Burak Baykara

Objective: The aim of the present study is to compare autistic symptoms and empathy of adolescents aged 12–18 years with bipolar disorder (BPSD) and disruptive mood dysregulation disorder (DMDD) to healthy adolescents. Methods: In this study, 21 adolescents diagnosed with BPSD, 21 adolescents diagnosed with DMDD and 21 healthy adolescents similar in age and gender were included. Autistic symptoms were evaluated using the Autism Diagnostic Interview‐Revised (ADI‐R) and Social Communication Questionnaire (SCQ), and empathy was evaluated with the KA‐SI Empathic Tendency Scale for Children and Adolescents (KA‐SI ETS). Results: Significant differences were detected among the groups in ADI‐R and SCQ, and healthy adolescents received statistically significantly lower scores. Empathy skills of healthy adolescents were evaluated as better than those in the BPSD and DMDD groups. Conclusion: In our study, it was shown that young people with a diagnosis of DMDD had more difficulties in empathy skills, and they had more autistic symptoms than young people with BPSD and healthy adolescents. Providing support in terms of these empathy skills and evaluation of autistic symptoms in the treatment of young people diagnosed with BPSD and DMDD may affect both the psychosocial functionality of the cases and the course of the disease.

Objective: This study aims to evaluate the long-term neurological outcomes of neonates diagnosed with mild hypoxic-ischemic encephalopathy (HIE) and compare them with moderate/ severe cases, hypothesizing that a significant proportion of mild HIE cases may experience adverse neurodevelopmental sequelae. Materials and Methods: This was a cross-sectional observational study evaluating the neurodevelopmental outcomes of neonates with mild versus moderate/severe HIE. Maternal, perinatal, and neonatal characteristics along with treatments were documented. Neurological outcomes were assessed via brain MRI, the Ankara Developmental Screening Inventory (ADSI), and developmental milestones. Results: The study included 42 infants, 20 (47.6%) were classified as having mild HIE and 22 (52.4%) as moderate/severe HIE. Baseline characteristics were similar except that moderate/ severe cases had lower 1-minute Apgar scores (median 4 vs. 6; P = .02) and more frequent need for advanced resuscitation (68% vs. 25%; P = .006). All moderate/severe infants received TH vs. none in the mild group. Invasive mechanical ventilation and adjuvant neuroprotective agents were also more frequently used in the moderate/severe group. Magnetic resonance imaging abnormalities consistent with HIE were present in 2/12 mild cases (16.7%) vs. 8/19 (42.1) in moderate/severe cases. There were no significant differences in HIE injury pattern between the 2 groups (P = .197). On ADSI screening, 8/12 (66.7%) mild HIE survivors showed gross motor delay compared with 5/7 (71.4%) moderate/severe survivors. Conclusion: Even infants with mild HIE are at risk of adverse neurological outcomes. The development of more sensitive diagnostic tools could improve treatment strategies and early interventions, ultimately impacting prognosis. With proper recognition, tailored follow-up, and appropriate therapeutic approaches, potential neurodevelopmental impairments in mild HIE cases could be mitigated. Cite this article as: Canbeldek M, Armağan C, Şenol HB, et al. Challenging mild hypoxic–ischemic encephalopathy: insights into neurological outcomes.Turk Arch Pediatr. 2025;60(5):507-514.

This study’s objective was to investigate the adverse effects of atypical antipsychotics (AAPs) on the metabolic, hematological, and endocrinological systems in the inpatient environment for children and adolescents with diverse psychiatric disorders. A retrospective assessment of 208 children’s and adolescents’ medical records was conducted. All patients were on AAP monotherapy. At baseline and after treatment, measurements of body weight, height, body mass index (BMI), BMI z-score, fasting blood glucose (FBG), total cholesterol, low-density lipoprotein cholesterol, triglycerides, high-density lipoprotein cholesterol, complete blood count, liver functions, thyroid functions, and prolactin levels were made. Scores from the Children’s Global Assessment Scale (CGAS) and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were preserved. The overall patient population had a mean age of 14.50 ± 2.32 years, 139 girls, and 69 boys. Of the patients, 63 (30.29%) were on risperidone (RIS), 69(33.17%) were on aripiprazole (ARI), 32 (15.39%) were on quetiapine (QUE), 42 (20.19%) were on olanzapine (OLA), and 2 (0.96%) were on clozapine (CLO). In the OLA group, the BMI and BMI z-score increased more than in the RIS, QUE, and ARI groups (P = .030, P = .014, and P = .001, respectively) (P = .001). The mean difference in CGAS and HoNOSCA between the start of antipsychotic medication and hospital discharge was statistically different for all four groups (P = .001 for all). The mean FBG levels in the OLA group increased statistically significantly (P = .013, P = .021) in contrast to the RIS group. In addition, a statistically significant difference in triglycerides across the groups was found (P = .003). According to the findings of our study, children and adolescents appear to be at a significant risk for psychotropic-induced PRL increase, weight gain, metabolic, and hematological consequences. To prevent serious health problems, a meticulous risk–benefit assessment for AAPs treatment should be done between clinicians and patients and their families.

Background. Gastrointestinal system disorders are known to be prevalent among children with autism spectrum disorder (ASD). Some ASD-associated comorbidities are abdominal pain, constipation, diarrhea, gastroesophageal reflux, sleep disturbances, epilepsy, and psychiatric problems. Nonetheless, there is still limited information about the presence of functional GI disorders (FGIDs) among children with ASD, especially in Türkiye. Using the Rome criteria, we aimed to investigate FGIDs in children with ASD. Methods. The sample of the study consisted of 68 children aged 4-10 years, diagnosed with ASD according to the DSM-5 diagnostic criteria and had scores greater than 30 on the Childhood Autism Rating Scale (CARS-2) and an age-sex matched control group (n=78). The Rome III criteria were used to evaluate FGIDs. Results. The frequency of FGIDs in the ASD group was higher (76.5%) compared to the control group (p<0.001). Compared to the control group, abdominal migraine frequency increased 10 times (p=0.012), functional constipation 7 times (p<0.001), and fecal incontinence 6 times (p<0.001) in the ASD group. Stool retention was not present in most children in the ASD group who were found to have fecal incontinence. Conclusion. In this study, the most common FGIDs in the ASD group were abdominal migraine, functional constipation, and non-retentive fecal incontinence. The finding that most children with ASD who had fecal incontinence did not show stool retention implicated social, psychological, and behavioral factors as the causes of incontinence. Raising awareness of healthcare professionals about the frequency of FGIDs in children with ASD will improve many areas in the daily lives of these children.

Background/aim: Neurofilaments are intermediary filaments associated with neurodegenerative processes. Thrombospondin-1 (TSP1) is a biological marker playing a role in synaptogenesis. This study aimed to investigate serum neurofilament light chain (NFL), and TSP1 levels of patients with autism spectrum disorder (ASD) compared to typically developing (TD) children. Materials and methods: Forty-three patients with ASD and forty-five TD children were included. Serum biomarker levels were measured using the sandwich ELISA technique. The Childhood Autism Rating Scale (CARS) was implemented to measure the severity of ASD. Results: NFL and TSP1 levels did not differ between study groups (For NFL, ASD = 47.8 ± 11.4 vs. TD = 48.2 ± 15.3 pg/mL, p = 0.785; for TSP1, ASD = 224.4 ± 53.7 vs. TD = 224.7 ± 69.0 ng/mL, p = 0.828). Stereotyped behavior and sensory sensitivity domain of the CARS scale was negatively correlated with serum TSP-1 (r = -0.390, p = 0.010) and NFL (r = -0.377, p = 0.013) levels. Age was also positively correlated with NFL levels (r = 0.332, p = 0.030) in the ASD groups but not in the TD group. Conclusion: Our results did not support the neurodegenerative process of ASD. Future studies are needed to investigate neuroprogression in a longitudinal follow-up

We investigated the effects of exercise in multiple sessions on anxiety- and depression-like behavior during aging, and the role of serotonin and serotonin 1A receptors in this process. Both 24-month-old (aged) and 6-month-old (adult) female rats were divided into five groups; aged control, adult control, aged + serotonin re-uptake inhibitors (SSRIs), aged + exercise, and aged + SSRIs + exercise. After exercise, all groups were evaluated using the open field arena, elevated plus maze and forced swim tests. We assessed serum corticosterone levels; number of amygdala, hippocampus and prefrontal cortex cells; tissue serotonin and serotonin 1A (5-HT1A) levels. In the open field test, aged rats exhibited a significant increase in locomotor activity compared to the SSRIs and SSRIs + exercise groups. During the elevated plus maze test, aged rats were observed less frequently in the open arms of assembly compared to adults. The duration increased in the exercise group and remained unchanged in the SSRIs group. In the forced swim test, the aged rats were more immobile compared to adults; no change was observed in the immobility time between these groups. The tissue serotonin levels in amygdala and hippocampus were higher in SSRIs + exercise group compared to the aged, exercised and SSRIs groups. The number of cells in the hippocampus, prefrontal cortex and amygdala decreased in the aged group compared to adult rats; increased numbers of cell were observed in exercise, SSRIs and SSRIs + exercise groups compared to aged rats. Exercise in multiple sessions may increase the number of cells in the hippocampus, prefrontal cortex and amygdala, which may reduce senile anxiety and depression. Also, serotonin and serotonin 1A receptors may play role in depression-like behavior.

Background: Language and communication are very important in child social, emotional and cognitive development. Delay in language is usually the first complaint for children diagnosed with autism spectrum disorder (ASD) or developmental language delay (DLD). This study evaluated language features and emotion regulation skills in children diagnosed withASDandDLDand their association with maternal depression.Method: The sample consisted of children aged 24–54 months diagnosed withASD(n= 31), or withDLD(n= 45), and 52 healthy controls. The Test of Early Language Development (TELD‐3) was used to evaluate language profiles, and the beck depression inventory (BDI) was used to examine maternal depression. Children's emotion regulation skills were evaluated using the emotion regulation checklist.Results: Children withDLDhad a significantly higher developmental age, were linguistically more developed and had better emotion regulation than theASDgroup. All domains of language onTELD‐3 except expressive syntax were more developed inDLD. MaternalBDIscore did not differ significantly betweenDLDandASD. Both of these disorders were not associated with maternal depression.Conclusion: Children withDLDwere less impaired than children withASD, both in terms of language and in emotion regulation.

RJLM Published on behalf of the Romanian Society of Legal Medicine Editor Dan Dermengiu Editor Emeritus Vladimir Belis ISSN 1221-8618 (print) ISSN 1844-8585 (online) Indexed