The article describes and discusses several key elements of the paediatric healthcare system in Israel, including paediatric training, family and community paediatrics, hospital-based paediatric services, preventive care services, and special programs such as the “Drop of Milk” (Tipat Halav) program. Although child care in Israel has gained several notable achievements, such as a low infant mortality rate, there are several significant challenges for the coming years. These include training of enough paediatricians and periodic updating of training programs to fulfil needs and provide an adequate preventive care from fetal life through infancy, childhood, and adulthood. In addition, paediatricians in Israel should continue to be involved in national public health programs to reduce health inequities among mothers and children and reduce health disparities among certain geographic areas and various populations. Graduates of paediatric residency are expected to be able to address the new technologies, the requirements for personal medicine and on-line medicine, and to be able to deal with both pure “medical” issues, and public health, lifestyle, and environmental issues.

The goal of the study was to provide missing data on the accuracy of enhanced transcutaneous bilirubinometry in a monoracial population of term neonates, considering three different measurement sites.Transcutaneous bilirubin was measured using the JM-105 device on the forehead, chest, and abdomen. Blood sampling for total serum bilirubin concentration has been performed within 10 minutes of transcutaneous measurements. Paired transcutaneous bilirubin and total serum bilirubin measurements were statistically analyzed.The study group consisted of 102 healthy term Slovak infants. The correlation between total serum bilirubin and transcutaneous bilirubin was significant (coefficient of determination R2: 0.9045 forehead, 0.8808 sternum, 0.8467 abdomen). Transcutaneous measurements underestimated serum bilirubin levels significantly when total serum bilirubin values were higher than 15 mg/dL, irrespective of the site of transcutaneous measurements. The lowest mean difference between total serum bilirubin and transcutaneous bilirubin was identified on the sternum (median: -1.1 mg/dL). The area under the curve was >0.97 and >0.93 for detecting total serum bilirubin levels >10 mg/dL and >13 mg/dL, respectively, for all measurement sites. Transcutaneous measurements on the forehead and sternum provided very high sensitivity, with the best performance at the forehead.Transcutaneous bilirubinometry using an enhanced device is an accurate, sensitive, and convenient screening method in term Caucasian neonates. Transcutaneous bilirubin measurements on the forehead, sternum, and abdomen are reliable, with the best performance on the forehead. It is necessary to confirm higher transcutaneous bilirubin values with a total serum bilirubin measurement.

The aim of this study is to compare the screen time and digital gaming habits of Turkish children before and during the coronavirus disease 2019 (COVID-19) pandemic.This cross-sectional descriptive study was carried out in a university hospital between May 7, 2020 and June 27, 2020. Healthy children aged 3-10 years who applied to the pediatrics clinics for outpatient care were included in the study. A structured survey was applied to the parents who agreed to participate.A total of 253 children were included in the study. It was found that the ratio of children with screen time of ≥1 hour during the pandemic was significantly higher than before the pandemic (p<0.001). It was determined that the ratio of children watching both adult and children's programs increased during the pandemic (p<0.001). The ratio of children playing digital games during the pandemic was also found to be increased significantly compared with that before the pandemic (p<0.001).This study demonstrated that screen and digital gaming time increased independently of sociodemographic characteristics during the COVID-19 pandemic compared with before the pandemic.

Childhood hypertension has become a significant public health problem due to increased prevalence in recent decades. High blood pressure causes increased mortality and morbidity in childhood, precedes adult hypertension, and causes increased cardiovascular events in adulthood. These concerns have led to an update of guidelines about childhood hypertension by the European Society of Hypertension in 2016 and the American Academy of Hypertension in 2017. This review highlights the important developments in these guidelines and recent literature about childhood hypertension in terms of diagnosis, prevalence, risk factors, diagnostic tools, prevention and management.

Aim:Urinary tract infections are the most common genitourinary tract disease in children, and inappropriate antibiotic and/or dose selection increase the likelihood of resistance. The aim of this study was to determine the prevalence of urinary tract infection pathogens, patterns of resistance to antibiotics, and empirical treatment options.Material and Methods:Between January 2013 and December 2017, urine culture and antibiogram results of pediatric patients aged 0 days to 16 years were analyzed retrospectively. Antibiotic susceptibilities were determined using disc diffusion according to methods of the Clinical and Laboratory Standards Institute.Results:Of the 1326 children with culture growth, 1070 (80.6%) were female and 256 (19.3%) were male. The most common microorganism found was (1138, 85.8%) E. Coli, followed by Klebsiella spp. (71, 5.3%), Enterobacter spp. (44, 3.3%), and Proteus spp. (28, 2.1%). High frequency of resistance to ampicillin, ampicillin-sulbactam, amoxicillin-clavulanate, cefuroxime axetil, as TMP-SMX was detected in all microorganisms, whereas resistance to amikacin, meropenem, imipenem, ertapenem, fosfomycin, and nitrofurantoin was low.Conclusion:E. coli was the most common causative agent of urinary tract infections in childhood. High resistance to ampicillin, ampicillin-sulbactam, amoxicillin-clavulanate, cefuroxime axetil, and TMP-SMX was detected in all agents in our center.

Aim:Factor VII deficiency is one of the hereditary coagulation disorders that has autosomal reccessive inheritance and is observed relatively frequently (1/500 000). It is clinically heterogeneous, and may be asymptomatic or lead to life-threatening bleeding. Thus, there is no correlation between FVII activity and clinical findings. Plasma-derived and recombinant FVII concentrates are currently used for treatment. In countries where access to these products is lacking, fresh frozen plasma and prothrombin complex concentrates are also used, though they contain low amounts of factor FVII. In this study, we present the clinical properties, treatments, and surgical interventions used in patients followed up in our clinic with a diagnosis of factor FVII deficiency.Material and Methods:Patients who were diagnosed as FVII deficiency in Division of Pediatric Hematology and Oncology between July 1997 and July 2018, were included in the study. The patients’ demographic characteristics, symptoms at presentation, PT, aPTT, and FVII values, types of bleeding, and treatments and surgical interventions used, were recorded. The bleedings observed in the patients were classified by severity as asymptomatic, minor, and major.Results:A total of 18 patients (7 girls and 11 boys) with a mean age of 9.64±9.63 years were included in the study. The mean follow-up time was found as 78.06±54.4 months. When the bleedings were classified clinically, no bleeding was observed in eight patients (44.4%). The factor FVII level was found as <10% in three of these eight asymptomatic patients and above 20% in the others. Minor bleeding was observed in nine patients (50%) and major bleeding was observed in one patient. When the patients were classified as asymptomatic and symptomatic, there was no significant difference between the two groups in terms of FVII level (p=0.57). A total of 21 surgical interventions were performed in 14 (78%) of 18 patients who were being followed up.Conclusion:FVII deficiency has a very wide spectrum both clinically and in terms of approach to surgical interventions. Therefore, patients with factor FVII deficiency should be followed up and treated by comprehensive care centers with close collaboration of multiple disciplines.

It is described as the eight small European Countries Initiative. The initiative developed during the 63rd session of the World Health Organization Regional Committee for Europe, held in 2013 in Istanbul, Turkey. Eight European countries counting a population of less than 1 million, gathered together under the auspices of the World Health Organization, to form the European Small Countries Initiative for Health. The eight countries include Andorra, Cyprus, Iceland, Luxembourg, Malta, Monaco, Montenegro, and San Marino. The main aim of the small countries network is to foster a common political commitment, useful to develop locally good health practices. A specific goal was the implementation of the Health 2020 European policy framework and strategy for the 21st century, in the context of countries with small populations. The rational is in fact, that countries with smaller populations have a significant advantage to promote and implement policies and strategies for health and well-being that draw on the contribution of many sectors. The eight small European Countries Initiative particularly aims at amplifying the voice of small countries in European and global health contexts, reaching out to local and international legislators and rulers. It further aims at sharing existing resources among members, with the intent to maximize assets, and innovating and applying solutions to increase capacity to improve health. The founding principle of the eight countries initiative network, is that the experiences of small countries can provide useful learning opportunities, particularly in the healthcare area, that can then be used at regional level in more populous nations.

This introductory article presents the project developed by the EPA-UNEPSA on child healthcare in Europe, emphasizing the role of local diversities as collective potentials. The EPA-UNEPSA is strongly convinced that an effective cooperation among European countries is based on the acknowledgement that diversity is a factor of strength, and not of weakness, and that such a factor may create the basis of an effective cooperation in all fields of public interest. Since its foundation in 1975, EPA-UNEPSA has worked to improve child healthcare and to strength the cooperation of children’s caretakers in Europe. The studies published in this volume pursue this line of thought, in the belief that contributing to the efforts of creating an effective platform for cooperation and a multidisciplinary approach to common issues in public health may reduce fragmentation of paediatrics and tackle the legal, economic, and organisational challenges of child healthcare in Europe.

Aim:To evaluate the birth prevalence of specifically selected major congenital anomalies and to determine the correlated neonatal and maternal characteristics.Material and Methods:Data were collected retrospectively from hospital-based records of infants who were born at 22 completed weeks of gestation with a birth weight of more than 500 g in Zekai Tahir Burak Gynecology Training and Research Hospital between 2013 and 2018. Abortions, stillbirths, and terminated pregnancies due to fetal anomalies were excluded. Average annual prevalences were calculated for each selected major congenital anomaly.Results:The total prevalence of congenital anomalies was 9.97 per 1000 in 102 379 live birth cohorts. The prevalence of severe congenital heart anomalies (SI-SII) was found as 21.1 per 10 000 live births. Down syndrome and meningomyelocele were the second and third most common anomalies, after congenital heart defects (13.87 and 9.97 per 10 000 live births, respectively). The prevalence of anomalies requiring specific surgery was found as 4.3 per 1000 live births. Congenital heart disease was present in 31.7% of patients who had Down syndrome. Atrioventricular septal defect accounted for 53.3% of congenital heart anomalies detected in Down syndrome. The prevalence of Down syndrome in babies of mothers aged 35 years and older was found as 46.67 per 10 000, which was significantly higher than in the group aged under 35 years (8.24 per 10 000). On the other hand, the prevalence of gastroschisis in babies of mothers aged 19 years and under was found as 5.81 per 10 000, which was higher than in the group aged 20 years and over (0.84 per 10 000).Conclusion:The actual magnitude of the number of births affected by congenital anomalies in Turkey is unknown. In our study, congenital heart diseases, Down syndrome, and meningomyelocele were found to be the most common congenital anomalies, respectively.