The relationship between mothers' Instagram follower count and the concept of sharenting

BACKGROUND

The phenomenon of sharenting has led to an increase in children's digital presence on social media platforms, particularly Instagram. This study aimed to examine the relationship between features of mothers' Instagram use and their sharing of photos related to their children.

METHODS

The present study was conducted with 130 mothers of children who applied to our university hospital and who had an Instagram account and allowed us to follow them. The mothers completed an online questionnaire that consisted of parents' sociodemographic data and data regarding social media use characteristics. We created a new Instagram account for this study, and we examined the mothers' Instagrams via this account. The number of Instagram followers was analyzed by dividing it into four equal 25% percentiles.

RESULTS

The present study found that mothers with more followers shared more photos about themselves and their children on Instagram per year (p < 0.001). It was confirmed that mothers with more followers were more likely to share their children's photos showing them alone, showing them playing, photos that included identity information, and photos that violated their privacy (p values respectively; p = 0.004, p = 0.001, p = 0.043, p = 0.015).

CONCLUSIONS

This study highlights the association between mothers' Instagram follower numbers and the presence of risky posts about their children on social media. The number of Instagram followers might serve as a predictor of sharenting behavior. The study's findings are discussed thoroughly, and recommendations are provided for future research and practice in this area.

Perceptions of pediatric residents and pediatricians about ethical dilemmas: The case of Turkey

BACKGROUND

This study determined the knowledge, attitudes, and behaviors of pediatricians and pediatric residents regarding issues of ethics, professional education, clinical ethical principles, and consent they encounter in health service delivery.

METHODS

Participants in the study were 134 pediatricians and pediatric residents from three hospitals in Ankara, Turkey. Participants were asked questions regarding their sociodemographic characteristics, their knowledge and views of ethics and ethical education, whether they had ever encountered an ethical problem, their beliefs about obtaining consent from pediatric patients and their families, and case-based questions. All data were collected and evaluated.

RESULTS

Of the participants in the study, 82 (61.2%) were residents, 41 (30.6%) were pediatricians, and 11 (8.2%) were faculty lecturers. The data revealed that 10% of the pediatricians and pediatric residents received ethical education, apart from medical ethics/deontology education at medical school, and 90.3% required further education on children and ethical problems. It was determined that 89% of residents and 78% of pediatricians needed help with the ethical problems they encountered during the diagnostic and treatment processes. Overall, 65.7% of the participants stated that the ethical problems they encountered affected the efficiency of health service delivery. It was observed that residents were more affected by ethical issues than pediatricians were. The present study revealed that pediatric residents and pediatricians need ethics education and there is a need to establish ethics counseling centers in hospitals. There is also a need for further studies in pediatrics and ethics.

Clinical characteristics of firearm-related injuries in children in Turkey

BACKGROUND

A significant number of children are injured by or die from firearm-related incidents every year, although there is a lack of global data on the number of children admitted to pediatric emergency departments (PEDs) and pediatric intensive care units (PICU) with firearm injuries. This study is the most comprehensive analysis of firearm injuries sustained by children in Turkey to date.

METHODS

This multicenter, retrospective, cohort study was conducted between 2010 and 2020 with the contributions of the PEDs, PICUs, intensive care units, and surgery departments of university hospitals and research hospitals.

RESULTS

A total of 508 children were admitted to hospital with firearm-related injuries in the research period, although the medical records of only 489 could be obtained. Of the total admissions to hospitals, 55.0% were identified as unintentional, 8.2% as homicide, 4.5% as self-harm, and 32.3% as undetermined. The Glasgow Coma Scale (GCS) and ventilation support were found to be the most significant predictors of mortality, while head/neck injury, length of stay (LOS) in the hospital and surgical interventions were found to be the most significant predictors of disability. The overall mortality of firearm-related injuries was 6.3%, and the mortality for children admitted to the PICU was 19.8%. The probability of disability was calculated as 96.0% for children hospitalized with firearm injuries for longer than 75 days.

CONCLUSIONS

Head/neck injury, LOS in the hospital, and surgical interventions were found to be the most significant parameters for the prediction of disability. Hospitalization exceeding 6 days was found to be related to disability.

Assessment of cows milk-related symptom scoring awareness tool in young Turkish children

BACKGROUND

The diagnosis of cows milk protein allergy (CMPA) is not always easy. Cow's Milk-related Symptom Score (CoMiSS) has been developed to raise the awareness of CMPA among the primary health-care providers. In this study, we aimed to evaluate the validity of CoMiSS as a diagnostic approach of CMPA in infants in our country.

METHODS

Infants with a CoMiSS of more than 12 points were included. An elimination diet was implemented in these infants for 4 weeks, and CoMiSS was reapplied. Infants with a reduction of ≥3 points in CoMiSS were considered responsive to the elimination diet, and an open oral challenge test was performed. Infants with symptom recurrence were diagnosed with CMPA.

RESULTS

The study included 168 infants. When they were included in the study, the first CoMiSS score was 13.6 ± 1.9. After the elimination diet, the number of responsive infants was 154 (91.7%). Of the infants, 91 (54.2%) were diagnosed with CMPA with positive challenge. The majority of the patients diagnosed with CMPA presented with gastrointestinal and/or dermatological symptoms (80.3%). Positive family history of allergy was more prevalent in CMPA(+) infants (P < 0.001). The mean atopic dermatitis score was higher in CMPA(+) infants (P = 0.001). Eosinophilia and cows milk-specific IgE (CM-sIgE) positivity were more prevalent in infants with CMPA (P = 0.01 and P < 0.001, respectively).

CONCLUSIONS

CoMiSS is a valuable tool to evaluate CMPA in primary care. The presence of multiple symptoms, especially skin involvement, helps to recognise infants with CMPA. Family history and eosinophilia also support the diagnosis of CMPA.

Evaluation of Childhood Vaccine Refusal and Hesitancy Intentions in Turkey

OBJECTIVE

To assess the factors affecting parental childhood vaccine refusal and hesitancy (CVRH) intentions in Turkey.

METHODS

A total of 33 children's parents who were referred to two different child health care clinics because of CVRH and 99 controls were enrolled into this study from November through December 2017. The socio-demographic characteristics and perceptions of the parents who refused at least one vaccine for their child/children were compared with controls.

RESULTS

The monthly household income was significantly lower in CVRH group than control group. Refusal of the heel stick, refusal of hearing test, not using baby car seat, irregular use of vitamin D and iron prophylaxis, using alterative/complementary medicine, distrust in vaccines were the parameters which were found significantly higher in refused vaccine group than in control group. The beliefs "It may be dangerous for children" and "Distrust to the vaccines" were the most determined factors with a ratio of 51.5% in CVRH group.

CONCLUSIONS

This is the first study conducted to investigate the social-demographic characteristics and perception of parental CVRH in Turkey. The beliefs "It may be dangerous for the children" and "Distrust the vaccines" were the most determined factors which may affect CVRH. Some child health protective strategies were less undertaken in CVRH group than in controls; including heel stick test, hearing test, using baby car seat and using of Vitamin D and iron prophylaxis. The parents who have CVRH intentions tend to behave irresponsibly in care of their children.

Plasma Amino-Terminal Propeptide of C-Type Natriuretic Peptide Concentration in Normal-Weight and Obese Children

OBJECTIVE

In studies on the relationship between amino-terminal propeptide of C-type natriuretic peptide (NT-proCNP) concentration and height velocity in children, CNP has been implicated as an emerging new growth marker during childhood. It has been reported that besides its well-studied role in growth, plasma CNP levels are reduced in overweight and/or obese adolescents, suggesting CNP as a potential biomarker in childhood obesity. The primary goal of this study was to test this hypothesis in a Turkish population.

METHODS

Consent was taken from 317 children [ages 0-18 (158 girls, 159 boys)] and their parents. All subjects were physically examined; anthropometric measurements were obtained. Body mass index was calculated. During routine blood work, 1 mL extra blood was taken. Plasma NT-proCNP concentration was measured by enzyme-linked immunosorbent assay.

RESULTS

Results confirmed the previously described relationship between plasma NT-proCNP concentration and growth velocity. Plasma NT-proCNP concentration showed a negative correlation with age, weight, and height in children. Gender was not a factor that alters the age-dependent plasma NT-proCNP concentration until puberty.

CONCLUSION

Unlike previous reports, plasma NT-proCNP concentration of overweight/obese children was not significantly lower than that of children with normal weight in age groups analyzed in a Turkish population. Thus, it is too early to conclude that CNP is a potential biomarker in childhood obesity. Further studies are necessary to address this question.

Secular trends in height, weight and body mass index of primary school children in Turkey between 1993 and 2016

BACKGROUND

The aim of the study was to analyze the secular trends in height, weight and body mass index (BMI) of children in a Turkish primary school in a 23-year time interval.

METHODS

The height, weight and BMI of 1099 children between 7 and 15 years old were measured. Data were compared to those of children of the same ages from previous measurements carried out in 1993 (867 children) and in 2003 (1214 children) in the same school. The changes in weight, height and BMI were determined and analyzed statistically.

RESULTS

Weight increments between 7.7 and 16.2 kg/23 years and height increments between 1.1 and 8.3 cm/23 years were observed in boys. For girls, weight increments between 6.5 and 13.4 kg/23 years and height increments between 1.3 and 7.2 cm/23 years were indicated. Usually, there were significant height increments between 1993 and 2016 in both genders. However, there were no significant differences in height between 2003 and 2016 for all age groups. Furthermore, there were significant differences in BMI measurements in all age and gender groups between 1993 and 2016.

CONCLUSIONS

The secular ascending trend in height seems to stop between 2003 and 2016; however, increments in weight and mean BMI tend to continue in Turkish primary school children and adolescents.

Assessment of developmental and radiological long-term outcomeof children with surgically treated midgut volvulus

BACKGROUND/AIM

The aim is to evaluate the long-term outcome of asymptomatic patients who underwent surgical correction for midgut volvulus.

MATERIALS AND METHODS

Seven patients managed surgically for midgut volvulus in the last 3 years were included. Demographic features, symptoms at presentation, diagnoses, surgical procedures, and complications were recorded. Patients were then contacted for follow-up and evaluation of long-term outcomes. General physical conditions, anthropometric parameters, feeding habits, and defecation histories were evaluated. Laboratory examinations were performed. Color Doppler ultrasonography (CDUS) was performed to evaluate blood flow in the superior mesenteric artery (SMA).

RESULTS

In total, seven patients were identified. The median age at admission was 3 days (0-90 days). Mean age at follow-up was 17 ± 2 months. Growth parameters were normal in all cases. Four patients had low levels of ferritin and transferrin saturation. One patient had microcytic anemia. Another patient had low serum zinc level. One patient who had ileal resection had a high level of steatorrhea in stool examination. In CDUS, SMA blood flow volume was low in all cases. Peak-systolic velocity and resistance index were low in all but one case.

CONCLUSION

Despite uneventful postoperative courses, all patients operated on for midgut volvulus showed mild laboratory changes and decreased blood flow in the SMA in long-term follow-up.

The relationship between family functioning and the crime types in incarcerated children

BACKGROUND

We investigated the relationship between the family functioning and crime types in incarcerated children.

METHODS

One hundred eighty two incarcerated children aged between 13-18 years who were confined in child-youth prisons and child correctional facilities were enrolled into this descriptive study. Participants completed demographic questions and the McMaster Family Assessment Device (Epstein, Baldwin, & Bishop, 1983) (FAD) with face to face interviews.

RESULTS

The crime types were theft, assault (bodily injury), robbery, sexual assault, drug trafficker and murder. The socio-demographic characteristics were compared by using FAD scale, and growing up in a nuclear family had statistically significant better scores for problem solving and communication subscales and the children whose parents had their own house had significantly better problem solving scores When we compared the crime types of children by using problem solving, communication and general functioning subscales of FAD, we found statistical lower scores in assault (bodily injury) group than in theft, sexual assault, murder groups and in drug trafficker group than in murder group, also we found lower scores in drug trafficker group than in theft group for problem solving and general functioning sub-scales, also there were lower scores in bodily injury assault group than in robbery, theft groups and in drug trafficker than in theft group for problem solving subscale.

CONCLUSIONS

The communication and problem solving sub-scales of FAD are firstly impaired scales for the incarcerated children. We mention these sub-scales are found with unplanned and less serious crimes and commented those as cry for help of the children.

Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries

OBJECTIVE

To evaluate the association between adverse childhood experiences - e.g. abuse, neglect, domestic violence and parental separation, substance use, mental illness or incarceration - and the health of young adults in eight eastern European countries.

METHODS

Between 2010 and 2013, adverse childhood experience surveys were undertaken in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, The former Yugoslav Republic of Macedonia and Turkey. There were 10,696 respondents - 59.7% female - aged 18-25 years. Multivariate modelling was used to investigate the relationships between adverse childhood experiences and health-harming behaviours in early adulthood including substance use, physical inactivity and attempted suicide.

FINDINGS

Over half of the respondents reported at least one adverse childhood experience. Having one adverse childhood experience increased the probability of having other adverse childhood experiences. The number of adverse childhood experiences was positively correlated with subsequent reports of health-harming behaviours. Compared with those who reported no adverse experiences, respondents who reported at least four adverse childhood experiences were at significantly increased risk of many health-harming behaviours, with odds ratios varying from 1.68 (95% confidence interval, CI: 1.32-2.15) - for physical inactivity - to 48.53 (95% CI: 31.98-76.65) - for attempted suicide. Modelling indicated that prevention of adverse childhood experiences would substantially reduce the occurrence of many health-harming behaviours within the study population.

CONCLUSION

Our results indicate that individuals who do not develop health-harming behaviours are more likely to have experienced safe, nurturing childhoods. Evidence-based programmes to improve parenting and support child development need large-scale deployment in eastern European.

Evaluation of hearing and speech-language in preschool children: how important, why we should perform?

The aim of the study was to present the hearing and speech-language findings of preschool children. The children in this study were aged 3-5 years. Sixtyseven of 239 children (28.0%) had been referred to a physician because of possible middle ear problems, and 25 of the 67 children had slight and mild conduction type hearing loss with air-bone gaps. One of 239 children had profound sensorineural hearing loss. Speech-language problems were found in 70 of 239 children (29.3%). Necessary attention should be paid to the evaluation of hearing and speech-language skills in preschool-aged children to avoid delayed detection and to give these children the opportunity for timely intervention for hearing and speech-language problems.

The influence of maternal smoking on maternal and newborn oxidant and antioxidant status

BACKGROUND

Maternal smoking has been suggested as a source of oxidant stress in pregnant women and in newborns exposed in utero. The aim of this study was to determine the influence of maternal smoking on oxidant status and antioxidant vitamins of mother-infant pairs.

MATERIALS AND METHODS

Socioeconomic and diet characteristics were recorded from 20 smoker and 20 non-smoker pregnant women of 36 weeks' gestation. On the day of delivery, venous blood samples of the women and cord bloods were taken. On postpartum day 7, milk and infant urine samples were collected. Plasma and milk beta-carotene, retinol, alpha-tocopherol and cotinine levels, plasma malondialdehyde levels, and urine cotinine levels were measured.

RESULTS

Milk alpha-tocopherol levels of smoking mothers were lower than those of non-smoking mothers. In smokers, there were no correlations between maternal vitamin A intakes and milk levels of retinol, and between maternal plasma levels and milk levels of beta-carotene.

CONCLUSIONS

Maternal smoking may lead to decreased milk levels of vitamin E, as a result of making use of this antioxidant in order to limit lipid peroxidation, as well as may lead to a possible limitation on the transfer of lipophilic antioxidants including vitamin A from blood plasma to milk. Further investigations conducted in large populations will be needed to assess the effects of maternal smoking on the oxidant and antioxidant status of breast milk.

Plasminogen activator inhibitor-1 (PAI-1) gene polymorphism (-675 4G/5G) associated with obesity and vascular risk in children

Atherothrombotic complications in insulin resistance are partly attributed to impaired fibrinolysis caused by increased PAI-1 plasma levels, and 4G/5G promotor polymorphism of the PAI-1 gene may modulate PAI-1 transcription.

OBJECTIVE

To investigate PAI-1-675 4G/5G allele gene polymorphism and its relationship with obesity in children. CHILDREN AND METHOD: The study participants were 133 apparently healthy non-obese children, 24 probable exogenously obese without family history (Group I), 66 probable familial obese (Group II), and 44 obese children who were referred to the pediatric endocrinology department with any complication of obesity (Group III). Group I and Group II obese children were gathered from a school-based epidemiological study.

RESULTS

Incidence of obesity was 19% in a school with high socio-economic status, whereas it was 4% in a school with low socio-economic status. Frequencies of 4G/4G gene polymorphisms were 24.81%, 37.50%, 64.80% and 61.11% in the control group, and groups I, II, and III, respectively. In groups II and III, 4G/4G gene polymorphism, and in non-obese control children 5G/5G gene polymorphism, was common. In obese children in the presence of family history for obesity and metabolic syndrome (odds ratio [OR]: 4.48, 95% confidence interval [CI]: 1.26-15.82), carriage of the 4G allele either in heterozygous or homozygous state increased the risk of vascular disease (OR: 6.10, 95% CI 1.64-22.90). In patients with acanthosis nigricans, high HOMA-IR values, hypertriglyceridemia and elevated atherogenic index, 4G/4G genotype frequency was remarkably higher compared to patients with other features of metabolic syndrome.

CONCLUSION

The increasing prevalence of childhood obesity in high socio-economic status is associated with health risks. In obese children with family history of obesity and cardiovascular disease or type 2 diabetes mellitus and in obese children who had any feature of metabolic syndrome, frequency of 4G/4G genotype was more than the 4G/5G and 5G/5G genotypes in the PAI-1 gene. These patients can be at increased risk for developing vascular disease. Acanthosis nigricans, high HOMA-IR value, hypertriglyceridemia and high atherogenic index can also reflect the high risk of vascular disease in metabolic syndrome.

The secular trends in height and weight of Turkish school children during 1993-2003

BACKGROUND

Secular changes in growth and development can be considered as the changing pattern of somatic development of children in a particular population from one generation to another. Developing countries, which have many changes in socio-economical conditions, reveal various trends in growth. The aims of this study were to analyse growth trends in weight and height of Turkish children from a school in Ankara over the period 1993-2003 with 10-year time interval, and to determine the relation between secular trends.

METHODS

Anthropometric measurements of 1214 children and adolescents (611 boys and 603 girls) aged between 7 and 15 years from Ankara, Turkey, obtained cross sectionally in 2003 were compared with measurements of 867 school children (451 boys and 416 girls) from a previous study which had been obtained in the same primary school in 1993. For 7-15 years of age the increments of weight and height were determined, and analysed statistically.

RESULTS

In 2003 survey boys and girls were taller and heavier than their peers from previous study in all age groups. For all cohorts in boys from 7 to 15 years, weight increments between 2.7 and 6.3 kg/decade and height increments between 1.7 and 5.5 cm/decade were demonstrated. For girls in the same cohorts, weight increments between 2.8 and 6.5 kg/decade and height increments between 1.8 and 5.7 cm/decade were indicated. Both weight and height increments suggest an upward displacement of growth curves in this interval of 10 years.

CONCLUSION

A significant secular increase in weight and height measurements were found in 7-15-year-old boys and girls in Ankara. These secular increases can be explained with improvements in social and health indicators that reflect the overall health status of the population. The secular increases in growth of Turkish school children may reveal updates of growth standards.

Interhospital transport of pediatric patients requiring emergent care: current status in Turkey

BACKGROUND

This study was designed to evaluate the current situation of interhospital transport of pediatric patients requiring emergent care.

METHODS

Using a clinical prospective and multicenter design, 1,666 interhospital transports of pediatric patients were evaluated in 18 centers. Non-emergency transports and newborn transports were not included, so 854 transports were eligible for evaluation. Data were collected by means of a comprehensive form filled by a physician at the receiving hospital.

RESULTS

The physicians who gave the decisions for the transports were pediatricians in 60%, general physicians in 15.4%, and residents in 6%, while no identification existed in 159 transports (18.6%). The receiving hospitals were not notified prior to the transport in 79.3%. Pretransport information about the patients were adequate in 26.1% and inadequate in 31.8%; no information was available in 42.1%. Ambulances were used in 64.4% of the transports, of which only 16.2% was fully equipped. Unqualified or inexperienced personnel were in charge in 42.8% of the transports. In 26.3% of the transports, the patients arrived at the receiving hospital in an agonized state.

CONCLUSION

It appears that there are no established guidelines for the emergency transport of pediatric children in Turkey.

Evaluation of erythropoiesis by serum transferrin receptor and ferritin in infants aged 0-6 months

The aim of this study was to evaluate erythropoiesis in 198 healthy babies aged 0-6 months by determination of their blood count, serum transferrin receptor (STfR), and ferritin levels. Anemia and microcytosis were present in 9% and 13% of the sample, respectively. Microcytosis rate was as high as 45% in 6-month-old babies. In infants with normal blood counts, the values of sTfR/ferritin and sTfR-F index were increasing with the increase of sTfR and decrease of ferritin beginning from 2 months of age. In the 5- to 6-month-old group, sTfR concentrations, sTfR/ferritin ratio, and sTfR-F index were higher in infants with anemia and microcytosis. This research showed a high frequency of iron deficiency detected in otherwise healthy babies. Only problems with early weaning practices were found to be significantly more common in babies with iron deficiency.

Attitudes and practices of breastfeeding mothers regarding fasting in Ramadan

OBJECTIVE

To investigate the attitudes and practices of breastfeeding mothers regarding fasting in Ramadan.

DESIGN

Cross-sectional observational survey.

SETTING

Well-child care clinic at Ankara University Medical School and a health station serving an impoverished population in Ankara, Turkey.

PARTICIPANTS

Breastfeeding mothers of infants aged 12 months or younger.

MAIN OUTCOME MEASURES

Fasting during Ramadan.

RESULTS

Of the 164 participating mothers, 61 (37%) were from the health station and 103 (63%) from the university clinic. Most mothers were older than 25 years of age (55%), had more than primary school education (64%), a single child (53%), were living in a nuclear family setting (70%), supplementing breastfeeding (73%) and fasting (52%). Among the 129 mothers of infants aged 6 months or younger, 22% perceived a decrease in their breast milk and 23% an increase in the amount of solid supplements the infant was receiving. Belief that breastfeeding mothers should fast (RR = 6.45, 95% CI: 2.44-17.06), that fasting does not decrease breast milk (RR = 6.24, 95% CI: 1.85-21.05), receiving well-child care at the health station (RR = 3.14, 95% CI: 1.33-7.44), giving supplements (RR = 2.82, 95% CI: 1.09-7.27) and having multiple children (RR = 2.78, 95% CI: 1.23-6.28) were associated with fasting, in a logistic regression model.

CONCLUSIONS

Fasting by breastfeeding mothers of infants is common during Ramadan, and rates are affected by beliefs of mothers on the effects of fasting on breastfeeding. We believe that child health care providers need to be knowledgeable about religious and cultural phenomena, study the effects of Ramadan fasting and form links with Islamic teachings to find religiously and culturally appropriate methods to combat the possible unfavourable effects for infants and children.

Socioeconomically advantaged infants attending a university well-child clinic in Ankara: are they breast-feeding optimally?

This longitudinal observational study aimed to determine the rates of initiation, duration and correlates of breast-feeding by mothers living in a socioeconomically advantaged urban environment in Turkey. Healthy, term infants born at Ankara University Faculty of Medicine Hospital who would be brought to the well-child clinic regularly for at least 12 months were enrolled. Data on feeding practices were obtained at the 1st, 2nd, 3rd, 4th, 5th, 6th, 9th and 12th month well child care visits. Breast-feeding outcome was categorized based on recommendations by the World Health Organization (WHO). The majority of the 295 participating mothers were older than 20 years, high school graduates, and lived in apartment housing, and 54.6% were employed. The rates of breast-feeding were 97.9%, 90.1%, 76.9% and 36.9% at 1, 4, 6 and 12 months, respectively, and rates of exclusive breast-feeding were 89.8%, 59.3% and 2.0% at 1, 4 and 6 months, respectively. At 6 months 69.8% of infants were receiving cow's milk and by 12 months only 23.4% of the infants had been breast-fed according to WHO recommendations. Neither gender; birth weight of infant; age, education, parity, previous breast-feeding experience of mother; nor the status of living as extended versus nuclear family were related to breast-feeding outcome. Mothers who were working (RR: 3.89, 95% CI: 1.42-10.65) and those who had less than 4 months postpartum leave from work (RR: 4.20, 95% CI: 2.16-8.17) were more likely to not breast-feed optimally. The results of this study indicate that even where breast-feeding is normative behavior, it may not be optimally practiced, leading to potentially detrimental nutrition for infants. Promotion of breast-feeding even in advantaged urban populations is needed.

Alternative diagnostic method for streptococcal pharyngitis: Breese scoring system

This study was performed to determine the effectiveness of the Breese scoring system for the diagnosis of streptococcal pharyngitis with respect to different age groups. Two hundred and two children aged three years and younger (Group 1), and 514 children over three years old (Group 2) with complaints of acute pharyngitis were evaluated by Breese scoring and throat-swab cultures. In Group 1, no significant difference was detected in Breese scoring between subjects who had positive and negative culture for group A beta-hemolytic streptococci (GABHS). However, in Group 2 the mean value of the Breese scores was found to be higher in subjects who had positive GABHS. The diagnostic value of Breese scoring was examined for each group. Its sensitivity, and positive and negative predictive values were higher in Group 2 than in Group 1. In conclusion, Breese scoring was determined to be helpful in the diagnosis of streptococcal pharyngitis in children over three years of age.

Immunogenicity study of a combined diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis vaccine used to reconstitute a freeze-dried Haemophilus influenzae type b vaccine (DTaP-IPV//PRP-T) administered simultaneously with a hepatitis B vaccine at two, three and four months of life

This study was designed to assess the immunogenicity of a vaccine combining diphtheria and tetanus toxoids, acellular pertussis vaccine, and inactivated poliovirus vaccine reconstituting Haemophilus influenzae type b polysaccharide conjugated to tetanus protein (DTaP-IPV//PRP-T; Pasteur Mérieux Connaught, Lyon, France) administered simultaneously in association with hepatitis B vaccine (RECOMBIVAX (¿trade mark omitted¿) Merck, Sharp & Dohme, West Point, PA, USA) for the primary immunization of infants. The vaccines were administered at two, three and four months of age. One hundred and sixty-two healthy infants, aged 8-10 weeks, were enrolled in the study. Blood samples were taken before the first dose and 4 weeks after the third dose. The infants were observed for 15 minutes after vaccination for any immediate reaction. Adverse events requiring a medical consultation were recorded by the parents in a diary over the 7 days following vaccination. Four weeks after the third immunization, the percentages of infants fulfilling seroconversion criteria were 98.9% for pertussis toxin, 95.9% for filamentous haemagglutinin, 100.0% for tetanus, 100.0% for diphtheria, 99.3% for poliovirus type 1, 100.0% for both poliovirus types 2 and 3, 98.0% for Haemophilus influenzae type b, and 100% for hepatitis B surface antigen. No vaccine-related serious adverse event was reported. The simultaneous administration of DTaP-IPV//PRP-T and hepatitis B vaccines at two, three and four months of age yielded clinically satisfactory immune responses to all antigens compared with historical controls and gave a good safety profile.

Assessment of the efficacy and safety of paracetamol, ibuprofen and nimesulide in children with upper respiratory tract infections

OBJECTIVE

The aim of this study was to assess and compare the efficacy and tolerability of paracetamol, ibuprofen and nimesulide in children with upper respiratory tract infections (URTIs).

METHODS

Ninety children with acute URTIs and fever were enrolled to the study. The patients were allocated to three groups. The first group was treated with paracetamol 10 mg/kg thrice daily; the second group with ibuprofen 10 mg/kg thrice daily; and the third group received nimesulide 2.5 mg/kg twice daily for 5 days.

RESULTS

The anti-pyretic activity of nimesulide was greater and more rapid than either paracetamol or ibuprofen. The number of patients with normal temperature was significantly greater in the first 2 days for the nimesulide group. The improvement in cough for the paracetamol group was better than the others.

CONCLUSION

The results of this study demonstrated that the anti-pyretic effectiveness of nimesulide is better than paracetamol and ibuprofen in febrile children with URTIs. However, new studies in larger paediatric populations are required to explore the anti-inflammatory effect of nimesulide.