Search

Objective To investigate the traumatic effects of the COVID-19 pandemic on middle-school students and their parents. Methods This epidemiological cross-sectional study was conducted with middle-school students in Denizli. A questionnaire consisting of the IES-R, CRIES-13 and a sociodemographic data form was delivered online. A total of 1059 participants who fully completed the questionnaire were included for analysis. Results The IES-R total and subdimension scores and the CRIES-13 scores were found to be significantly higher in families with an income level of ≤2,500 TL. The CRIES-13 scores of children were found to be significantly higher in divorced families. No statistically significant difference was determined between the IES-R total and subdimension scores of the parents who were healthcare workers and the CRIES-13 scale scores of their children. Conclusion A statistically significant, positive, moderate relationship was found between the IES-R scale total and subdimension scores of parents and the CRIES-13 scale scores of children. A low socioeconomic level was seen to increase the prevalence of anxiety in adults and adolescents. The children of divorced families were found to be at higher risk of PTSD. Successful management of mental health symptoms in parents will reflect positively on the mental health status of their children.

Amaç: Bu çalışmada; uzmanlık eğitimi sonrasında perkütan nefrolitotomiyi (PNL) 2. basamak ilçe devlethastanesinde gerçekleştiren bir cerrahın başarı oranları ve karşılaşılan komplikasyonları değerlendirmekamaçlandı.Gereç ve yöntem: Ocak 2019 ile Ocak 2020 tarihleri arasında böbrek taşı olan 97 hastadaki 102 renal üniteye2. basamak devlet hastanesinde PNL uygulandı. Tüm hastalara standart PNL 26 Fr rijit nefroskop ve pnömotik litotriptör kullanılarak prone pozisyonda uygulandı. Hastaların verileri retrospektif olarak toplandı. Başarı oranları, yatış süreleri, karşılaşılan komplikasyonlar literatür eşliğinde değerlendirildi.Bulgular: PNL yapılan 97 hastanın yaş ortalaması 41,7±10,5 ve bu hastaların 54’ü (%55,7) erkek, 43’ü (%44,3)kadındı. 42’si (%41,2) sol, 60’ı (%58,8) sağ böbrek olmak üzere 102 renal üniteye giriş sağlandı. Ortalamataş yükü 8,3±5,5 cm2 ve ortalama taş sayısı 2,4 olarak tespit edildi. Operasyon süresi ortalama 85±32 dakika olarak ölçüldü. Skopi süresi ortalama 1,2±0,2 dakika olarak izlendi. Toplam 102 vakanın 86’sında (%84,3) taşsızlık sağlandı. Klinik önemsiz rezidüel fragmanlar (>4 mm) da dahil edildiğinde genel başarı oranı %93,1 idi. Hastaların hastanede kalış süresi 2,7 (1-11) gün olarak izlendi. Majör ve minör komplikasyon görülen hasta sayısı 21 (%20,6)’di.Sonuç: PNL uzmanlık eğitimi sonrası 2. basamak ilçe devlet hastanelerinde literatürle uyumlu komplikasyon ve başarı oranları ile güvenli ve etkin bir şekilde uygulanabileceğini düşünmekteyiz., Purpose: The COVID-19 outbreak and the quarantine period had important psychosocial consequences. This study aimed to reveal the effects of the outbreak on anxiety and depression symptoms in older people and the factors associated with these symptoms.Materials and methods: Three hundred six people over the age of 65 were included in this study.Sociodemographic data form containing questions related to COVID-19 such as whether there is a healthworker in their first-degree relatives, whether they have had COVID-19, whether there is a decrease in thefrequency of physical activity and Hospital Anxiety Depression Scale (HADS) were applied in the online survey.Results: The mean age of the participants was 69.46±4.69 (167 women, 54.6%). Twenty-nine (9.5%) of theparticipants reported that they had COVID-19, and 247 (80.7%) reported that their physical activity decreased after the outbreak. The frequencies of those with above-threshold scores in depression and anxiety subscales were 28.8% and 28.4%, respectively. The frequency of above-threshold depression sypmtoms was less in those whose first-degree relatives are healthcare worker and more frequently in those with a decrease in daily physical activity. The frequency of above-threshold anxiety symptoms was more common in women, those living in rural areas, and those with low education. In the logistic regression analysis the decrease in physical activity after the epidemic predicted the presence of above-threshold depression symptoms; living in a rural area and having a shorter education level predicted the presence of above-threshold anxiety symptoms. In addition, having a first-degree relative of a healthcare worker was also found to be protective in terms of depression symptom risk.Conclusion: The COVID-19 outbreak had negative psychological consequences on older adults. While takingprecautions to prevent these results, older people living in rural areas with low education should be targeted first, and physical activity should be increased. Knowing these results can guide the prevention and treatment of psychiatric disorders that may occur in older people.

Purpose: This study aimed to investigate 764 children who applied to Pamukkale University Faculty of Medicine for the Special Needs Report, in terms of special needs levels, mental health diagnoses, additional physical illnesses, and their relevance to each other. The outcomes are intended to contribute to new studies in the field of medical health care. Materials and methods: A retrospective examination was made of the data of 764 children, aged between 0-18 years, who presented at the Child and Adolescent Psychiatry Health Board Polyclinic of Pamukkale University Medical Faculty between April 2019 and August 2020.Results: Evaluation was made of 764 cases with a mean age of 7.88±4.5 years. No difference was determined between the genders in respect of the Ankara Development Screening Inventory (ADSI), Wechsler Intelligence Scales for Children-Revised (WISC-R), and Wechsler Adult Intelligence Scale-Revised (WAIS-R) results. In the subtests of the AGTE applied to cases aged, Amaç: Pamukkale Üniversitesi Tıp Fakültesi’ne Çocuklar İçin Özel Gereksinim Raporu (ÇÖZGER) için başvuran 764 çocuğun; özel gereksinim düzeyleri, ruhsal tanıları, ek fiziksel hastalıkları ve birbirleri ile ilişkilerinin araştırılması ve sonuçların ruh sağlığı alanında yapılacak yeni çalışmalara katkı sağlaması amaçlanmıştır. Gereç ve yöntem: Nisan 2019-Ağustos 2020 tarihleri arasında Pamukkale Üniversitesi Tıp Fakültesi Çocuk ve Ergen Psikiyatrisi Sağlık Kurulu Polikliniği’ne başvuran 0-18 yaş aralığında 764 olgunun verileri retrospektif olarak taranmıştır.Bulgular: Çalışmaya yaş ortalaması ise 7,88±4,5 yıl olan 764 olgu alındı. Olguların Ankara Gelişim Testi Envanteri (AGTE), Wechsler Çocuklar için Zeka Ölçeği-Gözden geçirilmiş formu (WISC-R) ve Wechsler Yetişkin Zekâ Ölçeği-Düzenlenmiş (WAIS-R) sonuçları cinsiyet açısından karşılaştırıldığında aralarında istatistiksel olarak anlamlı bir farklılık bulunamamıştır. 6 yaş altında AGTE uygulanan olguların alt testleri incelendiğinde erkeklerde kaba motor alanda gelişim geriliğinin daha fazla olduğu bulunmuştur. ÇÖZGER’de olguların en sık gecikmiş dönüm noktası tanısı aldığı, en sık raporlanan özel gereksinim düzeyinin “ÖGV” olduğu, olguların özel gereksinim düzeyine göre cinsiyet açısından karşılaştırıldığında “ÖKGV” özel gereksiniminin erkek çocuklarda istatistiksel olarak anlamlı şekilde yüksek bulunduğu, OSB tanısının erkek cinsiyette anlamlı olarak daha yüksek olduğu, olguların ek tanılarının en sık olarak epilepsi ve serebral palsi olduğu saptanmıştır. Olguların cinsiyetlerine göre ek tanıları incelendiğinde; erkek çocukların istatistiksel olarak anlamlı şekilde kız çocuklara göre daha fazla genetik hastalığa sahip olduğu bulunmuştur.Sonuç: Çocuk psikiyatri uzmanları ve çocuklar ile ilgilenen tüm hekimlerin özel gereksinimi olan çocukların hem eğitim hem de sosyal haklarını sağlamak adına uygun yönlendirmeleri yapmaları gereklidir. Bu nedenle de ülkemizde çocuklar ile çalışan hekimlerin ÇÖZGER ile ilgili yeterli seviyede bilgi sahibi olması gerekmektedir.

It is well known that neurodegenerative illnesses like Alzheimer’s, which are associated with loss of cognitive functions, have been amplifying their impact on society with the increase of the lifetime expectation achieved in the last few decades. But also in the case of psychiatric and neurodevelopmental disorders for which aging is not a dominant factor (like, for example, autism, schizophrenia and bipolar diseases), the demands of the modern life have augmented their societal importance. Unfortunately, most of these types of diseases are of difficult clinical diagnosis due to the heterogeneity of their symptoms, what leads to errors in the initial diagnosis, for example of the bipolar disorder, close to 70%, with more than 30% of patients remaining misdiagnosed for at least 10 years. Altemative/complementary strategies that may help clinicians to improve these numbers are then of great relevance, in particular when they rely in fast and cheap analytical procedures having a molecular basis. Use of spectroscopic methods for accomplishment of this goal, through analysis of body fluids and identification of biomarker-related spectroscopic features, appears as a promising approach to this problem. In fact, this approach has been shown to be appropriate for helping diagnosis of other types of diseases, like cancer and infectious diseases, for example. In this investigation, vibrational spectroscopy (both infrared absorption - 1R - and Raman scattering), has been selected as analytical technique for trial diagnosis of a series of disorders affecting the cognitive functions. Vibrational spectroscopy is a veiy sensitive analytical method to sample composition and variability; it allows fast and cheap analyses and, when the object of analysis is a body fluid, the tests can be performed without requiring patients’ multiple visits to the health units (in contrast with the clinical traditional methods). The present program of studies focusses on the analysis of blood plasma samples of patients clinically diagnosed as bearing psychiatric or neurodevelopmental disorders, in order to find proper biomarker- related spectroscopic features that can help a correct diagnosis. Chemometrics is used to perform the analysis of the spectroscopic data obtained by 1R or Raman spectroscopies, in the search for a reliable statistical model to discriminate and classify the patients according to their disease. In this poster, the results obtained for the case of autism will be presented, together with the plan designed for the ongoing studies focusing on other types of illnesses, in particular, schizophrenia and bipolar diseases (including subgroups: bipolar depressive episode, manic episode and otimic), as well the relevant information about the research consortium established to undertake these studies. It will be shown that the information contained in the infrared spectra of blood samples of autistic patients allowed for their correct classification against the control group, thus testifying the potential of the used methodology for the aimed purposes.

Objective: Alcoholism is associated with genetic variants of genes related to alcohol metabolizing enzymes, dopaminergic, gamma-aminobutyric acidergic, glutamatergic, opioid, cholinergic, and serotonergic systems. Neurpeptide Y system and Neurexins were shown to be associated with alcohol dependence. Recent studies identified new genetic polymorphisms related to endogenous cannabinoid system, neuropetide Y and neurexin. In the present study, we aimed to investigate the association of Neurpeptide Y LEU7PRO rs16139 and neurexin 3 gene rs760288 polymorphisms with alcohol dependence in patients with alcohol dependence and healthy control subjects. Methods: 123 patients who were diagnosed with alcohol dependence according to the DSM-IV criteria and 159 healthy volunteers were included in the study. Blood samples were used to investigate polymorphisms. The genotyping of the neurexin 3 gene rs760288 and the neuropetide Y gene Leu7Pro rs16139 polymorphisms was performed using TaqMan SNP Genotyping Assays Real-Time PCR System. Results: Of the 2 genetic polymorphisms investigated in the present study, we detected association between and neurexin 3 gene rs760288 polymorphisms with alcohol dependence. Conclusions: Neurexin gene polymorphisms might be an important factor in development of alcohol addiction.

Dikkat Eksikliği Hiperaktivite Bozukluğu' nun (DEHB) etiyolojisi net olarak bilinmemekte olup, nörobiyolojik, genetik ve çevresel faktörlerin etyolojide birlikte yer aldığı düşünülmektedir. Bu çalışmada; uykuyu başlatma ve uyku etkinliğini sürdürmede rolü olan ve dopaminerjik sistemle de ilişkisi olduğu bilinen melatoninin etyopatogenezdeki rolünün araştırılması amaçlanmıştır. Çalışmaya 6-16 yaş aralığında, başka herhangi bir fiziksel ya da psikiyatrik hastalık öyküsü olmayan ve son altı ay içinde psikotrop ilaç tedavisi almamış olan 27 DEHB tanılı hasta ve 28 sağlıklıklı gönüllü kontrol dahil edilmiştir. Melatoninin ana metaboliti olan 6-Hidroksi Melatonin Sülfat'ın (6-OH MS) üriner eksresyonunun gündüz, gece ve 24 saatlik süre boyunca değerlendirilmesi için ayrı ayrı gündüz ve gece idrarı 24 saat boyunca toplanmıştır. Enzyme-Linked Immunosorbent Assay (ELISA) yöntemi ile 6-OH MS gündüz, gece ve 24 saatlik düzeyleri belirlenmiştir. Çalışma sonucunda gündüz, gece ve 24 saatlik 6-OH MS düzeylerinin vaka grubunda anlamlı olarak daha yüksek düzeyde bulunduğu saptanmıştır. 6-OH MS düzeylerinin cinsiyetlere göre karşılaştırılmasında farklılık saptanmamıştır. Tüm grupta, yaş, boy, yaşa göre boy, kilo, yaşa göre kilo, vücut kitle indeksi ve yaşa göre vücut kitle indeksi ile 6-OH MS düzeyleri arasında ilişki olmadığı belirlenmiştir. DEHB grubunun 6-OH MS düzeyleri ile Conners Anababa Derecelendirme Ölçeği Kısa Form alt ölçek puanları arasında da ilişki ortaya konamamıştır. Melatoninin DEHB etyopatogenezindeki yerinin anlaşılması için daha büyük örneklemli, tedavi sonrası düzeylerinin değerlendirildiği ve genetik analiz çalışmalarının da eklendiği daha ileri çalışmaların gerekli olduğu düşünülmektedir. The etiology of Attention Deficiy Hyperactivity Disorder (ADHD) is incompletely known and neurobiological, genetic and environmental factors are tought to be involved in the etiology together. In the present study, it is aimed to assess the role of melatonin which promote and maintain sleep and have relations with dopaminergic system, in the etiopathogenesis of ADHD. 27 patients between 6 and 16 years-old who have been firstly ADHD diagnosed, without other physical and psychiatric disease history and haven't taken psychotropic pharmacoterapy for six months and 28 healthy volunteer controls were included in the study. Urine samples were collected whole 24 hours cycle, daytime and nighttime separetely to assess the Daytime, nighttime and 24 hours excretion of the 6-Hidroxy Melatonin Sulphate (6-OH MS) which is the main metabolit of melatonin. Enzyme-Linked Immunosorbent Assay (ELISA) method is used for measuring daytime, nighttime and 24 hour urine 6-OH MS level. As a result of the study daytime, nighttime and 24 hour 6-OH MS levels were found significantly higher in patient group. In the comparison of 6-OH MS levels did not differ according to gender. There cannot been found a relationship between age, height, height for age, weight, weight for age, body mass index and body mass index for age and 6-OH MS levels in the whole group. There also cannot been found a relationship between 6-OH MS levels and Conners Parent Rating Scale short form subscale scores for ADHD group. To elucidate the role of melatonin in ADHD etiopathogenesis, studies with larger samples, assessment of the after treatment levels and studies with genetic analyzes included are needed. 132

Substance dependency is a serious problem that should be taken into consideration in an emergency service. Patients with substance dependence are seen by emergency services in many different clinical situations. Studies show that emergency service personnel are faced with substance-dependents most frequently. For this reason, substance dependency is a very important topic for emergency service personnel. A number of approaches have been reported regarding substance dependency treatment in the literature. The aim of this article is to review research about the management of substance dependency in an emergency service.

The purpose of this paper is to present sonographic and CT imaging findings of xanthogranulomatous cholecystitis (XGC) presented as Bouveret’s syndrome, a very rare cause of gastric obstruction. While the patient’s physical examination, upper GI endoscopy, and radiological findings all pointed to Bouveret’s syndrome, CT differential diagnosis suggested either XGC or gallbladder carcinoma, and the final diagnosis was done histopathologically. Our paper aims to increase awareness in radiologically diagnosing XGC cases by introducing the possibility of existence of Bouveret’s syndrome.

Pulmoner emboli (PE); genellikle derin baldır venlerinden kaynaklanan trombüslerin veya trombüs dışı maddelerin (hava, yağ, tümör hücresi, amniyotik sıvı, septik materyal gibi) embolizasyonu sonucu ortaya çıkan pulmoner arteriyel sistemin değişik derece ve lokalizasyondaki tıkayıcı hastalığıdır. PE tanısını koymada yalnızca öykü ve fizik muayenenin yetersiz olması nedeniyle; pek çok tanısal test kullanılmaktadır. Bu çalışmada, pulmoner emboli saptanan hastalarda pulmoner arter obstrüksiyon indeksi ve sağ/sol ventrikül oranları kullanılarak tespit edilen pulmoner emboli şiddeti ile D-dimer ve OTH arasındaki ilişkiyi ve OTH'nin pulmoner emboli şiddeti tanısında indikatör olarak kullanılabilirliğini araştırdık.Çalışmaya 63 PE vakası ve 41 tromboembolisi olmayan kişi dâhil edildi; Bilgisayarlı tomografi görüntülerinden PABTOİO ve RV/LV oranları hesaplandı. D-dimer ve OTH düzeyleri sırasıyla immüno-türbidimetrik ve elektriksel impedans yöntemleriyle belirlendi. İstatistiksel analizde parametrelerin gruplar arası karşılaştırmalarında Mann Whitney U testi, ölçekler arası ilişkileri saptamak için Pearson Korelasyon analizi, Niteliksel verilerin karşılaştırılmasında Pearson Ki-Kare testi kullanıldı.PE vakalarında OTH düzeyi ile PABTOİO düzeyi arasında istatistiksel açıdan anlamlı ilişki bulunamamıştır. (r=-0,027; p=0,835>0,05). Yine OTH düzeyi ile RV/LV oranı düzeyi arasında da istatistiksel açıdan anlamlı ilişki bulunamamıştır. (r=0,129; p=0,312>0,05). RV/LV oranı ile PABTOİO düzeyi arasında pozitif yönde anlamlı ilişki bulunmuştur. (r=0,282; p=0,0250,05).Çalışmamızda OTH'nin, PE'lilerde yüksek olmakla birlikte PABTOİO ve RV/LV oranı ile korele olmadığını tespit ettik. Klinik risk skorlaması, OTH ve D-dimer seviyelerini yükselten durumlar göz önünde bulundurularak yapılacak prospektif ve daha geniş vaka serisi içeren çalışmalarda, PABTOİO ve biyokimyasal parametrelerin birlikte kullanımının, PE tanısına katkı sağlayacağına inanıyoruz. Pulmonary embolism (PE); usually caused by deep calf vein thrombi, or substances in non-thrombus (air, fat, tumor cell, amniotic fluid, septic material), is a various degree and location of pulmonary arterial occlusive disease. Because history and physical examination in diagnosing PE is inadequate, many tests are used. In this study, we investigated patients with pulmonary embolism for pulmonary artery obstruction index, severity of pulmonary embolism determined by right / left ventricular rates, relationship between D-dimer and MPV and availability of MPV usage as indicator in severity of pulmonary embolism.63 PE and 41 cases of non-thromboembolism were included in the study. PABTOIO and RV / LV ratios were calculated from their computerized tomography images. D-dimer and MPV levels were determined respectively with immuno-turbidimetric and electrical impedance techniques. Statistical analysis for comparing parameters between groups were made with Mann-Whitney U test, for determining relationship between scales were made with Pearson correlation analysis and for comparing qualitative data made with Pearson's chi-square test.There is no significant relationship between MPV levels and level of PABTOIO in cases of PE (r=-0,027; p=0,835>0,05). Also, there was no statistically significant relationship between level of RV / LV ratio and level of MPV (r = 0.129, p = 0.312> 0.05). A positive significant relationship was found between the RV / LV ratio and level of PABTOIO (r = 0.282, p = 0.025 0,05).In our study we examined that MPV is higher in patients with PE but not correlated with PABTOIO and RV / LV ratio. According to clinical risk score and situations increasing MPV and D-dimer levels, we believe that prospective and larger case series has to be done for clinical value of using PABTOIO and biochemical parameters together. 75