Çocuklarda Çevresel Aciller

 Elektrik çarpmaları yüksek mortalite ve morbiditeyle seyreden sıklıkla çocuklarda evde ortamında kaza sonucu oluşan yaralanmalardır. Elektrik çarpmaları oldukça geniş bir klinik yelpazedeklinik bulgu verir, basit yanıklardan ciddi organ hasarına kadar varan tablolar görülebilir. Yaralanmanın şiddeti maruz kalınan elektrik akımının yoğunluğuna, cinsine, akıma maruz kalma süresine,akımın vücutta izlediği yola ve akıma maruz kalan dokunun direncine bağlı olarak değişmektedir.Olay yerinde arrest, bilinç kaybı, ciddi yanık gibi bulguları varlığında veya yüksek voltajlı elektrikçarpması durumunda hastalar, mutlaka yatırılarak çoklu sistem tutulumu, aritmi ve komplikasyonlaraçısından yakın izlenmelidir. Elektrik yaralanmaları, önlenebilir bir ölüm nedeni olması ve çoğunlukla evde kazası sonucu ortaya çıkması nedeniyle ev içi önlemlerin önemi büyüktür. Ayrıca ebeveynlere ve çocuk bakımı ile ilgilenenlere ilk yardım dersleri verilmesi, elektrik çarpmalarınınsonuçları ve önlemler konusunda eğitici ve bilgilendirici kılavuzların oluşturulması ve uygulanmasıgerekmektedir. Electrical injuries are accidents with high mortality and morbidity that often occur athome in children. Electrical injuries have a wide range of clinical presentation from mild burns to severe organ damage. The severity of the injury varies depending on the intensity of the electrical current, type, duration of exposure to the current, the path of the current in the body and the resistance ofthe tissue exposed to the current. In case of cardiac arrest, loss of consciousness, severe burns at thescene, or high voltage electrical injury, Patient should be hospitalized and closely monitored for multisystem involvement, arrhythmia, and complications. Since electrical injuries are a preventable cause ofdeath and mostly occur at home, domestic precautions are crucial. Also, first aid classes for parents andcaregivers, establishment and implication of educational and informative guidelines on the consequences of electrical injury and precautions are essential

Reasons for Failure of Antifungal-lock Therapy with Caspofungin: Need for Higher Concentrations

Antifungal-lock therapy (AfLT) has arrived as an investigational approach for preventing catheter removal with limited clinical evidence of its efficiency. The principle of AfLT consists of catheter lumen replenishment by a selected antimicrobial agent and then locking it for an alternative treatment to eradicate the microbes embedded in endoluminal biofilms. Herein, we report a pediatric hematology-oncology patient with Candida parapsilosis-related central venous access device infection in which catheter removal was performed despite the systemic and intraluminal caspofungin treatment. For now, we recommend higher doses of caspofungin for AfLT especially in Candida parapsilosis-related catheter infections

Confirmation of Nasogastric Tube Placement via Bedside Ultrasound in a Pediatric Intensive Care Unit

Introduction: Nasogastric tube (NGT) placement is a common procedure in pediatric intensive care and requires accurate verification to avoid complications. Traditional methods such as auscultation and radiography pose limitations such as unreliability and radiation exposure. The aim of this study was to confirm the placement of NGT using bedside ultrasonography (USG). Methods: A prospective study was conducted in a tertiary pediatric intensive care unit (PICU) using bedside USG to confirm NGT positioning. The study included 46 patients, with procedures ranging from November 2023 to January 2024. Placement confirmation techniques included USG visualization and the air bolus method when necessary. Results: All 68 NGT insertions were successfully visualized using USG. The median age of patients was 18 months, with the most common admissions being pneumonia and septic shock. An air bolus was used in 13.2% of the cases to indirectly confirm placement. Conclusion: Bedside USG is an effective and safe alternative for confirming NGT placement in the PICU, minimizing the risk of radiation, and leveraging the benefits of immediate and accurate bedside assessment. This method can replace radiography as the new standard for NGT placement confirmation

Improvement of bovine in vitro embryo production by fetal calf serum and cysteamine supplementation and investigation of freezability

The aim of this study was to investigate the effects of cysteamine (Cys) and fetal calf serum (FCS) in synthetic oviduct fluid (SOF) and charles and rosenkrans (CR1aa) on the bovine in vitro embryo production and its ability of freeze. The oocytes were divided into two groups and allowed to mature in TCM-199, with and without cysteamine. They were divided into 4 subgroups according to whether they contain Cys and FCS in 2 different culture media (SOF and CR1aa). Accordingly, 8 groups were formed as SOF+FCS+Cys, SOF+Cys, SOF+FCS, SOF, CR1aa+FCS+Cys, CR1aa+Cys, CR1aa+FCS and CR1aa. Embryos were cultured for 7-9 days and were frozen using vitrification method. Development of embryos was observed during the first 24 hr post-thaw period. The highest rate of compact morula was 20% in SOF+FCS+Cys and 19.4% in CR1aa+FCS+Cys. The rate of blastocyst in SOF+FCS and CR1aa+FCS were found 17.9% and 15.4% respectively and the difference between groups was statistically significant (P<0.05). During the 12 hr vitality assessment, the highest rate was determined in SOF+FCS (47%). The results indicate that FCS has a positive effect in reaching compact morula and blastocyst regardless of the presence of the culture medium or antioxidant used. There was no statistically difference between the values of post-thaw embryos