Abstract:Background: The thyroid gland and hormonal regulation are among the most important systems to be investigated in pre-term infants. This study sought to investigate thyroid hormone levels of healthy and unhealthy pre-term infants. Methods: The prospective study included 53 consecutive premature infants admitted to the neonatal intensive care unit within a duration of one year. Of these preterm babies, 20 were healthy, while 33 had problems such as asphyxia or RDS. Venous blood samples were collected at baseline 0-24 hours, 7 and 14 days and FT3, FT4, and TSH levels were determined. Other data recorded included demographic characteristics of the patients and clinical variables. Results:The most frequent health problems were RDS (87.9%), sepsis (30.3%), and retinopathy of prematurity (24.2%). The mean TSH levels showed a consistent decline at three consequent measurements in both groups, which were always significantly lower in unhealthy pre-terms. In both groups, TSH levels showed significant decreases on Day 7 and Day 14 compared to the baseline levels (p<005). The levels of FT3 and FT4 consistently showed significant correlations with gestational week and birth weight at each of the three measurements. Conclusion: Pre-term infants, especially those having problems, have significant hypothyroxinemia that may require thyroid hormone replacement therapy.

Objectives: To investigate the effect of rapid antigen testing (RAT) on the practice of antibiotic prescription as well as the accuracy of peripheral blood neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) values in detecting group A beta-hemolytic Streptococcus (GABHS) in children with tonsillopharyngitis. Methods: In a multicenter study performed in Turkey, we retrospectively analyzed data from 668 consecutive pediatric patients under 17 years of age, who presented with signs and symptoms of tonsillopharyngitis and underwent RAT. The rates of positive and negative RAT results were determined and patients' antibiotic prescriptions were examined in relation to RAT results. In addition, the accuracy of peripheral blood NLR and CRP values was examined for 212 patients whose laboratory data were available, with RAT as the reference standard. Results: Positive RAT results were observed in 190 of 668 (28.4%) patients. Antibiotics were prescribed to all 190 patients with positive RAT results and to 8 of 478 patients with negative RAT results. Overall, the rate of antibiotic prescription was 29.6%. Patients with positive and negative RAT results did not differ significantly with regard to NLR and CRP values. In ROC analysis, the area under the ROC curve (AUC) of NLR and CRP were 0.54 (95% confidence interval [CI] 0.45–0.64), and 0.55 (95% CI 0.45–0.65), respectively. Conclusion: RAT results proved highly associated with antibiotic prescribing, suggesting that RATs could be of great value in preventing unnecessary antibiotic use. Our findings also suggest that NLR and CRP are poorly accurate to identify GABHS in children with tonsillopharyngitis.

Neurogenic pulmonary edema is a clinical situation which developes as a result of central nervous system injury. It is rare in the childhood. Neurogenic pulmonary edema is a clinical diagnosis. Although the pathogenesis is not elucidated well, there is increase in pulmonary interstitial and alveolar fluid. The main principle in treatment of neurogenic pulmonary edema is supportive treatment and decreasing intracranial pressure as in acute respiratory distress syndrome. In this article, clinical properties of our two patients diagnosed with neurogenic pulmonary edema developed as a result of central nervous system injury are presented. (Turk Pediatri Ars 2015; 50: 241-4)

Objective Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory syndrome associated with multiorgan damage that occurs following coronavirus disease 2019 (COVID-19). Research on clinical and laboratory findings, and imaging studies, aiming to predict the progression to severe disease state is limited. This study recruited patients with MIS-C who presented with mild or severe symptoms from a single center in Turkey and evaluated factors related to their symptoms. Methods This retrospective study included 25 pediatric patients with mild and severe presentations of MIS-C. We explored the differences in demographic and clinical data on clinical severity to understand their possible diagnostic and prognostic values. Results Patients with MIS-C had cardiovascular symptoms (68%), gastrointestinal symptoms (64%), dermatologic/mucocutaneous findings (64%), lung involvement (36%), and neurological symptoms (16.0%). About 45.1% of patients with MIS-C had manifestations that overlapped with Kawasaki disease. Eleven patients (44%) were admitted to the intensive care unit, and one (4%) patient died. Grouping based on clinical severity did not differ statistically in terms of gender, age, height, weight, body mass index, and duration of hospital stay. Procalcitonin and ferritin levels correlated with disease severity. The receiver operating characteristic curve for D-dimer gave the highest value of area under the curve, among other biomarkers. The cutoff value for D-dimer was determined as more than 6780. Conclusions Although COVID-19 is usually mild in children, some can be severely affected, and clinical severity in MIS-C can differ from mild to severe multisystem involvement. This study shows that procalcitonin, ferritin, and D-dimer levels may give us information about disease severity.