Pediatric palliative care (PPC) is an evolving field that focuses on supporting children with life-limiting conditions, where the quality of care is vital. This study is a retrospective observational investigation that examines the experiences of caregivers to inform health and social service planning and enhance PPC quality. Methods: Data of pediatric patients aged 3 months to 18 years admitted to a PPC inpatient unit over two years were retrospectively reviewed. Sociodemographic characteristics of primary caregivers, including age, gender, number of siblings, education, income, occupation, and marital status, were recorded. Caregiver burden and burnout were assessed using the Zarit Burden Interview and the Maslach Burnout Inventory, respectively. Associations between caregiver characteristics and these measures were analyzed. Results: A total of 118 patients and caregivers were evaluated; 54.2% of patients were male. The most common diagnoses were neurological diseases (44.9%), followed by syndromic–genetic disorders (28.8%). About 34% of patients required more than three medical devices. Most caregivers were female (91.5%), mainly mothers and 53% had only primary education. No significant differences in care burden or burnout were found based on caregiver gender, marital status, or child’s diagnosis. However, the use of nasogastric tubes and multiple medical devices was associated with higher burnout. Lower income was significantly linked to higher care burden, while longer caregiving duration correlated with both increased burden and burnout. A moderate positive correlation was found between Zarit and Maslach scores. Conclusions: The complexity of PPC patients’ care increases caregiver burden and burnout. Expanding specialized PPC services is crucial to support caregivers and sustain home-based care.

Serial perirectal swabs are used to identify colonization of multidrug-resistant bacteria and prevent spread. The purpose of this study was to determine colonization with carbapenem-resistant Enterobacterales (CRE) and vancomycin-resistant Enterococci (VRE). An additional purpose was to establish whether sepsis and epidemic associated with these factors were present in the neonatal intensive care unit (NICU), to which infants with hospital stays exceeding 48 h in an external healthcare center NICU were admitted. Perirectal swab samples were collected in the first 24 h by a trained infection nurse using sterile cotton swabs moistened with 0.9% NaCl from patients admitted to our unit after hospitalization exceeding 48 h in an external center. The primary outcome was positivity in perirectal swab cultures, and the secondary outcomes were whether this caused invasive infection and significant NICU outbreaks. A total of 125 newborns meeting the study criteria referred from external healthcare centers between January 2018 and January 2022 were enrolled. Analysis revealed that CRE constituted 27.2% of perirectal swab positivity and VRE 4.8%, and that one in every 4.4 infants included in the study exhibited perirectal swab positivity. The detection of colonization by these microorganisms, and including them within the scope of surveillance, is an important factor in the prevention of NICU epidemics.

Purpose: On February 6, 2023, two earthquakes of magnitude 7.7 and 7.6 occurred consecutively in Turkey and Syria. This study aimed to investigate the predisposing factors for wound infection (WI) and the microbiological characteristics of wounds after earthquake-related injuries. Methods: This descriptive study evaluated pediatric patients’ frequency of WI, and the clinical and laboratory parameters associated with the development of WI were investigated. Results: The study included 180 patients (91 female). The mean age of the patients was 123.9 ± 64.9 months and 81.7% (n = 147) of them had been trapped under rubble. Antibiotic treatment to prevent WI had been administered to 58.8% (n = 106) of all patients. WI was observed in 12.2% (n = 22) of the cases. In patients who developed WI, the incidence of exposure to a collapse, crush syndrome, compartment syndrome, multiple extremity injury, fasciotomy, amputation, peripheral nerve injury, thoracic compression, blood product use, intubation, and the use of central venous catheters, urinary catheters, and thoracic tubes were more frequent (p < 0.05). The need for blood product transfusion was associated with the development of WI (OR = 9.878 [95% CI: 2.504–38.960], p = 0.001). The negative predictive values of not developing WI at values of white blood cell count of < 11,630/mm³, creatine kinase < 810 U/L, potassium < 4.1 mEq/L, ALT < 29 U/L, AST < 32 U/L, and CRP < 45.8 mg/L were 93.7%, 96.8%, 90.8%, 93.3%, 100%, and 93.5%, respectively. Gram-negative pathogens (81%) were detected most frequently in cases of WI. Seventy-five percent of patients were multidrug- and extensively drug-resistant. Conclusion: This study leans empirical approach of our disaster circumstances. In cases with risk factors predisposing to the development of WI, it may be rational to start broad-spectrum antibiotics while considering the causative microorganisms and resistance profile to prevent morbidity.

Objective: As known, COVID-19, stemming from the SARS-CoV-2 virus, exhibits distinct clinical patterns across various variants. This research endeavors to comprehensively analyze the variations in clinical presentations between these variants and the original strain, particularly in pediatric COVID-19 pneumonia cases. Materials and Methods: Patients diagnosed with COVID-19 pneumonia who were admitted to Mersin City Research and Training Hospital between June 2020-2022, were included in the study. Clinical and laboratory data of the patients were evaluated according to their variant status. Results: 56% (n=62) of 110 pediatric patients were female, and their average age was 11±5.9 (median 13). 31%(n=34) of the patients were infected with the original strain, 20% (n=22) were alpha, 40% (n=44) were delta, and 9% (n=10) were omicron variant. 6% (n=7) of the patients were asymptomatic, 11% (n=12) were mildly symptomatic, 76% (n=83) were moderate (respiratory distress), and 7% (n=8) were severe clinical patients requiring mechanical ventilation. Fever and shortness of breath were most frequently seen in delta, and cough in alpha variant (p=0.0001;p=0.014;p=0.039,respectively). The most severe disease detected in omicron was alpha, delta and original virüs (p=0.001). No relationship detected between the laboratory values of the patients and the variant status (p>0.05). When patients were compared based on radiological severity, no significant differences were found between the variants (p=0.214). However, when cases were classified according to pneumonia severity, regardless of the variant status, higher levels of ferritin (p=0.0001) and CRP (p=0.037) were observed, while lymphocyte count (p=0.009) decreased with increasing pneumonia severity. It's noteworthy that no patient fatalities occurred. Conclusion: In our study, the most severe clinical picture was shown in the omicron variant, followed by the alpha variant. But, omicron cases were limited, and it is important to examine variants in a larger population.

The Systemic Immune-Inflammation Index is a measurement of the systemic immune-inflammatory response (SII), which is used as both a diagnostic and predictive index for many diseases. Burns are a major public health problem among children. Infection caused by burns is the most important cause of mortality in children. In this study aims to investigate the predictive and diagnostic performance of SII for infection for pediatrics at the burn center and the causes of burns and responsible microorganisms and possible risk factors on infection. Data were collected retrospectively from 42 pediatric patients between 2013 and 2023 and analyzed in the burn center. Infected and uninfected burn patients were compared. Scalds were the most common cause of burns in both groups, (91.3%; 87%, respectively). The most frequently isolated microorganism was Pseudomonas aeruginosa (52,6%). Central venous catheter use was the biggest risk factor for infection (OR = 8,077; 95% CI 1,523 to 42,834). The AUC value demonstrated an acceptable diagnostic performance (AUC = 0,605; 95% CI 0,450 to 0,746) Similarly, the odds ratio suggested a potential relationship between SII and infection (OR = 2,057; 95% CI 0,489 to 8,657), but both failed to reach statistical significance. The results of this investigation indicate limited predictive and diagnostic utility for SII. CRP performed better diagnostically than SII (AUC = 0,877; 95% CI 0,747 to 0,955), suggesting that traditional inflammatory markers may still be a better way to predict infection in pediatric burns. Moreover, substantial disparities in hemoglobin levels, lymphocyte counts, CRP, and procalcitonin between infected and uninfected groups indicate that a multi marker strategy may prove more efficacious than dependence on a solitary index. While the SII showed a tendency to predict infection in pediatric burn patients, it did not achieve statistical significance in our research. These findings highlight the need for larger-scale studies to clarify the role of SII in infection prediction among pediatric burn patients. Further research with larger cohorts or multicenter studies could help determine whether SII has clinical utility in this population. Also, accurate identification of infectious agents, development of effective treatment strategies, avoidance of prophylactic antibiotic use, and strict adherence to isolation precautions will significantly reduce the risk of infection in centers where burn patients are followed up.