Assessment of Children Exposed to Maras Powder Intoxication

PubMed: 33009763INTRODUCTION: A smokeless tobacco known as Maras powder (MP) is commonly consumed in the southern region of Turkey. To the extent of our knowledge, no previous study in literature has reported acute MP intoxication in children. AIM: Our aim was to determine the clinical effects and treatment strategies of MP poisoning in children.Materials and methods: We retrospectively reviewed the medical records of children <18 years of age with MP intoxication who were followed up in the Intensive Care Unit between January 2016 and April 2018 in our center. RESULTS: Forty-one patients (M/F= 25/16) were included in this study. The mean age was 13.2±22.4 months (age range: 7 to 30 months). The patients presented with vomiting (n=23, 56%), cough (n=17, 41.5%), loss of consciousness (n=11, 26.8%), respiratory distress (n=6, 14.6%), convulsion (n=7, 17%), cyanosis (n=1, 2.4%), and abdominal pain (n=1, 2.4%) following oral ingestion of the substance. On their physical examination all patients with convulsion were in a comatose state. Thirty-two patients (78%) had tachycardia; 15 patients (36.5%) had pharyngeal hyperemia; and three (7.3%) had hiccups. Although the female patients had a lesser rate of symptoms than male patients, the difference was not statistically significant. CONCLUSIONS: Our aim was to inform the doctors about the clinical picture that develops after taking this substance and contribute to the understanding of the treatment approach. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

The effectiveness of hesperidin in the prevention of bacterial translocation caused by methotrexate in the gastrointestinal tract [Metotreksati{dotless}n neden oldugu gastrointestinal kanaldan bakteriyel translokasyonun önlenmesinde hesperidinin etkinligi]

Methotrexate (MTX) is an antimetabolite that it is widely used in childhood cancers. Gastrointestinal toxicity stemming from oxidative damage is an important factor limiting its use. MTX causes morphological damage in the mucosa of the small intestine and serious barrier function disorder. Bacterial translocation can be seen when intestinal barrier functions are deteriorated. The aim of this study was to investigate the effect of hesperidin, a powerful antioxidant, in the prevention of bacterial translocation caused by MTX. Rats were given a single intraperitoneal dose of MTX at 20 mg/kg body weight. Hesperidin was given with oral gavage at 200 mg/kg body weight through 5 days. On the 6th day, biopsy specimens from the ileocecal region, ascending colon and mesenteric lymph nodes were placed in culture media. Increased intestinal bacteria growth was found and prominent bacterial translocation were determined in the MTX group (P&lt;0.05). Hesperidin significantly reduced the growth load and bacterial translocation. This study showed that hesperidin protects against translocation by preventing damage caused by MTX

Meropenem versus piperacillin-tazobactam as empiric therapy for febrile neutropenia in pediatric oncology patients

PubMedID: 24969883Background: Infection is a serious cause of mortality in febrile neutropenia of pediatric cancer patients. Recently, monotherapy has replaced the combination therapy in empirical treatment of febrile neutropenia. Since there has been no reported trial comparing the efficacy of meropenem and piperacillin-tazobactam (PIP/TAZ) monotherapies, the present retrospective study was conducted to compare safety and efficacy in febrile neutropenic children with cancer. Materials and Methods: Charts of febrile, neutropenic children hospitalized at our center between March 2008 and April 2011 for hemato-oncological malignancies were reviewed. Patients received PIP/TAZ 360 mg/kg/day or meropenem 60 mg/kg/day intravenously in three divided doses. Duration of fever and neutropenia, absolute neutrophil count, modification, and success rate were compared between the two groups. Resolution of fever without antibiotic change was defined as success and resolution of fever with antibiotic change or death of a patient was defined as failure. Modification was defined as changing the empirical antimicrobial agent during a febrile episode. Results: Two hundred eighty four febrile neutropenic episodes were documented in 136 patients with a median age of 5 years. In 198 episodes meropenem and in 86 episodes PIP/TAZ were used. Duration of fever and neutropenia, neutrophil count, sex, and primary disease were not different between two groups. Success rates and modification rate between two groups showed no significant differences (p>0.05). Overall success rate in the meropenem and PIP/TAZ groups were 92.4% and 91.9% respectively. No serious adverse effects occurred in either of the groups. Conclusions: Meropenem and PIP/TAZ monotherapy are equally safe and effective in the initial treatment of febrile neutropenia in children with cancer

Evaluation of pediatric patients presenting with acute-onset unilateral transient acquired blepharoptosis

| Purpose: To evaluate the clinical features of pe diatric patients with acute-onset, unilateral transient acquired blepharoptosis. Methods: In this retrospective study, the clinical records of patients between April 2015 and June 2020 were reviewed for evaluation of demographic features, accompanying neurological and ophthalmologic manifestations, symptom duration, etiological cause, and imaging findings. Patients with congenital and acquired blepharoptosis with chronic etiologies were excluded. Results: Sixteen pediatric patients (10 boys and 6 girls) with acquired acute-onset unilateral transient blepharoptosis were included in this study. The patients??? mean age was 6.93 ?? 3.16 years. The most commonly identified etiological cause was trauma in 7 patients (43.75%) and infection (para-infection) in 5 patients (31.25%). In addition, Miller Fisher syndrome, Horner syndrome secondary to neuroblastoma, acquired Brown???s syndrome, and pseudotumor cerebri were identified as etiological causes in one patient each. Additional ocular findings accompanied blepharoptosis in 7 patients (58.33%). Blepharoptosis spontaneously resolved, without treatment, in all the patients, except those with Miller Fisher syndrome, neuroblastoma, and pseudotumor cerebri. None of the patients required surgical treatment and had ocular morbidities such as amblyopia. Conclusion: This study demonstrated that acute-onset unilateral transient blepharoptosis, which is rare in childhood, may regress without the need for surgical treatment in the pediatric population. However, serious pathologies that require treatment may present with blepharoptosis

Murray City Fire Dept. (MCFD) tribute sculpture by Jon Harris

Two photos show progress made by Jon with his chainsa

Replacing actinomycin-D with carboplatin for newly diagnosed rhabdomyosarcoma

PubMedID: 25921143Background: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the pediatric age group. All patients with RMS regardless of their initial stage or group receive combination chemotherapy as 'standard therapy' consisting of vincristine, actinomycin-D and cyclophosphamide. Actinomycin-D was not readily available in Turkey at one time. Carboplatin was used instead in order to prevent delays in treatment. The aim of this report is to present the results of patients with rhabdomyosarcoma receiving carboplatin or actinomycin-D therapy. Materials and Methods: Twenty four patients with rhabdomyosarcoma treated between December 2000 and June 2011 were included in this retrospective study. The patients were treated according to International Rhabdomyosarcoma Study Group guidelines. Eleven patients were treated with actinomycin-D and 13 with carboplatin (250 mg/m2/dose for 2 days). The two groups were then compared in terms of 2-and 5-year overall survival (OS) and hematological and non-hematological toxicities. Results: Age, sex, stage and the mean duration of follow-up were similar in both groups (p>0.05). Two- and five-year OS levels were 68.2% in the carboplatin group and 78.0% and 40.0%, respectively, in the actinomycin-D group. There was no statistical difference in the number of febrile episodes (p=0.86) and no other hematological and non-hematological adverse effects were recorded in both groups. Conclusions: The findings show that carboplatin can be used as an alternative drug in the primary treatment of rhabdomyosarcoma in the event that actinomycin-D is unavailable or not tolerated

Granulocyte transfusion in paediatric oncology patients with febrile neutropenia

38th Annual Meeting of the European-Group-for-Blood-and-Marrow-Transplantation (EBMT) -- APR 01-04, 2012 -- Geneva, SWITZERLANDWOS: 000302749201459…European Grp Blood & Marrow Transplantat (EBMT

Lamin protein gene expression in childhood acute lymphoblastic leukemia [Çocukluk çağı akut lenfoblastik lösemilerinde lamin protein gen ekspresyonu]

Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children. The identification of prognostic factors has become essential in design and analysis of modern therapeutic trials. The aim of this study is to present the expression patterns of lamin A/C, lamin B1 and B2 and their prognostic value in childhood acute lymphoblastic leukemias, which are thought to be related with cell proliferation and apoptosis. The study was carried out between January 2008 and March 2014 at the Cukurova University Faculty of Medicine, Division of Pediatric Oncology and sixty-four patients diagnosed with ALL and 35 control cases were included in the study. Real Time-Polymerase Chain Reaction (RT-PCR) method was used to detect lamin A/C, lamin B1 and lamin B2 protein expression at the time of the diagnosis and at the end of the induction treatment. At the time of the diagnosis, lamin B1 protein gene expression was lower in ALL patients when compared to the control group (p= 0.001). When lamin gene expression levels at the time of diagnosis and after induction therapy were compared, the lamin A/C and B2 gene expressions were significantly lower after the administration of induction chemotherapy (both values p= 0.0001). The decrease in lamin B1 gene expression was not statistically significant (p= 0.403). When the lamin expression levels in the control group were compared with the levels after induction chemotheraphy, lamin expressions were found to be significantly lower (all p values 0.0001). In childhood ALL, lamin B1 protein gene expression could be used as a diagnostic marker, while decrease in the lamin A/C and B2 protein gene expressions after induction could be used as a marker for response to therapy. Our study is the first to show in lamin protein gene expression relationship with diagnosis and prognosis in ALL in literature. Comprehensive multicenter studies are needed with a larger cohort of patients to reach more reliable results. © 2019, UHOD - Uluslararasi Hematoloji Onkoloji Dergisi. All rights reserved.TF2013LTP34, ID715This work was supported by ‘Cukurova University Research Projects Funding Unit’ with Project number TF2013LTP34 (ID715)

Treatment of Wilms tumor using carboplatin compared to therapy without carboplatin

PubMedID: 24729447Background: Wilms tumor (WT) is the most common pediatric malignant primary renal tumor. One of the main drugs used in treatment is actinomycin-D. This was not readily available in Turkey at one time. Carboplatin was used in the primary treatment of WT in order to prevent delays in treatment. The aim of this study is to present the results of patients with WT receiving carboplatin or actinomycin-D therapy. Procedure: Forty-eight consecutive patients with WT treated between July 2005 and December 2011 were included in this retrospective study. The patients were treated according to Turkish Pediatric Oncology Group guidelines. Nineteen patients were treated with actinomycin-D and 29 with carboplatin (500mg/m2/dose). The two groups were then compared in terms of 2- and 4-year overall survival (OS), event-free survival (EFS) and disease-free survival (DFS). Results: Two- and four-year OS rates in the carboplatin group were 90.0% and 90.0%, compared to 100.0% and 88.0%, respectively, in the non-carboplatin group. Two- and four-year EFS levels in the carboplatin group were 92.0% and 88.0%, respectively, compared to 82.0% and 76.0% in the non-carboplatin group. Two-and four-year DFS levels in the carboplatin group were 92.0% and 86.0%, respectively, compared to 77.0% and 77.0% in the non-carboplatin group. Conclusions: The findings show that the carboplatin can be used as an alternative drug in the primary treatment of WT in the event that actinomycin-D is unavailable or not tolerated. © 2014 Wiley Periodicals, Inc

The effect of Thrombocytopenia on outcome in critically ill children

Objective: Thrombocytopenia is common in pediatric intensive care unit. We aimed to investigate thrombocytopenia and risk factors associated with mortality in the pediatric intensive care unit. Design: One year hospital records were investigated retrospectively. Setting: Present study was performed in the pediatric intensive care unit in Çukurova University, Faculty of Medicine. Patients and participants: A total of 94 patients, 50 (53.2 %) boys and 44 girls (46.8%), were included in this study. The median age was 24 months with a range from 1 to 240 months. Thrombocytopenia was defi ned as platelet counts &lt;150x109/L. PRISM II score, mechanical ventilation (MV), use of central venous (CVC) or arterial catheters (AC), presence or absence of sepsis, coagulopathy, hemorrhage and receiving of transfusion were recorded at the time of admission. White blood cell count (WBC), aspartate aminotransferase (AST), alanin aminotransferase (ALT), total protein, albumin/globulin ratio, blood urea nitrogen (BUN), serum creatinine (Cr), total bilirubin, C reactive protein (CRP), procalcitonin (PCT) and lactate were recorded. Measurements and results: The incidence of thrombocytopenia was 59.57%. MV, CVC, coagulopathy, hemorrhage and transfusion were found to be signifi cant factors for thrombocytopenia. Leukocytosis and leucopenia were signifi cant in thrombocytopenic patients (p=0.024). Increased ALT, AST, BUN, total bilirubin and decreased total protein levels signifi cantly were related to thrombocytopenia. Hospital mortality rate was 37.2%. There was a signifi cant association between mortality and the presence of MV, CVC and AC. Sepsis, coagulopathy, hemorrhage and transfusion had strong correlation with mortality. Increased ALT, AST, BUN, bilirubin, PCT, lactate and decreased total protein levels were related to the mortality. Conclusions: The present study suggested that thrombocytopenia could be related to mortality and an indicator of poor prognosis in the pediatric intensive care unit. Therefore thrombocytopenia-associated risk factors should be closely followed up by physicians in critically ill children