A Relationship Between Clinical and Laboratory Characteristics in Children With Severe Scorpion Envenomation in Çukurova, Turkey

Gökay, Sinem Sarı; Yılmaz, Hayri Levent; Yildizdaş, Riza; Çelik, Tuğçe; Ekinci, Faruk; Kendir, Özlem Tolu; Horoz, Özden Özgür

doi:10.1097/pec.0000000000001483

Cited by 4 publications

(7 citation statements)

References 23 publications

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“…Most cases of severe envenomation occur in children and are associated with morbidity and mortality. 9 Although there is no accurate data worldwide, a 20% mortality rate is reported in untreated infants and 10% in untreated school-aged children. 10 Many studies have been conducted recently with the help of hematological parameters, especially, the ratio between the absolute number of neutrophils and the number of lymphocytes has been considered as a potential new biomarker predicting the worse clinical course of cancer, infectious diseases, cardiovascular diseases, end-stage renal disease, immunologic diseases, and schizophrenia.…”

mentioning

confidence: 99%

Is there any relationship between initial hematological parameters and severity of scorpion envenomation?

Horoz¹,

Yıldızdaş²,

Aslan³

et al. 2020

Turk J Pediatr

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Background and objectives. Most cases of severe scorpion envenomation occur in children and are associated with significant morbidity and mortality. Excessive systemic inflammatory response, which leads to multiple organ involvement, is an emerging challenge during severe envenomation. The aim of this study was to investigate if there was any relationship between initial hematological parameters and severe envenomation in pediatric patients presenting with scorpion envenomation.Method. This study was performed retrospectively, at the pediatric emergency unit and pediatric intensive care unit of the Çukurova University Medical School in Turkey. Two hundred and fifty-seven cases with scorpion envenomation, and a control group consisting of one hundred and fifteen healthy children were included in the study.Results. White blood cell, neutrophil, lymphocyte, platelet, neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR) and PDW values of patients were higher than the controls (p<0.05). Mean NLR was 3.8 ± 4.7 in patients. Patients were analyzed with the help of the decision tree model, and it was seen that in patients who had applied to hospital in less than an hour after the scorpion sting, 87.5% of the patients whose NLR value was between the 0.519-1.969 interval (below 2.1 which we found as the cut-off value) did not need to be hospitalized in the intensive care unit, 54.1% of the patients whose NLR value was higher than 1.969 needed to be hospitalized at the intensive care unit. Conclusions.Severe envenomation is associated with mortality and morbidity in children. Our findings showed that NLR seems to be a useful tool in predicting severe envenomation.

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mentioning

confidence: 99%

Is there any relationship between initial hematological parameters and severity of scorpion envenomation?

Horoz¹,

Yıldızdaş²,

Aslan³

et al. 2020

Turk J Pediatr

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“…3 In a study with 64 patients in Turkey, the death rate was 12%; the death rate in another study was reported as 0%. 8,9 Similarly, none of the patients in our research died (0%). So far, 13 species from 8 families have been identified, including Buthidae, Chacthida, Iurida, and Scorpionidae families in Turkey.…”

Section: Discussionmentioning

confidence: 53%

The Role of ProBNP on Prognosis in Scorpion Stings

Güllü

İpek

Dalkıran

et al. 2021

Wilderness & Environmental Medicine

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Introduction-Scorpion stings are a major health problem with potentially fatal consequences. Children under the age of 10 y especially face a great risk. Predicting the prognosis is important in reducing mortality and morbidity because it enables the use of early treatment options. In this study, we examine the relationship between proBNP and prognosis in scorpion stings.Methods-This is a retrospective analysis of patients aged ≤18 y who were admitted to the child emergency service with a scorpion sting. We examined the demographical data, clinical findings, laboratory records, treatments, and results of the patients. We classified stage 1 and stage 2 scorpion envenomation as group 1 (mild-moderate) and stage 3 and 4 as group 2 (severe). A t test was used for normally distributed data, and the Mann-Whitney U test was used for nonnormally distributed data. The correlation analysis was done using the Spearman test.Results-There were 32 (74%) patients in the mild-moderate group and 11 (26%) in the severe group. ProBNP 1 was significantly higher in the severe group at admission (P=0.016). There was no difference between the troponin I values (P=0.051). ProBNP 2 (12th hour) and proBNP 3 (24th hour) were higher in the severe group (P=0.001 and P=0.032, respectively). There was a negative correlation between proBNP and echocardiographic findings involving ejection fraction and shortening fraction (R=-0.703, P=0.002).Conclusions-In our study, the first proBNP values were significantly higher in the severe group. This suggests that proBNP may be beneficial in predicting prognosis.

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“…The most common symptom after a scorpion sting is pain at the site of the sting. 6,7,12,17,18 In cases of scorpion stings without systemic findings, providing analgesia is one of the most important steps of emergency intervention. However, as stated in a meta-analysis, there are insufficient studies that determine the analgesic(s) that are most effective for scorpion stings.…”

Section: Discussionmentioning

confidence: 99%

“…1,5 The type, age, and size of the scorpion, nutritional status, number of stings, venom injection depth, the sting being located closer to the head and neck, and age and health status of the patient may affect the clinical course. 6 Scorpion venoms are mixtures of many biologically active components, some of which are hemolysins and neurotoxins; the latter often act on ion channels. 7 When bound to these channels, inactivation is inhibited, leading to neuroexcitation and thus prolonged depolarization.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Intravenous Paracetamol, Dexketoprofen Trometamol, or Topical Lidocaine Use for Pain Relief in Scorpion Stings: A Placebo-Controlled, Randomized Study

Turgut

Yavuz

Gülaçtı

et al. 2022

Wilderness & Environmental Medicine

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Introduction-After a scorpion sting, patients commonly present to hospitals with pain. Our study sought to compare the analgesic efficacy of IV paracetamol, IV dexketoprofen trometamol, topical lidocaine, and placebo in patients reporting pain after presenting with a history of scorpion sting.Methods-This double-blind, randomized, placebo-controlled study was conducted in the emergency department of a tertiary hospital. Adult patients who presented with the complaint of pain after a scorpion sting and did not have systemic findings were randomly assigned to 1 of the following 4 groups: IV paracetamol, IV dexketoprofen trometamol, topical lidocaine, and placebo. The visual analog scale scores were measured at the time of presentation to the emergency department and at 30 and 60 min to determine the pain intensity.Results-The study included 106 patients, of whom 30 were in the paracetamol group, 26 in the dexketoprofen trometamol group, 25 in the topical lidocaine group, and 25 in the placebo group. We did not find a different analgesic effect among the groups in the first 30 min (P=0.185). IV paracetamol, dexketoprofen trometamol, and topical lidocaine did not show different analgesic effects in the first 60 min (P>0.05). IV paracetamol and dexketoprofen trometamol were found to provide a more effective analgesia than the placebo at 60 min (P<0.05). The analgesic effects of topical lidocaine and placebo did not differ (P=0.330).Conclusions-IV paracetamol and IV dexketoprofen trometamol provided analgesia in the first 60 min, similar to topical lidocaine but superior to placebo.

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A Relationship Between Clinical and Laboratory Characteristics in Children With Severe Scorpion Envenomation in Çukurova, Turkey

Cited by 4 publications

References 23 publications

Is there any relationship between initial hematological parameters and severity of scorpion envenomation?

Is there any relationship between initial hematological parameters and severity of scorpion envenomation?

The Role of ProBNP on Prognosis in Scorpion Stings

Comparison of Intravenous Paracetamol, Dexketoprofen Trometamol, or Topical Lidocaine Use for Pain Relief in Scorpion Stings: A Placebo-Controlled, Randomized Study

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