Epidemiologic Studies in Child and Adolescent Psychiatry: A Review of Methodology

Childhood psychiatric disorders are estimated to influence about 9 to 21% of relevant age group and interest in this disorders are increasing all over the world. The growing need to child and adolescent mental health leads the task of establishing proposals and policies in this field to become a priority for governments. The first step of such proposals should be determination of prevalence of child and adolescent mental disorders in that country. However, several major methodological problems make it hard to provide accurate prevalence estimates from epidemiological studies. Most common problems are within the fields of sampling, case definition, case ascertainment and data analyses. Such issues increases the costs of studies and hinder to reach large sample sizes. To minimize these problems, investigators have to be careful on choosing the appropriate methodology and diagnostic tools in their studies. Although there are many interviews and questionnaires for screening and diagnosing in child and adolescent psychiatry, only a few of them are suitable for epidemiological research. In parallel with the improvement in all fields of child and adolescent mental health in our country, some of the major screening and diagnosing tools used in prevalence studies in literature have already been translated and validated in Turkish. Most important of this tools for screening purposes are Child Behavior Checklist and Strengths and Difficulties Questionnaire and for diagnosing purposes are Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version and Development and Well-Being Assessment. The aims of this article are to review the methodological problems of epidemiologic studies in child and adolescent psychiatry and to briefly discuss suitable diagnostic tools for extended sampled epidemiologic studies in our country

MANAGEMENT OF CANALICULAR LACERATION

Amaç: Lakrimal drenaj sistemi travması olan hastaların tedavisinde kullanılan cerrahi tekniklerin sonuçlarını değerlendirmek. Gereç ve yöntem: Dokuz Eylül Üniversitesi Göz Hastalıkları Anabilim Dalı'nda kanalikül kesisi nedeni ile tedavi edilen 3 hastanın kayıtları retrospektif olarak incelendi. İki vakada 24 ‘gauge' branül kullanılarak bikanaliküler anüler entübasyon, bir hastada ise bikanaliküler nazal entübasyon, mukozal anastomoz ve kapak rekonstrüksiyonu ile kombine olarak uygulandı. Bulgular: İki hastada üst kanalikül, bir hastada ise alt kanalikül kesisi mevcuttu. Hastaların hepsinde kanalikül kesisi direk travma nedeniyle oluşmuştu. Tüp geri alınma zamanı ortalama 5,3 ay (4-6 ay) idi. Hiçbir hastada epifora veya diğer komplikasyonlar görülmedi. Sonuç: Kanalikül kesilerinin cerrahi tedavisi teknik olarak dikkat gerektiren bir işlemdir. Tecrübeli cerrahlarca dikkatli bir şekilde yapıldığında, polivinil kloridle yapılan bikanaliküler anüler entübasyon ve silikon tüple yapılan bikanaliküler nazal entübasyon ile başarılı sonuçlar elde edilebilir. Objective: To assess the results of surgical technique for the treatment of patients with trauma of the lacrimal drainage system. Material and method: Medical records of three patients treated for canalicular laceration in the Department of Ophthalmology Dokuz Eylul University wereevaluated retrospectively. In two cases bicanalicular annular intubation by using 24 gauge branule, in one case bicanalicular nasal entubation were performed combined with mucosal anastomosis and lid reconstruction. Results: Two patients had inferior canalicular laceration and one had a superior canalicular laceration. lacerations of our patients were caused by direct trauma. The silicone tubes were removed after a mean period of 5.3 months (Range 4 to 6 months) There were no persistent epiphora or other complication. Conclusion: The surgical treatment of canalicular laceration is a technically demanding procedure. Entubation techniques including bicanalicular annular with polyvinyl chloride material and bicanalicular nasal with silicone can achieve successful results, when it is performed carefully by experienced surgeons

Postantibiotic Effects of Tigecycline, Colistin Sulfate, and Levofloxacin Alone or Tigecycline-Colistin Sulfate and Tigecycline-Levofloxacin Combinations against <i>Acinetobacter baumannii</i>

Background: Colistin sulfate and levofloxacin, alone and in combination with tigecycline, were investigated for their in vitro activities and postantibiotic effects (PAEs) on 6 meropenem-resistant Acinetobacter baumannii. Methods: The in vitro activities of colistin sulfate and levofloxacin in combination with tigecycline were determined using a microbroth checkerboard technique. The results were interpreted based on the fractional inhibitory concentration index. To determine the PAEs, A. baumannii strains in the logarithmic phase of growth were exposed for 1 h to antibiotics, alone and in combination. Recovery periods of test cultures were evaluated using viable counting after centrifugation. Results: One synergistic interaction was observed for each of the tigecycline-colistin sulfate and tigecycline-levofloxacin combinations. Colistin sulfate produced a strong PAE ranging from 2.50 to 7.0 h in a concentration-dependent manner. PAEs were induced by levofloxacin (ranging from 0.35 to 2.45 h) and tigecycline (ranging from 0.05 to 1.40 h). In combination, tigecycline slightly changed the PAE of colistin sulfate and levofloxacin against the studied strains. Conclusion: This study's findings could have important implications for the timing of doses during antimicrobial therapy with tigecycline, colistin sulfate, and levofloxacin alone and in combination. copyright (C) 2010 S. Karger AG, Base