Smoking prevalence in students in Samsun was similar to that in a study conducted 15 years previously. It is important to use anti-smoking campaigns directly targeted at teenager and they should be fully informed of the harmful effects of smoking.

Schönlein purpurası tanısı alan 364 hasta retrospektif olarak incelendi. Hastaların demografik özellikleri, hastalığın sistemik etkileri, laboratuvar bulguları ve organ tutulumları kaydedildi. Bulgular: Hastaların %56,3'ü erkek (n=205), %43,7'si (n=159) kız, yaş ortalaması 8,32 ± 3,38 yıl idi. Tüm hastalarda hastalık seyri boyunca karakteristik palpabl purpura izlendi. Hastaların %57,1'inde (n=208) eklem tutulumu, %50,8'inde (n=185) gastrointestinal sistem tutulumu, %29,7'sinde (n=108) renal tutulum, %1,3'ünde (n=5) skrotal ve %0,8'inde (n=3) merkezi sinir sistemi tutulumu tespit edildi. Hastaların % 4,1'inde (n=15) Ailevi Akdeniz Ateşi mevcuttu. Yaş ve trombositozun renal tutulum için risk faktörü olduğu, ayrıca lökositozun da gastrointestinal tutulum için risk faktörü olduğu saptandı. Sonuç: Çalışmamızda cilt tutulumundan sonra en sık eklem tutulumu gözlenmiş olup böbrek tutulumu %29,7 sıklıkta saptanmıştır. Yaş ve trombositozun böbrek tutulumu, lökositozun ise gastrointestinal tutulum açısından risk faktörü olduğu saptanmıştır.

No abstract

Amaç: Nörogelişimsel gerilik, epilepsi nedeniyle polikliniğimize başvuran Angelman Sendromu kliniği taşıyan hastalarımızın genetik ve klinik özelliklerini sunmaktır. Gereç ve Yöntem: Angelman/ Prader-Willi Sendromu tanısı koyduğumuz hastaların verileri retrospektif olarak incelenmiştir. Bulgular: Mikrosefalisi, sürekli gülme atakları,hipotonisitesi,gelişimsel geriliği olan iki kız, üç erkek hastamızın floresan in situ hibridizasyon (FISH) incelemeleri 15q11-q13 delesyonu olarak sonuçlandı. Yaşları 1-4 yaş aralığındaydı. 3 hastamızın epilepsisi mevcuttu. Elektroensefalografilerinde (EEG) zemin aktivite bozukluğu ve diken dalgalardan oluşan epileptik aktivite saptandı. Antiepileptiklerle kontrol altına alındılar. Tüm hastalarda konuşma bozukluğu mevcutken, en sık görülen dismorfik bulgu geniş ağız, sonrasında sırasıyla frontal bossing, geniş aralıklı dişler ve burun kökü basıklığıydı. Prader-Willi tanısı alan nazogastrik (NG) ile beslenen 1 yaşındaki erkek hastada antenatal polihidramnioz ve inmemiş testis operasyonu hikayesi mevcuttu.Sık enfeksiyon geçiren bir hastada immün yetmezlik saptandı, intravenöz immunglobulin (İVİG) tedavisi alıyor. Kranial görüntülemede bir hastada terminal zon, bir hastada corpuscallozum inceliği saptandı. Diğer hastaların görüntülemeleri normaldi. Görme ve işitme geriliği izlenmedi. Tüm hastalarımız fizik tedavi ve konuşma terapisi almaktadır. Sonuç: Angelman Sendromu(AS) 15q11-q13 lokusunu içeren delesyon, uniparentaldizomi, imprintlenme defekti veya UBE3A gen defektinden kaynaklanan, nadir görülen bir genetik hastalıktır. 15q11q13 bölge delesyonu, AS' unun yaklaşık %70 inden sorumludur. Etkilenmiş kişilerde şiddetli mental retardasyon, motor gelişimde gerilik, konuşma bozukluğu, karakteristik yüz görünümü bulunmaktadır. 15q11-q13 delesyonlu kromozom anneden kalıtıldığında AS'u, babadan kalıtıldığında Prader-Willi sendromu oluşmaktadır

In this study; patients who underwent conventional tracheostomy while being followed up on a mechanical ventilator with endotracheal intubation in their pediatric intensive care unit were evaluated retrospectively. It was aimed to share the positive changes observed in clinical-mechanical ventilator parameters with the literature. Study data were obtained from the hospital information management system and recorded in the "Child Patient Evaluation Form with Tracheostomy" as follows: Demographic data, diagnosis of admission to pediatric intensive care unit, indications for mechanical ventilation and tracheostomy, changes in post-procedure mechanical ventilation parameters, tracheostomy complications, decannulation, survival and death rates etc. Post-discharge medical records were created by telephone interviews with parents. IBM SPSS 21 (Statistical Package for Social Sciences) program was used for statistical analysis. In our study; the most common indication (67.0%) for tracheostomy was the need for prolonged mechanical ventilation. Peak inspiratory pressure requirement on mechanical ventilator decreased statistically and tidal volume increased significantly in those who underwent tracheostomy due to prolonged mechanical ventilation requirement (both p<0.001). On the other hand, the mean length of stay in the pediatric intensive care unit after the procedure was statistically significantly shorter (p<0.001). Decannulation success was statistically significantly higher in those who underwent tracheostomy due to upper airway obstruction (p<0.02). In our study; only four (6.2%) patients died due to tracheotomy (cannula occlusion, unplanned decannulation, etc.). Clinicians should consider tracheostomy if extubation cannot be achieved in children and adolescents who have been given mechanical ventilation for a long time (>2-4 weeks) due to progressive primary disease. Tracheotomy should definitely be performed within appropriate medical indications in order to shorten the length of stay in the hospital/Pediatric intensive care unit and to provide medical care outside the hospital (e.g.; a suitable home environment) in order to create general psychosocial-physical well-being in the patients.

There are concerns on exposure to radiation especially in pediatric population, as magnetic resonance imaging (MRI) can be used in emergency departments and provides an imaging without radiation; its utilization has recently increased. This study aimed to evaluate MRI utilization trends in patients who underwent a MRI in a pediatric emergency department within a period of five years. Examination data of the patients admitted to pediatric emergency department between 2014 and 2018 were obtained from database of the hospital with the approval of Clinical Research Ethical Committee. Rate of MRI utilization in patients admitted to pediatric emergency department was 0.88%. There was a statistically significant increase in MRI utilization within five years (p<0.001). The rate of male patients (1.24%) who underwent MRI was significantly higher than that of female patients (0.65%) (p<0.0001). There was a statistically significant decrease in MRI utilization by age in all categories (p<0.0001). Neuroradiology imaging was the most common. Complaints at presentation and pre-diagnoses were analyzed. The results of MRI were evaluated by radiologists and 53.9% of the results were normal. The highest rate (46.1%) of MRI utilization was between 4 pm and 12 am in a day. The highest rate of MRI utilization was on Friday and the lowest rate was on Sunday. While MRI utilization has increased in pediatric patients, neuroradiology imaging is the most common type. MRI utilization in pediatric emergency department is higher in male patients and in the early ages.

No abstract

To make an accurate diagnosis of poisoning and determine the severity of poisoning quickly without losing time are critical for managing the patient's medical treatment and predicting the prognosis. This study aimed to investigate PSS and Glasgow Coma Scale Score (GCS) effectiveness in predicting outcomes in acute pediatric poisoning. We retrospectively reviewed the data of intoxicated patients aged under 18 years who were admitted to the pediatric emergency service of Ondokuz Mayıs University Faculty of Medicine Clinical Research and Practice Hospital between January 1, 2018, and December 31, 2018. Two hundred twenty-two patients were admitted to our pediatric emergency department (ED) after drug ingestions. Of the patients enrolled in the study, 148 (66.7 %) were female, and 74 (33.3%) were male. The mean age was 105.8±75.3 months, and the median age was 65 (12-213) months. 96 (43.3%) poisoning cases were in the age range of 12-18 years. According to Poisoning Severity Score, it was found that 84 cases (37.4%) were asymptomatic (PSS score=0), 86 cases (38.7%) were minor (PSS score=1), 48 cases (21.6%) were moderate (score=2) and four cases (1.8%) were severe (PSS score=3). Combined using the Poisoning Severity Score with the patient's biochemical and physiological values may help improve an accurate diagnosis of poisoning and determine the severity of poisoning more accurately.