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Respiratory distress and stridor are some of the common presenting symptoms for children in Pediatric Emergency Department. Most of these children are diagnosed as having common illnesses such as laryngitis, croup or laryngomalacia. However, Pediatric Emergency physicians must keep in mind other rare respiratory diseases other than laryngitis or croup in the differential diagnosis of stridor. Stridor may occur due to congenital and acquired diseases. Laryngeal web is one of the rare congenital causes of stridor, which usually presents in the first weeks of life; however, it is very rarely diagnosed in the later period. Herein, we report a one-year-old boy who was evaluated for croup and was diagnosed as having laryngeal web. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to document ovarian cyst frequency and characteristics as well as distribution of these parameters with respect to age in children and adolescents. Methods: We retrospectively analyzed the medical records of 1009 girls between the ages of 5-18 years who presented to our pediatric emergency department (PED) with pelvic pain and therefore underwent pelvic ultrasound examination between June 2011 and May 2014. Results: In total, 132 of 1009 girls (13.1%) were identified as having ovarian cysts ≥1 cm in diameter. The frequency of ovarian cysts was found to be 1.8% (6/337) in children aged 5-9 years and 18.8% (126/672) in those aged 10-18 years. All the cysts detected in children aged 5-9 years were small (<3 cm) and simple with age-specific frequencies ranging between 1.5-2.7%. With the onset of adolescence, ovarian cyst frequency started to increase with age and ranged between 3.8-31.3% throughout adolescence. Age of peak ovarian cyst frequency was 15 years with a rate of 31.3%. Large ovarian cysts (>5 cm) were identified in 19 adolescents (15.1%) with most occurring during middle adolescence. Of the 19 adolescents, five were found to have cyst-related significant ovarian pathologies including cystadenoma (n=3) and ovarian torsion (n=2). Conclusion: In children aged 5-9 years, ovarian cysts were infrequent and small (<3 cm). Peak ovarian cyst frequency was detected at the age of 15 years. All patients diagnosed with cyst-related significant ovarian pathologies were adolescents having a cyst >5 cm in diameter with a complex appearance in most. [ABSTRACT FROM AUTHOR]

Oxygen saturation is considered as the fifth vital sign especially in critically ill patients. The human eye is inadequate to assess and diagnose early hypoxia. Pulse oximetry devices were developed in 1900, still keeping actuality, permit to determine the oxygen saturation quickly without interference and pain in critically ill patients. Painful procedures, especially in children with respiratory distress, could lead to increase in respiratory effort and deepening in hypoxia. Recently, pulse oximetry devices are also used for cardiac screening in newborns. The devices are cheap, portable, readly available, and in different sizes. They also provide continuous monitoring of patients in departments where clinically ill patients are followed such as pediatric emergency department. Various types of pulse oximetry devices work in the same working principle; calculation of absorption of oxyhemoglobin and deoxyhemoglobin in different wavelength. Reasons due to the devices such as incorrect insertion of the probe, movement artifacts, ambient light and also reasons due to the patient such as hemoglobinopathies, skin pigmentation or nail polish, could cause measurement errors. All health providers should know the aim of pulse oximetry use, how to use these devices and for what they should pay attention to when using them. In this review, the use of pulse oximetry, its history, using areas, and the points in the use were discussed in detail. [ABSTRACT FROM AUTHOR]

Alcohol consumption has increased among adolescents in concordance with problems related to school, friends and family environment, and also as a result of their curiosity. Since alcohol intoxication cases increase in emergency services, pediatrician's knowledge of clinical and metabolic complications is getting more important. We present here 4 cases to underline the classical approach to alcohol intoxication. [ABSTRACT FROM AUTHOR]

Background/aim: This study aimed to investigate the effects of early adverse life events and being raised by an ambivalent mother on rats. Materials and methods: The rats were separated into four groups: 1) the control group (n = 12), which was raised under standard care; 2) the early handling (EH) group, which was raised using an EH model (n = 16); 3) the early deprivation (ED) group, which was raised using an ED model (n = 13), and 4) the ambivalent mother (AM) group, which spent 3 h/day with a "fake mother" (n = 17). When they became adults, their anxiety levels, depressive-like behaviors, and memory functions were measured using the elevated plus maze test, the forced swim test, and the novel object recognition test, respectively. Their neurodevelopment was evaluated by measuring the brainderived neurotrophic factor (BDNF) levels in the prefrontal cortex, the dentate gyrus, and the cerebellum via ELISA. Results: The rats in the ED and AM groups exhibited less anxiety and depressive-like behavior than those in the control and EH groups, particularly in females. There was no significant difference between the groups in memory function or brain BDNF levels. Conclusion: Severe and ambivalent early adverse life events may decrease anxiety and depressive-like behavior in adult rats. [ABSTRACT FROM AUTHOR]

Background/aim: To compare the behavioural and neurobiological consequences of chronic headache and chronic mild stress (CMS) in rats. Materials and methods: Forty-eight male Wistar rats were divided into 4 groups: 1) control group, 2) chronic headache group, 3) CMS group, and 4) sham group. Their behaviour prior to (D0) and after (D14) chronic stress was analysed. Afterwards, they were exposed to the Elevated Plus Maze (EPM) in order to evaluate anxiety-like behaviour and the Forced Swim Test (FST) for observation of depressive-like behaviour. Ultrasonic vocalisations (USVs) were recorded by a USV detector system at D0 and D14 and during the FST. The c-fos expressions in various brain regions were analysed 2 h after the EPM and FST. Results: The control group showed significantly more sleeping behaviour at D14 (χ² = 8.213, P = 0.042), emitted more negative and positive affect USVs at D14 (χ² = 9.853, P = 0.020) and during FST (χ² = 4.000, P = 0.046) than the chronic headache and CMS groups, and showed significantly less anxiety-like behaviour in the EPM than the CMS group (P = 0.021). Conclusion: These results suggest that CMS increases anxiety-like behaviour but not depressive-like behaviour, while chronic headache does not have a significant effect on these behaviours in rats. [ABSTRACT FROM AUTHOR]

A 7-month-old Turkish boy presented with partial albinism and typical clinical features of an accelerated phase, suggesting the diagnosis of Griscelli syndrome. The diagnosis was confirmed by light microscopic evaluation of hair and a peripheral blood smear. Genetic analysis identified a mutation in the Rab27A gene. He was initiated immunosuppressive treatment but accelerated phase could not be ameliorated. He unfortunately died from multiorgan failure. The finding of partial albinism in children should alert clinicians to consider Griscelli syndrome since simple methods can corfirm the diagnosis and early diagnosis is life-saving. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this survey was to investigate the current knowledge, attitudes, and practices of febrile children's caregivers about fever, antipyretic usage, and temperature measurement methods in a tertiary care hospital. Methodology: A 41-item questionnaire was administered to a convenience sample of febrile children's caregivers in face-to-face interviews by two research assistants from January 2012 through June 2012 in an urban region of Turkey. Results: A total of 1,032 caregivers completed the interview. Approximately one-third of caregivers considered a temperature of less than 37.8°C (100°F) to be a fever, and 13% of all respondents would give antipyretics for a body temperature ≤ 37.8°C. Furthermore, 76% of parents would wake their children from sleep to administer antipyretics. Although a high proportion (89.5%) of respondents believed that fever had harmful effects, 10.5% considered fever to be beneficial. Alternating use of acetaminophen and ibuprofen (44%) and giving antipyretics routinely (71%) before and after immunizations were common parental practices and generally advised by pediatricians. Parents with higher levels of education were more likely to consider fever to be beneficial and to treat fever with antipyretics, and less likely to seek medical attention for mild fever. Most caregivers stated that they were unsure about the right site (90%) and thermometer type (95%) for temperature measurement. Conclusions: Persistent fever anxiety and excessive antipyretic usage may be heightened by the lack of knowledge regarding accurate temperature measurement methods with digital thermometers in our population. Parental education may positively affect the approach to fever and antipyretic usage. [ABSTRACT FROM AUTHOR]

Objective: Carbon monoxide (CO) poisoning is a common problem in various countries, especially in Winter months. CO exposure results in the formation of carboxyhemoglobin (COHb), which is responsible for toxicity symptoms. In this study, we aim to demonstrate the demographic features and seasonal variations of this particular public health problem. Materials and Methods: We retrospectively evaluated hospital police reports and medical records of 2417 ED patients diagnosed with CO poisoning between 1999 and 2009. Sources of exposure, seasonal variation and demographic characteristics were analyzed. Results: The mean age of the patients, of whom 1418 (58.7%) were female, was 29±18 years. While 1708 patients (70.7%) were admitted to adult ED, 709 (29.3%) patients were admitted to pediatric ED. January and subsequent Winter months represented the most dangerous periods for CO exposure. No intentional (suicidal attempt) exposure to CO intoxication was reported and the major cause for intoxication included unsecured stoves and gas heaters. Conclusion: Emergency physicians should be familiar with symptoms and remedies of CO intoxication, which still constitutes a serious health problem. [ABSTRACT FROM AUTHOR]

Aims: Clinical forensic medicine deals with cases involving both the legal and medical aspects of patient care, such as motor vehicle trauma or poisoning. In this study, we aimed to draw attention to the forensic issues by retrospective investigation of 13823 emergency cases and to share our experiences on this topic. Materials and Methods: This retrospective study was conducted in a university Emergency Department (ED) in Ankara, Turkey. The data were collected from official hospital police sheets. Results: Between 2000 and 2005, 13823 legal cases (3.66% of all ED patients) were examined, and 58.23% of them were male. The mean age was 28.03±16.42 years. The main injury patterns were motor vehicle trauma (43.84%), physical assault (19.04%), suicide attempts (17.10%), and carbon monoxide (CO) poisoning (6.62%). Most of the cases were in the 20-29 years of age group (30.01%). Suicide attempts, CO poisoning and sexual assault victims were mostly female. 46.47% of the cases were admitted to the ED between 16:00 and 23:59. Forensic cases were mostly reported in May (9.92%). Two hundred and forty-two forensic cases died in the ED and 42 died outside the ED previously; 71.53% of them were male. The main cause of death was motor vehicle trauma (62.50%). [ABSTRACT FROM AUTHOR]

Abstract: Objective: To examine the utility of the Bayley Infant Neurodevelopmental Screener (BINS) for the neurodevelopmental follow up of high-risk preterms. Methods: The study group consisted of 122 preterm infants of the gestational ages between 26 and 37 weeks. Medical factors such as; mean birth weight, gestational age, gender, birth place and type, number of multiple pregnancy, days of hospitalization and oxygen therapy, use of antenatal steroids, and occurence of sepsis for each patient were evaluated. The neurodevelopmental examination and BINS administration was made at each visit to the patients whose ages were adjusted for prematurity. Results: At the corrected age of 7–10 months patients at 26–29 GA had significantly lower total means of BINS scores when compared to those of the other two groups at 30–32 and 33–37 GA (P<0.01 and P<0.001). At the corrected age of 3–4 months, the total means of the BINS scores of the patients at 30–32 GA were lower than that of the patients at 33–37 GA (P<0.009). at 7–10 months the scores of the items defining the expressive and cognitive functions of the patients at 26–29 GA were lower than those of the patients at 30–32 GA (P<0.05) and 33–37 GA (P<0.05). At 16–20 months the mean scores of the items of expressive functions were significantly lower in patients of the 26–29 GA compared to those of the patients of 33–37 GA (P<0.03). Conclusion: As data accumulates, BINS will turn out to be a quick way of determining infants at risk of developmental delay in many aspects of neurologically high risk conditions. [Copyright &y& Elsevier]

The use of pepper spray is common in our country during the police intervention to protesters. In this manuscript we investigated pepper spray exposure cases admitted to Gazi University Medical Faculty Gazi Hospital's Pediatric Emergency Department aimed in 2012. Gazi University Medical Faculty Gazi Hospital's Pediatric Emergency Department has reported 2534 forensic cases in 2012. Of these six were pepper spray exposure cases. Only one was male, while five cases were female. The mean age was 11.3 years. Two cases exposed to pepper spray while being at home, and remaining four exposed to pepper spray at school during the protests. Two cases had history of respiratory disease. In all cases, forensic reports were concluded as "No life-threatening injuries were determined". Exposure to tear gas, depending to its content, the intensity and duration of exposure may cause chronic respiratory diseases such as asthma, and threaten life. Sale and availability of tear gas which may result in serious consequences such as death should be restricted particularly for children and use of pepper spray should be limited in social events, health professionals should be educated about the possible harmful effects and treatment of paper spray exposure. [ABSTRACT FROM AUTHOR]