Objective: Isolated facial injuries are less common among pediatric trauma patients. The literature has focused on, especially, fractures in facial injuries. There is a limited number of studies evaluating all facial injuries in childhood. The study aims to evaluate the clinical characteristics of maxillofacial injuries and to identify patients who require further intervention. Methods: The data from pediatric patients with maxillofacial injury (<18 years) between January 2011 and December 2015 were collected. Demographic characteristics, trauma mechanisms, concomitant injuries, treatments, hospitalization, and follow-up results were recorded. Results: The median age of the patients (N = 2926) was 5.0 years (2.0–10.0 years), and 63.1% were boys. Falls and motor vehicle accidents were the leading mechanism of injury. The most common injury types were lacerations (49.3%) and fractures (15.5%). One hundred thirty (0.4%) patients had concomitant injuries. Surgical treatment was performed in only 3.4% of the patients, and the mortality rate was 0.6%. Patients with concomitant injuries had more hospitalization rates, surgical treatment, and organ dysfunction. All patients who underwent cardiopulmonary resuscitation and resulted in mortality were in the concomitant injury group. Conclusions: Isolated facial injuries are unlikely to be life-threatening, and basic interventions are sufficient in most of the maxillofacial injuries. The primary issue in maxillofacial injuries is to recognize and manage concomitant injuries that can lead to organ dysfunction and mortality.

Objective: This study aims to evaluate the long-term neurological outcomes of neonates diagnosed with mild hypoxic-ischemic encephalopathy (HIE) and compare them with moderate/ severe cases, hypothesizing that a significant proportion of mild HIE cases may experience adverse neurodevelopmental sequelae. Materials and Methods: This was a cross-sectional observational study evaluating the neurodevelopmental outcomes of neonates with mild versus moderate/severe HIE. Maternal, perinatal, and neonatal characteristics along with treatments were documented. Neurological outcomes were assessed via brain MRI, the Ankara Developmental Screening Inventory (ADSI), and developmental milestones. Results: The study included 42 infants, 20 (47.6%) were classified as having mild HIE and 22 (52.4%) as moderate/severe HIE. Baseline characteristics were similar except that moderate/ severe cases had lower 1-minute Apgar scores (median 4 vs. 6; P = .02) and more frequent need for advanced resuscitation (68% vs. 25%; P = .006). All moderate/severe infants received TH vs. none in the mild group. Invasive mechanical ventilation and adjuvant neuroprotective agents were also more frequently used in the moderate/severe group. Magnetic resonance imaging abnormalities consistent with HIE were present in 2/12 mild cases (16.7%) vs. 8/19 (42.1) in moderate/severe cases. There were no significant differences in HIE injury pattern between the 2 groups (P = .197). On ADSI screening, 8/12 (66.7%) mild HIE survivors showed gross motor delay compared with 5/7 (71.4%) moderate/severe survivors. Conclusion: Even infants with mild HIE are at risk of adverse neurological outcomes. The development of more sensitive diagnostic tools could improve treatment strategies and early interventions, ultimately impacting prognosis. With proper recognition, tailored follow-up, and appropriate therapeutic approaches, potential neurodevelopmental impairments in mild HIE cases could be mitigated. Cite this article as: Canbeldek M, Armağan C, Şenol HB, et al. Challenging mild hypoxic–ischemic encephalopathy: insights into neurological outcomes.Turk Arch Pediatr. 2025;60(5):507-514.

Background: Familial apo C-II deficiency is a rare hereditary disorder frequently caused by lipoprotein lipase (LPL) andAPOC2gene mutations. To date, less than 30 patients with familial apo C-II deficiency with 24 different mutations have been identified in the literature. Here, we describe two familial chylomicronemia syndrome cases in infants with two novel mutations of theAPOC2gene.Case presentation: Case 1, a 46-day-old female, was admitted to our hospital for evaluation due to the lipemic appearance of the blood sample. A clinical examination revealed hepatomegaly and lipemia retinalis. Triglyceride level of 6295 mg/dL was decreased with a strict low-fat diet, medium-chain triglycerides (MCT) oil-rich formula and omega-3 fatty acid supplementation. Due to low adherence to the diet, TG elevation was detected and fresh frozen plasma (10 mL/kg/day) was administered for 2 days. A novel homozygous p.Q25X (c.73C>T) mutation in theAPOC2gene was detected. Case 2, a 10-month-old female patient, referred to our center for the differential diagnosis of hyperlipidemia as her blood sample could not be assessed due to its lipemic appearance. Laboratory examinations showed a TG level of 4520 mg/dL which was reduced with a low-fat diet, MCT oil-rich formula and omega-3 fatty acid supplementation. Hepatosteatosis and splenomegaly were determined using abdominal sonography. A novel homozygous IVS2+6T>G (c.55+6T>G) mutation in theAPOC2gene was identified.Conclusions: We describe two novel homozygous mutations (p.Q25X [c.73C>T] and IVS2+6T>G [c.55+6T>G]) in theAPOC2gene in infants with hyperchylomicronemia. To the best of our knowledge, Case 1 is the youngest patient with familial apo C-II deficiency in the literature to date.

Objectives: Very low birth weight (VLBW) infants are at disproportionately high risk for neonatal seizures, yet optimal first-line antiseizure medication (ASM) strategies in this vulnerable population remain a matter of debate. Over the past decade, levetiracetam (LEV) has emerged as a promising alternative to phenobarbital (PB), driven by growing concerns over PB’s limited efficacy and potential neurotoxic effects. Methods: This retrospective cohort study analyzed medical records of VLBW infants treated for seizures at our Neonatal Intensive Care Unit from 2013 to 2023. We compared the efficacy and safety of LEV and PB as initial antiepileptic treatments. Data on gestational age, birth weight, type of seizures, electroencephalogram findings, and treatment outcomes were meticulously collected and analyzed. Results: The study included 103 VLBW infants (mean gestational age 26.17±2.31 weeks); 27 received LEV and 76 received PB. Baseline demographic and clinical characteristics were comparable between the two groups. Although the LEV group had a higher proportion of infants with severe intraventricular hemorrhage and necrotizing enterocolitis indicating a potentially more critical baseline, these differences were not statistically significant. The primary outcome revealed that significantly fewer infants in the LEV group were unresponsive to initial treatment compared to the PB group (14.8 vs. 56.6 %; p<0.001). Furthermore, lower gestational age was identified as a significant risk factor for PB unresponsiveness. Conclusions: This study supports that LEV is more successful in clinical seizure control compared to PB as the first choice in ASM selection in VLBW. If our study results are supported by randomized controlled prospective studies, LEV, with its potentially fewer side effects, could be included in clinical algorithms as the first-choice ASM especially for VLBW.