Retrospective Comparison of Moderate and Severe Diaphragmatic Eventration in Children: Efficiency of Radiological Classification

Aim:Diaphragmatic eventration (DE) is a congenital or acquired elevation of the hemi-diaphragm. The indications for surgery may be challenging because clinical symptoms do not always correlate with radiological severity. We aim to identify the factors for the necessity and the efficiency of thoracoscopic diaphragmatic plication (TDP) in children with DE.Materials and Methods:A retrospective cross-sectional analysis of patients treated for DE (April 2006-August 2017) was performed. Demographics, type of DE, laterality, associated malformations and clinical symptoms were evaluated. Patients were grouped in two groups (moderate and severe) according to their diaphragmatic elevation levels on X-ray at admission. The severe DE group (SDE, n=14) had a DE of more than 2 vertebral bodies whereas the DE was 2 vertebral bodies or less in the moderate DE group (MDE, n=16). The groups were then compared regarding the necessity of TDP. The efficiency of TDP was analyzed by comparison of the outcome of patients who underwent TDP with that of conservative management.Results:There were 30 DE cases with a median age of 13.75 months. DE was acquired in 5 patients. The right side was the dominant side (21/30). The most common clinical symptoms were pneumonia (21) and respiratory distress (7) while 6 cases were asymptomatic. Acquired DE and respiratory distress were significantly higher in the SDE group. Four patients (25%) in the MDE group and 13 patients (92.9%) in the SDE group required TDP (p=0.000). The total number of cases of pneumonia was significantly higher in the conservatively treated patients in the follow-up (p=0.023).Conclusion:Two vertebral bodies may be an efficient cut-off level to discriminate between MDE and SDE. Absolute indications for TDP are SDE, acquired DE and respiratory distress at admission. Patients that are conservatively treated are more prone to pneumonia

A Rare Cause of Acute Abdominal Pain in Childhood: Peptic Ulcer Perforation

Four children with a mean age of 12 years were referred to our emergency department with a history of abdominal pain. Examination revealed tenderness in the lower abdomen, in particular the left iliac fossa. The youngest child, who was 3 years old, also presented with shock. Abdominal X-rays revealed free air under both hemidiaphragms. Subsequent surgery was administered as the primary treatment of three patients and a partial resection was performed in the remaining one. The youngest child died and the others were discharged. These cases emphasize that although uncommon, alternate diagnoses must be kept in mind in children presenting with lower abdominal pain

Protective effects of hyperbaric oxygen and iloprost on ischemia/reperfusion-induced lung injury in a rabbit model

Durakoglugil, Emre/0000-0001-5268-4262; Dokumcu, Z/0000-0002-4996-7824; YILMAZ, Yeliz/0000-0003-1811-122X; Bozok, Sahin/0000-0002-1256-5055WOS: 000307333500001PubMed: 22676276Background: the role of multiorgan damage in the mortality caused by ischemic limb injury is still not clarified. the objective of this study was to examine the potential protective effects of hyperbaric oxygen (HBO) and iloprost (IL) therapy on lung damage induced by limb ischemia/reperfusion injury in a rabbit model, using both biochemical and histopathological aspects. Methods: Forty New Zealand white rabbits were randomly allocated into one of five study groups: HBO group (single session of HBO treatment); IL group (25 ng/kg/min infusion of IL); HBO + IL group (both HBO and IL); Control group (0.9% saline only); and a sham group. Acute hind limb ischemia-reperfusion was established by clamping the abdominal aorta for 1 h. HBO treatment and IL infusion were administrated during 60 min of ischemia and 60 min of reperfusion period. Blood pH, partial pressure of oxygen, partial pressure of carbon dioxide and levels of bicarbonate, sodium, potassium, creatine kinase, lactate dehydrogenase, and tumor necrosis factor alpha were determined at the end of the reperfusion period. Malondialdehyde was measured in the plasma and lung as an indicator of free radicals. After sacrifice, left lungs were removed and histopathological examination determined the degree of lung injury. Results: in the control group, blood partial pressure of oxygen and bicarbonate levels were significantly lower and creatine kinase, lactate dehydrogenase, malondialdehyde and tumor necrosis factor-a levels were significantly higher than those of the HBO group, IL group, HBO + IL group and sham group. Similarly, the malondialdehyde levels in the lung tissue and plasma levels were significantly lower in the treatment groups compared with the control group. the extent of lung injury according to the histological findings was significantly higher in the control group. Conclusions: These results suggest that both HBO and IL therapies and their combination might be effectively used in the prevention of lung injury after ischemia/reperfusion injury of the lower extremities

Pediatric Bilateral Pheochromocytoma and Experience of Laparoscopic Cortical Sparing Adrenalectomy

Pheochromocytomas are neuroendocrine tumors. In this report, we present a 15-year-old girl who had cerebral palsy and pheochromocytoma. She also had a diagnosis of hyperinsulinemic hypoglycemia in her history. She underwent bilateral laparoscopic cortical sparing adrenalectomy. We report the experience of laparoscopic bilateral cortical sparing adrenalectomy of a pediatric pheochromocytoma

Ege tıp öğretim elemanlarının sürekli mesleki gelişim konusundaki eğitim gereksinimlerinin belirlenmesi

Amaç: Ege Üniversitesi Tıp Fakültesinde görevli olan öğretim elemanlarının sürekli mesleki gelişimini (SMG) sağlayacak eğitici gelişim programlarının planlanması için eğitim gereksinimlerinin belirlenmesi amacıyla gerçekleştirilmiştir. Gereç ve Yöntem: Aralık 2019-Şubat 2020 ayları arasında yapılan kesitsel tipte araştırmadır. Ege Üniversitesi Tıp Fakültesinde görevli olan 225 öğretim elemanına ulaşılmıştır. Araştırmanın verilerini öğretim elemanlarının eğitim gereksinimlerini belirlemeye yönelik hazırlanan dijital anket formu ile toplanmıştır. Veriler, SPSS 21 paket programında değerlendirilmiştir. Verilerin analizinde dağılım istatistikleri (frekans, yüzde, ortalama, standart sapma) kullanılmıştır. Bulgular: Öğretim elemanlarının %61,6’sı (n:98) Dâhili Bilimler, %17’si (n:27) Cerrahi Bilimler, %21,4’ü (n: 34) Temel Bilimlerde görev yapmaktadır. Öğretim elemanları SMG etkinliklerini ayda dört saat, belli zamanlarda tekrarlanan modüler program ve en az 2-5 öğretim yöntemi ile yürütülmesini istedikleri belirlenmiştir. Sürekli mesleki gelişim etkinliklerinde eğitim becerileri olarak asistanların ve Dr. Öğr. Üyelerinin eğitim becerileri konusunda ihtiyaçları olduğu saptanmıştır. Araştırma becerileri olarak asistan ve uzmanların yayın hazırlama ve bilimsel toplantı, diğer öğretim elemanlarının araştırma planlama konusunda gereksinimlerinin olduğu belirlenmiştir. Kişisel gelişim ve uygulama becerileri olarak asistan ve uzmanların bilimsel toplantı, diğer öğretim elemanlarının ise kişisel gelişimlerini destekleyecek eğitimlere ihtiyaçlarının olduğu belirlenmiştir. Sonuç: Eğitici gelişim programlarının planlanmasında eğiticilerin gereksinimlerinin ve isteklerinin belirlenmesi sürekli mesleki gelişim etkinliklerinin başarısını etkilemektedir. Saptanan eğitim gereksinimleri doğrultusunda sürekli mesleki gelişim etkinlikleri düzenlenmesi önerilmektedir

Hospital Process of Children with Ingested Corrosive Substances: A Single Center Retrospective Study in Türkiye

Objective: This study retrospectively was aimed to determine how the treatment and care processes of children ingestion corrosivesubstances are maintained. Material and Methods: The population of the study is children with ingested corrosive substances, and the sample consisted of pediatric patients who ingestion corrosive substances from the pediatric surgery department of a university hospitalin western Türkiye. Medical and nursing files of children with corrosive substance ingestion from the university's electronic patient file were examined. The sample of the study consisted of 70 pediatric patients who came between the years 2018-2021. The analysis of data was calculated using SPSS 24.0 program, frequency, percentage, median, interquartile range, comparison analysis and logistic regression. Results: The median age at first admission of pediatric patients was 4.0 years and 57.1% were girls. 35.7% of the pediatric patients due to oil consumption, 30.0% of them applied to the pediatric surgery department in the summer season, and the hospital was not the first application center for 61.4%. According to the Rush Medicus Patient Classification System, 40% of the children were defined as low-level dependent patients. The first arrival age of children affects the level of nursing dependency. It was determined that the rate of dilatation in pediatric patients varied according to the hospital first application center. Conclusion: As a result, although the dependency level of the children taking corrosive substances to the nurse is low, it was determined that the child's first admission age and dilatation status affect the level of addiction.</p

Anxiety Levels and Needs of Fathers of Children Hospitalized in Pediatric Surgery Intensive Care Units

Aim: the purpose of this study was to determine the anxiety levels and needs of those fathers whose children were hospitalized in a pediatric surgery intensive care unit. Materials and Methods: This cross-sectional study was conducted with the fathers of children hospitalized in a pediatric surgery intensive care unit in 2016/2017 by using the critical care family needs inventory (CCFNI), and State and Trait Anxiety scale. Setting: Turkey, a university hospital. Results: This study included 113 fathers. the fathers’ mean age was 36.6±6.31 years. There was a weak positive correlation between the scores the fathers obtained from the State Anxiety scale and the CCFNI. There was a difference between the fathers’ intensive care needs in terms of their education levels. While ‘‘feeling that hospital personnel are attentive to the patient’’ was important for 92% of the fathers, ‘‘being sure that as much care as possible is given” was important for 88.5% and ‘‘being informed about the patient at least once a day’’ was important for 85.8%. Conclusion: the anxieties and needs of the fathers of the patients staying in a pediatric surgery intensive care unit were high, particularly in those with a low educational level. Health professionals should be aware of the fathers’ feelings, needs and stressors so that they can provide interventions specific to fathers

Living With My Baby With Congenital Anomaly: A Qualitative Case Report

This case report was made to understand the emotions, thoughts, and experiences of the mother, who was lying in the long-term neonatal intensive care unit. An individual in-depth interview was conducted once with the mother of the infant with the diaphragm hernia. The interview recorded and lasted approximately 30 min. The data were analyzed by inductive method and themes and codes were created. The mother of the infant with a diaphragmatic hernia was 31 years old, married with 2 children, and employed full-time. The infant was diagnosed antenatally at 37 weeks old, weighed 3.000 g, and was male. As a result of the interview, 3 main themes were identified: “Facing the disease,” “Experiences in intensive care,” and “Change in family life.” The results show that having an infant with congenital anomaly affects the life of all family members and shows the problems experienced strikingly