Author Of 2 Presentations
IGM-ENRICHED IMMUNOGLOBULIN (3 DAYS VS. 5 DAYS) AS ADJUVANT TREATMENT FOR SERIOUS INFECTIOUS DISEASE IN PEDIATRIC INTENSIVE CARE UNIT: RETROSPECTIVE, SINGLE-CENTER EXPERIENCE (PIGMENT STUDY)
Abstract
Background
Although there are studies in different age groups regarding the infusion of polyclonal IgM-enriched intravenous immunoglobin (Pentaglobin) in the treatment of sepsis, data on use in pediatric intensive care units are limited.
Objectives
The aim of this study was to evaluate clinical features and prognosis of children receiving Pentaglobin in the pediatric infectious disease unit due to serious infections.
Methods
We evaluated medical records of 254 children (aged between 1-216 months), receiving Pentaglobin infusion (104 children for 3 days,150 children for 5 days) in addition to standard treatment between 2010-2017.
Results
The mortality rate was lower in patients receiving Pentaglobin for 5-days comparing the patients receiving for 3-days (p<0.05). We observed a decreased mortality rate in 5-days group in children with sepsis, septic shock, and multi-organ failure groups, whereas the statistical significance has been only observed in septic shock group(p<0.05). According to the microbiological results, decreased mortality rate has been observed in all patients receiving 5-days treatment, while the statistical difference has been only observed for the infections due to Gram-negative pathogens(p<0.05). Statistical significance has been observed among children aged between 1-24 months between 5-days and 3-days group (p<0.05).
Conclusion
Polyclonal IgM-enriched immunoglobulin for 5-days as an adjuvant treatment for the serious infectious disease in the pediatric intensive care unit, showed a significant reduction for mortality in septic shock cases. The effect was shown to be more pronounced for gram-negative infections and for the 1-24-months age group. Prospective randomized controlled trials needed to support these results.
FATAL COURSE OF RAW POPPY PLANT INGESTION IN A 4-YEAR OLD GIRL
Abstract
Background
Poppy seed is used frequently in Turkey and globally and has an economic value since it is used as an industrial plant.
Objectives
Papaver somniferum subsp. anatolicum var. nigrum(blind poppy) is the variant that is mostly used in agriculture and consists of over 35 kinds of alkaloids including morphine, codeine, tebaine, noscapine and papaverin.
Methods
Here-in we report fatal course of 4 year-old girl due to excessive raw poppy plant ingestion.
Results
Previously-healthy, 4-year-old girl was brought to the emergency department with a complaint of loss of consciousness. Her family was occupied as poppy seed farm workers and they reported that they ate raw poppy plants approximately 12 hours prior. Physical examination revealed as tachycardia, hypertension, no response to painful stimuli and hyperactive deep tendon reflexes. Intravenous naloxone was administered after plasma opioid level was reported to be 1196 ng/mL and she had a brief gain of consciousness. Laboratory analysis showed elevated serum lactate and creatinine kinase levels. Large amounts of poppy seed were extracted during gastric lavage, however, after 7 days of admission, poppy seed has been seen in lavage. Due to all mechanical support, renal replacement therapy or other standard care, she died at the 12thday of her PICU admission. Analysis of the poppy showed unusually high levels of morphine, codeine, acetylhydrocodeine, papaverin and atropine alkaloids.
Conclusion
Raw poppy seed ingestion could be fatal during childhood, and clinical and laboratory findings might be related with the alkaloid ingredients.
Presenter of 1 Presentation
FATAL COURSE OF RAW POPPY PLANT INGESTION IN A 4-YEAR OLD GIRL
Abstract
Background
Poppy seed is used frequently in Turkey and globally and has an economic value since it is used as an industrial plant.
Objectives
Papaver somniferum subsp. anatolicum var. nigrum(blind poppy) is the variant that is mostly used in agriculture and consists of over 35 kinds of alkaloids including morphine, codeine, tebaine, noscapine and papaverin.
Methods
Here-in we report fatal course of 4 year-old girl due to excessive raw poppy plant ingestion.
Results
Previously-healthy, 4-year-old girl was brought to the emergency department with a complaint of loss of consciousness. Her family was occupied as poppy seed farm workers and they reported that they ate raw poppy plants approximately 12 hours prior. Physical examination revealed as tachycardia, hypertension, no response to painful stimuli and hyperactive deep tendon reflexes. Intravenous naloxone was administered after plasma opioid level was reported to be 1196 ng/mL and she had a brief gain of consciousness. Laboratory analysis showed elevated serum lactate and creatinine kinase levels. Large amounts of poppy seed were extracted during gastric lavage, however, after 7 days of admission, poppy seed has been seen in lavage. Due to all mechanical support, renal replacement therapy or other standard care, she died at the 12thday of her PICU admission. Analysis of the poppy showed unusually high levels of morphine, codeine, acetylhydrocodeine, papaverin and atropine alkaloids.
Conclusion
Raw poppy seed ingestion could be fatal during childhood, and clinical and laboratory findings might be related with the alkaloid ingredients.