Turkish archives of pediatrics最新文献

{"title":"Pediatric Sports Medicine: A Comprehensive Review.","authors":"Abdullah Akkuş, Hüseyin Aslan, Uğur Saraç, Resul Yilmaz, Sümeyye Dursun, Nefise Betül Ercan, Mehtap Yücel, Ceylani Özkaymakoğlu, Ali Tatlici, Ahmet Osman Kiliç, Abdullah Yazar, Fatih Akin, Chris G Koutures","doi":"10.65717/TurkArchPediatr.2026.26070","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26070","url":null,"abstract":"<p><strong>Unlabelled: </strong>As participation of children in exercise and organized sports increases worldwide, the health care needs of young athletes differ substantially from those of adults due to age-specific physiological, biomechanical, and psychosocial characteristics related to growth and development. Pediatric Sports Medicine (PSM) is a pediatric-based, multidisciplinary subspecialty that encompasses preparticipation physical evaluation (PPE), exercise prescription, management of sports injuries and overuse syndromes, sport-related concussion, heat-related illnesses, assessment of sudden cardiac event risk, relative energy deficiency in sport (RED-S), planning safe sports participation for children with chronic medical conditions, and safeguarding in sport. In the United States, PSM is formally structured through pediatric-based fellowship training and board certification, whereas Europe lacks a standardized model and relies on heterogeneous approaches integrating pediatrics, sports medicine, and rehabilitation. In Türkiye, sports medicine training remains largely adult-oriented. Given that pediatric subspecialty training is strictly based on prior pediatric specialization and that pediatricians are routinely consulted for comprehensive medical evaluations, the absence of a pediatric-based PSM structure has resulted in notable gaps in pediatric-specific PPE standardization, early sport specialization and load management, RED-S screening, integration of school-club-health care systems, and the health care component of safeguarding policies. This narrative review presents a literature-based synthesis of the conceptual foundations and clinical and public health rationale of PSM, summarizes relevant international guidelines and consensus statements, and proposes a feasible framework for its implementation in Türkiye, where this subspecialty has not yet been established.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 9","pages":"774-784"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932163","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":"Peer Bullying in Zülfü Livaneli's Novel \"Wait for Me\".","authors":"Yaren Nur Eraslan, Nejat Akar","doi":"10.65717/TurkArchPediatr.2026.26168","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26168","url":null,"abstract":"","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 9","pages":"852-853"},"PeriodicalIF":2.3,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932132","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 Childhood Behçet's Disease: A Single-Center Experience.","authors":"Onur Bahçeci, Fatma Aydın, Zeynep Birsin Özçakar","doi":"10.65717/TurkArchPediatr.2026.26039","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26039","url":null,"abstract":"<p><strong>Objective: </strong>Behçet's disease (BD) is a rare chronic inflammatory vasculitis in childhood that can involve vessels of all sizes. Clinical findings vary according to age, sex, and geographic regions. This study aimed to describe the demographic, clinical, and immunogenetic features of pediatric patients with BD and to compare clinical characteristics between human leukocyte antigen (HLA)-B51-positive and -negative patients.</p><p><strong>Methods: </strong>Medical records of patients diagnosed with BD between January 2020 and June 2025 were retrospectively reviewed. Patients younger than 18 years at diagnosis who met international criteria were included.</p><p><strong>Results: </strong>A total of 38 patients (20 females) were included. The median age at onset was 12.5 years and at diagnosis was 14 years. A family history of BD was present in 19 patients. HLA-B51 positivity was detected in 20 patients, and the pathergy test was positive in 13 patients. Subgroup analysis comparing HLA-B51-positive and -negative patients revealed no significant differences in demographic and clinical variables (P > .05). Recurrent oral ulcers were observed in all patients, skin lesions in 28 patients, genital ulcers in 25 patients, uveitis in 11 patients, and joint involvement in 10 patients. All patients received colchicine. Corticosteroids and azathioprine were used in 12 and 11 patients, respectively, while other immunosuppressive or biologic agents were reserved for severe organ involvement.</p><p><strong>Conclusion: </strong>In childhood BD, mucocutaneous findings are the most common manifestations. The high frequency of family history and HLA-B51 positivity highlights genetic predisposition. Colchicine is effective as first-line therapy, with additional immunosuppressive agents used according to organ involvement.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 9","pages":"838-844"},"PeriodicalIF":2.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932173","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":"Impact of Immunotherapy Combinations on Clinical Outcomes in Children with Acute Flaccid Paralysis: A Multicenter Intensive Care Study.","authors":"Edin Botan, Merve Boyraz, Servet Yüce, Hazal Ceren Tuğrul, Emrah Gün, Şeyma Erdem Torun, Hasan Özen, Merve Havan, Ayşe Aşık, Anar Gurbanov, Eda Eşe Karadağlı, Emine Ulu Botan, Alper Köker, Sinan Yavuz, Hatice Feray Arı, Muhterem Duyu, Özden Özgür Horoz, Faruk Ekinci, Oğuz Dursun, Rıza Dinçer Yıldızdaş, Tanıl Kendirli","doi":"10.65717/TurkArchPediatr.2026.25350","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25350","url":null,"abstract":"<p><strong>Objective: </strong>Acute flaccid paralysis (AFP) is a syndrome characterized by the rapid onset of limb weakness and decreased muscle tone, frequently accompanied by respiratory or bulbar involvement.</p><p><strong>Methods: </strong>This retrospective multicenter study evaluated the clinical characteristics, treatment modalities, intensive care processes, and outcomes of 68 children diagnosed with AFP who were admitted to pediatric intensive care units (PICUs) between January 1, 2018, and January 1, 2023.</p><p><strong>Results: </strong>The patients' ages ranged from 1 month to 18 years (mean 7.9 ± 4.5 years), and 33 (48.5%) were male. The mean PICU stay was 15.4 ± 19.5 days, and the mean total hospital stay was 23.3 ± 21.1 days. Respiratory support was required in 42 patients (61.8%). All patients received intravenous immunoglobulin (IVIG). Therapeutic plasma exchange (TPE) was administered to 25 of 43 Guillain-Barré syndrome (GBS) patients, 7 of 11 transverse myelitis (TM) patients, and 11 of 14 acute disseminated encephalomyelitis (ADEM) patients. Among 14 intubated GBS patients, 5 received IVIG for ≤2 days and 9 for ≥4 days. The duration of invasive mechanical ventilation (MV) was significantly longer in patients receiving IVIG for ≥4 days (P=.044). Guillain-Barré syndrome patients treated with combined IVIG and TPE had longer PICU stays compared with those receiving IVIG alone (P=.001).</p><p><strong>Conclusion: </strong>Combination immunotherapies were associated with longer MV duration and PICU stay compared with monotherapy in AFP patients. In intubated GBS patients, administration of IVIG over 2 days was associated with a shorter duration of invasive MV.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 10","pages":"911-918"},"PeriodicalIF":2.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120014","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 Disappearing Uncertainty: Preserving Doubt in the Age of Instant Science.","authors":"Hakan Babaoğlu, Özgür Kasapçopur","doi":"10.65717/TurkArchPediatr.2026.8001","DOIUrl":"10.65717/TurkArchPediatr.2026.8001","url":null,"abstract":"","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 8","pages":"658-659"},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655287","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":"Disparities in Congenital Adrenal Hyperplasia Screening Follow-up Times Between Immigrants/Refugees and Local Populations in Türkiye: A Cross-Sectional Study.","authors":"Emrullah Arslan, Mehmet Akif Sezerol","doi":"10.65717/TurkArchPediatr.2026.25540","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25540","url":null,"abstract":"<p><strong>Objective: </strong>Congenital adrenal hyperplasia (CAH) requires timely diagnosis to prevent life-threatening adrenal crises. This study aimed to evaluate the first-year results of the CAH screening program in a district with a high refugee density and to compare the screening process timelines between the local population and immigrants/refugees.</p><p><strong>Methods: </strong>This retrospective cross-sectional study analyzed data from the National Newborn Screening Program in Sultanbeyli, İstanbul, between January 2022 and January 2023. Newborns were stratified into 2o groups: local population (Turkish citizens) and immigrants/refugees. Screening outcomes, sample collection times, transfer times, and referral results were compared.</p><p><strong>Results: </strong>The study included 5934 newborns, of whom 14% (n=868) were immigrants/refugees. Analytical screening performance was comparable between groups, with similar rates of second-tier testing (1.76% vs. 1.8%) and recall (0.4%). However, a significant disparity was observed in the median age at sample collection, which was 12 days (range: 1-65) for immigrants/refugees compared to 6 days (range: 0-176) for the local population (P < .001). Being an immigrant was identified as an independent risk factor for delayed sampling, regardless of primary care registration status. Once samples were collected, transfer and approval times were identical for both groups.</p><p><strong>Conclusion: </strong>While the logistical infrastructure of the screening program functions efficiently for all infants, there is a critical delay in the initial access step for refugee newborns. This delay poses a risk for missed early diagnosis of salt-wasting CAH. Targeted interventions, including multilingual education at hospital discharge, are essential to ensure timely screening for this vulnerable population.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 8","pages":"696-702"},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655140","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 Profile and Outcomes of Congenital Heart Disease Among Children Under 5 Years: A Cross-Sectional Retrospective Study from Kigali-Rwanda.","authors":"Lojain Dafaalah, Emmanuel Rusingiza, Hussam AlKhalifamohamed, Sara Mohamed, Mohamed El Mustafa Yahya Mohamed Eldouma, Abuobieda Alawad, Muzamil Elkhalifa Mohammed Elkhalifa","doi":"10.65717/TurkArchPediatr.2026.25387","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25387","url":null,"abstract":"<p><strong>Objective: </strong>Congenital heart disease (CHD) is the most common congenital anomaly world-wide, yet data from Rwanda remain limited. Understanding its clinical profile and outcomes is essential for improving pediatric cardiac care. This study aimed to describe the clinical characteristics, diagnostic patterns, management strategies, and outcomes of cCHD among children under 5 years of age at a tertiary hospital in Kigali, Rwanda, and to compare these parameters across different CHD subtypes.</p><p><strong>Methods: </strong>A retrospective hospital-based cross-sectional study was conducted at the University Teaching Hospital of Kigali (CHUK), Rwanda, from June 2022 to December 2023. Medical records of children under 5 years with echocardiographically confirmed CHD were reviewed. Demographic, clinical, management, and outcome data were analyzed using descriptive statistics and comparative tests, with statistical significance set at P < .005.</p><p><strong>Results: </strong>Among 361 children with CHD, the mean age was 33.3 ± 20.8 months, and 51.8% were female. Acyanotic CHD predominated (83.7%), with ventricular septal defect (VSD) (35.1%) and patent ductus arteriosus (PDA) (29.8%) most common; Tetralogy of Fallot (TOF) was most frequent among cyanotic lesions (76.3%). The most common clinical features were breathing difficulties (71.5%) and failure to thrive (53.5%). Transthoracic echocardiography was the primary diagnostic tool, preceded by cardiac ultrasound in 66.2%. Medical therapy was the mainstay (furosemide 76.5%), with cardiac interventions performed in 34.6% (most commonly VSD closure and atrial septal defect (ASD) repair). Follow-up was the most frequent outcome (acya-notic 54%, cyanotic 71%), with low mortality (3.0% vs 3.4%). Children with cyanotic CHD wereolder and had higher anthropometric measurements, while stunting was more frequent in acyanotic lesions (96% vs 78%, P < .001). Clinical features were not associated with mortality, and alldeaths occurred in children without comorbidities, suggesting an acute course of deterioration.</p><p><strong>Conclusion: </strong>Acyanotic CHDs were predominant among children under 5 in Rwanda, with late presentation and limited access to definitive interventions. Strengthening early screening, diagnostic capacity, and surgical services is crucial to improving outcomes. Further research on genetic and familial risk factors is warranted.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 8","pages":"718-726"},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655371","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":"Balancing Overtreatment and Safety: Impact of 2023 Guideline Change on Antibiotic Use in Late Preterm Infants.","authors":"Dogan Kaymaz, Deniz Uzun, Ferhan Demirtas, Yasemin Ezgi Kostekci, Emel Okulu, Omer Erdeve, Begum Atasay, Saadet Arsan","doi":"10.65717/TurkArchPediatr.2026.25554","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25554","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of the 2023 national guideline revision, which increased the gestational age threshold for empirical antibiotic initiation from <34 to <35 weeks, on hospitalization and antibiotic exposure in infants born at 340/7-346/7 weeks.</p><p><strong>Materials and methods: </strong>This single-center retrospective cohort study included all live-born infants at 340/7-346/7 weeks between April 2018 and September 2023. The same cohort was reassessed according to the 2018 and 2023 Turkish Neonatology Society's national guidelines on the Diagnosis and Treatment of Neonatal Infections criteria. For each infant, neonatal intensive care unit (NICU) admission, empirical antibiotic use, and hospitalization duration were recalculated under both scenarios.</p><p><strong>Results: </strong>A total of 272 infants were included. Under the 2018 guideline, 68 infants (25.0%) required empirical antibiotics, whereas the 2023 guideline classified 197 infants (72.4%) as needing treatment, adding 129 newly eligible infants. Among these, 66 infants who had previously roomed-in required new NICU admission, increasing total admissions from 183 (67.3%) to 249 (91.5%). Median antibiotic duration increased from 0 days to 2 days, and median hospitalization increased from 5 to 6 days (both P < .001). None of the newly classified infants developed clinical or culture-proven early-onset neonatal sepsis (EONS).</p><p><strong>Conclusion: </strong>Raising the gestational age threshold to <35 weeks substantially increased empirical antibiotic use and NICU admissions without improving EONS detection. These findings highlight the need for more refined and clinically integrated risk-stratification strategies and underscore the broader implications of unnecessary antibiotic exposure, including increased NICU utilization, healthcare burden, and antimicrobial stewardship concerns.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 8","pages":"703-709"},"PeriodicalIF":2.3,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655320","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":"Extracorporeal Membrane Oxygenation in Pediatric Patients.","authors":"Ayşen Durak Aslan, Eda Eyduran, Merve Havan, Tanıl Kendirli","doi":"10.65717/TurkArchPediatr.2026.26583","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.26583","url":null,"abstract":"<p><strong>Unlabelled: </strong>The primary goal of extracorporeal membrane oxygenation (ECMO) is to provide time for the effective treatment of the underlying disease; it does not directly treat the disease itself but serves as a bridge to recovery or to definitive therapies such as heart or lung transplantation. This review article aims to examine the fundamental components and various cannulation strategies of ECMO in pediatric patients, as well as its indications, anticoagulation strategies, and potential complications.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 8","pages":"666-682"},"PeriodicalIF":2.3,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655124","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":"Community-Acquired Staphylococcus aureus Infections in Children: Clinical and Microbiological Characteristics.","authors":"Aslıhan Sahin, Esra Kaya","doi":"10.65717/TurkArchPediatr.2026.25504","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25504","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the clinical features, antimicrobial resistance, and temporal patterns of community-acquired Staphylococcus aureus infections among children in a tertiary hospital in Türkiye.</p><p><strong>Methods: </strong>Medical records of pediatric patients diagnosed between January 2022 and December 2024 were retrospectively reviewed. Demographic, clinical, and microbiological data were analyzed, and methicillin-resistant S. aureus (MRSA) and methicillin-susceptible (MSSA) isolates were compared to assess temporal variation and resistance profiles.</p><p><strong>Results: </strong>Twenty-six pediatric patients were included 17 (65.4%) MRSA and 9 (34.6%) MSSA. The median age was 1.6 years (min-max: 1 month-16 years), with 69.3% under 5 years. Fourteen (53.8%) were girls. Abscess was the most common presentation (53.8%), followed by blood-stream (26.9%) and urinary tract infections (19.2%). Compared with MSSA, MRSA cases had a similar median age (1.2 vs. 2.0 years; P=.892) and showed no association with chronic comorbidities (29.4% vs. 33.3%; P=1.000) or recent antibiotic use (47.1% vs. 44.4%; P=1.000). The MRSA was more frequent among abscess isolates (71.4%, 10/14); however, the MRSA proportion did not differ significantly by specimen type (P=.480) or study year (P=.261). MRSA isolates were highly susceptible to trimethoprim-sulfamethoxazole with low clindamycin resistance.</p><p><strong>Conclusion: </strong>The observed MRSA proportion and susceptibility profile underscores the importance of ongoing local surveillance and stewardship. Strengthening pediatric-focused infection control and optimizing empirical therapy, especially in outpatient soft tissue infections, are crucial.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 8","pages":"690-695"},"PeriodicalIF":2.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655130","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}