Objective: This study aimed to examine the causes and clinical course of trauma in trauma patients requiring pediatric intensive care unit (PICU) follow-up and evaluate possible differences related to demographic characteristics, trauma mechanism, trauma severity, and prognosis in refugee children. Material and Methods:The records of 175 patients admitted to our PICU between May 1, 2020 and April 30, 2021 with a preliminary diagnosis of trauma were retrospectively reviewed. The patients were divided into two groups as Turkish citizens and Syrian citizens (refugee children). The obtained data were compared between these two groups.Results: 119 (68%) were Turkish citizens and 56 (32%) were refugees. The median age of the Turkish citizens was 6 (3-12; IQR) years and the median age of the refugee patients was 4 (2-10; IQR) years (p = 0.092). Further, 70 (58.8%) of the Turkish citizens and 43 (76.8%) of the refugee patients were males (p = 0.027). In-vehicle traffic accidents were observed in 27 (22.7%) of the Turkish citizens and 4 (7.2%) of the refugee patients, with the difference being statistically significant (p = 0.011). The rate of non-vehicle traffic accident in the refugee patients was higher than that in the Turkish citizens (23.2% and 10%, respectively) (p = 0.035). Ten patients died due to trauma, of which 7 (5.8%) patients were Turkish citizens and 3 (5.3%) were refugee patients. Conclusion:In our study, we found that non-vehicle traffic accidents were more common in refugee patients, but there was no clinical difference between Turkish citizens and refugee patients. We think that more careful evaluation of immigrant problems, projects, and studies focused on the child population, improvement of socioeconomic conditions, and regular participation in the education system can reduce injury rates.

Aim: It is aimed to describe clinical properties and outcomes of pediatric hemolytic uremic syndrome hospitalized in pediatric intensive care. Material and Method: Our study was intended as observatory and retrospective. Symptoms before PICU admission, interventions before PICU admission, time period before PICU admission in days were defined as pre-PICU findings. Glasgow Coma Score (GCS) at admission, Pediatric Risk of Mortality Score (PRİSM-III), laboratory parameters, medical treatments, extracorporeal treatments data was collected as PICU interventions. Outcomes were examined as days in PICU, days in hospital and survival. Results: Twenty-three patients were included into study. Before PICU admission more than half of the patients were treated with antibiotics. Twenty-two were suffered from diarrhea. 3 patients had non-bloody diarrhea. 3 patients had central nervous system involvement presented as seizures. Intravenous diuretics (86.9%) and oral antihypertensives (73.9%) were the most common treatments in PICU. Eculizumab treatment was required for 6 patients. All patients got fresh frozen plasma. Nearly all of the patients required erythrocyte transfusions (95.6%). If we evaluated renal replacement therapies, 2 (8.6%) patients needed CRRT and 12 (52.7%) patients needed IHD. Extrarenal involvement was spotted in 5 patients (21.7%). Most of the patients were survived (95.3%). Conclusion: Hemolytic uremic syndrome is an important clinic entity. Most patients’ blood pressure could be controlled with oral antihypertensive treatments. Antibiotic prescriptions to diarrhetic patients should be more cautiously. There should be transfusion protocols of clinics about HUS patients to prevent over transfusion.

Objective Hereditary angioedema (HAE) is clinically characterized by recurrent attacks of angioedema. This study evaluated the clinical findings and examination results of patients admitted due to angioedema who then underwent a diagnostic test for HAE. The study aimed to assess the contribution of laboratory findings to the diagnostic process and to determine clinicians’ level of awareness regarding the differential diagnosis of angioedema and the appropriate laboratory tests. Methods Pediatric patients suspected to have HAE based on the presence of angioedema and screened for C1 esterase inhibitor levels and/or function were included in the study. Results A total of 136 patients were evaluated for a preliminary diagnosis of HAE in the presence of angioedema. Angioedema was accompanied by urticaria in 65 patients (47.7%) and itching in 24 patients (17.6%). Patients were evaluated using laboratory tests, C4 levels were studied in 124 patients (91.1%) and were found to be within normal reference limits. C1 esterase inhibitor levels were studied in all patients and were found to be within normal limits. C1 esterase inhibitor function was also studied in 101 patients (74.2%) and was found to be within normal limits. Discussion It was concluded that clinicians keep HAE in mind when encountering angioedema, but that increasing their knowledge of clinical findings that assist in differential diagnosis among angioedema types would be useful. The study authors would like to emphasize that this topic should be included in the specialty training curriculum to raise the awareness of clinicians, especially pediatricians, about clinical HAE findings and the algorithmic approach to the differential diagnosis of angioedema.

Amaç: İnhaler ilaçların tedavi başarısı ancak doğru bir teknikle uygulanırsa mümkün olmaktadır. Hatalı inhaler teknik; terapötik etkinliği azaltır, tedavi uyumunu bozar ve hastalığın yetersiz kontrolüne yol açar. Çalışmamızda; üçüncü basamak çocuk hastanesinde hem yataklı servis hem de poliklinik hizmetlerinde astımlı çocuk hasta takibinde önemli rol üstlenen pediatri asistan hekimlerinin uygun inhaler teknik konusundaki bilgi düzeylerini değerlendirmek ve kısa süreli bir eğitimin bilgi düzeyine katkısını belirlemek amaçlanmıştır. Gereç ve Yöntemler: Tüm katılımcılardan demo cihazlar ve manken kullanarak, inhaler cihaz kullanımını göstermeleri istendi. Bu değerlendirme ‘Ön-Test’ olarak adlandırıldı. Daha sonra katılımcılara maksimum 15 kişiden oluşan gruplar halinde, tüm uygulama basamaklarını içeren yüz yüze inhaler cihaz kullanım eğitimi verildi. Eğitim sonunda inhaler cihaz kullanımına ait basamaklar tekrar değerlendirildi. Bulgular: Ölçülü Doz İnhaler ve Kuru Toz İnhaler cihazlara ait inhaler teknik ile ilgili eğitim öncesi değerlendirme sonucunda 148 katılımcıdan hiçbirinin önceden belirlenmiş zorunlu basamakları eksiksiz tamamlayamadığı görüldü. Eğitim sonrasında tüm katılımcıların önceden belirlenen kontrol listesinin adımlarını tam olarak uygulayabildikleri gözlemlendi. Sonuç: Tıp fakültesi müfredatı ve uzmanlık eğitim sürecine astım tedavisi için son derece önemli olan inhaler cihazların uygulama eğitiminin dahil edilmesi gerektiğine dikkat çekmek istiyoruz. Sağlık profesyonelleri arasında, inhaler teknik uygulamalarını içeren hizmet içi eğitimlerin düzenli aralıklarla tekrarlanması uygulamadaki hataları gidermekle birlikte astım tedavisinde doğru inhaler tekniğin önemi konusundaki farkındalığı da arttıracaktır.