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Bu çalışmanın amacı çocuk yoğun bakım ünitesi (ÇYBÜ)'ne yatarak tedavi gören zehirlenme olgularının demografik, epidemiyolojik ve klinik özelliklerinin değerlendirilmesidir. Yöntemler: ÇYBÜ'de 1 Ocak 2015 ve 30 Haziran 2016 tarihleri arasında yatarak tedavi gören zehirlenme olguları geriye dönük olarak değerlendirildi. Bulgular: Çalışmaya 92 olgu dahil edildi. Ortalama yaş 63,65±59, 1 ay olup, olguların %73,9'unu 5 yaş ve altındaki çocuklar oluşturmaktaydı. Olguların %55,4'ü erkekti. Zehirlenmelerin %82,6'sı kaza sonucu, %14,1'i ise özkıyım amaçlı meydana gelmişti. Zehirlenmelerin %77,2'si ilaçlarla meydana gelmişti ve %18,3'ü çoğul ilaç alımına bağlıydı. En sık gözlenen ilaç grubu %24,2 ile santral sinir sistemi ilaçlarıydı. İlaç dışı zehirlenme nedenlerinde en sık görülen etkenin %42,8 ile pestisit ve insektisitler olduğu görüldü. Zehirlenme sonrası acil servise başvuru süresi ortanca 60 (10-2880) dakikaydı. Olguların %31,5'i bulguya yönelikti. Olguların %65,2'sine mide yıkama işlemi, %72,8'ine ise oral aktif kömür uygulandı. Toplam 3 olguya sürekli venövenöz hemodiyafiltrasyon yapıldı. Ortalama ÇYBÜ yatış süresi 19,53±14,37 saat, hastane yatış süresi ise 35,91±29,46 saatti. Çalışma süresinde özkıyım amaçlı alfa lipoik asit zehirlenmesi olan bir olgu kaybedildi. Sonuç: Çocukluk çağı zehirlenmeleri acil servis başvurularının ve hastane yatışlarının önde gelen nedenlerinden olup, morbidite ve mortalitenin önlenebilir bir nedenidir. Zehirlenmelerin büyük çoğunluğu evde bulunan ilaçlar ve temizlik ürünleriyle gerçekleştiğinden, ailelerin zehirlenmeler konusunda bilgilendirilmesi ve ilaçlar ile temizlik ürünlerinin çocukların erişemeyeceği yerlerde saklanması önemlidir. Ayrıca çocukluk çağı zehirlenmelerinin epidemiyolojik ve klinik özelliklerinin sağlık çalışanları tarafından bilinmesi hızlı tanı ve tedavi açısından büyük önem taşır. Anahtar Kelimeler: Zehirlenme, çocuk yoğun bakım ünitesi, epidemiyoloji, ilaç alımı, özkıyım Introduction: The aim of this study was to investigate demographic, epidemiologic, and clinical characteristics of cases admitted to pediatric intensive care unit (PICU) for poisoning. Methods: Cases with poisoning admitted to PICU between January 1, 2015 and June 30, 2016 were evaluated retrospectively. Results: Ninety two cases were enrolled in this study. The mean age was 63.65±59.1 months and 73.9% of the cases were under 5 years of age. Fifty five point four percent of the cases were male. Of the poisoning cases, 82.6% were accidental and 14.1% were suicidal. Seventy seven point two percent of the cases were drug related and 18.3% of them were multi-drug poisonings. Central nervous system drugs were the most frequently (24.2%) ingested drugs. The most common cause of non-drug poisonings were pesticide and insecticides (42.8%). The median duration of time from ingestion to admission to the pediatric emergency department was 60 (10-2880) minutes. Of the cases, 31.5% were symptomatic. Gastric lavage and activated charcoal were performed in 65.2% and 72.8% of the cases, respectively. Continuou...

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Objective: Hypoxia occurs following convulsions, and hypoxia is one of the most common causes of acute renal damage. The aim of this study was to investigate urinary levels of kidney injury molecules, including neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-b-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP) in children with febrile seizures (FS) for the first time. Methods: The study included 28 children with FS and 34 age and gender matched healthy children. Serum biochemistry and blood gases were measured in the serum samples. Estimated glomerular filtration rate (eGFR) was calculated. NGAL, NAG, L-FABP, and creatinine (Cr) were measured in the urine samples. The ratios of kidney injury markers to urinary Cr were used for comparisons.Results: There were no significant differences in eGFR and serum chemistry values between the FS and the control group (p > 0.05). Hypoxia was detected in 67.9% of the FS patients. The FS group had significantly higher urinary kidney injury molecules to Cr ratios compared to the controls, including NGAL/Cr (17.9 ± 9.8; 6.7 ± 4.0, respectively; p < 0.001), NAG/Cr (0.55 ± 0.29; 0.21 ± 0.16, p < 0.001), and L-FABP/Cr (4.85 ± 2.93; 1.74 ± 1.16, p < 0.001). Conclusion: Increased urinary NGAL/Cr, NAG/Cr, and L-FABP/Cr values, in patients with FS compared to healthy controls, suggest a possible subclinical renal damage in these patients. ARTICLE HISTORY

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Objective: The aim of the study was to examine and compare hepatitis A seropositivity in children. Materials and Methods: The study included patients aged 0-18 years who presented to our hospital and were examined for hepatitis A virus serology between 2009 and 2018. Patients were separated into 2 groups: those who presented before (group I) or after (group II) September 2012, when the mandatory hepatitis A vaccination program came into effect in Turkey. Results: In total, 34 809 patients were evaluated: 20 111 (57.8%) males and 14 698 (42.2%) females, with a mean age of 8.2 ± 5.3 years. Anti-hepatitis A virus immunoglobulin M positivity was observed in 3.3% of patients, most often in January and from January to April when the region experiences more rainfall. Anti-hepatitis A virus immunoglobulin M positivity decreased dramatically in group II compared to group I (0.26% vs. 7.42%, P < .001). Anti-hepatitis A virus immunoglobulin G positivity was observed in 53.8% of all patients. A statistically significant increase was determined in anti-hepatitis A virus immunoglobulin G seropositivity in group II compared to group I (81.9% vs. 42.1%, P < .001). Conclusion : Hepatitis A virus infection in Turkey decreased dramatically following improvements to infrastructure and sanitation and implementation of the vaccination program. This study is the most comprehensive report of hepatitis A seropositivity in Turkey to date.

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