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Amaç: Guillain Barre Sendromu (GBS) hızla ilerleyen, asendan, simetrik zayıflık ve arefleksi ile karakterize akut inflamatuar bir polinöropatidir. Çocukluk çağında akut flask paralizinin en sık nedenidir. Sıklıkla ilerleyici güçsüzlük, ilişkili hafif duyusal semptomlar ve spesifik olmayan enfeksiyondan birkaç gün veya hafta sonra ortaya çıkan albüminositolojik ayrışma ile karakterizedir. Nörolojik defisit günler ve aylar içinde ilerler. Gereç ve Yöntem: Bu çalışmada 2016-2018 yılları arasında kliniğimize başvuran farklı klinik bulgulara sahip toplam 7 GBS olgusu sunuldu. Bulgular: İki hastada akut motor aksonal nöropati (AMAN), iki hastada akut inflamatuar demiyelinizan polinöropati (AIDP), bir hastada Miller Fischer sendromu (MFS), bir hastada Bickerstaff beyin sapı ensefaliti (BBE) ve bir hastada atipik tanı konuldu. Guillain Barre sendromu. AMAN'lı olgularda solunum desteği gerekti ve bunlardan birinde ventilatör ilişkili pnömoni ve tansiyon pnömotoraks gelişti. Sonuç: Tüm olgular sekelsiz iyileşti.

Aim: There is a few studies examining primary headaches and online gaming or smartphone addiction in line with causality. Material and Method: Children and adolescents, aged 11-18 years old, those diagnosed with primary headaches of tension-type headache or migrain were evaluated in terms of smartphone and online game addiction. Smartphone Addiction Scale-Short Version (SAS-SV) and Online Game Addiction Scale (OGAS) was used. SPSS 17.0 program was used for statistical analyses. Results: Children and adolescents with or without primary headaches had similar online game and smart phone usage pattern. Conclusion: There is a need for further studies regarding primary headaches and its underlying factors in terms of online gaming or smart phone usage.

The cost analysis of the 7-year cross-section of the patients in pediatric neurology outpatient clinic including patients with foreign nationality was investigated retrospectively. Between January 10, 2013 and January 10, 2020, the total number of applicants, the nationalities of the patients, and the hospital cost were analyzed. Of 3,338 patients, aged between 0 and 20 years with mean age of 8.7 years at admission to the child neurology had received 17,476 clinical examinations. Of these, 51.6% were male and 93.5% cases were Turkish patients (n = 3,122), with 6.5% foreign nationals (n = 216). There was no difference in terms of gender between nationalities (p > 0.05). The total cost of cases with epilepsy was 1,312,427.73 Turkish Lira (TRY) and 6.2% account belonged to foreign nationals, mostly from Iraq (3.6%, n = 119) and Syria (2.4%, n = 80). The highest proportion of foreigner admissions due to epilepsy was in 2018 (11.1%). Mean average of health expenditures for foreign nationals diagnosed with epilepsy was 6.2% with the highest expenditure in 2019 (27.750,06 TRY). The proportion of admissions for epilepsy was 27.6% (17,476/63,173) among all neurological admissions. The proportion of Turkish patients was 25.6% (6,181/63,173), and 3.8% (1,295/3,398) accounted for foreigners' admissions. The proportion of total epilepsy costs compared with the total neurological admissions was 30% (1.312.427,73 TRY/4.347.592,80 TRY) and among them, the expenditure proportion for epilepsy in Turkish patients compared with that of total foreigner admissions was 3.9% (80.416,44 TRY/201.490,515 TRY). Expenditures for evaluating of epileptic children with foreign nationality cover an average of 6.5% of the entire section of the health expenditures made for patients with the diagnosis of epilepsy in the pediatric neurology outpatient clinic over the 7-year period. Epilepsy accounts for 30% admissions among all neurological admissions with 3.9% belonging to foreign national admissions.

Introduction: The most important purpose in neonatal pain management is to minimize the pain felt by newborns and to help the newborn cope with pain. This study planned to examine the effects of two non-pharmacological methods, using pacifiers or maternal holding, on neonates’ pain admitted to the outpatient clinic (OC) and hospitalized in the Neonatal Intensive Care Unit (NICU). Material and Methods: Ninety newborns (30 used pacifiers, 30 maternal holding,30 control) who applied to the OC and 60 newborns (30 used pacifiers, 30 control) admitted to the NICU were prospectively included in this study. The Neonatal Infant Pain Scale (NIPS) was used to evaluate behavioral responses to pain perception. Physiological parameters of newborns and their durations of crying were also evaluated. Results: When the NIPS scores were analyzed in OC group during and after the procedure, the lowest score was found in the group using pacifiers (p

Background/aim Vertigo is one of the rarely diagnosed disorders during childhood due to insufficient description of the children regarding their experiences to the physicians. The clinical features of children and adolescents admitted by acute vertigo symptoms were investigated to elaborate the subject retrospectively. Materials and methods BetweenJanuary 2017–July 2019, records of cases admitted with acute vertigo complaints to pediatric neurology were retrospectively examined. Results Of 761 patients, mean age was 13.8 years, 64% (n = 487) were women, 22.6% (n = 172) of which were children (1–11 years). A total of 37.3% of the cases (n = 284) had unknown etiology of acute vertigo symptoms, 39.6% (n = 301) had acute vertigo, and 23.1% (n = 176) were considered with no organicity problems but a group of the families stopped cooperating to the full extent in the study. Among all the patients, 25.6% (195/761) had paroxymal vertigo, 6.8% (52/761) had migraine-associated vertigo, 4.5% (34/761) had psychogenic vertigo, and 2.6% (20/761) had epileptic vertigo. Epileptic vertigo was significantly higher in younger children (mean age = 10.6, F(3) = 8874, P < .001), and the ratio of its occurence was also higher among children (60%, χ2 (3) = 20.347, P < .001). Conclusion Vertigo complaints are 1.7 times more common among the girls. Epileptic vertigo is significantly higher among the children. Among younger children, it seems important to consider epilepsy when vertigo emerged.

Background Lung ultrasound (LUS) has been successfully used in the diagnosis of different pulmonary diseases. Present study design to determine the diagnostic value of LUS in the evaluation of children with COVID-19. Method and objectives Prospective multi-center study, 40 children with confirmed COVID-19 were included. LUS was performed to all patients at admission. The chest X-ray and CT were performed according to the decision of the primary physicians. LUS results were compared with chest X-ray and CT findings and diagnostic performance was determined. Results Of the 40 children median (range) was 10.5 (0.4-17.8) years. Chest X-ray and LUS were performed on all and chest CT was performed on 28 (70%) patients at the time of diagnosis. Sixteen (40%) patients had no apparent chest CT abnormalities suggestive of COVID-19, whereas 12 (30%) had abnormalities. LUS confirmed the diagnosis of pulmonary involvement in 10 out of 12 patients with positive CT findings. LUS demonstrated normal lung patterns among 15 patients out of 16 who had normal CT features. The sensitivity and the area under the ROC curve (AUC) identified by the chest X-ray and LUS tests were compared and statistically significantly different (McNemar's test: p-value 0.016 and 0.001 respectively) detected. Chest X-ray displayed false-negative results for pulmonary involvement in 75% whereas for LUS it was 16.7%. Conclusions LUS might be a useful tool in the diagnostic steps of children with COVID-19. A reduction in chest CT assessments may be possible when LUS is used in the initial diagnostic steps for these children. This article is protected by copyright. All rights reserved.

Amac: A grubu beta hemolitik streptokokkal farenjit sonrasi gelisen otoimmun, hiperkinetik bir hareket bozuklugu olan Syndenham koresi, akut romatizmal atesin norolojik manifestasyonudur. Bu calismada Syndenham koresi tanisi alan hastalarin demografik ve klinik ozellikleri yanisira hasta yonetimi ve sonuclarinin literature sunulmasi amaclanmistir. Metod: Ankara Egitim ve Arastirma Hastanesi, Cocuk Norolojisi Polikliniginde Eylul 2016 - Eylul 2019 tarihleri arasinda basvuran Syndenham koresi tanisi alarak izlenen 33 cocuk ve adolesan hasta calismaya alinmistir. Hastalarin demografik, klinik ve laboratuvar ozelliklerine ait bilgiler, verilen tedaviler ve tedavi yanitlari ile hastalarin prognozlari retrospektif ve kesitsel olarak degerlendirilmistir. Sonuclar: Yas ortalamasi 119.6 ± 29.2 ay olan %24.2’si erkek hastalarin 30’unda (%90.9) ekokardiyografik valvulit syndenham koresine eslik ediyordu. Hemikore 11 hastada (%30) izlenirken, 12 hastada ekstremitelerde, 8 hastada govdede, 1 hastada yuzde belirgin kore izlendi. Anti-streptolizin-O yuksekligi 28 hastada (%84) saptandi. Ortalama 6.8 ± 1.1 ay sure ile Yirmi yedi hastaya (%81.8) haloperidol, 3 hastaya karbamazepin (%9), 2 hastaya sodyum valproat (%6) tedavisi verildi. Klinik remisyon ortalama 6.9 ± 1.2 ayda saglandi. Akut semptomatik tedavi icin verilen haloperidole bagli gelisen parkinsonizm izlenen tek yan etki olarak kaydedildi. Semptomlar gerileyip tedavi sonlandirildiktan sonra ortalama 9.6 ± 4.2 ay izlenen hastalarda rekurrens gorulmedi. Tartisma: Syndenham koresi, klasik olarak kendi kendini sinirladigi bilinen ancak islevselligi bozan, hayat kalitesini negatif yonde etkileyen akut romatizmal ates major kriterlerinden birisidir. Tani ve ayirici tani algoritmasinda netlesen yonetime ragmen tedavi acisindan celiskili ve tartismali bilgiler halen bir konsensus saglanmasina engel olmaktadir.

Kavramsallaştırma, gerçek hayattaki karmaşık ilişkiler ağını basitleştirerek soyutlaştırma çabasıdır. Dolayısıyla, bir kavramsallaştırmanın başarısı, gerçekliği açıklayabilme kabiliyetine bağlıdır. Weber’le birlikte başlayan ve Şarkiyatçılar tarafından kullanılmaya devam eden “İslâm şehri” kavramının, Müslümanların yaşadıkları şehirlerin gerçekliğinden kopuk bir kavramsallaştırma çabası olduğu ileri sürülmektedir. Zamanla Şarkiyatçılar da “İslâm şehri” kavramına yönelik eleştiriler getirmişlerdir. Ama ilginç bir şekilde kavram, bugüne kadar kullanılmaya devam etmiştir. Bu kavramsallaştırmanın iki açıdan sorunlu olduğu görülmektedir: İlki, bu kavramla, Müslümanların yaşadıkları şehirler ideal bir kalıba dökülmektedir. İkincisi, bu kavramsallaştırma üzerinden Müslümanların yaşadıkları şehirlerdeki bütün sorunlar “İslâm”a havale edilmektedir. Bu çalışmada, “İslâm şehri” yerine, “ebrû sanatı”ndan hareketle “ebrûlî şehir” kavramsallaştırmasına gidilmektedir. Bu bağlamda çalışmanın amacı, Şarkiyatçı bakış açısının standart İslâm şehri kavramsallaştırmaları yerine, içinde barındırdığı etkileşim ve ilintiye bağlı olarak “ebrûlî şehir” üzerinden kavramsal bir öneri geliştirmektir. “Ebrûlî şehir” kavramının, “İslâm şehri” kavramındaki iki eksikliği giderecek nitelikte olduğu düşünülmektedir. Buna göre “ebrûlî şehir” kavramının, Müslümanların yaşadıkları çok sayıda şehrin kendine özgü niteliğini dikkate alabileceği; ayrıca, şehirlerde yaşayan Müslümanların eksikliklerini “İslâm”a havale etme kolaycılığına da mani olabileceği ileri sürülmektedir., Conceptualization is an attempt to abstract by simplifying the complex network of relationships in real life. Thus, the success of a conceptualization depends on its ability to explain reality. It is claimed that the concept of “Islāmic city”, which started with Weber and continues to be used by Orientalists, is an effort to conceptualize the cities in which Muslims live, detached from the reality. Over time, Orientalists have also brought criticism towards the concept of “Islamic city”. But, interestingly, the concept has continued to be used up to the present. This conceptualization seems to be problematic in two respects: First, with this concept, the cities where Muslims live are cast into an ideal mold. Secondly, through this conceptualization, all the problems in the cities where Muslims live are referred to “Islām”. In this study, instead of the “Islāmic city”, the conceptualization of “marbled city” is used based on the “art of marbling”. In this context, the aim of the study is to develop a conceptual proposal based on the interaction and relevance it contains, rather than the standard Islāmic city conceptualizations in the orientalist view. It is thought that the concept of “marbled city” is capable of eliminating two deficiencies in the concept of “Islāmic city”. Accordingly, the concept of “marbled city” can also take into account the peculiarity of many cities where Muslims live; moreover, it is argued that it may prevent the convenience of referring the shortcomings of Muslims living in cities to “Islām”.

Migraine is one of the most debilitating disorders with its chronic nature seen in childhood characterized by episodic bilateral or unilateral throbbing pain on the head that strikes at any time. It is divided into two categories as with or without aura and is diagnosed according to the 2013 International Headache Society criteria. This study aims to present the pictures depicted by adolescents aged 14–18 who were diagnosed with migraine with visual aura by Ankara Training and Research Hospital Child Neurology Department. They were told to draw their visual auras as a picture that they depict or as a draft via changing another picture. In this article, five adolescents with migraine and their pictures related to their visual aura were presented. The diagnosis of migraine with visual aura in patients under 18 years of age would be supported by picturing of their visual images. Thus, pediatric patients could better express themselves and the clinician would better manage the process both in diagnosis and follow-up of the migraine with aura.

Objective: In the pediatric age group, it is important to detect the risk factors of stroke and diagnose it early, and prevent the recurrence of the disease. This study aimed to conduct a descriptive analysis of demographic and clinical characteristics of pediatric stroke cases in the 0-18 age group and to evaluate the relationship between etiologic causes, risk factors and functional status of these cases.Material and Methods: The medical files of the patients followed up by the Department of Pediatric Neurology of Ankara Training and Research Hospital were retrospectively examined. Cerebral magnetic resonance imaging and laboratory data were recorded. The Gross Motor Function Classification System, Box and Block Test, Nine-Hole Peg Test were used to evaluate the patients’ current functional status.Results: In 34 pediatric hemiplegic stroke cases, the median age of the onset of symptoms was one year (minimum 0, maximum 15 years). At the time of evaluation, hemiparesis was found in 73.5% of the cases and 41.2% had active seizures. Heterozygous factor V Leiden mutation was present in 17.6% of the patients, and homozygous MTHFR (c677c) mutation in 5.9%. When the etiologic factors were evaluated, there was a mass effect due to venous bleeding in 50%, arterial bleeding in 44.1%, and intracranial bleeding in 5.9% of the cases. Prophylaxis had been performed in 47.1% of the patients. There were no significant differences in functional parameters according to thrombophilic risk factors, whether the etiology was of arterial or venous origin, or whether they underwent prophylaxis (p>.05).Conclusion: Half of the patients had a stroke of venous origin, and hemiparesis was present in approximately two-third of the cases. Functioning levels seemed to be independent of the presence of etiologic source or thrombophilic risk factors of the disease., Amaç: Çocukluk yaş grubunda inme risk faktörlerinin tespit edilerek erken teşhis edilmesi ve hastalığın tekrarının önlenmesi önemlidir. Bu çalışmada, 0-18 yaş grubundaki pediatrik inme olgularının demografik ve klinik özelliklerinin tanımlayıcı bir analizinin yapılması ve bu olguların etiyolojik nedenleri, risk faktörleri ve fonksiyonel durumları arasındaki ilişkinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Ankara Eğitim ve Araştırma Hastanesi Çocuk Nörolojisi Bölümü tarafından takip edilen hastaların tıbbi dosyaları geriye dönük olarak incelendi. Serebral manyetik rezonans görüntüleme ve laboratuvar verileri kaydedildi. Hastaların mevcut fonksiyonel durumunu değerlendirmek için Kaba Motor Fonksiyon Sınıflandırma Sistemi, Kutu ve Blok Testi, Dokuz Delikli Peg Testi kullanıldı.Bulgular: 34 pediatrik hemiplejik inme vakasında semptomların başlama yaşı ortanca bir yıldı (minimum 0, maksimum 15 yıl). Değerlendirme anında olguların % 73.5’ inde hemiparezi bulundu ve % 41.2’ sinde aktif nöbet öyküsü vardı. Hastaların % 17.6’ sında heterozigot faktör V Leiden mutasyonu, % 5.9’ unda homozigot MTHFR (c677c) mutasyonu mevcuttu. Etiyolojik faktörler değerlendirildiğinde olguların % 50’ sinde venöz kanamaya, % 44.1’ inde arteryel kanamaya ve % 5.9’ unda intrakraniyal kanamaya bağlı kitle etkisi vardı. Hastaların % 47.1’ ine profilaksi uygulanmıştı. Trombofilik risk faktörlerine göre, etiyolojinin arteriyel ya da venöz orijinli olmasına göre veya profilaksi uygulanıp uygulanmadığına göre fonksiyonel parametrelerde anlamlı farklılık yoktu (p> .05).Sonuç: Hastaların yarısında venöz kaynaklı inme vardı ve vakaların yaklaşık üçte ikisinde hemiparezi mevcuttu. İşlevsel düzeyler, hastalığın etiyolojik kaynağı veya trombofilik risk faktörlerinin varlığından bağımsız görünüyordu.

Objective: Suicide attempts of adolescents have become one of the most common reasons among the admission to emergency departments for psychiatric reasons. The aim of this study is to identify sociodemographic and clinical characteristics, the diagnosis of depressive disorder and to assess the risk factors of adolescents who attempted suiside. Method: For this study, the patients that were admitted to Ankara Research and Training Hospital Emergency Department and were referred to Child and Adolescent Psychiatry outpatient clinic due to suicide attempt between April 2018 and December 2018 were included. “Child Depression Inventory”, “Beck Depression Inventory “ and “Sociodemographic Data Form” were used for the study. It was also evaluated whether the patients were diagnosed with “Major Depressive Disorder” according to DSM-5 as a result of psychiatric examination. SPSS 24.0 was used in the analyzes. T-test, Kruskal-Wallis test, Chi-square and Fisher’s exact test were used where appropriate. Results: Out of 38 patients who attempted suicide, 92,1% (n=35) were female. It was found that 92.1% (n=35) of the cases attempted suicide by overdose drug intake. Approximately half of the cases (44.7% n=17) reported the reason for suicide as “familial stressors”. As a result of the psychiatric evaluation, 42.1% (n=16) of the cases were diagnosed with “Major Depressive Disorder” according to DSM-5. Conclusion: Comprehensive evaluation of individual and environmental factors in adolescents who attempted suicide is considered important to identify the risk factors. Moreover strengthening the professional psychosocial support systems about increasing coping skills, gaining problem-solving skills of adolescents and informing families about approach to adolescents are thought that may contribute to protective measures.

Amaç: Hastanede yatan çocuk ve ergenlerdeki psikiyatrik semptomların tanınması, zamanında müdahale ve tedavi edilmesi oldukça önemlidir. Bu çalışmada bir eğitim araştırma hastanesindeki çocuk ve ergen psikiyatrisi konsültasyonlarının özelliklerinin incelenmesi amaçlanmıştır.Gereç ve Yöntemler: Mayıs 2016-Ekim 2018 tarihleri arasında yatan hasta kaydı bulunan çocuk ve ergen hastalar için istenen çocuk psikiyatri konsültasyonları geriye dönük olarak incelendi. Demografik ve klinik özellikler SPSS (Sosyal Bilimler İçin İstatistik Paket Programı) 17.0 kullanılarak analiz edildi. Sürekli değişkenlerin normal dağılıma uygunluğu Kolmogorov-Simirnov ile test edildi, karşılaştırmalarında Mann Whitney U testi kullanıldı. Kategorik değişkenler sıklık (n) ve yüzde (%) cinsinden ifade edildi ve Pearson ki-kare testi ile karşılaştırıldı. p, Objective: In hospitalized children and adolescents recognition of psychiatric symptoms, timely intervention and treatment are quite important. In this study, it was aimed to examine the characteristics of child and adolescent psychiatry consultations in a training and research hospital.Material and Methods: The psychiatric consultations of the child and adolescent inpatients between May 2016- October 2018 were assessed retrospectively. Demographic and clinical characteristics were analyzed using SPSS (Statistical Package Program for Social Sciences) 17.0. The compliance of continuous variables to normal distribution was tested using Kolmogorov-Simirnov test, Mann Whitney U test was used for comparisons. Categorical variables were expressed in terms of frequency (n) and percentage (%) and compared using the Pearson chi-square test. p values < 0.05 were regarded as statistically significant. Results: 66.9% (n = 85) of 127 children and adolescents evaluated within the scope of the study were females. 78.7% of the cases were in adolescent age group (13-17). Among the clinics that requested psychiatric evaluation, it was found that the highest rate of consultation was requested from the pediatric department with 93.7% (n = 119). Considering the reasons for requesting a consultation from the cases, it was found that the most requested consultation reason was the evaluation of suicide attempts (55.1%, n = 70). In the cross section evaluated, 19.7% (n = 25) of the cases were found to have at least one psychiatric disorder. It was found that at least one psychotropic drug was recommended to 18.1% of the cases.Conclusion: The importance of the Consultation-Liaison Psychiatry unit was highlighted in our study. Increasing awareness in the field of Consultation-Liaison is considered as a positive development, but it is thought that the services in this area should be improved more. Considering the different results found in the studies conducted in our country, to create a common language and algorithm in the field of consultation-liaison is thought to be important.

Aim: To investigate etiology and prognostic significance of pontine tegmentum lesions accompanying a cluster of acute flaccid myelitis. Method: We retrospectively examined patients from 6 centers in Turkey who manifested encephalitis or myelitis associated with dorsal pontine lesions on magnetic resonance imaging (MRI) between July 2018 and February 2019. Results: Twenty-two patients were evaluated. Ten of 22 (45%) presented with acute paralysis and 12 of 22 (55%) with brainstem symptoms only. Reverse transcription polymerase chain reaction for enterovirus was positive in 2 patients’ respiratory tract. Other etiologic factors were detected in 10 cases. On follow-up, patients presenting with symptoms of myelitis developed motor sequalae although spinal cord lesions on MRI resolved in 5 of 9 (55%). Encephalitic symptoms, present in 17 cases, recovered in 13 (76%), and brain MRI showed complete or near-complete resolution in 11 of 14 (78%). Conclusion: Various etiologic agents can be detected in patients with pontine involvement, even in a series collected during an outbreak of EV-D68. Encephalitis has a fair outcome but clinical recovery is slow and motor sequalae are frequent in spinal involvement, irrespective of follow-up spinal MRI findings.

Type 1 diabetes mellitus (DM) is characterized by irreversible, autoimmune, pancreatic β-cell destruction. During the disease, some patients experience a phase of Partial Clinical Remission (PCR) known as “honeymoon.” This is a transitory period that is characterized by insulin production by residual β cells following DM diagnosis and initiating the insulin therapy. In this study, we aimed to evaluate the influence of insulin production on immune system after the onset of diabetes, and we showed that the duration of honeymoon period could be related to the onset of other autoimmune conditions. For this retrospective study, 159 children aged between 11 and 18 years with type 1 DM were eligible. They have been diagnosed diabetes at least 10 years ago and use exogenous insulin. Our results showed that younger age at the onset of Type 1 DM in children, predicts Celiac Disease. Female sex and low HCO3 levels at the onset of DM had a high predictive value on patients who did not experience longer Partial Clinical Remission phase. Patients with higher BMI at the diagnosis of DM experienced shorter honeymoon period than the average. Smaller of our patients who diagnosed just DM have more than 297 days honeymoon period with respect to patients with one associated autoimmune disease. This may be due to a continuous and prolonged stimulation of immune system during the period of honeymoon that predispose the patient to develop other TH1 diseases. The patients who experienced more than 297 days Partial Clinical Remission seem under risk of developing one other autoimmune disease more than the patients who experienced less than 297 days Partial Clinical Remission. We have to consider that this observation is very intriguing because many protocols spring-up to try prolonging the honeymoon period in patients with autoimmune DM. If this aim is important from a metabolic point of view, long follow-ups are needed to be sure that the risk of other autoimmune diseases does not increase.

Amaç: Psödotümör serebri(PTS) tanısı konulan çocuk ve ergenlerin klinik özellikleri geriye dönükaraştırılarak primer ve sekonder PTS’nin puberte ve diğer değişkenler ilearasındaki ilişki araştırıldı.Gereç ve Yöntem: Ocak 2017 ile Eylül 2019 tarihleriarasında çocuk nörolojisi ünitesi tarafından PTStanısı ile takip edilen çocuk ve ergenlerin hastane dosyaları geriye dönükaraştırıldı. Olgular primer ve sekonder PTS şeklinde iki grupta incelendi. Bulgular: Olguların%70’i (n=14) primer (idiopatik), %30’u (n=6) sekonder PTS grubunda toplam 20çocuk ve ergen çalışmaya alındı. Olguların %55’i (n=11) pubertal dönemde iken,%45’i (n=9) prepubertal dönemde idi. Olguların %60’ı (n=12) kız, %40’ı (n=8)erkek idi. Yaş ortalaması 11,8 yıl (3.6 standart sapma) minimum 3 maksimum 17yaşında idi. Sekonder PTS’li olguların birinde enfeksiyona sekonder gelişen sinüsven trombozu, birinde nörobehçet, birinde vitamin D eksikliği, birinde üveit,birinde menenjit, birinde retinoik asid ilaç kullanımına bağlı PTS geliştiğisaptandı. Olguların %30’u (n=6) tesadüfensaptanırken, %20’sinde (n=4) baş ağrısı, %15’inde (n=3) özellikle geceleri farkedilen görmede azalma, %10’unda çift görme, %5’inde (n=1) kısmi görme kaybı,%5’inde (n=1) baş dönmesi ve %5’inde (n=1) nöbet varlığı nedeniylebaşvurdukları saptandı.Yaş, cinsiyet, pubertal dönem, başvurunedenleri, hastalık süresi, nörolojik muayenede patoloji, papil ödem varlığı, MRI,MR venografide patoloji varlığı, BOS basıncı düzeyleri değişkenlerinin primerve sekonder PTS’de birbirine benzer oldukları saptandı (p>.05).Sonuç: Yaklaşık üçte biritesadüfen saptanan PTS olgularının başvuru nedenleri ve muayene bulgularıprimer ya da sekonder oluşundan bağımsız görünmektedir., Objective: To investigate the clinical features of children and adolescents diagnosed with pseudotumor cerebri (PTC) retrospectively and to investigatethe relationship between primary and secondary PTC and puberty and other variables.Material and Methods: The hospital files of children and adolescents who were followed up with the diagnosis of PTC by the pediatric neurology unit between January 2017 and September 2019. Cases were divided into two groups as primary and secondary PTS.Results: A total of 20 children and adolescents were included in the primary (idiopathic) 70% (n=14) and secondary (30%) secondary PTC group. While 55% (n=11) of the cases were in the pubertal period, 45% (n=9) were in the prepubertal period. 60% (n=12) of the cases were female and 40% (n=8) were male. The mean age was 11.8 years (3.6 standard deviations), minimum 3-maximum 17 years. One patient had secondary sinus vein thrombosis secondary to infection, one neurobehcet, one vitamin D deficiency, one uveitis, one meningitis and one retinoic acid drug usage. While 30% (n=6) of the cases were detected incidentally, 20% (n=4) had headache, 15% (n=3) had decreased vision especially at night, 10% (n=2) had double vision, whereas there was partial vision in 5% (n=1), dizziness in 5% (n=1) and seizures in 5% (n=1). Age, sex, pubertal period, disease duration, pathology in neurological examination, presence of papilledema, pathology found in MRI or MR-venography, CSF pressure levels were similar in primary and secondary PTC (p>.05).Conclusion: Approximately one third of PTC cases are detected incidentally and the reason for admission or examination findings seem to be independent of whether it is primary or secondary.

Objectives: In this study, the relationship between preschool age group children’s language development and depression/anxiety symptoms of their mothers was investigated. Methods: Children aged 13-75 months and their mothers were included. Denver-II test and Beck Depression and anxiety scales were utilized. SPSS 17.0 program was used and p < 0.05 was considered as significant. Results: Of the 58 patients, 74.1% were male, with the mean age of 53.3 months. The mean maternal age was 31.5 years. The mean education level was 8.3 years for mothers. According to the Denver-II of language development, 53.4% of the cases were found to be "delayed" whereas 46.6% of all were “normal”, with significantly lower in “delayed” children (47.4 vs. 60 months; t (56) = -3.431, p = 0.001). Delayed language was significantly associated with lower mothers’ education level (7.4 vs. 9.3 years; t (56) = -2.466, p = 0.017). The median score of depression scale was significantly higher in the delayed language (18 vs. 13; z = -2.218, p = 0.027). Positive correlation was found between the mothers’ education and the language development (r = .324, p = 0.013). The anxiety symptom levels of the mothers were not associated with language development (p > 0.05). Conclusions: The level of education of mother seems to affect language development. There is a relationship between the depressive symptoms of the mother and the delay in language development. It seems important that the mothers of the cases whose children had language development to be directed to psychiatric evaluation.

Background Epilepsy is an important disorder that is sometimes accompanied by inattention problems. This study explored the features of seizures in children with epilepsy, with or without attention-deficit/hyperactivity disorder (ADHD). Methods Between January 2017 and January 2018, data records of children with epilepsy aged 5-18 years admitted to hospital were retrospectively collected. SPSS 17.0 was used for analyses and P Results Of 301 patients with epilepsy, 32 of them had ADHD. Median age at diagnosis of epilepsy in the epilepsy + ADHD group was lower than in the epilepsy alone group (6 vs 8 years; z = -2.989, P = 0.003). The two groups were similar in terms of duration of epilepsy, seizure types and features of complicated versus non-complicated epilepsy, number of anti-epileptic drugs (AED) used (for all, P > 0.05). The epilepsy + ADHD group had a significantly higher prevalence of intellectual disability (31.3% vs 12.6%; χ2 (1) = 7.9, P = 0.014) and specific learning disorder (12.5% vs 1.9%; χ2 (1) = 11.1, P = 0.009) than the epilepsy alone group (χ2 (1) = 11.1, P = 0.009). ADHD medication use was identified in 68.8% of children in the epilepsy + ADHD group. Conclusion Attention-deficit-hyperactivity disorder was identified in 11.8% of 5-18-year-old children (32/301) with epilepsy in a 1 year period. ADHD is more frequent in children with epilepsy in childhood (5-11 years of age). Epilepsy diagnosis is more frequent in younger children with ADHD. Children with epilepsy and ADHD, also have a significantly higher prevalence of intellectual disability and specific learning disorder. Younger children diagnosed with epilepsy should be carefully monitored for ADHD.

Phagophobia is a condition characterized by an avoidance of swallowing foods and an intense fear of choking while eating solid foods in the absence of physiological and anatomical abnormalities. Phagophobia is mentioned in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and International Classification of Diseases, 11th Edition in the new diagnostic category of avoidant/restrictive food intake disorder. The literature concerning phagophobia is sparse, and there is no specific treatment modality for this life-threatening condition. We describe a case of phagophobia in a 15-year-old girl who was treated successfully with low-dose aripiprazole as an augmentation therapy after she witnessed her father choking while eating chicken. To our knowledge, this is the first report showing that phagophobia was successfully treated with aripiprazole.

PubMedID: 30212767 Background: Knowledge has been expanding on myelin oligodendrocyte glycoprotein (MOG) antibody-associated central nervous system disorders. We delineate the clinical and paraclinical findings and outcome of our pediatric patients with MOG antibody seropositive disease. Methods: We retrospectively analyzed the clinical presentation, cerebrospinal fluid findings, magnetic resonance imaging (MRI) studies, course and outcome of children seropositive for anti-MOG IgG. Results: Total 20 children with neurological symptoms and serum anti-MOG IgG were identified from six centers in Turkey. Median age at onset was 9 years (mean 8.8 ± 5.0 years, range: 1.5–16.5 years). Final diagnoses were acute disseminated encephalomyelitis (ADEM) (n = 5), ADEM + optic neuritis (n = 4), neuromyelitis optica spectrum disorder (NMOSD) (n = 3), myelitis (n = 2), relapsing optic neuritis (n = 2), multiphasic DEM (n = 3), and unclassified relapsing demyelinating disease (n = 1). Seven/20 (35%) children experienced a single episode while 13/20 (65%) had a least one relapse during follow-up. On MRI, subcortical white matter, brainstem, and corpus callosum were preferentially involved regions. Full recovery was observed in 15/20 (75%) children. Conclusion: MOG autoimmunity in children has a wide clinical spectrum, tendency to relapse, and a favourable outcome compared with other relapsing demyelinating diseases. © 2018

The number of cancer diagnosis during pregnancy is increasing as a result of becoming widespread of screening tests and advanced pregnancy age. Gynecologic oncologists and oncologist make effort for medical and surgical treatments of cancer without any side effect on fetal well- being. In this review, the diagnosis, treatments and fetal effects of gynecologic cancers during pregnancy was discussed. [Archives Medical Review Journal 2015; 24(2.000): 211-227]

Myastenia gravis, iskelet kaslarında güçsüzlük ve yorgunlukla karakterize otoimmün hastalıktır. Burada sadece bulbar semptomlarla başvuran çocuk hasta sunulmuştur.Onbeş yaşında erkek hasta bir aydır yutkunmada zorluk, konuşmada pelteklik şikayeti ile başvurdu. Konuşmanın akşama doğru bozulduğunu, yorgunluğunun arttığını, yutkunmadaki zorluk nedeni ile katı gıdaları alamadığını sıvı gıda ile beslendiğini ifade etti. Bu şikayetlerine onbeş gündür göğüs ve omuz ağrısının eklendiğini belirtti. Hastanın fizik muayenesi normal idi. Yapılan elektromiyografisinde: ardışık sinir uyarım testinde anlamlı decrement yanıt elde edildi. Asetilkolin reseptör antikoru: 29.65mmol/L bulundu. Hasta intravenöz immünglobülin ve plazmaferez ile tedavi edildi. Hasta pridostigmin ve oral steroid ile taburcu edildi. Ancak izleminde ataklarının sık olmasından dolayı tedavisine azotiopürin eklendi. Sonuç olarak; myastenia gravis olgularının sadece bulbar semptomlarla başvurabileceği akılda tutulmalıdır., Myasthenia gravis is an autoimmune disease that can lead to weakness and fatigue of skeletal muscles. Here we introduce a child presenting with bulbar symptoms only.A fifteen year-old boy presented to the hospital with difficulty swallowing and speaking, and fatigue especially at evenings for one month. He could only take liquids. His neurological examination was normal. The sequential nerve stimulation test results were decreased on electromyography examination. The acetylcholine receptor antibody level was high. We considered the diagnosis of bulbar Myasthenia Gravis, and treated the patient with intravenous immunoglobulin and plasmapheresis. He was discharged with oral steroids and prydostigmin. He had frequent attacks during the follow-up and azathiprine was added to his treatment. In conclusion, pediatric patients with myasthenia gravis can apply only with bulbar symptoms

We demonstrate a method to produce vacuum tight, metal free, bakeable and alkali compatible feedthroughs for optical fibers. The manufacturing process mainly relies on encasing fibers made of fused silica with glass materials with lower melting points by heating. We analyze the vacuum and optical performance of the devices by various methods including helium leak checking and several spectroscopic schemes, among others electromagnetically induced transparency involving Rydberg states., 4 Pages, 4 Figures

Assisted reproductive technologies(ART) are widely used in the treatment of infertility. Many advances in ART have resulted in higher pregnancy rates for patients. The introduction of embryo cryopreservation and subsequently intracytoplasmic sperm injection(ICSI) in 1992 were the important developments in ART success. Development of preimplantation genetic diagnosis has facilitated the exclusion of genetically abnormal embryos but every development brought new risks about the manipulation of the oocyte, sperm or the embryo. The effects of different technologies used in in-vitro fertilization(IVF) on children conceived through ART are the topics of interest since the birth of the first IVF baby Louise Brown in 1978 and have been examined for years. There are many reasons why IVF babies might be exposed to greater risks than naturally conceived children. ART carries an increased risk of iatrogenic multiple pregnancies, which are associated with a higher rate of prematurity. However, adverse perinatal outcomes are not totally eliminated with applying single embryo transfer policies in daily practice and by reducing multiple pregnancy rates. Singleton children born after ART are also at risk for preterm delivery, low birth weight, neonatal mortality, and neonatal intensive care unit admission when compared to spontaneously conceived children. Technical factors, maternal age and underlying parental subfertility are likely to correlate to this risk but ART children are also at increased risk of congenital malformations even after adjustment for maternal age, subfertility or the parental characteristics. The aim of this review is to summarize perinatal outcomes and the congenital anomaly risk of IVF pregnancies and also examine the risks of different technologies including ICSI, blastocyst culture, and cryopreservation on this topic. [Archives Medical Review Journal 2014; 23(4.000): 575-586]

In the context of building a new foundation for the harmonious continuation of the established world order, religions/cultures/civilizations are now being summoned to the cause of creating peace and security. The dialogue projects which are carried out to serve this goal work to resolve the lack of mutual knowledge among the communities described as “the West and Islam”, to discover the common values, and thus to establish some kind of universal understanding. In this article, no distinction is made between the efforts variously described as “interreligious dialogue”, “intercultural dialogue”, or “the alliance of civilizations”. Instead, all these endeavors will be commonly referred to as the “Dialogue between the West and Islam”. This is because, in practice, these efforts are all premised upon the idea that Islam constitutes a threat to the universal values which the West represents. This paper argues that dialogue alone will be insufficient to preserve peace and security in a world in which some two billion eight hundred people are living on less than two dollars per day, and a further one billion two hundred million are struggling to stay alive with less than one dollar. One banner that the anti-globalist demonstrators unfurled in Geneva provides a succinct summary of this case: “If there is no justice, there will be no peace.”

To assess the effects of propofol and sevoflurane on the contraction elicited by dopamine, adrenaline and noradrenaline on isolated human umbilical arteries.Umbilical arteries were cut into endothelium-denuded spiral strips and suspended in organ baths containing Krebs-Henseleit solution bubbled with O2 +CO2 mixture. Control contraction to phenylephrine (10(-5) M) was recorded. Response curves were obtained to 10(-5) M dopamine, 10(-5) M adrenaline or 10(-5) M noradrenaline. Afterwards, either cumulative propofol (10(-6) M, 10(-5) M and 10(-4) M) or cumulative sevoflurane (1.2%, 2.4% and 3.6%) was added to the organ bath, and the responses were recorded. Responses are expressed percentage of phenylephrine-induced contraction (mean ± standard deviation) (P 0.05 = significance).Propofol and sevoflurane elicited concentration-dependent relaxations in strips pre-contracted with dopamine, adrenaline and noradrenaline (P 0.05). Highest (10(-4) M) concentration of propofol caused significantly higher relaxation compared with the highest (3.6%) concentration of sevoflurane in the contraction elicited by dopamine. High (10(-5) M) and highest concentrations of propofol caused significantly higher relaxation compared with the high (2.4%) and highest concentrations of sevoflurane on the contraction elicited by adrenaline. High and highest concentrations of sevoflurane caused significantly higher relaxation compared with the high and highest concentrations of propofol on the contraction elicited by noradrenaline.Dopamine, adrenaline and noradrenaline elicit contractions in human umbilical arteries, and noradrenaline causes the highest contraction. Both propofol and sevoflurane inhibit these contractions in a dose-dependent manner. Propofol caused greater relaxation in the contractions elicited by dopamine and adrenaline while sevoflurane caused greater relaxation in the contraction elicited by noradrenaline.

Assessments deliver information about the knowledge level of a student. Formative assessments' main purposes are to identify student's weaknesses and strengths, and support educators in the planning process of their instruction. In this paper a graphical user interface concept is presented to provide feedback with the aid of the editing results of medical students, who train with Virtual Patient, which is a computer-based simulation of patient care.

This study used the measure of percentage of body fat (%BF) to define obesity and evaluated the effect of percentage of %BF on clinical, surgical and pathological features in women with endometrial cancer.Between 2011 and 2013, bioelectrical impedance analysis and body size measurements of 94 patients whose endometrial biopsy revealed endometrial cancer were obtained. Patients were divided into two groups according to body mass index (BMI) (normal,30 kg/m(2); elevated, ≥ 30 kg/m(2)), and also classified by %BF (normal,32%; elevated, ≥ 32%).The patients' mean age was 55.0 ± 10.9 years. Mean %BF and BMI were 40.8% ± 9.8% and 32.9 ± 7.5, respectively. Eighty-three (88%) patients were obese according to %BF; 54 (57%) were obese according to BMI. Patients with elevated %BF were more likely to have less than 50% myometrial invasion (P = 0.004). Significantly more para-aortic lymph nodes were retrieved in patients with normal %BF or BMI (P0.001, P0.001). Patients with elevated %BF had longer operating times (P = 0.043) and were more likely to have stage I disease than patients with normal %BF (P0.001).Endometrial cancer patients with an elevated %BF are more likely to have stage I disease and less than 50% myometrial invasion than patients with normal %BF. Defining obesity by BF may provide better estimation of obesity prevalence in patients with endometrial cancer and further understanding the relationship between BF with endometrial cancer may give more information about the effects of obesity on endometrial cancer.