THE EFFECT OF COVID-19 OUTBREAK ON THE MENTAL STATUS OF HEALTH CARE PROFESSIONALS IN THE PEDIATRIC INTENSIVE CARE UNIT

Background: Coronavirus disease 2019 (COVID-19) may affect the mental status of health care professionals. The purpose of our study is to evaluate the mental health effects of the COVID-19 epidemic on health care professionals in the pediatric intensive care units (PICUs). Subjects and methods: Our study was conducted prospectively between 01.04.20 and 10.04.20. The created questionnaire was applied to health care professionals through online platforms. Thus it was involved in 5 different institutions that participated from different regions of Turkey. With the questionnaire, we applied; the participants\u27 age, gender, the general status of contamination and the level of COVID-19 knowledge were questioned. Besides; Beck Anxiety Scale, Acute Stress Scale (PCL-5), STAI-1 and STAI-2 (State and Trait Anxiety Inventory 1-2) scales were used to determine the anxiety levels. Results: A survey of 210 participants, 86 (41%) doctors, 124 (59%) nurses, were included in our study. When we evaluate the Beck anxiety levels, the majority of the participants (44%) were normal, while about one third had mild anxiety. When we evaluated the acute stress scale, all participants had a certain amount of stress levels. The majority (80 people each (38%)) experienced mild and moderate acute stress. Being female and having chronic disease poses a high risk for anxiety (OR, 0.330; 95% CI, 0.087-1.250, p <0.05 and OR, 0.246; 95% CI, 0.068-1.116, p<0.05), preoccupation (OR, 0.603; 95% CI 0.261-1.395, p<0.05 and OR, 0.433; 95% CI, 0.122-1.538, p<0.05) and acute stress (OR, 0.294; 95% CI, 0.033-2.649, p<0.05 and OR, 0.317; 95 % CI 0.060-1.679, p<0.05). Professional definition, marital status and having a child do not pose any risk factors. Conclusion: Our study has shown that the COVID-19 outbreak affects the mental status of health care professionals working at PICU at various levels

THE EFFECT OF COVID-19 OUTBREAK ON THE MENTAL STATUS OF HEALTH CARE PROFESSIONALS IN THE PEDIATRIC INTENSIVE CARE UNIT

Background: Coronavirus disease 2019 (COVID-19) may affect the mental status of health care professionals. The purpose of our study is to evaluate the mental health effects of the COVID-19 epidemic on health care professionals in the pediatric intensive care units (PICUs). Subjects and methods: Our study was conducted prospectively between 01.04.20 and 10.04.20. The created questionnaire was applied to health care professionals through online platforms. Thus it was involved in 5 different institutions that participated from different regions of Turkey. With the questionnaire, we applied; the participants\u27 age, gender, the general status of contamination and the level of COVID-19 knowledge were questioned. Besides; Beck Anxiety Scale, Acute Stress Scale (PCL-5), STAI-1 and STAI-2 (State and Trait Anxiety Inventory 1-2) scales were used to determine the anxiety levels. Results: A survey of 210 participants, 86 (41%) doctors, 124 (59%) nurses, were included in our study. When we evaluate the Beck anxiety levels, the majority of the participants (44%) were normal, while about one third had mild anxiety. When we evaluated the acute stress scale, all participants had a certain amount of stress levels. The majority (80 people each (38%)) experienced mild and moderate acute stress. Being female and having chronic disease poses a high risk for anxiety (OR, 0.330; 95% CI, 0.087-1.250, p <0.05 and OR, 0.246; 95% CI, 0.068-1.116, p<0.05), preoccupation (OR, 0.603; 95% CI 0.261-1.395, p<0.05 and OR, 0.433; 95% CI, 0.122-1.538, p<0.05) and acute stress (OR, 0.294; 95% CI, 0.033-2.649, p<0.05 and OR, 0.317; 95 % CI 0.060-1.679, p<0.05). Professional definition, marital status and having a child do not pose any risk factors. Conclusion: Our study has shown that the COVID-19 outbreak affects the mental status of health care professionals working at PICU at various levels

Evaluation of renal near-infrared spectroscopy for predicting extubation outcomes in the pediatric intensive care setting

BackgroundIn pediatric intensive care units, extubation failure following invasive mechanical ventilation poses significant health risks. Determining readiness for extubation in children can minimize associated morbidity and mortality. This study investigates the potential role of renal near-infrared spectroscopy (RrSO2) in predicting extubation failure in pediatric patients.MethodsA total of 84 patients aged between 1 month and 18 years, mechanically ventilated for at least 24 h, were included in this prospective study. RrSO2 levels were measured using near-infrared spectroscopy before and during an extubation readiness test (ERT). The primary outcome measure was extubation failure, defined as a need for reintubation within 48 h.ResultsOf the 84 patients, 71 (84.6%) were successfully extubated, while 13 (15.4%) failed extubation. RrSO2 was found to be lower in the failed extubation group, also decrease in RrSO2 values during ERT was significantly greater in patients with extubation failure. ROC analysis indicated a decrease in ΔRrSO2 of more than 6.15% from baseline as a significant predictor of extubation failure, with a sensitivity of 0.984 and a specificity of 0.889.ConclusionMonitoring changes in RrSO2 values may serve as a helpful tool to predict extubation failure in pediatric patients. Further multi-center research is warranted to improve the generalizability and reliability of these findings

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

Sudden sensorineural hearing loss associated with electronic cigarette liquid: the first case in the literature

Demir, Emine/0000-0003-4087-432X; Demir, Emine/0000-0003-4087-432XWOS: 000447580700006PubMed: 30262362Pediatric sudden sensorineural hearing loss (SSNHL) is a quite rare otologic emergency. Etiology of SSNHL isn't enough clear. Electronic cigarette (EC) is a device that uses increasingly and it contain liquid which keep nicotin and various chemicals. This liquid can be ingested mistakenly by children and various side effects may develop. But hearing loss wasn't reported before as a side effect. We presented an interesting case, she was 6-year-old who developed bilaterally SSNHL associated with drinking electronic cigarette liquid

The Differences in Viral Etiologies between Children with and without Severe Disability Admitted to the Pediatric Intensive Care Unit with Acute Respiratory Illness

Objectives The objectives of this study were to evaluate the differences in the viral etiologies and variability in the clinical course between children with and without severe disability (SD) admitted to the pediatric intensive care unit (PICU) with acute respiratory illness (ARI)

Otologic Findings Based on no Complaints in a Pediatric Examination

Demir, Emine/0000-0003-4087-432X; Demir, Emine/0000-0003-4087-432X;WOS: 000455643900007PubMed: 30647782Introduction the otological evaluation is highly significant in those branches of medicine in which the general evaluation of the patient is conducted by general practitioners and pediatricians. Objectives To investigate the otologic findings and their incidences in the sample, which consisted of patients who presented to the pediatric outpatient clinic with non-otologic complaints. Methods Patients, aged between 2 and 16 years, who had neither otorhinolaryngological complaints nor history of surgery by the otolaryngology (ear, nose and throat, ENT) department were included in the present study. the findings detected in the external auditory system and in the tympanic membranes as well as the otorhinolaryngologist's otologic examination findings of the referred patients were recorded from the files of each patient along with the applied medical and surgical treatments, and diagnostic investigations. Results of a total of 973 patients evaluated, 129 (13.2%) were referred to the ENT outpatient clinic due to any otologic pathology. in the otorhinolaryngological examinations, false positivity was detected in 12 (1.2%) patients, and pathological findings were detected in 117 (12%) patients who received the following diagnoses: 68 (6.9%) had otitis media with effusion(OME); 37 (3.8%) had cerumen impactions; 8 (0.8%) had acute otitis media (AOM); 2 (0.2%) had ticks in the external auditory canal; 2 (0.2%) had a retraction pocket in tympanic membrane; 1 (0.1%) had unilateral central dry perforation of the tympanic membrane; and 1(0.1%) had congenital cholesteatoma. Conclusion Any complications and sequelae that may develop due to any pathologies and predominantly infections can be prevented by an early diagnosis, which can be made by means of a simple examination, performed merely with an otoscope. Pediatricians and general practitioners should be in close contact with otorhinolaryngologists regarding the pathologies they identify

A rare cause of anaphylaxis: Cold exposure

WOS: 000430370600012Fiziksel ürtikerin bir formu olan soğuk ürtikeri, cildin soğuk ile teması sonrası mast hücrelerinden histamin ve diğer proinflamatuvar mediatörlerin salınımı ile oluşmaktadır (1). Tüm fiziksel ürtikerler arasında soğuk ürtikeri semptomatik dermografizmden sonra ikinci sıklıktadır (2,3). Soğuğa maruziyet histamin ve diğer proinflamatuvar mediyatörlerin salınımı ile ürtiker ve/veya anjioödem gelişimine neden olabilmektedir (2,4). Tipik olarak soğuk hava, soğuk sıvı ve nesneler ile temas sonrası dakikalar içinde semptomlar ortaya çıkmaktadır. Semptomların ortaya çıkması 2 saate kadar uzayabilir (3). Deri temas yüzeyi daha geniş olduğunda (soğuk suda yüzme vb.) jeneralize ürtiker, dispne, taşikardi, hipotansiyon, bilinç kaybı gibi yaşamı tehdit edebilen sistemik reaksiyonlar gelişebilmektedir (4). Genellikle yalnızca deriyle temas eden bölgede bulgu verir. Semptomların ortalama süresi 4,8-7,9 yıl arasında değişmektedir (3). Soğuk ürtiker sıklığı yaklaşık %0,05 olarak tahmin edilmektedir (3,5). Fiziksel ürtiker çeşitleri içindeki oranı coğrafik özelliklere bağlı olarak değişebilmekte ve sıklığı %5,2 - %33,8 arasındadır (5). Çocuklarda soğuk ile tetiklenen anaflaksi ise çok nadirdir ve literatürde olgu sunumu şeklinde yer almaktadır. Aşağıda soğuk su ile anaflaksi gözlenen iki çocuk olgu sunulmuştur

The Use of Lactobacillus Rhamnosus Gg, Saccharomyces Boulardii, and Pediococcus acidilacticii C69 to Control Vancomycin-resistant Enterococci Colonization in a Rat Model

Objective: Vancomycin-resistant enterococci (VRE) are responsible for a considerable amount of healthcare-associated infections. In this study, we investigated the ability of three probiotic organisms to eliminate VRE colonization or protect against gastrointestinal (GI) epithelium-induced injury in a rat model

A neglected cause of recurrent rhabdomyolysis, LPIN1 gene defect: a rare case from Turkey

Background. Rhabdomyolysis; can occur due to toxic, infectious, metabolic, and genetic causes. Severe rhabdomyolysis may progress to several clinical manifestations such as cardiac arrest and may pose a risk of mortality if it is not treated timely