Objective: To evaluate i) the frequency of typical hypothyroidism symptoms in children with subclinical hypothyroidism (SH), ii) to evaluate the association of SH with lipoproteins and iii) to investigate possible improving effects of L-thyroxine (LT4) treatment on these findings.Methods: Twenty-seven children with SH who had elevated thyroid-stimulating hormone (TSH: >4.94 µIU/L) but normal free T4 levels and healthy euthyroid children of similar age and sex were enrolled in the study. Anthropometric and laboratory (lipid profile and thyroid function tests) measurements were performed at diagnosis and six months after euthyroidism was achieved. All children were also subjected to a questionnaire on hypothyroid symptoms at diagnosis. The SH patients were subjected to the questionnaire also following treatment. Pre-treatment data were compared with those of controls and post-treatment measurements.Results: Anthropometric and laboratory parameters of the groups were not statistically different except for higher TSH levels in the SH group. Serum lipoprotein levels and dyslipidemia frequency were similar between the groups. Compared to the controls, hypothyroidism symptom score was significantly higher in the SH group. Six months after euthyroidism was achieved, a significant reduction in the hypothyroid symptom score was obtained in the SH group. Except for significantly higher serum TSH values, no significant differences regarding demographic characteristics, symptom scores and lipid parameters were present between patients with Hashimoto’s thyroiditis and the remaining SH patients. Conclusion: The results of this study showed that in children with SH i) the hypothyroidism symptom score was significantly higher than in euthyroid children, ii) LT4 treatment improved the hypothyroidism symptom score and iii) SH does not seem to be associated with dyslipidemia.

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INTRODUCTION: We aimed to investigate lung functions using tidal breath analysis (TBA) in high-risk infants with recurrent wheezing. METHODS: Lung functions measured using TBA in infants with physician-diagnosed recurrent wheezing (≥3 episodes) who applied our institution between 2018-2020, were retrospectively analyzed. Infants were assigned to two groups: high-risk infants with recurrent wheezing (n=30) and wheezy infants without high risk of atopy (n=33). RESULTS: High-risk infants with recurrent wheezing had lower mean values of tPTEF, tPTEF: tE, VPTEF, and VPTEF: VE than that of wheezy infants without high risk of atopy. There was no significant difference between two groups in terms of Vt/kg and respiratory rate. ROC curve analysis showed that tPTEF: tE ratio <26.5 demonstrated 63.3% sensitivity and 63.6% specificity for detection of high risk of atopy. DISCUSSION AND CONCLUSION: This study showed that high-risk infants with recurrent wheezing have lower lung function than those of wheezy infants without high risk of atopy. TBA might be useful method to evaluate lung function in wheezy infants.

The literature on neonates with SARS-CoV-2 is mainly concerned with perinatal cases, and scanty data are available about environmentally infected neonates. To fill knowledge gaps on the course and prognosis of neonatal cases, we analyzed 1-year data from the Turkish Neonatal Society in this prospective cohort study of neonates with postnatal transmission. Data from 44 neonatal intensive care units (NICUs), of neonates with positive RT-PCR results at days 5-28 of life, were extracted from the online registry system and analyzed. Of 176 cases, most were term infants with normal birth weight. Fever was the most common symptom (64.2%), followed by feeding intolerance (25.6%), and cough (21.6%). The median length of hospitalization was 9 days, with approximately one quarter of infants receiving some type of ventilatory support. Myocarditis (5.7%) was the most common complication during follow-up. Among the clinical findings, cough (odds ratio [

Background Few data are available concerning normative lung function parameters measured in unsedated neonates. Aim To evaluate lung function changes in neonates. Methods In this prospective cohort study, tidal breath parameters were measured using the MasterScreen PAED system and standardized protocols. Measurements were performed on 60 (30 male) term, healthy, unsedated neonates on the postnatal 2nd and 30th days. Results Expiratory time (TE; p < .001; Cohen's d = 0.561), exhaled volume to peak tidal expiratory flow (VPTEF; p < .001; Cohen's d = 0.789), minute ventilation (p < .001; Cohen's d = 0.926), tidal volume (VT; p < .001; Cohen's d = 1.835), expiratory flow when 75%, 50%, and 25% of tidal volume remaining in the lungs (TEF75 [p < .001; Cohen's d = 1.070], TEF50 [p < .001; Cohen's d = 0.824], TEF25 [p < .001; Cohen's d = 0.568]), and inspiratory time (Ti; p < .001; Cohen's d = 0.654) were higher on Day 30 compared to Day 2, while time to reach peak tidal expiratory flow to total expiratory time (TPTEF/TE; p = .006; Cohen's d = 0.371), the volume until peak tidal expiratory flow to total expiratory volume (VPTEF/VE; p = .001; Cohen's d = 0.447), and respiration rate (RR; p = .001; Cohen's d = 0.432) were lower, and Ti/TE was unchanged. Positive correlation was observed between length and VT (r = .347; p = .008) on Day 2 and (r = .338; p = .008) on Day 30. Conclusions The present study reveals the physiological changes occurring in lung functions in healthy term neonates during the neonatal period.

Aim To assess the lung functions with impulse oscillometry (IOS) and spirometry in children with type 1 diabetes mellitus (T1DM). Methods Fifty‐one children with T1DM, and sex‐ and age‐matched 53 healthy control (HC) subjects were included in this study. Demographic, clinical, and laboratory characteristics of the subjects were recorded and their pulmonary functions were analyzed by IOS and spirometry. Results In IOS, zR5, zR10, and zR20 levels were higher in children with T1DM compared with HCs (P = .019, P = .017, and P = .002, respectively). In spirometry, zFEF75 and zFEF25‐75 were lower in children with T1DM compared with HCs (P = .025, P = .001, respectively). In IOS, zR5‐20 (P = .008, P = .005, respectively) and zAX (P = .013, P = .009, respectively) were significantly lower in good‐controlled group compared with moderate‐ and poor‐controlled group. In spirometry, zFEF25‐75 was significantly higher in good‐controlled group compared with moderate‐ and poor‐controlled group (P = .005, P = .009, respectively). HbA1c was positively correlated with zR5‐20 value (r = .339; P = .017) in male children with T1DM. The duration of the disease was positively correlated with zR5‐20 (r = .290; P = .043) and zFres (r = .358; P = .010). According to the receiver operating characteristic curve analysis to estimate optimal cut‐offs to discriminate good control level of T1DM (HbA1c < 7%), a zR5‐20 ≤ 2.28 demonstrated a 75.0% sensitivity and 82.9% specificity, with an area under the curve of 0.805 ([confidence interval, 0.615‐0.995]; P = .007). Conclusions This study showed subclinical impairment of lung functions which is associated with disease duration and the degree of metabolic control in children with T1DM.

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Key words children, intramuscular injections, necrotizing fasciitis, pseudomonas aeruginosa.Necrotizing fasciitis (NF) is a deep-seated infection of the subcutaneous tissue that results in progressive destruction of fascia and fat, but may spare the skin. It is classified into two types: Type 1 is polymicrobial, and is caused by aerobic and anaerobic bacteria.Type 2 is monomicrobial, and is most often caused by Group A Streptococci. 1,2 Monomicrobial NF caused by Pseudomonas aeruginosa is extremely rare. Only five such cases have been reported in children: three of whom had acute leukemia and presented with NF involving the vulva; one who developed NF following penetrating trauma; and the last who was an immunocompetent infant. [3][4][5][6][7] We report the second case of a Type 2 NF caused by P. aeruginosa in a 3-year-old boy without any known immunodeficiency or complicated medical illnesses. To our knowledge, the present case is also the first case in the literature that developed Type 2 NF caused by P. aeruginosa following an i.m. injection. Case ReportA three-year-old boy was brought to the emergency room for evaluation of his perineoscrotal wounds. His history revealed i.m. ampicillin-sulbactam injection for upper respiratory tract infection four days prior to his admission. He had developed scrotal and perineal wounds on the second day of the treatment. Upon his admission to the emergency room, patchy necrotic areas surrounded by violet-colored skin and blisters that rapidly spread to the left buttock were seen (Fig. 1). The child was otherwise stable with a heart rate of 120 b.p.m., blood pressure of 80/40 mmHg, and his temperature was 38.2°C. Complete blood count indices were: hemoglobin = 10.5 g/dL; hematocrit = 33%; leukocytes = 8360 mm3; platelets = 233 000/mm3; C-reactive protein = 27.3 mg/dL; and erythrocyte sedimentation rate = 64 mm/h. Cultures obtained from the cutaneous blister secretion and tissue biopsies both revealed P. aeruginosa infection.