Objective: Murmurs are abnormal audible heart sounds produced by turbulent blood flow. Therefore, murmurs in a child may be a source of anxiety for family members. Families often use online materials to explore possible reasons for these murmurs, given the accessibility of information on the Internet. In this study, we evaluated the quality, understandability, readability, and popularity of online materials about heart murmur.Methods: An Internet search was performed for “heart murmur” using the Google search engine. The global quality score (on a scale of 1 to 5, corresponding to poor to excellent quality) and Health on the Net code were used to measure the quality of information presented. The understandability of the web pages identified was measured using the Patient Education Materials Assessment Tool (score range from 0 to 100%, scores below 70% reflect poor performance). The readability of each web pages was assessed using four validated indices: the Flesch Reading Ease Score, the Flesch–Kincaid Grade Level, the Gunning Frequency of Gobbledygook, and the Simple Measure of Gobbledygook. The ALEXA traffic tool was used to reference domains’ popularity and visibility.Results: We identified 230 English-language patient educational materials that discussed heart murmur. After exclusion, a total of 86 web pages were evaluated for this study. The average global quality score was 4.34 (SD = 0.71; range from 3 to 5) indicating that the quality of information of most websites was good. Only 14 (16.3%) websites had Health on the Net certification. The mean understandability score for all Internet-based patient educational materials was 74.6% (SD = 12.8%; range from 31.2 to 93.7%). A score suggesting these Internet-based patient educational materials were “easy to understand”. The mean readability levels of all patient educational materials were higher than the recommended sixth-grade reading level, according to all indices applied. This means that the level of readability is difficult. The average grade level for all web pages was 10.4 ± 1.65 (range from 7.53 to 14.13). The Flesch–Kincaid Grade level was 10 ± 1.81, the Gunning Frequency of Gobbledygook level was 12.1 ± 1.85, and the Simple Measure of Gobbledygook level was 9.1 ± 1.38. The average Flesch Reading Ease Score was 55 ± 9.1 (range from 32.4 to 72.9).Conclusion: We demonstrated that web pages describing heart murmurs were understandable and high quality. However, the readability level of the websites was above the recommended sixth-grade reading level. Readability of written materials from online sources need to be improved. However, care must be taken to ensure that the information of web pages is of a high quality and understandable.

Objectives: Carbon monoxide (CO) poisoning remains the foremost cause of poisoning worldwide. This study aimed to investigate the effects of hyperbaric oxygen therapy (HBOT) and normobaric oxygen therapy (NBOT) on thiol/disulfide homeostasis in children with CO intoxication. Methods: Eighty-one children aged 0 to 18 years with CO intoxication were included in this cross-sectional study. No changes were made in the routine clinical evaluation and treatment practices of the patients. Thirty-two children who received HBOT and 49 children who received NBOT were compared for serum native thiol, disulfide, and total thiol levels, as well as for the changes in disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios before and after treatment. Results: Antioxidant levels, such as native thiol and total thiol, were significantly decreased in patients who received HBOT and increased in those who received NBOT (P = 0.02 and P = 0.01, respectively). There was no statistically significant difference between the 2 groups concerning the change of native thiol/total thiol ratios (P = 0.07). In addition, there was no significant difference regarding changes in disulfide, disulfide/native thiol, and disulfide/total thiol levels before and after treatment (P = 0.39, P = 0.07, and P = 0.07, respectively). Conclusions: Although thiol-disulfide balance is maintained in patients treated with HBOT, antioxidant levels decrease significantly compared with NBOT. Despite efficiency of HBOT in CO intoxication, oxidative stress and reperfusion injury due to hyperoxygenation should be considered in the treatment of HBOT.

OBJECTIVE: Haematological parameters are peripheral inflammation markers that can be used to demonstrate the relationship between psychopathology and inflammation. In this study, we aimed to compare adolescents who attempted suicide with healthy adolescents in terms of haematological parameters.MATERIAL AND METHODS: The haemogram records of 765 adolescents admitted to the Paediatric Emergency Service between October 2018 and March 2020 were retrospectively evaluated. The control group was created from the haemogram records of adolescents who had similar age and sex characteristics, who had been examined in paediatric outpatient clinics during the above-mentioned period and who did not have any organic or psychopathological disorder. After implementation of the exclusion criteria, 95 adolescents with suicide attempts and 95 healthy adolescents were included in the study. The case and control groups were statistically compared in terms of neutrophil/lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), mean platelet volume (MPV) and red cell distribution width (RDW) parameters.RESULTS: It was found that in adolescents with suicide attempts, NLR and MLR values were significantly higher than in the control group. There was no significant difference between the groups in terms of other parameters. In terms of NLR and MLR parameters, there was no statistical difference among the three subgroups of the case group separated according to the psychiatric diagnoses. However, NLR was found to be significantly higher in comparison with the control group of these three subgroups.CONCLUSIONS: The NLR and MLR parameters of adolescents who attempted suicide were higher than those of the control group. There is a need for more comprehensive studies on the evaluation of inflammatory parameters in adolescents who have attempted suicide.