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Background: This study evaluated of clinical characteristics, outcomes, and mortality risk factors of a severe multisystem inflammatory syndrome in children admitted to a the pediatric intensive care unit. Methods: A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 41 PICUs in Turkey. The study population comprised 322 children diagnosed with multisystem inflammatory syndrome. Results: The organ systems most commonly involved were the cardiovascular and hematological systems. Intravenous immunoglobulin was used in 294 (91.3%) patients and corticosteroids in 266 (82.6%). Seventy-five (23.3%) children received therapeutic plasma exchange treatment. Patients with a longer duration of the PICU stay had more frequent respiratory, hematological, or renal involvement, and also had higher D-dimer, CK-MB, and procalcitonin levels. A total of 16 patients died, with mortality higher in patients with renal, respiratory, or neurological involvement, with severe cardiac impairment or shock. The non-surviving group also had higher leukocyte counts, lactate and ferritin levels, and a need for mechanical ventilation. Conclusions: In cases of MIS-C, high levels of D-dimer and CK-MB are associated with a longer duration of PICU stay. Non-survival correlates with elevated leukocyte counts and lactate and ferritin levels. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality. Impact: MIS-C is a life-threatening condition.Patients need to be followed up in the intensive care unit.Early detection of factors associated with mortality can improve outcomes.Determining the factors associated with mortality and length of stay will help clinicians in patient management.High D-dimer and CK-MB levels were associated with longer PICU stay, and higher leukocyte counts, ferritin and lactate levels, and mechanical ventilation were associated with mortality in MIS-C patients.We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the world has a large number of reported COVID-19 cases and deaths. Information on characteristics and mortality rate of pediatric intensive care unit (PICU) cases with COVID-19 remains limited. This study aims to identify the risk factors for mortality related to COVID-19 in children admitted to PICU. Methods: A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 44 PICUs in Turkey. Children who were 1 month-18-year of age with confirmed COVID-19 admitted to PICU were included in the study. Children with multisystem inflammatory syndrome and asymptomatic for COVID-19 were excluded. Results: Of 335 patients with COVID-19, the median age was 6.8 years (IQR: 1.2-14) and 180 (53.7 %) were male, 215 (64.2 %) had at least one comorbidity. Age and gender were not related to mortality. Among 335 patients, 166 (49.5%) received mechanical ventilation, 17 (5.1%) received renal replacement therapy and 44 (13.1 %) died. Children with medical complexity, congenital heart disease, immunosuppression and malignancy had significantly higher mortality. On multivariable logistic regression analysis, organ failure index [odds ratio (OR): 2.1, 95 confidence interval (CI): 1.55-2.85], and having congenital heart disease (OR: 2.65, 95 CI: 1.03-6.80), were associated with mortality. Conclusions: This study presents detailed data on clinical characteristics and outcomes of patients with COVID-19 admitted to PICU in the first pandemic year in Turkey. Our study shows that having congenital heart disease is associated with mortality. In addition, the high organ failure score in follow-up predict mortality.

Bu araştırmanın amacı lise öğrencilerinin arkadaşlık ilişkisi ile benlik saygısı ve bazı değişkenlerin ilişkisinin incelenmesidir.Araştırma ilişkisel tarama modelindedir. Araştırmanın örneklemi 2018-2019 eğitim öğretim yılı II. döneminde Malatya il merkezinde ve ilçelerinde bulunan 7 farklı lisenin 9., 10., 11. ve 12. sınıflarında öğrenim gören 555 öğrenciden oluşmaktadır. Demografik verilerin toplanabilmesi için 'Kişisel Bilgi Formu', ergenlerin akran ilişkilerini incelemek amacı ile Kaner (2000) tarafından geliştirilen 'Akran İlişkileri Ölçeği', benlik saygılarını inceleme amacı ile 'Rosenberg Benlik Saygısı Ölçeği' kullanılmıştır. Verilerin analizinde iki grubun ortalamalarını karşılaştırmada Mann-Whitney U testi, 3 ve daha fazla gruplu karşılaştırmalarda ise nonparametrik varyans analizi Kruskall-Wallis H testi kullanılmıştır. Arkadaşlık ilişkisi puan ortalamaları ile benlik saygısı puan ortalamaları arasında bir ilişki olup olmadığını belirlemek için Spearman Sıra Farkları Korelasyon hesabı yapılmıştır.Öğrencilerin arkadaşlık ilişkileri puanı cinsiyete ve ekonomik duruma göre anlamlı farklılık göstermektedir. Öğrencilerin arkadaşlık ilişkileri puanı sınıf düzeylerine, anne-baba eğitim düzeylerine ve anne-baba tutumlarına göre anlamlı bir farklılık göstermemektedir. Buna karşılık, anne-baba tutumu ve anne eğitim düzeyi değişkenlerine göre arkadaşlık ilişkileri ölçeğinin bazı alt boyutlarında anlamlı farklılık bulunmuştur. Benlik saygısı puanı ve bağlılık alt boyutu puanı ile arkadaşlık ilişkileri toplam puanı arasında pozitif yönde anlamlı bir ilişki olduğu saptanmıştır. Benlik saygısı puanı ve sadakat alt boyutu ile kendini açma alt boyutu puanları arasında negatif yönde anlamlı ilişki vardır.Anahtar Kelimeler: Lise öğrencileri, arkadaşlık ilişkisi, benlik saygısı, akran ilişkileri The aim of this study is to investigate the relationship between high school students' friendship and self-esteem and some variables.The research is relational survey model. The sample of the study consists of 555 students in the 9th, 10th, 11th and 12th grades of 7 different high schools in Malatya city center and districts in the second semester of 2018-2019 academic year. Personal Information Form was used to collect demographic data. The Peer Relationship Scale developed by Kaner (2000) was used to examine the peer relationships of adolescents. The Rosenberg Self-Esteem Scale was used to examine self-esteem. In the analysis of the data, Mann-Whitney U test was used to compare the averages of two groups, and nonparametric variance analysis Kruskall-Wallis H test was used in comparisons with three or more groups. Spearman Rank Differences Correlation Calculations were performed to determine whether there was a relationship between the mean scores of friendship and self-esteem.The friendship relationships of the students showed that significant differences according to gender and economic situation. There was no significant difference between the students' friendship relations, class levels, parental education levels and parental attitudes. On the other hand, there was significant difference in some sub-dimensions of the friendship relationship scale according to the parental attitude and mother education level variables. It was found that there was a significant positive relationship between self-esteem commitment and subscale scores. There is a negative correlation between self-esteem and loyalty sub-dimension and self-opening sub-dimension.Key words: High school students, friendship, self-esteem, peer relationships 81