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.

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.

Since the outbreak of the Syrian civil war in 2011, the population of Arab refugees in Turkey has rapidly increased. While cystic fibrosis (CF) is believed to be rare among Arabs, recent studies suggest it is underdiagnosed. This study aims to present the demographic, clinical, and genetic characteristics of CF patients among Arab refugees in Turkey. Additionally, a comparison is made between the findings in the National CF Registry 2021 in Turkey (NCFRT) and the refugee CF patient group. The study included refugee patients between the ages of 0 and 18 years who were diagnosed with CF and received ongoing care at pediatric pulmonology centers from March 2011 to March 2021. The study examined demographic information, age at diagnosis, age of diagnosis of patients through CF newborn screening (NBS), presenting symptoms, CF transmembrane conductance regulator (CFTR) mutation test results, sputum culture results, weight, height, and body mass index (BMI) z score. Their results were compared with the NCFRT results. The study included 14 pediatric pulmonology centers and 87 patients, consisting of 46 (52.9%) boys and 41 (47.1%) girls. All of the patients were Arab refugees, with 80 (92%) being Syrian. All the patients were diagnosed in Turkey. The median age at diagnosis of patients was 22.33 (interquartile range, 1–258) months. The median age of diagnosis of patients through NBS was 4.2 (interquartile range, 1–12) months. The median age of older patients, who were unable to be included in the NBS program, was 32.3 (interquartile range, 3–258) months. Parental consanguinity was observed in 52 (59.7%) patients. The mutation that was most frequently found was F508del, which accounted for 22.2% of the cases. It was present in 20 patients, constituting 32 out of the total 144 alleles. There was a large number of genetic variations. CFTR genotyping could not be conducted for 12 patients. These patients had high sweat tests, and their genetic mutations could not be determined due to a lack of data. Compared to NCFRT, refugee patients were diagnosed later, and long-term follow-up of refugee CF patients had significantly worse nutritional status and pseudomonas colonization.  Conclusion: Although refugee CF patients have equal access to NBS programs and CF medications as well as Turkish patients, the median age at diagnosis of patients, the median age of diagnosis of patients through NBS, their nutritional status, and Pseudomonas colonization were significantly worse than Turkish patients, which may be related to the difficulties of living in another country and poor living conditions. The high genetic heterogeneity and rare mutations detected in the refugee patient group compared to Turkish patients. Well-programmed NBS programs, thorough genetic studies, and the enhancement of living conditions for refugee patients in the countries they relocate to can have several advantages such as early detection and improved prognosis. What is Known:• Children who have chronic diseases are the group that is most affected by wars.• The outcome gets better with early diagnosis and treatment in patients with Cystic Fibrosis (CF). What is New:• Through the implementation of a newborn screening program, which has never been done in Syria previously, refugee patients, the majority of whom are Syrians were diagnosed with cystic fibrosis within a duration of 4 months.• Despite equal access to the newborn screening program and CF medications for both Turkish patients and refugee patients, the challenges of living in a foreign country have an impact on refugees.

Bordetella pertussis is a highly contagious respiratory infection affecting infants, particularly those in vulnerable populations. This study investigates the increase in pertussis cases following refugee influxes and natural disasters. This retrospective study analyzed 28 infants hospitalized in our hospital's pediatric ward due to whooping cough between December 27, 2023, and April 30, 2024. Demographics, vaccination status, clinical findings, treatments, and outcomes were reviewed. Of the 28 infants, 60.7% were male and 39.3% were of Syrian origin; 42.9% were unvaccinated. The mean age was 3.46 ± 3.48 months, and median hospitalization was 11 days. All presented with respiratory distress. Paroxysmal cough (96.4%), feeding difficulty (53.6%), and fever (32.1%) were common. Convulsions occurred in 10.7%, and apnea in 3.6%. B. pertussis was confirmed by PCR in all cases. Chest radiographs showed pneumonic infiltrates in 85.7%. Macrolide antibiotics were given to all. Leukocytosis (15,000-30,000/µL) was observed in 53.6%, extreme leukocytosis in 7.1%, and lymphocytosis in 64.3%. Respiratory support was needed in 78.6%. Four required ICU care; two intubated patients died of multiple organ failure. Pertussis remains a serious health threat, especially among unvaccinated and displaced infants. Strengthening immunization programs and ensuring early diagnosis and treatment are essential to reduce disease burden.

Vitamin ve Minerallerin Günlük Hayatımızdaki Yeri Murat ERSOY Vitamin ve Minerallerin İlave Olarak Alınması Gereken Durumlar Güldane Aylin İNAL Gebelikte Kullanılması Gereken Vitamin ve Mineraller Utkucan OKUDUCU Vitamin A Saliha BARUTÇU Adnan BARUTÇU Vitamin B1 (Tiamin) Burcu KÖŞECİ Vitamin B2 (Riboflavin) Nazmiye TÜZEL GÜNDÜZ Vitamin B3 (Niasin) Engin AYDIN Vitamin B5 (Pantotenik Asit) Nahide HAYKIR Vitamin B6 (Piridoksin) Merve YOLDAŞ ÇELİK Vitamin B7 (Biyotin) Fatma Derya BULUT İrem KEKEÇ Vitamin B9 (Folik Asit) Necla İPAR Vitamin B12 (Kobalaminler) Feza SARI ŞEN Vitamin C Hüseyin GÜMÜŞ Halil ASLAN Vitamin D Abdullah GÜNDÜZ Deniz KOR Vitamin E Sevinç GARİP Vitamin K Aysel Burcu İBİLİ Demir Cüneyt UĞUR Çinko Melis AKPINAR Kalsiyum Hilmi Onur KABUKÇU Magnezyum Merve KİŞİOĞLU Sodyum Hülya NALÇACIOĞLU Klor Gözde ATASEVER YILDIRIM Potasyum Mihriban İNÖZÜ Fosfor Ali Emre ÇETİNKOL İyot Mehmet Deniz ERHAN Selenyum Adnan BARUTÇU Krom Atilla GÜRAY Bakır Esra EREN Flor Enes Kaan KILIÇ Manganez Furkan KALAYCI Molibden Esra KARA Bor Fatma Derya BULUT Omega-3 Ümit ECE Omega - 6 Mehmet ALMACIOĞLU Koenzim Q10 Ezgi BURGAÇ Kolin-İnositol-PABA Zeliha HAYTOĞLU