Search

Copyright of Journal of Behcet Uz Children's Hospital is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Humanities & Tourism Research (JoHUT) is the property of Journal of Humanities & Tourism Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We aimed to determine the threshold value of lactate levels, and to analyze its avaliability as mortality biomarker by correlating it with scoring systems in pediatric intensive care unit (PICU). Material and Methods: Observational retrospective cohort study. Our study was conducted among patients admitted to the 24-bed tertiary PICU of our hospital in 2015. All children between the ages of 1 month and 18 years were evaluated. Among 433 patients whose arterial blood gases were obtained during hospitalization, a total of 382 were included in the study. Patients with congenital metabolic disease with lactic acidosis were excluded. The arterial blood lactate levels on admission, PIM-2, PRISM-III and PELOD scores and survival status of the patients were evaluated. Correlation between lactate levels and mortality scores, threshold values of lactate levels and the factors affecting mortality risk were the main variable of interest. Results: There was a significant correlation between lactate levels and scores in patients who died (p<0.001). Receiver operating characteristic (ROC) curve analysis showed that blood lactate level was an effective parameter on mortality (area under the curve=AUC: 0.861; p<0.001) with a cut-off value of 2.55 mmol/L. The mortality risk was 1.38 fold higher in patients with higher levels of lactate. Conclusion: In our series, the levels of lactate were higher in critically ill children who died. Again, lactate levels and mortality scores of these children were correlated. In our series, the levels of lactate were higher in critically ill children who died. Again, lactate levels and mortality scores of these children were correlated. We were able to establish a cut-off point with high specificity for predicting evolution. These findings should be validated in prospective and multicenter studies for their incorporation into scoring systems. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Journal of General Medical Research is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The study aims to investigate the changes caused by diabetic ketoacidosis (DKA) on heart rate variability (HRV). Material and Methods: This prospective study was conducted at a tertiary referral center. It is investigated patients with DKA under 18 years old between May 2016 and December 2016. 24-h rhythm Holter electrocardiography recorded during DKA and upward 72nd h after ketoacidosis. Results: A total of 18 patients with DKA were included in the study in the age range of 1 month–18 year. Repeat Holter electrocardiography recording in the patients took place within an average of 4.6±1.1 days. Heart rate change parameters were found to be shorter at the time of DKA. A statistically significant difference was observed between the values of HRV. Conclusion: It is an important factor affecting the development of cardiac autonomic neuropathy at acute blood glucose elevation such as DKA. [ABSTRACT FROM AUTHOR]

Objective: A particular electroencephalography parameter known as the bispectral index (BIS) is one of the objective methods used to assess sedative and hypnotic effects. The aim of this study is to monitor the level of consciousness of patients who underwent sedation-analgesia in pediatric intensive care unit (PICU) and to evaluate how their sedation levels were affected by painful procedures by examining BIS and Ramsey Sedation Scale (RSS). Method: This prospective observational study was held 43 pediatric patients who were hospitalized in the 24-bed university-affiliated tertiary PICU. BIS, RSS and vital signs were recorded both before and after the endotracheal suctioning procedure. Patients were divided into two groups according to the chosen analgesic which was fentanyl or morphine. Percentage change (BIS, electromyography activity, signal quality index, RSS score, heart rate, oxygen saturation) of before/after endotracheal suctioning was calculated. Results: The increase in BIS value, increase heart rates and decrease RSS of patients with endotracheal suctioning were found to be significant (p<0.01, p=0.01, p<0.001 respectively). Percentage changes were compared between two groups and there was no significant difference between morphine and fentanyl group. Conclusion: Even in patients receiving strong analgesic agents like opioids, any painful procedures such as endotracheal suctioning increase the BIS values of the patients and disrupt their comfort. Continuous BIS value tracing may be more beneficial than clinical scoring systems on sedation monitoring and patient comfort. We also suggest further studies with different groups of analgesic agents should be conducted. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Behcet Uz Children's Hospital is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/aim: Hyperlactatemia is a common finding in critically ill patients and has significant prognostic implications. However, a single lactate measurement has not been correlated to mortality consistently. In this study, we aimed to correlate the clinical efficacy of lactate clearance for the prediction of mortality in pediatric intensive care unit patients. Materials and methods: This retrospective observational study was performed in the pediatric intensive care unit in patients with lactate level >3 mmol/lt. Initial, 6th h, and 24th h lactate levels were recorded and lactate clearance was calculated using these values (lactate level at admission -- level 6 h later x 100/lactate level at admission). Results: A total of 172 patients were included in the study. Forty-four out of 172 patients died. Median (IQR) lactate (mmol/L) at admission was low in those who survived in comparison to nonsurvivors 4.4 (3.1) vs. 5.75 (7.7) (p = 0.002). Clearance at 6th h was significantly lower in those who died (11.7%) than those who survived (36.7) (p = 0.001). 6th h lactate clearance level <20.7% predicted mortality with a sensitivity of 63.6% and specificity of 69.5% along with a positive predictive value of 41.8 and a negative predictive value of 84.8 (p = 0.004). Both lactate levels and lactate clearance values were significantly predictive factors for mortality (p < 0.05). Only a positive moderate correlation was found between the percentage of PRISM-IV % and 6th h lactate level. Conclusion: The present study revealed that lactate clearance is a simple and rapid risk-stratification tool holding to be a potential biomarker of managing the treatment efficacy of children in the pediatric intensive care unit. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Harran University Medical Faculty / Harran Üniversitesi Tıp Fakültesi Dergisi is the property of Harran University Medical Faculty and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Dr. Behcet Uz Children's Hospital is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Nitric oxide therapy is not routinely used in the treatment of pediatric acute respiratory distress syndrome (PARDS), but it is recommended to be used as an adjunctive therapy in some selected cases. In our study, we aimed to discuss patients with PARDS who were treated with inhaled nitric oxide (iNO) therapy. Methods: The data of patients who were hospitalized in the pediatric intensive care unit with a diagnosis of PARDS and received iNO treatment between January 2016 and January 2018 were retrospectively analyzed. Age, gender, length of stay, mortality, number of days on mechanical ventilation, use of vasoactive drugs, mortality scores, lactate levels, OI (oxygenation index), PaO2/FiO2, methemoglobin levels, iNO administration time, echocardiographic findings and underlying primary diseases were recorded. Results: It was determined that 9 patients who were followed up with the diagnosis of PARDS were given iNO treatment. Except for one patient, they were diagnosed with pneumonia developing on the basis of chronic disease and PARDS secondary to septic shock. Five patients died while receiving iNO therapy. Seven patients were ventilated with iNO in addition to conventional mechanical ventilation methods. Two patients who died were ventilated with HFOV (high frequency oscillatory ventilation). In 3 of 9 patients, inhaled nitric oxide treatment was successful. Conclusion: Although inhaled nitric oxide treatment is a known treatment used in different diseases, the level of its effect in PARDS patients continues to be investigated. We think that this treatment can be beneficial when applied in selected patients and experienced centers. [ABSTRACT FROM AUTHOR]

Objective: Although it has different mortality and morbidity rates all over the world, childhood poisoning has an important place among childhood health problems. Considering increase in health expenditures, duration of hospital stay and loss of labor caused by poisonings, the problem has not only medical but also social aspects. Method: In addition to demographic data of 1043 pediatric patients admitted to our hospital with complaints of poisoning, pre-admission intervention, place of poisoning, admission time, agent and time of poisoning, time elapsed after poisoning, admission findings, hospitalization period, diagnostic tests applied and treatment modalities were evaluated retrospectively with their prognosis. Results: Of the 1043 cases, 54.5% were female. Female ratio increased to 82% in 139 cases of suicide. When the causes of poisoning were examined, they occurred due to use of pharmaceutical agents drugs (47.2%), industrial (41.5%), and agricultural products (5.4%), CO (2.7%), foods (2.6%), unknown factors (0.5%), and animal bites (0.2%). Gastric-lavage, activated-charcoal, intravenous-fluid regimen (33%) were the most common treatment modalities. Two of the three mortal cases were due to colchicine, and the third one was caused by CO poisoning. Conclusion: Although the development in the diagnosis and treatment of poisonings is pleasing, the most accurate approach to this issue will be to increase the protective measures. In addition to these standard measures, each country should set priorities in line with its own epidemiological study. Regarding the higher mortality rate (22%) we may suggest that clinicians should be more careful and aggressive in the diagnosis and treatment of colchicine intoxications, which can be associated with mortality even at low doses. [ABSTRACT FROM AUTHOR]

Background: We aimed to examine microvolt T wave alternans (MTWA) in 24-hour Holter electrocardiography (ECG) of children with repaired tetralogy of Fallot (TOF) to assess associations of MTWA with ventricular arrhythmias, ECG parameters, and echocardiographic findings.Methods: Holter ECG records and archive files of 56 repaired TOF patients (62.5% male) who were analyzed retrospectively. Subjects' ECG parameters and MTWA values were compared with age-sex-matched control group. T wave changes were analyzed by time-domain-modified moving average method from the three channels of 24-hour Holter ECG.Results: Mean age was 123.4 ± 48.3 months. Median MTWA value was 55.5 μV in the control group, whereas 95.5 μV in patients group (P < 0.001). A significant weak positive correlation was found between the presence of ventricular extrasystoles and tricuspid regurgitation. There was no correlation between ECG parameters, echocardiographic findings, and MTWA.Conclusions: MTWA was increased in children with repaired TOF as reported before. To our knowledge, this is the first study analyzing MTWA with 24-hour Holter ECG in repaired TOF patients. [ABSTRACT FROM AUTHOR]