Objectives The hyperinflammatory state and the viral invasion may result in endothelial dysfunction in SARS-CoV-2 infection. Although a method foreseeing microvascular dysfunction has not been defined yet, studies conducted in patients diagnosed with COVID-19 have demonstrated the presence of endotheliitis. With this study, we aimed to investigate the microvascular circulation in patients diagnosed with COVID-19 and multisystem inflammatory syndrome in children (MIS-C) by nailfold videocapillaroscopy (NVC). Methods Thirty-one patients with SARS-CoV-2 infection, 25 of whom were diagnosed with COVID-19 and 6 with MIS-C and 58 healthy peers were included in the study. NVC was performed in eight fingers with 2 images per finger and 16 images were examined for the morphology of capillaries, presence of pericapillary edema, microhemorrhage, avascular area, and neoangiogenesis. Capillary length, capillary width, apical loop, arterial and venous width, and intercapillary distance were measured from three consecutive capillaries from the ring finger of the non-dominant hand. Results COVID-19 patients showed significantly more capillary ramification ( p < 0.001), capillary meandering ( p = 0.04), microhemorrhage (p < 0.001), neoangiogenesis (p < 0.001), capillary tortuosity ( p = 0.003). Capillary density ( p = 0.002) and capillary length (p = 0.002) were significantly lower in the patient group while intercapillary distance ( p = 0.01) was significantly longer compared with healthy volunteers. Morphologically, patients with MIS-C had a higher frequency of capillary ramification and neoangiogenesis compared with COVID-19 patients (p = 0.04). Conclusion Abnormal capillary alterations seen in COVID-19 and MIS-C patients indicate both similar and different aspects of these two spectra of SARS-CoV-2 infection and NVC appears to be a simple and non-invasive method for evaluation of microvascular involvement.

No abstract

No abstract

Purpose: Successful resuscitation and early defibrillation are critical in survival after in- or out-of-hospital cardiopulmonary arrest. This study aimed to determine the knowledge, skills, and attitudes of the pediatric healthcare professionals about the defibrillator use and to offer solutions if there was room for improvement. Procedures: This was a multicenter survey study. Findings: The study included 716 healthcare professionals with an average age of 30.1 ± 5.8 years; 50% (n=358) were pediatric residents and 41.3% (n=296) had less than three years of professional experience. Self-declared level of knowledge about defibrillation/cardioversion was low-to-medium for 66.5% (n=476); 60.8% (n=435) had never practiced these procedures and 22.2% (n=159) had never received any training about defibrillator use. There was a significant relationship between professional experience and the proportion of participants who correctly responded to the first-shock dose for defibrillation but not for cardioversion. Conclusion: Professional experience is crucial in the correct defibrillator use. However, the defibrillation/cardioversion procedures are prone to errors since they are not commonly applied in day to day practice. An ideal approach to improve the experience of personnel could be to use practical training with case-based simulations and to educate the personnel about the features of the defibrillators available in their clinics.

Koronavirüs hastalığı-2019'da (COVID-19), asemptomatik ve hafif-orta semptomatik bireylerden oluşan alt grupta göğüs bilgisayarlı tomografinin (BT) yararları tartışmalıdır. Çoğu hasta bu alt grupta olduğundan, triyaj için, en yüksek tanı performansına ve en az riske sahip tanı aracını seçmek gerekir. Ağır hastalık bulguları olmayan COVID-19 şüphesi olan bireylerde göğüs BT bulgularını ve ilk göğüs BT duyarlılığını değerlendirmeyi amaçladık. Gereç ve Yöntem:Retrospektif bir çalışma yürüttük. Hafif-orta derecede klinik bulguları olan semptomatik bireyler ve COVID-19 pozitif hasta ile yakın temasta bulunan asemptomatik bireyler çalışmaya dahil edilmiştir. Ağır klinik bulguları olan bireyler dışlandı. Başvuru gününde ters