{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T17:22:55Z","timestamp":1773163375828,"version":"3.50.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Health Sciences"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Immunoglobulin A (IgA) vasculitis is a common systemic vasculitis in children, involving the skin, joint, gastrointestinal tract and kidneys. Scrotal involvement is a less common manifestation in the course of IgA vasculitis, which alters disease management. The purpose of this study was to present the characteristics of patients with IgA vasculitis with scrotal involvement and to compare patients with and without scrotal involvement. We also aimed to investigate the relationship between scrotal involvement and disease activity and inflammatory markers. This medical record review study was conducted in 234 male patients under the age of 18 years who were diagnosed with IgA vasculitis and followed for at least 6\u00a0months in the Pediatric Rheumatology Clinic. Demographic characteristics, clinical findings, laboratory findings, and pediatric vasculitis activity score (PVAS) of IgA vasculitis patients were recorded. CRP to albumin ratio (CAR), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were calculated using the patients\u2019 complete blood count parameters and C reactive protein (CRP) levels. Two hundred thirty four male patients with IgA vasculitis were included in the study. Scrotum involvement was detected in 34 (14.5%) of patients. The mean age at diagnosis of 34 patients with scrotal involvement was 7.37 (4.41\u20138.43) years. Of the 34 patients, 15 had scrotal pain, swelling and rash, 12 had scrotal pain and swelling, and 2 had only scrotal swelling. Two (5.9%) patients had penile involvement with scrotal involvement. Patients were divided into two groups as those with scrotal involvement (<jats:italic>n<\/jats:italic>\u2009= 34, 10.2%) and those without (<jats:italic>n<\/jats:italic>\u2009= 200, 89.8%). Local edema, widespread skin involvement, hematuria, penile involvement, PVAS and CAR were significantly higher in IgA patients with scrotal involvement than in those without (<jats:italic>p<\/jats:italic>\u2009&lt; 0.001, <jats:italic>p<\/jats:italic>\u2009&lt; 0.001, <jats:italic>p<\/jats:italic>\u2009= 0.019, <jats:italic>p<\/jats:italic>\u2009= 0.001, <jats:italic>p<\/jats:italic>\u2009&lt; 0.001, and <jats:italic>p<\/jats:italic>\u2009= 0.004, respectively).<\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusion<\/jats:italic>: Widespread purpura, local edema, penile involvement and hematuria are more common in patients with scrotal involvement than those without. PVAS and some systemic inflammatory markers such as CAR may be helpful in predicting scrotal involvement.<\/jats:p>\n          <jats:p>\n            <jats:table-wrap>\n              <jats:table>\n                <jats:tbody>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:bold>What is known:<\/jats:bold>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td align=\"left\">\u2022 <jats:italic>IgA vasculitis is the most common type of vasculitis in childhood and scrotal involvement is very rare during the course of the disease.<\/jats:italic>\u2022 <jats:italic>PVAS is a scoring system used to measure the severity of childhood vasculitis.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:bold>What is new:<\/jats:bold>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td align=\"left\">\u2022 <jats:italic>PVAS might be promising surrogate tool for predicting scrotal involvement in patients with IgA vasculitis.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                <\/jats:tbody>\n              <\/jats:table>\n            <\/jats:table-wrap>\n          <\/jats:p>","DOI":"10.1007\/s00431-025-06120-w","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T18:35:46Z","timestamp":1744310146000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Characteristics of scrotal involvement in IgA vasculitis: Relationship with disease activity and inflammatory markers"],"prefix":"10.1007","volume":"184","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8958-5935","authenticated-orcid":false,"given":"Seyma","family":"Ertem","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5446-667X","authenticated-orcid":false,"given":"Zahide Ekici","family":"Tekin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3279-8435","authenticated-orcid":false,"given":"Merve Cansu","family":"Polat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9911-9225","authenticated-orcid":false,"given":"Didem","family":"\u00d6zt\u00fcrk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4619-8342","authenticated-orcid":false,"given":"Emine","family":"\u00d6z\u00e7elik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7942-3714","authenticated-orcid":false,"given":"Mehve\u015f I\u015f\u0131klar","family":"Ekici","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3691-8708","authenticated-orcid":false,"given":"Yasemin U\u011fur","family":"Es","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8287-5972","authenticated-orcid":false,"given":"Sultan Nilay","family":"Yo\u011fun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7841-265X","authenticated-orcid":false,"given":"\u015eeyma Erdem","family":"Torun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2987-1980","authenticated-orcid":false,"given":"C\u00fcneyt","family":"Karag\u00f6l","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1808-3655","authenticated-orcid":false,"given":"Banu \u00c7elikel","family":"Acar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"issue":"1","key":"6120_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/art.37715","volume":"65","author":"JC Jennette","year":"2013","unstructured":"Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F et al (2013) 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 65(1):1\u201311. https:\/\/doi.org\/10.1002\/art.37715","journal-title":"Arthritis Rheum"},{"issue":"2","key":"6120_CR2","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1007\/s10067-006-0266-6","volume":"26","author":"S Ozen","year":"2007","unstructured":"Ozen S, Bakkaloglu A, Dusunsel R, Soylemezoglu O, Ozaltin F, Poyrazoglu H et al (2007) Childhood vasculitides in Turkey: a nationwide survey. Clin Rheumatol 26(2):196\u2013200. https:\/\/doi.org\/10.1007\/s10067-006-0266-6","journal-title":"Clin Rheumatol"},{"issue":"6","key":"6120_CR3","doi-asserted-by":"publisher","first-page":"1707","DOI":"10.1007\/s10067-019-04460-1","volume":"38","author":"SG Karadag","year":"2019","unstructured":"Karadag SG, Tanatar A, Sonmez HE, Cakmak F, Kiyak A, Yavuz S et al (2019) The clinical spectrum of Henoch-Schonlein purpura in children: a single-center study. Clin Rheumatol 38(6):1707\u20131714. https:\/\/doi.org\/10.1007\/s10067-019-04460-1","journal-title":"Clin Rheumatol"},{"issue":"Suppl 3","key":"6120_CR4","doi-asserted-by":"publisher","first-page":"iii95","DOI":"10.1093\/rheumatology\/kez599","volume":"59","author":"S Ozen","year":"2020","unstructured":"Ozen S, Sag E (2020) Childhood vasculitis. Rheumatology 59(Suppl 3):iii95\u2013iii100. https:\/\/doi.org\/10.1093\/rheumatology\/kez599","journal-title":"Rheumatology"},{"issue":"1","key":"6120_CR5","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s42358-018-0039-3","volume":"58","author":"IM Buscatti","year":"2018","unstructured":"Buscatti IM, Abrao HM, Kozu K, Marques VLS, Gomes RC, Sallum AME et al (2018) Characterization of scrotal involvement in children and adolescents with IgA vasculitis. Advances in rheumatology 58(1):38. https:\/\/doi.org\/10.1186\/s42358-018-0039-3","journal-title":"Advances in rheumatology"},{"issue":"4","key":"6120_CR6","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1111\/j.1651-2227.2006.00173.x","volume":"96","author":"TS Ha","year":"2007","unstructured":"Ha TS, Lee JS (2007) Scrotal involvement in childhood Henoch-Schonlein purpura. Acta Paediatr 96(4):552\u2013555. https:\/\/doi.org\/10.1111\/j.1651-2227.2006.00173.x","journal-title":"Acta Paediatr"},{"issue":"9","key":"6120_CR7","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1093\/rheumatology\/kez041","volume":"58","author":"S Ozen","year":"2019","unstructured":"Ozen S, Marks SD, Brogan P, Groot N, de Graeff N, Avcin T et al (2019) European consensus-based recommendations for diagnosis and treatment of immunoglobulin A vasculitis-the SHARE initiative. Rheumatology 58(9):1607\u20131616. https:\/\/doi.org\/10.1093\/rheumatology\/kez041","journal-title":"Rheumatology"},{"issue":"4","key":"6120_CR8","first-page":"269","volume":"6","author":"Y Tabel","year":"2012","unstructured":"Tabel Y, Inanc FC, Dogan DG, Elmas AT (2012) Clinical features of children with Henoch-Schonlein purpura: risk factors associated with renal involvement. Iran J Kidney Dis 6(4):269\u2013274","journal-title":"Iran J Kidney Dis"},{"issue":"2","key":"6120_CR9","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1159\/000365692","volume":"8","author":"A Dalpiaz","year":"2015","unstructured":"Dalpiaz A, Schwamb R, Miao Y, Gonka J, Walzter W, Khan SA (2015) Urological Manifestations of Henoch-Schonlein Purpura: A Review. Current urology 8(2):66\u201373. https:\/\/doi.org\/10.1159\/000365692","journal-title":"Current urology"},{"issue":"3","key":"6120_CR10","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1080\/00325481.2020.1807161","volume":"133","author":"SG Karadag","year":"2021","unstructured":"Karadag SG, Cakmak F, Cil B, Tanatar A, Sonmez HE, Kiyak A et al (2021) The relevance of practical laboratory markers in predicting gastrointestinal and renal involvement in children with Henoch-Schonlein Purpura. Postgrad Med 133(3):272\u2013277. https:\/\/doi.org\/10.1080\/00325481.2020.1807161","journal-title":"Postgrad Med"},{"key":"6120_CR11","doi-asserted-by":"publisher","first-page":"107454","DOI":"10.1016\/j.intimp.2021.107454","volume":"94","author":"W Fu","year":"2021","unstructured":"Fu W, Ye W, Liu X, Zhu S, Fu H, Zhu R et al (2021) Meta-analysis of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in Henoch-Schonlein purpura and its complications. Int Immunopharmacol 94:107454. https:\/\/doi.org\/10.1016\/j.intimp.2021.107454","journal-title":"Int Immunopharmacol"},{"issue":"4","key":"6120_CR12","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1080\/00325481.2019.1609814","volume":"131","author":"RMK Ekinci","year":"2019","unstructured":"Ekinci RMK, Balci S, Sari Gokay S, Yilmaz HL, Dogruel D, Altintas DU et al (2019) Do practical laboratory indices predict the outcomes of children with Henoch-Schonlein purpura? Postgrad Med 131(4):295\u2013298. https:\/\/doi.org\/10.1080\/00325481.2019.1609814","journal-title":"Postgrad Med"},{"issue":"10","key":"6120_CR13","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1136\/annrheumdis-2012-202111","volume":"72","author":"P Dolezalova","year":"2013","unstructured":"Dolezalova P, Price-Kuehne FE, Ozen S, Benseler SM, Cabral DA, Anton J et al (2013) Disease activity assessment in childhood vasculitis: development and preliminary validation of the Paediatric Vasculitis Activity Score (PVAS). Ann Rheum Dis 72(10):1628\u20131633. https:\/\/doi.org\/10.1136\/annrheumdis-2012-202111","journal-title":"Ann Rheum Dis"},{"issue":"7","key":"6120_CR14","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.1002\/art.40112","volume":"69","author":"KA Morishita","year":"2017","unstructured":"Morishita KA, Moorthy LN, Lubieniecka JM, Twilt M, Yeung RSM, Toth MB et al (2017) Early outcomes in children with antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol 69(7):1470\u20131479. https:\/\/doi.org\/10.1002\/art.40112","journal-title":"Arthritis Rheumatol"},{"key":"6120_CR15","doi-asserted-by":"publisher","unstructured":"Gagne SJ, Sivaraman V, Bosman ES, Klamer B, Morishita KA, Huber A, et al (2024) Comparing rituximab and cyclophosphamide in induction therapy for childhood-onset anti-neutrophil cytoplasmic antibody-associated vasculitis: an ARChiVe registry cohort study. Arthritis Care Res. https:\/\/doi.org\/10.1002\/acr.25455","DOI":"10.1002\/acr.25455"},{"key":"6120_CR16","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s13075-016-0959-4","volume":"18","author":"A Hocevar","year":"2016","unstructured":"Hocevar A, Rotar Z, Jurcic V, Pizem J, Cucnik S, Vizjak A et al (2016) IgA vasculitis in adults: the performance of the EULAR\/PRINTO\/PRES classification criteria in adults. Arthritis Res Ther 18:58. https:\/\/doi.org\/10.1186\/s13075-016-0959-4","journal-title":"Arthritis Res Ther"},{"key":"6120_CR17","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.eucr.2016.01.004","volume":"6","author":"S Modi","year":"2016","unstructured":"Modi S, Mohan M, Jennings A (2016) Acute scrotal swelling in henoch-schonlein purpura: case report and review of the literature. Urology case reports 6:9\u201311. https:\/\/doi.org\/10.1016\/j.eucr.2016.01.004","journal-title":"Urology case reports"},{"issue":"6","key":"6120_CR18","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1097\/MPH.0000000000002161","volume":"43","author":"Y Ma","year":"2021","unstructured":"Ma Y, Zhang S, Chen J, Kong H, Diao J (2021) Henoch-schonlein purpura with scrotal involvement: a case report and literature review. J Pediatr Hematol Oncol 43(6):211\u2013215. https:\/\/doi.org\/10.1097\/MPH.0000000000002161","journal-title":"J Pediatr Hematol Oncol"},{"issue":"2","key":"6120_CR19","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s002470050029","volume":"30","author":"L Ben-Sira","year":"2000","unstructured":"Ben-Sira L, Laor T (2000) Severe scrotal pain in boys with Henoch-Schonlein purpura: incidence and sonography. Pediatr Radiol 30(2):125\u2013128. https:\/\/doi.org\/10.1007\/s002470050029","journal-title":"Pediatr Radiol"},{"issue":"1","key":"6120_CR20","doi-asserted-by":"publisher","first-page":"21","DOI":"10.2174\/1573397115666191126093927","volume":"16","author":"ED Batu","year":"2020","unstructured":"Batu ED, Ozen S (2020) Measuring vasculitis with numbers: outcome scores. Curr Rheumatol Rev 16(1):21\u201328. https:\/\/doi.org\/10.2174\/1573397115666191126093927","journal-title":"Curr Rheumatol Rev"},{"issue":"1","key":"6120_CR21","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s12969-017-0164-2","volume":"15","author":"Y Feng","year":"2017","unstructured":"Feng Y, Tang X, Liu M, Zhou J, Zhao X, Li Q (2017) Clinical study of children with Takayasu arteritis: a retrospective study from a single center in China. Pediatr Rheumatol Online J 15(1):29. https:\/\/doi.org\/10.1186\/s12969-017-0164-2","journal-title":"Pediatr Rheumatol Online J"},{"issue":"3","key":"6120_CR22","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1007\/s00467-022-05675-2","volume":"38","author":"B Avci","year":"2023","unstructured":"Avci B, Kurt T, Aydin F, Celikel E, Tekin ZE, Sezer M et al (2023) Association of pediatric vasculitis activity score with immunoglobulin A vasculitis with nephritis. Pediatr Nephrol 38(3):763\u2013770. https:\/\/doi.org\/10.1007\/s00467-022-05675-2","journal-title":"Pediatr Nephrol"},{"issue":"9","key":"6120_CR23","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1007\/s00296-014-3049-4","volume":"34","author":"B Makay","year":"2014","unstructured":"Makay B, Gucenmez OA, Duman M, Unsal E (2014) Response to: predictive role of neutrophil-to-lymphocyte ratio in Henoch-Schonlein purpura-related gastrointestinal bleeding. Rheumatol Int 34(9):1333. https:\/\/doi.org\/10.1007\/s00296-014-3049-4","journal-title":"Rheumatol Int"},{"issue":"9","key":"6120_CR24","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1111\/ped.13652","volume":"60","author":"SH Hong","year":"2018","unstructured":"Hong SH, Kim CJ, Yang EM (2018) Neutrophil-to-lymphocyte ratio to predict gastrointestinal bleeding in Henoch: Schonlein purpura. Pediatr Int 60(9):791\u2013795. https:\/\/doi.org\/10.1111\/ped.13652","journal-title":"Pediatr Int"},{"issue":"1","key":"6120_CR25","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1007\/s10067-022-06366-x","volume":"42","author":"J Liu","year":"2023","unstructured":"Liu J, Ye B, Su D, Qin S, Zhao W, Pang Y (2023) Evaluation of laboratory predictors for intravenous immunoglobulin resistance and coronary artery aneurysm in Kawasaki Disease before and after therapy. Clin Rheumatol 42(1):167\u2013177. https:\/\/doi.org\/10.1007\/s10067-022-06366-x","journal-title":"Clin Rheumatol"},{"issue":"4","key":"6120_CR26","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.reumae.2023.03.005","volume":"19","author":"DE Kamal","year":"2023","unstructured":"Kamal DE, Zaghlol RS, Hussien MHS, Makarm WK (2023) Utility of neutrophil\/albumin ratio and C-reactive protein\/albumin ratio as novel inflammatory markers in Behcet\u2019s disease. Reumatol Clin 19(4):188\u2013196. https:\/\/doi.org\/10.1016\/j.reumae.2023.03.005","journal-title":"Reumatol Clin"},{"key":"6120_CR27","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.12659\/MSM.912495","volume":"25","author":"N Seringec Akkececi","year":"2019","unstructured":"Seringec Akkececi N, Yildirim Cetin G, Gogebakan H, Acipayam C (2019) The C-reactive protein\/albumin ratio and complete blood count parameters as indicators of disease activity in patients with Takayasu Arteritis. Med Sci Monit 25:1401\u20131409. https:\/\/doi.org\/10.12659\/MSM.912495","journal-title":"Med Sci Monit"},{"issue":"1","key":"6120_CR28","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s12969-021-00517-1","volume":"19","author":"X Liu","year":"2021","unstructured":"Liu X, Wang L, Zhou K, Shao S, Hua Y, Wu M et al (2021) Predictive value of C-reactive protein to albumin ratio as a biomarker for initial and repeated intravenous immunoglobulin resistance in a large cohort of Kawasaki disease patients: a prospective cohort study. Pediatr Rheumatol Online J 19(1):24. https:\/\/doi.org\/10.1186\/s12969-021-00517-1","journal-title":"Pediatr Rheumatol Online J"},{"issue":"10","key":"6120_CR29","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.2340\/00015555-2733","volume":"97","author":"LE Hetland","year":"2017","unstructured":"Hetland LE, Susrud KS, Lindahl KH, Bygum A (2017) Henoch-schonlein purpura: a literature review. Acta Derm Venereol 97(10):1160\u20131166. https:\/\/doi.org\/10.2340\/00015555-2733","journal-title":"Acta Derm Venereol"},{"issue":"10","key":"6120_CR30","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1016\/0022-3468(95)90424-7","volume":"30","author":"J Ben-Chaim","year":"1995","unstructured":"Ben-Chaim J, Korat E, Shenfeld O, Shelhav A, Jonas P, Goldwasser B (1995) Acute scrotum caused by Henoch-Schonlein purpura, with immediate response to short-term steroid therapy. J Pediatr Surg 30(10):1509\u20131510. https:\/\/doi.org\/10.1016\/0022-3468(95)90424-7","journal-title":"J Pediatr Surg"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-025-06120-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-025-06120-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-025-06120-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T19:03:19Z","timestamp":1746903799000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-025-06120-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,10]]},"references-count":30,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["6120"],"URL":"https:\/\/doi.org\/10.1007\/s00431-025-06120-w","relation":{},"ISSN":["1432-1076"],"issn-type":[{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,10]]},"assertion":[{"value":"15 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 March 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 April 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the principles of the Declaration of Helsinki. The study was approved by the ethical committee of Ankara Bilkent City Hospital (audit ref. No: TABED- 1\u2013362).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"289"}}