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OBJECTIVES: Vaccines are crucial for preventing the spread of the coronavirus pandemic and controlling its effects. We aimed to determine the desire of children aged 12-18 to be vaccinated with the current vaccines, the reasons for wanting or not wanting to be vaccinated, where they had learned about the vaccine, how many of the children with a history of chronic disease want to be vaccinated, and which factors affect them. METHODS: A questionnaire form was completed for children aged 12-18 years who applied to Gazi University Pediatric Emergency Department and the Child Health and Diseases Polyclinic between April 1, 2022, and September 30, 2022. RESULTS: A total of 924 children participated in the study. The mean age of the participants was 14.64±1.77 years. The willingness to be vaccinated was 83.1%. Being older, living in the city, having a mother, father, or sibling who was vaccinated, information about vaccines obtained from health personnel, a completed national vaccination program, and the presence of a first-degree relative in the healthcare field significantly increased the probability of the child being vaccinated. The most important factors affecting the desire to be vaccinated in children were the vaccination status of the mother, father, or sibling and the completed national vaccination program. CONCLUSION: We found that the immunization status of the parents is the most important factor guiding the child's desire to be vaccinated and that the most common reason for vaccine hesitancy is the side effects of the vaccine.

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BACKGROUND AND OBJECTIVES: Dermatologic lesions that occur primarily or are secondary to disease are among the most common reasons for referral to the Pediatric Emergency Department (PED). This study aims to reveal the clinical features, diagnostic distribution, and management of patients who presented to the PED with dermatologic lesions. METHODS: The study was a retrospective cross-sectional study involving children aged 0-18 years who presented to Gazi University Faculty of Medicine, PED, in 2018 with dermatologic lesions. The SPSS-20 program was used for data analysis. RESULTS: A total of 1590 patients, 57.8% (919) male, were included in the study. The median age was 75 (minimum: 4 days; maximum: 17 years, 11 months) months. The frequency of dermatologic lesions was 4.33% (433/10,000). Allergic and infectious dermatologic lesions, which are the two most common skin lesions in all age groups, were seen in 46.2% (735) and 30.5% (485) (patients, respectively. Urticaria (n = 588, 37%) was the most common in allergic rashes, and viral rashes (n = 162, 10.2%) were the most common in infectious rashes. Ninety-four percent (1495) of the patients were discharged from the PED. Two patients were hospitalized and followed up as dermatologic emergencies. CONCLUSION: Urticaria and viral eruptions are common dermatologic lesions in our PED. Both conditions are easily recognized and treated by physicians. Most lesions do not require hospitalization. Dermatologic emergencies, although rare, should be well-known to physicians.

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BACKGROUND: Our study sought to externally validate the Infant Scalp Score (ISS) within an international pediatric emergency department (PED) setting. The ISS for pediatric Closed Head Injury (CHI), includes age, hematoma localization, and size, and has the potential to predict the presence of Traumatic Brain Injury (TBI) on computed tomography. We aimed to describe a potentially low risk cohort of children younger than 24 months with CHI and scalp hematomas, where clinicians may limit diagnostic radiation exposure to this vulnerable patient population. METHODS: This single-center retrospective study was conducted in Gazi University. Faculty of Medicine, Pediatric Emergency Department, a tertiary trauma care hospital. We reviewed patients (< 24 months) with CHI and scalp hematoma who visited the PED of our institution between January 1, 2019, and June 30, 2021 for rates of TBI and clinically important TBI (ciTBI). RESULTS: 380 cases met inclusion criteria for this study. The median age was 11 months and 58.7% were male children. 121 (31.8%) patients underwent CT, and 57% (n:69) of these studies were normal. TBI on CT was found in 26 (21.5%) patients with ciTBI was detected in 5 (1.3%) patients. All children with TBI were noted to have ISS scores of ≥ 5. Hematoma location OR 18.9 (95% CI, 3.4-105.1) and hematoma size OR 3.0 (95% CI, 1.2-7.3) were positively associated with presence of TBI. CONCLUSIONS: Children with ISS scores of ≥ 5 were noted to have increased rates of both TBI and ciTBI. CHI related scalp hematomas located in the temporal/parietal region or with a size greater than 3 cm were associated with increased rates of TBI. Within the context of this study, ISS scores of 4 or less represented a lower risk for TBI and ciTBI. Future research on this potentially low risk pediatric CHI cohort is needed.

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BACKGROUND: A significant number of children are injured by or die from firearm-related incidents every year, although there is a lack of global data on the number of children admitted to pediatric emergency departments (PEDs) and pediatric intensive care units (PICU) with firearm injuries. This study is the most comprehensive analysis of firearm injuries sustained by children in Turkey to date. METHODS: This multicenter, retrospective, cohort study was conducted between 2010 and 2020 with the contributions of the PEDs, PICUs, intensive care units, and surgery departments of university hospitals and research hospitals. RESULTS: A total of 508 children were admitted to hospital with firearm-related injuries in the research period, although the medical records of only 489 could be obtained. Of the total admissions to hospitals, 55.0% were identified as unintentional, 8.2% as homicide, 4.5% as self-harm, and 32.3% as undetermined. The Glasgow Coma Scale (GCS) and ventilation support were found to be the most significant predictors of mortality, while head/neck injury, length of stay (LOS) in the hospital and surgical interventions were found to be the most significant predictors of disability. The overall mortality of firearm-related injuries was 6.3%, and the mortality for children admitted to the PICU was 19.8%. The probability of disability was calculated as 96.0% for children hospitalized with firearm injuries for longer than 75 days. CONCLUSIONS: Head/neck injury, LOS in the hospital, and surgical interventions were found to be the most significant parameters for the prediction of disability. Hospitalization exceeding 6 days was found to be related to disability.

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BACKGROUND: Epistaxis is a mostly self-limiting condition common among children and is rarely severe. In this study, it was aimed to evaluate the incidence, demographic characteristics, causes of bleeding and treatment methods of patients who presented to the pediatric emergency department (PED) with epistaxis, and to determine in which cases a laboratory test should be used. METHOD: Admitted to Gazi University Faculty of Medicine, PED which provides trauma care and is a tertiary hospital, from 1 January 2019 to 31 December 2019, 452 patients aged 0-18 years who presented with epistaxis for any reason or secondary to systemic disease were analysed retrospectively. RESULTS: The annual incidence was found at 1.23%. The median age was 5.25 years, 258 of the cases (57.1%) were male. It was found that the cases most frequently applied to the hospital in the autumn months (37.6%). Sixty of the patients (13.3%) had a chronic disease and 54 (11.9%) had a history of drug use. Bleeding time was less than 5 minutes in 75.2% and 84.4% of the bleeding was unilateral. Nasal bleeding is local in 73.4%; 4.7% of them developed because of systemic reasons. The most common cause of epistaxis; while they were trauma at the first 10 years of age, they were idiopathic causes after the age of 10 years. In 434 (96%) of the patients, epistaxis spontaneously stopped and there was no need for additional treatment. CONCLUSION: As a result of this study, it was concluded that laboratory tests should be performed in cases with chronic disease history, bilateral bleeding, active bleeding and nontraumatic epistaxis. The situation that causes epistaxis in the childhood age group should be determined with a good history and physical examination, laboratory tests should not be used in every patient.

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BACKGROUND: Antiepileptic drugs (AEDs) are among the most common causes of severe delayed-type hypersensitivity reactions such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and Drug Reaction with Eosinophilia and Systemic Symptoms(DRESS) in children. These reactions are more commonly seen with aromatic AEDs such as phenytoin and carbamazepine than the non-aromatic or new generation AEDs. However immediate-type hypersensitivity reactions such as urticaria/angioedema, anaphylaxis are very rare with AEDs. CASE: Levetiracetam is an increasingly used new non-aromatic antiepileptic drug and reported to have a better safety profile in daily practice. We present the first adolescent case who developed an anaphylactic reaction with intravenous levetiracetam, not reported in this age group before in the literature. CONCLUSION: Hypersensitivity reactions in the form of anaphylaxis can be rarely observed with new generation AEDs. Therefore, when any antiepileptic drug is started on any patient, immediate type serious reactions such as anaphylaxis should be kept in mind, not only focusing on delayed reactions such as SJS, TEN,or DRESS.

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BACKGROUND: Supraventricular tachycardia (SVT) is the most common type of tachycardia in childhood. The incidence is 1-4/1000 in childhood and 0.6/1000 in newborns. CASE: Here we report a 28-day-old male newborn who was diagnosed SVT, admitted to the Pediatric Emergency Department after restlessness that had started three hours before admission and measurement of the heart rate was above 250 beats/min. CONCLUSIONS: This case is presented in order to emphasize that SVT is rare in the neonatal period and SVT is successfully terminated with the administration of intraosseous adenosine.

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