A retrospective study to describe the clinical pattern of dermatologic lesions from the pediatric emergency department: our experience from a tertiary care hospital in Turkey.

BACKGROUND AND OBJECTIVES: Dermatologic lesions that occur primarily or are secondary to disease are among the most common reasons for referral to the Pediatric Emergency Department (PED). This study aims to reveal the clinical features, diagnostic distribution, and management of patients who presented to the PED with dermatologic lesions. METHODS: The study was a retrospective cross-sectional study involving children aged 0-18 years who presented to Gazi University Faculty of Medicine, PED, in 2018 with dermatologic lesions. The SPSS-20 program was used for data analysis. RESULTS: A total of 1590 patients, 57.8% (919) male, were included in the study. The median age was 75 (minimum: 4 days; maximum: 17 years, 11 months) months. The frequency of dermatologic lesions was 4.33% (433/10,000). Allergic and infectious dermatologic lesions, which are the two most common skin lesions in all age groups, were seen in 46.2% (735) and 30.5% (485) (patients, respectively. Urticaria (n = 588, 37%) was the most common in allergic rashes, and viral rashes (n = 162, 10.2%) were the most common in infectious rashes. Ninety-four percent (1495) of the patients were discharged from the PED. Two patients were hospitalized and followed up as dermatologic emergencies. CONCLUSION: Urticaria and viral eruptions are common dermatologic lesions in our PED. Both conditions are easily recognized and treated by physicians. Most lesions do not require hospitalization. Dermatologic emergencies, although rare, should be well-known to physicians.

Nebulized Ipratropium Bromide-induced Anisocoria: Why Is Anisocoria Observed?

Pharmacological anisocoria is a rare but benign condition. This paper presents an eleven-year-old patient with asthma who developed ipratropium bromide-associated anisocoria during nebulizer treatment. Hypotheses regarding the possible causes of anisocoria are discussed and precautions to be taken during treatment are presented. To prevent the development of anisocoria, it was found that it is important to use the appropriate mask during nebulizer treatment, to place the mask on the face properly, and, if possible, to administer drugs by closing the eyes. Further, it is recommended that patients undergo an ophthalmological examination before discharge and that they and their families be informed that the condition is temporary.

La homeostasis de tiol/disulfuro es un indicador del estrés oxidativo en los niños críticamente enfermos con sepsis / Thiol-disulphide homeostasis is an oxidative stress indicator in critically ill children with sepsis

Objetivo. Evaluar un novedoso marcador del estrés oxidativo (la homeostasis de tiol /disulfuro) en la sepsis pediátrica y determinar sus efectos sobre el pronóstico de esta afección. Métodos. En el estudio, se incluyeron pacientes con diagnóstico de sepsis y controles sanos. Se midieron las concentraciones de tiol total, tiol nativo, disulfuro, disulfuro /tiol total, disulfuro /tiol nativo y tiol nativo/tiol total en los grupos con sepsis y de referencia. Se compararon los parámetros entre los supervivientes y los no supervivientes del grupo con sepsis. Se midieron las concentraciones de hemoglobina, leucocitos, trombocitos, lactato y proteína C-reactiva en los pacientes con sepsis al momento del diagnóstico. Se utilizaron el puntaje de riesgo de mortalidad pediátrico (Pediatric Risk of Mortality, PRISM) y el puntaje de disfunción orgánica (Pediatric Logistic Organ Dysfunction, PELOD) para estimar la gravedad de la enfermedad. Resultados. En el grupo con sepsis se incluyó a 38 pacientes y en el de referencia, a 40 niños sanos. Las concentraciones plasmáticas de tiol en los pacientes con sepsis fueron significativamente inferiores que las del grupo de referencia (p < 0,001). Conclusión. La homeostasis de tiol/disulfuro fue anormal en los niños con sepsis en la unidad de cuidados intensivos pediátricos.

The aim of this study is to evaluate a novel oxidative stress marker (thiol-disulphide homeostasis) in paediatric sepsis and to determine their effects on the prognosis of sepsis. Patients diagnosed with sepsis (n= 38) and healthy controls (n= 40) were incorporated in the study. Total thiol, native thiol, disulphide, disulphide/total thiol, disulphide/native thiol, and native thiol /total thiol levels were measured in the sepsis and control groups. Additionally, the parameters were compared between survivors and non-survivors in the sepsis group. The levels of hemoglobin, white blood cell, platelet, lactate, and C-reactive protein were measured in patients with sepsis at diagnosis. The paediatric risk of mortality and paediatric logistic organ dysfunction scores of the patients were used to estimate the disease severity. The plasma thiol levels of the patients with sepsis were significantly lower than the control group (p < 0.001). This study showed that thiol/disulphide homeostasis is abnormal in children with sepsis in Paediatric Intensive Care Unit.

Thiol-disulphide homeostasis is an oxidative stress indicator in critically ill children with sepsis. / La homeostasis de tiol/disulfuro es un indicador del estrés oxidativo en los niños críticamente enfermos con sepsis.

The aim of this study is to evaluate a novel oxidative stress marker (thiol-disulphide homeostasis) in paediatric sepsis and to determine their effects on the prognosis of sepsis. Patients diagnosed with sepsis (n= 38) and healthy controls (n= 40) were incorporated in the study. Total thiol, native thiol, disulphide, disulphide/total thiol, disulphide/native thiol, and native thiol /total thiol levels were measured in the sepsis and control groups. Additionally, the parameters were compared between survivors and non-survivors in the sepsis group. The levels of hemoglobin, white blood cell, platelet, lactate, and C-reactive protein were measured in patients with sepsis at diagnosis. The paediatric risk of mortality and paediatric logistic organ dysfunction scores of the patients were used to estimate the disease severity. The plasma thiol levels of the patients with sepsis were significantly lower than the control group (p < 0.001). This study showed that thiol/disulphide homeostasis is abnormal in children with sepsis in Paediatric Intensive Care Unit.

Objetivo. Evaluar un novedoso marcador del estrés oxidativo (la homeostasis de tiol /disulfuro) en la sepsis pediátrica y determinar sus efectos sobre el pronóstico de esta afección. Métodos. En el estudio, se incluyeron pacientes con diagnóstico de sepsis y controles sanos. Se midieron las concentraciones de tiol total, tiol nativo, disulfuro, disulfuro /tiol total, disulfuro /tiol nativo y tiol nativo/tiol total en los grupos con sepsis y de referencia. Se compararon los parámetros entre los supervivientes y los no supervivientes del grupo con sepsis. Se midieron las concentraciones de hemoglobina, leucocitos, trombocitos, lactato y proteína C-reactiva en los pacientes con sepsis al momento del diagnóstico. Se utilizaron el puntaje de riesgo de mortalidad pediátrico (Pediatric Risk of Mortality, PRISM) y el puntaje de disfunción orgánica (Pediatric Logistic Organ Dysfunction, PELOD) para estimar la gravedad de la enfermedad. Resultados. En el grupo con sepsis se incluyó a 38 pacientes y en el de referencia, a 40 niños sanos. Las concentraciones plasmáticas de tiol en los pacientes con sepsis fueron significativamente inferiores que las del grupo de referencia (p < 0,001). Conclusión. La homeostasis de tiol/disulfuro fue anormal en los niños con sepsis en la unidad de cuidados intensivos pediátricos.