Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9–12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells × μL, p = 0.028; platelet count 166 vs. 216 cells × 10 3 /μL, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 µg/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% ( p < 0.001, 95% CI 0.217–0.550), lethargy increased the risk of overlap with KD by 2.6-fold ( p = 0.011, 95% CI 1.244–5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% ( p < 0.001, 95% CI 0.298–0.559). Conclusion : Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD. What is Known: • In some cases of MIS-C, the clinical symptoms overlap with Kawasaki disease. • Compared to Kawasaki disease, lymphopenia was an independent predictor of MIS-C. What is New: • Half of the patients had clinical features that overlapped with Kawasaki disease. • In patients whose clinical features overlapped with KD, procalcitonin levels were almost 15 times higher than normal. • Lethargy increased the risk of overlap with KD by 2.6-fold in MIS-C pa...

Our results indicate that pediatric patients with ALL should be screened for transfusional iron load and the amount of erythrocyte transfusions seems to be a more reliable indication than serum ferritin levels to detect cardiac iron loading in these patients.

Objectives Foreign body aspiration (FBA) has a wide clinical spectrum, patients may be asymptomatic or present with cardiopulmonary arrest. Radiological imaging methods are used in addition to history and physical examination findings for certain diagnosis. Lung ultrasonography (LUS), whose usage area is increasing year by year, can be included in these. This study aimed to investigate ultrasonography findings in FBA and hypothesized that LUS may have a standard place in FBA diagnosis. Methods Patients who administered to the pediatric emergency department between August 2019–August 2021, considered according to the clinical findings and physical examination possible FBA, and who undergone rigid bronchoscopy by pediatric surgery were included in the study. Results Thirty‐two patients were included in the study. According to the results of bronchoscopy, FBA was detected in 25 patients. The most common finding in radiography was hyperinflation on one side, while LUS findings were confluent‐B lines in eight patients, barcode‐sign in five patients, pleural line abnormalities in two patients, and pleural consolidation in two patients. Conclusion This study is the first study aiming to evaluate LUS findings in FBA to the best of our knowledge. The B‐lines, barcode sign, pleural line abnormalities and consolidation are seen findings in LUS of the patients with FBA. Although it is far from replacing chest radiography in these patients, it is possible to say that it has an equivalent value with chest radiography.

Background. High-flow nasal cannula (HFNC) is widely used as a feasible and tolerable respiratory support method. However, patients should be closely monitored, especially when used with moderate-severe respiratory distress indications. Because these patients can easily develop respiratory failure and escalated care may be required. The aim of this study is to determine the predictive factors in patients treated with HFNC who received escalated respiratory support for HFNC failure.Methods. A retrospective study of patients admitted with respiratory distress and treated with HFNC therapy between January 2014 and December 2018 was carried out. The variables evaluated were age, gender, vital signs before and two hours post HFNC therapy, underlying disease, use of steroid, salbutamol and antibiotic therapy, blood gase analysis and lactate values, hospitalization in pediatric intensive care unit, respiratory viral panel and need for escalation of respiratory support. HFNC failure was identified requiring noninvasive or invasive respiratory support despite HFNC therapy.Results. 243 patients receiving HFNC therapy were included in this study. The median age was 11 months [interquartile range(IQR) 5-27]. The diagnosis of 183 patients (75.3%) were acute bronchiolitis and 60 patients (24.7%) were pneumonia. Of 243 patients, 29 (%11.9) received escalated care. 22 invasive and 7 non-invasive respiratory supports were provided. The lower pH on admission was found in the non-responder group. Moreover, heart rate and respiratory rate did not decrease two hours after HFNC therapy.Conclusions. The careful monitoring of patients receiving HFNC therapy is critical. Because these patients are at risk for needing escalated care. We found that low pH values on admission and high pulse rate and respiratory rate observed at the second hour of follow-up period could be predictive factors for HFNC failure.

Background and Objectives: The aim of the study was to test the effectiveness of the peer education method on the learning and application of Basic Life Support (BLS) in high school students and to test the effectiveness of the peer education model on the BLS instructor training. Methods: High school grade one students were included in the study. Students were divided in two groups (Group A and Group B). Peer instructors who were trained by health professionals trained students in Group A. Peer instructors who were trained by their peers trained students in Group B. Pre- and post-training awareness and knowledge tests were applied to measure the awareness and knowledge of all students. Students’ success in applying BLS steps was evaluated by a practical exam that was coordinated by physicians using a checklist. Results: Result of the pre-post training awareness questionnaire, pre-post training knowledge tests, and practical exam indicated that instructors trained by their peers were as effective as the instructors trained by medical physicians in terms of giving BLS training to high school students. In the 16-step BLS application competence evaluation, the students in Group A applied BLS with a success rate of 90.2% and in Group B with a success rate of 93.4%. Conclusion: In the current study, it was shown that the peer education model is effective in BLS training and BLS instructor training in high school students. This novel method of peer education gives an opportunity to overcome the stated shortage in the budget and in trained instructors.