Effect of Helicobacter Pylori Infection on Serum Vitamin D Levels Patients with Dyspepsia

Introduction: We aimed to compare serum levels of Vitamin D3 in patients with and without Helicobacter pylori (HP) infec- tion detected with the upper gastrointestinal endoscopic examination. We hypothesized that patients diagnosed with HP pathologically had low serum vitamin D3 levels. Methods: The study was held between July 1, 2019, and March 31, 2021, tertiary referee hospital. The upper gastrointestinal system endoscopic data of pediatric patients with treatment-resistant dyspeptic complaints who were followed up in the Pediatric Gastroenterology outpatient clinic of hospital between July 1, 2019, and March 31, 2021, were retrospectively evaluated. The age, height, height standard deviation score (SDS), weight, weight SDS, body mass index (BMI), BMI SDS, and serum Vitamin D3 levels of the patients who were divided into two groups according to the presence of HP histopathologi- cally in the endoscopic biopsy samples were examined. Results: Eighty-six patients were evaluated, while 58 (67.44%) were girls and 28 (32.55%) were boys. The median age was 14.43 (ınterquartile range [IQR]=4.99) years. Histopathological evaluation of biopsy materials taken from the antrum and cor- pus of 43 patients who underwent upper gastrointestinal endoscopy revealed HP positivity in 43 patients (50.00%). HP was not detected in 43 patients (50.00%). The median Vitamin D3 level was 10.00 ng/ml in the HP positive group (IQR=6.00), and the median was 14.00 ng/ml (IQR=9.30) in the negative group. This study found a significant difference between HP positive and HP negative patient groups in Vitamin D3 serum levels (p=0.033). Discussion and Conclusion: Vitamin D3 serum levels were found to be significantly lower in the HP positive group than that of controls (p=0.033). This finding supports that mucosal damage may affect Vitamin D3 absorption. Early diagnosis and treatment maintain their importance to prevent long-term consequences of chronic infection

Evaluation of Clinical Characteristics, Laboratory, Radiological Findings and Outcomes of Hospitalized Children with Coronavirus Disease 2019

ABSTRACTObjective: We assessed our knowledge about the epidemiological, clinical characteristics, laboratory/radiological findings, and outcomes of hospitalized children with COVID-19. Materials and Methods: This retrospective single-center study was conducted on 54 children with COVID-19 who were hospitalized from March 16, 2020, to April 26, 2020, in the Pediatric Department at Sancaktepe Training &amp;Research Hospital Istanbul, Turkey. Results: The median age of our patients was 121.5 months (range 1-214 months), of the 54 hospitalized children, 48.1% (n=26) were female, and 51.9% (n=28) were male. The most common symptom was cough (n=24, 44.4%). The median duration of hospitalization was five days (range 1-13 days). According to the PCR test results, 24 (44.4%) patients were positive, and 30 (55.6%) were negative. Among 54 children, white-cell count (WBC), absolute neutrophil count (ANC) were significantly lower, and CRP levels were significantly higher in PCR negative patients. Computed tomography was performed in 26 children, and 19 (73.1%) CT scans were consistent with classic/probable/indeterminate COVID-19 predominant patterns. Oxygen requirement was significantly higher in our PCR negative patients. Conclusion: As a result of the low sensitivity of PCR test results, clinicians should consider clinical signs and symptoms in deciding on the diagnosis and treatment of COVID-19. Keywords: Children, clinical features, Covid19&nbsp;</p

Çocuk Acil Servisinin En Küçük Misafirleri: Yenidoğanlar

Amaç Yenidoğan dönemi çocukluk çağının en savunmasız dönemlerinden biridir. Çalışmamızda çocuk acil servisine getirilen yenidoğan bebeklerin başvuru nedenleri ile izlem özelliklerini değerlendirmeyi amaçladık. Gereç ve Yöntemler 01.09.2018-01.09.2019 tarihleri arasında İstanbul Şehit Prof. Dr. İlhan Varank Sancaktepe Eğitim ve Araştırma Hastanesi çocuk acil servisine başvuran yenidoğanların demografik ve klinik bilgileri hastane veri tabanından alınarak geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, başvuru nedeni, başvuru zamanı ve klinik seyirleri değerlendirildi. Bulgular İncelenen 12 aylık süreçte çocuk acile başvuran hasta sayısı 209.030 idi. Yenidoğanlar (0-28 gün) başvuruların %1,54’ünü (3224) oluşturuyordu, %46,96’sı (1.514) kız, %53,04’ü (1.710) erkekti. Vakaların en sık başvuru yaşının %63,94 (2062) ile 7-28 günler arasında olduğu görüldü. Sarılık (n=1.193, %37) en sık başvuru nedeniydi. En fazla başvuru Ağustos ayında (n=428, %13,28) olduğu görüldü. Hastaların %89,61’i (2.890) ayaktan, %10,39’u (334) yatırılarak izlendi. Takip sırasında kaybedilen olgumuz olmadı. Sonuç Çalışmamızda, yenidoğan başvurularının büyük çoğunluğunu normal sağlıklı yenidoğan bebeklerin oluşturduğu görülmüştür. Ailelere doğum öncesi ve sonrası eğitim verilmesinin acil servise gereksiz başvuruları azaltabileceğini ve ciddi bulguları olan bebeklerin erken başvurularını sağlayabileceğini düşünüyoruz.Objective The neonatal period is one of the most vulnerable periods of childhood. In our study, we aimed to evaluate the reasons for admission and follow-up characteristics of newborn babies admitted to the pediatric emergency department. Material and Methods Demographic and clinical characteristics of newborns applied to the pediatric emergency department of Istanbul Sancaktepe Training and Research Hospital between 01.09.2018 and 01.09.2019 were taken from the hospital database and analyzed retrospectively. Age, gender, reason for admission, time of admission and clinical course of the patients were evaluated. Results The number of patients admitted to the pediatric emergency department during the 12-month period was 209.030. Newborns (0-28 days old) constituted 1.54% (3224) of the admission, 46.96% (1,514) were girls, 53.04% (1,710) were boys. The most of the cases (63.94%, n=2062) were between 7 and 28 days old. Jaundice (n=1,193, 37%) was the most common reason for admission. The highest number (n=428, 13.28%) of admissions was in August, 89.61% (2,890) of the patients were followed up outpatient and 10.39% (334) of them were hospitalized. We did not have any mortality cases during follow-up. Conclusion In our study, it was observed that the majority of newborn admissions consisted of normal healthy newborn babies. We think that providing education to families before and after delivery can reduce unnecessary admissions to the emergency department and provide early admissions of babies with severe symptoms

Manisa merkez yarı kentsel bölgede bir aile sağlığı birimine kayıtlı kadınlarda bazı birinci basamak sağlık hizmet özelliklerinin değerlendirilmesi

Özet                       Amaç: Birinci basamak sağlık hizmet özellikleri kaynakça doğrultusunda bilimsel olarak ölçülebilir niteliktedir ve ilk başvuru, süreklilik, kapsayıcılık ve koordinasyon gibi temel hizmet özellikleri üzerinden değerlendirilir. Yöntem: Örnek seçiminde çok aşamalı küme örnekleme yöntemi kullanılmış, veriler yüz yüze görüşme tekniğine göre yapılandırılmış anketle toplanmıştır. Araştırma bölgesindeki toplam hane sayısı 870’tir. Küme örnekleme yöntemi ile 376 haneden 318 kadına ulaşılmıştır. Araştırmanın ulaşılabilirlik oranı % 84.6’dır. Araştırmanın bağımlı değişkenleri; İlk başvuru, Süreklilik, Kapsayıcılık ve OHS (Olağan Hizmet Sürekliliği) gibi hizmet özellikleridir. Bağımsız değişkenler ise kadının ve eşinin yaşı, kadın ve eşinin eğitimi, medeni hal, kadının çalışma durumu, sosyal sınıf (eşin işine göre), gelir algısı, bölgede yaşama yılı, göç edilen bölge, sağlık güvencesi, aile tipi, beş yaşından küçük çocuk varlığı ve hanedeki çocuk sayısı kullanılmıştır. Bulgular: Katılımcıların yaş ortalaması 38.3±15.3’tür. Bir sağlık sorunu nedeniyle aile hekimine başvurma % 61.0, ondan bir önceki sağlık sorununda AH’ne (Aile Hekimi) başvuru %55,2 oranındadır. Bu soruların her ikisine de “aynı aile hekimine başvururum” cevabını verenlerin (OHS) oranı  %40.1 olmuştur. Aile Sağlığı Birimini yakın, normal mesafe bulanların oranı %93.1’dir. Aile hekiminin ismini bilme %84, ebenin ismini bilme %36.2, her türlü sorununuzla sürekli ilgilenen bir hekim veya sağlık kuruluşuna kayıtlı olduğunu söyleyenlerin %74.5’tir. Son bir yılda evime ebe ziyareti aldım diyenler %40.6 oranındadır. Sonuç: Araştırmanın yapıldığı ASB’de geçen bir yıllık ilk AH uygulama döneminde sosyalleştirme dönemiyle karşılaştırıldığında, tedavi edici hizmet örüntüsünün değişmediği buna karşın gezici ebe hizmetlerinin azaldığı görülmüştür.Anahtar Kelimeler: Aile sağlığı birimi, ilk başvuru, süreklilik, kapsayıcılık, olağan hizmet sunucu sürekliliğiAbstractAim: The capability of primary care services can be scientifically measured and assessed via basic elements of these services such as accessibility, longitidunality, comprehensiveness and coordination. Methods: A multistage cluster sampling method was used and the data were collected by face to face interviews with a structured questionnaire. An overall 870 households which were recorded in  a Family Practice Unit (FPU) consisted of the universe of this study and 318 women were identified from a sample of 376 households by cluster sampling method. The response rate was of 84.6%. The dependent variables in the study were, the First contact care, Continuity (Usual provider continuity), Comprehensiveness; whereas independent variables were, the women’s and husband's age, the women's and husband's education, marital status, women's occupational status, family social class, perception of income, years of residency in the region, the area of emigration, health insurance status, family type, existence of children under five years of age. Results: The average age of participants was 38.3 ± 15.3. The percentage of women who preferred FPU services for their most recent health problem was 61.0%, whereas this percentage was 55.2% for the previous experienced health problem. The Usual Provider Continuity (UPC) rate was 40.1%. 93.1 percent of women stated that FPU is quite close to their house. The proportion of the women who knew the name of their family physician was 84.0% and 36.2% them knew the name of their midwife. Of the respondents, 74.5% had been registered with a PHC facility or a primary care physician.  Midwives visited 40.6% of the respondents at least once during the last year. Conclusion: This research indicates that, the pattern of therapeutic services was not changed in the new FPU system, compared to the previous socialized health organization in the Primary Care services. Besides this fact, mobile midwife services might be said to have decreased in the new FPU system.Key Words: Family health unit, the first contact, continuity, comprehensiveness, usual provider continuity.                                                 </span

Levels of pro- and anti-inflammatory cytokines in cystic fibrosis patients with or without gingivitis

Background: Inflammatory periodontal diseases are caused by interaction between gram negative, anaerobic bacteria and host response. Persistent infection of Pseudomonas aeruginosa in cystic fibrosis (CF) patients also cause increased pro-inflammatory response and the imbalance of pro- and anti-inflammatory response in brochoalveolar lavage fluid which leads to destruction of lungs. The aim of this study is to evaluate periodontal status of CF patients, to measure level of cytokines and biochemical molecules in gingival crevicular fluid (GCF), and to detect presence of P. aeruginosa in dental plaque samples. Materials and methods: GCF samples were collected from 41 CF patients and 39 healthy (non-CF) subjects. Interleukin (IL)-1ß, IL-17, IL-10, human neutrophil elastase (HNE), cystic fibrosis transmembrane regulator (CFTR) protein, and human β-defensin-1 (HBD1) in GCF were evaluated by ELISA method. Dental plaque samples were collected from 18 CF patients with history of P. aeruginosa colonization and 15 non-CF subjects. Presence of P. aeruginosa was evaluated by using conventional culture methods and molecular methods. Results: Levels of IL-1ß, HNE, and HBD1 in CF patients were significantly higher than non-CF subjects. However, IL-10 level was significantly lower in CF patients. Increased pro-inflammatory (IL-1ß) and decreased anti-inflammatory (IL-10) cytokine levels were observed in GCF samples from CF patients, irrespective of their periodontal status. P. aeruginosa were detected in four samples of 18 CF patients, and all were negative in non-CF group. Conclusions: As a result of this study, CF coexists increasing pro-inflammatory and decreasing anti-inflammatory response locally. Due to increasing pro-inflammation, CF patients should be followed-up more often than non-CF children