Objectives: Chest pain in childhood is a frequent cause of referral to pediatric cardiology departments although cardiac etiology is very rare. Etiology is usually unidentified and named as 'idiopatic chest pain'. It is also well known fact that chronic pain is associated with insuffiency of some nutritional factors even in childhood. Our aim was to investigate if there is a relationship between nutritional defiencies with idiopathic chest pain in children. Methods: We retrospectively reviewed 364 patients who were referred pediatric cardiology department in one year period due to experienced chest pain more than one time. Among these patients, a total of 109 patients who had complete blood count, serum ferritin, vitamin B 12 and 25-(OH) vitamin D levels in pediatric outpatient clinics before and the etiology was still unidentified after a detailed cardiac and other examinations formed the study group. Age and sex matched 59 healthy children without chest pain formed the control group. All participants had been evaluated with a detailed physical examination and patients in chest pain group also had an electrocardiographic ve echocardiographic evaluation. Results: Vitamin B12 and Vitamin D levels were lower in noncardiac chest pain group while there was no difference between groups in term of ferritin levels and complete blood count parameters. These difference is statistically significant particularly in vitamin D levels. Conclusions: Our results showed that low Vitamin D levels is associated with chronic chest pain in children. The present study provide the necessity of evaluating nutritional parameters in children with noncardiac chest pain.

ABS TRACT Objective: Sudden cardiac death (SCD) that may occur during sports activation of young healthy athletes is a painful condition and impose responsibilities on both families and physicians. Although, there is not an established standard protocol in medical screening of sports preparticipation, any of the screening procedure cannot completely rule out the presence of cardiovascular disease and prevent from SCD. The aim of this study is to evaluate the frequency of cardiac anomalies in healthy children evaluated by electrocardiography (ECG) and transthoracic echocardiography before sports participation and to question the necessity of pediatric cardiologist evaluation in the light of the available data. Material and Methods: All children who were admitted to Pediatric Cardiology Department of Keçiören Training and Research Hospital to get certificate to conform sports activation and underwent cardiac examination, ECG and echocardiography between October 2018 and October 2019 were enrolled in the study and findings were evaluated retrospectively. Results: A total of 785 children and adolescents with median age of 12 (minumum 5-maximum 18) years were enrolled in the study in one year period. A total of 27 (3.4%) participants showed abnormal findings on physical examination. ECG abnormalities were detected in 48 (6.1%) participants. Structural cardiac anomalies were observed in 53 (6.7%) participants by echocardiography. None of the echocardiographic diagnoses were hemodynamically significant. Conclusion: Echocardiography allows to diagnose cardiomyopathies or hemodynamically significant structural heart diseases which lead to decision of sports disqualification. However, in such a case, symptoms and ECG abnormalities may occur earlier and may be a guide for physicians for further examination. Comprehensive cardiac evaluation by a pediatric cardiologist including echocardiography should be performed in patients with suspected personal and family history, pathological findings in physical examination and/or pathological ECG findings.

ABS TRACT Objective:Overdose drug intake is a common method of suicide attempt among children and adolescents which can cause cardiac complications. However, the current body of knowledge about cardiotoxicity largely consists of limited adult studies and case reports. We investigated the prevalence of cardiac involvement through cardiac biomarkers and electrocardiographic findings of suicidal attempt at pediatric age. Material and Methods: A retrospective review of 158 suicide attempts by drug overdose under age of 18 who were admitted to pediatric emergency department was made. Demographic features, applied medical procedures, patients' routine laboratory findings, electrocardiographic findings and serum levels of high sensitive troponin I, CK-MB and myoblobin were rewieved. Results: Of these 158 cases, 82.3% (130) were girls and the average age was 15.5±1.4 (7-17) years. Seventy nine cases (50%) were multidrug intake. The mean duration of admission to the emergency room was 3.9 hours after drug intake. None of the cases had obvious electrocardiographic changes in terms of myocardial injury. However, mild QRS widening and QT prolongation were detected in three patients. Elevated myoglobin level was detected in 36 cases whereas two cases had elevated CK-MB levels. Increased level of high sensitive troponin I level was in only one case who took overdose asetil salisylic acide and mianserine. Conclusion: Cardiac complications may occur in suicidal attempt by drug overdose in children. High clinical suspicion with evaluation through electrocardiography and cardiac biomarkers is needed to detect this vital condition.ÖZET Amaç: Aşırı dozda ilaç alımı, çocuk ve ergenlerde kardiyak komplikasyonlara neden olabilen yaygın bir intihar girişimi yöntemidir. Bununla birlikte, kardiyotoksisite hakkında mevcut bilgi birikimi büyük ölçüde sınırlı yetişkin çalışmaları ve vaka raporlarından oluşmaktadır. Bu çalışmada , intihar girişimi bulunan çocuklarda kardiyak etkilenimi, kardiyak biyobelirteçler ve elektrokardiyografik bulgular ile değerlendirdik. Gereç ve Yöntemler: Çocuk acil servisine intihar amaçlı aşırı dozda ilaç alımı ile başvuran 18 yaş altı 158 hasta retrospektif olarak gözden geçirildi. Demografik özellikler, uygulanan tıbbi prosedürler, hastaların rutin laboratuvar bulguları, elektrokardiyografik bulguları ve yüksek duyarlı troponin I, CK-MB ve miyoblobin düzeyleri değerlendirildi. Bulgular: Çalışmaya dahil olan 158 vakanın 130'u (%82,3) kız, yaş ortalaması 15,5±1,4 (7-17) yıl idi. Yetmiş dokuz olgu (%50) çoklu ilaç alımı ile başvurdu. Acil servise ortalama başvuru süresi ilaç alımından itibaren 3,9 saat idi. Hiçbir olguda miyokard hasarı açısından belirgin elektrokardiyografik değişiklikler saptanmadı. Ancak, üç hastada QRS mesafesinde hafif genişleme ve QT uzaması tespit edildi. Otuz altı olguda yüksek miyoglobin düzeyi, iki olguda yüksek CK-MB düzeyi bulundu. Artmış yüksek duyarlı troponin I seviyesi, sadece aşırı dozda asetil salisilik asit ve mianserin alan bir vakada saptandı. Sonuç: Çocuklarda intihar amaçlı ...

Objective: Vitamin B12 is crucial for cell metabolism, deoxyribonucleic acid synthesis and cell proliferation. Hematological and neurological systems are known to be affected in vitamin B12 deficiency. The aim of this study was to research the effects of vitamin B12 deficiency on kidney function parameters.Material and Methods: Thirty-four children with vitamin B12 deficiency and 36 sex and age-matched healthy controls were included in the study. Complete blood count, serum urea, creatinin, vitamin B12, holotranscobalamin, methyl malonic acid, homocysteine, ferritin, folate and estimated glomerular filtration rate were recorded. Additionally, spot urine protein, microalbumin and neutrophil gelatinase-associated lipocalin were measured.Results: Kidney function parameters were normal for childrens that participated the study. Serum kidney function parameters adjusted for age also showed no significant difference between the two groups. No correlation was found between serum vitamin B12 and neutrophil gelatinase-associated lipocalin; however, a negative correlation was detected between neutrophil gelatinase-associated lipocalin and holotranscobalamin (r =-0.24, p =0.045). Holotranscobalamin was substantially lower in the group with vitamin B12 deficiency (p<0.001). Conclusion:No negative influence of B12 deficiency on kidney function was found in non-anemic children.