Objective: Poisonings are significant causes of preventable morbidities and mortalities in pediatric patients hospitalized in pediatric intensive care units. In this study, we aimed to evaluate ...demographic and epidemiologic features, interventions, treatments, clinical course, and prognosis of patients hospitalized in pediatric intensive care unit for poisoning retrospectively. Methods: The recordings of 172 patients admitted to the pediatric intensive care unit with acute poisoning between 2015 and 2019 were evaluated retrospectively. Results: A total of 172 patients were admitted to our pediatric intensive care unit with the diagnosis of poisoning. Eighty-eight of them (51.2%) were girl. The average age was 5.8±5.6 years, and mean length of stay was 2.9 days. It was noted that 72.1% of patients with poisoning were accidental, whereas 27.9% of them were suicidal. Majority of suicidal patients were girls (89.5%), and the mean age was 13.1±4.9 years. However, only 36.2% of patients with accidental poisoning were girls and the mean age was 3.1±2.6 years. Patients with poisoning were most commonly seen during spring. The most common cause of poisoning was drugs (76.7%). Poisoning with multiple drugs were seen in 36 patients (20.9%). Central nervous system drugs were the most common cause (32.7%). Nausea-vomiting (17.4%), altered mental status (12.7%), and abdominal pain (7.5%) were the most common symptoms. Thirteen patients required invasive mechanical ventilation. Five patients were treated with hemodialysis and eight patients treated with plasma exchange. Conclusion: Poisonings are important part of pediatric intensive care unit hospitalization. Accidental poisoning is common especially in children under five years of age. Taking preventive measures, educating parents about home accidents, storing medications in safe and locked places and keeping them out of reach of children can reduce the rate of accidental poisoning.
Aim: The study aimed to compare the levels of iron and ferritin in children with Attention Deficit Hyperactivity Disorder (ADHD) and Attention-Deficit Hyperactivity Disorder-Not Otherwise Specified ...(ADHD-NOS) and to assess the relationship between ADHD symptom severity and anxiety symptom severity with iron and ferritin levels. Materials and Methods: This study was planned as a cross-sectional, retrospective study. The study was performed by scanning the records of patients who applied to our clinic between January 2012 and January 2013. Accordingly, 205 ADHD and ADHD-NOS case records were evaluated. Patients were diagnosed clinically according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) criteria. ADHD symptom severity was assessed by the Turgay DSM-IV-TR-Based Child and Adolescent Behavior Disorders Screening and Rating scale. Anxiety symptom severity was assessed by The Screen for Anxiety Related Emotional Disorders. Results: Among the whole sample, 99 (48.3%) patients had ADHD and 106 (51.7%) had ADHD-NOS. In the ADHD group, the average age of the children was 10.88+ or -3.02 years, while that of the children in the ADHD-NOS group was 9.93+ or -2.49 years. Iron and ferritin were measured in 81 of the 205 patients participating in the study. There was no statistically significant difference between the two groups in terms of iron or ferritin levels (p>0.05). Statistically significant negative correlations between ADHD hyperactivity symptom severity and iron levels, and ADHD attention deficit symptom severity and ferritin levels were found. Ferritin levels correlated statistically with the total number of psychiatric diagnoses in the children. Conclusion: Iron and ferritin levels may be differentially affected in children with ADHD. The results we obtained from our study should be supported by studies with larger samples. Keywords: ADHD, iron, ferritin
Objective: This study aimed to determine the sleep habits and sleep problems of patients with conduct disorder (CD) and to compare them with healthy controls. Materials and Methods: This ...cross-sectional study included 45 children diagnosed with CD and 50 healthy controls. Sleep was evaluated by children’s sleep habits questionnaire (CSHQ). Qualitative variables between groups were compared using chi-square test, whereas quantitative variables were compared using t-test. Correlation analyses were conducted to evaluate relationships between the quantitative variables. Linear regression analysis was conducted to evaluate the predictors of severity of CD symptoms. P was set at 0.05. Results: The average ages of children in CD and control groups were 11.04±1.20 and 10.00±1.55 years, respectively. Moreover, 71.1% in the CD group were boys (vs. 78.0% in the control group). The groups were comparable in terms of socio-demographic features (all p>0.05). Scores of all CSHQ subscales were significantly elevated in the CD group compared with the control group (p<0.001). Clinically significant sleep problems were significantly elevated in the CD group (p<0.001). In the regression analysis, bedtime resistance and daytime sleepiness emerged as significant predictors of the severity of CD. Conclusion: Sleep problems may be common among Turkish children with CD, and bedtime resistance and daytime sleepiness may indicate severity of symptoms. Multimodal treatment for CD among children may address sleep problems.
Aim: In this study, we aimed to compare the levels of vitamin B12 and folate in children with Attention Deficit and Hyperactivity Disorder (ADHD) and Attention Deficit and Hyperactivity Disorder-Not ...Otherwise Specified (ADHD-NOS). Materials and Methods: This study was planned as a cross-sectional, retrospective study. Patients were recruited between January 2012 and January 2013 and 205 case records were evaluated. The ADHD and ADHA-NOS groups were compared according to vitamin B12 and folate levels. Symptom severity was evaluated by the Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating scale. Anxiety symptom severity was assessed by The Screen for Anxiety Related Emotional Disorders. Results: The average age of the children in the ADHD group was 10.88+ or -3.02 (n=99) years, and the average age of the children in the ADHD-NOS group was 9.93+ or -2.49 (n=106) years. There was no statistically significant difference between two groups in terms of Vitamin B12 level and folate level (p>0.05). A statistically significant negative correlation between the total number of diagnoses of a child and vitamin B12 levels was found. Folate levels correlated significantly with anxiety total scores generalized anxiety subscale. Conclusion: Vitamin B12 levels may be affected in children with impairing ADHD symptoms and increased comorbidities. The results of the study should be supported by future studies. Keywords: ADHD, vitamin B12, folate
In attention deficit hyperactivity disorder (ADHD), deteriorations of brain gut axis has been shown in previous studies. One area where the most important challenges are seen in ADHD is social ...functioning. Zonulin is a protein found in the intestinal intraepithelial component; it has been shown that the level of zonulin increases when intestinal permeability is impaired. Changes in intestinal function were shown in ADHD. Zonulin has been shown to be associated with social impairment in children with autism spectrum disorder. In this study, it was aimed to evaluate the relationship between the ADHD symptoms and zonulin in children with ADHD. Secondarily relation of zonulin and difficulties in social functioning was examined in these children.
Forty children diagnosed with ADHD and forty-one healthy children similar age and gender to ADHD group and their mothers were included in the study. Children without any chronic systemic immunological or infectious diseases were included in the case and control group. The ADHD symptoms were scored by the DuPaul ADHD scale and the social functioning of the children was assessed by the Social Responsiveness Scale (SRS). Serum zonulin levels were analyzed by enzyme-linked immunosorbent assay.
Children with ADHD had higher serum zonulin levels and were more impaired in social functioning compared to controls. The level of zonulin was independently predicted with hyperactivity symptoms and SRS scores in regression analysis.
In this sample of children with ADHD, elevated zonulin levels were associated with increased symptoms of hyperactivity and impairment of social functioning.
•A bidirectional communication has been shown between the gut and the brain.•Zonulin (prehaptoglobulin) is the most important modulator of intracellular tight junction.•Zonulin might be a biomarker of hyperactivity impulsive symptoms in ADHD.•Serum zonulin is related with social dysfunctions in ADHD.
In children and adolescents, especially younger ones, recurrent abdominal pains may develop as a response to psychosocial stressors. They may be considered as functional and be one of the common ...reasons for clinical referrals. A rare cause of recurrent, organic abdominal pain is abdominal epilepsy. Abdominal epilepsy may be considered in differential diagnosis of patients that were thought to have functional complaints. In this case, a 16-year-old adolescent girl whose chief complaints included loss of consciousness and recurrent abdominal pains lasting for a year is presented.
In this review, we explore the intricate development of sexual identity, drawing insights from genetic, endocrinological, neuroanatomical, and neurophysiological studies. Gender identity, ...encapsulating an individual's internal perception as male or female, undergoes a nuanced and gradual formation, commencing early in life and progressing through distinct stages. Gender nonconformity delineates behaviors that diverge from culturally prescribed norms, while gender dysphoria encompasses the emotional distress experienced by some individuals due to a mismatch between their gender identity and assigned sex at birth. The genesis of sexual identity involves multifaceted processes spanning numerous years. Human sex differentiation involves the suppression or inactivation of specific genes, a phenomenon illuminated by genetic investigations into gender dysphoria, which have shown comparable rates of genetic variations to the general population. Nevertheless, twin studies suggest an augmented likelihood of transsexuality among family members, hinting at potential environmental influences. Brain sexual differentiation occurs during mid-to-late pregnancy due to the impact of gonadal hormones. The mechanisms underpinning the loss of feminine brain characteristics and subsequent masculinization likely involve a combination of factors, indicating a complex interplay rather than a singular cause. Studies propose that human sexual behavior is not governed by a solitary gene but rather by a network of genes dispersed across the genome. Notably, disparities in brain structures, functionalities between genders, as well as variations in endocrine and serotonin-dopamine levels, are implicated in the etiology of gender dysphoria, contributing to the understanding of this complex phenomenon situated between genders.
Bu gözden geçirmede cinsel kimlik gelişimini bu konuda yapılan genetik, endokrinolojik, nöroanatomik, nörofizyolojik çalışmaların ışığında açıklanması hedeflenmiştir. Cinsel kimlik bireyin kendisini öznel olarak kadın ya da erkek olarak algılamasını ifade eder. Cinsel kimlik gelişiminin erken yaşlarda başladığı, uzun yıllar süren aşamalı bir süreç olduğu ve çeşitli aşamalardan geçtiği belirtilmektedir. Cinsiyet uygunsuzluğu kültürel olarak tanımlanan normlara uymayan cinsiyet rol davranışını belirtir. Cinsiyet hoşnutsuzluğu ise, cinsiyet uyumsuzluğu olan bazı bireylerin yaşayabileceği duygusal karmaşa veya sıkıntıyı ifade etmektedir. İnsanlarda cinsiyet farklılaşması bazı genlerin basımlanması ya da inaktivasyonu ile meydana gelmektedir. Cinsiyet hoşnutsuzluğ örneklemlerindeki genetik araştırmalar rutin moleküler karyotiplemede değişiklik oranlarının genel popülasyona benzer olduğunu göstermiştir. Ancak yapılan ikiz çalışmalarında aile üyeleri arasında artan transseksüelite riski paylaşılmış çevrenin de etken olabileceğini düşündürmüştür. İnsanlarda beynin cinsel yönden farklılaşması gonadal hormonlar etkisi ile gebeliğin ortası/sonlarında olmaktadır. Eldeki veriler değerlendirildiğinde beynin dişil özelliklerinin kaybolması ve erkeksileşmesi için olasılıkla birden fazla mekanizmanın rol oynayabileceği düşünülebilir. Yapılan çalışmalar insanlarda cinsel davranışın tek bir gen tarafından belirlenmediğini, tüm genoma yayılmış çoklu genlerce belirlendiğini düşündürmektedir. Erkek ve kadın beyni yapı ve işlevlerin farklı olması, endokrinolojik ve serotonin- dopamin düzeyinde ki farklılıklar cinsiyetler arasında CH etiyolojisinde etkili olabilir.
Objective: This study was to determine the relation between alexithymia and suicidal ideation and factors associ-ated with suicidal ideation in patients with social anxiety disorder (SAD). Also we ...determined whether alexithymia is predictor of suicidal ideation related with SAD. Methods: One hundred and sixty-four SAD (n=57), panic disorder (PD) (n=58), healthy controls (HC) (n=49) subjects (according to DSM-5) were included to study. Alexithymia was measured by Toronto Alexithymia Scale-20(TAS-20), suicidal ideation was measured by Suicidal Ideation Scale (SIS), social anxiety level were evaluated with Liebowitz Social Anxiety Scale and anxiety and depression level evaluated with Beck Depression Inventory and Beck Anxiety Inventory, State and Trait Anxiety Scales. Results: Alexithymia, the rate of was found to be 38.6% in SAD patients and 29.3% in PD patients. In SAD group, significant correlation was found between TAS 20, its factors and SIS. With path analysis, it was found that TAS 20 total scores predicted SIS scores only indirectly and via their effects on trait anxiety and subjective depressive symptoms. Conclusion: In alexithymic SAD patient’s suicidal ideation may occur when comorbid depression is present. Based upon the findings alexithymia may not be a good predictor of suicidal ideation for preventing suicidal attempts in patients with social anxiety disorder.
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common and heritable neurodevelopmental disorders which may last through the life-span. A consensus report on diagnosis and ...management of ADHD among Turkish youth was prepared previously. However, the participants as well as the management options were rather limited and developments in the past decade necessitated a revision and update of the consensus. Therefore, this review aims to summarize the consensus among Child and Adolescent Psychiatrists from Türkiye on the nature and management of pediatric ADHD. For those aims, the etiology of ADHD, diagnostic and evaluation process, epidemiology, developmental presentations, differential diagnoses and comorbidities, course/outcome and pharmacological as well as non-pharmacological management options were reviewed and suggestions for clinical practice are presented. Since ADHD is a chronic disorder with wide-ranging effects on functionality that is frequently accompanied by other mental disorders, a multidimensional therapeutic approach is recommended. However, since the disorder has neurobiological basis, pharmacotherapy represents the mainstay of treatment. Additional therapies may include psychosocial therapy, behavioral therapy, school-based therapeutic approaches, and family education. This review provides recommendations for ADHD at the national and global levels. It contains information about ADHD that will contribute to and facilitate clinicians' decision-making processes. It is advisable to consider this guideline in clinical practice.
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