Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Nature as representative of spiritul wholeness in today's art

Güncel anlamda görsel sanatlarda doğa ve ruhsallık kavramlarını ele almak sanat tarihsel bir perspektifi gereksinir. Tarihsel olarak bakıldığında bu kavramlar bizi sembolizm ve onun muştuladığı romantizm akımlarına ulaştırır. Bu doğrultuda bir çalışma günümüze kadar uzanan bir izlek oluşturmayı mümkün kılar.Sembolizm düşe ve imgeleme yaklaşımıyla gerçeğin görünümlerini sorgulayan bir iç dil geliştirmiştir. Rüyalar, fanteziler ve bilinç dışı bu ifade için ona kaynaklık ederken, doğayı derinlemesine ruhsal bir kavrayışla ifade etmede esin vermiştir. Mistisizm, ölüm, erotizm, öte dünya, mistik varlıklar ve gizemli olan, ifade edilemeyen her şey sembolizmin ilgi alanına girmektedir. Uzamla bağını koparmış, fantastik ve düşsel dışavurumu ifade etmede imge bilinçdışı yeni bir boyut kazanmıştır. Bu içeriğin ve dilin romantizmi şekillediğini ve öncülü bir doğaya sahip olduğunu söylemek mümkündür.Romantizmle birlikte özellikle doğa, metafizik anlamlar kazanarak, manevi arayışlara eşlik eden, ruhsal özgürlüğün sembolü haline gelmiştir. Duygularla, düş gücüyle, melankoli ve nostalji ile özdeşleşmiştir. Aşkınlık ve sınırsızlığı ifade etmek için yeni bir ruhsal bütünlüğün temsilcisi olarak gündeme gelir. Panteizme yaklaşan bir tavırla doğa tanrısal varoluşa ulaşmanın yüce duyguların sembolüdür. Günümüzde hala pastorallik benzer duygusal çağrışımları akla getirir.Günümüz sanatında birbirine girift ele alınan doğa ve ruhsallık kavramları tarihsel bağlamı içerisinde ele almak ilişkisel anlamda önem taşır. Farklı medyalarla iş üreten birçok güncel sanatçıda, üretimin şekillenmesinde bu birikimin ve esinin izlerine rastlıyoruz.Considered historically, After the Industrial Revolution, the urban life, financial and technological changes have brought with them suspicions concerning that human being will not able to have connections with nature and his own presence again.In this sense, for human being, it is possible to mention a new life model which requires adoptation process.The new life model is described as different mentality and perception that change culture, human relations and iner life. The distinctive feature of this mentality is the great significance for reason and reasonable approches that keep the iner life in the second place. This situation has brought with it the fall of religious morals, the weakness of humanistic relationship and a standart lifeformulation.Historically, since the apperance of Romanticism, a lot of artists working witj different techniques deal with the nature almost as the worship of the nature to describe its spiritual theme. The new meanings are referred to the nature as the need to revive the connection with the nature, the universe, the instinct and the power of spirit.The nature has also become a bsis for nostalgic longings with utopian approach. The most significant feature of the theme of the nature is described as an attempt to have spiritual themes

Investigation of children victims of road traffic injuries required intensive care

Children are considered vulnerable road users (VRUs) in the literature, with high mortality and morbidity rates in accidents, resulting in various injuries such as head and neck injuries, fractures, tears, and post-traumatic stress disorder. The study was conducted retrospectively among patients admitted to the Pediatric Intensive Care Unit between October 1, 2017, and January 1, 2022, in a Hospital in Bursa. Eighty-six children were admitted to the study. Of them, 74.4% were male and 25.6% female. The average age was 8.8±5.0 years. The accidents occurred predominantly in urban areas (67.4%), with 32.6% occurring in rural areas. Pedestrians were 68.6% of the victims. Most accidents happened on Sundays (22.1%) and weekdays (62.8%). The distribution of accidents by season showed that most accidents occurred in the fall (29.1%), followed by spring (26.7%), summer (25.6%), and winter (18.6%). The most common time for accidents was between 18:00 and 00:00 (59.3%), and preschool-age children were most involved (44.2%). The most frequent type of injury was multiple trauma (50%), followed by isolated cranial trauma (29.1%). Of 14.0% victims died, and two became permanent care patients. The findings provide valuable insights for developing policies to prevent accidents and reduce associated morbidity and mortality. [Med-Science 2023; 12(4.000): 1284-9

Depression Status in Children’s Parents During Hospitalization in the Pediatric Intensive Care Unit

Aim: The purpose of this research was to determine depression levels in parents of children hospitalized in the intensive care unit and to identify any variation between maternal and paternal depression levels. Method: The study was performed with 25 mothers and fathers of patients hospitalized between February and April 2015 in the Gaziantep University Faculty of Medicine Hospital, Pediatric Intensive Care Unit. The Beck Depression Inventory was used to evaluate the parents’ depression levels. Results: The mothers and fathers of 25 patients were included in the study. The mean age of the patients was 61.2 ± 53.8 months (range, 3-172 months). Nineteen (76%) of patients had poor socioeconomic status, 4 (16%) had average socioeconomic status, and 2 (8%) had good status. The mean Beck Depression Inventory score was 17.9 ± 11.1 among mothers and 17.1±9.95 among fathers. No correlation was determined between socioeconomic status and maternal or paternal depression level (p= 0.64 and p= 0.77, respectively). Similarly, there was no correlation between education level and maternal or paternal levels of depression (p= 0.37 and p= 0.77). Conclusion: Depression levels in both mothers and fathers of children hospitalized in the pediatric intensive care unit are significantly higher than those of the normal population. This study might now be repeated with wider patient groups. This study reveals the need for mothers and fathers of patients to be given psychological counseling and psychiatric support