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Papers by sabri demir

Turkish Journal of Medical Sciences, 2021

The aim of this study was to investigate the healing effects of bone marrow-derived mesenchymal s... more The aim of this study was to investigate the healing effects of bone marrow-derived mesenchymal stem cells (BM-MSCs) on experimental testicular torsion in rats. Materials and methods: Three groups consisting of 10 Wistar albino rats were created. In Group I, the left testicle was explored and relocated in the scrotum without any attempt to modify it. In Group II, the left testicle underwent torsion for three h and then was detorsed and relocated. In Group III, in addition to torsion and detorsion, BM-MSCs were administered intratesticularly. The rats were sacrificed on the seventh day, and the healing status of the testicles was investigated with histopathological and biochemical analyses. BM-MSC involvement was investigated by immunofluorescence microscopy. Statistical analysis was performed using SPSS 15.0. A p-value < 0.05 was considered statistically significant for all variables. Results: Immunofluorescence microscopy showed that BM-MSCs were located around the Leydig cells in Group III. Under light microscopy, the mean Johnsen Score of Group III was significantly higher than that of Group II (p = 0.035). The interleukin-10 (IL-10) level was significantly higher in Group III compared to Group II (p = 0.003). While the malondialdehyde (MDA) values in Group I (the control group) were lower than in the other groups (p = 0.037), the superoxide dismutase (SOD) values were similar (p = 0.158). Although there was no statistically significant difference between Group II and Group III in terms of MDA, it was lower in Group III. Although the tissue SOD levels were higher in Group III than in Group II, the difference was not statistically significant. Conclusion: This study has demonstrated that BM-MSCs significantly corrected the Johnsen Score and increased anti-inflammatory cytokine levels after testicular torsion. BM-MSCs can be used in testicular torsion as supportive therapy to minimize tissue damage.

Türkiye çocuk hastalıkları dergisi, Mar 27, 2020

Objective: We aimed to investigate the potential of assessing thiol/disulfide homeostasis as nove... more Objective: We aimed to investigate the potential of assessing thiol/disulfide homeostasis as novel oxidative stress markers to improve the challenging diagnosis of acute appendicitis in children. Material and Methods: A total of 60 pediatric patients (0-18 years) were enrolled in the study, 30 of which were in the control group and 30 in the acute appendicitis group. Native thiol, total thiol, dynamic disulfide, dynamic thiol, ischemia modified albümin, albumin, White blood cell, hemoglobin, hematocrit, and platelet counts of both groups were measured. The results of both groups were compared using the SPSS (Statistical Package for Social Sciences) version 17 (Chicago, USA) program. For all variables, p <0.05 was considered significant. Results: Total thiol (p<0.001), native thiol (p<0.001), and albümin (p<0.001) levels were significantly decreased while dynamic disulfide, dynamic thiol (p=0.003), and ischemia modified albümin (p<0.001) levels those indicating oxidant side were increased in acute appendicitis group compared to control. White blood cell counts in acute appendicitis group were higher (p<0.001), and platelet counts were lower (p=0.03) than the control group. Conclusion: In the differential diagnosis of acute appendicitis, especially in case that are difficult to diagnose, besides a physical examination, imaging, and current laboratory tests, quantification of thiol/disulfide homeostasis may be helpful in diagnosing. In addition, evaluating albumin and IMA levels may increase the specificity of the test. This test can be more helpful in cases diagnosis is difficult such as children small in their ages and mental retardation.

Pediatric practice and research, Sep 1, 2022

Objective: We compare the diagnostic approaches: surgeon prediction, surgeon prediction plus ultr... more Objective: We compare the diagnostic approaches: surgeon prediction, surgeon prediction plus ultrasound imagining (US) as the first-line imaging modality, and magnetic resonance imagining (MRI) as the second-line imaging for suspected pediatric appendicitis. Material and Method: Three hundred sixty-one patients with a clinically suspected appendicitis were prospectively divided into three groups by the type of diagnostic approach. Results: A total of 51 patients were diagnosed via only the surgeon prediction. Of the patients, 254 only underwent a US examination, and 56 patients underwent both US and MRI. Considering the diagnostic groups, the accuracy of both the "surgeon prediction only" and "surgeon prediction + US + MRI" groups was 100%. The "surgeon prediction + US" group revealed a sensitivity value of 62,4% with an accuracy rate of 59,8%. The sensitivity and specificity of US were 61,0%, 65,5%, respectively. These values were 100% for MRI. The sensitivity, specificity of our institutional algorithm were 100,0%, 94,4%, and the positive-negative predictive values were 94,7%, 100%. Conclusions: To diagnose appendicitis in children, surgeon's assessment, prudence, and clinical evaluation should be the first method of diagnosis. US is a useful method to support surgeons in ensuring an accurate diagnosis, and MRI can be trusted as an additional method to verify a correct diagnosis.

Türkiye çocuk hastalıkları dergisi, Mar 11, 2022

Objective: Persistent air leaks remain one of the most complications that delay chest tube remova... more Objective: Persistent air leaks remain one of the most complications that delay chest tube removal and prolonged hospitalization. In literature, there are limited but favorable results about autologous blood patch pleurodesis (ABPP) for prolonged air leaks (PAL). We aimed to describe our experiences with ABPP for PAL regarding its effectiveness and reliability in children. Material and Methods: A retrospective single-center study was performed on patients under 18 years of age with PAL. PAL was defined as the presence of alveolar-pleural fistulas lasting longer than 5 days. The etiological causes including previous thoracic surgery, thoracic trauma, and spontaneous pneumothorax of PAL were included. The study took into account patients from January 1, 2016, to December 1, 2021. Autologous blood patch pleurodesis (ABPP) was performed through a pre-existing chest tube. 1-2 cc/kg of fresh whole blood that was taken from a peripheral vein and instilled through the existing chest tube on day 1. The procedure was repeated on days 2 and 4 if the air leak persisted with a maximum limit of three. During the follow-up period, complications of the procedure were evaluated. Complete success was considered as resolving air leaks. Results: Of 11 children, males were more common (n=7, 63.9%). The mean age of children who underwent ABPP for PAL was 13.4±2.1 years (IQR 10-17). The mean number of repeating procedures was 1.8 ranging from 1 to 3 applications. In our study group, thoracic procedures secondary to spontaneous pneumothorax were the most common etiologic cause. Most of the patients had PAL during forced expiration only (n=6, 54.5%), and the mean number of ABPP applications was found 1.7 in this group. But the patients having continuous PAL required 3.1 applications for improvement (mean value). Complete recovery was possible in six cases after the first application (54.5%). PAL improved in all cases after repeating ABPP procedures (100% healing). We had seen no complications in terms of respiratory distress due to the application of ABPP or infection. Conclusion: We report about our experiences of autologous blood patch pleurodesis (ABPP) in children as an alternative treatment option for PAL. ABPP is an easily applicable therapy with high effectiveness and being away from complications and, the use of ABPP for PAL was successful in all patients of our series.

The Turkish Journal of Pediatrics

Background. Mass lesions of the umbilical cord are rare anomalies. There have been rare reports o... more Background. Mass lesions of the umbilical cord are rare anomalies. There have been rare reports of hemangiomas of the umbilical cord, but the co-occurrence of omphalocele and hemangioma of the umbilical cord has not been previously reported. Nonetheless, the condition is clinically significant as it may cause the disturbance of intrauterine fetal circulation, retardation of fetal growth and development, non-immune hydrops fetalis, morbidity and mortality. Case. Here we aim to report a case that was prenatally diagnosed with an omphalocele and that presented after birth with a hemangioma on the omphalocele sac. Conclusions. When dealing with umbilical mass lesions in the prenatal and postnatal periods, a hemangioma on the omphalocele sac should be considered in the differential diagnosis of patients when an omphalocele is suspected.

Turkish Journal of Pediatric Disease, 2021

Objective: Corrosive burns of esophagus occurring in childhood has life-threatening complications... more Objective: Corrosive burns of esophagus occurring in childhood has life-threatening complications. Its detection via biochemical substrates instead of performing esophagoscopy is crucially important for children. Determination of oxidative stress markers including thiol/disulfide homeostasis and ischemia modified albumin levels may provide valuable information for corrosive esophageal burns. The study aims to investigate the relation between esophageal corrosion and thiol/disulfide homeostasis and ischemia-modified albumin levels in children. Material and Methods: Eighteen patients who underwent esophagoscopy due to corrosive substances intake (esophagoscopy group) and age and gender-matched 18 volunteers (control group) were included study. Blood levels of native thiol (-SH), total thiol (SH+SS), dynamic disulfide (SS), albumin and ischemia modified albumin (IMA) were measured in both groups. SPSS 17.0 was used for analyses and p <0.05 was considered significant. Results: Laboratory results of cases with esophageal burn (n = 13) and without burn (n = 5) and control (n = 18) were compared. There was a significant decrease in levels of dynamic disulfide (p=0.03), and dynamic disulfide/total thiol ratio (p=0.01) of children with esophageal burn compared with that of children with no burn or were found to be statistically significant. Conclusion: Decreased levels of disulphide and dynamic disulfide/total thiol ratio would be used as a laboratory test to show corrosion in the esophagus. However, randomized, multicentric studies with larger samples are needed.

Pediatric Practice and Research, 2021

Aim: We aimed to retrospectively evaluate the patients with labial fusion who presented to or wer... more Aim: We aimed to retrospectively evaluate the patients with labial fusion who presented to or were referred to the pediatric surgery clinic in a tertiary pediatric hospital. Material and Method: Between 01/01/2005 and 31/12/2020, 889 patients admitted or consulted to the pediatric surgery clinic due to labial fusion, age at the time of diagnosis, complaints on admission, which clinic referred the patient to the pediatric surgery clinic, treatments, recurrence, and complications were evaluated retrospectively. Results: The mean age of the patients was 2.21 (0.1–11) years. Most of the patients (82.5%) were asymptomatic. Parents noticed the condition and brought their child directly to the pediatric surgery clinic in 72.3% of the cases. Otherwise, patients were consulted to the pediatric surgery clinic from pediatric clinics, the pediatric endocrinology clinic, the pediatric nephrology clinic, or the pediatric emergency department. During the initial examination, manual separation was ...

Türkiye çocuk hastalıkları dergisi, Sep 23, 2021

Objective: The COVID-19 pandemic has led to major changes in healthcare around the world, includi... more Objective: The COVID-19 pandemic has led to major changes in healthcare around the world, including postponing elective surgery. The aim of this study is to examine the COVID-19 test results in pediatric patients who are asymptomatic and have no history of contact with a COVID-19 case prior to their scheduled elective surgery. Material and Methods: This prospective study has evaluated pediatric patients who were asymptomatic and had no contact history with a COVID-19 case and who were scheduled for elective surgery between 01.05.2020-31.10.2020 in one of the world's largest pediatric hospitals. Nasopharyngeal swab (PCR) samples were obtained from all patients one day before the scheduled elective surgery. Results: Eight hundred twelve patients in this study had a mean age of 6.98 ± 4.37 years. The PCR test was positive in 4 patients (0.49%), and one patient had diarrhea during the quarantine period of 15 days. Conclusion: The low PCR positivity rate in patients scheduled for elective surgery after a detailed history and physical examination raises the question whether elective surgery can be planned without testing. Pediatric surgeons can continue elective surgical procedures by taking precautions, but without requesting PCR, in patients who are asymptomatic and have no suspicious contact history.

The Turkish journal of gastroenterology, Feb 17, 2020

Bezoars are accumulated collections of indigestible material in the gastrointestinal tract. Altho... more Bezoars are accumulated collections of indigestible material in the gastrointestinal tract. Although their true incidence in the pediatric population is unknown, bezoars usually occur in females, adolescents, and children with psychiatric or neurological disorders (1).

Pediatric Surgery International, Mar 23, 2020

Aim We aimed to determine predictive factors for predicting cystobiliary fistulas (CBF) in childr... more Aim We aimed to determine predictive factors for predicting cystobiliary fistulas (CBF) in children after treatment of liver hydatid cyst (LHD). Methods The records of patients who were treated for LHD between 01.06.2009 and 1.06.2019 were retrospectively reviewed. Age, sex, laboratory test results, size and number of cysts, method of first intervention (percutaneous or surgery), whether or not CBF developed and how it was treated were investigated. Among findings, those could be predictive were investigated. Data were evaluated with SPSS 21.0 program, p < 0.05 was considered significant. Results Of the 97 patients, 48 (49.5%) were male, 49 (50.5%) female, the mean age was 11.2 years, Eighty patients had right (82.5%), 13 had left, and 4 had bilobar involvement. As first intervention, surgery was performed in 39 (40.2%); percutaneous treatment was performed in 58 (59.8%) patients. In 8 patients (20.5%) in surgery group and in 6 patients (10.3%) in percutaneous group, totally in 14 patients (14.4%), CBF developed. The mean cyst diameter of CBF-developed group was 114.36 mm, and of CBF-undeveloped group was 74.30 mm. There was no statistically significant differences between groups in terms of age, sex, involved lobe, other organ involvement, and preoperative results ( p > 0.5). There was a significant relationship between the cyst diameter and the rate of CBF development in both surgical and percutaneous groups ( p < 0.05). ROC analysis was performed, and the cut-off value for the development of CBF detected as 69 mm for children. Since obstructive jaundice seen in adults is not common in children, an increase in liver function tests and bilirubin levels were not seen in our patients. Conclusion A significant correlation was found only between the size of the cyst and developing CBF. Cysts greater than 69 mm have a higher risk of developing CBF after both percutaneous and surgical treatment and should be closely monitored.

Annals of Pediatric Surgery, Sep 22, 2022

Background: The aim of the study is to evaluate the clinical characteristics and compare the trea... more Background: The aim of the study is to evaluate the clinical characteristics and compare the treatment methods for perianal abscesses by assessing our treatment experiences. Methods: We have retrospectively analyzed the records of the children who received perianal abscess and fistulain-ano treatment between January 2014 and January 2022. Demographic information of the patients, complaints, treatment procedures, abscess recurrence, and development of fistula-in-ano was evaluated. Patients with systemic diseases and inflammatory bowel diseases were excluded from the study. Results: A total of 312 children (230 boys, 82 girls) were included in the study. The median age was 24.3 ± 18.1 months (1-216). In the first examination, 61 (19.5%) patients had fistula-in-ano and 25 1(80.5%) patients had a perianal abscess. The most common symptoms were erythema in the perianal region, mass, constipation, rectal bleeding, and inability to defecate. Spontaneous drainage was determined in 34.3% (n = 86) of the perianal abscess, and 65.7% (n = 165) of perianal abscesses were treated with incision-drainage without general anesthesia and systemic antibiotherapy. In the follow-up, fistula-in-ano formed in 27 patients who had a perianal abscess. Twenty-four of the patients who developed fistula-in-ano, were seen after spontaneous drainage, and 3 of them were seen after incision drainage. Perianal abscess recurred in 64 patients. Spontaneously drained abscess significantly increased the development of fistula-in-ano (p = 0.001). However, recurrences in a perianal abscess (25.4%) do not increase the fistula-in-ano formation (p > 0.05). In fistula-in-ano treatment, 10 (11.5%) patients were resolved spontaneously, 70 (79.5%) patients were treated with fistulotomy and 8 (9%) patients were treated with fistulectomy. Conclusion: Treatment of perianal abscess and fistula-in-ano in children is still controversial. According to our results, incision-drainage and antibiotic usage in the treatment of the perianal abscess are the most appropriate treatment to decrease the rate of fistula-in-ano.

Türkiye çocuk hastalıkları dergisi, Jun 27, 2022

Objective: We aimed to investigate the epidemiological and characteristic features of patients tr... more Objective: We aimed to investigate the epidemiological and characteristic features of patients treated for breast masses in our clinic and share our experiences. Material and Methods: Patient records were reviewed retrospectively. Demographic and clinical data were investigated. The patients were divided into those who were operated on at the first admission (group 1) and those who were operated on after the follow-up (group 2) and compared. The statistical analysis evaluated with SPSS version 21. p<0.05 was considered significant. Results: Forty-eight patients who were operated on for breast mass in 10 years were included in the study. There was no difference between the groups regarding mean age and complaints at presentation (p=0.723, P=0.555, respectively). Ultrasound was performed on all patients. It was observed that the masses were located more frequently in the right breast in Group 1 (58.3%) and the left breast in Group 2 (p=0.386). In addition, it was noticed that the masses were most frequently located in the upper lateral quadrant of the breast in both groups (62.5% and 70.89%, respectively). The longest diameters of the masses were longer in group 1 than in group 2 (51.79±11.11 mm and 35.16±3.74 mm, respectively, p<0.001). Radiologically, most of the masses were reported as Breast Imaging Reporting and Data System (BI-RADS 3) in both groups (41.7% and 54.2%, respectively, p=0.444). Fine-needle aspiration biopsy (FNAB) was performed on nine patients in Group 1 and one in Group 2 (p=0.004). According to the FNAB reports, phyllodes tumors were detected in two patients, while the others were reported as fibroadenoma. The most common fibroadenomas were detected in the histopathological evaluations after surgical excision. In addition, a premalignant breast mass was detected in 6.2% of all patients. Conclusion: We recommend surgical excision in children with large, rapidly growing breast masses or suspected phyllodes tumors.

Anatolian Current Medical Journal, Jan 24, 2022

Aim: Renal tumors in children are rare. Wilms' tumor (WT) is the most common renal tumor in child... more Aim: Renal tumors in children are rare. Wilms' tumor (WT) is the most common renal tumor in childhood. The aim of this study is to investigate the data on the demographic factors, treatment, and follow-up results of pediatric patients who were operated on for renal tumors and determine the factors affecting mortality. Material and Method: Patients who were operated for renal tumor in our clinic in 2005-2020 were evaluated retrospectively. Age at diagnosis, gender, complaint, localization of the involved kidney, additional anomalies, tumor size, tru-cut biopsy performed, tumor stage, distant metastasis, applied treatments, pathology, treatment complications, and follow-up period were examined. Results: Of the 47 patients, 25 were female and 22 were male. The mean age was 45.46 (2-204) months. The tumor was located in the right in 21 cases, left in 23 cases and bilateral in three cases. The mean length of the tumor was 11.73 cm. At the time of diagnosis, there was metastasis in 15 cases (31.9%). While metastasis were the most common seen in lung (24.3%), bone-cell metastases were seen in clear cell carcinoma (33.3%) and brain metastases were seen in rhabdoid tumor (50%). Tru-cut biopsy was performed in 15 (31.9%) cases and biopsy was diagnostic in ten cases. Histopathologically, 41 cases had WT (87.23%), three cases were clear cell carcinoma (6.3%), two cases had anaplasia rhabdoid tumor (4.2%), and one case had metanephric adenoma. Relaps occured in nine cases (19.14%) during the follow-up period. Histopathologically, one case was a clear cell carcinoma, one case was a rhabdoid tumor, and seven cases were unilateral WT. The survival rate of our series was 89,4%. Conclusion: The most common renal tumor in childhood was WT. Surgery have no effect on survival; the most important survival factors were detecting the existence of rhabdoid tumors and anaplasia histopathologically. Therefore, during the followup and treatment of renal tumors in childhood, pathological examination should be of primary importance and followed up with the pediatric oncologists.

Journal of Burn Care & Research, Jun 3, 2021

Burned children generally arrive at emergency departments before referring to specialized burn ce... more Burned children generally arrive at emergency departments before referring to specialized burn centers. Their initial treatments are performed by non-burn doctors who work in emergency departments. The aim of this study was to evaluate emergency department doctors’ knowledge regarding the initial interventions and transfer of pediatric burn patients. There were 196 participants who completed the survey: 59 were emergency medicine specialists, 46 were general practitioners, and 91 were emergency medicine residents. Sixty-five stated that they always calculate the burn surface areas, and 144 stated that the Parkland formula should be used to calculate the fluid requirements for the first 24 hours. Of all participants, only 21 marked the correct choice as the Lund–Browder scheme to calculate the total burned surface area in children. Only 52 participants marked the correct choice as the Lactated Ringer’s of the fluid given in the first 24 hours. Only 108 correctly recognized inhalation injury. To the question “What is the first intervention that doctors should do at the emergency room to burned children?,” 127 participants stated correctly as the assessment of airway maintenance. Among the participants, 124 stated that they use lidocaine pomades when covering burned children’s wounds. Incorrect interventions with burned children increase morbidity and mortality. This survey shows that non-burn doctors working in emergency departments have insufficient knowledge about pediatric burns and require further training. Therefore, they should be trained continuously and regularly on the approach to both adult and childhood burns.

Journal of Surgical Research, May 1, 2021

BACKGROUND The most common thoracic injury in children, resulting in trauma, is pulmonary contusi... more BACKGROUND The most common thoracic injury in children, resulting in trauma, is pulmonary contusion (PC). Bone marrow-derived mesenchymal stem cells (BM-MSCs) are used in wound healing and many other diseases. This study aims to examine the effects of BM-MSCs on PC healing in rats. MATERIALS AND METHODS A total of 45 male Wistar albino rats were used. Four groups were formed. BM-MSCs were labeled with the green fluorescent protein. PC was observed in the control group. In group II, PC occured and left to spontaneous healing. In group III, PC formed and BM-MSCs were given. In group IV, BM-MSCs were given without PC formation. Subjects were sacrificed 1 week later. Whether there was any difference in terms of BM-MSC involvement and lung injury score was investigated. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS), version 17.0, software (SPSS Inc., Chicago, IL), and p value of <0.05 was considered statistically significant. RESULTS BM-MSCs were collected much more in the lungs in group III than in group IV. Group III had a lower lung injury score value than group II. CONCLUSION The greater involvement of the BM-MSCs in the injury site, and further reductions in lung injury score suggest that BM-MSCs are contributing to the healing of the injury. The use of BM-MSCs in risky patients with diffuse PC may be an alternative treatment to conventional methods.

Journal of Urological Surgery, Sep 1, 2021

This study aims to evaluate outcomes of redo orchiopexy and the effect of redo surgery timing upo... more This study aims to evaluate outcomes of redo orchiopexy and the effect of redo surgery timing upon testicular volume. Materials and Methods: This prospective study involved children receiving redo orchiopexy for recurrent undescended testis. Patients were recruited to assess testicular position, volume, blood flow and presence of microlithiasis. Testis volume was measured by ultrasound and compared with recently developed normative values for testicular size. Results: A total of 38 patients (40 testes) required redo orchiopexy were reviewed in the study. Thirty three of invited boys could be investigated as long term participation. As a result of long term follow up; 28 of the testes were at scrotum, 2 of them were at inguinal canal and 3 of them were non-palpable, with a 15% failure rate of redo orchiopexy. For all patients evaluated in the control visit mean testis volume was 1.23 mL, at 24 of whom were significantly smaller than the normative values for the same age (p<0.001). Eleven of the testes (33.3%) had microlithiasis. The average of duration between primary and redo orchiopexy was 13.5 months in the group of normal volume testes, 23.3 months in the group of significantly smaller testes (p=0.056). Conclusion: The long-term volumes of testes after redo orchiopexy were significantly less than the normative values. Frequent and long time follow up of operated undescended testes and early intervention of recurrent cases may improve outcomes of surgery.

Journal of Burn Care & Research, Jul 27, 2021

The aim of this study was to evaluate the results of an algorithm that was created to prevent cor... more The aim of this study was to evaluate the results of an algorithm that was created to prevent coronavirus disease-2019 (COVID-19) transmission during the management of children with burns in a tertiary pediatric burn center. Children admitted to the burn center between May 2020 and November 2020 were prospectively evaluated for cause, burn depth, TBSA, length of stay, symptoms suggesting COVID-19, suspicious contact history, history of travel abroad, and COVID-19 polymerase chain reaction (PCR) test results. Patients were divided into two groups: unsuspected (group 1) and suspected (group 2), depending on any history of suspicious contact, travel abroad, and/or presence of symptoms. A total of 101 patients were enrolled in the study, which included 59 boys (58.4%) and 42 girls (41.6%). Group 1 included 79 (78.2%) patients, and group 2 consisted of 22 (21.8%) patients. The most common cause of the burns was scald injuries (74.2%). The mean age, TBSA, and length of stay were 4.5 years, 12.0%, and 13.2 days, respectively. Four patients (3.9%) had a positive PCR test (two patients in each group). Comparing groups, males were more commonly found in group 2 (P = .042), but no differences were found for the other variables. No patients or burn center staff members developed COVID-19 during the course of hospitalization. In conclusion, every child should be tested for COVID-19 upon admission to a burn unit, and a modified algorithm should be constructed for the handling and management of pediatric burn patients.

Turkish Journal of Pediatric Disease

Objective: Burns are complex, traumatic incidents including significant morbidity and impairment ... more Objective: Burns are complex, traumatic incidents including significant morbidity and impairment of psychological, emotional, and physical well-being. This study aimed to determine the relationship between self-esteem and social anxiety in adolescents with burns. Material and Methods: A cross-sectional, descriptive research design was used. The research was carried out in the 12-bed Pediatric Burn Center with 86 adolescents. The data collection form, Rosenberg Self-Esteem Scale and the Social Anxiety Scale for Children was used. Comparisons were made at the p<.05 significance level for statistical analyses. Results: Hot liquid (31.4%), chemicals (22.1%), flames (17.4%), electricity (16.3%), and contact with hot objects (12.8%) were burn factors. It was determined that 81.4% of the participants had a scar/mark. The total body surface area of the burn was determined as 1%-10% (61.6%), 10%-25% (32.6%), ≥50% (3.5%), and 25%-50% (2.3%). The multiple linear regression model established...

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, Aug 31, 2021

Amaç: Çalışmamızın amacı, travmatik pnömotoraks gelişen çocukların demografik özelliklerini, klin... more Amaç: Çalışmamızın amacı, travmatik pnömotoraks gelişen çocukların demografik özelliklerini, klinik karakteristiklerini, uygulanan tedavi yöntemlerini değerlendirmek ve konuyla ilgili tecrübelerimizi paylaşmaktır. Gereç ve Yöntemler: Travmatik pnömotoraks nedeniyle tedavi edilen çocukların dosyaları retrospektif olarak tarandı. Hastaların yaşı, cinsiyeti, travmanın mekanizmaları, nedeni, pnömotoraks olan taraf, pnömotoraksın izole olup olmadığı, yatış süreleri, tedavi yöntemleri, göğüs tüpü süresi, mekanik ventilatöre bağlanıp bağlanmadığı, eşlik eden diğer sistem travmaları araştırıldı. Kız ve erkek cinsiyet arasında, önce künt ve penetran travmalar ardından izole ve izole olmayan toraks travmaları arasındaki farklılıklar araştırıldı. İstatistiksel analiz SPSS versiyon 21 ile yapıldı. İstatistiksel olarak p<0,05 anlamlı olarak kabul edildi. Bulgular: Travmatik pnömotoraks gelişen 60 hastanın 37'si erkek ve yaş ortalamaları 9.9 yıldı. Yoğun bakım ünitesinde ortalama yatış süreleri 8.2 gün, serviste 7.3 gün, toplam hastanede yatış süreleri ise 12.4 gün idi. Kırk sekiz hastada künt, 12 hastada ise penetran travma görüldü. Hastaların 16'sında izole travmatik pnömotoraks görülürken 37'sinde pulmoner kontüzyon eşlik etmekteydi. Otuz dört hastaya konservatif tedavi, 24'üne tüp torakostomi, iki hastaya torakotomi, bir hastaya da torakoskopi yapıldı. Dört hasta mekanik ventilatöre bağlandı. Travmatik pnömototoraks en sık 4-7 yaş ve 16-18 yaşları arasında görüldü. Her iki cinsiyette de yüksekten düşme en sık travma nedeni olmasına rağmen erkek hastalarda penetran travmalar daha çok görüldü. Penetran travmalı çocukların hepsi 12 yaşından büyüktü. Toraks travmalarına en sık eşlik eden akciğer hasarı pulmoner kontüzyon, en sık eşlik eden diğer sistem yaralanması ise kafa travmasıydı. Yüksekten düşme sonucu yaralanan bir hasta kaybedildi. Sonuç: Çocuklarda görülen travmatik pnömotoraksların çoğu evde gelişen önlenebilir kazalar sonucu meydana gelmektedir. Bunların önlenmesi için evlerde gerekli önlemlerin alınmasının yanı sıra, aileler ve çocuklara yönelik eğitimler yapılmalıdır. Okült ve mekanik ventilatöre ihtiyaç duymayacak olan asemptomatik izole travmatik pnömotoraks olgularında konservatif tedavi, ilk uygulanacak tedavi olmalıdır. Bu hastalar sıkı takip edilip gerektiğinde tüp torakostomi uygulanmalıdır. Objective: Aim of our study is to evaluate the demographic and clinical characteristics and treatment modalities of children with traumatic pneumothorax and to share our experiences. Material and Methods: Files of children treated for traumatic pneumothorax were retrospectively reviewed. Age, gender, mechanism of trauma, causes, side of pneumothorax, lengthof-stay in hospital, treatment modalities, chest-tube duration, need for mechanical ventilation and other accompanying traumas were investigated. Differences between genders, blunt and penetrating traumas, and isolated and non-isolated thoracic traumas were investigated, respectively. Statistical analysis was done with SPSS version 21. p<0.05 was considered significant. Results: Of 60 patients, 37 were male and mean age was 9.9 years. Average length-of-stay in intensive care unit was 8.2, length-of-stay in ward was 7.3, and the total length-of-stay in the hospital was 12.4 days. Forty-eight had blunt and 12 had penetrating trauma. Isolated-traumatic pneumothorax was observed in 16, pulmonary contusion was accompanying in 37 patients. Thirty-four underwent conservative treatment, 24 underwent tube thoracostomy, two thoracotomy, and one thoracoscopy. Four patients were connected to mechanical ventilator. Although falling from height was the most common cause of trauma in both genders, penetrating traumas were more common in males. All children with penetrating trauma were over 12 years. The most common accompanying lung injury to thoracic trauma was pulmonary contusion, and the most common accompanying trauma from the other system injuries was head trauma. One-patient who was admitted due to falling died. Conclusion: Most traumatic pneumothoraces in children occur as a result of preventable home-accidents. In order to prevent these, education of families and children should be provided as well as taking necessary measures at home. Conservative treatment should be the first treatment in occult and asymptomatic isolated-traumatic pneumothorax cases that do not require mechanical ventilation. These patients should be closely monitored and tube-thoracostomy performed when necessary.