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The purpose of this study to determinate whether there is a relationship between the nutritional status and white matter integrity in older patients by using Diffusion Tensor Imaging (DTI). The patients were evaluated by Mini-Nutritional Assessment Scale. The patients are categorized in the groups of well-nourished, risk of malnutrition, or malnourished, depending on the overall score> 23.5, 17–23.5, or 17; respectively. All patients had brain MRI and DTI. The mean diffusivity (MD), fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) values were calculated by ROI-based method in white matter tracts. Total of the 224 patients; 86 patients had normal nutrition status (group 1), 107 patients were diagnosed with malnutrition risk (group 2) and 31 patients were diagnosed with malnutrition (group 3). Significantly decreased FA values of genu of corpus callosum, forceps minor and significantly increased MD values of middle cerebellar peduncle, and superior frontooccipital fasciculus were detected in group 2 in comparison to group 1 (p < 0.05). After adjusting for the folate and age, MD and RD values of cingulum remained significantly higher and the AD values of superior cerebellar peduncle remained significantly lower in group 3 (p < 0.05). Malnutrition was associated with deteriorated DTI values, especially in cingulum and superior cerebellar peduncle. Assessing the nutritional status of older individuals is crucial to avoid its negative impact on brain. Early diagnosis of malnutrition-related impaired WM integrity is important for prevention and intervention, and DTI is a useful non-invasive technique to be used for this purpose. [ABSTRACT FROM AUTHOR]

Background. Beta blockers (BB) are used for very different indications in both adults and children. There can be mild adverse effects with normal doses. When taken in toxic doses, this can have fatal results in children. There are some standard therapies during BB poisoning such as insulin and glucagon but there is not enough knowledge concerning intravenous lipid infusion therapy (ILI). Case. Herein we present a case of propranolol poisoning in a previously healthy 2-year-old girl. In this patient, cardiac arrest developed twice, and cardiopulmonary resuscitation was performed for 5 and 20 minutes, respectively. We initiated inotropes, insulin, calcium and glucagon with a lack of response to all medical treatment. We used ILI and the patient improved after this treatment. She recovered without any disability. Conclusions. ILI treatment should be considered with life-threatening BB poisoning which is unresponsive to standard therapies. [ABSTRACT FROM AUTHOR]

• Critically ill children often require transport to developed centers where higher levels of care can be provided. • Most patients (82.4%) were transported by land, and 17.6% were transported by air ambulance. • Vital signs were assessed, and certain critical interventions such as intravenous fluids and respiratory support were provided more frequently during air transport, possibly due to the fact that physicians were always present during air transport. • Specialized pediatric transport teams are needed to improve the quality of pediatric critical care transport. Critically ill children often require transport to tertiary centers where higher levels of care can be provided. In this study, we aimed to evaluate the reasons for transport, complications that occurred during transport, and the clinical outcomes of the patients transferred to our tertiary pediatric intensive care unit (PICU). This retrospective study was conducted in a tertiary pediatric hospital with 250 beds and 20 tertiary PICU beds. During the study period, 108 patients were transferred to our PICU. The mean age was 75.0 ± 70.5 months (range, 1-211 months), and 59 were female. Most patients (82.4%) were transported by land; 17.6% were transported by air ambulance. Fourteen patients were referred for liver transplantation, and 7 patients were referred because of a need for extracorporeal membrane oxygenation support and heart transplantation or left ventricular assist device placement. Two patients were transported by air while on extracorporeal membrane oxygenation. Complications occurred in 25% of patients. Vital signs were assesed, and certain critical interventions such as intravenous fluids and respiratory support were provided more frequently during air transport, possibly due to the fact that physicians were always present during air transport. Quality improvement of transport teams and multicenter and nationwide studies on PICU transport are needed. [ABSTRACT FROM AUTHOR]