Characteristics of Children with Acute Carbon Monoxide Poisoning in Ankara: A Single Centre Experience

The purpose of the study was to define characteristics of children with acute carbon monoxide poisoning. Eighty children hospitalized with acute carbon monoxide poisoning were recruited prospectively over a period of 12 months. Sociodemographic features, complaints and laboratory data were recorded. When the patient was discharged, necessary preventive measures to be taken were explained to parents. One month later, the parents were questioned during a control examination regarding the precautions that they took. The ages of the cases were between one month and 16 yr. Education levels were low in 86.2% of mothers and 52.6% of fathers. All families had low income and 48.8% did not have formal housing. The source of the acute carbon monoxide poisoning was stoves in 71.2% of cases and hot-water heaters in 28.8% of cases. Three or more people were poisoned at home in 85.1% of the cases. The most frequent symptoms of poisoning were headache and vertigo (58.8%). Median carboxyhemoglobin levels at admission to the hospital and discharge were measured as 19.5% and 1.1% (P < 0.001). When families were called for re-evaluation, it was determined that most of them had taken the necessary precautions after the poisoning incident (86.3%). This study determined that children with acute childhood carbon monoxide poisoning are usually from families with low socioeconomic and education levels. Education about prevention should be provided to all people who are at risk of carbon monoxide poisoning before a poisoning incident occurs.

Treatment of brucellosis in a young child with trimethoprim/sulfamethoxazole anaphylaxis

Brucellosis is a common zoonotic disease throughout the world. Brucella spp. transmit to humans through contact with fluids of infected animals, especially sheep, cattle, and goats. It is also transmitted by ingestion of fluid-derived products of infected animals, such as unpasteurized milk and cheese. Brucella spp. changes pH level of intracellular environment, so the first treatment approach is to administer antibiotics that have activity in acidic conditions. Anti-brucellosis treatment regimens include doxycycline for children older than eight years old and rifampicin and trimethoprim/sulfamethoxazole [TMP-SMX] combination therapy for children under eight years old, which may be able to act intracellularly under acidic conditions. A TMP-SMX allergy causing anaphylaxis has been reported previously. No alternative anti-brucellosis treatments have been reported in the literature for patients under eight years old with a TMP-SMX allergy. Here, we report a case of a child with brucellosis and a TMP-SMX allergy who was under eight years old at the time of diagnosis and was successfully treated with rifampicin, ciprofloxacin, and gentamicin

Insulin sensitivity obtained from the oral glucose tolerance test and its relationship with birth weight

Glucose intolerance and insulin sensitivity in preadolescent children might predict the risk of developing type 2 diabetes mellitus in adult life in small for gestational age [SGA] children. We aimed to investigate whether reduced birthweight is related to low insulin sensitivity in preadolescence. Twenty-five SGA children and 29 appropriate for gestational age children [AGA] children born between 1993 and 1994 were evaluated for insulin sensitivity in preadolescence. At the beginning of the study, body mass index [BMI] was calculated and an oral glucose tolerance test [OGTT] was performed. Blood samples to measure glucose and insulin were taken every 30 minutes during OGTT. Homeostasis of model assessment-insulin resistance [HOMA-IR] and composite index [Cl] values were measured to assess insulin sensitivity. On the OGTT, 120-minute glucose and insulin levels were higher in SGA than AGA children [P=0.02 and P=0.001, respectively]. Although there was no difference between HOMA-IR values, the mean Cl value was lower in SGA than AGA children [P=0.001]. There was an inverse correlation between birthweight and 120-minute glucose concentrations [r=-0.30, P=0.02]. This correlation was stronger between birthweight and 120-minute insulin concentrations [r=-0.50, P=0.001] BMI was positively correlated with 120-minute insulin [r=0.50, P=0.001] There was no relationship between HOMA-IR values and birth size, but the Cl index was positively correlated with birthweight [r=0.40, P=0.002]. Birthweight may be a predictive factor for insulin sensitivity and Cl is more reliable than HOMA-IR to assess this sensitivity in preadolescence