Turkish archives of pediatrics最新文献

{"title":"Attention-Deficit/Hyperactivity Disorder Symptoms in School-Aged Children with a History of Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Denitis Syndrome: A Comparative Evaluation with Healthy Peers.","authors":"Gizem Durcan, Mehmet Yildiz, Aybike Aydin Okuyan, Eren Tabel, Sezgin Sahin, Kardelen Taysi, Elif Kilic Konte, Nergis Akay, Burak Dogangun","doi":"10.65717/TurkArchPediatr.2026.26431","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26431","url":null,"abstract":"<p><strong>Objective: </strong>Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is the most common periodic fever syndrome of childhood, and growing evidence links early-life inflammation to neurodevelopment, but whether PFAPA affects attention and behavior at school age is unknown. This study compared parent-reported attention-deficit/hyperactivity disorder (ADHD) symptoms in school-aged children with a preschool PFAPA diagnosis with those of healthy peers and examined associations with PFAPA-related clinical characteristics.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 96 children (mean age 10.84 ± 1.64 years) diagnosed with PFAPA during the preschool years and followed at a pediatric rheumatology clinic and 81 healthy controls (10.40 ± 1.88 years) without chronic disease or tonsillectomy. Attention-deficit/hyperactivity disorder symptoms were assessed with the Revised Conners' Parent Rating Scale-Short Form (CPRS-R:S).</p><p><strong>Results: </strong>The groups did not differ in age or sex. No significant between-group difference was found on any CPRS-R:S subscale. Within the PFAPA group, an earlier age at symptom onset was weakly but significantly correlated with a higher ADHD Index (ρ = -0.317, P = .002), and this association remained significant after false discovery rate correction (false discovery rate-adjusted P value [pFDR] = 0.048) and multivariable adjustment (β = -0.295, P = .004); subgroup analyses by comorbidity, tonsillectomy, and medication use showed no differences.</p><p><strong>Conclusion: </strong>Children with a preschool diagnosis of PFAPA did not show increased parentreported ADHD symptoms at school age. The weak association with earlier onset warrants cautious interpretation. These findings suggest that the immune-neurodevelopment relationship should be considered in a disease-specific manner, distinguishing PFAPA's benign, episodic course from chronic autoinflammatory diseases.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 10","pages":"936-944"},"PeriodicalIF":2.3,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Obesity Overtakes Underweight: Is It Really the Child's Fault?","authors":"Durmuş Doğan","doi":"10.65717/TurkArchPediatr.2026.1001","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.1001","url":null,"abstract":"","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 10","pages":"860-863"},"PeriodicalIF":2.3,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Chronic Hemodialysis in Children Younger Than 2 Years or Weighing <10 kg: A Single-Center Comparative Study.","authors":"Esra Karabag Yilmaz, Nur Canpolat, Elif Orkan, Gülseren Pehlivan, Seha Saygılı, Güntülü Şık, Ayse Agbas, Lale Sever, Salim Caliskan","doi":"10.65717/TurkArchPediatr.2026.26268","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26268","url":null,"abstract":"<p><strong>Objective: </strong>Chronic hemodialysis (HD) in infants and small children is technically demanding, and data on treatment burden and clinical outcomes remain limited. This study compared treatment-related complications and outcomes in infants and small children receiving chronic HD with those in older children treated at the same center.</p><p><strong>Methods: </strong>This single-center retrospective cohort study evaluated all children who initiated chronic HD at a tertiary pediatric nephrology center between January 2015 and December 2025. The study group comprised 16 children who initiated HD before 2 years of age and/or at a body weight <10 kg and remained on HD for at least 3 months. The control group included all eligible children aged >2 years and weighing ≥10 kg who fulfilled the same minimum HD-duration criterion and initiated HD within 6 months before or after the HD initiation date of any study patient. This calendar-time sampling strategy yielded 36 contemporaneous controls. Growth, vascular access burden, anemia- and mineral and bone disorder-related parameters, kidney transplantation (KTx), and mortality were compared.</p><p><strong>Results: </strong>Median age at HD initiation was 1.0 year (IQR, 0.6; 1.9) in the study group and 14.4 years (IQR, 9.6; 16.4) in the control group (P < .001). The change in height standard deviation scores during HD follow-up did not differ significantly between groups. The study group had a higher catheter burden per patient-year, lower time-averaged hemoglobin, greater erythropoiesis-stimulating agent requirements, more frequent erythrocyte transfusions, higher timeaveraged parathyroid hormone levels, and lower calcitriol doses (all P < .05). No statistically significant differences were detected in KTx rate, time to transplantation, or mortality.</p><p><strong>Conclusion: </strong>Chronic HD may provide a feasible bridge to KTX in selected infants and small children. No statistically significant differences in growth trajectories, transplantation, or mortality were observed between the groups. However, due to the small number of patients, this result should not be interpreted as evidence of equivalence. On the other hand, younger and smaller patients experienced greater vascular access and anemia-related treatment burdens, as well as a less favorable mineral and bone disorder profile.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 10","pages":"928-935"},"PeriodicalIF":2.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurometabolic Epilepsies: A Practical Guide to Recognition, Diagnostic Workup, and Precision Treatment.","authors":"Esma Şengenç, Tanyel Zubarioglu, Ertuğrul Kiykim, Çiğdem Aktuğlu Zeybek","doi":"10.65717/TurkArchPediatr.2026.26401","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26401","url":null,"abstract":"<p><strong>Unlabelled: </strong>Neurometabolic epilepsies are a heterogeneous group of inherited metabolic disorders in which seizures are a major clinical feature and may be the presenting symptom. Although each disorder is rare, they are clinically significant because many are potentially treatable and early intervention can substantially improve neurological outcomes. The clinical spectrum includes neonatal epileptic encephalopathies, infantile spasms, developmental and epileptic encephalopathies, progressive myoclonic epilepsies, and late-onset epileptic syndromes. Epileptogenesis arises from diverse mechanisms, such as impaired cerebral energy metabolism, neurotransmitter dysfunction, accumulation of neurotoxic metabolites, cofactor deficiencies, and organelle dysfunction. Recognizing a metabolic etiology requires a high index of suspicion. Key diagnostic clues include early seizure onset, developmental delay or regression, episodic neurological deterioration, movement disorders, multisystem involvement, characteristic neuroimaging findings, and a suggestive family history. A structured diagnostic approach that integrates first-tier biochemical investigations, targeted metabolic testing, cerebrospinal fluid studies, neurophysiological assessment, neuroimaging, and molecular genetic testing is essential for timely diagnosis. In critically ill patients, empirical administration of pyridoxine, pyridoxal-5'-phosphate, folinic acid, biotin, and selected cofactors should be considered while diagnostic investigations are ongoing. Ketogenic dietary therapy is a disease-specific treatment for selected disorders of cerebral energy metabolism, particularly glucose transporter type 1 deficiency syndrome and pyruvate dehydrogenase complex deficiency.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 10","pages":"870-885"},"PeriodicalIF":2.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Anxiety and Breastfeeding Self-Efficacy in the Neonatal Intensive Care Unit: A Narrative Review of Their Relationship with Breastfeeding Outcomes.","authors":"Seda Güray, Nejat Narli","doi":"10.65717/TurkArchPediatr.2026.26108","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26108","url":null,"abstract":"<p><strong>Unlabelled: </strong>Mothers of infants cared for in the neonatal intensive care unit (NICU) experience substantial psychological burden related to preterm birth, mother-infant separation, and stressors inherent to the intensive care environment. In this context, maternal anxiety and breastfeeding self-efficacy have been identified as key psychosocial factors influencing the initiation and continuation of breastfeeding. This narrative review examines the relationship between maternal anxiety and breastfeeding self-efficacy during the NICU stay and evaluates how this interaction is reflected in breastfeeding outcomes based on current evidence. The literature search was conducted in March 2025 using PubMed/MEDLINE, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar. Studies published between January 2000 and March 2025 were considered for inclusion in this narrative review. Quantitative, qualitative, and mixed-methods studies were thematically synthesized. The review focused on the theoretical foundations of breastfeeding self-efficacy, the relationships between maternal anxiety and lactation, the impact of the NICU environment on maternal psychological well-being, and factors associated with breastfeeding outcomes in hospitalized term and late preterm infants. The evidence indicates an inverse association between maternal anxiety and breastfeeding self-efficacy and suggests that breastfeeding self-efficacy may serve as an explanatory construct linking maternal psychological status to breastfeeding outcomes. The co-occurrence of high anxiety and low breastfeeding self-efficacy has been associated with less favorable breastfeeding patterns, whereas structured professional support and breastfeeding counseling are associated with more positive breastfeeding trajectories. In conclusion, breastfeeding in the NICU should be understood as a multidimensional process shaped by maternal psychological status, breastfeeding self-efficacy, and professional support. This review highlights the relevance of psychosocial factors for understanding breastfeeding support needs in the NICU.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 10","pages":"864-869"},"PeriodicalIF":2.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Neonates Presenting to the Pediatric Emergency Department with Non-Birth-Related Trauma.","authors":"Songül Tomar Güneysu, Okşan Derinöz Güleryüz, Ayla Akca Çağlar","doi":"10.65717/TurkArchPediatr.2025.25575","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2025.25575","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the mechanisms of non-birth-related trauma in term neonates (<28 days old) presenting to a tertiary pediatric emergency department and to propose preventive strategies.</p><p><strong>Methods: </strong>The authors retrospectively reviewed term neonates diagnosed with trauma unrelated to birth who presented to the Pediatric Emergency Department of Gazi University Faculty of Medicine between June 2018 and December 2023.</p><p><strong>Results: </strong>There were 78 neonates (55.1% male; mean age 18.0 ± 9.8 days) included in this study. All patients were brought by their parents in an outpatient setting. Falls were the leading cause of presentation (69.3%), most commonly involving strollers. Physical examination was unremarkable in 59% of cases. Cranial computed tomography was performed in 69.3%, revealing abnormalities in 40.7% of scans, whereas 12.8% did not undergo any imaging. A significant association was observed between PECARN risk stratification and both computed tomography (CT) utilization and detection of pathological findings. Most neonates (84.6%) were discharged home and the overall hospitalization rate was 7.7%.</p><p><strong>Conclusion: </strong>Non-birth-related trauma in neonates is predominantly mild and associated with favorable outcomes. However, imaging utilization remains relatively high despite largely benign clinical presentations. The frequent use of CT, even in the presence of normal physical examination findings, reflects the clinical uncertainty inherent in neonatal neurological assessment and the limited applicability of existing pediatric decision rules in this age group. These findings underscore the need for more standardized neonatal trauma assessment pathways to support judicious imaging decisions, reduce unnecessary radiation exposure, and optimize patient safety.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 10","pages":"919-927"},"PeriodicalIF":2.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental Determinants of Child Health: The Role of \"Healthy Places and Healthy Environment\".","authors":"Yakup Gözderesi, Jacqueline O'Hagan, Caroline Scott, Charlene Brooks","doi":"10.65717/TurkArchPediatr.2026.9001","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.9001","url":null,"abstract":"","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 9","pages":"758-762"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Fallacy of a Single Flick.","authors":"Sanjay Kalra, Nitin Kapoor","doi":"10.65717/TurkArchPediatr.2026.26544","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26544","url":null,"abstract":"","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 9","pages":"858-859"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Academic Mobbing: A Silent Threat to Institutional Integrity.","authors":"Kehinde Precious Fadele, Don Eliseo Lucero-Prisno, Bipin Chaurasia","doi":"10.65717/TurkArchPediatr.2026.26463","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26463","url":null,"abstract":"","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 9","pages":"856-857"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Is the Hematologic Inflammatory Index Useful for Detecting Acute Appendicitis in Pediatric Patients?\".","authors":"Samir Iddir, Brahim Lounis","doi":"10.65717/TurkArchPediatr.2026.26346","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26346","url":null,"abstract":"","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 9","pages":"854-855"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}