Peritumoral Adipose Tissue Density Predicts the Malignancy in cT1 Renal Masses.

OBJECTIVE: Not only the frequency of surgery for small renal masses has increased secondary to the improvements and frequent use of imaging techniques but also the frequency of detection of benign lesions in nephrectomy specimens has increased as well. We aimed to assess the predictive value of computed tomography density of perirenal adipose tissue and peritumoral adipose tissue in distinguishing between benign and malignant renal masses. MATERIALS AND METHODS: The current study included 116 patients who underwent nephrectomy for renal masses between January 2015 and December 2020. Clinicodemographic and preoperative computed tomography features and final pathological findings of the patients were recorded. According to the final pathological results, the patients were divided into 2 groups benign (n = 32) and malignant (n = 84). Groups were compared statistically in terms of perirenal adipose tissue and peritumoral adipose tissue density. RESULTS: The median tumor size was 5.00 cm. The rate of benign tumors was higher in female patients (P = .005). The median peritumoral adipose tissue density among cT1 and cT1a tumors was higher in the malignant group (P < .001, for each). At a cutoff value of 97.50 Hounsfield Units, the peritumoral adipose tissue density had a sensitivity of 83.0% and a specificity of 79.2% for predicting the presence of malignant tumors in ≤7 cm renal masses. Using a cutoff value of -97.50 Hounsfield Units, the peritumoral adipose tissue density had a sensitivity of 88.9% and a specificity of 83.3% for predicting the presence of malignant tumors in ≤4 cm renal masses. CONCLUSION: The peritumoral adipose tissue density in the preoperative computed tomography images predicts the malignancy in cT1 renal masses.

Lamina Measurements with Computed Tomography for C2 Translaminar Screw Fixation in Pediatric and Adult Cases.

AIM: To measure C2-related morphometric parameters in a Turkish population. MATERIAL AND METHODS: The computed tomography (CT) images of three groups (Group 1: paediatric cases aged 1-6 years, Group 2: age7-16 years, and Group 3: adult cases), who had cervical spine CT were used to measure some morphometric parameters for safe C2 translaminar screw fixation. The measured parameters included thickness, height and length of the C2 lamina on both sides and the C2 lamina-midline angle. RESULTS: C2 lamina thickness at the thinnest point on the right and left sides was found to be 4.4 ± 0.5 mm and 4.6 ± 0.5 mm in Group 1, 5.3 ± 0.8 mm and 5.6 ± 0.8 mm in Group 2, and 6.8 ± 1.4 mm and 7.0±1.5 mm in Group 3, respectively (p > 0.05). The height of the C2 lamina at the thinnest point on the right and left sides was found to be 5.8 ± 0.8 mm, and 5.8 ± 0.7 mm in Group 1,10.4 ± 1.4 mm and 10.6 ± 1.4 mm in Group 2, and 10.6 ± 1.8 mm, and 10.7 ± 1.5 mm in Group 3, respectively (p > 0.05). The mean length of the C2 lamina was found to be 20.6 ± 2.4 mm in Group 1, 31.4 ± 4.1 mm in Group 2, and 36.7 ± 3.3 mm in Group 3 (p < 0.05). There was no significant difference between Group 2 and Group 3 in respect of mean lamina angle (44º vs 45º) but it was lower in Group 1 (35º). CONCLUSION: This study revealed the appropriateness of C2 anatomy for safe C2 translaminar screw fixation.

Post-activation depression of primary afferents reevaluated in humans.

Amplitude variation of Hoffmann Reflex (H-reflex) was used as a tool to investigate many neuronal networks. However, H-reflex itself is a subject to intrinsic changes including post-activation depression (P-AD). We aimed to investigate P-AD and its implication on motor control in humans. Upon tibial nerve stimulation in 23 healthy participants, peak-to-peak amplitude change of H-reflex was investigated using surface electromyography (SEMG) of soleus muscle. Variety of stimulus intensities, interstimulus intervals (ISIs), voluntary contraction levels/types and force recording were used to investigate the nature of P-AD. We have shown that P-AD was significantly stronger in the shorter ISIs. The only exception was the ISI of 200 msecs which had a weaker P-AD than some of the longer ISIs. Sudden muscle relaxation, on the other hand, further increased the effectiveness of the ongoing P-AD. Moreover, P-AD displayed its full effect with the first stimulus when there was no muscle contraction and was efficient to reduce the muscle force output by about 30%. These findings provide insight about the variations and mechanism of P-AD and could lead to improvements in diagnostic tools in neurological diseases.

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T).

AIM: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. METHOD: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. RESULTS: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. CONCLUSION: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.

Prevalence of Childhood Affective disorders in Turkey: An epidemiological study.

AIM: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. METHODS: This study was conducted as a part of the "The Epidemiology of Childhood Psychopathology in Turkey" (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. RESULTS: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. CONCLUSION: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.

Associations Between Father Temperament, Character, Rearing, Psychopathology and Child Temperament in Children Aged 3-6 Years.

Temperament refers to the totality of individual characteristics present from birth that determine a child's unique style of behavior. Maternal personality and attitudes, one of the factors affecting temperament traits in children, is a frequently investigated subject. However, paternal variables have remained insufficiently studied. The purpose of this study is to investigate the associations between the fathers' temperament, character, attitudes, psychopathology and temperament of the 3-6 years-old children. The parents of 36-60 months-old children in the preschool settings in Samsun were included in the study (n:200). Their mothers completed "Maternal Sociodemographic Form" prepared by the researcher, and the temperament of children "Children Behaviour Questionnare" were scored by the mothers. Their fathers completed "Paternal Sociodemographic Form", and to assess father psychopathology "Brief Symptom Inventory", to determine father temperament and character "Temperament and Character Inventory" and to determine attitudes "Parenting Attitudes Scale" were scored by the fathers. In this study, we found several significant associations between children's temperament and fathers temperament and character, attitudes styles and psychopathology. The scores of paternal harm avoidance increase and self directedness decrease were found to be significantly positivily correlated with negative temperamental charecteristics of the children. The democratic attitudes of fathers were significantly correlated with positive temperamental scores of the children. All domains of paternal psychopathology were found to be in significant association with negative temperamental characteristics of the children. Our findings showed the complex interplay between determinants of parenting. Specifically, this study is one of the first to investigate paternal personality, psychopathology and attitudes, alone and in interaction with preschool child temperament.

Preliminary results from a nationwide adult cardiology perspective for pulmonary hypertension: RegiStry on clInical outcoMe and sUrvival in pulmonaRy hypertension Groups (SIMURG).

OBJECTIVE: The present study was designed to evaluate the characteristics of pulmonary hypertension (PH) and adult cardiology practice patterns for PH in our country. METHODS: We evaluated preliminary survey data of 1501 patients with PH (females, 69%; age, 44.8±5.45) from 20 adult cardiology centers (AdCCs). RESULTS: The average experience of AdCCs in diagnosing and treating patients with PH was 8.5±3.7 years. Pulmonary arterial hypertension (PAH) was the most frequent group (69%) followed by group 4 PH (19%), group 3 PH (8%), and combined pre- and post-capillary PH (4%). PAH associated with congenital heart disease (APAH-CHD) was the most frequent subgroup (47%) of PAH. Most of the patients' functional class (FC) at the time of diagnosis was III. The right heart catheterization (RHC) rate was 11.9±11.6 per month. Most frequently used vasoreactivity agent was intravenous adenosine (60%). All patients under targeted treatments were periodically for FC, six-minute walking test, and echo measures at 3-month intervals. AdCCs repeated RHC in case of clinical worsening (CW). The annual rate of hospitalization was 14.9±19.5. In-hospital use of intravenous iloprost reported from 16 AdCCs in CWs. Bosentan and ambrisentan, as monotreatment or combination treatment (CT), were noted in 845 and 28 patients, respectively, and inhaled iloprost, subcutaneous treprostinil, and intravenous epoprostenol were noted in 283, 30, and four patients, respectively. Bosentan was the first agent used for CT in all AdCCs and iloprost was the second. Routine use of antiaggregant, anticoagulant, and pneumococcal and influenza prophylaxis were restricted in only two AdCCs. CONCLUSION: Our nationwide data illustrate the current status of PH regarding clinical characteristics and practice patterns.

Impact of Chronic Rheumatic Valve Diseases on Large Vessels.

BACKGROUND AND AIM OF STUDY: Rheumatic valvular heart disease, which remains a common health problem in developing countries, has numerous consequences on the heart chambers and circulation. The study aim was to investigate the effects of chronic rheumatic valve disease on the diameters of the descending aorta (DA) and inferior vena cava (IVC). METHODS: A total of 88 patients with echocardiographically documented rheumatic valvular heart disease and 112 healthy controls were enrolled into the study. All patients underwent detailed echocardiographic examinations, while their height and body weight were recorded and adjusted to their body surface area. RESULTS: The most common involvement was mitral valve disease, followed by aortic valve disease and tricuspid valve disease. The mean diameter of the DA (indexed to BSA) was 1.79 ± 0.49 cm for patients and 1.53 ± 0.41 for controls (p <0.001). The mean diameter of the IVC (indexed to BSA) was 1.69 ± 0.73 for patients and 1.38 ± 0.35 cm for controls (p <0.001). There was a significant positive correlation between mitral valve mean gradient and IVC diameter (p = 0.01, r = 0.18). There were also strong associations between the mitral valve area and the diameters of the DA (p = 0.001, r = -0.239) and IVC (p <0.001, r = -0.246). CONCLUSION: Rheumatic valve disease, especially mitral stenosis, was closely related to remodeling of the great vessels.

Maternal stress and perinatal features in autism and attention deficit/hyperactivity disorder.

BACKGROUND: We investigated the shared and non-shared perinatal risk factors for autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD) in a clinical sample. Additionally, we compared these groups regarding pre/postpartum maternal stress and the duration of breastfeeding. METHODS: Children aged 3-18 years old with ASD (n = 100) were compared with age- and gender-matched children with ADHD (n = 100) and with age- and gender-matched healthy controls (n = 80). RESULTS: Prematurity of the neonate and maternal stress/depressive mood in pregnancy were common risk factors shared by ASD and ADHD. Postpartum maternal depressive mood may be more specific to ASD, while shorter duration of breastfeeding may be related to ADHD. CONCLUSIONS: ASD and ADHD may have some perinatal features in common. Identification of perinatal factors for ASD and ADHD carries clinical implications in terms of primary prevention.

[Relationship between the Psychiatric Symptoms in Expecting Parents and Postpartum Depression and Infantile Colic: A Multicenter Follow up Study]. / Anne ve Baba Adaylarinda Psikiyatrik Belirtiler ile Dogum Sonrasi Depresyon ve Infantil Kolik Arasi Iliski: Çok Merkezli Bir Takip Çalismasi.

OBJECTIVE: The aim of this study is to evaluate the relationship between postpartum depression (PPD), infantile colic (IC) and different psychosocial variables, psychiatric symptoms, attachment style and perceived social support in expecting parents. METHOD: Two hundred forty five expecting mothers and 150 expecting fathers were first interviewed between the 22-34 weeks of pregnancy. Sociodemografic data form, Adult Attachment Style Scale (AASS), State Anxiety Inventory (SAI), Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS) and Brief Symptom Inventory (BSI) were filled out by each expecting parent. Second interview was conducted between the postpartum 4-24 weeks. Data form consisting health, nutrition, sleep and crying problems of the infant and EPDS and SAI were filled out by mothers and SAI by fathers. RESULTS: One in every four mothers had PPD symptoms above the threshold on EPDS. Maternal and paternal insecure attachment style, maternal psychiatric symptoms and postpartum anxiety level were found to be the predictors of PPD. One in every five infants had IC and maternal education level, hostility score and PPD symptoms along with paternal insecure attachment style and psychiatric symptoms were the main predictors of IC. CONCLUSION: Results about PPD and IC regarding maternal variables are consistent with the literature. In addition, paternal insecure attachment style is found to be an important risk factor for both PPD and IC. Fathers should also be included in further studies exploring PPD or IC.

Abuse Characteristics and Psychiatric Consequences Associated with Online Sexual Abuse.

The current study examined the rate and psychiatric correlates of sexual abuse involving the use of digital technologies by the offender in a wide sample of juvenile victims. Sociodemographic, abuse, and psychiatric characteristics of 662 sexually abused children and adolescents were evaluated. Of these, 93 reported that digital devices were used by the offender in several ways to facilitate the sexual abuse. The offender-victim relationship was initiated through the Internet in 39 victims. Involvement of digital technologies in sexual abuse was significantly associated with penetrative and recurrent form of sexual abuse commited by multiple offenders with coexisting violence. Additionally, victims of sexual abuse with a digital component were 4.21 times more likely to develop any psychopathology, 3.77 times more likely to have depression, and 2.14 times more likely to have post-traumatic stress disorder as a result of sexual abuse. These results indicated that the offender's use of digital technology may aid the initiation and facilitation of the sexual abuse of youths and may relate to more severe outcomes. This study revealed the importance of raising the awareness of professionals and the community about the potential risks associated with digital technologies and sexual abuse. Mental health professionals should consider this additional form of victimization, especially when dealing with sexual abuse victims.

Relationship between Neurocardiogenic Syncope and Ventricular Repolarization.

BACKGROUND: We aimed to analyze ventricular repolarization in neurocardiogenic syncope (NCS) patients by using T-peak-T-end interval, T-peak-T-end/QT ratio, T-peak-T-end/QTc ratio and corrected QT interval (QTc), QT dispersion (QTd), QT index (QTI) and corrected QT interval index (QTcI) comparing with the corrected JT dispersion (JTcd), and corrected JT (JTc) and the corrected JT interval index (JTcI), by inspecting ventricular activation until termination of repolarization. These parameters are used as an index of potential ventricular arrhythmogenesis. METHODS: We have studied patients with head-up tilt table test (HUTT) (+) (33 patients; mean age: 28 ± 11 years) and HUTT (-) as control group (33 patients; mean age: 30 ± 11 years). In all patients, T-peak-T-end interval, T-peak-T-end/QT ratio, T-peak-T-end/QTc ratio, QT, QTd, QTI, QTc, QTcI, JTd, JTc, and JTcI were measured on electrocardiogram. RESULTS: The following parameters were statistically significant between groups: QTd (22.72 ± 17.54 msn; 11.21 ± 13.40 msn; P = 0.004), QTc (424.27 ± 33.75 msn; 403.66 ± 38.08 msn; P = 0.023), QTcI (114.09 ± 14, 29%; 106.71 ± 15.33%, P = 0.047), and QTI (100.72 ± 7.19%; 97.14 ± 7.13%, P = 0.046). Furthermore, T-peak-T-end interval was significantly prolonged in the study group (93.78 ± 20.27 msn; 81.21 ± 11.66 msn; P = 0.003). T-peak-T-end/QT ratio was significantly higher in the study group (0.24 ± 0.04 msn; 0.22 ± 0.04 msn; P = 0.030). T-peak-T-end/QTc ratio was significantly higher in the study group (0.22 ± 0.04 msn; 0.20 ± 0.03 msn; P = 0.015). The JTc and JTd were also significantly higher in the study group ([103.00 ± 9, 72%; 95.44 ± 10.26%, P = 0.003], [27.57 ± 16.01 msn; 10.45 ± 16.08 msn; P < 0.001], respectively). CONCLUSIONS: Electrocardiographic ventricular repolarization parameters including T-peak-T-end interval, T-peak-T-end/QT ratio, T-peak-T-end/QTc ratio, QTc, QTd, QTI, QTcI, JTc, JTd, and JTI are prolonged in NCS.

Mother-Child Interactions of Preterm Toddlers.

INTRODUCTION: We aimed to investigate the mother-toddler relationship in preterm toddlers. METHODS: The sample consisted of 18 mothers and their preterm toddlers (group 1) and 20 mothers and their fullterm toddlers (group 2). Anxiety and depressive symptom levels, attachment pattern, and parental attitudes of mothers and social-emotional problems and developmental level of the toddlers were explored to assess possible confounding factors in the mother-toddler relationship. Two researchers rated the Parent Infant Relationship Global Assessment Scales (PIRGAS). RESULTS: Both the mothers in group 1 and group 2 had similar Beck Depression Inventory (BDI) and State and Trait Anxiety Inventory (STAI) scores. However, the mothers who gave birth before 32 weeks of gestation had higher trait anxiety scores than others (46±2.4 vs. 42.3±5.4, p=0.01). The groups had similar Brief Infant Toddler Social Emotional Assessment Scale (BITSEA) problem and competency scores. The parenting style of group 1 revealed that they had higher scores on the Parenting Attitude Research Instrument (PARI) subscale 5 (excessive discipline) (39.6 vs. 32.1; p=0.02). CONCLUSION: Mother-toddler interaction and attachment security were found to be similar in fullterm and moderately preterm healthy toddlers. Our findings suggest that not the preterm birth itself but the medical, developmental, and/or neurological consequences of prematurity may affect the mother-toddler interaction. To explore the independent effect of prematurity in mother-toddler dyadic relationship, longitudinally designed studies are warranted.

The Psychiatric Consequences of Child and Adolescent Sexual Abuse.

INTRODUCTION: The purpose of this study was to investigate the psychiatric consequences of sexual abuse and its associated factors in children and adolescents referred to our child and adolescent psychiatry clinic from official medico-legal units. METHODS: All victims of sexual abuse (n=590) aged 1-18 (mean: 13.56±3.38) referred from forensic units to Ondokuz Mayis University Child and Adolescent Psychiatry Clinic over a period of 2 years [boys: 83 (14.1%); girls: 507 (85.9%)] were included. Child and adolescent psychiatry and forensic medicine specialists evaluated all the cases. The Wechsler Intelligence Scale for Children-Revised Form (WISC-R) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T) were applied. RESULTS: Abuse-related psychiatric diagnoses (of which 45.9% were major depressive disorder and 31.7% were post-traumatic stress disorder cases) were made in 75.2% of the cases. In 80.3% of the cases, the perpetrators were known to their victims [incest, n=91 (15.1%)], and intercourse took place in 48.8%. Although gender and age were not significantly associated with the appearance of any psychiatric disorders, severity of abuse (e.g., intercourse; p=.006), additional physical assault (p<.001), and incest (p<.001) had a significant correlation with psychiatric disorders. To explore the predictive value of multiple factors in the appearance of any sexual assault-related psychiatric disorder, a logistic regression model was used to determine the best linear combination of age, gender, abuse severity, incest, involvement of any other victim, additional physical assault, and length of time from first abuse to first psychiatric evaluation. This combination of variables (occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation) significantly predicted the appearance of a psychiatric disorder of any kind (χ2=55.42; df=7; n=522; p<.001). CONCLUSION: Our findings reveal that the occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation predict higher rates of sexual abuse-related psychiatric disorders.

Child sexual abuse in Turkey: an analysis of 1002 cases.

This study investigated the characteristics of abuse suffered by children, the dimensions of the psychiatric effects associated with abuse, and the factors affecting these. One thousand two cases aged under 18, exposed to sexual abuse, and referred over a 7-year period were assessed. Girls represented 80.8% of cases, and the numbers rose with age. The aggressors were all male, and 88.2% were known to their victim. Approximately half the children were exposed to sexual abuse involving penetration. Psychological pathology was identified in 62.1%. Female gender, the presence of penetration, physical violence, and incest significantly increased the development of psychological pathology. Levels of awareness in people close to and trusted by the child must be raised to minimize the adverse effects of trauma in the long term, preventive measures must be taken, and medical and social support units from which victims can receive assistance need to be established.

Effects of lying position on P-wave dispersion in patients with heart failure.

OBJECTIVE: It was the aim of this study to investigate the effects of the right lateral decubitus, left lateral decubitus and supine lying position on P-wave dispersion (PWD) in patients with heart failure (HF). SUBJECTS AND METHODS: Seventeen patients with HF whose ejection fraction was <35% were included in the study. Right lateral decubitus, left lateral decubitus and supine electrocardiogram (ECG) recordings were obtained. The recordings for each of the three positions were taken after the patients had maintained each position for 30 min to ensure a stabilized hemodynamic position. For the baseline recording, in supine position, there was no 30-min waiting period before the ECG. RESULTS: After the right lateral decubitus position, there was a statistically significant reduction in the longest P-wave duration (100.0 ± 14.5 and 84.7 ± 16.2 ms; p = 0.001) and a significant decrease in PWD (41.7 ± 8.0 and 24.1 ± 7.1 ms; p < 0.0001). After the left lateral decubitus position, there was no significant change between the baseline PWD values (41.7 ± 8.0 and 40.2 ± 9.7 ms; p = 0.606). After the supine position, there was no significant change between the baseline PWD values (41.7 ± 8.0 and 39.7 ± 9.4 ms; p = 0.427). CONCLUSION: Our study revealed that patients' PWDs and maximum P-wave durations were lower in the right lateral decubitus lying position than in other positions. The clinical implication of this study needs to be further explored.

Effect of methylphenidate treatment on appetite and levels of leptin, ghrelin, adiponectin, and brain-derived neurotrophic factor in children and adolescents with attention deficit and hyperactivity disorder.

OBJECTIVES: We aimed to explore whether the use of methylphenidate relates leptin, ghrelin, adiponectin, and brain-derived neurotrophic factor (BDNF). In addition, the relationship between methylphenidate-related weight loss in attention deficit hyperactivity disorder (ADHD) patients and these biomolecules were evaluated. METHODS: Thirty ADHD patients receiving methylphenidate and 20 healthy controls were included. Leptin, ghrelin, adiponectin, and BDNF levels were measured at baseline and after two-month treatment in both groups. RESULTS: At baseline, leptin, ghrelin, adiponectin, and BDNF levels were similar in the ADHD and control groups. The most common adverse events occurring in the ADHD group after a 2-month treatment period included loss of appetite (70%) and weight loss (66.7%). A significant difference was found in body weight, BMI, and CGI scores of the ADHD patients after the treatment. While post-treatment ghrelin and adiponectin levels were significantly higher in the ADHD group, BDNF level was significantly lower. Post-treatment decrease in leptin levels was not significant. CONCLUSIONS: Leptin and BDNF were not associated with poor appetite and/or weight loss due to methylphenidate treatment. However, ghrelin and adiponectin might be biomolecules that play a role in underlying neurobiological mechanisms of methylphenidate-related appetite or weight loss.

Self-esteem and psychiatric features of Turkish adolescents with psychogenic non-epileptic seizures: a comparative study with epilepsy and healthy control groups.

OBJECTIVE: Children and adolescents with psychogenic non-epileptic seizures (PNES) and epilepsy are known to have psychosocial problems. The aim of the present study was to compare the psychosocial difficulties, history of stressful life events/abuse, psychiatric diagnosis, and self-esteem of adolescents with PNES to the ones with epilepsy and healthy controls at a tertiary care center in Turkey. METHOD: Thirty-four adolescents with PNES diagnosed by video-EEG were compared with 23 adolescents that have epilepsy and 35 healthy volunteers. Comorbid psychiatric diagnoses of participants were examined by semi-structured interviews using Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (KSADS-PL). Self-esteem of adolescents was evaluated by Rosenberg Self Esteem Scale (RSES). RESULTS: No differences in sociodemographic features were observed between the groups. The PNES group showed significantly higher rates of parental conflicts, difficulties in relationship with siblings/peers, school under-achievement, and history of stressful events/abuse. The rates of comorbid psychiatric disorders were 64.7% in PNES and 47.8% in epilepsy group. The most common disorders in both groups were attention deficit hyperactivity disorder (ADHD) and depressive disorder. The rate of posttraumatic stress disorder (PTSD) was significantly increased in the PNES group. Additionally, adolescents with PNES displayed significantly lower levels of self-esteem than the other groups. CONCLUSION: It could be concluded that both disorders involved a high risk for developing psychiatric disorders; additionally, adolescents with PNES have higher rates of stressors and lower levels of self-esteem. Findings from this investigation point to the importance of psychiatric interventions in pediatric PNES and also epilepsy.

Prognostic role of echocardiographic and hematologic parameters in heart failure patients complicated with incidental pleural effusion diagnosed during echocardiographic evaluation.

We aimed to determine long-term prognostic role of echocardiographic and hematologic parameters in heart failure patients complicated with incidental pleural effusion (PE) diagnosed during echocardiographic evaluation. The study was performed by evaluating patient records in which PE was incidentally detected during echocardiographic examination in a tertiary teaching hospital between Jan 2002 and Dec 2012. Total 151 patients with heart failure complicated with PE were analyzed. All patients' mortality data were collected from registry center of Social Insurance Institution which is officially responsible for recording all mortality data in Turkey. Detailed echocardiographic and hematologic parameters including creatinine, uric acid, albumin, sodium, potassium, hemoglobin at the time of hospital admission were analyzed. Data from 151 eligible patients were analyzed. We compared patients who died (n = 51) during follow-up with the survivors (n = 100) in terms of patients' echocardiographic and hematological features. Mean duration of follow-up was 71.5 ± 45.6 months. Fifty-one patients (33.8 %) died during this follow-up period. From all echocardiographic parameters only dilated left atrium (LA) diameter was found to be associated with a poor prognosis (p = 0.034). Low albumin, sodium and hemoglobin levels were associated with poor prognosis (p < 0.001, p = 0.002 and p = 0.007, respectively). We showed that dilated LA, as well as low albumin, low sodium and low hemoglobin levels had a worse prognostic significance than patients with normal LA size, within normal limits of albumin, sodium and hemoglobin levels in patients with heart failure complicated with PE determined incidentally by echocardiography.