Fakülteler / Faculties
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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 The Relationship Between Body Image and Anthropometric Measurements Among Adolescent Girls During Menstrual and Non-menstrualtime Periods: A Cross-Sectional Study(2022) Turker, Perim Fatma; Caliskan, Hilal; Bayram, SinemIntroduction: In recent studies, it has been suggested that anxiety about body image increases during menstruation in adolescents and may affect nutritional status. This study aimed to evaluate the relationship between adolescents' body images, body perceptions and anthropometric measurements during menstrual and non-menstrual time periods.Methods: This cross-sectional study was carried out in a private high school between September November 2021. Participants were adolescent girls aged 14-18. The questionnaire included information about menstruation, anthropometric measurements, and the Body Cathexis Scale (BCS) and Stunkard Figure Rating Scale.Results: The mean age (total=291) was 15.9(1.13) years, body mass index (BMI) was 21.13(3.33) kg/m2, waist circumference was 70.48(8.87) cm and the BCS was 97.39(24.59). The majority of students have normal BMI. However, according to waist circumference 28.5% of the them were obese (>= 90th percentile). Difference between actual BMIs and body image in the menstrual period was significant (p<0.001), the agreement with each other was slight (K=0.172). There was a significant difference (p<0.001) between actual BMIs and body image in the non-menstrual period and the agreement with each other was moderate (K=0.474). During non-menstrual periods, 79.7% of students with normal BMI perceived their body images as normal, and 70.5% of overweight students perceived as overweight.Conclusions: Since the menstruation is a period in which body image is perceived differently than it is, special consideration of adolescent girls in terms for eating disorders should be encouraged.Item Translation, Cultural Adaptation, and Validation of the Youth Attitude to Noise Scale into Turkish (YANS-Tr)(2022) Ozmen, Kuebra; 0000-0001-7838-8314; 35900394Context: With the changing lifestyle in modern society, the youth has become the target of substantial noise exposure. Both environmental noise and the use of personal electronic devices create a risk for youth's hearing conservation as reported in several studies. Aims: This study aims to adapt and validate the Youth Attitude to Noise Scale (YANS), developed by Widen and Erlandsson for use in the Turkish setting. Settings and Design: The linguistic adaptation of the YANS into Turkish (YANS-Tr) was conducted with three experts in linguistics. A cross-sectional study was designed for high school students to establish the evidence for the reliability and validity of the scale. Methods and Material: 345 high school students participated in the pilot study. The demographic data form developed by the researcher was used to retrieve the information related to participants. Lastly, the 19-item YANS-Tr was delivered to students. Statistical analysis used: Exploratory and confirmatory factor analyses were performed for the construct validity. The Cronbach's alpha coefficients were calculated for each dimension and the whole scale. Results: Four-dimensional structure was yielded for the YANS-Tr as in the original version of the scale. However, some items (8th, 10th, 18th, and 19th) were loaded under different dimensions. The reliability coefficient of the scale (Cronbach's alpha = 0.79) was within the acceptable range. The mean overall YANS-Tr score was 2.68. When the mean scores are compared with other countries, Turkey stands higher than Sweden (2.10), close to Serbia (2.76) and Brazil (2.80), and lower than Belgium (3.10) and China (3.46). Conclusions: The YANS-Tr is shown to be a valid and reliable assessment tool to evaluate the students' attitude to noise in Turkey.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 Emotional and physical maltreatment, early maladaptive schemas, and internalizing disorders in adolescents: a multi-group path model of clinical and non-clinical samples(2021) Yigit, Ibrahim; Kilic, Harun; Guzey Yigit, Melike; Celik, Cihat; 0000-0003-0556-9960; W-5957-2018Many studies have supported the mediating role of maladaptive schemas in the relationship between early childhood adversity and psychopathology in both clinical and non-clinical adolescent samples. However, to the best of our knowledge, there has been no study to simultaneously test the mediating role of maladaptive schemas in a combined model included in both clinical and non-clinical samples of adolescents. The sample of the study consisted of 132 non-clinical (M = 15.65, SD = 1.15) and 193 clinically referred (M = 15.05, SD = 1.07) adolescents. Criteria for the clinical sample included being diagnosed with generalized anxiety disorder, depressive disorder or mixed anxiety and depressive disorder. Participants were administered The Childhood Trauma Questionnaire, Young Schema Questionnaire, Children's Depression Inventory, and Spielberger State-Trait Anxiety Inventory. The aim of the present study was to test the hypothesized mediation model that Disconnection/Rejection and Impaired Autonomy schema domains would mediate the relationship between childhood maltreatment and psychological symptoms for clinical and non-clinical adolescent samples, separately. Furthermore, we tested whether structural paths of the model were different across the two samples, using multiple-group path analysis. Results showed that Disconnection/Rejection and Impaired Autonomy emerged as significant mediators in both samples. In addition, only the association between Disconnection/Rejection and depression was stronger in the clinical sample compared to the non-clinical sample.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.