ÖZET Amaç: Bu çalışmada DSM-5 tanı ölçütlerine göre yeniden düzenlenen Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi (6-18 Yaş) -Şimdi ve Yaşam Boyu Şekli-DSM-5 Kasım 2016-Türkçe Uyarlaması'nın (ÇDŞG-ŞY-DSM-5-T) geçerlik ve güvenirliğinin değerlendirilmesi amaçlanmıştır. Yöntem: Yaşları 6-17 arasındaki, 150 çocuk ve ergene ÇDŞG-ŞY-DSM-5-T uygulanmıştır. ÇDŞG-ŞY-DSM-5-T ile konulan tanıların geçerliği, klinik değerlendirme ile konulan DSM-5 tanıları (uyum geçerliği) ve o tanıyı değerlendiren ölçek puanları (eş zaman geçerliği) dikkate alınarak değerlendirilmiştir. Değerlendiriciler arası güvenirlik seçkisiz yöntemle belirlenen 20 katılımcıda incelenmiştir. Ayrıca aynı yöntemle seçilen 20 farklı katılımcıyla yapılan ilk değerlendirmeden üç hafta sonra ÇDŞG-ŞY-DSM-5-T uygulanarak test-tekrar test güvenirliği araştırılmıştır.Bulgular: ÇDŞG-ŞY-DSM-5-T ile yapılan görüşme ile konulan tanıların uyumunun yeme bozuklukları, seçici konuşmazlık ve otizm spektrumu bozuklukları açısından çok iyi (κ=0,92-1,0), dışa atım bozuklukları, obsesif kompulsif bozukluk, karşıt olma/karşı gelme bozukluğu, yaygın anksiyete bozukluğu, sosyal anksiyete bozukluğu, depresif bozukluklar, yıkıcı duygudurum düzensizliği bozukluğu ve dikkat eksikliği hiperaktivite bozukluğu açısından iyi (κ=0,67-0,80) düzeyde olduğu gözlenmiştir. Değerlendiriciler arası güvenirliğin seçici konuşmazlık için çok iyi (κ=1,0), karşıt olma/karşı gelme bozukluğu, yıkıcı duygudurum düzensizliği bozukluğu, dikkat eksikliği hiperaktivite bozukluğu ve depresif bozukluklar için iyi derecede (κ=0,63-0,73) olduğu; test-tekrar test güvenirliğinin de otizm spektrumu bozuklukları için çok iyi derecede (κ=0,82), dikkat eksikliği hiperaktivite bozukluğu, karşıt olma/karşı gelme bozukluğu, depresif bozukluklar ve yaygın anksiyete bozukluğu ve için iyi derecede (κ=0,62-0,78) olduğu görülmüştür.Sonuç: Bu çalışmanın sonuçları ÇDŞG-ŞY-DSM-5-T'nin görüşme çizelgesine yeni eklenen seçici konuşmazlık, yıkıcı duygudurum düzensizliği bozukluğu ve otizm spektrumu bozuklukları dâhil birçok tanı grubu için geçerli ve güvenilir veri sağladığını düşündürmüştür. Method:A total of 150 children and adolescents between 6 and 17 years of age were assessed with K-SADS-PL-DSM-5-T. The degree of agreement between the DSM-5 criteria diagnoses and the K-SADS-PL-DSM-5-T diagnoses were considered as the measure of consensus validity. In addition, concurrent validity was examined by analyzing the correlation between the diagnoses on K-SADS-PL-DSM-5-T and relevant scales. Interrater reliabilities were assessed on randomly selected 20 participants. Likewise, randomly selected 20 other participants were interviewed with K-SADS-PL-DSM-5-T three weeks after the first interview to evaluate test-retest reliability. Results:The consistency of diagnoses was almost perfect for eating disorders, selective mutism and autism spectrum disorder (κ=0.92-1.0), substantial for elimination disorders, obsessive-compulsive disorder, oppositional defiant disorder, generalized anxiety disorder, s...

To compare sugammadex and neostigmine regarding the efficacy in reversing rocuronium-induced neuromuscular block, the incidence of post-operative respiratory complications and costs in patients undergoing surgery for the treatment of obstructive sleep apnoea (OSA). Methods: After obtaining ethical approval and patient consent, 74 patients in ASA physical status I or II were randomised into two groups to receive 2-mg kg −1 sugammadex (Group S) or 0.04-mg kg −1 neostigmine+0.5-mg atropine (Group N). Groups were compared regarding time to TOF (train-of-four) 0.9, operating room time, post-anaesthesia care unit (PACU) stay, post-operative respiratory complications, costs related to neuromuscular block reversal, anaesthesia care and complication treatment. Results: Patient demographics, anaesthesia, surgical data and total rocuronium doses were similar between groups. Time to TOF 0.9 was shorter for group S [Group N: 8 (5-18) min; Group S: 2 (1.5-6) min (p<0.001)]. Operating room time [Group S: 72.4±14.3 min; Group N: 96.6±22.8 min (p<0.001)] and PACU stay [Group S: 22.9±10.1 dk; Group N: 36.3±12.6 dk (p<0.001)] were also shorter in Group S. After extubation, desaturation was observed in 12 (32.4%) patients in group N and in 4 (8%) patients in group S (p=0.048). In group N, three patients were reintubated; there were eight (21.6%) unplanned intensive care unit (ICU) admissions. There was one unplanned ICU admission in group S. Negative pressure pulmonary oedema was observed in one patient in group N. The results regarding costs were as follows. The reversal cost was higher in the sugammadex group (vial cost 98.14 TL) than that in the neostigmine group (ampoule cost 0.27 TL; total 6147.88 TL vs. 3569.5 TL); however, complication treatment cost and total cost were lower in group S than those in group N (199.5 TL vs. 3944.6 TL) (staff anaesthesia doctor cost was 0.392 TL per min and the cost of nurse anaesthetist was 0.244 TL per min). Conclusion: This study confirmed the efficacy of sugammadex over neostigmine for the reversal of rocuronium-induced neuromuscular block. Sugammadex decreases the incidence of post-operative respiratory complications and related costs in patients with OSA.

ObjectiveObjectiveaaWe evaluated the distribution of alpha-2A adrenergic receptor (ADRA2A) and catechol-o-methyltransferase (COMT) single nucleotide polymorphisms (SNPs) among ADHD subtypes and other homogeneous patient populations including treatment-resistant cases and patients with high symptom severity.MethodsMethodsaa121 ADHD patients aged 6–18 years were included in the study. Diagnosis and subtypes designation were confirmed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) and symptoms were evaluated using the Conners' Parent (CPRS) and Teacher Rating Scales (CTRS). The response to methylphenidate was assessed objectively using the Clinical Global Impression-Severity Scale (CGI-S) and Global Assessment of Functioning Scale (GAS) as well as the Continuous Performance (CPT) and Trail Making tests (TMT-A, B). Patients were genotyped for ADRA2A (rs1800544) and COMT (rs4680) SNPs by PCR/RFLP and compared to a gender-matched control group.ResultsAlthough there was no association of COMT (rs4680) SNP with symptoms or diagnosis, the ADRA2A polymorphism, low socioeconomic status (SES), and comorbid psychiatric diagnosis were all associated with poor response to methylphenidate in logistic regression analysis.ConclusionClinicians may consider adjuvant strategies when these negative factors are present to increase the success of tailored ADHD treatments in the future.

Objectives. The total antioxidant capacity (TAC) of a sample can be measured with a ferric reducing antioxidant power (FRAP) assay. There are commercially available kits for FRAP assays, however they are more expensive than in-house kits. We aimed to evaluate a FRAP direct measurement method under our laboratory conditions using a microplate reader and establish reference values to use in future research projects. Methods. An inhouse microplate adaptation of the FRAP method was evaluated. Reference values of FRAP were established for one hundred and twenty subjects aged between 25-55 years. FRAP levels were estimated in 30 serum samples with high glucose concentration, 44 hyperbiluribinemic neonatals and 16 patients receiving renal replacement therapy (RRT). Results. The mean FRAP level was 890±235 µmol/L. The median TAC level was 904 µmol/L. This method was found to be linear up to at least 2000 µmol/L. The intra-and inter-assay coefficients of variation were 2.7-6.7% and 5.3-10.1%, respectively. The mean FRAP level was lower than normal in diabetes and RRT patients and higher in hyperbiluribinemic neonatals (687±209 µmol/L, 609±250 µmol/L and 945±187 µmol/L, respectively). Conclusions. Our reference values give comparable results with the literature. This method is simple, reliable, and inexpensive. It could be used for studies of oxidative stressrelated diseases.Eur Res J 2016;2(2):126-131

The repair of hypospadias is among the most difficult problems in urology, as it demands the construction of a well-functioning urethra and a good cosmetic appearance. We performed a retrospective analysis of 422 cases subjected to one-stage anterior hypospadias repair between 1982 and 1999 in our clinic and investigated the effects of factors like degree of hypospadias, surgical technique, and the surgeon's experience on outcome. The operations used were MAGPI (91), urethral advancement (10), Mathieu (260), modified Allen-Spence (50), onlay island flap (5), and double-faced island flap (6) procedures. The early complication rate was 18%, while the final success rate following secondary interventions was 95%. The complications included fistula formation in 49 cases (12%), flap necrosis in 12 (3%), meatal problems in 12 (3%), residual chordee in 4 (1%), and urethral stricture in 1 (<1%). Complication rates were significantly higher if the meatus was proximal or there was severe chordee and in the first 6 years of the study. The flap procedures were associated with a higher complication rate. It is concluded that one-stage procedures are successful in the repair of anterior hypospadias in experienced hands with proper patient selection.

Clinicians should be aware of the psychiatric comorbidities when treating adolescents with acne vulgaris. Especially, low self-esteem and life quality impairment should warn clinicians to predict high social anxiety levels in adolescent acne patients.

OBJECTIVE: In this study, we evaluated vitamin B12 and iron parameters in Turkish children with ADHD in order to examine the relationship between ADHD symptoms and these parameters. METHODS: Drug-naive 100 ADHD patients, aged between 6 and 12 years old, were included in the study. None of them had acute or chronic diseases. All patients were assessed by using the Schedule for Affective Disorders and Schizophrenia for School Age Children -Present and Lifetime Version (K-SADS-PL). Conners Parent Rating Scale (CPRS) was used for screening ADHD symptoms and symptom severity. Blood samples were evaluated for ferritin, haemoglobin, MCV, RDW, and vitamin B12 parameters. RESULTS: We indicated an inverse relationship between haemoglobin levels and learning, anxiety subscale scores of CPRS. Also, vitamin B12 and psychosomatic subscale scores were found negatively related whereas the relationship was in the opposite direction for ferritin. Vitamin B12 level was negatively correlated with learning problems and psychosomatic subscales of CTRS in the combined subtype of ADHD. CONCLUSION: Vitamin B12 and iron support may be useful in treatment of childhood ADHD, especially for learning problems, besides medication. ARTICLE HISTORY

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