Pediatri Yoğun Bakım Ünitesinde Takip Edilen Kalp Hastalarının Klinik Özellikleri ve Mortaliteye Etki Eden Faktörler

Amaç: Çocuk Yoğun Bakım Ünitesinde ÇYBÜ kalp hastalığı nedeni ile takip edilen hastaların klinik özellikleri ve mortalite üzerine etki eden faktörlerin belirlenmesi amaçlandı.Gereç ve Yöntem: Ocak 2009-Aralık 2011 tarihleri arasında yatırılarak izlenen konjenital ve akkiz kalp hastalığı tanısı konan hastalar incelendi. Hastaların tanıları, klinik özellikleri ve mortalite üzerine etki eden faktörler araştırıldı.Bulgular: Çalışmada kalp hastalığı tanısı ile yatırılarak izlenmiş 65 olgunun verileri değerlendirildi. Hastaların büyük çoğunluğu VSD gibi asiyanotik hastalardı ve bunlar genellikle enfektif endokardit EE tanısı ile izlendi. Büyük çoğunluğunda konjestif kalp yetmezliği KKY , pulmoner hipertansiyon PHT ve büyüme geriliği mevcuttu. Atriyoventriküler septal defekt AVSD tanılı hastalar pnömoni, akut konjestif kalp yetmezliği KKY ve pulmoner hipertansiyon krizi nedeniyle yatırılmış Down sendromlu vakalardan oluşmaktaydı. Siyanotik hasta grubu ise fallot tetralojisi TOF , büyük arter transpozisyonu BAT , trikuspit kapak atrezisi TA , hipoplastik sol kalp sendromu ve geniş VSD gibi tek ventrikül yapısına sahip hastalıklardan oluşmaktaydı. Miyokardit vakalarının büyük bir çoğunluğu viral miyokardite bağlandı. Kardiyomiyopatili KMP 14 olgu incelendi ve Naxos hastalığı olan 2 olgu ile non-compaction’lu 1 olgu kaybedildi. Aritmi nedeniyle 5 SVT’li, 2 Long QTc sendromlu olgu izlendi. Hastaların % 20’de kalp hastalığı dışında başta Down sendromu olmak üzere ek hastalıklar vardı. Sonuç: Yoğun bakım ünitesinde takip edilen hastalarda Atriyoventriküler septal defekt AVSD , dilate kardiyomiyopati DKMP ciddiyeti, mekanik ventilatöre bağlanma durumlarının ve inotrop kullanımının mortalite için risk faktörü olduğu saptand

Severe Metabolic Acidosis and Pulmonary Edema: A Near-Drowning Case

Drowning is defined as a situation which results in the death of the patient within the first 24 hours, while “near-drowning” refers to all conditions of submersion which does not cause death but brings about morbidity and damaging effects. A twenty-five-month-old boy was found immobile in a bathtub filled with water. The patient was transported to the intensive care unit from the emergency department where he vas ventilated with a bag-mask, then intubated, and diagnosed with respiratory insufficiency, and his respiration was supported by mechanical ventilator. Physical examination of the patient showed that he was hypothermic, not breathing spontaneously, his heart rate was 120/min., blood pressure 100/80 mmHg, he was unconscious, and Glasgow Coma scale was 5. The first blood analysis results were mmol/L. The pulmonary edema regressed, cardiopulmonary hemodynamic returned to normal. Then, at the 48th hour he was weaned from mechanical ventilator support. The patient was discharged from the hospital in good health, without negative cognitive and motor symptoms on the 10th day. The present case report aimed to highlight the importance of basic and advanced life support in cases of near-drowning which happens frequently among children, and to discuss the management of pulmonary edema and other complications

Cumhurbaşkanlığı Muhafız Alayı

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2016.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Ünsal, Mehmet Süha

INFANTILE OSTEOPETROSIS ASSOCIATED WITH RICKETS

A 3-year-old female child was diagnosed as malignant autosomal recessive form of infantile osteopetrosis by presence of anemia, thrombocytopenia, hepatosplenomegaly, failure to thrive, visual and hearing loss, and the typical radiological images on plain radiograms. The patient had associated clinical and laboratory findings of rickets as a rare presentation. Treatment with calcitriol was initiated with a short-term calcium supplement

Benzalkonium Chloride Intoxication Mimicking Herpes Zoster Encephalitis

Benzalkonium chloride (BAC) is a frequently used disinfectant and its most well-known side effect is contact dermatitis. In this report, two children who had vesicular dermatitis, headache, lethargy, fever and encephalopathy mimicking Herpes zoster encephalitis were presented. Their consciousness level improved on the second day. From the medical history it was understood that the mother had applied 20% BAC solution to the scalps of two children. The aim of the presentation of this report is to draw attention to the fact that BAC application to the scalp for treating pediculosis capitis may resemble the herpes encephalitis clinical picture

CASE REPORT - UNUSUAL PRESENTATION OF CONGENITAL PLASMODIUM VIVAX MALARIA IN A NEONATE FROM TURKEY

A 28-day-old full-term male neonate was admitted with symptoms and findings of jaundice, hepatosplenomegaly, thrombocytopenia and a cavernous hemangioma on the forearm. Patient"s mother gave a history of antimalarial drug usage before pregnancy. He did not have characteristic symptoms like fever and chills at presentation, and had an associated hemangioma which could partly explain the jaundice and thrombocytopenia. The diagnosis of congenital malaria was established only when Plasmodium vivax was detected after the third blood smear

Large ascending aortic aneurysm and severe aortic regurgitation in a 7-year-old child with Marfan syndrome and a review of the literature

WOS: 000223919800004PubMed: 15529906A 7-year-old girl was admitted because of dyspnea on exertion and palpitations. Her symptoms had gradually worsened for the last 6 months. She had physical features of the Marfan syndrome. Transthoracic echocardiography showed an ascending aortic aneurysm, severe aortic regurgitation, and mildly dilated left ventricle. Because of marked aortic aneurysm and severe aortic regurgitation, the patient was treated with a beta-blocker and an angiotensin converting enzyme inhibitor. Surgery was refused by her parents. We describe here a child with Marfan syndrome in whom significant dilatation of the ascending aorta and severe aortic regurgitation is encountered and major cardiovascular complications of Marfan syndrome were reviewed

The prevalence of varicocele in Turkish primary school age children in Kahramanmaras

Objectives: The aim of this study was to determinethe prevalence and site of varicocele in children inKahramanmaras, a city in the south of Turkey and has apopulation of 505,950 in 2007.Materials and Methods: A total of 4543 boys (range,7-14 years of age; mean age±SD, 10.53±1.15 years)were included in this study. All children were examined bytwo specialists at their school and fi ndings of the physicalexaminations were recorded. Varicoceles were classifi edas grade 1 palpable during Valsalva maneuver, grade 2palpable without Valsalva maneuver, and grade 3 visiblewithout the need for palpation. Scrotal pain and contact toany physician were also questioned.Results: Students’ mean age was 10.53±1.15 years.Varicocele was detected in 259 (5.70%) of the 4543 boysaged between 7-14 years; the prevalence was 1.08% inthose aged 7-10 years, and 9.72 % at 11-14 years. Thevaricocele was unilateral in 187 (72.2%) of the 256 boys;of these, fi ve was on the right and the others on the leftside. Three children having grade 3 left varicocele de-scribed left scrotal pain and no children with varicocelehad contact to any physician for examination.Conclusion: According to the resuls of present study, theprevalence of varicocele increases with age. In the 7-14years age group, varicocele is often asymptomatic. Ex-amination of the testicles should be a part of the routinephysical examination for the detection of asymptomaticvaricocele, especially during adolescence