Traumatic Head Injuries in Infants

We read the article titled " Factors Affecting Mortality in Pediatric Severe Traumatic Cerebral Injury " prepared Özcan et al. published in the fourth issue of your journal in 2022, with great interest. Thanks to the authors and editorial board for this informative and interesting article. However, we would like to point out a few points about infant trauma that may contribute to the discussion of the article

Patients non-covıd-19 diagnosis in pandemic clinics: three case reports

With the pandemic process, the frequency of clinicians' referrals for thoracic imaging has increased. In this article, three cases diagnosed other than COVID-19 in pandemic clinics are presented. A 33-years-old male admitted to the pandemic clinic with sore throat and dyspnea for two days. A large pneumothorax was observed on thorax imaging. The tube thoracostomy was performed. The patient was discharged after 14 days of follow-up. A 31-years-old female patient was admitted to pandemic clinic with the complaints of exertional dyspnea, cough, sore throat and abdominal pain for two weeks. Massive effusion was observed on thorax imaging. As a result of further examinations, the patient was diagnosed with metastatic colon carcinoma. An 18-years-old male patient was admitted to the pandemic clinic with chest pain lasting for a day. Mediastinal emphysema was observed on thorax imaging. The increased number of thoracic imaging during the pandemic process will lead to an increase in the incidence of asymptomatic and subclinical thoracic pathologies. This increase of incidence should be reveled with further epidemiological studies.Pandemi süreciyle birlikte klinisyenlerin toraks görüntülesine başvuru sıklığı artmıştır. Bu yazımızda pandemi kliniklerinde COVİD-19 dışı tanı konulan üç olgu sunulmuştur. Otuzüç yaşında erkek hasta pandemi kliniğine iki gündür devam eden göğüs ağrısı nefes darlığı şikayeti ile başvurdu. Toraks görüntülemesinde geniş pnömotoraks izlendi. Hastaya tüp torakostomi uygulandı. Hasta 14 gün izlem sonrası taburcu edildi. Otuzbir yaşında kadın hasta pandemi kliniğine iki haftadır devam eden efor dispnesi, öksürük, göğüs ağrısı ve karın ağrısı şikayeti ile başvurdu. Toraks görüntülemesinde massif efüzyon izlendi. Ileri tetkikler sonucu hastaya metastatic kolon carsinomu tanısı konuldu. Onsekiz yaşında erkek hasta pandemi kliniğine bir gündür devam eden göğüs ağrısı nedeniyle kabul edildi. Toraks görüntülemesinde mediastinal amfizem izlendi. Pandemik süreç sırasında artan torasik görüntüleme sayısı, asemptomatik ve subklinik torasik patolojilerin görülme sıklığında artışa neden olacaktır. İnsidanslardaki bu artış geniş epidemiyolojik çalışmalar ile ortaya konulmalıdır

Characteristics of school injuries presenting to the emergency department

School injuries account for approximately one-fifth of pediatric injuries. We aimed to investigate the frequency and severity of school injuries among school-aged children and determine clinical diagnoses and surgery requirement data. Methods In this prospective study, children who were admitted to the emergency department due to school accidents over a 5-month period were included. Demographics, activity during trauma, mechanism of trauma, nature, severity, emergency department outcomes, and surgery requirement were evaluated. Results The study included a total of 504 school-aged children, of whom 327 (64.9%) were male and 177 (35.1%) were female. Of the children, 426 (84.5%) had no evidence of injury or minor injury, while 78 (15.5%) had moderate or severe injury. There was a statistically significant difference between these two groups in terms of gender ( p = 0.031). Of the 78 children with moderate or severe injuries, 45 had extremity fractures, 18 had lacerations, 5 had maxillofacial injuries, 4 had cerebral contusion, 1 had lung contusion, and 1 had cervical soft-tissue damage. Two patients with fractures and two with eyelid lacerations were treated surgically, and four patients with brain contusion were hospitalized for a close follow-up. Conclusion This study revealed that the most common moderate or severe injuries in school accidents referred to emergency department were distal radius fractures and lacerations

Evaluation of low tidal volume with positive end-expiratory pressure application effects on arterial blood gases during laparoscopic surgery

Abstract Background: Pneumoperitoneum (PNP) and patient positions required for laparoscopy can induce pathophysiological changes that complicate anesthetic management during laparoscopic procedures. This study investigated whether low tidal volume and positive end-expiratory pressure (PEEP) application can improve ventilatory and oxygenation parameters during laparoscopic surgery. Methods: A total of 60 patients undergoing laparoscopic surgery were randomized to either the conventional group (n ¼ 30, tidal volume ¼ 10 mL/kg, rate ¼ 12/minute, PEEP ¼ 0 cm H 2 O) or the low tidal group with PEEP group (n ¼ 30, tidal volume ¼ 6 mL/kg, rate ¼ 18/minute, PEEP ¼ 5 cm H 2 O) at maintenance of anesthesia. Hemodynamic parameters, peak plateau pressure (Pplat) and arterial blood gases results were recorded before and after PNP. Results: There was a significant increase in the partial pressure of arterial carbon dioxide (PaCO 2 ) values after PNP in the conventional group in the reverse Trendelenburg (41.28 mmHg) and Trendelenburg positions (44.80 mmHg; p ¼ 0.001), but there was no difference in the low tidal group at any of the positions (36.46 and 38.56, respectively). We saw that PaO 2 values recorded before PNP were significantly higher than the values recorded 1 hour after PNP in the two groups at all positions. No significant difference was seen in peak inspiratory pressure (Ppeak) at the reverse Trendelenburg position before and after PNP between the groups, but there was a significant increase at the Trendelenburg position in both groups (conventional; 21.67 cm H 2 O, p ¼ 0.041, low tidal; 23.67 cm H 2 O, p ¼ 0.004). However, Pplat values did not change before and after PNP in the two groups at all positions. Conclusion: The application of low tidal volume þ PEEP þ high respiratory rate during laparoscopic surgeries may be considered to improve good results of arterial blood gases

Analgesia after thoracotomy

Yetersiz ağrı tedavisi hastanın iyileşmesini olumsuz etkiler. Torakotomi bilinen en ağrılı operasyonlardan birisidir (1). Torakotomi sonrası ağrı ile pulmoner fonksiyonlar önemli derecede etkilenir. Bu ağrıya sebep olan faktörler arasında; kotların kesilmesi, çekilmesi, kotların vertebral cisime önden ve sternal kartilaja arkadan yapışan fibröz bağlantılarının koparılması ve çekilmesi ve göğüs duvarı kaslarının kesilmesi yer almaktadır Ağrının yol açtığı komplikasyonlar arasında; solunum hareketlerinde azalmaya bağlı öksürememe ile bronşiyal sekresyonların atılamaması, atelektazi, pnömoni, bronşit, hipoksemi, respiratuar yetmezlik ve uzamış mekanik ventilasyon gibi sorunlar yer almaktadır.Inadequate pain treatment adversely affects the patient's recovery. Thoracotomy is one of the most painful operations known (1). After thoracotomy, pulmonary functions are significantly affected by pain. Factors causing this pain include; pain-related complications include; problems such as failure to cough due to decreased respiratory movements and bronchial secretions, atelectasis, pneumonia, bronchitis, hypoxemia, respiratory failure and prolonged mechanical ventilation

Re-Prealbumin: A New Biomarker for Predicting Prognosis in Patients with Severe COVID-19

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Developing intracranial hypotension after spinal anesthesia

ntrakraniyal hipotansiyon, ortostatik baş ağrısı ile ortaya çıkan beyin omurilik sıvısı (BOS) basıncı düşüklüğü ile karakterize bir tablodur. 30 yaşında, 165cm boyunda ve 64kg ağırlığında olan kadın hastanın spinal anestezi sonrası postoperatif 1. günde enseden başlayıp tüm başına yayılan, ayağa kalkınca artış gösteren baş ağrısı şikayeti olmuş. Olgunun postoperatif 12. günde bu şikayetine çift görme yakınması, bulantı ve kusma şikayetleri eklenmiş. Hasta intrakraniyal hipotansiyon olarak değerlendirildi. Dirençli olmayan intrakraniyal hipotansiyon tedavisinde yatak istirahati, hidrasyon, kafein ve teofilinin etkili bir tedavi yöntemi olduğu kanaatindeyiz.Intracranial hypotension is an entity, which occurs with orthostotic headache and characterized with low cerebrospinal fluid (CSF) pressure. The patient was 30 years old and 165cm height, 64kg weight female patient. She had complaints of headache that began from neck to the all of head, increased by standing up and developed at the first day postoperatively following spinal anesthesia. Diplopia, nausea and vomiting were also noted by the twelfth postoperative day. The patient was evaluated as intracranial hypotension. We believe that bed rest, hydration, caffeine and theophylline administration are effective medical treatment for non resistant intracranial hypotension

Developing intracranial hypotension after spinal anesthesia

ntrakraniyal hipotansiyon, ortostatik baş ağrısı ile ortaya çıkan beyin omurilik sıvısı (BOS) basıncı düşüklüğü ile karakterize bir tablodur. 30 yaşında, 165cm boyunda ve 64kg ağırlığında olan kadın hastanın spinal anestezi sonrası postoperatif 1. günde enseden başlayıp tüm başına yayılan, ayağa kalkınca artış gösteren baş ağrısı şikayeti olmuş. Olgunun postoperatif 12. günde bu şikayetine çift görme yakınması, bulantı ve kusma şikayetleri eklenmiş. Hasta intrakraniyal hipotansiyon olarak değerlendirildi. Dirençli olmayan intrakraniyal hipotansiyon tedavisinde yatak istirahati, hidrasyon, kafein ve teofilinin etkili bir tedavi yöntemi olduğu kanaatindeyiz.Intracranial hypotension is an entity, which occurs with orthostotic headache and characterized with low cerebrospinal fluid (CSF) pressure. The patient was 30 years old and 165cm height, 64kg weight female patient. She had complaints of headache that began from neck to the all of head, increased by standing up and developed at the first day postoperatively following spinal anesthesia. Diplopia, nausea and vomiting were also noted by the twelfth postoperative day. The patient was evaluated as intracranial hypotension. We believe that bed rest, hydration, caffeine and theophylline administration are effective medical treatment for non resistant intracranial hypotension