Trait anger and anger expression style in adolescents with chronic disease and determination of related factors

Kronik hastalıklar, ergenlerde birçok psikolojik ve duygusal problem neden olur. Akut hastalığa sahip ergenlerden farklı olarak, kronik hastalığa sahip bir ergenin çok sayıda ilaçlar, tedavi rejimleri, girişimler, diyetler gibi kronik ve sınırlayıcı koşullarda uzun süreler, hatta tüm hayatı boyunca yaşaması gerekir. Bu ergenlerde öfke önemli bir reaksiyondur. Bu çalışmanın amacı; kronik hastalığı olan ergenlerde sürekli öfke ve öfke ifade biçimlerini araştırmak ve akut hastalık nedeni ile hastaneye başvuran ergenler ile karşılaştırmak ve buna etki eden faktörleri araştırmaktır. Bu çalışmaya Hacettepe Üniversitesi Tıp Fakültesi, İhsan Doğramacı Çocuk Hastanesinde Nisan –Haziran 2014 tarihleri arasında izlenen yüz akut hastalığı olan ergen ve yüz kronik hastalığı olan ergen alınmıştır. Verileri toplamak için "Demografik Bilgi Formu" ve "Sürekli Öfke ve Öfke İfade Tarzı Ölçeği" kullanılmıştır. Akut ve kronik hastalık gruplarında sürekli öfke, içe yönelik öfke ve dışa yönelik öfke puanları arasında istatistiksel anlamlı fark izlenmemiştir. Fakat, kronik hastalık grubunda öfke kontrol puanları, akut hastalık grubundan anlamlı olarak yüksek bulunmuştur (p<0.011). Akut ve kronik hasta gruplarında; kızlar ve erkekler arasında ve yaş grupları arasında öfke ve öfke ifade puanları arasında fark bulunmamıştır. Ailenin büyüklüğü, kardeş sayısı ve ailenin ekonomik durumu gibi faktörlerin öfke ve ifadeleri üzerine bazı etkileri saptanmıştır. Kronik hastalığa sahip ergenler, akut hastalığa sahip ergenlere göre öfkelerini daha fazla kontrol edebilmektedirler.Chronic diseases cause many psychological and emotional problems in adolescents. Different from an adolescent with acute disease the adolescent with chronic disease must live in this chronic and restricted conditions with many drugs, treatment regimens, interventions, diets etc. for long periods even in his/her whole life. Anger is one of the important reaction in these adolescents. The aim of this study was to investigate trait anger and anger expression style of adolescents with chronic disease and compare with the adolescents admitted to the hospital for acute diseases and search for the related factors. A hundred adolescents with chronic diseases and a hundred adolescents with acute diseases, between the ages 12 to 18 years who were followed up in Hacettepe University Medical Faculty, İhsan Doğramacı Children's Hospital from April to June 2014 were included in this study. "Demographic Questionnaire" and "Trait Anger and Anger Expression Style Scale" were used to collect data. It was observed that there were not statistically important difference between acute and chronic disease groups for trait anger, and anger-in, anger-out sub-scales. But in chronic disease group, anger control scores were significantly higher than acute disease group (p<0.011). There were not differences between girls and boys, and age groups for anger and anger expression styles in acute and chronic disease groups. Family size, siblings number, and economical status of family have some effect on trait anger and anger expression styles. Adolescents with chronic disease were able to control their anger than the adolescents with acute disease

Differential diagnosis of primary immunodeficiency in patients with BCGitis and BCGosis: A single-centre study

BCG infections occur more frequently in patients with underlying primary immunodeficiency disease (PIDD). In this study, we aimed to evaluate the ratio of PIDD in the patients with BCG infections. Patients with BCG infections were analyzed in a tertiary referral centre in the 2015-2020 period. Forty-seven patients with BCGitis/BCGosis were evaluated; thirty-four (72.3%) had BCGitis, and 13 (27.7%) had BCGosis. Common tissue and organs affected are lymph nodes (57.4%), skin and subcutaneous tissue (48.9%), lungs (23.4%) and liver (17%). PIDD was shown in 26 patients (55.3%), including 92.3% of patients with BCGosis and 41.2% of patients with BCGitis. Ten patients had Mendelian susceptibility to Mycobacterial disease (MSMD) (21.2%), six had predominantly antibody deficiency (PAD) (12.7%), five had severe combined immunodeficiency (SCID) (10.6%), three had CGD (6.3%), and two had CID (4.2%). Mortality was reported in two patients (4.2%) with CID (ZAP70 deficiency (n = 1) and PIK3R1 deficiency (n = 1)). Parental consanguinity (84%), axillary lymphadenopathy (65%), mycobacterial lung disease (42%), hepatomegaly (30%) and growth retardation (19%) were significantly high in patients with PIDD diagnosis. Isolated vaccination site infection was also recorded in patients with PIDD (CID (n = 1), SCID (n = 1), PAD (n = 5)). BCG vaccination should be planned with caution for the cases with suspected PIDD. This study indicates that almost all patients (92.3%) with BCGosis and one in every two patients (41.2%) with BCGitis have an underlying PIDD. Parental consanguinity, axillary lymphadenopathy, mycobacterial lung disease, hepatomegaly and growth retardation (19%) are important clinical features in the differential diagnosis of PIDD