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AMAÇ: Bu çalışma mantar tüketimi ile ilgili çocuk acil başvurularının klinik özellikleri ve sonlanımlarını değerlendirerek merkezimize ait tabloyu resmetmek, hasta yönetimi ve eğitim planlamasına yol gösterici veri üretmek amacıyla gerçekleştirildi. GEREÇ VE YÖNTEM: Geriye dönük 10 yıllık sürede mantar zehirlenmesi tanısı ile acil servise başvurmuş 18 yaş altı hastaların dosyaları incelendi ve oluşturulan bir form üzerinden hastaların demografik ve klinik özellikleri kaydedilerek değerlendirildi. BULGULAR: Değerlendirilen süre kapsamında çocuk acil servise başvurmuş toplam 689.000 hastadan 65 çocuk (%0,009) mantar zehirlenmesi tanısı almıştı. Mantar yedikten sonra semptomların başlama süresi ortalama 5,2±10,3 saatti ve hastaların %71’inde semptomlar ilk 6 saat içinde başlamıştı. Büyük çoğunluğunda gastrointestinal yakınmalar ön planda olup, kusma (%78) en sık görülen semptomdu. Hastaların tamamı hastaneye yatırıldı. Hastanede izlem süresi ortalama 3±1,5 gündü. Hasta yaşının küçük olması, başvuru fizik muayenesinde patolojik bulgu saptanması ve spesifik hepatoprotektif ve antidot tedavileri verilmiş olması hastanede yatış süresinin daha uzun olması ile ilişkili bulundu(p

We aimed to evaluate patients with acute ataxia and to determine the warning clinical factors in the early prediction of neurological emergencies.Patients with a history of balance and gait coordination disorder and clinically diagnosed as acute ataxia in pediatric emergency department were included in the study. As a result of final diagnosis, the characteristics of patients with and without clinically urgent neurological pathology (CUNP) were compared. CUNP was defined as any nervous system disorder requiring early diagnosis and prompt medical or surgical treatment and/or intensive care unit admission to prevent disabling or life-threatening evolution.Eighty-eight patients with a median age of 5 years were included in the study (37 [42%] patients with CUNP and 51 [58%] without CUNP). In the CUNP group, the median age of patients and symptom duration were significantly higher (P 0.001 and P = 0.011, respectively). The most common etiologies were acute post/parainfectious cerebellar ataxias (n = 40 [45.4%]), acute cerebellitis (n = 9 [10.2%]), and Guillain-Barré syndrome (n = 8 [9%]). Hyporeflexia/areflexia and dysmetria were associated with a higher risk of CUNP. Headache, loss of consciousness, and visual dysfunction were the findings appearing exclusively in patients with CUNP.The most common etiologies in acute ataxia are benign and transient, whereas life-threatening conditions may occur rarely and may require urgent intervention. Older age; prolonged symptom duration; focal neurological deficits such as hemiparesis, hyporeflexia, and visual impairment; and nonspecific findings such as loss of consciousness and headache are the most striking "red flags" of a potential neurological emergency and should alert clinicians to CUNP.

Objective: The aim of this study is to determine the environmental stressors perceived by patients hospitalized in the coronary intensive care unit.Methods: This descriptive study was conducted on 315 patients hospitalized in the coronary intensive care unit of a hospital between 01.08.2019 and 01.12.2019. Patient Identification Form and Intensive Care Unit Environmental Stressor Scale (ICUESS) were used to collect data. Data were analyzed by using SPSS 22,0 program. Results were interpreted at a significance level of p, Amaç: Bu araştırma, koroner yoğun bakım ünitesinde yatan hastaların algıladıkları çevresel stresörlerin belirlenmesi amacıyla yapılmıştır.Yöntem: Tanımlayıcı tipteki bu çalışma, bir hastanenin koroner yoğun bakım ünitesinde yatan 315 hasta üzerinde 01.08.2019-01.12.2019 tarihleri arasında yapıldı. Veri toplamak için, Hasta Tanıtım Formu ve Yoğun Bakım Ünitesinde Çevresel Stresörler Ölçeği (YBÜÇSÖ) kullanıldı. Veriler; SPSS 22.0 programı kullanılarak analiz edildi. Analiz sonuçları p

Cefdinir is a third-generation oral cephalosporin used frequently in the pediatric population. The most common side effects of cefdinir are diarrhea, nausea and dyspepsia. The side effect of turning the stool color to red and giving a bloody appearance, which is alarming for both families and physicians, is very rare. In this case report, we discussed 4 cases who referred to the emergency department with bloody stool due to the use of cefdinir. The important conclusion to be drawn from this case report is to know the rare side effects of commonly used drugs such as cefdinir. This will save time and resources and prevent unnecessary interventions on the patient.

This study analyzed the utility of the systemic immune-inflammation index (SII) in predicting serious bacterial infections (SBIs) in infants with fever without a source (FWS).Infants (aged 1-4 months) evaluated in the pediatric emergency department for FWS were divided into two groups:The study included 223 infants with a mean age of 76.65 ± 25.42 days; 62 (27.8%) of them were included in the SBI group, and all of them were diagnosed with a urinary tract infection (UTI). The hospitalization rate and length of hospital stay were significantly higher in UTI patients (p 0.001 for each). The mean SII was 795.76 ± 475.85 in the SBI group and 318.24 ± 300.70 in the non-SBI group, and there was a significant difference between the groups (p 0.001). In diagnosis of SBI, the area under the curve values were found to be 0.89 [95% confidence interval (CI): 0.85-0.94] for C-reactive protein (CRP), 0.86 (95% CI: 0.81-0.91) for absolute neutrophil count (ANC), 0.84 (95% CI: 0.78-0.89) for the SII, and 0.81 (95% CI: 0.74-0.87) for WBC. In the multivariate logistic regression analysis, high CRP and SII values were found to be predictive factors for UTI without bacteremia (p 0.001 and p = 0.008, respectively).We found that high CRP and SII values could be predictive for UTI without bacteremia in infants with FWS. The SII may be preferred because it can be easily calculated using the hemogram results, is not accompanied by extra costs, and does not require further blood collection.

Pediatric stroke is a neurological emergency. Knowing the predictive clinical markers for childhood stroke will help in early diagnosis and patient management. This study aims to (1) evaluate patients admitted to the pediatric emergency department (PED) with acute neurological signs and/or symptoms who underwent neuroimaging and (2) determine the clinical warning signs for the early recognition of stroke.One hundred one patients aged 1 month to 18 years who were admitted with stroke-related neurological signs and symptoms and underwent neuroimaging in the PED were retrospectively analyzed using the file record system. As a result of these imaging tests, the characteristics of patients with stroke and nonstroke were compared.The mean age of the 92 included patients was 10.7 (SD, 4.5) years. Among the admission symptoms of the patients, a significant difference was observed only in terms of speech disorder, whereas a significant difference was found in the examination results for altered consciousness and dysarthria. The incidences of hemiplegia and hemiparesis were higher in the stroke group, but they were not statistically significant. The median duration of time from symptom onset to PED admission was 240 minutes (interquartile range, 30-1440 minutes). The mean time from PED admission to magnetic resonance imaging in the stroke group was 2.3 (SD, 0.7) hours, which was significantly shorter than for the nonstroke group (4.9 [SD, 1.2] hours, P = 0.002).Childhood stroke is a neurological emergency that requires a multidisciplinary approach. Early stroke diagnosis is vital for treatment and prognosis. With respect to sudden neurological deficits, particularly dysarthria, altered consciousness, hemiplegia, and hemiparesis, should alert clinicians to stroke. In addition, interdepartmental cooperation is essential both in the rapid recognition of stroke and the treatment and follow-up processes.

To evaluate the effectiveness of the systemic immune-inflammation index (SII) and other biomarkers in distinguishing parapneumonic effusion (PPE) and empyema.Patients who were thought to have pleural effusion secondary to pneumonia in the pediatric emergency department (PED) between 2004 and 2021 were retrospectively evaluated. The patients were divided into two groups as empyema and PPE. The efficacy of infection markers in predicting empyema was compared.Fifty-nine patients (59.3% male) were included in the study. Forty-three (72.9%) patients were in the PPE and 16 (27.1%) were in the empyema group. Length of hospital stay and pleural fluid thickness measured with thoracic ultrasonography were significantly higher in the empyema group (p = 0.018 and p = 0.002, respectively). The mean SII was 1902.73 ± 1588.87 in PPE patients, while it was 6899.98 ± 6678 in empyema patients (p = 0.009). C-reactive protein (CRP), white blood cell (WBC) count, absolute neutrophil count (ANC), and neutrophil-lymphocyte ratio (NLR) ​​were significantly higher in the empyema group; absolute lymphocyte count (ALC) and lymphocyte-monocytes ratio (LMR) were significantly lower than the PPE group. When the best cut-off values of inflammation markers are determined according to the area under the curve, the highest odds ratios suggesting empyema were found in SII, LMR, CRP, and ANC, respectively.Inflammation markers can be useful in predicting empyema. The best markers were found to be SII, LMR, CRP, and ANC. High SII is one of the practical diagnostic markers that can be used differentiate empyema from PPE in PED.

BACKGROUND Acute appendicitis is the most common reason for abdominal surgery in children. The aim of this study was to evaluate the utility of biomarkers in predicting complicated appendicitis (CA). METHODS Patients having a diagnosis of acute appendicitis who underwent operations were retrospectively determined, and the utility of biomarkers in predicting CA was evaluated. RESULTS A total of 251 patients were included in the study. The mean age was 130.9 ± 48.8 months, 148 of the cases (59%) were simple appendicitis, and 103 (41%) were CA. The C-reactive protein (CRP) levels, immature granulocyte (IG) percentage, white blood cell counts, and absolute neutrophil counts were significantly higher in the CA patients. The bilirubin levels and neutrophil to lymphocyte ratios were not useful for predicting CA. The best area under the curve (AUC) values to predict CA were with the IG percentage and CRP level (0.82), the IG percentage [odds ratio (OR) 9.36, 95% CI (4.94-17.75), p

Aim: Patient selection and management of rapid sequence intubation (RSI) application in the emergency department can be challenging for clinicians. In this study, we aimed to describe the demographic information, clinical characteristics, and medical conditions of the patients who underwent RSI in our hospital’s pediatric emergency department and to present patient management strategies.Methods: Cases between 1 month to 18 years old who underwent RSI in the emergency department between January 2021 and January 2022 were analyzed retrospectively.Results: Eleven patients; 7 girls (63,6%) and 4 boys (36,4%) were included in the study. The median age of the patients was 6(2-15) [minimum (min)-maximum (max)]. The median time from symptom onset to presentation was 120 minutes (min-max 15 minutes-2 weeks). RSI indications were trauma (n=5), intracranial mass (n=4), ventriculoperitoneal shunt dysfunction (n=1), and refractory status epilepticus (n=1). All patients had focal neurological deficits on examination. Glasgow Coma Scale median score was 8 (min-max 4-15). The first neuroimaging method was cranial tomography in ten (90.9%) patients. Intracranial hemorrhage was present in 45.4% (5 patients) of the patients. No complications were observed in any of the patients during the RSI application. One patient died due to intracranial hemorrhage and shunt dysfunction. Neurological deficits (dysarthria, gait disturbance, hemiparesis, and visual impairment) were detected in five patients during their first-month follow-up.Conclusion: This retrospective study identified critically ill children who were admitted to the emergency department with acute neurological symptoms and underwent RSI to prevent increased intracranial pressure and further brain damage., Amaç: Acil serviste hasta seçimi ve hızlı seri entübasyon (HSE) uygulamasının yönetimi klinisyenler için zor olabilir. Bu çalışmada hastanemiz çocuk acil servisinde HSE yapılan hastaların demografik ve klinik özelliklerini ile hasta yönetim stratejilerinin değerlendirilmesi amaçlandı.Yöntemler: 1 Ocak 2021 ile 1 Ocak 2022 tarihleri arasında çocuk acil servisinde HSE uygulanan 18 yaşından küçük hastalar çalışmaya dâhil edildi.Bulgular: Çalışmaya 11 hasta dâhil edildi. Hastaların medyan yaşı 6 (2-15) idi [minimum (min)-maksimum (maks)], 7’si kızdı (%63,6). Semptom başlangıcından başvuruya kadar geçen süre medyan değeri 120 dakikaydı (min-maks 15 dakika-2 hafta). HSE endikasyonları travma (n=5), kafa içi kitle (n=4), ventriküloperitoneal şant disfonksiyonu (n=1), dirençli status epileptikus (n=1) idi. Hastaların Glasgow Koma skala skorları ortanca değeri 8 (min-maks 4-15) idi. Hastaların tamamında fokal nörolojik defisit mevcuttu. İlk nörogörüntüleme yöntemi 10 (%90.9) hastada kraniyal tomografiydi ve beş hastada (%45,4) intrakraniyal kanama mevcuttu. HSE’ye bağlı hiçbir hastada komplikasyon izlenmedi. Hastalardan ikisi exitus oldu (intrakraniyal kanama ve şant disfonksiyonu nedeniyle). Birinci ay kontrollerinde beş hastada dizartri, yürüme bozukluğu, hemiparezi, görme bozukluğu gibi nörolojik defisitler tespit edildi.Sonuç: Bu retrospektif çalışma, akut nörolojik semptomlarla acil servise başvuran ve kafa içi basıncının artmasını ve daha fazla beyin hasarını önlemek için HSE uygulanan kritik hasta çocukları tanımladı.

Fever without a source (FWS) is common clinical status in the young infants. The aim of this study was to evaluate the clinical and laboratory findings of coronavirus disease (COVID-19) infection in well-appearing infants with FWS. Well-appearing febrile infants between 30 and 90 days who were evaluated as FWS in the pediatric emergency department and tested for COVID-19 were divided into two groups: COVID-19 (+) and (−). The clinical and laboratory findings of the patients were compared. The study included 95 febrile infants with FWS, and the mean age was 59.62 ± 16.82 days. The nasopharyngeal COVID-19 polymerase chain reaction test results of 29/95 (30.5%) patients were positive, while 66/95 (69.5%) were negative. The complaints of irritability and nasal congestion were found to be significantly more common in COVID-19-positive patients (p = 0.04 and p = 0.041, respectively). The hospitalization rate (p = 0.009), length of hospital stay (p = 0.026), initiation of antibiotic treatment (p COVID-19 infection may present as an FWS. During the pandemic period, testing for COVID-19 among infants who were evaluated as FWS may reduce unnecessary hospitalizations and antibiotic treatments, and shorten hospital stays and duration of antibiotics.

It is mentioned that the acute renal angina index (aRAI), a new concept, can be used in emergency departments to calculate and accurately predict the risk of developing acute kidney injury (AKI). The aims of the study included: to evaluate the predictive performance of the aRAI (AKI risk classification tool) in predicting AKI in the pediatric emergency department.Patients who met the criteria for systemic inflammatory response syndrome were examined. AKI was defined with creatinine N1.5× baseline 24-72 hours after hospitalization. aRAI and original RAI scores were calculated for patients and were shown as renal angina positive (RA+) above a population-derived threshold. The performance of aRAI in predicting AKI compared to changes in creatinine and original RAI was evaluated.In total, 241 eligible subjects were enrolled. The median age of the patients was 17 months (min-max 1-192). AKI developed in 60 (24.8%) of the patients. According to the aRAI, 76 (31.5%) of 241 patients were RA(+). The aRAI had an NPV of 1.00 and an AUC of 0.948 (0.914-0.983) for the prediction of AKI. Sensitivity was 95% for the aRAI as compared to 48% for an elevation in SCr noted to be at least two times greater than the baseline while in the PED and 61% for original RAI.The aRAI is easily computable, does not depend on complex computational or derivation methods, and is universally accessible. We confirm and extend the findings of previous study reporting the performance of RAI for early prediction of AKI.

Benign acute childhood myositis (BACM) is associated with several viral infections. The aim of this study was to evaluate the progression of myositis symptoms, laboratory findings and oseltamivir treatment in children with influenza- and non-influenza-associated BACM.Patients aged 0-18 years old, admitted to the pediatric emergency department in the seasonal influenza period between 2018 and 2020 were retrospectively analyzed. Patients with acute onset calf tenderness, pain, difficulty in walking and elevated serum creatine phosphokinase were included and were grouped according to influenza rapid test kit results as influenza (A and B) positive, and influenza negative. The time to symptom resolution, laboratory data and the oseltamivir treatment were compared between the groups.There were 94 patients (67 male, 27 female) with a mean age of 77 ± 22 months. Influenza A was detected in 21, influenza B in 27, and neither were detected in 46 patients. Time to symptom resolution of BACM was shorter in the influenza-positive patients than in influenza-negative patients (2.9 ± 1.4 days and 3.5 ± 1.5 days, respectively, P = 0.027). Oseltamivir did not reduce the symptom resolution time in influenza patients. All children had normal hemoglobin and platelet counts, elevated creatine phosphokinase and 76% of them had leukopenia. Neither clinical recurrence nor metabolic disease were reported.Symptoms of BACM tended to resolve slightly earlier in influenza-positive patients and the duration of symptoms was not affected by oseltamivir treatment.

BACKGROUND The aims of this study were to describe the etiologies of acute headache presenting to the pediatric emergency department, determine their clinical characteristics, the prevalence of red flag findings and neuroimaging and identify predictors of headaches because of serious intracranial diseases. MATERIALS AND METHODS Patients from 2 to 18 years of age who visited pediatric emergency department with a chief complaint of headache between January 1, 2016 and August 31, 2020 were retrospectively evaluated. RESULTS The mean age of the 558 patients included in the study was 11.17±3.78 years, and 290 (52%) were female. The most common cause of acute headache was head and neck area infections (except central nervous system infections) in 355 (63.6%) patients. Forty patients (7.2%) had a headache because of serious intracranial diseases. According to binary logistic regression analysis, the findings that predicted a serious intracranial diseases were abnormal neurological physical examination [odds ratio (OR): 187.57; 95% confidence interval (CI): 32.67-1076.64], recent onset or suddenly severe headache (OR: 14.41; 95% CI: 3.14-65.91), and vomiting (OR: 9.42; 95% CI: 1.90-46.63). Neuroimaging was performed in 63 (11.3%) patients, and 7 (1.25%) had a pathology requiring emergency treatment. CONCLUSIONS The majority of acute headaches were evaluated as secondary headache. The most common cause of acute headache was head and neck area infections. Abnormal neurological physical examination, recent onset or suddenly severe headache, and vomiting were the most useful red flags for predicting serious intracranial diseases. The requirement for neuroimaging should be evaluated individually for each patient.

Amaç: Ebeveynlerin kronik hastalığı olan çocuğa sahip olması yaşam kalitelerini ve ruhsal durumlarını olumsuz etkilemektedir. Çalışmamızda, kronik hastalığı olan ve önceden sağlıklı akut hastalık ile acil servise başvuran çocukların annelerinde sürekli ve durumluk kaygı düzeyleri ile depresyon düzeylerinin belirlenmesi ve bunu etkileyen faktörlerin değerlendirmesi amaçlanmıştır. Gereç-Yöntem: Çalışmamız prospektif kesitsel bir çalışmadır. Çocuk Acil Kliniğine önceden sağlıklı ve akut hastalık ile başvuran çocukların anneleri ile kronik hastalığı olan çocukların anneleri çalışmaya dahil edildi. Beck Depresyon Ölçeği (BDÖ) ve Durumluk-Sürekli Kaygı Envanteri (State Trait Anxiety Inventory-STAI) çalışmaya katılan tüm annelere uygulandı. Olguların sosyodemografik verileri sosyodemografik veri toplama formu ile elde edildi. Mann-Whitney-U, Ki-kare ve tek yönlü Anova testleri ile post-hoc analizlerde Tukey HSD istatiksel analizler için kullanıldı. Bulgular: Çalışmaya 101 (%49) kronik ve 105 (%51) akut hastalığı olan çocukların anneleri dahil edildi. Akut ve kronik hasta grupları arasında sürekli kaygı düzeyi ve BDÖ puanları arasında ise anlamlı farklılık saptanmıştır (sırasıyla p=0,004 ve p=0,001). Durumluk kaygı düzeyi puanlarında anlamlı farklılık saptanmamıştır (p=0,778). Hastalar BDÖ’nin kesme puanı (17 puan) dikkate alınarak muhtemel depresyon açısından ikiye ayrıldığında kronik hastalığı olan çocukların annelerinde akut hastalığı olan çocukların annelerine göre yüksek risk altında oldukları saptanmıştır (χ 2=8,641; p=0,004). Sonuç: Çalışmamızın sonuçlarında kronik hastalığı olan çocukların annelerinde sürekli kaygı düzeyleri ve depresif belirti oranları önceden sağlıklı ve akut nedenle acil servise başvuran çocuk annelerine göre anlamlı yüksek tespit edilmiştir. Kronik grup ebeveynlerin eğitim ve sosyoekonomik düzeylerinin daha düşük olduğu saptanmıştır. Kronik hastalığı olan çocukların ebeveynleri ruhsal etkilenim açısından değerlendirilmeli, depresyon ve anksiyete gibi bozukluklar tespit edildiğinde psikolojik yardım almaları sağlanmalıdır.

Kounis syndrome is defined as a hypersensitivity coronary disease consisting of an allergic, anaphylactic or anaphylactoid reaction combined with acute coronary syndrome [1]. To our knowledge, case...

Background The aim of this study was to evaluate the epidemiological, demographic, clinical characteristics and laboratory findings of pediatric COVID-19 patients. Methods Patients with a positive COVID-19 nasopharyngeal polymerase chain reaction (PCR) test between 11 March 2020 and 31 December 2020 were evaluated. Results During the study period, 3118 patients underwent PCR tests, and 621 of them (19.9%) were positive. Of the patients with a positive test result, 335 were male (53.9%), the median age was 11 years. There were 308 (49.6%) patients that had a history of household exposure. The mean time between the onset of the patients complaints and the diagnosis was 1.88 ± 1.16 days. The most common symptoms were: fever (n = 424), cough (n = 419) and nasal symptoms (n = 157); loss of smell (3.5%) and taste (4.3%) were other symptoms observed in only patients aged 10 years or older. The most common abnormal laboratory finding was lymphopenia (n = 29, 36.7%). Of the 621 patients, the vast majority (n = 546, 87.9%) were classified as mild COVID-19 disease. There was a significant relationship between disease severity and age and comorbidity (p = 0.01 and p < 0.001, respectively). Only 34 patients (5.5%) were admitted to hospital, and two patients were followed-up with a diagnosis of multisystem inflammatory syndrome in children. The mortality rate was 0.32%. Conclusion COVID-19 can cause different symptoms in children. Although the disease generally causes a mild clinic presentation, it should be kept in mind that it may be more severe especially in children with comorbidities.

Amaç: Bilinç kişinin kendisinin ve çevresinin farkında olma durumudur. Koma ve bilincin bozulduğu diğer durumlar, serebral işlevlerin, yapısal veya yapısal olmayan (toksik, metabolik, farmakolojik, nöbetler) nedenlerle bozulması sonucu ortaya çıkarlar. Çalışmamızda travma dışı akut bilinç kaybı ile çocuk acil servisine başvuran hastaların klinik ve laboratuvar özellikleri değerlendirerek; etyoloji ve prognozu etkileyen faktörlerin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: SBÜ Ankara Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi Çocuk Acil Kliniğine travma dışı bilinç değişikliği nedeniyle başvuran ve yatırılarak tedavi edilen 57 hasta çalışmamıza dahil edildi. Hastalar başvuru esnasındaki Glasgow koma skalası değerlerine göre 2 gruba ayrıldı ve gruplar arasında etiyoloji, morbidite, yatış süresi, mortalite açısından farklılık olup olmadığı araştırılmıştır.Bulgular: Hastaların yaş ortalaması 4,6±3,91 yıl (4 ay-15 yıl) olup; 33’ü (%58) kızdı. Glasgow Koma Skalası 8 ve altında olanlar Grup-1, 9-15 arasında olanlar Grup-2 olarak tanımlandı. Glasgow Koma Skalası değerine göre 44 hasta (%77,2) Grup-1, 13 hasta (%22,8) Grup-2’ye dahil edildi. Grup-1 ve Grup-2 hastaları arasında etiyolojik dağılım, sekel ve mortalite açısından anlamlı fark bulunamamıştır.Sonuç: Çocukluk döneminde travma dışı bilinç kaybı acil müdahale edilmesi, tanıya yönelik tetkiklerin alınması ve tedavi edilmesi gereken bir durumdur. Öncelikli olarak enfeksiyon hastalıkları ve entoksikasyonlar düşünülmelidir. Nörolojik sekel yönünden enfeksiyon ve status epileptikus tanısı alan hastalar arasında anlamlı fark olmadığı tepit edildi., Objective: Consciousness is the state of being aware of oneself and its environment. Coma and other conditions in which consciousness is impaired ocur as a result of impairment of cerebral functions due to structural or nonstructural reasons (toxic, metabolic, pharmacological,seizures). In our study, by evaluating the clinical and laboratory characteristics of patients who presented to the pediatric emergency service with nontraumatic acute loss of consciousness; It was aimed to determine the factors affecting the etiology and prognosis.Materials and Methods: 57 patients who were brought to the Pediatric Emergency Clinic due to nontraumatic loss of consciousness and hospitalized were included in our study. The patients were divided into 2 groups according to the Glasgow coma scale (GCS) values at the time of admission and it was investigated whether there was any difference between the groups in terms of etiology, morbidity, length of stay and mortality.Results: The mean age of the patients was 4,6±3,91 years (4 months-15 years); 33 (58%) were female. Those with GCS 8 and below were defined as Group-1 and those 9-15 were defined as Group-2. According to the Glasgow Coma Scale value, 44 (77 %) patients were included in Group-1 and 13 (23%) in Group-2. There was no significant difference in etiological distribution sequelae and mortality between two groups.Conclusion: Nontraumatic loss of consciosness in childhood is a condition that requires urgent intervention,diagnostic tests and treatment. First of all, infectious diseases and intoxications should be considered. There was no significant difference between patients diagnosed with infection and status epilepticus in terms of neurological sequelae.

Objectives: The aim of our study is to examine the efficacy and safety of intravenous magnesium sulfate in moderate-severe acute bronchiolitis. Working hypothesis: Intravenous magnesium sulfate treatment may be effective in the treatment of patients with bronchiolitis . Study design: Retrospective, single-center cohort study Methodology: We conducted a study in 150 infants presenting with moderate to severe acute bronchiolitis. A total of 150 infants aged 1 month to 2 years who presented with acute bronchiolitis to our pediatric emergency department between January 2018 and March 2019 were admitted into the study. The demographic characteristics, clinical score, and management of the patients were examined. Results: A total of 150 infants were analyzed: 62 in the magnesium sulfate group (Group I) and 88 in the supportive care group (Group II). Baseline clinical characteristics were similar in both groups. Length of hospitalization was significantly shorter in Group II. Clinical severity scores were also lower significantly earlier in Group I (p=0.031, p=0.008, respectively at first and fourth hour). Conclusions: Intravenous magnesium treatment in moderateto severe acute bronchiolitis does not appear to conferany significant decrease in clinical severity scores when compared to only supportive care

Introduction Serious bacterial infections (SBI) are major causes of mortality and morbidity in children. The aim of this study was to determine the accuracy of the immature granulocyte (IG) percentage in predicting SBI. Methods Patients admitted to the pediatric emergency department with fever were divided into two groups: with SBI and with non-SBI. White blood cell (WBC) count, absolute neutrophil count (ANC), C-reactive protein (CRP), and the percentage of IG value were recorded, and their accuracy in predicting SBI was evaluated. Results Sixty-one (14.3%) patients fell into the SBI group and 367 (85.7%) were with non-SBI. Mean IG percentage among SBI patients was 0.84 ± 1.21 and 0.27 ± 0.20 for with non-SBI patients (P = .001). Based on disease, the highest IG percentage was found in patients diagnosed with sepsis (IG 3.7 ± 3.5%) and with bacterial meningitis (IG 1.6 ± 1.3%). The area under the curve (AUC) of IG percentage to predict SBI was 0.83 with 95% confidence interval (CI) [0.78-0.88]; WBC was 0.76 (95% CI 0.70-0.83); ANC was 0.73 (95% CI 0.67-0.80), and CRP was 0.79 (95% CI 0.73-0.85). When infection markers were compared to the most appropriate cut-off values in predicting SBI, IG percentage showed the highest sensitivity and specificity. When the cut-off value was determined as >0.35 for IG percentage, sensitivity was 75.4% and specificity was 76.6% in predicting SBI. Conclusion Patients with SBI had a higher IG percentage. Compared to other biomarkers, IG percentage had higher sensitivity and specificity in predicting SBI.

Background : During the coronavirus disease 2019 (COVID-19) pandemic period, the use of emergency services with pediatric non-COVID patients has decreased considerably. We aimed to examine whether there was a change in the demographic data, triage profile, causes, management, and cost of pediatric emergency department (PED) visits of non-COVID patients during the pandemic period. Methods : This study was a retrospective, single-center, observational comparative study that was conducted at the PED. Patient records were examined during “the pandemic spring” and the same period of the previous year. Patient demographics, waiting time, and outcome of the PED visit were analyzed in the entire population of children admitted to the PED during the study period, whereas more precise data such as the reason for PED use, duration of symptoms, urgency levels according to the Emergency Severity Index (ESI), final diagnosis, management, and cost of patient care were analyzed in a sample of admitted patients. We used the chi-square test, Fisher's exact test, and Mann–Whitney U test for statistical analyses. Results : A total of 62,593 PED visits occurred. During the pandemic period, PED visits showed a decrease of 55.8% compared to the previous year. Patients included in the sampling study group were selected using a systematic random sampling method. The median waiting time during the pandemic period was significantly shorter than the previous year (median 14 min [IQR: 5–32] vs. median 5 min [IQR: 2–16]; p

Background: The aim of this study was to evaluate the application of the rapid influenza antigen test and the contribution of the test result to patient management in febrile infants aged 29‒90 days. Methods: The medical records of febrile infants without a focus who presented during influenza seasons from 2017‒2019 were analyzed retrospectively. The study was carried out in the Department of Pediatric Emergency, Dr. Sami Ulus Maternity and Children’s Training and Research Hospital. The demographic characteristics, clinical and laboratory findings, and management of the patients were examined. The patients were divided into two groups as ‘with’ and ‘without’ testing based on whether a rapid influenza antigen test was performed or not. Test results were categorized as positive or negative. Serious bacterial infection (SBI) risk and patient management were evaluated according to test results. Results: A total of 173 patients (110 males/63 females) were evaluated. The influenza test was performed in 94 (54.3%) patients, and 31.9% were positive. SBI was present in 8.7% of all patients. The mean values of white blood cell (WBC), absolute neutrophil, platelet count, C-reactive protein (CRP) and, lumbar puncture, hospitalization, and initiation of antibiotic therapy were significantly lower in the positive group compared to the negative and without testing groups (P

Background: Cup feeding has been used as an alternative feeding method for preterm infants. Objective: The purpose of this study was to determine the effect of bottle and cup feeding on exclusive breastfeeding rates at hospital discharge and 3 and 6 months post-discharge in late preterm infants. Methods: Included in the study were preterm infants of 32 to 35 weeks’ gestation fed only by intermittent gastric tube at the time of recruitment; 522 infants were randomly assigned to 2 groups: the cup-fed group (n = 254) and bottle-fed group (n = 268). Main outcomes were prevalence of exclusive breastfeeding at discharge and 3 and 6 months after discharge, and length of hospital stay. Results: Infants randomized to cup versus bottle feeding were more likely to be exclusively breastfed at discharge home (relative risk [RR], 1.58; 95% confidence interval [CI], 1.36-1.83), 3 months after discharge (RR, 1.64; 95% CI, 1.42-1.89), and 6 months after discharge (RR, 1.36; 95% CI, 1.14-1.63). There was no significant difference between groups for length of hospital stay. The mean hospital stay was 25.96 ± 2.20 days in the bottle-fed group and 25.68 ± 2.22 days in the cup-fed group. There was no significant difference between groups for time spent feeding, feeding problems, or weight gain in hospital. Conclusion: Cup feeding significantly increased the likelihood of late preterm infants being exclusively breastfed at discharge and 3 and 6 months after discharge, and cup feeding did not increase the length of hospital stay. Overall, we recommend cup feeding as a transitional method prior to breastfeeding for late preterm infants during hospitalization.

Osteopetrozis kemik rezorpsiyon kusuru nedeniyle oluşan yaygın kemik sklerozuyla karekterize kalıtımsal bir hastalıktır. Osteopetrozisin malign formu infantlarda makrosefali, hepatosplenomegali, sağırlık, körlük ve ciddi anemiyle farkedilir. Hepatosplenomegali ve anemi nedeni araştırılırken malign osteopetrosiz tanısı alan hasta sunuldu., Osteopetrosis is a hereditary disorder that is caused by a bone resorption defect and characterized with diffuse sclerosis of the bones. The severe form is detected in infancy because of macrocephaly, hepatosplenomegaly, deafness, blindness, and severe anemia. In this article we reported a case diagnosed as malign osteopetrosis while investigating the causes of anemia and hepatosplenomegaly