ABSTRACT
ABSTRACT Objective: A very small amount of Atropa belladonna (AB) can lead to serious symptoms of poisoning and can cause death in children. In this study, demographic, clinic and laboratory results of AB poisoning were evaluated. Methods: A total of 108 cases with belladonna poisoning were retrospectively evaluated. At time of admission, age, age groups, gender, signs and symptoms caused by poisoning, duration of stay in hospital, laboratory data, intensive care needs, and applied treatments were recorded. Results: Approximately 44.4% were females and 55.6% were males. While the most common symptoms were xeroderma and flushing, the most frequent findings were tachycardia and mydriasis. Eight patients complained about astasis and five of them were taken into the intensive care unit. Astasis complaint was relatively higher (p < 0.01) in the patients who needed intensive care than those who did not. Creatine kinase levels were relatively higher (p = 0.06) in the intensive care patients as compared to non-intensive care patients. Neostigmine was given to all patients. Five patients, who failed to respond to therapy, were taken into the intensive care and respond to treatment successfully with physostigmine. Conclusion: Atropa belladonna poisoning may seriously progress in the act of late diagnosis and treatment in childhood. Thus, it is crucial to realize that AB poisoning should be taken into consideration in the patients with flushing, xeroderma with mydriasis, tachycardia, tremor, abdominal pain, and fever symptoms. Patients with astasis complaints should be evaluated carefully in terms of intensive care need. Patients with a Glasgow Coma Scale lower than 12 should be observed in the intensive care.
ABSTRACT
ABSTRACT Background: Acute lymphoblastic leukaemia (ALL) is the most common malignancy in childhood. Although some prognostic factors have been defined to date, the estimation of prognosis is currently not perfect. Previous studies had shown an association of FLT3 with poor prognosis and CCAAT-enhancer-binding protein α (CEBPA) mutation with the development of acute myeloid leukaemia (AML). Here, we aimed to evaluate the prognostic value of FLT3-ITD and CEBPA mutations in ALL. Methods: Sixty-one patients with ALL were included in the study. The patients were divided into three risk groups according to BFM risk classification. All of the patients were examined for FLT3-ITD mutations and 45 of them for CEBPA mutations. Mutation positive and negative patients were compared in terms of their risk groups, translocations and cell lineage. The clinical courses of the patients were appraised. Results: FLT3-ITD mutation was detected in 3 of the 61 patients, and CEBPA mutations were detected in 11 of the 45 patients. The incidence of established prognostic indicators including BFM risk classification, t(9; 22); BCR-ABL, t(1; 19); E2A-PBX1, t(12; 21); TEL-AML1, t(4; 11); MLL-AF4 were similar between FLT3-ITD and CEBPA positive and negative patients. A patient with an FLT3-ITD mutation was very susceptible to pancytopenia after maintenance treatment and two other patients with FLT3-ITD mutations were more prone to febrile neutropenia. Conclusion: Our results suggested that CEBPA or FLT3-ITD mutations might not be related to ALL prognosis in the sampled Turkish patients. However, FLT3-ITD mutation might have an influence on the response of bone marrow to chemotherapy.