INTRODUCTION: The identification of atopy, which contributes to the development of allergic diseases, is crucial for implementing early strategies, including allergen avoidance and specific therapies such as immunotherapy. Allergen sensitization is influenced by environmental factors and exhibits regional variation. This study aimed to determine the aeroallergen profile in İstanbul, in the Marmara region of Türkiye.
METHODS: This cross-sectional retrospective study was conducted in the Pediatric Allergy Clinic of a tertiary hospital between December 2012 and December 2016. It included patients younger than 18 years of age with respiratory allergy symptoms who attended regular outpatient follow-up and had complete clinical and laboratory records.
RESULTS: A total of 2370 children (58.5% male; mean age 6.33±3.22 years, range 0.75–18) were included. Of these, 1500 (66.6%) had asthma (AS) and 1629 (66.8%) had allergic rhinitis (AR). Skin prick testing revealed sensitization in 1119 patients (47.2%). Age, total IgE levels, eosinophil percentages, and atopy frequency differed between patients with and without AS, whereas among those with and without AR, only age and atopy showed no significant difference. House dust mites were identified as the most common aeroallergens, followed by grass pollens, while tree pollens and dog epithelium were the least common. Polysensitization was most frequently observed in patients with both AS and AR, and its prevalence increased with age.
DISCUSSION AND CONCLUSION: In İstanbul, house dust mites were the most common aeroallergens, followed by grass pollens. Atopy was associated with a markedly increased prevalence of both AS and AR, underscoring the clinical relevance of sensitization profiling in regional pediatric populations.

INTRODUCTION: This study aimed to validate various β-hCG decline thresholds for predicting the success of single-dose methotrexate (MTX) treatment, compare fertility outcomes across different treatment modalities, and identify predictors of treatment success in women with tubal ectopic pregnancy (EP).
METHODS: This retrospective study included 687 women diagnosed with tubal EP and treated with a single-dose MTX protocol between January 2013 and May 2018. Data collected included patient demographics, clinical presentation, serial β-hCG levels, ultrasound findings, treatment modalities, and subsequent fertility outcomes. The predictive value of different percentage declines in β-hCG levels between Days 0–4 and Days 4–7 was analyzed.
RESULTS: The study included women with a mean age of 30.65±5.64 years (range: 16–53). A decline of ≥40% in β-hCG levels between Day 4 and Day 7 following MTX treatment ruled out the need for second-line intervention with 57% sensitivity and 96% specificity (AUC=0.87, 95% CI: 0.81–0.93, p<0.0001). Patients successfully treated with MTX exhibited a significantly greater mean β-hCG decline (0.39±0.24) compared with those requiring second-line intervention (0.08±0.22; p<0.0001).
DISCUSSION AND CONCLUSION: Higher β-hCG decline thresholds between Day 4 and Day 7 demonstrate high specificity for predicting successful MTX treatment in tubal EP. Tubal-preserving strategies, such as salpingostomy and MTX, appear to be associated with improved subsequent pregnancy rates compared with salpingectomy.

INTRODUCTION: Preterm prelabor rupture of membranes (PPROM) before 26 weeks of gestation presents a significant clinical challenge due to its association with high rates of neonatal morbidity and mortality. We aimed to assess neonatal outcomes and risk factors associated with perinatal mortality in pregnancies complicated by periviable preterm prelabor rupture of membranes (PPROM).
METHODS: This retrospective cohort study analyzed medical records of 119 pregnancies complicated by PPROM between 20+0 and 25+6 weeks’ gestation, managed expectantly at a tertiary care center from 2015 to 2019. Data on maternal demographics, sonographic and laboratory parameters, and neonatal outcomes were collected. Statistical analyses included t-tests, Mann–Whitney U, chi-square, and ROC curve analysis to determine predictive cut-offs for perinatal mortality.
RESULTS: Of 142 women with mid-trimester PPROM, 119 (83.8%) were managed expectantly. Of the 119 cases, 53 neonates survived to discharge (44.5%). Gestational age at delivery, birth weight, and latency period were significantly higher in the survival group (p<0.001). ROC analysis revealed GA ≤23 weeks, latency ≤9 days, and birth weight ≤640 g as significant predictors of mortality. The combination model (AUC 0.78) yielded high sensitivity (90.38%) but limited specificity (50%).
DISCUSSION AND CONCLUSION: This study confirms that key prognostic indicators for neonatal survival in periviable PPROM include gestational age at delivery, latency period, and birth weight. The survival benefit was most evident in pregnancies with latency beyond 9 days and deliveries occurring after 23 weeks. While ROC-derived models can guide clinical decision-making, their specificity limitations must be considered. Further prospective, multicenter research is needed to validate these findings.

INTRODUCTION: The objective of this study was to assess thyroid function status at the time of diagnosis in children with Hashimoto’s thyroiditis (HT) and to analyze the clinical and biochemical features of different presentations.
METHODS: Pediatric patients diagnosed with HT between January 2018 and December 2022 were retrospectively enrolled. At the initial evaluation, thyroid function status was used to categorize patients into five groups. Comparative analyses were performed to evaluate demographic, clinical, and laboratory characteristics among these categories.
RESULTS: Among the 270 patients included in the study (aged 2–18 years; mean age 12.1±3.5 years), 81.5% were female, 73.3% were pubertal, and 41.1% had a family history of thyroid disease. Most patients were identified through blood tests performed because of a positive family history or routine screening. Indications included annual screening for type 1 diabetes mellitus (5.9%), neck swelling (4.1%), constipation (1.9%), and vitiligo (1.5%). At diagnosis, 51.5% of patients were euthyroid, while 84 (31.1%) had subclinical hypothyroidism, 31 (11.5%) had overt hypothyroidism, 12 (4.4%) had subclinical hyperthyroidism, and 4 (1.5%) had overt hyperthyroidism.
DISCUSSION AND CONCLUSION: Most pediatric patients with HT in this study had normal or mildly affected thyroid hormone levels at diagnosis. A substantial proportion of patients were identified through a positive family history and routine screening for other autoimmune diseases, emphasizing the importance of antibody screening in children with a positive family history and in selected cases.

INTRODUCTION: This study aimed to enhance the differential diagnosis of scabies and atopic dermatitis in pediatric patients by integrating hematologic and epidemiological parameters alongside clinical symptoms.
METHODS: A retrospective review was conducted on 376 pediatric patients (188 with scabies, 188 with atopic dermatitis) who presented with itching and/or rash between December 2023 and December 2024. Age, sex, presenting complaints, complete blood count parameters (neutrophils, lymphocytes, eosinophils, platelets, total leukocytes), and total serum IgE levels were analyzed and compared between groups.
RESULTS: Neutrophil counts, eosinophil percentages, and total IgE levels were significantly higher in the scabies group (p<0.05), while lymphocyte and platelet counts were higher in the atopic dermatitis group (p<0.05). Children with scabies presented at an older age (6.93±4.60 vs. 5.37±4.03 years) and were more likely to be male (p<0.05). “Itching alone” was the most common complaint in scabies, whereas “rash” and “skin thickening” were more frequent in atopic dermatitis. A positive family history was significantly more common in the scabies group (p<0.01).
DISCUSSION AND CONCLUSION: By highlighting distinct distributions of total IgE and basic hematologic markers, this study offers clinically relevant insight into differentiating scabies from atopic dermatitis in children. Demographic variables such as age, sex, and symptom patterns further support diagnostic decision-making in pediatric allergy and primary care settings.

INTRODUCTION: Cystic hygroma is a congenital mono- or multiloculated cystic anomaly caused by abnormal fluid accumulation in the lymphatic system. It is the most common anomaly seen in the fetal back and neck, with an incidence of 1%. We aimed to determine the association between the diagnosis of cystic hygroma and adverse pregnancy outcomes.
METHODS: We retrospectively reviewed data on fetuses diagnosed with cystic hygroma by ultrasonography and evaluated demographic data, genetic results, anatomical screening results, and perinatal outcomes. In these cases, karyotyping was the only method available for genetic evaluation.
RESULTS: Sixty pregnancies with a cystic hygroma diagnosis were included in the study. Fifty patients (83.3%) underwent invasive procedures, 25 fetuses (42.6%) had abnormal karyotypes, and the most common karyotype was trisomy 21. Twenty-six fetuses (43.3%) had congenital anomalies. Twenty fetuses were terminated, and 23 fetuses experienced intrauterine demise. Seventeen fetuses (28.3%) were delivered, and 5 (8.3%) were alive and without complications. Hydrops fetalis and structural anomalies were associated with worse outcomes, although statistical significance was limited by sample size.
DISCUSSION AND CONCLUSION: Cystic hygroma coexists frequently with abnormal karyotypes and congenital anomalies. The fetal outcome is more favorable in the absence of additional adverse outcomes. Cytogenetic evaluation, fetal echocardiography, and second-trimester ultrasonography are essential for assessing prognosis and informing parents.

INTRODUCTION: To evaluate whether excessive gestational weight gain (GWG) and change in body mass index (BMI) are associated with delivery timing among women delivering at term (≥37 weeks), independent of pre-pregnancy BMI.
METHODS: We conducted a retrospective single-center cohort study including 625 singleton pregnancies delivered between April 2022 and April 2025 at Istanbul Okan University Hospital. Pregnancies with major fetal anomalies, pre-existing maternal disease, induced labors, elective caesareans, or multiple gestations were excluded. GWG was classified according to 2009 Institute of Medicine criteria, and ΔBMI was calculated as end-of-pregnancy minus baseline BMI. The primary outcome was delivery at ≥41 versus <41 weeks. Analyses included χ2, t-test/Mann–Whitney U, ANOVA, and multivariable logistic regression adjusting for maternal age, parity, pre-pregnancy BMI, smoking, education, and fetal sex.
RESULTS: Mean maternal age was 28.8±5.3 years; 17.4% delivered at ≥41 weeks. GWG was above recommendations in 40.2%, within recommendations in 36.0%, and below recommendations in 23.8%. In crude analyses, ≥41-week delivery was more frequent among women above versus within IOM recommendations (21.5% vs. 14.7%, p=0.036). ΔBMI was higher in the ≥41-week group (5.83±1.81 vs. 4.99±1.79 kg/m2; p<0.001). In adjusted models, GWG categories were not independently associated with ≥41 weeks. Compared with normal BMI, underweight (OR 0.18, 95% CI 0.05–0.66) and overweight (OR 0.35, 95% CI 0.16–0.76) women had lower odds. Smoking (OR 2.25, 95% CI 1.12–4.53) increased, while high-school education (vs university) decreased odds (OR 0.18, 95% CI 0.08–0.42).
DISCUSSION AND CONCLUSION: Excessive GWG was linked to ≥41-week delivery in unadjusted but not adjusted analyses, whereas higher ΔBMI remained associated. Findings underscore the complex role of weight dynamics in late-term pregnancy and support incorporating structured GWG counseling into antenatal care.

INTRODUCTION: To evaluate whether focal lymphovascular space invasion (LVSI) affects 5-year disease-free survival (DFS) in patients with stage 1 endometrial cancer according to the 2023 FIGO classification.
METHODS: This retrospective cohort study included 475 patients with FIGO 2023 stage 1 endometrial cancer treated between 2014 and 2018. Patients were categorized as LVSI-negative (n=444) or focal LVSI (n=31). Those with substantial LVSI were excluded. Clinicopathological variables, recurrence patterns, and survival outcomes were compared between the groups. Kaplan–Meier analysis and Cox regression models were used to identify prognostic factors for DFS.
RESULTS: Focal LVSI was present in 6.5% of patients. The focal LVSI and LVSI-negative groups were comparable in terms of age, grade, menopausal status, and depth of myometrial invasion. During a median follow-up of 67 months, 12 recurrences occurred in the LVSI-negative group, whereas no recurrences were observed among patients with focal LVSI. The 5-year DFS rates were 97.3% and 100%, respectively (log-rank p=0.48). In multivariate Cox regression analysis, focal LVSI was not an independent predictor of DFS (p=0.982).
DISCUSSION AND CONCLUSION: Focal LVSI, as defined by FIGO 2023 and WHO criteria, was not associated with an increased risk of recurrence or reduced DFS in stage 1 endometrial cancer. These results suggest that patients with focal LVSI may not require adjuvant therapy, supporting a more individualized and conservative management approach, pending validation in prospective molecularly characterized studies.

INTRODUCTION: Congenital heart disease (CHD) is one of the most common congenital anomalies and a leading cause of neonatal morbidity and mortality. Early identification of risk factors associated with mortality in affected newborns is essential for improving outcomes. This study aimed to determine the prevalence, mortality rate, and independent risk factors associated with mortality among newborns with CHD admitted to the neonatal intensive care unit (NICU).
METHODS: This retrospective study examined newborns with CHD followed up in the NICU of Medeniyet University, Göztepe Training and Research Hospital between January 2010 and January 2014. Sociodemographic, perinatal, and clinical data were extracted from a detailed review of medical records.
RESULTS: The prevalence of CHD was 6.5% in 3023 neonates followed up in the NICU. The most common CHD types were PDA (21.3%), PFO (15.7%), and VSD (14.2%). The mortality rate in newborns with CHD was 13.2% (n=26). Factors independently associated with mortality in these newborns included a low first-minute Apgar score (OR: 0.777, p=0.039), hypoplastic left heart syndrome (OR: 19.397, p=0.005), cardiomyopathy (OR: 7.607, p=0.042), and the need for endotracheal intubation (OR: 9.731, p=0.005).
DISCUSSION AND CONCLUSION: The prevalence of CHD diagnosis in our NICU setting was 6.5%, and the mortality rate in these newborns was 13.2%. Neonates with low Apgar scores, hypoplastic left heart syndrome, cardiomyopathy, and those undergoing endotracheal intubation should be monitored closely to allow for prompt life-saving interventions. Larger population-based studies are warranted to improve perinatal and postnatal management strategies for CHD.

Abernethy malformation is a rare syndrome characterized by a congenital portosystemic shunt and the partial or total absence of the portal vein. This case report describes a 9-year-old male patient with type 1 Abernethy malformation presenting with scrotal varicocele and rectal bleeding. The patient presented with complaints of scrotal swelling and rectal bleeding. Physical examination revealed scrotal varicose veins, and laboratory tests showed no abnormalities except for a minimally prolonged INR. Radiological evaluation identified a portosystemic shunt between the splenic vein and the left iliac vein, leading to the diagnosis of type 1 Abernethy malformation. Further investigations for other congenital anomalies revealed no additional findings. Abernethy malformation is an extremely rare condition that may present with a variety of symptoms. In cases with findings such as rectal bleeding and scrotal varicocele, indicative of systemic collateral dilatation, Abernethy malformation should be considered among the rare differential diagnoses.