children who do not smoke at home are exposed to passive smoking. This finding suggests that families are biased towards reporting smoking cessation alongside their sick children and those children are also exposed to cigarette smoke in out-of-home settings

Abusive Head Trauma in Turkey and Impact of Multidisciplinary Team Establishment Efforts on Case Finding and Management: Preliminary Findings

Aim: Abusive head trauma (AHT) is the most common cause of death as the result of child abuse. A task force is planned to provide training on AHT to professionals in different disciplines on clinical presentation, diagnostic workup, and organization of multidisciplinary evaluation at the hospital and community levels. This study reports on the preliminary findings of the pre-intervention phase of a larger study

Abusive Head Trauma in Turkey and Impact of Multidisciplinary Team Establishment Efforts on Case Finding and Management: Preliminary Findings

Aim: Abusive head trauma (AHT) is the most common cause of death as the result of child abuse. A task force is planned to provide training on AHT to professionals in different disciplines on clinical presentation, diagnostic workup, and organization of multidisciplinary evaluation at the hospital and community levels. This study reports on the preliminary findings of the pre-intervention phase of a larger study

COVID-19 Disease in Presenting to the Pediatric Emergency Department: A Multicenter Study of 8886 Cases.

Background: The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical out-comes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population.Methods: This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific anti-bodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of con-tact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded.Results: A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0-15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9-10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU.Conclusion: Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups.(c) 2022 Elsevier Inc. All rights reserved