Dolly Yafet Aji

Haemoperfusion in Amanita phalloides Poisoning

Amanita phalloides is responsible for about 90 per cent of all fatal cases of mushroom intoxication. The amatoxins, the main toxic component of these fungi, are responsible for gastro-intestinal symptoms as well as hepatic and renal failure. Three brothers with Amanita phalloides poisoning were admitted with gastro-intestinal symptoms beginning 12 h after ingestion. Jaundice, hepatomegaly and neurological symptoms were not present, but liver enzymes were moderately increased. Alfa-amanitin was detected in sera of all patients. All patients underwent charcoal hemoperfusion and two of them had additional hemodialysis along with conservative therapy. Liver enzymes that showed a marked increase on the second day of therapy decreased to normal levels on the 28th day. All of our patients survived. This life saving role of early haemoperfusion in Amanita phalloides poisoning is emphasized.

Prognostic factors in meningococcal disease and a new scoring system

One‐hundred‐and‐forty patients diagnosed as having meningococcal disease have been investigated retrospectively with respect to prognostic factors. The overall mortality was 8.6%, the mortality rate of the infants under 6 months of age being higher than that of the other groups. In cases where there was no meningitis or leucocytosis, the presence of hypotension, disturbed consciousness and diffuse petechiae increased the mortality rate significantly. High fever did not have any effect on mortality. We propose a new practical and reliable scoring system for meningococcal disease for determining the influence of prognostic factors on mortality.

İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı’nda 2000 2006 yıllarında ölen olguların değerlendirilmesi Orijinal Araştırma

Aim: To review nbsp; childhood mortality in Istanbul University Cerrahpasa Medical Faculty Department of Pediatrics Material and Method: A retrospective study based on hospital records and case histories of the pattern of mortality among children admitted between 2000 and 2006 was done Results: 569 children died out of the 12 859 admitted between Jan 1st 2000 and Dec 31st 2006 with an overall mortality of 4 4 42 7 of the cases had been referred from other health centers 55 9 of the cases were neonates and 60 7 of them were born before the 32th gestational week 24 2 of the mothers nbsp; had not been followed up and 60 1 had health problems during pregnancy Early rupture of membranes oligo anhydramnios were the leading problems 17 8 The most common causes of neonatal deaths nbsp; were respiratory distress syndrome 44 3 and septicaemia 24 5 The laeding causes of death in older children were infectious diseases 59 4 and haematological oncological diseases 25 1 The rate of infectious diseases decreased by age as the rate of haematological oncological diseasas increased 27 2 of total deaths nbsp; was due to septicaemia Leukemias 33 3 followed by lymphomas 19 1 nbsp; were the leading causes of death among haematological oncological patients 56 2 of nbsp; the patients had received blood products 74 7 had received antimicrobial drugs 20 4 had been dialysed and or nbsp; operated on and 60 3 had been ventilated 30 8 of the deaths had occurred within the first 24 hours of admission There were doubts about the nbsp; diagnosis made in 11 6 of the cases nbsp; and the rate of autopsies performed was nbsp; 3 3 Conclusions: Good recording and determining the causes of childhood mortality as in this study are very important points for planning health care in both nbsp; hospitals and countries Turk Arch Ped 2007; 42: 148 52 Key words: Childhood death mortality

Cerrahpaşa Çocuk Acil 94: Genel Değerlendirme

1 Ocak 31 Aralik 1994 doneminde Cerrahpasa Tip Fakultesi Cocuk Sagligi ve Hastaliklari Anabilim Dali Acil birimine 1 gun 14 yas arasinda ortalama 5 6±6 1 yil 6 839 u 55 erkek 5 645 i 45 kiz toplam 12 484 hasta basvurdu Bunlarin 10 762 si 86 ayaktan 1 611 i 13 yatirilarak tedavi edildi 111 1 hasta baska merkezlere sevk edildi Yatirilan 1 611 hastanin 833 u 52 acil girisim 458 i 28 acil yasam destegi 320 si 20 acil olmasa da hastane sartlarinda tetkik ve tedavi gerektirdi Acil girisim gerektiren hastalarin klinigimizde yatirilarak tedavi edilen tum hastalara n=3 520 orani 24 yogun bakim gerektirenlerin ise 13 idi Acil girisim gerektirenlerin 491 i 60 akut alt solunum yollari hastaliklari bronkopnomoni bronsiyolit astim 218 i 26 akut ishallerdi Acil yasam destegi gerektirenlerin 136 si 30 degisik nedenli konvulziyonlar 124 u 27 akut zehirlenmeler idi Anahtar kelimeler: Acil Yogun Bakim Acil Yasam Destegi Acil Servis

Amanita Phalloides Zehirlenmesinde Hemoperftizyon

Amanita phalloides mantar zehirlenmesine bagli olumlerin 90 indan sorumludur Bu mantarlarin ana toksik ogeleri olan amatoksinler hepatik ve renal yetersizligin yani sira gastrointestinal belirtilerden de sorumludurlar A phalloides den zehirlenen ve yedikten 12 saat sonra gastrointestinal belirtiler ortaya cikan 3 erkek kardes yatirilmistir Olgularda sarilik hepatomegali norolojik belirtiler mevcut degildi ancak karaciger enzimleri orta derecede yuksekti Tum hastalarin serumlarinda alfa amanitin saptanmistir Hastalarin hepsine karbon hemoperfiizyonu uygulanmis ayrica destek tedavinin yani sira iki hastaya hemodiyaliz de yapilmistir Tedavinin ikinci gunu belirgin yukselme gosteren karaciger enzimleri 28 gunde norma e donmustur Hastalarin hepsi iyilesmislerdir Anahtar kelimeler: Mantar Zehirlenmesi Amanita Phalloides Zehirlenmesi Amatoksinler Hemoperfuzyon