Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Effects of Electromagnetic Field on the Endocrine System in Children and Adolescents(2015) Sangun, Ozlem; Dundar, Bumin; Comlekci, Selcuk; Buyukgebiz, Attila; 0000-0002-9079-4574; 26841641; C-3882-2008Children are exposed to various kind of non-ionizan radiation in their daily life involuntarily. The potential sensitivity of developing organism to the effects of radiofrequency (RF) signals, the higher estimated specific absorption rate (SAR) values of children and greater lifetime cumulative risk raised the scientific interest for children's vulnerability to electromagnetic fields (EMFs). In modern societies, children are being exposed to EMFs in very early ages. There are many researches in scientific literature investigating the alterations of biological parameters in living organisms after EMFs. Although the international guidelines did not report definite, convincing data about the causality, there are unignorable amount of studies indicating the increased risk of cancer, hematologic effects and cognitive impairment. Although they are less in amount; growing number of studies reveal the impacts on metabolism and endocrine function. Reproductive system and growth look like the most challenging fields. However there are also some concerns on detrimental effects of EMFs on thyroid functions, adrenal hormones, glucose homeostasis and melatonin levels. It is not easy to conduct a study investigating the effects of EMFs on a fetus or child due to ethical issues. Hence, the studies are usually performed on virtual models or animals. Although the results are conflicting and cannot be totally matched with humans; there is growing evidence to distress us about the threats of EMF On children.Item Tic Disorder Probably Associated with Steroid Responsive Encephalopathy with Autoimmune Thyroiditis (SREAT)(2014) Saygi, Semra; Ozkale, Yasemin; Erol, Ilknur; https://orcid.org/0000-0002-8522-5078; https://orcid.org/0000-0003-3009-336X; 24633901; AAB-1203-2021; AAL-6136-2021Steroid responsive encephalopathy with autoimmune thyroiditis (SREAT), a rare disorder in individuals of all age groups, including children, is characterized by high titers of anti-thyroid peroxidase antibodies. The present report concerns a previously healthy 12-y-old boy who presented with motor tics. The patient underwent an extensive work-up to identify the underlying etiologies and risk factors predisposing him to tic disorder. Based on the clinical and laboratory results, a diagnosis of SREAT was made. Although some studies have reported associated behavioral and cognitive changes, myoclonus, seizures, pyramidal tract dysfunction, psychosis, and coma. The authors describe a case of tic disorder, probably due to SREAT, as well as its course of treatment.Item Coexistence of Tubo-Ovarian Abscess and Carcinoid Tumor of the Appendix in A Sexually Inactive Girl: A Case Report(2022) Acer-Demir, Tugba; Sagnak-Akilli, Muge; Guney, Lutfi Hakan; Arslan, Esra Elif; Fakioglu, Ender; https://orcid.org/0000-0001-5391-9094; https://orcid.org/0000-0002-7437-2734; E-4455-2019; AFT-2490-2022Background: Tubo-ovarian abscess (TOA) is mostly a sequela of pelvic inflammatory disease (PID) which is seen in sexually active women. Although very rare, TOA could be seen in virgin adolescent girls. Fifteen cases of TOA were reported in virgin girls in English literature. Only one of these cases was suspected to be due to appendicitis. Herein, we present the first case of coexistence of tubo-ovarian abscess and carcinoid tumor of the appendix in a sexually inactive girl. Case presentation: A 13-year-old girl presented with abdominal pain and fever. Ultrasonography reported that there was a 63x48 mm sized, heterogeneous, thick-walled, dense-content complicated cyst in the right ovary which was thought to be a hemorrhagic cyst and a tubular structure, measuring 12 mm in its thickest part which was thought to be the appendix. During the operation, a TOA was observed in the right adnexal region. The thick, edematous appendix which was lying separately was excised. The TOA was evacuated; a drain was placed. The appendix pathology was reported as "carcinoid tumor. " Conclusion: We present the first case of TAO with carcinoid tumor of appendix and the second case of TAO that was suspected to be due to appendicitis. When the sexually inactive TOA cases including our case were reviewed, we found that the median age was 15 years (12-47 years) and 11 of 16 cases (69%) were under 18 years of age. The presenting symptoms were abdominal or pelvic pain in all cases, fever in 11 cases (69%), vomiting in 6 cases (38%), dysuria in 5 cases (31%), and diarrhea in 3 cases (19%). Both perforated appendicitis and TOA patients have the same clinic presentation such as fever, abdominal tenderness, increased leukocyte count, increased inflammatory markers. The differential diagnosis can be achieved by radiological examinations such as ultrasonography, computerized tomography or magnetic resonance imaging.Item Follow-Up Results of Patients with ADCK4 Mutations and the Efficacy of Coq10 Treatment(2017) Atmaca, Mustafa; Gulhan, Bora; Korkmaz, Emine; Inozu, Mihriban; Soylemezoglu, Oguz; Candan, Cengiz; Bayazit, Aysun Karabay; Elmaci, Ahmet Midhat; Parmaksiz, Gonul; Duzova, Ali; Besbas, Nesrin; Topaloglu, Rezan; Ozaltin, Fatih; https://orcid.org/0000-0003-2373-1837; 28337616; AAM-2935-2021ADCK4-related glomerulopathy is an important differential diagnosis in adolescents with steroid-resistant nephrotic syndrome (SRNS) and/or chronic kidney disease (CKD) of unknown origin. We screened adolescent patients to determine the frequency of ADCK4 mutation and the efficacy of early CoQ10 administration. A total of 146 index patients aged 10-18 years, with newly diagnosed non-nephrotic proteinuria, nephrotic syndrome, or chronic renal failure and end-stage kidney disease (ESKD) of unknown etiology were screened for ADCK4 mutation. Twenty-eight individuals with bi-allelic mutation from 11 families were identified. Median age at diagnosis was 12.4 (interquartile range [IQR] 8.04-19.7) years. Upon first admission, all patients had albuminuria and 18 had CKD (6 ESKD). Eight were diagnosed either through the screening of family members following index case identification or during genetic investigation of proteinuria in an individual with a history of a transplanted sibling. Median age of these 8 patients was 21.5 (range 4.4-39) years. CoQ10 supplementation was administered following genetic diagnosis. Median estimated glomerular filtration rate (eGFR) just before CoQ10 administration was 140 (IQR 117-155) ml/min/1.73m(2), proteinuria was 1,008 (IQR 281-1,567) mg/m(2)/day. After a median follow-up of 11.5 (range 4-21) months following CoQ10 administration, proteinuria was significantly decreased (median 363 [IQR 175-561] mg/m(2)/day, P=0.025), whereas eGFR was preserved (median 137 [IQR 113-158] ml/min/1.73m(2), P=0.61). ADCK4 mutations are one of the most common causes of adolescent-onset albuminuria and/or CKD of unknown etiology in Turkey. CoQ10 supplementation appears efficacious at reducing proteinuria, and may thereby be renoprotective.Item Early Maladaptive Schemas Differing According To Sex May Contribute To Migraine Among The Youth(2022) Aksu, Gullen Guller; Kayar, Ozan; Tufan, Ali Evren; Kultulk, Meryem Ozlem; Sucu, Damla Hazal; Tasdelen, Bahar; Toros, Fevziye; Olzge, Aynur; 35459526Objective: Despite many diverse findings from studies about the comorbidity of psychiatric disorders and migraine, there are still unknown points. Schemas, which are the basic structures of cognition, are understudied. This study examined the effects of sex on early maladaptive schemas (EMSs) and the clinical characteristics of migraine in adolescents with migraine.Methods: The sample comprised 171 adolescents (67.3% females, n = 115) aged 12-18 years. The clinical characteristics of migraine (duration, severity, frequency of headaches, etc.), accompanying symptoms (nausea, vomiting, photophobia, etc.) and EMSs were evaluated depending on sex. Psychopathology and abuse history were analyzed as covariates in this study.Results: The mean age was 15.4 +/- 1.9 among the females and 15.2 +/- 2.0 among the males (p = 0.65). There was no difference in terms of migraine characteristics, and except for dizziness and pain relief by massage, all other symptoms were similar between the sexes. Female adolescent migraineurs significantly elevated scores for EMS of emotional deprivation, abandonment/instability, defectiveness/shame (disconnection/rejection domain), dependence/incompetence, vulnerability to harm/illness, failure (in impaired autonomy/performance domain) and negativity/pessimism (in hypervigilance/inhibition domain). On the other hand, male migraineurs had significantly elevated scores only in insufficient self-control/self-discipline (in impaired limits domain). Type of migraine and current psychopathology had no significant effect on the EMS domains, while sexual abuse history significantly affected some EMS.Conclusion: Our study highlights the importance of screening for EMSs among adolescent patients with migraine. Schema therapy and similar therapeutic interventions may be used in the management of migraine in adolescents. Gender may also be important (c) 2022 Published by Elsevier B.V. on behalf of The Japanese Society of Child Neurology.Item Correlates and predictors of re-incarceration among Turkish adolescent male offenders: A single-center, cross-sectional study(2022) Aksu, Gulen Guler; Kutuk, Meryem Ozlem; Tufan, Ali Evren; Sanberk, Sati; Guzel, Esra; Dag, Pelin; Tan, Muhammed Emin; Akyol, Betul; Toros, Fevziye; 34924111Background: Adolescents involved in the legal system are known to be under elevated risk for repeat offending. There may be many reasons for recidivism. Specifically, we aim to investigate the clinical, socio-demographic, and familial factors and psychopathology among adolescents in a penal institution and to determine risk factors for re-incarceration. Methods: This single-center cross-sectional survey was conducted at Tarsus Closed Penal Institution for Children and Youth. This institution is for males only, and all male adolescents detained at the center within the study period were evaluated with semi-structured interviews (K-SADS-PL). The adolescents completed Meaning and Purpose of Life Scale, The EPOCH measure of Adolescent Well-being, Family Sense of Belonging Scale, Children's Alexithymia Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory for themselves. Descriptive and inferential analyses were used. P was set at 0.05. Results: Ninety adolescent offenders with a mean age of 16.6 years (S.D = 0.7) were enrolled. Mean age at first offense was 14.6 years (S.D = 2.1). The most common reason for offenses was reported as as being with peers who were offenders, too (57.8%). Most common diagnoses were substance use (36.7%), attention deficit/hyperactivity disorder (33.3%), and conduct disorder (26.7%). Rates of offending and conviction in first-degree relatives were 62.2% and 60.0%, respectively, and most of the adolescents had at least one peer with a criminal record (n = 71, 78.9%). Re-incarcerated adolescents had lower education, committed more violent crimes, and reported elevated use of substances, suicide attempts, and psychopathology. However, in regression analysis, age of onset was the sole predictor of re-incarceration. Conclusion: Turkish male adolescents in forensic settings may be screened for externalizing disorders and referred for treatment. Re-incarcerated Turkish youth may be more susceptible to peer influence, substance use and externalizing disorders. It may be prudent to systematically screen offending youth for psychiatric disorders regardless of the individual's request for treatment and refer identified cases to treatment. Integration of child and adolescent psychiatrists with penal institutions serving youth may help in this regard.Item Sounds unrealistic: an adolescent girl with anorexia nervosa consumes 19 L of fluid in a few hours: what happens to the physiology?(2020) Oden Akman, Alkim; Cak, H. Tuna; Pehlivanturk-Kizilka, Melis; Balik, Zeynep; Akbulut, Ozlem; Kanbur, Nuray; 31522380Background Adolescents with eating disorders (EDs) may present not only with abnormal eating behaviors but also with abnormal drinking behaviors varying widely. These behaviors include water loading to cheat on weight measurements, to feel full and suppress appetite and/or to induce vomiting; as well as restricting fluid intake in addition to food. Method We present a 16-year-old female adolescent with anorexia nervosa restrictive type and major depressive disorder who was hospitalized due to acute food refusal and developed generalized seizures due to dilutional hyponatremia in consequence of consuming excessive amount of water. Psychiatric diagnoses were made according to 'The Diagnostic and Statistical Manual of Mental Disorders' (5th ed.; DSM-5) criteria. Results After starting nutritional rehabilitation with a low calorie meal plan to avoid refeeding syndrome, a weight gain of 2 kg was noted in the second day of hospitalization. At the bedside visit, she was observed in a disoriented manner and consecutively in seconds, lost consciousness with a generalized tonic-clonic seizure lasting 2 min. Her serum sodium level was measured as 116 mEq/L, which was normal at the time of admission. It was later learned that she secretly ingested 19 L of water in a short amount of time. She regained consciousness and no further seizures were observed after intravenous sodium deficit correction and fluid restriction therapy. Her serum sodium level was normalized (137 mEq/L) within 12 h. Conclusion A thorough clinical assessment of hydration and drinking behaviors as well as eating behaviors is essential for patients with EDs to avoid serious medical complications with high mortality and morbidity during follow-up. It is interesting that this amount of fluid consumption in such a short period of time did not present to the clinic with vomiting, gastric dilatation or bowel irrigation symptoms in a case with acute food refusal and restriction for a year, instead absorbed very quickly causing acute and severe symptomatic hyponatremia with generalized seizures.Item Normative values for semicircular canal function with the video head impulse test (vHIT) in healthy adolescents(2020) Emekci, Tugba; Ugur, Kadriye Serife; Cengiz, Deniz Ugur; Kilinc, Fatma Men; 33151099Background The vHIT device, which has a mechanism based on measuring the VOR gain, helps us to quickly evaluate six semicircular canals. Aims/Objectives The aim of this study was to establish normative values for semicircular canal function with the video head impulse test (vHIT) battery in normal adolescents. Material and methods 100 (50 females, 50 males) individuals aged 11-18 years, with a mean age of 14.99 years, were included in the study. Results As a result of the vHIT evaluations performed with vHIT Otometrics ICS Impulse A/S Taastrup, Denmark, the mean lateral canal vestibulo-ocular reflex (VOR) gain value was 0.96, the mean anterior canal VOR gain value was 0.89, and the mean posterior canal VOR gain value was 0.87, all of which were within the normal value range. Conclusion and significance While the VOR gain values and asymmetry values are within the normal value range and are similar to the literature, no statistically significant correlation was observed between these values and age. As a result, the vHIT battery is an easy, fast, and practical test method that can be used in adolescents.Item Usage of Analgesics among Young Girls and Dysmenorrhea(2017) Oksuz, Ergun; Sozen, Fisun; Kavas, Ece; Arik, Elif Pinar; Akgun, Yasemin; Bingol, Puren; Kotuz, Pinar; Ogus, Ersin; 0000-0002-9877-421X; 0000-0002-5723-5965; 0000-0002-1951-2693; AAJ-1058-2021; K-8238-2012; AAC-1823-2021Objective: This study aimed to determine dysmenorrhea prevalence and menstruation characteristics among young girls and whether dysmenorrhea affects the use of analgesics. Methods: This cross-sectional study was conducted in female university students who applied to Baskent University's Medicosocial Center. Results: There were 190 participants in the dysmenorrhea group and 80 participants in the control group. The prevalence of dysmenorrhea was 70%. Reading of the drug prospectus in the dysmenorrhea group was higher than in the control group (69.9% vs. 46.8%, p < 0.05). Recommending her own drug to someone else (67.8% versus 53.3%, p < 0.05) and not paying attention to the recommended drug use period (72.5% vs. 59.7%; p < 0.05) was higher in the dysmenorrhea group than in the control group. In the dysmenorrhea group, the reasons to take the last pain relievers were headache or abdominal pain in the same order as the control group and the rate of abdominal pain was higher in the study group (30.0% versus 11.5%, p < 0.05). The inability to remember the name of the last used pain reliever was higher in the study group (24.2% versus 17.5%, p < 0.05). The rate of knowing the name of any three different pain relievers was higher in the study group (81.6% versus 80.4%, p < 0.05). Conclusion: University students who are in need of medication due to diseases more frequently encounter drugs. Developing behaviors on rational drug use in these students may provide productive results. It may be effective to organize contact meetings for students on the use of non-prescription drugs.Item The High Level of Psychiatric Disorders Associated with Migraine or Tension-type Headache in Adolescents(2017) Kutuk, Meryem Ozlem; Guler, Glen; Toros, Fevziye; Ozge, Aynur; Tasdelen, Bahar; 0000-0002-2918-7871; AAI-9626-2021Objectives: This study aimed to evaluate the relation between psychiatric disorders, andmigraine or tensiontype headache (TTH), together with severity of depression and anxiety symptoms, in adolescents with headache. Methods: Headache types of 140 adolescents aged 12 to 18 years were investigated by a headache specialist, through facetoface interviews according to the diagnostic criteria of International Classification of Headache Disorders, 3rd edition beta version (ICHD3 beta). Psychiatric disorders of participants were assessed via DSMIV diagnostic criteria. Sociodemographic information form, Depression Scale, and the StateTrait Anxiety Scale for Children were applied to the patients accordingly. Results: Higher rates of psychiatric disorders (82%) were observed in the migraine and tensiontype headache (TTH) groups. The most frequent comorbid psychiatric disorder was anxiety disorder. In patients with TTH, the number of attacks was statistically higher. In patients with migraine, the frequency of throbbing headache was elevated with the co-occurrence of anxiety disorder and attention deficit hyperactivity disorder (ADHD). In patients with TTH, the description of worsening of pain with movement was raised with anxiety disorder comorbidity. A weak correlation existed between headache prevalence and headache severity in patients with migraine. Similarly, in the TTH group, a weak association between headache prevalence and depressionanxiety scores were reported. Conclusions: Our findings support the association between migraine or TTH and anxiety and depression symptoms in adolescents. This highlights the importance of headache considering possible comorbid psychiatric disorders. This implies a necessity for multidisciplinary and prospective clinical studies to make clear the importance of the chronification hypothesis.