Background: Chest pain, as a common cause of hospital admissions in childhood, necessitates detailed investigations due to a wide range of differential diagnoses. In this study, we aimed to determine the distribution of diseases causing chest pain in children and investigate the clinical characteristics of children with chest pain.Methods: This study included 782 patients aged between 3 and 18 years who presented to a paediatric cardiology outpatient clinic with chest pain between April 2017 and March 2018. Aetiological causes and demographic features of the patients were analysed.Results: Most prevalent causes of chest pain were musculoskeletal system (33%) and psychogenic (28.4%) causes. Chest pain due to cardiac reasons was seen in eight patients (1%). Diseases of musculoskeletal and gastrointestinal systems and psychogenic disorders were significantly more common in male and female patients, respectively (p < 0.001 for all). In winter, patients’ age and the number of patients with ≥12 years were higher than those in other seasons (p < 0.001). Most of the parents (70.8%) and patients (90.2%) thought that chest pain in their children was caused by cardiac causes.Conclusion: Most of the diagnoses for chest pain in childhood period are benign and include the musculoskeletal system and psychogenic diseases. Although chest pain due to cardiac diseases is rare, a comprehensive analysis of medical history, detailed physical examination and cardiac imaging with echocardiography is needed to reach more accurate diagnoses.

The primary aim of this study was to evaluate the effects of nocturnal enuresis (NE) on Health-Related Quality of Life (HRQoL) in children with a special emphasis on the domains of HRQoL. This was a case-control study in which consecutive children with NE were recruited along with their parents. Age and sex-matched children without enuresis served as controls. Age-appropriate children and proxy versions of the German Quality of Life Questionnaire (KINDL) were used to evaluate HRQoL and its domains. The clinicodemographic characteristics and family data were collected. HRQoL and the domain scores were compared between the patients and the control subjects. 100 children (50 of whom are males) with enuresis along with their parents were included in the study. 100 children served as the control group. The mean age of the patients was 9.58±2.77 years, and was no different from that of the control group. 55% of the children were receiving treatment for NE. The most common treatment was the nighttime waking (40%). The most commonly used drug was desmopressin. The median score of the health-related quality of life was 78.8 [69.2–83.3] in children with NE versus 90 [86.7–91.7] in the control group (p<0.001). In all domains, the median scores were significantly lower in children with NE compared with the controls. Turkish children with NE had a significantly lower HRQoL score compared with children without NE. All the domain scores were also significantly lower in children with NE compared with the control subjects.

Background: The growing number of patients in paediatric emergency departments requires fast and precise triage assessments. The implementation of large language models faces obstacles due to their limited interpretability. We aimed to compare the performance of ChatGPT 4o and Grok 3 with that of nurses and physicians in paediatric emergency triage. Methods: This prospective observational study evaluated paediatric emergency patients presenting to our paediatric emergency department between March and April 2025. Demographic data, chronic disease status, presenting complaints, and vital signs were documented. Patients were triaged according to ESI criteria by nurses, paediatric specialists (gold standard), ChatGPT 4o, and Grok 3. Inter-rater agreement was analysed using Cohen's kappa**. Cochran's Q and McNemar's tests were used for paired comparisons.** Results: A total of 1,505 paediatric emergency patients were included in the analysis. No ESI-1 cases were observed; therefore, critical patients were defined as ESI-2. Nurses achieved 53.1% (95% CI: 50.6–55.6) accuracy in triage assessments, while ChatGPT 4o achieved 76.1% (95% CI: 73.9–78.2) and Grok 3 achieved 47.0% (95% CI: 44.5–49.6) accuracy (Cochran's Q = 275.68, p < 0.001). ChatGPT 4o showed good agreement with physicians ( κ = 0.69). For critical patient identification, sensitivity was 37.2% for nurses, 82.9% for ChatGPT 4o, and 97.7% for Grok 3; however, Grok 3 demonstrated substantial over-triage (36.3%) and low positive predictive value (37.2%). ChatGPT 4o achieved the lowest mean absolute ESI error (0.25 ± 0.45). Nurses' critical patient recognition improved from 28.3% to 59.5% ( p < 0.01) for children with chronic illnesses. Conclusion: ChatGPT 4o achieved the most favourable balance of sensitivity and specificity. The superior performance of nurses in recognising critically ill patients with chronic diseases suggests that AI systems should augment nursing expertise rather than replace it.

Background: Management of pediatric anaphylaxis in the emergency department remains clinically important. The research investigated pediatric anaphylaxis medical indicators together with physician adherence to international treatment protocols at a Turkish tertiary medical center. Methods: Between September 2014 and July 2025, 166 pediatric anaphylaxis patients were retrospectively reviewed for triggering factors, clinical findings, treatment approaches, and quality indicators. Results: The mean age of the patients was 7.4 ± 5.6 years. Food allergy was the main cause with 53%, followed by drugs with 24.7%. Food allergy in infants was 85.7%, while drug reactions in adolescents reached 37.2% (p < 0.001). Skin findings were present in 93.4% of the patients, and respiratory symptoms were present in 67.5% of the patients. Epinephrine was administered to 97.6% of patients, 95.2% of whom were given intramuscularly. The rate of epinephrine administration in the first 30 min was 61.1%. Drug-induced anaphylaxis showed the highest proportion of severe cases (81.6%, p < 0.001). A biphasic reaction was seen in 6%. The auto-injector prescription rate was 7.8%, and the allergist referral rate was 15.7%. No deaths were observed. Conclusions: While acute-phase management largely adheres to international guidelines, significant gaps persist in post-discharge care with low auto-injector prescription and allergist referral rates.

The Medical Bulletin of Sisli Etfal Hospital