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    Evaluation of the core muscles of children and adolescents with nocturnal enuresis using shear wave elastography: a preliminary study
    (Nature Portfolio, 2025) Sinanoglu, Muhammed Selcuk; Dag, Nurullah; Sinanoglu, Bercem; Ozdemir, Filiz
    The purpose of this study was to determine any changes in the rectus abdominis and diaphragm muscles, which are core muscles, in children and adolescents with nocturnal enuresis (NE) using the shear wave elastography (SWE). In this case-control study, the rectus abdominis and diaphragm muscles of 40 children and adolescents with NE and 40 healthy controls were evaluated. The rectus abdominis muscle was examined at the right supra- and subumbilical levels, and the diaphragm at the right 9th-10th intercostal space. The thickness of both muscles was measured by gray scale ultrasound and muscle stiffness was measured by SWE. The demographic characteristics of the patients such as sex and age and their anthropometric measurements including height, weight, and BMI were recorded. Compared to the control group, the NE group had significantly lower mean rectus abdominis muscle stiffness values on both the supraumbilical and subumbilical levels (p < 0.05). There was no significant difference in mean rectus abdominis thickness and diaphragm thickness-stiffness values between the groups (p > 0.05). According to the results of the study, it is thought that NE children have problems with core stabilization and that children with NE should be directed to appropriate treatment. However, future studies are needed with larger sample sizes and other factors that are thought to affect muscle architecture.
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    Multidrug-resistant uropathogens in pediatric urinary tract ınfections: a multicenter retrospective trend analysis (2020-2024)
    (Springer, 2026) Erdogan, Esra; Yetisgen, Azize; Dogan, Serpil; Sinanoglu, Muhammed Selcuk; Kilic, Fedli Emre; Kurt, Osman
    Large-scale public health disruptions, including pandemics and natural disasters, may influence healthcare delivery, pathogen distribution, and antimicrobial resistance (AMR). This retrospective multicenter study evaluated uropathogen profiles and temporal trends in antibacterial resistance among hospitalized pediatric patients with urinary tract infections (UTIs) across periods corresponding to the COVID-19 pandemic, the February 6, 2023 Kahramanmara & scedil; earthquakes, and the post-earthquake phase in heavily affected regions of T & uuml;rkiye. Hospitalized pediatric patients (0-18 years) with culture-confirmed UTIs admitted between January 2020 and December 2024 to three tertiary care hospitals were included. Pathogen identification and antibacterial susceptibility testing were performed using standard microbiological methods in accordance with EUCAST criteria. Uropathogen distribution and resistance patterns were compared across predefined study periods. A total of 1131 pediatric patients were analyzed, of whom 54.29% were female. Gram-negative bacteria predominated (89.57%), with Escherichia coli (59.86%) and Klebsiella spp. (18.92%) being the most frequently isolated pathogens. Across the study periods, E. coli demonstrated significant increases in resistance to ampicillin (63.26% to 81.90%), ceftriaxone (41.99% to 53.76%), ceftazidime (39.46% to 63.10%), and trimethoprim-sulfamethoxazole (32.27% to 40.34%) (all p < 0.01). Among Klebsiella spp., a significant temporal increase was observed only for imipenem resistance, which rose from 18.64% during the COVID-19 period to 37.50% during the earthquake period before declining to 13.21% in the post-earthquake period (p = 0.021). Multidrug-resistant (MDR) phenotypes were predominantly detected among Gram-negative organisms, with the highest proportions observed in Serratia spp., Citrobacter spp., Enterobacter spp., and Pseudomonas spp., while MDR prevalence in E. coli was comparatively lower. Temporal variations in antibacterial resistance were observed among pediatric UTI pathogens during periods of major public health disruption. These findings highlight the importance of sustained regional surveillance and context-aware empiric treatment strategies in settings exposed to systemic healthcare stressors.
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    The Value of HALP Score, SII, and SIRI in Predicting the Need for Intensive Care and Assessing Disease Severity in Pediatric Diabetic Ketoacidosis Cases
    (Mdpi, 2025) Sinanoglu, Muhammed Selcuk; Dolanbay, Turgut; Demir, Bilgehan; Nogay, Suleyman; Celiloglu, Can; Polat, Muhammed Eyyub
    Objective: The aim of this study was to evaluate whether Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) scores, the Systemic Immune-Inflammation Index (SII), and the Systemic Inflammatory Response Index (SIRI) can predict intensive care unit (ICU) or inpatient admissions in pediatric diabetic ketoacidosis (DKA) cases and to determine their sensitivity and specificity. Methods: This retrospective study included 39 pediatric patients (<18 years) diagnosed with DKA (pH < 7.3, HCO3 < 15). HALP, SII, SIRI, and urine ketone values were collected from medical records. Statistical analyses included ROC curve analysis, correlation tests, and appropriate parametric or non-parametric comparisons to evaluate associations with 30-day outcomes. Results: The median age was 13 years (IQR: 8-15), 56.4% were male, and 64.1% required ICU monitoring. ICU patients had significantly lower pH (p = 0.005) and HCO3 (p = 0.012) and significantly higher monocyte, SII, and SIRI values (all p <= 0.018). ROC analysis showed SIRI had the highest predictive power for ICU admission (cut-off: 3911; sensitivity: 76%; specificity: 85.7%), followed by SII. HALP scores did not demonstrate any value in assessingdisease severity for predicting ICU admission (AUC = 0.25). Conclusion: SIRI and SII are reliable predictors of ICU admission in pediatric DKA. HALP scores do not predict ICU admission and should not be considered a marker of disease severity. Incorporating SIRI and SII into clinical decision-making may improve early risk stratification. Prospective multicenter studies are warranted to validate these results.