We compared the accuracy and utility of 3 infrared (IFR) thermographs fitted with axillary digital thermometers used to measure temperature in febrile and afebrile children admitted to an emergency triage room.A total of 184 febrile and 135 afebrile children presenting to a triage room were consecutively evaluated. Axillary temperature was recorded using a digital electronic thermometer. Simultaneously, IFR skin scans were performed on the forehead, the neck (over the carotid artery), and the nape by the same nurse. Fever was defined as an axillary temperature ≥37.5°C. The temperature readings at the 4 sites were compared.For all subjects, the median axillary temperature was 37.7 ± 1.5°C, the IFR forehead temperature was 37 ± 1.1°C, the IFR neck temperature was 37.6 ± 1.5°C, and the IFR nape temperature was 37 ± 1.2°C. A Bland–Altman plot of the differences suggested that all agreements between IFR and axillary measures were poor (the latter measure was considered the standard). The forehead measurements had a sensitivity of 88.6% and a specificity of 60% in patients with temperatures ≥36.75°C. The sensitivities of the neck measurement at cut-offs of ≥37.35°C and ≥36.95 were 95.5% and 78.8% for those aged 2 to 6 years. Thus, 11.4% of febrile subjects were missed when forehead measurements were performed.An IFR scan over the lateral side of neck is a reliable, comfortable, rapid, and noninvasive method for fever screening, particularly in children aged 2 to 6 years, in busy settings such as pediatric triage rooms.

Background: Thoughts about suicide are quite common in adolescent. While such thoughts can be caused by many reasons, the most wellknown of these are mood disorders. There are studies related to coexistence of thyroid pathologies and mood disorders in adult. Objectives: In this study, we aimed to investigate the difference of thyroid hormone levels in between adolescents with suicide attempt history and normal population. Methods: The study was prospective and was designed as a case-control study. Demographic characteristics of the patients were obtained and Serum fT3, fT4 and TSH levels were examined. Results: 222 cases were included in the study, including 101 cases and 121 controls. As for TSH levels, the mean serum levels of the whole group was 1.96 ± 1.08 mU/L, while the mean serum levels of the control group was 2.33 ± 1.5 mU/L and the mean serum levels of the case group was 0.50 ± 0.3 mU/L which revealed that the mean serum levels of the case group was significantly lower (p<0.01). Conclusion: It was found that serum TSH levels were significantly lower in case group than control group and the individuals with subclinical hyperthyroidism had more suicide attempts than the ones in control group.

In this MPV levels were significantly higher in children with amebiasis compared to controls. MPV can be used as an acute phase reactant in children with Entamoeba histolytica gastroenteritis.

the case highlights two important points. First, this case report demonstrates a limited awareness of anorexia nervosa and of a psychosomatic or psychiatric origin of weight loss in children among physicians. Second, disrupted eating behaviors and mood changes may be predicting factors for the development of full-blown anorexia nervosa.

Background: The aims of this study were to evaluate the outcomes of patients with severe bronchiolitis who received preemptive high-flow nasal cannula (HFNC) treatment according to the authors' protocol, and to identify potential baseline characteristics that might predict patients who will not benefit from HFNC. Methods: This was a retrospective chart review of patients with severe bronchiolitis, who received preemptive HFNC treatment according to the authors' protocol and who were admitted to the pediatric emergency department between January 1, 2015, and December 31, 2016. Results: Eighty-four patients in total were enrolled over the 2 year period. Twenty-three patients (27.3%) failed HFNC. Of these, four responded to non-invasive mechanical ventilation and 19 required subsequent invasive ventilation. According to logistic regression analysis, existence of a chronic condition, significant tachycardia, existence of dehydration, and a venous pH <7.30 at admission were found to be predictors of HFNC failure. There were no cases of pneumothorax or any other reported adverse effects related to HFNC therapy. Conclusions: Preemptive HFNC treatment, complying with a preestablished protocol, might be a safe way to support patients with severe bronchiolitis in high-volume, resource-limited pediatric emergency departments. The existence of a chronic condition, significant tachycardia, dehydration, and a venous pH <7.30 at admission could be risk factors for preemptive HFNC treatment failure in severe bronchiolitis.

Bu çalışmada bir sıçan modelinde alt ekstremite iskemi reperfüzyonunun karaciğer üzerindeki etkisi ile karaciğerin spesifik iskemi reperfüzyonunun karaciğer üzerindeki etkisi karşılaştırıldı.Ça lış mapla nı:Otuz adet Sprague-Dawley tipi erkek sıçan 10'arlı olarak rastgele üç gruba ayrıldı: kontrol grubu (Grup 1), alt ekstremite iskemi reperfüzyon grubu (Grup 2) ve karaciğer iskemi reperfüzyon grubu (Grup 3). Grup 2'de sol alt ekstremiteye bir saat süreyle iskemi uygulandı. Grup 3'te karaciğere bir saat süreyle iskemi ve ardından 24 saat süreyle reperfüzyon uygulandı. Reperfüzyon sonrası karaciğer dokuları çıkarıldı ve gruplar biyokimyasal ve histolojik olarak değerlendirildi.Bul gu lar: Karaciğer malondialdehit düzeyleri Grup 2 ve Grup 3'te kontrol grubuna kıyasla anlamlı olarak yüksek idi (p<0.001). Grup 2'de malondialdehit düzeyleri Grup 3'e kıyasla anlamlı olarak yüksek idi (p= 0.019). Karaciğer glutatyon düzeyleri Grup 2 ve Grup 3'te kontrol grubuna kıyasla anlamlı olarak düşük idi (p<0.001). Ancak, Grup 2'de glutatyon düzeyleri Grup 3'e kıyasla anlamlı olarak yüksek idi (p= 0.005). Histolojik değerlendirmede karaciğer hasar skoru Grup 3'te Grup 2'ye kıyasla daha yüksek olmakla birlikte (p= 0.015), TUNEL(+) hücre sayısı açısından iki grup arasında anlamlı bir fark yoktu (p>0.05). So nuç:Alt ekstremite iskemi reperfüzyonu sonrası karaciğerde reperfüzyon hasarı, spesifik olarak karaciğerde meydana getirilen iskemi reperfüzyon hasarı kadar önemlidir. Özellikle vasküler travma sonrası yapılan reperfüzyon ameliyatlarında veya alt ekstremite vasküler travma sonrası kanamayı durdurmak için ayak turnikelerinde bu durum göz önünde bulundurulmalıdır.

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