Objective: Sepsis is a clinical syndrome with many faces. For successful treatment of pediatric sepsis, clinicians need a comprehensive understanding of the disease's risk factors, diagnostic procedures, and therapeutic approaches. Our study compared clinical features, laboratory data, and prognostic variables between culture-positive and culture-negative sepsis cases in children admitted to a tertiary pediatric intensive Methods: A total of 57 pediatric patients aged 1-month to 18 years who presented to University of Health Sciences T & uuml;rkiye, Sancaktepe & Scedil;ehit Prof. Dr. & Idot;lhan Varank Training and Research Hospital with suspected or confirmed sepsis between February 2022 and January 2023 were assessed. The study included those who fulfilled the diagnostic criteria for sepsis or septic shock. Demographic data, clinical variables, and outcome measures were analyzed. Results: Among sepsis cases, 20 (35%) had a positive blood culture, whereas 37 (64.9%) had a negative blood culture. A significantly greater proportion of cases with positive blood cultures required mechanical ventilation (p=0.034) and had longer PICU stays (p=0.004). There were no statistically significant differences between the two groups in treatment modalities, such as therapeutic plasma exchange, renal replacement therapy, and use of inotropic agents. Mortality rates were higher in the culture-positive group, but the difference was not statistically significant (p=0.509). Conclusion: Although microbiological culture is critical for sepsis diagnosis, culture-negative children may have poor outcomes. Identification of risk factors for mortality and morbidity helps determine which cases should be followed more closely, based on the severity of the disease process, and which require the most appropriate treatment.
Objective: This study aims to evaluate the psychological issues experienced by individuals diagnosed with Fabry disease (FD) and examine whether these issues are associated with serum globotriaosylsphingosine (Lyso-Gb3) levels and target organ involvement. Methods: This study included 51 individuals: 22 FD patients (FD group) and 29 healthy controls (control group). The FD group comprised 18 adults and four pediatric patients, and both groups were matched for age and gender. The Symptom Checklist-90 (SCL-90) was administered to participants aged 15 years and older, while the Conners' Parent Rating Scale-Revised Long Form (CPRS-R/L) was used for pediatric patients. The FD group was also assessed for organ involvement and plasma Lyso-Gb3 levels. Results: Somatization was the most prevalent psychiatric symptom among adult FD patients (32%). Compared with the healthy control group, adult FD patients exhibited higher scores across multiple SCL-90 subscales, including somatization, depression, anxiety, interpersonal sensitivity, and anger-hostility. However, a statistically significant difference was only observed in the somatization subscale (p=0.042). All SCL-90 subscale scores were significantly correlated with involvement of the central nervous system (CNS) and the cardiovascular system (CVS). No significant correlation was found between SCL-90 subscale scores and Lyso-Gb3 levels (p>0.05). Among pediatric patients, CPRS-R/L scores were higher in the FD group than in controls, with a significant difference observed only in the oppositional subscale (p=0.04). Conclusion: Patients with FD exhibit a higher prevalence of psychiatric disorders than age-and sex-matched healthy controls. CNS and CVS involvement appears to be a significant risk factor for psychiatric comorbidities. No significant association was identified between serum Lyso-Gb3 concentrations and the presence of psychiatric disorders.
Objective: Adolescence represents a high-risk period for self-harm behaviors. This study aimed to evaluate the demographic and clinical characteristics of patients aged 9-18 years who presented to the pediatric emergency department with suicidal drug ingestion, and to identify age-specific risk factors. Methods: This retrospective cohort study included 67 patients admitted to a tertiary pediatric emergency department between January 2023 and December 2024. Patients were stratified into early adolescence (9-14 years) and mid-to-late adolescence (15-18 years) groups. Clinical outcomes and demographic data were analyzed. Results: The cohort was 83.6% female with a mean age of 13.93 +/- 1.4 years. Multi-drug ingestion was identified in 56.7% of patients. While the gender distribution was similar across groups, the 15-18-year age group exhibited significantly higher rates of multidrug ingestion (78.6% vs. 41.0%; p=0.003), recurrent suicide attempts (53.6% vs. 23.1%; p=0.010), and symptomatic presentation (64.3% vs. 35.9%; p=0.022). Furthermore, multidrug ingestion significantly increased the risk of intoxication in the 9-14 age group (p=0.012). Conclusion: Clinical complexity increases with age, characterized by higher rates of multidrug use and recurrence among older adolescents. Consequently, prevention strategies should prioritize safe medication storage and age-specific psychosocial interventions involving both families and schools.
Objective: This study aimed to evaluate the diagnostic and prognostic significance of anti-phospholipase A2 receptor (PLA2R) in primary membranous nephropathy (PMN) patients and determine the most appropriate cut-off value. Methods: Between June 2022 and June 2023, 74 patients who were followed up with PMN, secondary MN, non-MN nephrotic syndrome and 15 healthy volunteers were included. Anti-PLA2R antibody levels were evaluated by enzyme-linked immunosorbent assay (ELISA) (EUROIMMUN, L & uuml;beck, Germany). Receiver operating characteristic (ROC) curve analysis was performed. Results: The ELISA kit showed sensitivity of 30% and specificity of 100% when the cut-off value of 20 relative units (RU)/mL was used. According to the ROC curve analysis, the cut-off value was found to be 1.19 RU/mL. When using this value, sensitivity was 66.6% and specifity was 72.7%. However when cut-off value was used 2 RU/mL, sensitivity and specifity was 46.6% and 100%, respectively. Only part of PMN patients were antibody positive; all other groups were negative. All PMN patients were antibody positive at diagnosis; and as for patients with active disease 25% were positive and 25% were borderline. Whereas for patients with complete and partial remission and 18.8% of these were antibody positive. Anti-PLA2R positive patients had higher mean proteinuria and lower mean albumin. Anti-PLA2R positive PMN patients had lower mean hemoglobin and hematocrit values. Conclusion: Anti-PLA2R may be helpful in diagnosis in PMN patients when secondary causes are well excluded at the time of diagnosis and also be helpful in predicting progression during follow-up.
Objective: This study aimed to investigate the correlation between carotid artery intima-media thickness (c-IMT) and increased body mass index (BMI), particularly in the context of childhood obesity. Furthermore, the study emphasizes the potential utility of c-IMT as a parameter for followup and monitoring during diagnosis and management. Methods: This case-control study was conducted at the pediatric endocrinology unit and the well child polyclinic between January and August 2017. A total of 96 children aged 6 to 18 years were included. Anthropometric measurements, including height, weight, and waist circumference, were recorded, and BMI Z-scores were calculated accordingly. Biochemical tests included fasting blood glucose, insulin, total cholesterol, triglycerides, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. c-IMT was measured using B-mode ultrasonography with a 7.5 MHz linear probe, targeting both the common and internal carotid arteries. Morphological features of the artery, including luminal echogenicity and intima-media surfaces, were also evaluated. Results: c-IMT values were significantly higher in obese children compared with the control group. There were no significant differences between the study groups in mean age or gender. When the two groups were compared, there was a significant increase in c-IMT levels among those with high ALT levels compared with those with normal ALT levels. A correlation between high AST levels and c-IMT was observed only in the obese patient group. A threshold of 0.8 mm was set as the upper limit for normal c-IMT values. No patient had a c-IMT measurement above 0.8 mm. Conclusion: This study demonstrates that increased c-IMT in obese children may serve as an early indicator of endothelial dysfunction and preclinical atherosclerosis. Measuring c-IMT could be a non-invasive and practical method for risk stratification and early cardiovascular monitoring in pediatric obesity. Further longitudinal studies are warranted to establish its predictive value.
Objective: To compare pain, functional outcomes, and complication rates in patients with isolated lateral malleolus fractures who were considered to have syndesmotic instability on preoperative radiographic evaluation but were treated with or without syndesmotic screw fixation according to intraoperative assessment after fibular fixation. Methods: This retrospective cohort study included 43 adult patients who underwent surgical treatment for isolated lateral malleolus fractures and had preoperative radiographic findings suggestive of syndesmotic instability. After open reduction and internal fixation of the fibula, syndesmotic stability was reassessed intraoperatively under fluoroscopy using the Cotton test, with additional external rotation stress testing when needed. Patients were divided into a stable group who did not require syndesmotic fixation (n=23) and an unstable group who underwent syndesmotic screw fixation (n=20). Pain was assessed using the visual analogue scale (VAS) at 1 year postoperatively, and functional outcome was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score at 2 years postoperatively. Results: The median age was 28 years [interquartile range (IQR), 22-45], and the median follow-up was 30 months (IQR, 26-44). Baseline demographic characteristics and follow-up duration were comparable between groups. Median VAS scores were 1 (IQR, 1-2) in the stable group and 1 (IQR, 1-2.75) in the unstable group (p=0.633). Median AOFAS scores were 91 (IQR, 88-93) and 90.5 (IQR, 82.25-93.50), respectively (p=0.750). Complication rates were 4.3% and 15.0%, respectively; the difference was not statistically significant (p=0.395). Conclusion: Selective syndesmotic fixation based on intraoperative assessment after fibular fixation may be a reasonable strategy for radiographically unstable, isolated lateral malleolus fractures.
Objective: Progressive supranuclear palsy (PSP) with ventricular dilatation and idiopathic normal pressure hydrocephalus (iNPH) may present with overlapping symptoms, particularly when gait disturbance predominates. This study compared midbrain qualitative signs and quantitative metrics to identify the most accurate marker for differentiating PSP from iNPH. Methods: We retrospectively enrolled 32 patients with PSP, 33 with shunt-predictive iNPH, and 35 age-matched healthy controls, all of whom fulfilled established clinical criteria. High-resolution isotropic magnetization prepared rapid acquisition gradient echo (1.0 mm voxel size) was used to evaluate the hummingbird sign (HBS), morning glory sign, midbrain-to-pons area ratio (M/P), Magnetic Resonance Parkinsonism Index (MRPI), and its updated version, MRPI 2.0. Binary logistic regression analysis was performed to assess the predictive value of midbrain metrics and qualitative features. Results: All imaging markers differed significantly among PSP, iNPH, and control subjects (p<0.01). The M/P ratio, MRPI, and MRPI 2.0 effectively distinguished all group pairs, with the M/P ratio demonstrating fair accuracy [area under the curve (AUC)=0.81; accuracy 74%]. Both MRPI versions achieved acceptable performance (AUC<0.78). The HBS demonstrated good discriminatory performance in differentiating PSP from iNPH (AUC=0.82; accuracy 81%) and emerged as the sole independent predictor in logistic regression [AUC=0.87; odds ratio (OR): 32; p<0.01]. The MRPI 2.0 outperformed all qualitative features (AUC=0.94; OR: 18; p<0.01) in distinguishing iNPH from healthy individuals. Conclusion: Quantitative metrics for Parkinsonism showed stepwise differences across PSP, iNPH, and control groups. The HBS outperformed all quantitative measures in distinguishing PSP from iNPH when a predefined point-based system was applied.
Objective: Heart failure (HF) is a major contributor to global cardiovascular mortality and morbidity. Despite advances in treatment, mortality Methods: This study examined 57 male and 47 female patients (total n=104) who were treated for congestive HF (CHF) at our hospital between 01.01.2010 and 31.12.2012. We investigated parameters affecting the number and duration of hospitalizations among patients with HF during the previous year. Results: The mean age was 75.62 +/- 10.53 years (range, 52-102 years). Eighty six (82%) cases were older than 65 years, and 45 (42.3%) had been hospitalized more than once for CHF in the previous year. Hospitalization rates were low: 2 times for 28 (26.9%) cases, three times for 6 (5.1%) cases, four times for 7 (6.7%) cases, five times for 2 (1.9%) cases, and finally six times for 1 (1%) case. The mean interval between the hospitalizations for 44 patients hospitalized more than once was 77.1 +/- 79.878 days, ranging between 5 and 360 days. Eleven (10.6%) cases were alcohol consumers and 21 (20%) were smokers. According to functional capacity (FC) by New York Heart Association (NYHA), 4 (3.8%) cases were classified as class I, 48 (46.2%) cases were classified as class II, 26 (25%) cases were classified as class III, and 26 (25%) cases were classified as class IV. A significant difference was found between FC and the total hospitalization period, and between FC and the hospitalization rate (p<0.001, for both). A significant association was found between alcohol use and hospitalization rate (p=0.006) and between alcohol use and total hospitalization Conclusion: The incidence of HF is increasing in patients older than 65 years. The frequency and duration of hospitalization among patients do not differ between female and male patient groups. The frequency and duration of patient hospitalization increase as the NYHA functional class advances.
Objective: Helicobacter pylori (H. pylori) has been implicated in modulating systemic immune responses and may potentially influence the onset of atopic disorders. Nevertheless, its specific relationship with systemic atopic markers remains unclear. We investigated the link between H. pylori infection and systemic indicators of atopy by analyzing serum immunoglobulin E (IgE) levels alongside peripheral inflammatory parameters. Methods: In this retrospective analysis, data from 312 adult patients (246 females, 66 males) assessed for H. pylori infection between January 2023 and January 2025 were reviewed. Infection status was determined using stool antigen assays and/or histological examination of endoscopic biopsy specimens. Laboratory results included serum total IgE, eosinophil counts, complete blood count, C-reactive protein (CRP), and systemic inflammation markers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation. Comparative statistical evaluations were performed between H. pylori-positive and -negative groups. Results: Serum IgE concentrations were not significantly different between H. pylori-positive and -negative individuals (median: 42.5 IU/mL vs. 37.5 IU/mL; p=0.891). Similarly, eosinophil counts and the majority of inflammatory indices exhibited no substantial variation. Notably, neutrophil counts were slightly elevated in the H. pylori-positive cohort (median: 4.00 vs. 3.60 x103/& micro;L; p=0.043). Other markers, such as NLR, PLR, SII, SIRI, Conclusion: H. pylori infection in adults was not associated with significant alterations in systemic atopic markers, including serum IgE and eosinophil counts, or with prominent changes in inflammatory indices. A mild rise in neutrophil levels may suggest a subtle systemic immune response rather than a marked inflammatory state.
Hidradenoma papilliferum (HP) is a rare, benign, slow-growing tumorof apocrine origin, primarily located in the anogenital region ofadultwomen. We report a rare case of HP in a 52-year-old postmenopausal woman presenting with a painful, nodular lesion on the clitoral area. Histopathologic examination confirmed the diagnosis after surgical excision. The lesion showed positive expression for estrogen and progesterone receptors, and p63 in myoepithelial cells. Although HP is typically asymptomatic and commonly seen on labial structures, its occurrence in the clitoris with painful presentation is rare. Awareness of such atypical localizations is crucial for proper diagnosis and management.
Objective: Perinatal asphyxia is among the leading causes of morbidity in the newborn period and can give rise to hypoxic-ischemic encephalopathy (HIE). While therapeutic hypothermia is well established for moderate-to-severe HIE, the optimal management of infants with mild HIE-Sarnat stage I-remains controversial. What is becoming increasingly clear, however, is that a mild HIE may not always be a benign condition and that subtle brain injury may be present even with a mild clinical presentation. We aimed to evaluate cranial magnetic resonance imaging (MRI) findings in newborns with perinatal asphyxia classified as Sarnat stage I and to explore whether infants with normal versus abnormal imaging differ in their clinical presentation or laboratory markers. Methods: We conducted a retrospective cohort study of newborns admitted to our neonatal intensive care unit with perinatal asphyxia who met the criteria for Sarnat stage I HIE. Demographic data, Apgar scores, umbilical cord blood gas values, maternal risk factors, and neuroimaging results were recorded. Cranial MRI scans were classified as normal or abnormal, and the two groups were compared. Results: Sixty-six neonates were enrolled. MRI was normal in 54 (81.8%) patients and abnormal in 12 (18.2%) patients. Infants in the abnormal group tended to have lower Apgar scores and more pronounced metabolic acidosis, although neither difference reached statistical significance. The most common abnormal findings were hemorrhagic in nature-subdural, intraventricular, and parenchymal hemorrhages each accounted for a third of abnormal scans. Conclusion: Nearly one-fifth of neonates with mild HIE demonstrated abnormal cranial MRI findings. Closer follow-up may be considered, since mild HIE may be associated with subclinical brain injury.
Objective: Normal pressure hydrocephalus (NPH) is a chronic, progressive condition primarily affecting elderly patients. Based on etiology, NPH is categorized into two subtypes: secondary NPH and idiopathic NPH (iNPH). This study focused only on patients with iNPH, aiming to identify critical considerations in diagnosis, treatment, and postoperative follow-up. Methods: This retrospective study analyzed data from 45 patients diagnosed with iNPH who underwent programmable ventriculoperitoneal shunt implantation between 2016 and 2024. Parameters evaluated included patient demographics, presenting symptoms, duration of symptoms before surgery, comorbidities, preoperative and postoperative Evans indices, shunt pressures, urinary incontinence, gait improvement, changes in preoperative subarachnoid space, ventricular dimensions, postoperative complications, and Mini-Mental State Examination (MMSE) scores. Results: The findings underscored the importance of multidisciplinary follow-up in elderly patients with comorbidities, the role of MMSE scores in assessing cognitive status preoperatively and postoperatively, and the limited utility of the Evans index as a postoperative marker. Adjusting shunt pressure was shown to play a crucial role in minimizing complications. Conclusion: In this highly sensitive patient population, timely and appropriate shunt surgery significantly enhances quality of life and reduces caregiver burden.
Objective Surgery for vestibular schwannoma (VS), located in the cerebellopontine angle, presents a significant neurosurgical challenge due to the tumor's proximity to cranial nerves and critical neural and vascular structures. This study aimed to evaluate the efficacy and safety of combining intraoperative neuronavigation (NN) and neuromonitoring (NM) in the resection of VS tumors. Methods We retrospectively reviewed the medical records of patients who underwent VS tumor resection at our center between 2018 and 2023. Patients were divided into two groups: those who underwent surgery with NN and NM guidance (nVS group) and those who underwent surgery without these techniques (pVS group). The groups were compared with respect to cranial nerve identification, preservation of facial nerve function, advantages and limitations of NN and NM systems, and extent of tumor resection. Results In the pVS group, intraoperative visualization of the facial nerve was not achieved in seven patients (46.7%). Conversely, all patients in the nVS group had their facial nerves successfully identified intraoperatively (p<0.001). Postoperative evaluation revealed worsening facial nerve function, as measured by the House-Brackmann scale, in seven (46.7%) patients in the pVS group compared with two (16.7%) patients in the nVS group (p<0.001). The median time from anesthesia induction to surgery commencement was significantly shorter in the pVS group (p<0.001). Conclusion The combined use of NN and NM enhances tumor margin identification and adjacent structure visualization during surgery. Additionally, it facilitates real-time monitoring of neurological functions, contributing to improved surgical outcomes and reduced risk of postoperative complications.
Objective: Microvolt T-wave alternans (MTWA) test is a non-invasive method for risk assessment before sudden cardiac death and malignant ventricular tachycardia. Cardiac resynchronization therapy (CRT) is effective in improving left ventricular (LV) systolic function and cardiac electrical activity. The present study investigates the effect of various pacemaker stimulation modes on MTWA in patients receiving CRT. Methods: The study included 35 patients who received CRT. MTWA was measured in LV, right ventricular (RV), biventricular (BV), and right atrial (RA) modes at 6 +/- 2 months after CRT implementation. MTWA results were classified as negative or non-negative. Positive and indeterminate results were considered non-negative. Continuous variables were expressed as mean +/- standard deviation, and Cohen's kappa statistic was used to compare various pacing modes, with analyses conducted in SPSS at a significance level of p<0.05. Results: RA pacing was concordant with RV pacing in 27 (76.2%) patients (kappa=0.509; p=0.001); with LV pacing in 23 (65.7%) patients (kappa=0.263; p=0.094); and with BV pacing in 26 (74.3%) patients (kappa=0.463; p=0.003). The positive and negative predictive values of results obtained during RA pacing for predicting similar results obtained during RV pacing were 73.1% and 88.9%, respectively; for LV pacing, 65.4% and 66.7%, respectively; and for BV pacing, 69.2% and 88.9%, respectively. We did not find any differences in non-negative MTWA results across different pacing modes with respect to types of cardiomyopathies, statin or amiodarone treatment, and presence or absence of diabetes mellitus or hypertension. Conclusion: Similar results are achieved when comparing the MTWA results following RA, LV, RV, and BV pacemaker stimulations in patients receiving CRT.
Objective: We evaluated the association between pathological findings, menopausal status, and indications for endometrial biopsy. Methods: We included 931 patients who underwent endometrial biopsy for various gynaecological indications at our clinic between October 2023-October 2024. Medical data were retrieved from patient records. Patients were evaluated according to age, menopausal status (premenopausal or postmenopausal), endometrial thickness, biopsy indication, and pathological findings. Pathological findings were compared across biopsy indications and menopausal status. Results: The mean age of patients was 47.1 +/- 9.1 years, and the mean endometrial thickness was 9.8 +/- 5.2 mm. Of the total, 695 (74.7%) were premenopausal and 236 (25.3%) were postmenopausal. Menometrorrhagia was the most common indication for biopsy (32.8%) and endometrial polyps were the most frequent histopathological finding (32%). Of the 15 patients diagnosed with malignancy, 2 underwent biopsy for menometrorrhagia and 13 for postmenopausal bleeding; these correspond to 0.7% and 5.7% of the total cohort, respectively. Secretory endometrium, proliferative endometrium, and endometrial polyps were significantly more common in premenopausal women (p<0.001), whereas malignancy and endometrial atrophy were significantly more common in postmenopausal women (p<0.001). Conclusion: Because endometrial cancer is more prevalent in older women, malignancy should be considered in the histopathological evaluation of endometrial samples obtained from women with postmenopausal bleeding.
Objective: To examine the clinical and sociodemographic characteristics and treatment approaches of patients with psychotic spectrum disorders receiving services from a community mental health center. Methods: This cross-sectional study included 203 patients diagnosed with psychotic spectrum disorders who were registered at a community mental health center and consented to participate. Data were collected through face-to-face interviews conducted by the clinician. Patients diagnosed by a clinician according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic criteria provided written and verbal informed consent. The sociodemographic data form and the Positive and Negative Syndrome Scale were administered to all participants. Prior to the commencement of the study, ethical approval was obtained from the Yalova University Ethics Committee and institutional permission was granted by the Provincial Directorate of Health (approval no: 2025/330, date: 25.06.2025). Results: In our study, the majority of patients were male (66.5%). Mental disorders were more frequently observed among first-and second-born children within households. A psychiatric disorder was present in the first-degree relatives of 88 patients (43.3%). Additionally, a history of legal issues was identified in 55 (27.1%) patients, and tobacco use was reported by 114 (56.2%) patients. Regarding treatment, 45 patients (22.2%) were receiving long-acting injectable paliperidone palmitate (3-month formulation), and 28 patients (13.8%) were receiving long-acting injectable aripiprazole. Conclusion: This study is one of the few investigations in T & uuml;rkiye examining the clinical and treatment characteristics of patients with psychotic spectrum disorders who receive services from a community mental health center. Therefore, we believe that our study makes a significant contribution to the existing literature.
Objective: To evaluate the prognosticvalue of the uric acid-to-albumin ratio (UAR) for predicting major adverse cardiovascular and cerebrovascular events (MACCE) after carotid artery stenting (CAS). Methods: A total of 332 patients who underwent CAS were retrospectively enrolled in the study. For each patient, the uric acid level was divided by the corresponding serum albumin level to calculate the UAR. Patients were followed up for the occurrence of MACCE. The association between UAR and MACCE was analyzed to determine its predictive value. Results: Patients were followed up for an average of 45.30 +/- 27.26 months. Those who experienced MACCE were significantly older and were more likely to have undergone prior carotid endarterectomy. Additionally, they exhibited elevated serum creatinine and uric acid levels. In contrast, serum albumin and hemoglobin levels were significantly lower in the MACCE group. Furthermore, patients who developed MACCE had longer lesion lengths, required longer stents, and experienced higher rates of periprocedural stroke and in-hospital mortality. Multivariable logistic regression analysis identified a history of endarterectomy, elevated serum creatinine levels, and higher UAR as independent predictors of MACCE. Conclusion: Higher UAR values were significantly associated with increased risk of adverse outcomes. These findings suggest that UAR may serve as a simple, accessible, and cost-effective biomarker for risk stratification and prognosis in patients undergoing CAS.
Objective: Nausea and vomiting are among the most common and distressing side effects caused by chemotherapy. This study aimed to evaluate the effectiveness of the antiemetic protocol used in our center and to explore possible improvements. Methods: In this study, the medical records of patients aged between 1 month and 18 years who were diagnosed with solid tumors and lymphomas and who received chemotherapy and radiotherapy in our clinic were retrospectively reviewed. Results: Of the patients included in the study, 60.9% (n=53) were male, and 39.1% (n=34) were female. Among the 151 chemotherapy cycles administered, acute and delayed vomiting were observed in 26.5% and 18% of cycles, respectively. Refractory and anticipatory vomiting occurred in 6% and 18% of cases, respectively. Refractory vomiting was detected in adolescents, in the germ cell tumor group, and during the initial chemotherapy cycles. The lowest incidence of acute vomiting (0%-20%) occurred in patients who engaged in play activities or watched television or videos during treatment. In 70.2% of the chemotherapy cycles, granisetron was administered alone, while aprepitant was added in 23.2%. Conclusion: Chemotherapy-associated vomiting is a frequent and undesirable side effect in pediatric patients. The relationship between nausea and vomiting and factors such as parental smoking, educational background, and activities during chemotherapy administration warrants further investigation.
