2026-03-10
Lan Shao, Dongdong You, Yunpeng Shao, Huanhuan Xu, Feng Li
Background. Neonatal bacterial meningitis remains a severe infectious disease associated with substantial mortality and long-term neurological sequelae. This study aimed to identify factors associated with poor outcomes and to determine independent prognostic predictors in neonates with bacterial meningitis. Methods. This retrospective multicenter cohort study included neonates diagnosed with bacterial meningitis. Clinical characteristics, laboratory findings, microbiological data, treatment responses, and outcomes were analyzed. Univariate and multivariable logistic regression analyses were performed to identify factors associated with poor outcomes. Results. A total of 85 neonates were included in the final analysis. 31 neonates (36.5%) experienced poor outcomes, including death or long-term neurological sequelae. In multivariable analysis, the presence of neurological signs at admission (odds ratio [OR]: 7.315; 95% confidence interval [CI]: 1.875–28.535) and the development of acute neurological complications during hospitalization (OR: 7.541; 95% CI: 2.045–27.807) were the only factors independently associated with poor outcomes. Several variables, including elevated cerebrospinal fluid protein levels, early administration of blood-brain barrier (BBB)-permeable antibiotics prior to lumbar puncture, and adequate response to initial antimicrobial therapy, were significantly associated with outcomes in univariate analyses but did not retain statistical significance after multivariable adjustment. Conclusions. Neurological involvement at presentation and acute neurological complications are key independent predictors of poor outcomes in neonatal bacterial meningitis. Other clinical and laboratory variables may reflect disease severity or early clinical course and may assist in early risk stratification.
2026-02-26
Nazlı Gülsüm Akyel, Tuba Banaz, Burcu Arı Gökhan
Background. Enterobius vermicularis is a nematode that predominantly affects the pediatric population, particularly in families with school-aged children. While it typically causes intestinal symptoms, rare cases of extraintestinal involvement have been reported, including female genital tract involvement and complications such as appendicitis or enterocolitis. Perianal parasitic abscesses are also rare, with only a few cases reported in the literature. Case Presentation. A 17-year-old female presented with abdominal pain during menstruation. Pelvic ultrasound revealed a septated cystic lesion located posterior to the uterus. Magnetic resonance imaging (MRI) demonstrated a perianal lesion with thick material, appearing iso- to hyperintense on both T1- and T2-weighted images. The lesion extended into the left gluteal muscles and showed peripheral contrast enhancement and diffusion restriction. Notably, there were no surrounding inflammatory changes, making an abscess diagnosis less likely. Surgical drainage revealed pus, and cytological analysis identified abundant parasitic oocytes consistent with E. vermicularis . The patient was treated with surgical drainage followed by pyrantel pamoate, resulting in near-complete resolution of the lesion at the one-month follow-up MRI. A literature review was also conducted to identify previously reported cases of parasitic abscesses and to explore the differential diagnoses of perianal cystic lesions. Conclusions. Perianal abscesses due to parasitic infections are rare, particularly those caused solely by E. vermicularis . Given the high prevalence in childhood infestations, parasitic abscesses should be considered in the differential diagnosis of perianal collections in pediatric patients, especially in the absence of peripheral inflammatory signs.
2026-02-26
Seda Ayaz Taş, Seda Yakıt Yeşilyurt, Tansu Birinci Olgun, Sezen Tezcan, Sinan Taş, Mustafa Dilek
Background. Early feeding skills and general movements (GMs) are negatively affected by hypotonia due to prematurity. Interventions for feeding skills can be guided by understanding the relationship between feeding skills and GMs. In the light of this, the study focused on understanding the relationship between early feeding skills and preterm infants’ GMs in the neonatal intensive care unit (NICU). Methods. Participants in this cross-sectional study were forty infants with a postmenstrual age of 34–37 weeks who were hospitalized in the NICU at Abant İzzet Baysal University Training and Research Hospital. The data consisted of demographic characteristics (birth weight, gestational age, date of birth, age, and sex), feeding skills, assessed with the Early Feeding Skills Assessment Tool, and GMs, assessed with the General Movement Assessment. Results. A strong correlation was found between the Oral-Motor Function subscale of the Early Feeding Skills Assessment Tool and the Upper Limbs subscale of the General Movements Motor Optimality Score (rho=0.74, p=0.001). Among the demographic characteristics, only maternal age was associated with feeding skills. A weak correlation was determined between the Physiologic Stability subscale of the Early Feeding Skills Assessment Tool and maternal age (rho=0.34 p=0.03). Conclusions. This study reveals the relationship between feeding skills and general movement of preterm infants at NICU. GMs of upper extremity were found to positively affect feeding skills. This process may be accelerated by interventions to improve the GMs of upper extremity during the transition to oral feeding.
2026-02-26
Özge Başaran, Adalet Elçin Yıldız, Yelda Bilginer, Seza Özen
Chronic nonbacterial osteomyelitis (CNO) is a rare, autoinflammatory bone disorder that predominantly affects children and adolescents. The disease covers a broad clinical spectrum ranging from isolated bone lesions to its severe multifocal form, chronic recurrent multifocal osteomyelitis (CRMO). Although its exact pathogenesis remains elusive, recent advances highlight a pivotal role of innate immune dysregulation, particularly involving imbalanced cytokine signaling. These abnormalities drive sterile bone inflammation and osteoclast activation, leading to bone pain and lytic or sclerotic lesions. CNO remains a diagnosis of exclusion owing to the lack of specific biomarkers or standardized diagnostic criteria; however, the recently developed European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ACR) classification framework represents an important step toward uniformity in research and clinical trials. Whole-body magnetic resonance imaging has emerged as the imaging modality of choice for diagnosis and monitoring, while biopsy is reserved for atypical or unifocal cases. Management is empirical and guided by disease severity, with nonsteroidal anti-inflammatory drugs as first-line therapy, followed by corticosteroids, disease-modifying antirheumatic drugs, bisphosphonates, and biologic agents such as tumor necrosis factor (TNF) inhibitors in refractory cases. New insights into the interleukin (IL)-1, IL-6, and IL-17/23 pathways have opened avenues for targeted therapies, including Janus kinase (JAK) inhibitors, in difficult-to-treat patients. Despite earlier perceptions of a benign course, long-term follow-up indicates a risk of relapses and structural complications, underscoring the need for early recognition and multidisciplinary management. Ongoing international collaborations are expected to refine diagnostic precision and optimize treatment strategies to improve outcomes in pediatric CNO.
2026-02-26
Mert Uçar, Aysun Ata, Burcu Barutçuoğlu, Güneş Ak, Sara Habif, Zühal Parıldar, Damla Gökşen, Şükran Darcan, Samim Özen
2026-02-26
Sinem Akgül, Özge Başaran, Melis Pehlivantürk Kızılkan, Gülen Eda Ütine, Leman Akcan Yıldız, Yılmaz Yıldız, Ali Düzova, Enver Hasanoğlu
Background. Scientific congresses are critical platforms for knowledge dissemination and collaboration. The scientific value of presented abstracts is best demonstrated through their subsequent publication as full-text articles in peer-reviewed journals. This study aimed to evaluate the publication rate and characteristics of oral abstracts presented at the Turkish National Pediatric Congresses (TNPC) between 2019 and 2023. Methods. Abstract books of five consecutive congresses were reviewed. The publication status of each abstract was determined through systematic searches in Web of Science, PubMed, Scopus, Google Scholar and the TR Index utilizing the title, keywords from the title and author names. Parameters such as study design, collaboration type, index status and the impact factor of the journal, the year it was published, and time to publication were analyzed. Additionally, the subspecialty of each abstract and the publication rate for each subspecialty were evaluated. Results. Among 268 oral abstracts, 111 (41.8%) were published as full-text articles. Of these, 66 (59.5%) were published in journals indexed in the Science Citation Index Expanded. Approximately one-third (32.4%) of the articles were published in Q1 or Q2 ranked journals. The average impact factor was 1.72 ± 1.26 and the mean time to publication was 1.6 ± 1.17 years. The most common study design published was retrospective (51.3%), and the majority were single-center studies (88.3%). The highest publication rates were observed in the fields of rheumatology, adolescent medicine, and infectious diseases. Conclusion. A significant portion of the papers presented at TNPC congresses are published in peer-reviewed scientific journals. The fact that more than one-third of the published studies appear in high-impact journals demonstrates the academic quality of the papers presented at the congresses and the effectiveness of the selective evaluation process. The findings provide valuable contributions to the monitoring and development of academic productivity in the field of pediatrics in Türkiye.
2026-02-26
Şebnem Çalkavur, Oğuz Han Kalkanlı, Tuna Ketenci, Nazan Kavas, Miray Yılmaz Çelebi, Arzu Bayram, İlker Devrim
2026-02-26
Salih Keskin, Mithat Temizer
Background. Vaccine hesitancy has intensified since COVID-19. In Türkiye, a performance-based family medicine system provides free vaccines. Before May 2024, physicians could remove refusals from metrics tied to pay deductions, obscuring true rates. A new policy mandating documentation created a natural experiment. We used population-based data to quantify these previously hidden dose-specific refusal rates across the childhood schedule. Methods. We conducted a population-based ecological analysis of monthly dose-specific refusals among children aged 0–59 months in Balıkesir Province, in 2024. Refusals were extracted from Performance Exception Forms. Rates were calculated per 1,000 target children (Wilson 95% confidence intervals [CI]s), using populations derived from Turkish Statistical Institute counts. To quantify the policy’s impact, we fitted an interrupted time-series regression with a fixed breakpoint at May 2024. This model estimated the baseline level and slope (January-April) and compared them to the immediate level shift and new monthly slope post-reform (May–December). Results. Of 3,584 missed-dose exceptions, 3,002 (83.8%) were refusals. The aggregate refusal rate was 3.9 per 1,000 (January-April) versus 21.6 per 1,000 (May–December), while the rate of on-schedule vaccinations decreased from 99.3% to 97.5%. Segmented regression indicated a baseline of 2.6 per 1,000 and a post-policy level increase of 13.7 per 1,000 (p=0.005); pre- and post-policy monthly slopes were not significant. Refusals concentrated in booster and later-scheduled doses (18–48 months), whereas primary-series doses showed lower, comparatively stable rates. Notably, refusal for the second measles-mumps-rubella dose (MMR-II, 48 months) rose toward year-end, reaching 47.4 per 1,000 in December (95% CI, 35.1–63.6). Conclusions. Mandatory documentation exposed substantial under-ascertainment of parental refusal in performance-based records. Refusal is disproportionately clustered at booster and later-childhood visits, with MMR-II approaching herd-immunity margins. Programmatically, pediatric booster encounters are key leverage points for targeted counseling, and sustained, transparent surveillance as enabled by the new policy, is essential for early signal detection and response.
2026-02-26
Mishquat Shabbir, Fatima Zahid, Noman Alam, Manahil Bahrawar
2026-02-26
Sümeyye Sözduyar, Hilmican Ulman, Ali Tekin, İbrahim Ulman, Sibel Tiryaki
Background. Cystinuria is a rare autosomal recessive disorder leading to recurrent cystine stone formation, often necessitating repeated surgical interventions. In Türkiye, tiopronin—a proven medical therapy—has become inaccessible since 2019, raising concerns about its economic and clinical consequences. This study aimed to compare the annual hospital costs of surgical management with the theoretical cost of tiopronin therapy in pediatric cystinuria patients. Methods. This single-center, retrospective study included 10 consecutive pediatric patients (median age: 12 years; range: 3-17 years) with genetically or biochemically confirmed cystinuria who underwent surgery for cystine stones in 2023. The annual cost of surgical management was calculated by summing all direct medical costs (operating room, anesthesia, devices, hospitalization, and related diagnostics) obtained from the hospital billing database. The theoretical annual cost of tiopronin therapy was calculated based on the last accessible market price of the drug in Türkiye, converted to Turkish Lira at the 2023 average exchange rate, and adjusted per patient using a standard dosing regimen of 15 mg/kg/day. Costs were compared using the Mann-Whitney U test. Results. The median annual surgical cost per patient was 49,936 TL (range: 14,791–84,576 TL), compared to a theoretical tiopronin cost of 27,923 TL (range: 9,307–27,925 TL). Surgical management was significantly more expensive than tiopronin therapy (p=0.001) in 9 of 10 cases. Six patients had a history of tiopronin use, and five of them experienced a surgery-free interval during medication (median duration: 3 years; range: 2-6 years). Preliminary follow-up data for 2024 revealed that 70% of patients required further surgical interventions (median: 2 surgeries per patient), demonstrating the persistent and recurrent nature of the disease when managed solely with surgery. Conclusion. Surgical treatment of cystinuria poses a substantially higher economic burden compared to tiopronin therapy. Our findings support the reintroduction of tiopronin into the Turkish healthcare system, particularly for pediatric patients with frequent stone recurrence.
2025-12-29
Chenglv Liu, Lijie Dong, Qiaoling Yang, Lang Bai
Background. To investigate the diagnostic and pathological staging value of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 levels in retinopathy of prematurity (ROP). Methods. A total of 70 infants with ROP (140 eyes) treated at our hospital from October 2018 to October 2023 were enrolled as the ROP group, while 70 healthy preterm infants (140 eyes) of the same gestational age without ROP were selected as the control group. The relative expression levels of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 were detected by quantitative real-time PCR. Logistic regression analysis was used to identify factors influencing ROP occurrence. The diagnostic efficacy of the three circular RNAs (circRNAs) was evaluated using receiver operating characteristic (ROC) curve analysis. Results. The relative expression levels of hsa_circ_0061346 in serum were significantly higher in the ROP group than in the control group (6.27 ± 3.60 vs. 0.72 ± 0.31, P Conclusion. The combined detection of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 may provide a novel approach for the early diagnosis and severity assessment of ROP.