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Gurkas E.,Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital | Serdaroglu A.,Gazi University | Hirfanoglu T.,Gazi University | Kartal A.,Gazi University | And 2 more authors.
European Journal of Paediatric Neurology

Background Epilepsy is one of the most common chronic neurologic disorders. Daily periodicity of epileptic seizures has been known for over a century. The diurnal patterns of epileptic seizures have also been observed in studies. Aim To investigate the sleep/wake cycle, day/night, and 24-h periodicity of various seizure subtypes and seizure onset localizations in children. Methods We analyzed the clinical seizures of 170 consecutive epilepsy patients who underwent video-electroencephalography (EEG) monitoring over the last 5 years. Semiology of the seizures was classified according to the semiological seizure classification. Origin of the seizures was defined by the onset of ictal activity on EEG. Seizures were evaluated in terms of occurrence during the day (06:00-18:00 h) or night (18:00-06:00 h), in wakefulness or in sleep, and within a 3-h time interval throughout 24 h. Results A total of 909 seizures were analyzed. Auras, dialeptic, myoclonic, hypomotor, atonic seizures, and epileptic spasms occurred more frequently in wakefulness; tonic, clonic, and hypermotor seizures occurred more frequently in sleep. Auras, dialeptic, and atonic seizures and epileptic spasms occurred more often during daytime; hypermotor seizures occurred more often at night. Generalized seizures were seen most frequently in wakefulness (between 12:00 and 18:00 h); frontal lobe seizures were seen at night and in sleep (between 24:00 and 03:00 h); temporal lobe seizures were seen in wakefulness (between 06:00 and 09:00 h and between 12:00 and 15:00 h); occipital seizures were seen during daytime and in wakefulness (between 09:00 and 12:00 h and between 15:00 and 18:00 h, respectively); parietal seizures were seen mostly during daytime. Conclusions Seizures in children occur in specific circadian patterns and in specific sleep/wake distributions depending on seizure onset location and semiology. © 2016 European Paediatric Neurology Society. Source

Ipek H.,Bakirkoy Training and Research Hospital for Psychiatry | Mutlu C.,Bakirkoy Training and Research Hospital for Psychiatry | Sonmez H.E.,Istanbul University | Uneri O.S.,Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital
Dusunen Adam

Psychotic symptoms may present in many neurological and general medical conditions in which, diagnosing is sometimes difficult. We reported a 16-year-old female presenting acute psychotic symptoms and diagnosed with Anti-N-Methyl-D-Aspartate Receptor (Anti-NMDAR) encephalitis. In this case report, main characteristics of anti-NMDAR encephalitis were highlighted and reviewed. Clinicians, especially psychiatrists, should consider a differential diagnosis of anti-NMDAR encephalitis in young, female patients with acute onset of psychotic symptoms, disorganized behaviors, decreased level of consciousness and new onset seizures, and remember that laboratory and imaging tests can be negative for a period of time. Source

Bozkurt A.,Near East University | Bozkurt O.H.,Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital | Bozkurt O.H.,Near East University | Sonmez I.,Near East University
Archives of Sexual Behavior

Western studies have consistently found that androphilic (sexually attracted to men) male-to-female transsexuals have a later birth order and a relative excess of brothers compared with appropriate control participants. However, non-Western studies on birth order and sibling sex ratio in androphilic males (transsexual or non-transsexual) are rare. The objective of the study was to test the hypothesis that androphilic male-to-female transsexuals have a late birth order and a relative excess of brothers in a non-Western culture with a higher fertility rate. The participants were 60 androphilic male-to-female transsexuals and 61 male heterosexual controls. The transsexual participants had significantly more older brothers than the control participants, but the groups did not differ in their numbers of older sisters, younger brothers, or younger sisters. The foregoing pattern is usually referred to as the “fraternal birth order effect.” Slater’s and Berglin’s Indexes both showed that the mean birth order of the control participants was very close to that expected from a random sample drawn from a demographically stable population whereas the mean birth order of the transsexual participants was later. A measure of sibship composition, brothers/all siblings, showed that the transsexual group had a higher proportion of male siblings compared with the control group. In conclusion, the present study found that Turkish androphilic male-to-female transsexuals show the same high fraternal birth order that has been found in comparable androphilic samples in Western Europe, North America, and the South Pacific, which suggests a common underlying biological causal mechanism. © 2014, Springer Science+Business Media New York. Source

Guney E.,Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital | Yalcin O.,Bakirkoy Research and Training Hospital for Psychiatry
International Journal of Human Genetics

Attention Deficit Hyperactivity Disorder (ADHD) is a disorder with a strong genetic background, and genetic factors are thought to play a crucial role in its aetiology and developmental course. In this study the researchers investigated the correlation of ADHD with the dopamine receptor D4 (DRD4) gene. Fifty patients (6-10 years of age) diagnosed between 1994 and 2001 and followed up 7-14 years until their adolescence and young adulthood (16-25 years of age) were included in the study. Fifty healthy individuals of the same age were included as the control group. DRD4 gene analysis of patients was performed after detailed clinical evaluation. The researchers found that 88% of patients continued to meet the criteria of ADHD in adolescence and young adulthood. The most frequent DRD4 gene alleles among the ADHD and control groups were 4-, 8-and 2-repeat alleles. While the frequency of the 8-repeat allele was higher than reported global estimations, none of the three alleles were found to be significant for ADHD. However, in the presence of the 2-repeat allele for the combined subtype of ADHD diagnosed in childhood, the persistence ratio was found to be statistically significant in adolescence and young adulthood. The DRD4 gene may play a role in the developmental course of ADHD in the Turkish population. © Kamla-Raj 2013. Source

Koksal T.,Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital | Akelma A.Z.,Kecioren Training and Research Hospital | Koksal A.O.,Kecioren Training and Research Hospital | Kutukoglu I.,Ankara University | And 5 more authors.
Journal of Microbiology, Immunology and Infection

Background/Purpose: Cost-effectiveness studies about rotavirus (RV) vaccination programs were performed in many countries due to the severe economic burden of RV infections. This study is an economic evaluation performed to assess the potential for introducing the RV vaccine to the Turkish National Immunization Program. Methods: In this retrospective clinical study, the records and laboratory findings of a total of 4126 patients admitted to Turgut Ozal University Hospital, Ankara, Turkey with acute gastroenteritis were analyzed. A model described by Parashar et al. was used to obtain the annual episodes of diarrhea, hospitalization and outpatients visits in Turkey. Monovalent and pentavalent vaccination was assumed to protect in average 85% of RV acute gastroenteritis. All costs are expressed in 2012 United States (US) $, where US$1 equals 1.8 Turkish Liras (TL). Losses of labor costs were not taken into consideration. Results: The vaccination program with 85% coverage was cost effective and cost saving compared to no vaccination. A projected birth cohort of 1.25 million children was followed until 5 years of age; a routine vaccination could potentially avert 210,994 cases of diarrhea treated in outpatient hospital facilities and 42,715 hospitalizations. The RV associated economic burden was obtained as US$17,909 million per year (US$14.33 per birth annually) in medical direct costs by using the national level of RV diarrhea disease burden estimates. For monovalent and pentavalent vaccination, assuming a cost of US$31.5 and US$38 per vaccine course, the cost of the vaccination program was estimated to be approximately US$37,878 million and US$45,475 million, respectively. Conclusion: At a cost per vaccine course of US$31.5 for monovalent and US$38 for pentavalent vaccine, routine RV vaccination could be potentially cost effective and also cost saving in Turkey. National RV vaccinations will play a significant role in preventing RV infections. © 2016. Source

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