Fakülteler / Faculties
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Item Subcortical Auditory Processing and Speech Perception in Noise Among Individuals With and Without Extended High-Frequency Hearing Loss(JOURNAL OF SPEECH LANGUAGE AND HEARING RESEARCH, 2024-05-16) Colak, Hasan; Aydemir, Berfin Eylul; Sakarya, Merve Deniz; Cakmak, Eda; Alniacik, Asuman; Turkyilmaz, Meral DidemPurpose: The significance of extended high -frequency (EHF) hearing (> 8 kHz) is not well understood so far. In this study, we aimed to understand the relationship between EHF hearing loss (EHFHL) and speech perception in noise (SPIN) and the associated physiological signatures using the speech-evoked frequency-following response (sFFR). Method: Sixteen young adults with EHFHL and 16 age- and sex-matched individuals with normal hearing participated in the study. SPIN performance in right speech-right noise, left speech-left noise, and binaural listening conditions was evaluated using the Turkish Matrix Test. Additionally, subcortical auditory processing was assessed by recording sFFRs elicited by 40 -ms /da/ stimuli. Results: Individuals with EHFHL demonstrated poorer SPIN performances in all listening conditions (p < .01). Longer latencies were observed in the V (onset) and O (offset) peaks in these individuals (p <= .01). However, only the V/A peak amplitude was found to be significantly reduced in individuals with EHFHL (p < .01). Conclusions: Our findings highlight the importance of EHF hearing and suggest that EHF hearing should be considered among the key elements in SPIN. Individuals with EHFHL show a tendency toward weaker subcortical auditory processing, which likely contributes to their poorer SPIN performance. Thus, routine assessment of EHF hearing should be implemented in clinical settings, alongside the evaluation of standard audiometric frequencies (0.25-8 kHz).Item Determinants of Unmet Need For Family Planning: Evidence From The 2018 Turkey Demographic and Health Survey(JOURNAL OF BIOSOCIAL SCIENCE, 2024) Okem, Zeynep Guldem; Pekkurnaz, DidemUnmet need for family planning is a valuable concept to indicate the discrepancy between women's fertility preferences and contraceptive use. Unmet need may lead to unintended pregnancies and unsafe abortions. These may result in health deterioration and reduced employment opportunities for women. The 2018 Turkey Demographic and Health Survey report indicated that the estimated unmet need for family planning doubled from 2013 to 2018, returning to the high levels of the late 1990s. Considering this unfavourable change, this study aims to investigate the determinants of unmet need for family planning among married women of reproductive age in Turkey by using the 2018 Turkey Demographic and Health Survey data. Logit model estimations revealed that women who were at older ages, more educated, wealthier, and had more than one child were less likely to have unmet need for family planning. Employment statuses of women and their spouses and place of residence were significantly associated with unmet need. Results emphasised that training and counselling to enhance the use of family planning methods should effectively target young, less educated, and poor women.Item Literature Review and 2 Cases of Isolated Chylothorax After Pediatric Living-Donor Liver Transplant(2023) Tirnova, Ismail; Alim, Altan; Vehbi, Sezan; Demir, Baris; Akbulut, Akin; Karatas, Cihan; Kanmaz, Turan; 0000-0003-4488-1607; 37503801; ISB-9235-2023Objectives: Chylothorax without chylous ascites after liver transplant is rare. We present 2 cases of isolated chylothorax after liver transplant and a literature review. Materials and Methods: We compiled a literature review of chylothorax cases after abdominal surgery and analyzed the cases related to liver transplant. The demographic information, follow-up results, and treatment details of our 2 cases of chylothorax after living-donor pediatric liver transplant were discussed. Results: An 8-month-old child and a 15-month-old child with cholestatic liver disease and urea cycle defect, respectively, underwent living-donor left lateral segment liver transplant. Patients who presented with chylothorax after discharge were treated conservatively. Conclusions: Isolated chylothorax is rare complication after abdominal surgery, which is mostly possible to treat with conservative methods. Interventional procedures and a surgical approach should only be performed in resistant cases when conservative treatment has failed.Item Determining the Factors Affecting Chemotherapy-Induced Nausea and in Children with Cancer(2023) Ay, Ayse; Boztepe, Handan; Ozbay, Sevil Cinar; Yilmaz, Pinar; Karadavut, Burcu; Burhanogullari, Dilek; Akyuz, Canan; 37845092Purpose: We evaluated the factors affecting chemotherapy-induced nausea and vomiting (CINV) in children with cancer.Design and methods: This cross-sectional study was conducted with 62 children aged 9 to 18 years old with a solid tumor who received chemotherapy for the first time, and their parents. Data were collected using a data collection form, the State-Trait Anxiety Inventory for Children, the Beck Anxiety Inventory, the Spielberger StateTrait Anxiety Inventory, and the Baxter Retching Faces Scale. Data were analyzed using Spearman's correlation and logistic regression analyses.Results: Risk factors related to the child, treatment, and parent were examined. Child-related factors were determined as diagnosis (odds ratio [OR] = 5.5), time since diagnosis (OR = 1.9, OR = 4.7), pretreatment anxiety of the child (r = 0.439, r = 0.422), and past experience of nausea and vomiting before treatment (OR = 1.2). Treatment-related factors involved anti-emetic prophylaxis (OR = 4.9, OR = 9.2). Parent-related factors included pretreatment anxiety of the parent (r = 0.271, r = 0.287), accommodation (OR = 5.5), not eating (OR = 1.2, OR = 1.3), and bad smell (OR = 1.2), which were described amongst parents' as factors that trigger CINV.Conclusions: The occurrence of CINV is significantly affected by child-, treatment-, and parent-related risk factors. Practice implications: Pediatric nurses should create an environment for children and their parents to reduce their anxiety and provide basic knowledge and skills about the management of CINV.Item The Middle Ear Functions and Vestibular-Evoked Potentials in Springboard-Platform Diving Children(2023) Borisova, Natalia; Ozer, Fulya; Kuntman, Berna Deniz; Erbek, Seyra H.; 0000-0002-8453-6069; 0000-0003-0038-8167; AAJ-2445-2021; JNE-6747-2023Objective: To examine the middle ear and Eustachian tube functions of children who perform springboard and platform diving sports professionally and to evaluate the vestibulospinal and vestibuloocular reflexes of these athletes with evoked myogenic potentials.Methods: Two groups consist of athletes and a control group. Pure tone audiometry and speech audiometry, Eustachian tube function test and resonance frequency in multifrequency tympanometry, and ocular/cervical vestibular-evoked myogenic potentials were performed in all participants.Results: Forty-five ears in 25 athletes were evaluated as non-patent Eustachian tube. In athlete girls, resonance frequency mean value was measured lower than the control group in both ears. Cervical vestibular-evoked myogenic potentials amplitude mean values were statistically lower in athlete girls in the left ear (P = .031), and ocular vestibular-evoked myogenic potentials amplitude mean values were statistically higher in athlete boys in the left ear (P = .024). Conclusions: Repeated diving from very high meters platform did not cause significant difference on resonance frequency of the middle ear, but cause frequently common Eustachian tube dysfunction. Acrobatic movements on the air before the diving caused changes in ocular/cervical vestibular-evoked myogenic potentials amplitude values of athletes. Eustachian tube function should be followed at different times of the year to see any effect on the performance of this sport. The importance of the vestibular system and the medial vestibulospinal tract in spring-board and platform diving athletes was emphasized first in this study. To monitor health of vestibular system and middle ear with different and more specific test materials may be important for their longer professional careers. However, this issue should be proven with future studies.Item An Infrequent Case of Sudden Flushing: Infantile Cutaneous Mastocytosis(2023) Gultekingil, A.; Olcay, L.; Togral, A. Karatas; Ayva, E. S.; 0000-0001-7955-5735; AAR-9945-2020Introduction: Sudden flushing is a common symptom in infants but it can be a manifestation of lifethreatening disease, therefore differential diagnosis is crucial for an infant with flushing. Case Description: Here, we describe a two-month-old boy who presented to the Paediatric Emergency Department with four sudden attacks of flushing with accompanying fatigue, especially after feedings. Upon physical examination, a 5x7 cm brown lesion on his left hypochondra was noted. His laboratory tests were unremarkable. Pathological examination of a biopsy of the lesion revealed diffuse mast cell infiltration. The patient was diagnosed with cutaneous mastocytosis. Conclusion: This case underscores the importance of the detailed examination of children with sudden attacks of flushing to make a correct diagnosis and to prevent future life-threatening complications of infrequent clinical entities.Item COVID-19 Infections in Pediatric Renal Transplant Recipients(2022) Yilmaz, Aysun Caltik; Baskin, Esra; Gulleroglu, Kaan; Karakaya, Deniz; Akdur, Aydincan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-0774-4419; https://orcid.org/0000-0003-1434-3824; https://orcid.org/0000-0002-3462-7632; 35384829; AAD-1877-2021; AAJ-8833-2021; AAJ-8097-2021Objectives: The new coronavirus SARS-CoV-2 (COVID-19) first appeared in Turkey in March 2020, spread rapidly, and caused many deaths. Although COVID-19 is mostly a respiratory disease, it can cause kidney and multiorgan failure in some cases. We believe that by sharing information about the course and effects of COVID-19 infection in kidney transplant recipients receiving long-term immunosuppressive therapy our understanding will improve. Materials and Methods: Between March 2020 and October 2021, COVID-19 was researched in kidney transplant recipients under the age of 20 years who were followed at the Baskent University Transplantation Center. We documented the clinical characteristics and prognosis of pediatric kidney transplant recipients with COVID-19 disease. Results: Our study group included 23 patients with COVID-19 infection from 215 pediatric kidney transplant recipients. The mean age of the patients was 14.6 +/- 4.7 years; there were 9 female patients. The mean follow-up time posttransplant was 62.3 +/- 43.2 months. In 13 patients (56.5%), fever was the most frequent symptom. Most patients (n = 18, 78%) had minor symptoms and recovered completely after receiving supportive treatment. Four patients (17%) required hospitalization. One was diagnosed with COVID-19 infection 1 week after being treated with rituximab for acute antibody-mediated rejection. That patient died because of significant lung disease and multiorgan failure. Conclusions: Despite the fact that most of our pediatric transplant recipients had mild symptoms of COVID-19, we believe that particular caution should be observed in patients who have recently received intensive immunosuppressive medications. As a result of potential new vaccines, national immunization programs, and the emergence of novel virus strains, the clinical picture may change in the future. We believe that, as information sharing increases, we will learn more about COVID-19 in renal transplant recipients.Item Pathology, Classification, Clinical Manifestations and Prognosis of Langerhan's Cell Histiocytosis: A Single Center Experience(2022) Hasbay, Bermal; Kocer, Nazim Emrah; Kayaselcuk, Fazilet; Canpolat, Emine Tuba; Buyukkurt, Nurhilal; Erbay, AyseObjective: The aim of the study is to raise awareness about clinical features, histopathological and radiological analyzes and treatment details of this rare disease. Methods: A total of 55 Langerhans cell histiocytosis patients, diagnosed between the year 2006 and October 2020 in our department were included in the study. The patients were evaluated in terms of age, gender, tumor localization, risk groups, treatment modalities, recurrence, and outcome of the disease. Results: Twenty-three out of 55 patients were children and 32 were adults. The ages of the patients were between 7 months and 72 years. Thirty-seven of the cases were male and 18 were female. The most common clinical complaint in both groups was pain and swelling. The duration between the onset of the patient complaints and admission to the hospital varies between 7 days-12 months in children, and 10 days-23 years in adults. Forty-three of the cases had single organ involvement and 12 had multiorgan involvement. The most frequently affected organ in both groups was bone. Forty of the 55 patients had follow-up data and the treatment modalities are as follows: Nine patients radiotherapy, 8 patients chemotherapy+steroid, 7 patients chemotherapy, 2 patients chemotherapy+radiotherapy+steroid, 1 patient steroid, 2 patients chemotherapy+radiotherapy. Eleven patients were followed up without additional treatment after surgery. Median follow-up from the time of biopsy was 45.9 months in children and 41.9 months in adults. Conclusions: As a result, diagnosis requires a high degree of suspicion and final diagnosis is based on the histological examination of the lesions and biopsies.Item Anocutaneous Reflex Revisited: How Valuable Is Its Determination in Children with Spina Bifida? A Descriptive Study in A Cohort of 217 Patients(2022) Ozel, Kerem; Canmemis, Arzu; Goknar, Nilufer; Candan, Cengiz; Alizada, Orkhan; Alatas, Ibrahim; 35147971AIM: To determine the clinical value of anocutaneous reflex (AR) in children with neurogenic bladder due to spina bifida (SB). MATERIAL and METHODS: Patients who were diagnosed with SB were prospectively evaluated; moreover, AR and bulbocavernous reflex were examined. Patients were divided into those with and without AR. Age, gender, diagnosis, ventriculoperitoneal shunt presence, symptomatic urinary tract infections, leg movements, clean intermittent catheterization and anticholinergic therapy, lesion level, urodynamic detrusor, and sphincter activity were evaluated. Chi-square test and univariate regression analysis were done. The AR value was evaluated by two by two contingency table. RESULTS: This study evaluated 217 patients (109 boys and 108 girls). AR was present and absent in 53 and 164 patients, respectively. Anticholinergic therapy was necessary in 37.7% and 23.8% of patients with and without AR (p=0.015), respectively. Patients with AR had higher lesion level (p=0.005), more detrusor overactivity, and less detrusor underactivity (p=0.007). Less detrusor sphincter dyssynergia (DSD) was noted in patients with AR (p=0.029). AR specificity was 83%, and positive predictive value in predicting detrusor overactivity and DSD was 76% and 80, respectively. CONCLUSION: AR determination is a valuable and simple tool in neurogenic bladder. This report delineates the clinical significance of this reflex and is the largest cohort describing this significance. This simple examination should not be skipped in the initial evaluation and follow-up of these patientsItem Association Of Pediatric Vasculitis Activity Score With Immunoglobulin A Vasculitis With Nephritis(2023) Avci, Begum; Kurt, Tuba; Aydin, Fatma; Celikel, Elif; Tekin, Zahide Ekinci; Sezer, Muge; Tekgoz, Nilufer; Karagol, Cuneyt; Coskun, Serkan; Kaplan, Melike Mehves; Bayrakci, Umut Selda; Acar, Banu; https://orcid.org/0000-0002-5375-379X; 35895124Background Immunoglobulin A vasculitis with nephritis (IgAVN) is the most serious complication affecting long-term prognosis. Understanding the risk factors and markers for the development of IgAVN is essential. The aim of this study is to identify IgAVN-associated factors and to evaluate the usability of Pediatric Vasculitis Activity Score (PVAS) at diagnosis as an early marker for the development of IgAVN. Methods We conducted a retrospective case-control study of 314 patients divided into two groups: those with nephritis (IgAVN) and without nephritis (non-IgAVN). The groups were compared in terms of clinical symptoms, laboratory values, and PVAS values. Results In total, 18.5% of the patients had IgAVN; they were older than the non-IgAVN patients (median age was 8.8, p < 0.05). Arthritis/arthralgia, abdominal pain, and intestinal bleeding were more common, systolic and diastolic BP were higher in IgAVN (p < 0.05). CRP, serum creatinine, and urine protein/Cr, PVAS were higher, while serum albumin was lower in IgAVN (p < 0.05). The receiver operator characteristic curve (ROC) analysis showed that IgAV patients with a determined cut-off PVAS value greater than 3 had 70.7% sensitivity in predicting whether or not they would develop IgAVN. Logistic regression analysis found that PVAS > 3 and low serum albumin at the time of diagnosis were independent risk factors for IgAVN. Conclusion Our study revealed that PVAS > 3 at diagnosis is an independent predictor of IgAVN. Patients with PVAS > 3 should be followed more closely to ensure early diagnosis and management of IgAVN.