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Ozyurt G.,Behcet Uz Childrens Hospital | inal Emiroglu N.,Dokuz Eylul University | Baykara B.,Dokuz Eylul University
Anadolu Psikiyatri Dergisi | Year: 2015

The usage of antipsychotics in children and adolescents increase in the general of the world and it was reported that 90% of these antipsychotics were atypical antipsychotic by researchers. Clozapine is considered to be the prototype of the atypical antipsychotics, as it was the first to be recognized as having less extrapyramidal side effects, not causing tardive dyskinesia, and not elevating prolactin. Clozapine is not a first choice antıpsychotic but it can be used when other antipsychotics cannot be effective. Atypical antipsychotics, also clozapine, alter ability of body to regulate response to changes in temperature and humidity, patients may become hypothermic or hyper-thermic; more likely in temperature changes due to inhibition of the hypothalamic control area. Transient tempe-rature alteration can occur with clozapine in up to 50% of patients, usually within the first three weeks of treatment. In this article we present a 17 years old male adolescent with early onset schizophrenia. Although three different atypical antipsychotics were used and there was no treatment response in that case. After clozapine was administered, transient thermoregulation alteration was seen at the beginning of the treatment. © 2015, Cukurova University, Faculty of Medicine. All rights reserved. Source

Kepenekli E.,Marmara University | Soysal A.,Marmara University | Yalindag-Ozturk N.,Marmara University | Ozgur O.,Diyarbakir Childrens Hospital | And 4 more authors.
Japanese Journal of Infectious Diseases | Year: 2015

Health care-associated infections (HCAIs) cause considerable morbidity and mortality in pediatric intensive care units (PICUs). The objective of this point prevalence study was to assess the burden of HCAIs in PICUs in Turkey. Fifty PICUs participated in this study. Data regarding demographics, microbiological findings, therapeutic interventions, and outcomes were collected for all PICU inpatients. A total of 327 patients participated in the study: 122 (37%) experienced 1 or more HCAI. The most frequently reported site of infection was lower respiratory tract (n=77, 63%). The most frequently isolated pathogens were Pseudomonas aeruginosa, Acinetobacter species, and Candida species. Two hundred and forty-seven patients (75%) were receiving antimicrobial therapy at the time of the survey, and the most frequently administered antimicrobials were third generation cephalosporins. Hospital type, male, PICU stay > 7 days, and mechanical ventilation were found to be independent risk factors for HCAIs. At the 4-week follow up, 43 (13%) patients had died, 28 (65%) of whom died of HCAIs. Endotracheal intubation, urinary catheter, male, and HCAIs were independent risk factors for mortality. This national, multicenter study documented a high prevalence of HCAIs in Turkey. In light of the ‘primum non nocere’ principle, the prevention of these infections should be a priority of public health policy. © 2015, National Institute of Health. All rights reserved. Source

Inal-Emiroglu F.N.,Dokuz Eylul University | Karabay N.,Dokuz Eylul University | Guleryuz H.,Behcet Uz Childrens Hospital | Baykara B.,Dokuz Eylul University | And 2 more authors.
Neuropsychobiology | Year: 2015

Objectives: The aim of the present study was to assess differences and correlations between the hippocampal volumes (HCVs), serum nerve growth factor (NGF), and brain-derived neurotrophic factor (BDNF) levels in adolescents with bipolar disorder (BP) compared to healthy controls. Methods: Using structural magnetic resonance imaging, we compared HCVs of 30 patients with euthymic BP who were already enrolled in a naturalistic clinical follow-up. For comparison, we enrolled 23 healthy controls between the ages of 13 and 19. The boundaries of the hippocampus were outlined manually. The BDNF and NGF serum levels were measured with the sandwich ELISA. Results: The groups did not differ in the right or left HCVs or in the NGF or BDNF serum levels. However, negative correlations were found between the right HCVs and the duration of the disorder and medication and positive correlations were found between the duration of the medications and the NGF and BDNF levels in the patient group. Additionally, positive correlations were found between the follow-up period and left normalized HCVs in both the BP and lithium-treated groups. Conclusions: The right HCVs may vary with illness duration and the medication used to treat BP; NGF and BDNF levels may be affected by long-term usage. Further research is needed to determine whether these variables and their structural correlates are associated with clinical or functional differences between adolescents with BP and healthy controls. © 2015 S. Karger AG, Basel. Source

Celik O.,Private Clinic | Aydin S.,Firat University | Celik N.,Behcet Uz Childrens Hospital | Yilmaz M.,Firat University
Peptides | Year: 2015

Mammalian reproduction is a costly process in terms of energy consumption. The critical information regarding metabolic status is signaled to the hypothalamus mainly through peripheral peptides from the adipose tissue and gastrointestinal tract. Changes in energy stores produce fluctuations in leptin, insulin, ghrelin and glucose signals that feedback mainly to the hypothalamus to regulate metabolism and fertility. In near future, possible effects of the nutritional status on GnRH regulation can be evaluated by measuring serum or tissue levels of leptin and ghrelin in patiens suffering from infertility. The fact that leptin and ghrelin are antagonistic in their effects on GnRH neurons, their respective agonistic and antagonistic roles make them ideal candidates to use instead of GnRH agonist and antagonist. Similarly, kisspeptin expressing neurons are likely to mediate the well-established link between energy balance and reproductive functions. Exogenous kisspeptin can be used for physiological ovarian hyperstimulation for in-vitro fertilization. Moreover, kisspeptin antagonist therapy can be used for the treatment of postmenapousal women, precocious puberty, PCOS, endometriosis and uterine fibroids. In this review, we will analyze the central mechanisms involved in the integration of metabolic information and their contribution to the control of the reproductive function. Particular attention will be paid to summarize the participation of leptin, kisspeptin, ghrelin, NPY, orexin, urocortin, VIP, insulin, galanin, galanin like peptide, oxytocin, agouti gene-related peptide, and POMC neurons in this process and their possible interactions to contribute to the metabolic control of reproduction. © 2015 Elsevier Inc. All rights reserved. Source

Celik O.,Private Clinic | Unlu C.,Acibadem University | Otlu B.,Inonu University | Celik N.,Behcet Uz Childrens Hospital | Caliskan E.,Medical Park Hospital
Fertility and Sterility | Year: 2015

Objective To determine whether laparoscopic endometrioma resection alters peri-implantation endometrial HOXA-10, HOXA-11, LIF, ITGB3 and ITGAV mRNA expression. Design Case-control study. Setting Medical school. Patient(s) Twenty infertile patients with uni- or bilateral endometrioma, five infertile patients having nonendometriotic benign ovarian cyst, and five fertile control subjects. Intervention(s) Mid-luteal-phase endometrial sampling was performed at the time of surgery. Second endometrial biopsies were obtained 3 months after laparoscopic endometrioma resection during the mid-luteal phase of the cycle. Main Outcome Measure(s) Endometrial HOXA-10, HOXA-11, LIF, ITGAV, and ITGB3 mRNA expressions were evaluated with the use of reverse-transcription polymerase chain reaction. Result(s) Significantly decreased endometrial ITGAV mRNA expression was noted in biopsies obtained from endometrioma and nonendometriotic cyst groups before surgery. Trends toward decreased endometrial HOXA-10, HOXA-11, LIF, and ITGB3 mRNA expressions were noted in the endometrioma and nonendometriotic cyst groups before surgery compared with the fertile subjects. However, the differences failed to show statistical significance. Compared with preoperative values, significantly increased HOXA-10 (12.1-fold change) and HOXA-11 (17.2-fold change) mRNA expressions were noted in endometrial biopsies obtained from subjects who were undergoing endometrioma surgery. Fold change in endometrial ITGAV mRNA after endometrioma surgery was found to be 30.1 and indicated a positive regulation. However, this fold increase was statistically insignificant. Expressions of these endometrial receptivity markers did not change significantly after surgical removal of nonendometriotic benign ovarian cysts. Conclusion(s) Laparoscopic endometrioma resection increases peri-implantation endometrial HOXA-10 and HOXA-11 mRNA expression, suggesting an improvement in endometrial receptivity. © 2015 American Society for Reproductive Medicine. Source

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