Mustafa Yaşar Özdamar

The parent is the most critical link and decision-maker between the patient and the healthcare provider in treating many pediatric diseases. This entity is essential for the management of pediatric breast diseases for which the rate of surgical intervention is known to be very low. Although previous publications have emphasized that pediatric breast diseases may cause alarming anxiety in parents, the demographic factors that influence this anxiety have not been investigated. Even if practitioners complete patient management with appropriate procedures, treatment is incomplete if the questions remain unanswered. In this observational prospective study, we investigated the demographic factors that affect parental anxiety, which should be prioritized to prevent incomplete management. The Beck Anxiety Inventory score (BAS) created by the parents of 409 boys and girls aged 0 to 17 with breast conditions was recorded at the diagnosis, termination of treatment, and final control stages. A 2-stage hierarchical logistic regression model was applied to show how strongly the demographic characteristics of parents and their children predicted the parental BAS. Of the demographic characteristics, there was a significant correlation (P < .05) between the patient’s sex, age, developmental period, Tanner stage, referral status, management method, family’s place of residence, economic distress, and BAS. However, according to the 2-stage hierarchical regression model, only 3 demographic characteristics, the patient’s gender, place of residence, and method used in patient management, significantly predicted BAS (P < .05, ΔR ² = .35). Among the many factors that affect anxiety experienced by parents whose son or daughter has breast problems, the gender of the child, place of residence of the family, and management methods used by the practitioner are demographic characteristics that should be taken into consideration.

Pediatric breast conditions, which rarely require biopsy or excision and where follow-up with ultrasound is sufficient, are usually temporary. To understand childhood's physiological and pathological conditions, it is necessary to know the stages of intrauterine development, as in every organ. In neonatal and subsequent childhood periods, ultrasound is sufficient as a radiological examination after history and physical examination. Malign masses are sporadic, and benign masses are rarely encountered. Parental anxiety is an essential factor affecting patient management from the first admission to the final follow-up examination. For this reason, practitioners need to know information that reassures patients and parents with an appropriate methodology in developmental breast diseases.

Background: Taxifolin (TXF) is a flavonoid found abundantly in citrus/onion. Encouraging results on its renoprotective effect have been reported in a limited number of drug-induced nephrotoxicity animal models. The present study aimed to evaluate for the first time the potential renoprotective effects of TXF in a paracetamol (PAR)-induced nephrotoxicity rat model. Methods: Rats were divided into three equal groups (n = 6 animals per group). Group 1 (PAR group, PARG) received PAR diluted in normal saline by gavage (1000 mg/kg). Group 2 (TXF group, TXFG) received TXF diluted in normal saline by gavage (50 mg/kg) one hour after PAR administration. Group 3 (control group, CG) received normal saline. Twenty-four hours after PAR administration, all animals were sacrificed using high-dose anesthesia. Blood samples were collected and kidneys were removed. Results: The serum blood urea nitrogen, creatinine levels and serum malondialdehyde levels were significantly increased in the PARG. The serum glutathione peroxidase, glutathione reductase and total glutathione levels were significantly higher in the TXFG. At the same time, the kidneys of the PARG animals demonstrated tubular epithelium swelling, distension and severe vacuolar degeneration. The kidneys of the TXFG animals showed mildly dilated/congested blood vessels. Conclusions: The TXF renoprotective effects are promising in preventing PAR-induced nephrotoxicity, mainly through antioxidant activity, and warrant further testing in future studies.

Henoch-Schönlein purpura, leukocytoclastic vasculitis is the most common vasculitis of childhood. Immunoglobulin-A accumulates in the small veins of the skin, joints, gastrointestinal tract and kidney. The involvement of the skin in palpable purpuric rash is usually the first finding and basically shows the lower extremities and hips. Joints can be affected, kidneys can be affected. Complaints of gastrointestinal system usually occur one week after purpuric rash. The most common clinical features of the digestive system are abdominal pain and vomiting. The incidence of Intussusception in digestive tract involvement is about 1-5%. However, intussusception is not the first symptom. In our case, abdominal pain and Intussusception are the first findings. Typical rash appeared three days after operative. Second case in literature.

AIM: This study aimed to determine the effect of multidimensional training program on children with constipation and fecal incontinence and their mothers on anxiety and their constipation management. METHOD: The study had an experimental design with a pretest-posttest control group. The intervention group consisted of children diagnosed with functional constipation (n=20) and fecal incontinence (n=21) and their mothers in the Pediatric Surgery Clinic. The control group consisted of healthy (n=20) children who applied to two different Family Health Centers for any reason. Data were collected between February 2016 and June 2017 using a descriptive questionnaire, a nutrient consumption frequency form, the Rome III diagnostic criteria form, and the Trait Anxiety Scale for Children. RESULTS: After the training program, the mean score of the Trait Anxiety Scale for Children decreased in both intervention groups (p<0.01) and increased in the control group (p<0.05). In addition, the frequency of the consumption of milk, caffeinated drinks, and white bread was reduced in the children of both intervention groups after the training program. The consumption of dried legumes, vegetables, and whole wheat bread increased. According to the Rome III diagnostic criteria, it was determined that constipation symptoms were not observed in 50% of the children. CONCLUSION: The training program had a significant influence on the prevention and management of constipation and anxiety. Given that constipation is associated with both physical and mental health outcomes, the approach for the treatment should be holistic in nature, involving a multidisciplinary team. Fonksiyonel Kabızlığı ve Fekal İnkontinansı Olan Çocuklara ve Annelerine Verilen Eğitimin Anksiyete ve Kabızlık Yönetimi Üzerine Etkisi AMAÇ: Bu araştırma fonksiyonel kabızlığı ve fekal inkontinansı olan çocuklara ve annelerine verilen eğitimin anksiyete ve kabızlık yönetimi üzerine etkisini belirlemek amacı ile yapılmıştır. YÖNTEM: Araştırma öntest-sontest kontrol gruplu deneysel tasarımda yürütülmüştür. Girişim grubunu Çocuk Cerrahisi Polikliniğinde fonksiyonel kabızlık (n=20) ile fonksiyonel kabızlık ve fekal inkontinans (n=21) tanısı konulan çocuklar ve anneleri oluşturmuştur. Kontrol grubu ise iki farklı Aile Sağlığı Merkezine herhangi bir nedenle başvuran sağlıklı (n=20) çocuklardan oluşmuştur. Araştırmanın verileri Şubat 2016-Haziran 2017 tarihleri arasında Tanımlayıcı Soru Formu, Besin Tüketim Sıklığı Formu, Rome III Tanı Ölçütleri Formu ve Çocuklar İçin Sürekli Kaygı Ölçeği ile toplanmıştır. BULGULAR: Eğitim programından sonra her iki girişim grubu Sürekli Kaygı Ölçeği puan ortalamasında azalma (p<0,01), kontrol grubunda ise artma saptanmıştır (p<0,05). Ayrıca eğitim programından sonra her iki girişim grubu çocukların süt, kafeinli içecekler ve beyaz ekmek tüketimi sıklığında azalma, kurubaklagil, sebze ve tam buğday ekmeği tüketimi sıklığında ise artma belirlenmiştir. Rome III tanı ölçütlerine göre çocukların %50’sinde kabızlık belirtileri görülmemiştir. SONUÇ: Eğitim programının fonksiyonel kabızlık ile fonksiyonel kabızlık ve fekal inkontinansı olan çocuklarda kabızlığın önlenmesi, yönetimi ve anksiyete üzerine önemli etkisinin olduğu belirlenmiştir. Fiziksel ve ruhsal sağlık sonuçlarıyla ilişkili olan kabızlığın tedavisi çok alanlı ekip anlayışı ve bütüncül yaklaşım ile yapılmalıdır. Cite this article as: Yıldırım, A., Biçer, Ş., Hacıhasanoğlu-Aşılar, R., Özdamar, M. Y., Şahin, H., Gül, V. (2020). The effect of multidimensional training program to children with functional constipation and fecal incontinence on children’s and their mothers’ anxiety and constipation management. Florence Nightingale Journal of Nursing, 28(3), 321-332.

Introduction: Diagnostic discrimination between acute appendicitis (AA) and mesenteric lymphadenitis (AML) may require more diagnostic tests or great skill after excluding other diagnoses. This study aimed to make a differential diagnosis between AA and AML patients with previous and new parameters and to examine which parameters should be taken into account regarding whether the AML patient should be hospitalized or discharged. Material and methods: One hundred and twenty-three AML and 134 AA patients, randomly selected, were included in the study. Demographic, clinical, and laboratory data of all subjects were analyzed. Ultrasonographic and rarely computed tomography examinations evaluating for the enlarged lymph nodes with the shortest diameter in the right lower quadrant of the AML patients were performed. Also, the erect abdominal radiographs (EAR) of AML and AA patients were evaluated. Results: While there was no statistically significant difference in age or gender, C-reactive protein, white blood cell count, monocyte percentage as well as symptoms between the AA and AML groups (p > 0.05), neutrophil and lymphocyte percentage, appearance of EAR and L/M ratio were significantly different between the two groups (p < 0.05). There was no correlation between the short-axis diameter of the mesenteric lymph node and clinical and laboratory findings in the AML group (p > 0.05). Conclusions: Based on the results with ROC curve analysis, we propose to take into account the L/M ratio and the EAR from the parameters in the differential diagnosis between AA and AML in addition to previously reported parameters. Also, we recommend that the same features may be used to decide whether AML patients under observation are hospitalized or not.

Testicular ischemia and necrosis, especially in the infant age, may result from incarcerated inguinal hernia. Duration of ischemia is a significant factor for the affected testicle. We aimed to present a case series on the conservative management in the testicular ischemia caused by incarcerated inguinal hernia. Inguinal hernia repairs performed in between March 2009 and December 2014 were investigated retrospectively. Patients' characteristics, hernia side, incarceration, testicular ischemia and complications were recorded. Color Doppler ultrasonography was performed in the incarcerated inguinal hernia patients preoperatively and was repeated on 3 and 7 days and then at 1, 3 and 6 months postoperatively. The testicle sizes, volumes, and arterial flow patterns of them were recorded at the same time. Total 785 inguinal hernias were treated in 738 male patients, ranging from 18 days to 16 years. From all male patients, 44 (5.9%) had the IIH. There were 16 (36.3%) irreducible hernias in 44 incarcerated hernia patients. Of these 16, testicular ischemia was determined in 9 (56.2%) infants with the irreducible incarcerated hernia. Orchidopexyprocedure was performed in these patients. Testicular atrophy was occurred in two patients (22.2%). In the others, testicular volumes and perfusions were normal during follow-up (mean 8.3 ± 2.2 months). Testicular ischemia resulting from incarcerated inguinal hernia may be treated conservatively without orchiectomy for the ischemic testicle and testicular ischemia may be followed with color Doppler ultrasound for atleast 6 months. The inguinal hernia repair in infants should be subject to urgent surgery rather than elective surgery. So, the testicular ischemia in infants with the inguinal hernia will be an avoidable complication.