65 results on '"Teksam O"'
Search Results
2. Presentations of children to emergency departments across Europe and the COVID-19 pandemic: A multinational observational study
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Nijman, RG, Honeyford, K, Farrugia, R, Rose, K, Bognar, Z, Buonsenso, D, Da Dalt, L, De, T, Maconochie, IK, Parri, N, Roland, D, Alfven, T, Aupiais, C, Barrett, M, Basmaci, R, Borensztajn, D, Castanhinha, S, Vasilico, C, Durnin, S, Fitzpatrick, P, Fodor, L, Gomez, B, Greber-Platzer, S, Guedj, R, Hartshorn, S, Hey, F, Jankauskaite, L, Kohlfuerst, D, Kolnik, M, Lyttle, MD, Mação, P, Mascarenhas, MI, Messahel, S, Özkan, EA, Pučuka, Z, Reis, S, Rybak, A, Ryd Rinder, M, Teksam, O, Turan, C, Thors, VS, Velasco, R, Bressan, S, Moll, HA, Oostenbrink, R, Titomanlio, L, In association with the REPEM network (Research in European Pediatric Emergency Medicine) as part of the EPISODES study group, and Pediatrics
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in association with the REPEM network (Research in European Pediatric Emergency Medicine) as part of the EPISODES study group ,SARS-CoV-2 ,COVID-19* / epidemiology ,COVID-19 ,General Medicine ,Europe ,Pandemics ,SDG 3 - Good Health and Well-being ,General & Internal Medicine ,Communicable Disease Control ,HDE PED ,Humans ,Child health, COVID-19 pandemic, COVID-19 ,Europe / epidemiology ,Child ,Emergency Service, Hospital ,11 Medical and Health Sciences ,Retrospective Studies - Abstract
Background During the initial phase of the Coronavirus Disease 2019 (COVID-19) pandemic, reduced numbers of acutely ill or injured children presented to emergency departments (EDs). Concerns were raised about the potential for delayed and more severe presentations and an increase in diagnoses such as diabetic ketoacidosis and mental health issues. This multinational observational study aimed to study the number of children presenting to EDs across Europe during the early COVID-19 pandemic and factors influencing this and to investigate changes in severity of illness and diagnoses. Methods and findings Routine health data were extracted retrospectively from electronic patient records of children aged 18 years and under, presenting to 38 EDs in 16 European countries for the period January 2018 to May 2020, using predefined and standardized data domains. Observed and predicted numbers of ED attendances were calculated for the period February 2020 to May 2020. Poisson models and incidence rate ratios (IRRs), using predicted counts for each site as offset to adjust for case-mix differences, were used to compare age groups, diagnoses, and outcomes. Reductions in pediatric ED attendances, hospital admissions, and high triage urgencies were seen in all participating sites. ED attendances were relatively higher in countries with lower SARS-CoV-2 prevalence (IRR 2.26, 95% CI 1.90 to 2.70, p < 0.001) and in children aged p < 0.001). The lowering of pediatric intensive care admissions was not as great as that of general admissions (IRR 1.30, 95% CI 1.16 to 1.45, p < 0.001). Lower triage urgencies were reduced more than higher triage urgencies (urgent triage IRR 1.10, 95% CI 1.08 to 1.12; emergent and very urgent triage IRR 1.53, 95% CI 1.49 to 1.57; versus nonurgent triage category, p < 0.001). Reductions were highest and sustained throughout the study period for children with communicable infectious diseases. The main limitation was the retrospective nature of the study, using routine clinical data from a wide range of European hospitals and health systems. Conclusions Reductions in ED attendances were seen across Europe during the first COVID-19 lockdown period. More severely ill children continued to attend hospital more frequently compared to those with minor injuries and illnesses, although absolute numbers fell. Trial registration ISRCTN91495258 https://www.isrctn.com/ISRCTN91495258.
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- 2022
3. LP-52: Evaluation of Possible Immunomodulatory Changes in Carbon Monoxide Poisoning
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Girgin, G., Tekşam, O., Özgüneş, H., Baydar, T., and Sabuncuoğlu, S.
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- 2023
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4. P0648 / #1963: IMPROVING ANTIBIOTIC DELIVERY TIMES OF PATIENTS APPLYING TO PEDIATRIC EMERGENCY CLINIC WITH NEUTROPENIC FEVER
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Birbilen, A.Z., primary, Akcan Yildiz, L., additional, Aydin, O., additional, Unal, B., additional, Hanalioğlu, D., additional, Ceyhan, M., additional, and Teksam, O., additional
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- 2021
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5. Research priorities for European paediatric emergency medicine
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Bressan, S, Titomanlio, L, Gomez, B, Mintegi, S, Gervaix, A, Parri, N, Da Dalt, L, Moll, Henriette, Waisman, Y, Maconochie, IK, Oostenbrink, Rianne, Er, A, Anil, M, Bal, A, Manzano, S, Lacroix, L, Galetto, A, Beattie, T, Bidlingmaier, C, Lucas, N, Maranon, R, Pucuka, Z, Latvia, R, Loellgen, R, Keitel, K, Hoeffe, J, Geurts, Dorien, Dubos, F, Lyttle, M, Bognar, Z, Simon, G, Fodor, L, Romanengo, M, Gras-le-Guen, C, Greber-Platzer, S, Cubells, CL, Teksam, O, Turan, C, Van de Voorde, P, Basmaci, R, Frassanito, A, Saz, U, Irfanos, I, Sotoca, J, Berant, R, Farrugia, R, Velasco, R, Nijman, R, Macao, P, Ege Üniversitesi, and Pediatrics
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medicine.medical_specialty ,Delphi Technique ,Priority list ,Psychological intervention ,Delphi method ,Pediatrics ,Pediatric Emergency Medicine/organization & administration ,Hospital/organization & administration ,Quality Improvement/organization & administration ,1117 Public Health and Health Services ,Europe/epidemiology ,03 medical and health sciences ,0302 clinical medicine ,Paediatric emergency medicine ,030225 pediatrics ,Epidemiology ,medicine ,Medicine and Health Sciences ,Humans ,UK ,Child ,Emergency Service ,Science & Technology ,ddc:618 ,business.industry ,Pediatric Emergency Medicine ,Health Priorities ,Health services research ,030208 emergency & critical care medicine ,1103 Clinical Sciences ,Emergency department ,Quality Improvement ,health services research ,REPEM ,Europe ,epidemiology ,Scale (social sciences) ,Family medicine ,Pediatrics, Perinatology and Child Health ,1114 Paediatrics and Reproductive Medicine ,Original Article ,Health Services Research ,business ,Emergency Service, Hospital ,Life Sciences & Biomedicine - Abstract
Mintegi, Santiago/0000-0002-2342-8881; Gomez, Borja/0000-0001-6542-4494; Nijman, Ruud Gerard/0000-0001-9671-8161; Parri, Niccolo/0000-0002-8098-2504; Maconochie, Ian/0000-0001-6319-8550, WOS: 000495095400013, PubMed: 31023707, Objective Research in European Paediatric Emergency Medicine (REPEM) network is a collaborative group of 69 paediatric emergency medicine (PEM) physicians from 20 countries in Europe, initiated in 2006. To further improve paediatric emergency care in Europe, the aim of this study was to define research priorities for PEM in Europe to guide the development of future research projects. Design and Setting We carried out an online survey in a modified three-stage Delphi study. Eligible participants were members of the REPEM network. in stage 1, the REPEM steering committee prepared a list of research topics. in stage 2, REPEM members rated on a 6-point scale research topics and they could add research topics and comment on the list for further refinement. Stage 3 included further prioritisation using the Hanlon Process of Prioritisation (HPP) to give more emphasis to the feasibility of a research topic. Results Based on 52 respondents (response rates per stage varying from 41% to 57%), we identified the conditions 'fever', 'sepsis' and 'respiratory infections', and the processes/interventions 'biomarkers', 'risk stratification' and 'practice variation' as common themes of research interest. the HPP identified highest priority for 4 of the 5 highest prioritised items by the Delphi process, incorporating prevalence and severity of each condition and feasibility of undertaking such research. Conclusions While the high diversity in emergency department (ED) populations, cultures, healthcare systems and healthcare delivery in European PEM prompts to focus on practice variation of ED conditions, our defined research priority list will help guide further collaborative research efforts within the REPEM network to improve PEM care in Europe.
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- 2019
6. Research priorities for European paediatric emergency medicine
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Bressan, S., Titomanlio, L., Gomez, B., Mintegi, S, Gervaix, A, Parri, N, Da Dalt, L, Moll, H.A. (Henriëtte), Waisman, Y, Maconochie, IK, Oostenbrink, R. (Rianne), Er, A., Anil, M., Bal, A., Manzano, S., Lacroix, L, Galetto, A., Beattie, T., Bidlingmaier, C., Lucas, N, Maranon, R., Pucuka, Z., Latvia, R., Loellgen, R., Keitel, K., Hoeffe, J., Geurts, D., Dubos, F., Lyttle, M., Bognar, Z., Simon, G., Fodor, L., Romanengo, M., Gras-le-Guen, C., Greber-Platzer, S., Cubells, C.L., Teksam, O., Turan, C., Voorde, P. (Patrick) van de, Basmaci, R., Frassanito, A., Saz, U., Irfanos, I., Sotoca, J., Berant, R., Farrugia, R., Velasco, R, Nijman, R.M. (Romana), Macao, P., Bressan, S., Titomanlio, L., Gomez, B., Mintegi, S, Gervaix, A, Parri, N, Da Dalt, L, Moll, H.A. (Henriëtte), Waisman, Y, Maconochie, IK, Oostenbrink, R. (Rianne), Er, A., Anil, M., Bal, A., Manzano, S., Lacroix, L, Galetto, A., Beattie, T., Bidlingmaier, C., Lucas, N, Maranon, R., Pucuka, Z., Latvia, R., Loellgen, R., Keitel, K., Hoeffe, J., Geurts, D., Dubos, F., Lyttle, M., Bognar, Z., Simon, G., Fodor, L., Romanengo, M., Gras-le-Guen, C., Greber-Platzer, S., Cubells, C.L., Teksam, O., Turan, C., Voorde, P. (Patrick) van de, Basmaci, R., Frassanito, A., Saz, U., Irfanos, I., Sotoca, J., Berant, R., Farrugia, R., Velasco, R, Nijman, R.M. (Romana), and Macao, P.
- Abstract
Objective Research in European Paediatric Emergency Medicine (REPEM) network is a collaborative group of 69 paediatric emergency medicine (PEM) physicians from 20 countries in Europe, initiated in 2006. To further improve paediatric emergency care in Europe, the aim of this study was to define research priorities for PEM in Europe to guide the development of future research projects. Design and Setting We carried out an online survey in a modified three-stage Delphi study. Eligible participants were members of the REPEM network. In stage 1, the REPEM steering committee prepared a list of research topics. In stage 2, REPEM members rated on a 6-point scale research topics and they could add research topics and comment on the list for further refinement. Stage 3 included further prioritisation using the Hanlon Process of Prioritisation (HPP) to give more emphasis to the feasibility of a research topic. Results Based on 52 respondents (response rates per stage varying from 41% to 57%), we identified the conditions ’fever’, ’sepsis’ and ’respiratory infections’, and the processes/interventions ’biomarkers’, ’risk stratification’ and ’practice variation’ as common themes of research interest. The HPP identified highest priority for 4 of the 5 highest prioritised items by the Delphi process, incorporating prevalence and severity of each condition and feasibility of undertaking such research. Conclusions While the high diversity in emergency department (ED) populations, cultures, healthcare systems and healthcare delivery in European PEM prompts to focus on practice variation of ED conditions, our defined research priority list will help guide further collaborative research efforts within the REPEM network to improve PEM care in Europe.
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- 2019
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7. Evaluation of oxidative stress and antioxidant parameters in children with carbon monoxide poisoning
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Teksam, O, primary, Sabuncuoğlu, S, additional, Girgin, G, additional, and Özgüneş, H, additional
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- 2019
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8. Congenital Mirror Movements in Gorlin Syndrome: A Case Report With DTI and Functional MRI Features
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Ozturk Z, Teksam O, Utine E, Yildiz Fg, Temucin C, Rahsan Gocmen, Erdal Sag, and Çocuk Sağlığı ve Hastalıkları
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0301 basic medicine ,Male ,Pathology ,medicine.medical_specialty ,Movement disorders ,Adolescent ,Basal Cell Nevus Syndrome ,Nevoid basal-cell carcinoma syndrome ,Mirror movements ,Pediatrics ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Basal cell carcinoma ,Movement Disorders ,medicine.diagnostic_test ,business.industry ,Genetic disorder ,Magnetic resonance imaging ,Anatomy ,medicine.disease ,Magnetic Resonance Imaging ,stomatognathic diseases ,030104 developmental biology ,Diffusion Tensor Imaging ,Pediatrics, Perinatology and Child Health ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Diffusion MRI - Abstract
Congenital mirror movements are rare conditions that define the inability to perform unimanual movements. Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, is a genetic disorder with multiple nevi predisposing to basal cell carcinoma, odontogenic keratocysts, and skeletal malformations. Herein we report on an adolescent patient with Gorlin syndrome and coexisting congenital mirror movements. To our knowledge, this is the first patient in the literature who has both of these very rare conditions.
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- 2015
9. ABSTRACT 72
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Gultekingil Keser, A., primary, Teksam, O., additional, Hizarcioglu Gulsen, H., additional, Aydemir, Y., additional, Berberoglu Ates, B., additional, Saltik Temizel, I.N., additional, and Demir, H., additional
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- 2014
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10. PReS-FINAL-2258: Final diagnoses of pediatric patients presenting with musculoskeletal symptoms in a center from the eastern Mediterranean
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Cavkaytar, O, primary, Duzova, A, additional, Teksam, O, additional, Kale, G, additional, and Ozen, S, additional
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- 2013
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11. 103: Acute Cardiac Effects of Carbon Monoxide Poisoning in Children
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Teksam, O., primary, Gumus, P., additional, Bayrakci, B., additional, Erdogan, I., additional, and Kale, G., additional
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- 2008
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12. P061: Antenatally diagnosed malformations in a Perinatology Unit and their impact on perinatal mortality
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Deren, O., primary, Onderoglu, L., additional, Saygan-Karamursel, B., additional, Savas-Alparslan, A. B., additional, Kizilkilic-Parlakgumus, A., additional, Teksam, O., additional, Caglar, M., additional, and Tekinalp, G., additional
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- 2003
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13. Return visits to the emergency department among febrile children
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Klein-Kremer, A., Teksam, O., and Goldman, R.D.
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Hospitals -- Emergency service ,Children -- Health aspects ,Health ,Health care industry ,Science and technology - Abstract
Introduction: Returning to the ED may increase crowding. We wanted to determine characteristics of febrile children 3-36 months seen and returned to the ED within 72 hours, and compare them to a matched population who did not return. Of particular interest we wanted to look at demographic variables and extent of the evaluation in the ED. Methods: We reviewed health records of patients 3-36 months old during 3 months with a chief complaint of fever who were discharged from the ED. We compared the 'return group'--patient who returned to the ED within 72 hours and age-matched 'control group' of 3 consecutive patients (+ 1 month) with fever who did not return to the ED. Results: We included 488 visits--183 returned to the ED within 72 hours and 305 did not return. The average temperature at home in children who returned to the ED was higher (p = 0.008) and the duration of fever was longer by a day (p < 0.01). Patients presenting with pain tended to return more frequently (p = 0.03).There was no difference between the groups in the rate of obtaining blood cultures. No differences found between the first and second visit in the 'return group.' Conclusion: Higher temperature is associated with returning to the ED and educational efforts among parents should be considered to disconnect height of temperature and need to return to the ED. Pain should also be dealt early on in the ED visit, as this may be associated with returning later to the ED. Keywords: ED revisits, fever, pediatrics
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- 2009
14. Perinatal outcomes of spontaneous twins compared with twins conceived through intracytoplasmic sperm injection.
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Saygan-Karamursel B, Teksam O, Aksu T, Yurdakok M, and Onderoglu L
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OBJECTIVE: To compare perinatal outcomes in spontaneous twins compared with those conceived by intracytoplasmic sperm injection (ICSI). DESIGN: Retrospective case-control study. PATIENTS: Cases consisted of 274 intracytoplasmic sperm injection twins, controls were 348 naturally conceived twins delivered between 1999 and 2003 in a tertiary hospital. MAIN OUTCOME MEASURES: Birth weight, gestational age at birth, cesarean delivery rate, perinatal mortality and morbidity, congenital anomalies, gestational diabetes and pregnancy induced hypertension. RESULTS: Preterm deliveries (76.6% vs. 64.1% <37 weeks and 19.7% vs. 13.2% <32 weeks) and low birth weight (73% vs. 60.3% <2500 g and 19.7% vs. 12.6% <1500 g) were significantly higher in the ICSI group compared with controls. Gestational diabetes mellitus (8% vs. 2.9%) and cesarean deliveries (95.2% vs. 77.6%) were more common in cases compared with the control group. There was a significantly higher rate of perinatal morbidity (16.4% vs. 7.8%) and mortality (8% vs. 2.6%) in ICSI twins. The incidence of congenital malformations diagnosed at birth was higher in cases (4.4%) compared with controls (0.9%) but the difference was not significant when adjusted for maternal age. CONCLUSION: Perinatal outcomes of twins after ICSI treatment are less optimal than naturally conceived twins. [ABSTRACT FROM AUTHOR]
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- 2006
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15. Assessment of children presenting with rheumatic complaints to a tertiary center in Turkey: differences in an Eastern Mediterranean population
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Bircan Cavkaytar Ö, Düzova A, Teksam Ö, Ayaz N Aktay, Derman O, Bakkaloglu A, Kale G, and Özen S
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Pediatrics ,RJ1-570 ,Diseases of the musculoskeletal system ,RC925-935 - Published
- 2008
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16. Acute Alcohol Intoxication-Related Metabolic and Biochemical Disturbances in Adolescents: A Matched Case-Control Study.
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Hanalioglu D, Ozkocer C, Can Ozalp E, Dikmen ZG, Pinar A, and Teksam O
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- Humans, Adolescent, Female, Male, Case-Control Studies, Emergency Service, Hospital statistics & numerical data, Ethanol blood, Retrospective Studies, Glasgow Coma Scale, Alcoholic Intoxication blood
- Abstract
We aimed to investigate clinical and laboratory characteristics of acute alcohol intoxication (AAI) in adolescents who presented to the pediatric emergency department (ED) at a tertiary referral center from 2006 to 2019. All consecutive adolescents with AAI (n = 335) and their sex- and age-matched control subjects (n = 335) with undetectable ethanol levels were included in this case-matched study. Mean serum ethanol level was 156.4 ± 58.4 (range: 50.8-341.2) mg/dL in the acute alcohol intoxication (AAI) group. Glasgow coma scores were lower in AAI group (14 [14-15] vs 15 [15-15], P < .001). Acidosis (16.3%), hyperlactatemia (60.9%), hypoglycemia (1.7%), hypernatremia (2.2%), hypokalemia (12.3%), hyperchloremia (20.4%), hypocalcemia (13.9%), hypermagnesemia (9.7%), and hyperalbuminemia (10.4%) were significantly more common in the AAI group than the control group. Blood pH, lactate, Na+, K+, Ca++, Mg++, albumin, blood urea nitrogen (BUN), and uric acid levels were correlated with serum ethanol levels. This study shows that AAI frequently leads to mild to moderate metabolic/biochemical derangements in adolescents., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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17. Predictors of Clinically Important Neuroimaging Findings in Children Presenting Pediatric Emergency Department.
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Gungor E, Haliloglu G, Yalnizoglu D, Oguz KK, and Teksam O
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- Humans, Male, Female, Child, Child, Preschool, Adolescent, Infant, Retrospective Studies, Ataxia, Emergency Service, Hospital, Neuroimaging methods, Magnetic Resonance Imaging, Tomography, X-Ray Computed
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Objective: The aim of the study is to evaluate predictors of clinically important neuroimaging results, that is, computed tomography and magnetic resonance imaging in children in an academic pediatric emergency department (PED) from 2015 to 2019., Methods: This study was conducted in an academic PED. The patient's demographic and clinical characteristics of PED visits and neuroimaging findings requested at the PED were recorded for January 1, 2015, to December 31, 2019. In addition, descriptive statistics and logistic regression analyses were conducted. We described and determined the predictors of clinically important neuroimaging findings in children., Results: Clinically important neuroimaging findings were detected in patients with blurred vision ( P = 0.001), ataxia ( P = 0.003), unilateral weakness ( P = 0.004), and altered level of consciousness ( P = 0.026). Clinically important neuroimaging was found 9.4 times higher in patients with altered level of consciousness, 7.4 times higher in patients with focal weakness, 4.6 times higher in patients with blurred vision, and 3.5 times more in patients presenting with ataxia., Conclusions: Advanced neuroimaging, especially for selected patients in PED, can improve the quality of health care for patients. On the other hand, irrelevant neuroimaging findings can lead physicians away from prompt diagnosis and accurate management. According to our study, advanced neuroimaging can be performed in the early period for both diagnosis and early treatment, especially in selected patients with ataxia, blurred vision, altered consciousness, and unilateral weakness. In other cases, clinicians may find more supporting evidence., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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18. Lung ultrasound findings in children with foreign body aspiration.
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Aydin O, Birbilen AZ, User IR, Turer OB, and Teksam O
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- Child, Humans, Infant, Bronchoscopy methods, Radiography, Ultrasonography, Retrospective Studies, Lung diagnostic imaging, Foreign Bodies diagnostic imaging, Foreign Bodies surgery, Lung Diseases
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Objectives: Foreign body aspiration (FBA) has a wide clinical spectrum, patients may be asymptomatic or present with cardiopulmonary arrest. Radiological imaging methods are used in addition to history and physical examination findings for certain diagnosis. Lung ultrasonography (LUS), whose usage area is increasing year by year, can be included in these. This study aimed to investigate ultrasonography findings in FBA and hypothesized that LUS may have a standard place in FBA diagnosis., Methods: Patients who administered to the pediatric emergency department between August 2019-August 2021, considered according to the clinical findings and physical examination possible FBA, and who undergone rigid bronchoscopy by pediatric surgery were included in the study., Results: Thirty-two patients were included in the study. According to the results of bronchoscopy, FBA was detected in 25 patients. The most common finding in radiography was hyperinflation on one side, while LUS findings were confluent-B lines in eight patients, barcode-sign in five patients, pleural line abnormalities in two patients, and pleural consolidation in two patients., Conclusion: This study is the first study aiming to evaluate LUS findings in FBA to the best of our knowledge. The B-lines, barcode sign, pleural line abnormalities and consolidation are seen findings in LUS of the patients with FBA. Although it is far from replacing chest radiography in these patients, it is possible to say that it has an equivalent value with chest radiography., (© 2022 Wiley Periodicals LLC.)
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- 2023
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19. Respective roles of non-pharmaceutical interventions in bronchiolitis outbreaks: an interrupted time-series analysis based on a multinational surveillance system.
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Lenglart L, Ouldali N, Honeyford K, Bognar Z, Bressan S, Buonsenso D, Da Dalt L, De T, Farrugia R, Maconochie IK, Moll HA, Oostenbrink R, Parri N, Roland D, Rose K, Akyüz Özkan E, Angoulvant F, Aupiais C, Barber C, Barrett M, Basmaci R, Castanhinha S, Chiaretti A, Durnin S, Fitzpatrick P, Fodor L, Gomez B, Greber-Platzer S, Guedj R, Hey F, Jankauskaite L, Kohlfuerst D, Mascarenhas I, Musolino AM, Pučuka Z, Reis S, Rybak A, Salamon P, Schaffert M, Shahar-Nissan K, Supino MC, Teksam O, Turan C, Velasco R, Nijman RG, and Titomanlio L
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- Child, Humans, Child, Preschool, Communicable Disease Control, SARS-CoV-2, Disease Outbreaks prevention & control, COVID-19 epidemiology, COVID-19 prevention & control, Bronchiolitis epidemiology, Bronchiolitis prevention & control
- Abstract
Background: Bronchiolitis is a major source of morbimortality among young children worldwide. Non-pharmaceutical interventions (NPIs) implemented to reduce the spread of severe acute respiratory syndrome coronavirus 2 may have had an important impact on bronchiolitis outbreaks, as well as major societal consequences. Discriminating between their respective impacts would help define optimal public health strategies against bronchiolitis. We aimed to assess the respective impact of each NPI on bronchiolitis outbreaks in 14 European countries., Methods: We conducted a quasi-experimental interrupted time-series analysis based on a multicentre international study. All children diagnosed with bronchiolitis presenting to the paediatric emergency department of one of 27 centres from January 2018 to March 2021 were included. We assessed the association between each NPI and change in the bronchiolitis trend over time by seasonally adjusted multivariable quasi-Poisson regression modelling., Results: In total, 42 916 children were included. We observed an overall cumulative 78% (95% CI -100- -54%; p<0.0001) reduction in bronchiolitis cases following NPI implementation. The decrease varied between countries from -97% (95% CI -100- -47%; p=0.0005) to -36% (95% CI -79-7%; p=0.105). Full lockdown (incidence rate ratio (IRR) 0.21 (95% CI 0.14-0.30); p<0.001), secondary school closure (IRR 0.33 (95% CI 0.20-0.52); p<0.0001), wearing a mask indoors (IRR 0.49 (95% CI 0.25-0.94); p=0.034) and teleworking (IRR 0.55 (95% CI 0.31-0.97); p=0.038) were independently associated with reducing bronchiolitis., Conclusions: Several NPIs were associated with a reduction of bronchiolitis outbreaks, including full lockdown, school closure, teleworking and facial masking. Some of these public health interventions may be considered to further reduce the global burden of bronchiolitis., Competing Interests: Conflict of interest: N. Ouldali reports travel grants from Pfizer, GSK and Sanofi. No other authors have conflicts of interest to disclose., (Copyright ©The authors 2023. For reproduction rights and permissions contact permissions@ersnet.org.)
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- 2023
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20. Clinical features and management of animal bites in an emergency department: a single-center experience.
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Aydin O, Aydin Goker ET, Arslan ZA, Sert HM, and Teksam O
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- Male, Female, Animals, Humans, Dogs, Emergency Service, Hospital, Anti-Bacterial Agents therapeutic use, Mammals, Rabies epidemiology, Rabies prevention & control, Bites and Stings therapy, Bites and Stings drug therapy, Rabies Vaccines therapeutic use
- Abstract
Objectives: This study aimed to evaluate the clinical features, management, and outcomes of patients with animal bites presented to the pediatric emergency department of a tertiary center., Methods: Patients with ICD-10 code W54 (contact with dog) and W55 (contact with other mammals) between March 1
st , 2017, and July 1st , 2021, were included in the study. Demographic characteristics of the patients, type of contacted animal, wound characteristics (muscle involvement, soft tissue defect, vascular injury, type of nerve injury, and Lackmann's classification), wound care measurements, tetanus prophylaxis, administration of rabies immunoglobulin and antibiotics, location of the injury, existing fractures, suturing, splinting, surgical consultations and hospitalization status were recorded., Results: Four hundred and nineteen incidents of animal bites (240 males and 179 females) occurred over a four-year period. 51% was due to a dog bite; 47% was by a cat. The median age was nine years (IQR: 5-14 years). Most bites (91.6%) involved only a single anatomical site. The extremities were the commonly involved part (right upper limb [35.3%], left upper limb [21.2%], right lower limb [12.6%], left lower limb [16%]). Head-neck and face injury ratio was 17.6%. Torso (5.7%) and genitalia (5.2%) were uncommonly involved. A consultation was requested from at least one surgical department for 8% of the patients. 97.1% of patients received a rabies vaccine. Most attacks were trivial and did not require hospitalization., Conclusion: Animal bites often cause minor injuries. However, multiple dog attacks can be seen related to a high number of stray animals in our country. Therefore, these patients may present with major traumas. Surgical intervention and hospitalization may be required. Emergency physicians play an essential role in acute management and rabies prophylaxis in these patients.- Published
- 2023
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21. Practices of pediatric emergency physicians on the first febrile and afebrile seizures: a research in European Pediatric Emergency Medicine Survey Study.
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Teksam O, Serdaroglu E, Haliloglu G, Konuskan B, and Yalnizoglu D
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- Child, Humans, Infant, Seizures diagnosis, Seizures therapy, Surveys and Questionnaires, Pediatric Emergency Medicine, Seizures, Febrile diagnosis, Seizures, Febrile therapy, Physicians, Emergency Medicine
- Published
- 2022
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22. Age and C-reactive protein as modifiers of Kocher criteria in pediatric septic knee monoarthritis.
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Hanalioglu D, Turker E, Kamaci S, Ozsurekci Y, Cengiz AB, Ceyhan M, and Teksam O
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- Arthrocentesis adverse effects, Child, Child, Preschool, Fever etiology, Humans, Knee Joint, Retrospective Studies, Arthritis, Infectious complications, Arthritis, Infectious diagnosis, C-Reactive Protein metabolism
- Abstract
Introduction: Although Kocher criteria can distinguish a septic hip from an aseptic cause, they may not apply to a septic knee. We aimed to identify predictors to discriminate septic and aseptic causes of acute knee monoarthritis in children who underwent arthrocentesis., Methods: We conducted a retrospective cohort study among children who underwent arthrocentesis for suspected septic arthritis of the knee. Collected data included demographic, clinical and laboratory characteristics. We performed univariate and multivariable analyses to identify predictors of the septic knee. We further investigated accuracy of different predictive models., Results: A total of 60 patients who underwent arthrocentesis for suspected knee septic arthritis were included in this study. Septic arthritis of the knee was confirmed in 32 (53%) patients. Age ≤ 5 years (OR 4.237, [95% CI 1.270-14.127], p = 0.019), WBC > 12,000 cells/mm
3 (OR 5.059, [95% CI 1.424-17.970], p = 0.012), and CRP > 2 mg/dL (OR 3.180, [0.895-11.298], p = 0.074) were the most important predictors of a septic knee. Three-tier model comprising these three factors (AUC 0.766) and 4-tier model with addition of fever >38.5°C (AUC 0.776) performed better than Kocher criteria (AUC 0.677), modified Kocher criteria (AUC 0.699) and Full Model (adding age ≤ 5 years and CRP >2 mg/dL to Kocher criteria) (AUC 0.746). Full Model successfully ruled out septic arthritis if all 6 criteria were negative., Conclusion: Based on these findings, we propose an algorithm to identify low, intermediate and high-risk patients for knee septic arthritis. Our proposed two-step algorithm incorporating major (age, WBC, CRP) and minor (fever, ESR, non-weight bearing) criteria can serve as a simple decision-support tool to justify arthrocentesis in children with suspected knee septic arthritis., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier Inc. All rights reserved.)- Published
- 2022
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23. The common triggers of urticaria in children admitted to the pediatric emergency room.
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Bezirganoglu H, Arik Yilmaz E, Sahiner UM, Soyer O, Sekerel BE, Teksam O, Buyuktiryaki B, and Sackesen C
- Subjects
- Allergens, Child, Emergency Service, Hospital, Hospitalization, Humans, Immunoglobulin E, Food Hypersensitivity complications, Food Hypersensitivity diagnosis, Food Hypersensitivity epidemiology, Hypersensitivity, Immediate, Urticaria diagnosis, Urticaria epidemiology, Urticaria etiology
- Abstract
Background: Urticaria frequently causes pediatric emergency department (PED) admissions. Children with urticaria may unnecessarily avoid suspected allergens. We aimed to investigate the possible and exact triggers of urticaria in children admitted to the PED., Methods: Medical records of children admitted to the PED within a 1-year period were evaluated for the International Classification of Diseases 10 (ICD-10) L50 urticaria code, noting symptoms, and possible triggers of urticaria. We performed telephone interviews to complete the missing data and further diagnostic tests for IgE-mediated allergies to identify the exact triggers of urticaria., Results: Among 60,142 children, 462 (0.8%) with the L50 code were evaluated. Possible triggers based on the history and physical examination could be identified in 46%: infections (18%), drugs (11%), foods (8%), infections and drugs (3%), insects (3%), pollen (1%), blood products (0.4%), and vaccines (0.4%). The most frequent infections related to urticaria were upper respiratory tract infections (74.5%), urinary tract infections (13.2%), gastroenteritis (8.2%), and otitis media (4.1%). After a diagnostic workup, IgE-mediated allergic diseases were diagnosed in 6% of patients. Twenty-two percent of the patients had multiple PED admission for the same urticaria flare. Urticaria severity was found to be the most important risk factor for readmissions to the PED (odds ratio: 3.86; 95% confidence interval: 2.39-6.23; p < .001). No relationship between urticaria severity, duration, and the triggers was present., Conclusions: Despite detailed diagnostic tests, IgE-mediated allergic triggers were rarely the cause of urticaria in children admitted to the PED. Infections are the most frequent trigger. Severe urticaria causes more frequent readmissions to the PED., (© 2022 Wiley Periodicals LLC.)
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- 2022
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24. Prevalence of Anosmia in 10.157 Pediatric COVID-19 Cases: Multicenter Study from Turkey.
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Elvan-Tuz A, Karadag-Oncel E, Kiran S, Kanik-Yuksek S, Gulhan B, Hacimustafaoglu M, Ozdem-Alatas S, Kuyucu N, Ozdemir H, Egil O, Elmas-Bozdemir S, Polat M, Bursal-Duramaz B, Cem E, Apaydin G, and Teksam O
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- Adolescent, Adult, Anosmia epidemiology, Child, Cohort Studies, Humans, Prevalence, Prospective Studies, SARS-CoV-2, Turkey epidemiology, Ageusia diagnosis, COVID-19 complications, COVID-19 epidemiology
- Abstract
Introduction: COVID-19-related anosmia is a remarkable and disease-specific finding. With this multicenter cohort study, we aimed to determine the prevalence of anosmia in pediatric cases with COVID-19 from Turkey and make an objective assessment with a smell awareness questionnaire., Material and Methods: This multicenter prospective cohort study was conducted with pediatric infection clinics in 37 centers in 19 different cities of Turkey between October 2020 and March 2021. The symptoms of 10.157 COVID-19 cases 10-18 years old were examined. Age, gender, other accompanying symptoms, and clinical severity of the disease of cases with anosmia and ageusia included in the study were recorded. The cases were interviewed for the smell awareness questionnaire at admission and one month after the illness., Results: Anosmia was present in 12.5% (1.266/10.157) of COVID-19 cases 10-18 years of age. The complete records of 1053 patients followed during the study period were analyzed. The most common symptoms accompanying symptoms with anosmia were ageusia in 885 (84%) cases, fatigue in 534 cases (50.7%), and cough in 466 cases (44.3%). Anosmia was recorded as the only symptom in 84 (8%) of the cases. One month later, it was determined that anosmia persisted in 88 (8.4%) cases. In the smell awareness questionnaire, the score at admission was higher than the score one month later (P < 0.001)., Discussion: With this study, we have provided the examination of a large case series across Turkey. Anosmia and ageusia are specific symptoms seen in cases of COVID-19. With the detection of these symptoms, it should be aimed to isolate COVID-19 cases in the early period and reduce the spread of the infection. Such studies are important because the course of COVID-19 in children differs from adults and there is limited data on the prevalence of anosmia., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2022
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25. Evaluation of changes in physician behavior after introduction of pediatric syncope approach protocol in the emergency department.
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Akcan Yildiz L, Haliloglu G, Yalnizoglu D, Ertugrul I, Alehan D, and Teksam O
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- Child, Electrocardiography, Emergency Service, Hospital, Humans, Retrospective Studies, Physicians, Syncope diagnosis, Syncope etiology, Syncope therapy
- Abstract
Objectives: Syncope is a common presenting symptom in the pediatric emergency department (PED). The etiology of pediatric syncope is generally benign. However, differentiating cardiac and other serious causes from benign causes of syncope are crucial. The aim of this study was to evaluate the change of physicians' behavior after introduction of an institutional protocol designed to act as a guide in the assessment and management of syncope patients in the PED., Methods: This was a retrospective study, conducted at the PED of our University Children's Hospital. A "pediatric syncope approach protocol" was introduced on March 1, 2019 for quality improvement purposes. Documented information in the medical records, laboratory investigations and the patients' final diagnoses during the six-month periods before and after the protocol introduction were compared., Results: 268 patients were included in the study (131 pre-protocol, 137 post-protocol patients). When compared with the pre-protocol group, there was a significant improvement in the documentation of syncope characteristics (prodromal findings, predisposing factors, association with exercise), cardiac, neurological and electrocardiographic (ECG) warning signs and ordering of cardiac markers in the post-protocol group., Conclusions: The introduction of the syncope approach protocol in PED has enabled an evidence-based and systematic evaluation and management of syncope patients, and reduced the rates of low-yield investigations. Sustained implementation of this protocol can have long-term benefits in the care of children with syncope at the emergency department., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)
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- 2022
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26. Update on the Coordinated Efforts of Looking After the Health Care Needs of Children and Young People Fleeing the Conflict Zone of Ukraine Presenting to European Emergency Departments-A Joint Statement of the European Society for Emergency Paediatrics and the European Academy of Paediatrics.
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Nijman RG, Bressan S, Brandenberger J, Kaur D, Keitel K, Maconochie IK, Oostenbrink R, Parri N, Shavit I, Teksam O, Velasco R, van de Voorde P, Da Dalt L, Guchtenaere A, Hadjipanayis AA, Ross Russell R, Del Torso S, Bognar Z, and Titomanlio L
- Abstract
This joint statement by the European Society for Emergency Paediatrics and European Academy of Paediatrics aims to highlight recommendations for dealing with refugee children and young people fleeing the Ukrainian war when presenting to emergency departments (EDs) across Europe. Children and young people might present, sometimes unaccompanied, with either ongoing complex health needs or illnesses, mental health issues, and injuries related to the war itself and the flight from it. Obstacles to providing urgent and emergency care include lack of clinical guidelines, language barriers, and lack of insight in previous medical history. Children with complex health needs are at high risk for complications and their continued access to specialist healthcare should be prioritized in resettlements programs. Ukraine has one of the lowest vaccination coverages in the Europe, and outbreaks of cholera, measles, diphtheria, poliomyelitis, and COVID-19 should be anticipated. In Ukraine, rates of multidrug resistant tuberculosis are high, making screening for this important. Urgent and emergency care facilities should also prepare for dealing with children with war-related injuries and mental health issues. Ukrainian refugee children and young people should be included in local educational systems and social activities at the earliest opportunity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Nijman, Bressan, Brandenberger, Kaur, Keitel, Maconochie, Oostenbrink, Parri, Shavit, Teksam, Velasco, van de Voorde, Da Dalt, Guchtenaere, Hadjipanayis, Ross Russell, del Torso, Bognar and Titomanlio.)
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- 2022
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27. Neurologic manifestations in children with COVID-19 from a tertiary center in Turkey and literature review.
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Laçinel Gürlevik S, Günbey C, Ozsurekci Y, Oygar PD, Kesici S, Gocmen R, Aydin O, Temucin Ç, Tufan E, Terzi K, Baltu D, Ozturk TT, Teksam O, Ozen S, Oguz KK, Cengiz AB, and Yalnızoglu D
- Subjects
- Child, Humans, Infant, Retrospective Studies, SARS-CoV-2, Systemic Inflammatory Response Syndrome, Turkey epidemiology, COVID-19 complications, Nervous System Diseases epidemiology, Nervous System Diseases etiology
- Abstract
Background: Since December 2019, coronavirus disease 2019 (COVID-19) has become a global pandemic caused by highly transmissible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although respiratory disease and multisystem inflammatory syndrome in children (MIS-C) are main clinical presentations in children, numerous neurological manifestations are being described increasingly. We aimed to investigate new onset neurological symptoms associated with SARS-CoV-2 in pediatric patients in order to establish a possible relationship as well as to understand the underlying pathophysiological mechanisms between SARS-CoV-2 infection and neurological findings., Methods: We analyzed retrospectively children who had neurologic manifestations temporally associated with SARS-CoV-2 infection at Hacettepe University İhsan Doğramaci Children's Hospital. We performed a literature search between March 20, 2020 and March 30, 2021. Articles that report children with COVID-19 related neurological manifestations were included., Results: We have observed 15 consecutive cases with new onset neurological manifestations along with confirmed SARS-CoV-2 infection. Age at hospitalization ranged from three months to 17 years. Ten patients had central nervous system involvement, and most common manifestation was encephalopathy (5/10), which is also one of the most common manifestations of the patients mentioned in the relevant 39 articles we reviewed., Conclusion: Children with COVID-19 can present with neurologic findings such as encephalopathy, seizures, cerebrovascular events as well as abnormal eye movements. Clinical suspicion and awareness are required to show the association between neurologic manifestations and COVID-19., (© 2022 Published by Elsevier Ltd on behalf of European Paediatric Neurology Society.)
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- 2022
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28. Clinical course of COVID-19 infection in paediatric familial Mediterranean fever patients.
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Kaya Akca U, Sener S, Balık Z, Gurlevik S, Oygar PD, Atalay E, Cuceoglu MK, Basaran O, Batu ED, Teksam O, Bilginer Y, Ozsurekci Y, and Ozen S
- Subjects
- Child, Colchicine therapeutic use, Humans, SARS-CoV-2, COVID-19 complications, Familial Mediterranean Fever complications, Familial Mediterranean Fever diagnosis, Familial Mediterranean Fever drug therapy
- Abstract
Objective: To evaluate the course of coronavirus-19 (COVID-19) infection in paediatric familial Mediterranean fever (FMF) patients and to investigate the risk factors for COVID-19 infection., Methods: Medical records of 100 consecutive paediatric FMF patients and their COVID-19 infection status were evaluated. Age- and gender-matched control group consisted of 51 patients with positive results for severe acute respiratory syndrome coronavirus 2., Results: Twenty-five of 100 paediatric FMF patients were detected to have COVID-19 infection. A history of contact with a COVID-19 case was present in ∼95% of patients in both the FMF and control groups with COVID-19 infection. Asymptomatic infection was detected in two patients in the paediatric FMF group (8.0%) and 17 patients in the control group (33.3%) (P = .017). Mild disease was observed in 23 paediatric FMF patients (92.0%) and 28 control patients (54.9%) (P = .001), whereas moderate disease was present in only 6 control patients (11.7%) (0 vs 11.7%, P = .074). Severe or critical disease was not observed in any patients., Conclusion: Paediatric FMF patients receiving colchicine had no moderate COVID-19 disease compared to the control group. We suggest that colchicine use may tune down the severity of the disease even if it does not prevent COVID-19 infection., (© Japan College of Rheumatology 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2022
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29. The Burden of Burnout Syndrome in Pediatric Intensive Care Unit and Pediatric Emergency Department: A Multicenter Evaluation.
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Yazıcı MU, Teksam O, Agın H, Erkek N, Arslankoylu AE, Akca H, Esen F, Derinoz O, Yener N, Kılınc MA, Yılmaz R, Koksoy Ö, Kendirli T, Anıl AB, Yıldızdas D, Ozturk N, Tekerek N, Duyu M, Kalkan G, Emeksiz S, Kurt F, Alakaya M, Goktug A, Ceylan G, and Bayrakcı B
- Subjects
- Child, Cross-Sectional Studies, Emergency Service, Hospital, Female, Humans, Intensive Care Units, Pediatric, Burnout, Professional epidemiology, Physicians
- Abstract
Objective: The objective of this study was to detect variables associated with burnout syndrome (BS) in pediatric intensive care units (PICUs) and pediatric emergency medicine departments (PEDs) in high-volume centers from different parts of Turkey., Methods: An observational, cross-sectional multicenter study was performed. The Maslach Burnout Inventory scale was administered to all of health care providers working in PICUs and PEDs. In this study, health care providers were defined as physicians, nurses, and other staff (secretaries, cleaning and patient care staff) working in PICU and PEDs., Results: A total of 570 participants completed the survey. The major finding of this study was that 76.1% (n = 434) of PICU and PED health care professionals had BS. The most prominent subscale of BS was emotional exhaustion (62.5%). The rate of BS was higher among health care providers working in PEDs compared with PICUs (79.1% vs 73.7%, P = 0.04). The frequency of BS according to emotional exhaustion and depersonalization subscales was higher in health care providers of PEDs. The rate of BS was also significantly higher in younger employees, females, those working 51 or more hours totally in a week, those having a low monthly salary, those single or divorced, those without children, those with no childcare at home, those not owning a home, those not doing regular exercise and not having regular breakfast, those with total employment time of less than 1 year, and those not having a car or not having a hobby. In PEDs, when the daily evaluated number of patients was equal to or more than 44 (sensitivity, 88%; specificity, 66%), it predicted the occurrence of BS. In PICUs, when the number of patients cared for by 1 nurse was equal to or more than 3, it predicted the occurrence of BS (sensitivity, 78%; specificity, 62%)., Conclusions: By creating early intervention programs to prevent BS, shortages of health care professionals can be avoided and the costs of health care expenditures related to infections can be decreased., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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30. Challenging diagnosis and rare disease in children: Dermatitis artefacta.
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Isiyel E, Ersoy Evans S, Akar HT, Gurbanov A, Karaduman A, Foto-Ozdemir D, and Teksam O
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- Child, Humans, Skin, Dermatitis diagnosis, Dermatitis etiology, Rare Diseases diagnosis
- Published
- 2021
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31. Longitudinal Follow-up of Antibody Responses in Pediatric Patients With COVID-19 up to 9 Months After Infection.
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Oygar PD, Ozsurekci Y, Gurlevik SL, Aykac K, Kukul MG, Cura Yayla BC, Ilbay S, Karakaya J, Teksam O, Cengiz AB, and Ceyhan M
- Subjects
- Adolescent, Antibodies, Viral immunology, Antibody Formation, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Immunoglobulin A, Immunoglobulin G biosynthesis, Immunoglobulin G immunology, Infant, Longitudinal Studies, Male, Prospective Studies, Antibodies, Viral biosynthesis, COVID-19 immunology, SARS-CoV-2 immunology
- Abstract
Introduction: Antibody response developed within 2-3 weeks after exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to decrease over time; however, there is limited data about antibody levels at 6 months or later postinfection, particularly in children., Materials and Method: A prospective multicenter study was performed using 315 samples of 74 confirmed and 10 probable coronavirus disease 2019 pediatric cases. About 20% of these cases were classified as asymptomatic, 74% as mild/moderate and 6% as severe/critical. Patients were included if at least 2 samples were available. The antibody response was classified as either early-period or late-period (14 days-3 months and after 6 months, respectively) for IgG response whereas IgA response was tested on various time intervals, including as early as 4 days up to 3 months. Euroimmun Anti-SARS-CoV-2 IgG and IgA and Genscript SARS-CoV-2 Surrogate Virus Neutralization Kits were used for antibody detection., Results: There was no difference between the early-period and late-period IgG positivity (P = 0.1). However, the median IgG levels were 11.98 in the early periods and 4.05 in the late periods, with a significance of P < 0.001. Although the decrease in IgG levels was significant in asymptomatic and mild/moderate cases (P < 0.008 and P < 0.001, respectively), the decrease in severe/critical cases was moderate (P = 0.285). The sensitivity of the IgG after 15 days was higher than 94%, and the sensitivity of IgA was 88% on days 8-15., Conclusion: SARS-CoV-2 IgG antibody levels decreased after 6 months. The decrease was moderate in severe/critical cases. Overall, 95.8% of the patients remained positive up to 9 months after infection. Although the IgA response may be useful early on, the IgG response is useful after 14 days., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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32. Penile involvement of immunoglobulin a vasculitis/Henoch-Schönlein purpura.
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Kaya Akca U, Batu ED, Serin O, Ipek OF, Aydin O, Teksam O, Bilginer Y, and Ozen S
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- Child, Child, Preschool, Humans, Immunoglobulin A, Male, Penis, Skin, IgA Vasculitis diagnosis, IgA Vasculitis drug therapy, Vasculitis
- Abstract
Background: Immunoglobulin A vasculitis/Henoch-Schönlein purpura (IgAV/HSP) is a leukocytoclasia vasculitis of childhood, predominantly affecting the skin, joints, gastrointestinal tract, and kidneys. The involvement of the penis is rare., Objective: We aimed to describe this rare manifestation of IgAV/HSP and to review the previous studies, including similar cases., Methods: Clinical data were reviewed for two children of penile involvement of IgAV/HSP in our hospital. More clinical cases were retrieved from the databases of PubMed/MEDLINE and Scopus from database inception to February 1, 2020., Results: We presented two boys aged three and five years both of whom had penile lesions after presenting with the typical rash of IgAV/HSP on lower extremities. The penile lesions improved entirely in a few days without treatment in one and with corticosteroid treatment in the other. The literature review revealed 12 articles describing 20 patients with penile involvement of IgAV/HSP. The penile findings were edema, erythema, ecchymosis, purpuric rash, edema, color change, stiffness of the shaft or prepuce, and tenderness. Penile lesions appeared before the purpuric rash of IgAV/HSP in three of 22 patients. The penile involvement could make the diagnosis challenging especially if the penile lesions appear before the typical rash of the disease. The lesions improved entirely in the short term in all patients; in five without treatment in fifteen after corticosteroid or immunosuppressive drug treatment., Conclusions: It is important to raise awareness about this rare manifestation among health care providers. It is not clear whether corticosteroid treatment should be initiated for treatment since it seems as a self-limited feature. Treatment with corticosteroids could be considered in the treatment of selected cases especially with systemic involvement., Competing Interests: Conflict of interest statement The authors declare that there is no conflict of interest regarding the publication of this article., (Copyright © 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2021
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33. Predictors of Severe Clinical Course in Children With Carbon Monoxide Poisoning.
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Akcan Yildiz L, Gultekingil A, Kesici S, Bayrakci B, and Teksam O
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- Carboxyhemoglobin analysis, Child, Glasgow Coma Scale, Humans, Intensive Care Units, Troponin T, Carbon Monoxide Poisoning diagnosis, Carbon Monoxide Poisoning epidemiology, Carbon Monoxide Poisoning therapy, Hyperbaric Oxygenation
- Abstract
Objective: Carbon monoxide (CO) is a gas, which is produced by incomplete combustion of hydrocarbon-containing substances, and causes significant tissue and organ damage in the common event of CO poisoning. This study aims to evaluate the demographic, clinical, and laboratory characteristics of patients diagnosed with CO poisoning in the emergency department and to determine the factors associated with severe course in the acute phase of poisoning., Methods: A total of 331 patients diagnosed with CO poisoning in Hacettepe University Children's Hospital, Pediatric Emergency Unit, between January 2004 and March 2014 were included in the study. Their demographic characteristics, presenting complaints, physical examination findings, Glasgow Coma Scale scores, carboxyhemoglobin, leukocyte, hemoglobin, troponin T, pH and lactate levels, type of treatment (normobaric or hyperbaric oxygen), intensive care unit admissions, and outcome of poisoning were investigated., Results: Ninety-three patients were given hyperbaric oxygen. Fifty-one patients were admitted to the pediatric intensive care unit, 18 patients have had a severe clinical course, and 6 patients have died. The risk factors associated with severe disease course were determined to be low Glasgow Coma Scale score, high leukocyte count, and high troponin T levels at presentation., Conclusions: Glasgow Coma Scale score, leukocyte count, and troponin T level may be beneficial in predicting clinical outcomes and tailoring therapy in children with CO poisoning., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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34. Variability in the management and imaging use in paediatric minor head trauma in European emergency departments. A Research in European Pediatric Emergency Medicine study.
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Velasco R, Moore CM, Deiratany S, D'Elia F, Tourteau LB, Zuiani C, Bognar Z, Erdelyi K, Fadgyas B, Fejes M, Teksam O, Mirzeyev Y, Esmeray P, Fernández SM, Ricondo A, Da Dalt L, Bressan S, Priante E, Snoeck E, Broers M, Castman-Berrevoets CE, Fernandes RM, Borges J, Obieta A, Alcalde M, Piñol S, González J, Azzali A, Gioè D, La Spina L, Bianconi M, Arribas M, and Parri N
- Subjects
- Adolescent, Child, Emergency Service, Hospital, Glasgow Coma Scale, Humans, Retrospective Studies, Craniocerebral Trauma diagnostic imaging, Craniocerebral Trauma therapy, Pediatric Emergency Medicine
- Abstract
Objective: The objective of the study was to assess the variability in the management of paediatric MHT in European emergency departments (EDs)., Methods: This was a multicentre retrospective study of children ≤18 years old with minor head trauma (MHT) (Glasgow Coma Scale ≥14) who presented to 15 European EDs between 1 January 2013 and 31 December 31. Data on clinical characteristics, imaging tests, and disposition of included patients were collected at each hospital over a 3-year period., Results: We included 11 212 patients. Skull radiography was performed in 3416 (30.5%) patients, range 0.4-92.3%. A computed tomography (CT) was obtained in 696 (6.2%) patients, range 1.6-42.8%. The rate of admission varied from 0 to 48.2%., Conclusion: We found great variability in terms of the type of imaging and rate of CT scan obtained. Our study suggests opportunity for improvement in the area of paediatric head injury and the need for targeted individualised ED interventions to improve management of MHT., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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35. Pediatricians' Attitude in Management of Acute Bronchiolitis: Did Guidelines Overcome Practices?
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Gultekingil A, Gocer E, Anil M, Agin H, Anil AB, Işguder R, Kurt F, Incekoy-Girgin F, Erkek N, Durak F, Akca H, Berksoy E, Goktug A, Gunay I, Derinoz O, Yalindag-Ozturk N, Azapagasi E, Besli GE, Odek C, Tekin D, Dursun O, Kendirli T, and Teksam O
- Abstract
Background: Acute bronchiolitis is one of the most common diseases of early childhood. There are many recent changes in the treatment of acute bronchiolitis. The aim of this study is to evaluate treatment approaches to acute bronchiolitis among clinicians and to observe compliance with clinical guidelines. Materials and Methods: Our study was designed as a multicenter cross-sectional descriptive study. A cohort of pediatric residents, fellows, and attendants were surveyed with a questionnaire including general and occupational characteristics of pediatricians and treatment choices in acute bronchiolitis. Results: A total of 713 questionnaires were collected. Most commonly applied treatment among pediatricians was inhaled salbutamol, followed by intravenous hydration, hypertonic saline, and inhaled steroid. Most commonly preferred treatment in the management of mild bronchiolitis was oral hydration and inhaled salbutamol in severe bronchiolitis. Conclusion: Although recent guidelines for the treatment of acute bronchiolitis does not support the use of many different therapies, pediatricians still tend to use them, especially bronchodilators, corticosteroids, and antibiotics.
- Published
- 2020
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36. Risk factors for seizure recurrence in a pediatric observation unit.
- Author
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Gultekingil A, Teksam O, Haliloglu G, and Yalnizoglu D
- Subjects
- Age of Onset, Case-Control Studies, Child, Child, Preschool, Electroencephalography, Epilepsy epidemiology, Female, Humans, Infant, Male, Prospective Studies, Recurrence, Risk Factors, Seizures epidemiology, Time Factors, Anticonvulsants therapeutic use, Clinical Observation Units statistics & numerical data, Epilepsy drug therapy, Seizures therapy
- Abstract
Background: Most patients present with seizures to pediatric emergency department (PED) are observed for extended periods for the risk of possible acute recurrence., Objective: The aim of this study is to determine the risk factors of acute recurrence within first 24 h., Methods: Patients who presented to PED with seizure during past 24 h were enrolled. Demographic features, number and duration of seizures, diagnostic studies, physical examination findings, presence and time of seizure recurrence in PED were noted., Results: 187 patients were eligible for the study. 46% had recurrence of seizures in 24 h, 90,8% of recurrence within the first 6 h. Univariate analysis showed that younger patients, epileptic patients who were on multiple antiepileptic drugs (AEDs), who had multiple seizures during the past 24 h, who had abnormal neurological examination or neuroimaging findings had increased risk of seizure recurrence. Multivariate analysis showed that number of seizures during the past 24 h and previous use of AEDs was significantly associated with increased risk of recurrence., Conclusion: Risk factors for acute recurrence should be evaluated for each patient. Patients without risk factors and no seizures during the first 6 h should not be observed for extended periods in PED., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
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37. Predictive factors for progression to chronicity or recurrence after the first attack of acute urticaria in preschool-age children.
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Cetinkaya PG, Soyer O, Esenboga S, Sahiner UM, Teksam O, and Sekerel BE
- Subjects
- Acute Disease, Chronic Disease, Disease Progression, Female, Humans, Infant, Male, Predictive Value of Tests, Prognosis, Prospective Studies, Risk, Antibodies, Viral blood, Child, Preschool, Food Hypersensitivity epidemiology, Herpes Simplex epidemiology, Herpesvirus 1, Human physiology, Respiratory Tract Infections epidemiology, Urticaria epidemiology
- Abstract
Introduction and Objectives: Preschool-aged group is frequently affected by urticaria, and infections are the most frequently documented factors that cause acute urticaria in children. This prospective study was designed to investigate the underlying factors of acute urticaria in under five-year-old children and to describe predictive factors for progression to chronicity or recurrence after the first attack., Patients and Methods: Children younger than five years of age with acute urticaria were recruited between July 2015 and July 2016. Patients (n=83) were grouped into those below and above two years of age. In order to assess the risk factors for progression to chronicity or recurrence, logistic regression analysis was performed., Results: Upper respiratory tract infection was the most common detectable reason for acute urticaria (49.4%). Herpes Simplex Virus type 1 was significantly isolated in the cases with the manifestation of an acute single-episode urticaria (p=0.042). Angioedema and food allergy were predominantly observed under two years old (p=0.001, p=0.006 respectively). A positive relationship was determined between the duration of urticaria and chronicity (r=0.301, p=0.006). The absence of atopic dermatitis (OR: 6.95, 95% CI: 1.35-35.67, p=0.020), negative Herpes virus serology (OR: 4.25, 95% CI: 0.83-21.56, p=0.040), and unknown etiology (OR: 3.30, 95% CI: 1.12-9.71, p=0.030) were the independent risk factors for recurrent urticaria., Conclusions: Preschool-aged children with acute urticaria should be evaluated for infections at the time of admission. Patients with unknown etiology, negative Herpes virus serology, absence of atopic dermatitis, and long lasting urticaria should be followed up for chronicity and recurrence., (Copyright © 2019 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
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38. A comparison between the feeding practices of parents and grandparents.
- Author
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Metbulut AP, Özmert EN, Teksam O, and Yurdakök K
- Subjects
- Body Mass Index, Case-Control Studies, Child, Preschool, Feeding and Eating Disorders epidemiology, Female, Grandparents, Humans, Male, Mothers, Parenting, Surveys and Questionnaires, Feeding Behavior, Feeding and Eating Disorders etiology, Health Knowledge, Attitudes, Practice
- Abstract
The aim of this study is to evaluate and compare mothers' and grandparents' feeding behaviours, the differences between the behaviours, the relationship between children's feeding problems and grandparents' feeding behaviours, as well as the relationship between grandparents' feeding behaviour and children's body mass index (BMI). This study prompts physicians to pay attention to the on feeding behaviours of grandmothers when evaluating the feeding problems and behaviours of children. This study is a controlled case study. Two hundred children (between 2 and 5 years of age) were included. Amongst these children, 150 of them were only fed by their mothers and 50 of them were fed by both their mother and grandmother. The feeding behaviour was evaluated by the Comprehensive Feeding Practices Questionnaire (CFPQ).Three domains emerged in this study: Some of the feeding behaviours were significantly different between the mothers and grandmothers who were questioned in the CFPQ. The feeding behaviours are related to the feeding problems; in this study, we show that, in some cases, whether some feeding behaviours were applied either more or less had a significant influence on feeding problems. There were positive correlations between the feeding behaviours of mothers and grandmothers. Conclusion: There is limited research about grandmothers' influence on child feeding. Research in grandmothers' feeding behaviours may reveal key concerns in children feeding problems and in preventing childhood obesity. What is Known: • According to studies, there are differences between the feeding behaviours of mothers and grandmothers. What is New: • This study is the first to explore the relationship between the feeding problems and feeding behaviours of both mothers and grandmothers. Also, a comparison of the mothers' and fathers' mothers' feeding behaviours has not yet been carried out.
- Published
- 2018
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39. Repeated doses of salbutamol and aeroallergen sensitisation both increased salbutamol-induced hypoxia in children and adolescents with acute asthma.
- Author
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Ozer M, Buyuktiryaki B, Sahiner UM, Teksam O, Karaatmaca B, Soyer O, and Sekerel BE
- Subjects
- Acute Disease, Administration, Inhalation, Adolescent, Asthma complications, Child, Child, Preschool, Drug Administration Schedule, Female, Humans, Infant, Male, Nebulizers and Vaporizers, Oximetry, Prospective Studies, Risk Factors, Albuterol administration & dosage, Asthma drug therapy, Bronchodilator Agents administration & dosage, Hypoxia diagnosis, Hypoxia etiology
- Abstract
Aim: We aimed to identify the frequency, magnitude and risk factors of salbutamol-induced hypoxia in children with acute asthma., Methods: This study was conducted at Hacettepe University on children who presented to the paediatric allergy clinic or the paediatric emergency room with acute asthma between July 2014 and June 2015. Vital signs, pulse oximetry-defined oxygen saturation and modified pulmonary index scores were evaluated before and after the first, second and third doses of nebulised salbutamol and repeated one and 10 days later., Results: We included 304 patients (65.7% male) from median age of 5.3 years (range 1-18 years). Salbutamol-induced hypoxia was detected in 14.7%, 3.9% and 1.3%, respectively, after the first, second and third doses of salbutamol. The risk factors for hypoxia were younger age and a higher modified pulmonary index score, but the risk factors for salbutamol-induced hypoxia were the number of salbutamol doses given in the last six hours and the presence of aeroallergen sensitisation. The maximum decrease in oxygen saturation after salbutamol was %5., Conclusion: Although bronchodilators are the first-line treatment for acute asthma, they caused modest hypoxaemia, especially at repeated doses and, or, in patients with aeroallergen sensitisation., (©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)
- Published
- 2018
- Full Text
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40. Risk factors associated with clinically significant gastrointestinal bleeding in pediatric ED.
- Author
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Gultekingil A, Teksam O, Gulsen HH, Ates BB, Saltık-Temizel İN, and Demir H
- Subjects
- Adolescent, Child, Child, Preschool, Erythrocyte Transfusion, Female, Gastrointestinal Hemorrhage therapy, Hemoglobins analysis, Humans, Infant, Intubation, Gastrointestinal, Male, Melena etiology, Pallor etiology, Prospective Studies, Risk Factors, Tachycardia etiology, Emergency Service, Hospital, Gastrointestinal Hemorrhage complications, Gastrointestinal Hemorrhage diagnosis
- Abstract
Introduction: Gastrointestinal bleeding is a common problem in pediatric emergency department (PED). Some of these patients can lose significant amount of blood which may lead to shock. The aim of this study is to determine the risk factors predicting clinically significant gastrointestinal (GIS) bleeding in patients presenting to PED., Methods: This study was performed prospectively from January 1st 2013 to December 31th 2013 in patients with upper or lower GIS bleeding. Clinically significant GIS bleeding was defined as >2g/dL hemoglobin decrease at any time during observation in PED, need for erythrocyte transfusion or need for rapid endoscopic evaluation., Results: 105 patients were enrolled, 81 of which were eligible for the study. Twenty two patients (26,8%) had clinically significant GIS bleeding. These patients have significantly more commonly have upper GI bleeding and symptoms of melena, pallor and tachycardia. Initial laboratory findings revealed lower hemoglobin, RBC and albumin levels with higher WBC and BUN levels. They need significantly more nasogastric tube placement and PPI and H2 blocker treatment. Final diagnosis included more gastritis and peptic ulcers. These patients have less hematochezia, less lower gastrointestinal bleeding and less commonly diagnosed as acute gastroenteritis or Mallory Weiss tear as a final diagnosis., Conclusions: Pediatric emergency physicians should be aware of clinical and laboratory parameters of patients with clinically significant GIS bleeding to predict which patients are under risk of life threatening blood loss. Patients who have melena, pallor, tachycardia, anemia and uremia at presentation are more prone to have significant GIS bleeding., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
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41. Acute Abducens Nerve Paralysis in the Pediatric Emergency Department: Analysis of 14 Patients.
- Author
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Teksam O, Gultekingil A, Konuskan B, Haliloglu G, Oguz KK, and Yalnizoglu D
- Subjects
- Adolescent, Child, Child, Preschool, Diagnosis, Differential, Diagnostic Imaging, Emergency Service, Hospital, Female, Humans, Infant, Male, Retrospective Studies, Abducens Nerve pathology, Abducens Nerve Diseases diagnosis, Abducens Nerve Diseases etiology
- Abstract
Objectives: Sixth cranial nerve (SCN) palsy is an uncommon but important neurological problem in patients admitted to pediatric emergency department. The underlying etiology of SCN palsy has a wide range from viral infections to intracranial tumors; therefore, a careful and systematic approach is necessary while examining these patients., Methods: Fourteen patients who presented with acute SCN paralysis to pediatric emergency department during the last 10 years were examined., Results: The age at the time of admission ranged between 14 months and 16 years (median, 9.5 years). Of the 14 patients, 5 were girls and 9 were boys. A total of 3 of the 14 patients had bilateral cranial nerve VI paralysis, and 9 patients had additional abnormal findings on neurological examination. Neuroimaging studies included cranial tomography (n = 3) and brain magnetic resonance imaging in all patients. The underlying etiology was malignancy (n = 3); glioma, medulloblastoma, acute lymphoblastic leukemia, and dural sinus thrombosis (n = 2); as well as Guillain-Barre syndrome (n = 2), multiple sclerosis (n = 1), pseudotumor cerebri (n = 1), and meningitis (n = 1). The remaining 4 patients had miscellaneous benign etiologies., Conclusions: Other lesions of primary brain tumors causing increased intracranial pressure constitute 50% of the underlying etiology, followed by Guillain-Barre syndrome (14.2%). However, these patients had neurological symptoms signs, in addition to diplopia or SCN paralysis. Patients admitted to pediatric emergency department with acute SCN paralysis should be examined in detail to disclose the underlying etiology especially if they present with additional clinical signs or symptoms.
- Published
- 2016
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42. Congenital Mirror Movements in Gorlin Syndrome: A Case Report With DTI and Functional MRI Features.
- Author
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Sag E, Gocmen R, Yildiz FG, Ozturk Z, Temucin C, Teksam O, and Utine E
- Subjects
- Adolescent, Basal Cell Nevus Syndrome pathology, Diffusion Tensor Imaging, Humans, Magnetic Resonance Imaging, Male, Basal Cell Nevus Syndrome complications, Movement Disorders complications, Movement Disorders congenital
- Abstract
Congenital mirror movements are rare conditions that define the inability to perform unimanual movements. Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, is a genetic disorder with multiple nevi predisposing to basal cell carcinoma, odontogenic keratocysts, and skeletal malformations. Herein we report on an adolescent patient with Gorlin syndrome and coexisting congenital mirror movements. To our knowledge, this is the first patient in the literature who has both of these very rare conditions., (Copyright © 2016 by the American Academy of Pediatrics.)
- Published
- 2016
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43. The factors affecting neonatal presentations to the pediatric emergency department.
- Author
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Batu ED, Yeni S, and Teksam O
- Subjects
- Acute Disease, Adult, Colic complications, Colic diagnosis, Female, Hospitalization statistics & numerical data, Humans, Hyperbilirubinemia complications, Hyperbilirubinemia diagnosis, Infant, Newborn, Infant, Premature, Male, Maternal Age, Parity, Patient Acuity, Pregnancy, Prospective Studies, Referral and Consultation, Tertiary Care Centers, Young Adult, Emergency Service, Hospital statistics & numerical data, Hospitals, Pediatric statistics & numerical data, Irritable Mood, Jaundice, Neonatal etiology, Vomiting etiology
- Abstract
Background: A pediatric emergency department (PED) may be utilized by neonates for nonurgent complaints. Various factors, such as primiparity, maternal age, early postnatal discharge, race, income, and maternal and paternal educational levels, have been reported to affect the acuity of neonatal emergency department utilization., Objective: To determine the characteristics of PED visits by neonates (infants ≤ 28 days of age) and to evaluate the factors affecting the acuity of these visits., Methods: We prospectively collected the data of neonates who were admitted to the PED of a tertiary university hospital within a 6-month period. Presenting problems were classified as acute if diagnostic tests were requested or the patient was hospitalized, unless the final diagnosis was "normal newborn.", Results: Over this period, 28,389 children (0-18 years of age) visited the PED, of which 531 were newborns (1.9%). The mean age was 14.1 ± 8.3 days, with a slight predominance of males (57.3%). The chief complaints were jaundice (23.4%), irritability (9.5%), and vomiting (7.1%), and the most common diagnoses were normal newborn (33.9%), indirect hyperbilirubinemia (13.2%), and colic (5.8%). Acute visits were 55.7% of the total visits. Premature infants, infants of multiparous mothers, infants of older mothers (≥25 years), and physician-referred infants were more likely to present with acute problems (p values were 0.001, 0.013, 0.006, and <0.001, respectively)., Conclusion: The results suggest that there may be a relationship between nonacute neonatal visits to a PED and insufficient knowledge of the caretaker on newborn care. Thus, more detailed education and early postnatal support programs regarding newborn care may help to decrease nonacute PED visits by neonates., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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44. Fatal poisoning in children: acute colchicine intoxication and new treatment approaches.
- Author
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Ozdemir R, Bayrakci B, and Teksam O
- Subjects
- Acute Disease, Blood Transfusion, Child, Child, Preschool, Dose-Response Relationship, Drug, Female, Humans, Infant, Intensive Care Units, Pediatric, Male, Medical Records, Poisoning mortality, Poisoning therapy, Retrospective Studies, Suicide, Attempted, Treatment Outcome, Colchicine poisoning, Critical Care methods
- Abstract
Background: Colchicine poisoning is potentially life-threatening. Deaths generally result from hypovolemic shock and cardiovascular collapse or secondary to rapidly progressive multiorgan failure., Objective: The purpose of this study is to discuss the clinical effects, treatments and outcomes of pediatric colchicine poisoning and highlight the possible benefits of urgent plasma and whole blood exchange therapy for those patients who were believed to ingest potentially lethal doses of the drug., Methods: Current study was designed as an observational case series study. The medical records of children aged 0-16 years who were hospitalized for colchicine poisoning at the Pediatric Intensive Care Unit of, between November 1985 and March 2011 were retrospectively evaluated., Results: We present twenty-three children with colchicine poisoning. Nausea and vomiting were the most common presenting complaint, in 70% of patients. Sixteen of the 23 cases presented after ingesting sub-toxic doses of colchicine (< 0.5 mg/kg), whereas 3 patients had consumed toxic doses of the drug (0.5-0.8 mg/kg). The remaining 4 patients were hospitalized after taking colchicine at a lethal dose (> 0.8 mg/kg). Three patients (13%) died., Conclusions: Any patient suspected of ingesting high doses of colchicine should prompt immediate fluid and electrolyte resuscitation and invasive hemodynamic monitorization in a pediatric intensive care unit. Although there is lack of strong evidence, early initiation of either whole blood or plasma exchange may be considered in patients presenting with lethal-dose colchicine intoxication. These reported experience of us put forth further research for consideration.
- Published
- 2011
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45. Acute cardiac effects of carbon monoxide poisoning in children.
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Teksam O, Gumus P, Bayrakci B, Erdogan I, and Kale G
- Subjects
- Adolescent, Biomarkers blood, Carbon Monoxide Poisoning diagnosis, Carbon Monoxide Poisoning epidemiology, Cardiovascular Diseases diagnosis, Child, Child, Preschool, Electrocardiography, Female, Glasgow Coma Scale, Humans, Infant, Male, Retrospective Studies, Carbon Monoxide Poisoning complications, Cardiovascular Diseases etiology
- Abstract
Objective: Carbon monoxide (CO)-induced cardiotoxicity has been investigated infrequently in children and reports of its cardiovascular effects are limited to isolated case reports. Our aims were to describe acute cardiac effects and associated factors with myocardial injury in children with CO poisoning., Methods: We reviewed the medical records of children below 17 years of age who were diagnosed with CO poisoning at pediatric emergency department between July 2004 and June 2007. Patients who had carboxyhemoglobin level at least 10% were included. Myocardial injury was defined as elevated cardiac biomarkers (creatine kinase-MB or troponin-t). Carboxyhemoglobin level, electrocardiogram (ECG) findings, cardiac biomarkers, and echocardiograph results were recorded for each patient., Results: Cardiac biomarkers were drawn in 107 patients, of which 16 patients (15%) had cardiac biomarkers confirmed diagnosis of myocardial injury. Sinus tachycardia was present in 32% of patients on baseline ECG. None of the patients had ischemic changes on ECG. Echocardiograph was performed in 27 patients (25% of patients with biomarkers drawn), of which nine patients had low ejection fraction and abnormal left ventricular function. Determinators of myocardial injury included a Glasgow Coma Scale (GCS) score
- Published
- 2010
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46. Should the recommended dose of epinephrine for severe croup be changed?
- Author
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Teksam O
- Subjects
- Child, Preschool, Female, Humans, Bronchodilator Agents administration & dosage, Croup drug therapy, Epinephrine administration & dosage
- Published
- 2010
- Full Text
- View/download PDF
47. Establishment of interdisciplinary child protection teams in Turkey 2002-2006: identifying the strongest link can make a difference!
- Author
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Agirtan CA, Akar T, Akbas S, Akdur R, Aydin C, Aytar G, Ayyildiz S, Baskan S, Belgemen T, Bezirci O, Beyazova U, Beyaztas FY, Buken B, Buken E, Camurdan AD, Can D, Canbaz S, Cantürk G, Ceyhan M, Coskun A, Celik A, Cetin FC, Coskun AG, Dağçinar A, Dallar Y, Demirel B, Demirogullari B, Derman O, Dilli D, Ersahin Y, Eşiyok B, Evinc G, Gencer O, Gökler B, Hanci H, Iseri E, Isir AB, Isiten N, Kale G, Karadag F, Kanbur N, Kiliç B, Kultur E, Kurtay D, Kuruoglu A, Miral S, Odabasi AB, Oral R, Orhon FS, Ozbesler C, Ozdemir DF, Ozkok MS, Ozmert E, Oztop DB, Ozyürek H, Pasli F, Peksen Y, Polat O, Sahin F, Rifat Sahin A, Salacin S, Suskan E, Tander B, Tekin D, Teksam O, Tiras U, Tomak Y, Tumer AR, Turla A, Ulukol B, Uslu R, Tas FV, Vatandas N, Velipasaoglu S, Yagmur F, Yağmurlu A, Yalcin S, Yavuz S, and Yurdakok K
- Subjects
- Child, Child Abuse classification, Child Abuse statistics & numerical data, Child, Preschool, Education organization & administration, Humans, International Cooperation, Iowa, Program Development, Program Evaluation, Turkey, Universities, Child Abuse prevention & control, Child Welfare, Interdisciplinary Communication, Patient Care Team organization & administration
- Abstract
Objectives: The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year outcome., Methods: A team of instructors evaluated needs and held training activities in Turkey annually, and provided consultation when needed. Descriptive analysis was done via Excel and SPSS software., Results: Eighteen training activities were held with 3,570 attendees. Over the study period, the number of MDTs increased from 4 to 14. The MDTs got involved in organizing training activities in their institutions and communities. The number of medical curriculum lectures taught by MDTs to medical students/residents, conferences organized by the MDTs, and lectures to non-medical professional audiences increased significantly (R(2)=91.4%, 83.8%, and 69.2%, respectively). The number of abuse cases assessed by the MDTs increased by five times compared to pre-training period., Conclusions: A culturally competent training program had a positive impact on professional attitudes and behaviors toward recognition and management of child abuse and neglect in Turkey. The need to partner with policy makers to revise current law in favor of a greater human services orientation became clear., Practice Implications: Pioneers in developing countries may benefit from collaborating with culturally competent instructors from countries with more developed child protection systems to develop training programs so that professional development can improve recognition and management of child abuse and neglect.
- Published
- 2009
- Full Text
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48. The effects of surfactant and antenatal corticosteroid treatment on the pulmonary pathology of preterm infants with respiratory distress syndrome.
- Author
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Teksam O and Kale G
- Subjects
- Autopsy, Drug Therapy, Combination, Female, Gestational Age, Hemorrhage drug therapy, Hemorrhage pathology, Humans, Hyaline Membrane Disease drug therapy, Hyaline Membrane Disease pathology, Infant, Newborn, Lung pathology, Male, Pneumonia drug therapy, Pneumonia pathology, Pulmonary Atelectasis drug therapy, Pulmonary Atelectasis pathology, Pulmonary Emphysema drug therapy, Pulmonary Emphysema pathology, Respiratory Distress Syndrome, Newborn pathology, Severity of Illness Index, Treatment Outcome, Adrenal Cortex Hormones therapeutic use, Infant, Premature, Lung drug effects, Pulmonary Surfactants therapeutic use, Respiratory Distress Syndrome, Newborn drug therapy, Respiratory System Agents therapeutic use
- Abstract
The aim of this study was to investigate the effects of antenatal steroid treatment and/or postnatal surfactant replacement therapy on the incidence and extent of selected histopathological findings. Seventy complete autopsies were reviewed, and only lung tissues were examined and graded. Infants were divided into treatment and control groups as follows: group 1: surfactant-treated infants (n=15); group 2: infants whose mothers were given steroid treatment (n=16); group 3: surfactant-treated infants whose mothers were given steroid treatment (n=10). The control group included 29 patients not treated with surfactant and steroid. The overall incidence and severity of hyaline membrane and pulmonary hemorrhage were similar in each treatment group when compared to the control group. However, when the treatment groups were compared with each other, the incidence of severe hyaline membrane was more common in group 1 than in group 3. A significant reduction in severe hyaline membrane was associated with combined surfactant and antenatal steroid therapy. However, the cause for the similar incidence of selected histopathological findings in the treatment groups and the control group may be linked to oxygen toxicity due to insufficient antioxidant capacity in premature infants and barotrauma from mechanical ventilation.
- Published
- 2009
- Full Text
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49. Horseshoe lung associated with cardiac-type total anomalous pulmonary venous return in a newborn.
- Author
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Teksam O, Haliloglu M, and Karagoz T
- Subjects
- Angiography, Female, Heart Defects, Congenital surgery, Humans, Infant, Newborn, Lung diagnostic imaging, Lung surgery, Pulmonary Veins diagnostic imaging, Pulmonary Veins surgery, Tomography, X-Ray Computed, Heart Defects, Congenital diagnostic imaging, Lung abnormalities, Pulmonary Veins abnormalities
- Abstract
Horseshoe lung is a rare pulmonary anomaly characterized by fusion of the posterobasal portions of the right and left lung behind the heart anterior to the aorta and the spinal column. This anomaly is almost always associated with lung hypoplasia. The case of a newborn who had horseshoe lung with left lung hypoplasia and cardiac-type total anomalous pulmonary venous return is reported.
- Published
- 2008
- Full Text
- View/download PDF
50. Vascular endothelial growth factor levels in newborns with meconium stained amniotic fluid.
- Author
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Teksam O, Tekinalp G, Yurdakok M, Yigit S, Korkmaz A, and Guc D
- Subjects
- Asphyxia Neonatorum diagnosis, Biomarkers blood, Diagnosis, Differential, Humans, Hydrogen-Ion Concentration, Infant, Newborn, Amniotic Fluid, Fetal Blood chemistry, Fetal Distress diagnosis, Meconium, Vascular Endothelial Growth Factor A blood
- Abstract
Objective: The effects of meconium-stained amniotic fluid (MSAF) on cord blood vascular endothelial growth factor (VEGF) levels have not been explored. The aim of this study was to verify whether MSAF influences cord blood VEGF levels in healthy term neonates and we can use cord blood VEGF levels in infants with MSAF as an indicator of fetal distress., Methods: Using an enzyme-linked immunosorbent assay double sandwich method, plasma VEGF levels were determined in 18 healthy term neonates with MSAF and in 16 healthy term neonates without MSAF., Results: VEGF plasma levels were not significantly different between healthy term neonates with or without MSAF., Conclusion: Intrauterine meconium passage could not affect VEGF levels on cord blood in term newborn infants and VEGF level may not be used as an indicator of fetal distress in infants with MSAF.
- Published
- 2008
- Full Text
- View/download PDF
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