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Öğe Accompanying Infections in Hospitalized Children with Neurological Disease(Galenos Publ House, 2022) Cokyaman, Turgay; Kasap, Tolga; Celik, TaylanIntroduction: Infections in children with neurological disease often require hospitalization and are treated with antibiotics. In this study, it was aimed to determine the accompanying infections, antibiotics used and pathogenic microorganisms grown in cultures in hospitalized children with neurological disease. Materials and Methods: Digital medical files of patients between one month and 18 years old admitted to the pediatric neurology service were retrospectively analyzed. Diagnoses of neurological and infectious disease, antibiotics and antiepileptics used, and culture antibiogram results were recorded. Results: The most common infectious disease in children with neurological disease was lower respiratory tract infections (50%). Antibiotic use rate in children with neurological diseases was 51.9% (32.4% single and 19.4% combined). Lower respiratory tract infections (50%) were the leading antibiotic indications. Third generation cephalosporins (46%) were the most used in mono antibiotherapy, carbapenems (26.6%), gylicopeptides (26.6%) and broad-spectrum penicillins (10%) were used at higher rates in combined antibiotherapy. Pathogenic microorganisms such as Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Morganella morganii and Enterococcus raffinosus were grown in urine cultures, Staphylococcus aureus and Enterococcus faecium in blood cultures. 59.3% of the children with neurological diseases were receiving antiepileptic treatment. Valproic acid 24.6%, levetiracetam 20.0%, phenobarbital and carbamazepine were used at 10.8% frequency. Conclusion: The most common infectious disease in hospitalized children with neurological disease is lower respiratory tract infections. Although cephalosporin is mostly preferred in mono-antibiotherapy, carbapenem and glycopeptides come to the fore in combined therapy. It is important to know the infections that may develop in the follow-up of this group of patients and the possible causative pathogens for rapid and effective treatment and to reduce health costs.Öğe Adolesanlarda internet bağımlılık ve riskini etkileyen faktörler ile prososyal davranışlar arasındaki ilişkinin değerlendirilmesi(Çanakkale Onsekiz Mart Üniversitesi, 2021) Kasap, Tolga; Kaymaz, NazanAmaç: Adolesan yaş grubundaki çocukların internet bağımlılık ve riskini etkileyen faktörleri incelemek ve internet bağımlılığı ile prososyal davranışlar arasında anlamlı bir ilişki olup olmadığını saptamaktır. Yöntem: Araştırma 1 Temmuz 2019 – 1 Mart 2020 tarihleri arasında Çanakkale Onsekiz Mart Üniversitesi Sağlık Uygulama ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları Adolesan İzlem Polikliniği'ne başvuran, kronik hastalığı olmayan 10-18 yaş aralığındaki çocuklar ile yapılmıştır. Veriler sosyodemografik veri formu, Young İnternet Bağımlılığı Ölçeği Kısa Formu (YİBO-KF), Çocuk Prososyallik Ölçeği (ÇPÖ) kullanılarak toplanmıştır. Bulgular: Tarihler arasında polikliniğe başvuran 2503 adolesandan kriterlere uyan ve çalışmaya katılmayı kabul eden 488 kişi çalışmanın evrenini oluşturdu. Çalışmaya katılanların %59.8'i (n=292) kız, %40.2'si (n=196) erkekti. Katılımcıların ortalama yaşları 13,7±2,2, %19,9'u (n=97) tek çocuk, %62.3'ünün (n=304) okul başarısı iyi, %88.1'i (n=430) il/ilçe merkezinde yaşamaktaydı. Çalışmaya katılan çocukların %24'ü (n=117) kilolu ve aşırı kilolu (obez) sınıfına girmektedir. Çocukların internet kullanıcısı oldukları süre ortalama 4,2±2,5 yıl olarak saptandı. Çocukların %79,9'unun (n=390) kendine ait telefonu olduğu ve bu çocukların % 96,1'inin (n=375) telefonlarından internete girdiği, ortalama internet kullanım sürelerinin günde 2,8±1,9 saat olduğu saptandı. Katılımcıların annelerin günlük internet kullanım süresi 2,3±1,2 saat ve babaların günlük internet kullanım süresi 2,5±1,3 saat olarak saptandı. ÇPÖ okul başarısı iyi olanlarda daha yüksek ve çocuğun günlük internet kullanım süresi ile negatif yönlü zayıf düzeyde korele olduğu saptandı ve bu fark istatiksel olarak anlamlıydı. ÇPÖ ile YİBÖ-KF arasında negatif yönlü zayıf düzeyde korelasyon saptandı ve bu fark istatiksel olarak anlamlıydı. YİBÖ-KF, erkeklerde, obezitesi olanlarda, orta adolesan yaş grubunda, okul başarısı orta seviyede olanlarda ve kendine ait telefonu olanlarda daha yüksek saptandı ve bu fark istatiksel olarak anlamlıydı. YİBÖ-KF, çocuğun internet kullanıcısı olduğu süre, ebeveynlerin günlük internet kullanım süresi ve çocuğun günlük sanal oyun oynama süresi ile pozitif yönlü zayıf düzeyde korele, çocuğun günlük internet kullanım süresi ile pozitif yönlü orta düzeyde korele olduğu görüldü ve bu fark istatiksel olarak anlamlıydı. Yapılan çoklu regresyon analizinde YİBÖ-KF puan ortalamasını en çok etkileyen parametrenin çocuğun günlük internet kullanım süresi olduğu, ÇPÖ puan ortalamasını ise okul başarı düzeyi olduğu saptandı. Sonuç: Her geçen gün daha çok kişinin hayatına giren internetin insanlara sunduğu imkânlarla günümüzün vazgeçilmez iletişim araçlarından olması beraberinde bağımlılık sorunu ortaya çıkarmaktadır. İnternet bağımlılığının yarattığı etkiler nedeniyle önem gerektiren bir halk sağlığı sorunu olduğu göz önüne alınarak bu durumu önlemek için etkili önlemler gerekmektedir. Anahtar kelimeler: İnternet bağımlılığı, adolesan, prososyal davranış, çocukÖğe Are Mental Health Problems and Mindfulness Awareness Related to Levothyroxine Replacement in Adolescent Patients With Hashimoto's Thyroiditis?(SAGE Publications Inc., 2023) Uzun, Mehmet Erdem; Kaymaz, Nazan; Kara, Özlem; Kasap, TolgaConsidering the possible adverse effects of thyroid autoantibodies on the brain, the present study aimed to investigate whether there was a difference in mental health difficulties and mindfulness awareness levels between subclinical Hashimoto’s thyroiditis patients with and without levothyroxine (LT4) use. A case-control study was conducted. The Strengths and Difficulties Questionnaire (SDQ) and the Mindful Attention Awareness Scale (MAAS) were used to screen mental health difficulties and mindfulness awareness. Scale scores were compared by performing correlation analysis between the groups with respect to LT4 use and thyroid autoantibodies. Levothyroxine alone does not affect scale results. Higher thyroid peroxidase antibody (TPOAb) titers were positively correlated with the behavioral problems subscale of the SDQ, while awareness level in patients was inversely correlated with higher thyroglobulin antibody (TgAb) levels.Öğe Contribution of Neutrophil/Lymphocyte Ratio, RDW, RPR, MPV and MPR Indexes to Febrile Seizure Diagnosis(Bursa Uludag Univ, 2020) Cokyaman, Turgay; Kasap, TolgaINTRODUCTION: In this study, it was aimed to investigate in detail the contribution of hemogram indices such as neutrophil/lymphocyteratio (NLR), red blood cell distribution width (RDW), RPR, MPR, mean platelet volume (MPV), and platelet count (PLT) to the diagnosis of febrile seizure (FS). MATERIALS and METHODS: 91 FS, 116 febrile disease and 100 healthy control cases were included in the study. Significant hemogram indices in favor of FS were determined as a result of double and triple group comparisons with appropriate statistical analyzes, and diagnostic cut-off values, sensitivity and specificity were calculated for FS diagnosis according to receiever operating characteristic (ROC) curve analysis. RESULTS: NLR index was significantly higher in the FS group. The median was 2.6 in the FS group, 1.6 and 0.7 in the febrile disease and healthy control groups, respectively (p<0.001). In the ROC curve analysis, the cut-off values, sensitivity and specificities of the NLR index for FS diagnosis were determined. The 1/ RPR index was found to be statistically significantly lower in FS group. It was found to be 20.5 in the FS group, 23.3 and 23.2 in the febrile disease and healthy control groups, respectively (p=0.003). Similar to the NLR, cut-off values, sensitivity and specificities were calculated for FS diagnosis in the ROC curve analysis within the 1/RPR index. CONCLUSIONS: NLR and 1/RPR indexes are cheap and easily accessible hemogram parameters that can contribute to the diagnosis of FS. They can be used simply by practitioners and pediatricians in emergency rooms and out patient clinicsÖğe Contribution of neutrophil/lymphocyte ratio, RDW, RPR, MPV and MPR indexes to febrile seizure diagnosis(Galenos, 2020) Çokyaman, Turgay; Kasap, TolgaINTRODUCTION: In this study, it was aimed to investigate in detail the contribution of hemogram indices such as neutrophil/lymphocyteratio (NLR), red blood cell distribution width (RDW), RPR, MPR, mean platelet volume (MPV), and platelet count (PLT) to the diagnosis of febrile seizure (FS). MATERIALS and METHODS: 91 FS, 116 febrile disease and 100 healthy control cases were included in the study. Significant hemogram indices in favor of FS were determined as a result of double and triple group comparisons with appropriate statistical analyzes, and diagnostic cut-off values, sensitivity and specificity were calculated for FS diagnosis according to receiever operating characteristic (ROC) curve analysis. RESULTS: NLR index was significantly higher in the FS group. The median was 2.6 in the FS group, 1.6 and 0.7 in the febrile disease and healthy control groups, respectively (p<0.001). In the ROC curve analysis, thecut-off values, sensitivity and specificities of the NLR index for FS diagnosis were determined. The 1/RPR index was found to be statistically significantly lower in FS group. It was found to be 20.5 in the FS group, 23.3 and 23.2 in the febrile disease and healthy control groups, respectively (p=0.003). Similar to the NLR, cut-off values, sensitivity and specificities were calculated for FS diagnosis in the ROC curve analysis within the 1/RPR index. CONCLUSIONS: NLR and 1/RPR indexes are cheap and easily accessible hemogram parameters that can contribute to the diagnosis of FS. They can be used simply by practitioners and pediatricians in emergency rooms and out patient clinics. © 2020, Galenos. All rights reserved.Öğe Evaluation of Hemogram Indices of Children with Epilepsy Receiving Short-Term Levetiracetam Treatment(2022) Çokyaman, Turgay; Kasap, TolgaObjective: The effects of levetiracetam on hemogram parameters are comparable with other antiepileptics. This study aimed to compare the effects of levetiracetam monotherapy for at least 6 months on hemogram indices with valproic acid. Methods: Cases aged 6-18 years who received levetiracetam (n = 42) or valproic acid (n = 46) monotherapy for at least 6 months were randomly selected. The hemogram data closest to the study cutoff point of those who completed a minimum of 6 months of monotherapy were recorded. White blood cell count, neutrophil count, lymphocyte count, red blood cell distribution width, platelet, mean platelet volume, neutrophil/lymphocyte ratio, red cell distribution width to platelet ratio, mean platelet volume to platelet ratio, platelet to lymphocyte ratio, and lymphopenic case rates were compared between levetiracetam and valproic acid groups. Results: The number of lymphopenic cases (absolute lymphocyte < 1500/mm3 ) was higher in the levetiracetam group (n = 8) compared to the valproic acid group (n = 3) (log-rank analysis, P = .002). The lymphocyte count was found to be lower in the levetiracetam group compared to the valproic acid group (mean 2274 ± 964 vs. 2523 ± 653, P = .153). The neutrophil/lymphocyte ratio (mean 2.4 ± 2.3 vs. 1.6 ± 1.3, P = .042) and platelet to lymphocyte ratio indices (mean 141 ± 63 vs. 105 ± 40, P = .002) associated with lymphocyte count were significantly higher in the levetiracetam group. Conclusion: Levetiracetam has more lymphopenia side effects than valproic acid. Viral, fungal, and opportunistic infections that develop during levetiracetam treatment may be due to lymphopenia. In cases deemed necessary, absolute lymphocyte count, lymphocyte subgroup analysis, and serum immunoglobulin levels should be reviewed.Öğe Evaluation of Hemogram Indices of Children with Epilepsy Receiving Short-Term Levetiracetam Treatment(Aves, 2022) Cokyaman, Turgay; Kasap, TolgaObjective: The effects of levetiracetam on hemogram parameters are comparable with other antiepileptics. This study aimed to compare the effects of levetirace-tam monotherapy for at least 6 months on hemogram indices with valproic acid. Methods: Cases aged 6-18 years who received levetiracetam (n = 42) or valproic acid (n = 46) monotherapy for at least 6 months were randomly selected. The hemogram data closest to the study cutoff point of those who completed a minimum of 6 months of monotherapy were recorded. White blood cell count, neutrophil count, lymphocyte count, red blood cell distribution width, platelet, mean platelet volume, neutr ophil /lymp hocyt e ratio, red cell distribution width to platelet ratio, mean platelet volume to platelet ratio, platelet to lymphocyte ratio, and lymphopenic case rates were compared between levetiracetam and valproic acid groups. Results: The number of lymphopenic cases (absolute lymphocyte < 1500/mm3) was higher in the levetiracetam group (n = 8) compared to the valproic acid group (n = 3) (log-rank analysis, P = .002). The lymphocyte count was found to be lower in the levetiracetam group compared to the valproic acid group (mean 2274 +/- 964 vs. 2523 +/- 653, P = .153). The neutr ophil /lymp hocyt e ratio (mean 2.4 +/- 2.3 vs. 1.6 +/- 1.3, P = .042) and platelet to lymphocyte ratio indices (mean 141 +/- 63 vs. 105 +/- 40, P = .002) associated with lymphocyte count were significantly higher in the levetiracetam group. Conclusion: Levetiracetam has more lymphopenia side effects than valproic acid. Viral, fungal, and opportunistic infections that develop during levetiracetam treatment may be due to lymphopenia. In cases deemed necessary, absolute lymphocyte count, lymphocyte subgroup analysis, and serum immunoglobulin levels should be reviewed.Öğe Evaluation of the Relationship Between Adolescents’ Internet Addiction Risks and Prosocial Behaviors(Galenos Publishing House, 2023) Kasap, Tolga; Kaymaz, Nazan; Aylanç, Hakan; Battal, FatihIntroduction: Prosocial behavior is defined as behavior that is done voluntarily, aiming to benefit another person or group. Prosocial behavior appears in preschool, around age two, and increases in frequency and variety throughout life. While the internet can provide many positive prospects, exposure to negative behaviors on the internet may cause an individual to normalize them over time, which eventually could cause humans to lose certain senses. As a fast-growing addictive behavior, internet addiction (IA) can lead to poor social communication, loneliness, depression, etc. However, it should be remembered that many positive behaviors may be learned through the internet. The present study aimed to evaluate the relationship between IA and prosocial behavior in adolescents. Materials and Methods: A cross-sectional study was conducted with healthy adolescents aged 10 to 18. The participants were asked to answer a questionnaire including socio-demographic information and two scales; i) Young’s Internet Addiction Scale-Short Form (YIAS-SF); for evaluating IA, ii) Child Prosociality Scale (CPS); for evaluating the tendency to engage in prosocial behaviors. The scale scores were compared with each other through the socio-demographic features of the participants. Results: The study sample consisted of 488 adolescents (292 females, 196 males) with a mean age of 13.75. The parameter that affected the YIAS-SF score most was found to be the adolescent’s duration of daily internet use (p<0.01 and ?=0.396), and it was determined that the parameter that affected the CPS score the most was school success (?=-0.166, p<0.001). A negative correlation was found between CPS and YIAS-SF (p=0,001, r=-0,269). Furthermore, there was a negative correlation between the adolescent’s CPS score and the mother’s daily internet use duration in comparison to the adolescent’s and the father’s (p=0.344 and r=-0.043). Conclusion: Since there is an inverse relationship between the risk of IA and prosocial behaviors, prosocial behaviors should be motivated in adolescents at high risk of IA. To promote prosocial behaviors in adolescents, mothers should be informed that the duration of their own daily internet time has a more significant effect on the adolescent’s prosocial behavior than the adolescent’s daily internet use time. ©Copyright 2023 by Bursa Uludağ University, Department of Pediatrics.Öğe Hemogram Parameters Cannot Distinguish Pediatric COVID-19 from Other Respiratory Infections(2024) Çelik, Taylan; Kasap, Tolga; Çakan, Beyza; Kılıç, Nimet AydemirTo fight against the pandemic, which has become the most significant public health problem of modern times, the isolation of patients and early detection of the coronavirus disease-2019 (COVID-19) disease are crucial. This study aimed to show the diagnostic predictor of hemogram parameters and the rates obtained from these parameters in differentiating COVID-19 from other respiratory tract diseases. Data of patients aged between 1 month and 18 years who were admitted to the 3 rd and 2nd level pediatric emergency with the pre-diagnosis of “COVID-19-like disease” between 12 January 2022 and July 12, 2022, which is one month after the Omicron (Nu) variant was accepted as an established variant in Türkiye, were retrospectively reviewed. A total of 724 children with pre-diagnosis of COVID-19-like disease whose complete blood count and severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) polymerase chain reaction (PCR) test from oropharynx/nasopharyngeal swab samples were included in the study. Two hundred children were positive for SARS-CoV-2 PCR (27.6%). Total leukocytes, neutrophils, lymphocytes, monocytes, eosinophils, platelets, platelet distribution width, platelet crit counts, and neutrophil/lymphocyte ratio were lower, and hemoglobin values were higher in the COVID-19 group than in the other group. These differences were statistically significant (p<0.05). When these parameters were evaluated by receiver operating characteristic analysis, the area under the curve values of the other parameters, except the eosinophil count, were statistically significant. However, when the obtained possibility ratios were examined, significant cut-off values could not be obtained regarding diagnostic predictiveness. It was found that using complete blood count parameters in the diagnostic process is not helpful in differentiating SARS-CoV-2 from other respiratory tract diseases. It is essential to conduct studies with larger sample sizes to understand whether complete blood count parameters can predict the diagnosis of COVID-19.Öğe Serum brain-derived neurotrophic factor in the diagnosis of febrile seizure(John Wiley and Sons Inc, 2021) Çokyaman, Turgay; Kasap, Tolga; Şehitoğlu, HilalBackground Brain-derived neurotrophic factor (BDNF) is a noncovalently linked homodimer protein from the neurotrophic growth factor family. Although it is expressed throughout the brain, it is produced more intensively in the entorhinal cortex and hippocampus and can cross the blood-brain barrier in two directions easily. The aim of this study is to understand, for the first time, whether there is a relationship between febrile seizure (FS) and BDNF. Methods The study included cases diagnosed with FS and febrile illness, of similar age, weight, and height, between 6 months and 6 years. Samples for serum BDNF measurement were taken within the first 24-48 h of admission at the hospital and levels were measured using the commercial enzyme-linked immunosorbent assay kit and expressed in ng/mL. Results Eighty cases (40 FS, 40 febrile illness) were included in the study. The mean serum BDNF was found to be 6.7 +/- 2.4 ng/mL in the FS group and 4.5 +/- 2.6 ng/mL in the febrile illness group (P = 0.001). No relation was found between gender, age, body weight, length, and platelet counts and serum BDNF levels. The optimal cut-off value for serum BDNF was found to be 5.2 ng/mL (75% sensitivity, 62.5% specificity, AUC: 0.723) to distinguish between FS and febrile illness. Conclusions Excluding demographic variables such as gender, age, weight, length, and platelet counts serum BDNF levels have increased in children with FS. Considering the hippocampal origin of FS, we can suggest that the pathophysiology of FS may be related to the BDNF.
