Yenidoğandan adolesana COVID-19 pandemisinde çocuklarda kardiyak tutulum şekilleri

Introduction: Coronavirus 2 (SARS-CoV-2) has infected people of all ages all across the world, with children accounting for 1.7 percent of cases. Despite the fact that over 90% of children with COVID-19 had asymptomatic, mild, or moderate disease, new worries about hyperinflammatory states or Kawasaki-like disease have surfaced. Materials and Methods: We would like to present 17 patients with different patterns of myocardial involvement. They were selected from our database of 214 patients (19 newborns) hospitalized for SARS-CoV-2 infection treatment in our pediatrics clinic from March 2020 to October 2020. Selection criteria involved cardiac involvement in terms of positive laboratory findings (elevated troponin I) electrocardiographic and echocardiographic findings. Results: Cardiac involvement was detected in only 17 (7.9%) of the 214 hospitalized patients. Patients were grouped into three categories according to their hospitalization units which were neonatal intensive care, pediatric intensive care and pediatric inpatient clinic. Most of our patients (88.2%) had elevated troponin I levels whereas 12 patients (70.5%) had abnormal electrocardiograms and echocardiographic exams. Fourteen (82.3%) of patients with high troponin I levels had also abnormal electrocardiograms whereas 13 (76.4%) of them had abnormal echocardiographic exams. Conclusion: Although we did not observe cardiac involvement in most of the patients (92.1%) hospitalized for SARS-CoV-2 infection treatment in our pediatrics clinic, subjects with involvement had quite diverse patterns ranging from only troponin I elevation to the multisystem inflammatory syndrome in children needing arteriovenous extracorporeal membrane oxygenation therapy.Giriş: COVID-19 çocuklarda hafif seyirli bir hastalık olmakla beraber, Kawasaki benzeri hastalık ya da hiperinflamatuar durumlar ile kendini gösterebilmektedir. Biz çalışmamızda COVID-19 pandemisinde çocuklarda kardiyak tutulum sıklığı ve şekillerini ortaya koymayı amaçladık. Gereç ve Yöntem: Mart 2020 ile Ekim 2020 arasında SARS-CoV-2 enfeksiyonu nedeni ile pediatri kliniğimizde tedavi gören 214 hastamızdan değişik şekillerde kardiyak tutulum gözlediğimiz 17 hastayı sunmak istiyoruz. Hastaların seçilme kriterleri laboratuar (artmış troponin I), elektrokardiyografik ve ekokardiyografik bulgulara dayanmaktadır. Hastalar tedavi gördükleri birimler olan pediatri servisi, yenidoğan yoğun bakım ünitesi ve çocuk yoğun bakım ünitesi olarak üç ayrı gruba ayrılmışlardır. Bulgular: Kardiyak tutulum 214 hastanın %7,9’unda gözlenmiş olup bunların %88.2’sinde troponin I yüksekliği, %70,5’inde anormal elektrokardiyografi bulguları ve yine %70,5’inde anormal elektrokardiyografi bulguları saptadık. Troponin I yüksekliği saptanan hastaların %82.3’ünde beraberinde anormal elektrokardiyografi bulguları saptanırken, yine bu hastaların %76.4’ünde anormal ekokardiyografi bulguları saptadık. Yedi hasta çoklu sistem inflamatuar sendromu olarak değerlendirildi. Sonuç: SARS-CoV-2 enfeksiyonu tedavisi alan hastalarımızın büyük bir kısmında kardiyak tutulum tespit etmedik. Tutulum saptadığımız hastalarda ise tutulum şekli oldukça değişkenlik göstermekte idi. Lakin bu yelpazenin bir ucunda sadece troponin I yüksekliği olan hastalarımız var iken diğer ucunda ekstrakorporeal membran oksijenizasyonu tedavisine ihtiyaç duyan sol ventrikül sistolik fonksiyon bozukluğu olan hastalarımız mevcuttu

Nazım'ın demirden kadınları

Taha Toros Arşivi, Dosya Adı: Nazım Hikmetİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

Ha Mayın Tarlası, Ha GDO Tarlası...

Ulusal Biyogüvenlik Kanun Tasarısı gündemde. Bu yasanın amacı, genetik tohum tekellerine, amaçlarına ve çıkarlarına hizmet. Yani sağlığımız ve ulusal gıda güvenliğimiz ABD, Dünya Ticaret Örgütü, IMF ve çokuluslu şirketlerin ellerine bırakılıyor..

İstanbul’da Tüplü Dalış Ölümleri

Türkiye’de tüplü dalış aktivitesi günden güne gelişmektedir. Dalıcı sayısının artmasına bağlı olarak dalışa bağlı ölümlerde de belirgin artış görülmektedir. İngiltere’de yapılan bir araştırmada yetmiş beş bin dalışta bir ölüm, beş bin dalışta bir kaza olayı meydana geldiği ortaya konmuştur. Tüplü dalış sırasında meydana gelen ölümlere günlük otopsi rutininde ender rastlanmaktadır.Adli Tıp Kurumu (ATK)Morg İhtisas Dairesi’nde 1995-2001 yılları arasındaki kayıtların taranması sonucunda üç tüplü dalış ölümü olgusuna otopsi yapıldığı tespit edilmiştir. Olgular incelendiğinde olay yeri inceleme bulgularının otopsiyi yapan adli hekime ulaşmadığı, saptanan harici lezyonların orijininin karanlıkta kaldığı veya kesin ölüm nedeninin saptanamadığı görülmüştür. Gelecekte, kanıt zincirinin kopmaması için camiamızda dalış eğitimi almış, gerektiğinde olay yeri incelemesine katılabilecek bilgi birikimine sahip adli tıp uzmanlarının yer alması gerektiğine inanıyoruz. Anahtar kelimeler: Adli otopsi, tüplü dalış ölümleri, hava embolisi, barotravma, dekompresyon hastalığı

Effect of Helicobacter Pylori Infection on Serum Vitamin D Levels Patients with Dyspepsia

Introduction: We aimed to compare serum levels of Vitamin D3 in patients with and without Helicobacter pylori (HP) infec- tion detected with the upper gastrointestinal endoscopic examination. We hypothesized that patients diagnosed with HP pathologically had low serum vitamin D3 levels. Methods: The study was held between July 1, 2019, and March 31, 2021, tertiary referee hospital. The upper gastrointestinal system endoscopic data of pediatric patients with treatment-resistant dyspeptic complaints who were followed up in the Pediatric Gastroenterology outpatient clinic of hospital between July 1, 2019, and March 31, 2021, were retrospectively evaluated. The age, height, height standard deviation score (SDS), weight, weight SDS, body mass index (BMI), BMI SDS, and serum Vitamin D3 levels of the patients who were divided into two groups according to the presence of HP histopathologi- cally in the endoscopic biopsy samples were examined. Results: Eighty-six patients were evaluated, while 58 (67.44%) were girls and 28 (32.55%) were boys. The median age was 14.43 (ınterquartile range [IQR]=4.99) years. Histopathological evaluation of biopsy materials taken from the antrum and cor- pus of 43 patients who underwent upper gastrointestinal endoscopy revealed HP positivity in 43 patients (50.00%). HP was not detected in 43 patients (50.00%). The median Vitamin D3 level was 10.00 ng/ml in the HP positive group (IQR=6.00), and the median was 14.00 ng/ml (IQR=9.30) in the negative group. This study found a significant difference between HP positive and HP negative patient groups in Vitamin D3 serum levels (p=0.033). Discussion and Conclusion: Vitamin D3 serum levels were found to be significantly lower in the HP positive group than that of controls (p=0.033). This finding supports that mucosal damage may affect Vitamin D3 absorption. Early diagnosis and treatment maintain their importance to prevent long-term consequences of chronic infection

Evaluation of Risk Factors in Nosocomial Vancomycin-Resistant Enterococci Colonization and Infection

Introduction: Vancomycin-resistant enterococci (VRE) have recently been observed as an increasingly responsible agent among nosocomial infections. In our study, we aimed to investigate the possible risk factors for VRE colonization and infection. Materials and Methods: This study was conducted prospectively in the hematology, oncology and bone marrow transplantation departments between September 2004 and April 2005. Rectal swab culture was obtained on admission day and once a week from patients who had been hospitalized in these departments. A follow-up form was completed for each patient. Stata version 8.0 was used for statistical analysis. Results: A total of 462 rectal swab samples were obtained in the seven-month period. VRE was isolated in 13 patients. All these patients were from the hematology department. Female gender, long duration of hospitalization, prolonged neutropenia, total parenteral nutrition, sucralfate usage, central venous catheterization, and duration of antibiotic usage (third- and fourth- generation cephalosporins, metronidazole, amikacin, glycopeptides, macrolides, carbapenems, quinolones) were found as risk factors with univariate analysis. In multivariate analysis, long duration of hospitalization was found as an independent risk factor. Conclusion: Establishing the risk factors for colonization and infection with VRE can contribute to the implementation of effective infection control measures