Hatice Büşra Kütükçü

Objective: To evaluate the diagnostic and prognostic utility of the hemoglobin–albumin–lymphocyte–platelet (HALP) score and several systemic inflammatory indices derived from routine blood parameters—including the systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), pan-immune inflammation value (PIV), and systemic inflammatory response index (SIRI)—for pathogen differentiation and clinical assessment in culture-proven late-onset neonatal sepsis (LOS). Methods: A retrospective analysis was conducted on a cohort of 150 neonates with culture-proven LOS. Systemic inflammatory indices were calculated at baseline (first week of life) and at the time of septic insult. The discriminative power of these indices was assessed via ROC curve analysis, with optimal cut-off points determined by the Youden Index. Risk stratification was performed using Odds Ratio (OR) modeling with 95% Confidence Intervals (CIs) to evaluate the predictive strength of each marker according to its respective threshold. Results: Diagnosis-phase assessments identified SII as the premier discriminator for microbiological etiology (AUC = 0.869; OR = 44.57), outperforming PLR and PIV. Although HALP demonstrated moderate efficacy in distinguishing pathogens, it lacked prognostic value regarding mortality. Conversely, SIRI displayed limited clinical utility, yielding the lowest predictive performance in our cohort. Conclusions: In neonatal sepsis, the HALP score provided additional clinical information when compared with several hematological inflammatory indices. Although HALP was not associated with mortality, prospective multicenter studies are needed to clarify the role of these cost-effective markers in pathogen differentiation and clinical assessment of LOS.

Objective: This study aimed to evaluate the impact of the revised 2022 American Academy of Pediatrics (AAP) guideline for hyperbilirubinemia on hospitalization rates and short-term outcomes. Materials and Methods: This retrospective observational study compared 2 periods, before (period 1: January 1-August 31, 2022) and after (period 2: September 1-December 31, 2022) implementation of the AAP 2022 guideline in a tertiary neonatal unit. Neonates born at ≥35 weeks’ gestational age who met phototherapy criteria were included. In period 2, infants who would have been hospitalized under the previous 2004 guideline but not under the new one were followed to assess the need for hospitalization and the occurrence of neurotoxicity. Results: The rate of hospitalization due to hyperbilirubinemia decreased from 23% (n = 95/409) in period 1 to 14% (n = 25/173) in period 2 (P = .017). When the new guideline was retrospectively applied, it was found that 58% (n = 55) of previously hospitalized patients in period 1 would not have required admission under the new criteria. In period 2, 37 neonates met the previous criteria, but only 25 were hospitalized under the new guideline; 2 of the 25 required rehospitalization. The remaining 12 newborns were followed as outpatients without developing neurotoxicity. Overall, 51% (n = 67) of newborns who met previous criteria did not meet the new hospitalization thresholds. Conclusion: The implementation of the AAP 2022 guideline was associated with a reduced risk of hospitalization without an increased risk of bilirubin-related neurotoxicity. Structured followup and individualized risk assessment remain essential for safe outpatient management. Cite this article as: Demirtaş F, Kütükçü B, Köstekçi YE, et al. Impact of the 2022 American Academy of Pediatrics hyperbilirubinemia guideline on hospitalization rates and short-term outcomes: A single-center study. Turk Arch Pediatr. 2025;60(5):531-535.

Leishmania is a vector-induced endemic tropical disease caused by protozoans. The most common cutaneous, mucosal and visceral forms are the cutaneous form. The main drugs in treatment are pentavalent antimony compounds, but their side effects create limitation of use. Local antimony compounds are used primarily in the treatment of cutaneous leishmaniasis. In some cases, alternative treatment modalities are required due to insufficient response to local treatment. Systemic amphotericin B treatment is one of the alternative treatments. In a patient who developed cutaneous Leishmania at 21 months and who did not respond with local meglumine antimoniate therapy, a total of 21 mg/kg dose of systemic amphotericin B was given intermittently and successful results were obtained.

Leishmania is a vector-induced endemic tropical disease caused by protozoans. The most common cutaneous, mucosal and visceral forms are the cutaneous form. The main drugs in treatment are pentavalent antimony compounds, but their side effects create limitation of use. Local antimony compounds are used primarily in the treatment of cutaneous leishmaniasis. In some cases, alternative treatment modalities are required due to insufficient response to local treatment. Systemic amphotericin B treatment is one of the alternative treatments. In a patient who developed cutaneous leishmania at 21 months and who did not respond with local meglumine antimoniate therapy, a total of 21 mg / kg dose of systemic amphotericin B was given intermittently and successful results were obtained.