Factors Associated with Substance Use in Adolescents Under Legally Required Health Care

Objective:In this study, cases who applied to the polyclinic, where we followed the patients under legally required health care clinic in the last year, were evaluated. It was aimed to compare the socio-demographic and clinical characteristics of patients who use and do not use substances.Methods:Between September 2021 and August 2022, the files of cases aged 14-18 years with health precautions were reviewed retrospectively. Data of 75 cases with complete file information were recorded and analyzed.Results:Seventy-five patients (47 girls, 28 boys) were included in the study. Thirty four patients (21 girls, 13 boys) had substanceuse. The mean age was 15.9±1.2 years and the mean duration of education was 9.5±1.9 years. Legally required counseling was 72% (n=54), education was 29.3% (n=22), institutional care was 22.7% (n=17) Smoking and alcohol use (p=0.001) school absenteeism (p=0.002), criminal behavior (p=0.012), number of negative life events (p=0.025), exposure to emotional abuse (p=0.025) and care measures (p=0.017) were found to be higher in patients with substance use. Academic achievement was lower in patients using substance (p=0.001). Substance use was found to be higher in those residing in the city center than in the districts and rural areas (p=0.002). At least one psychiatric diagnosis (p=0.001), more than one psychiatric diagnosis (p=0.001) and conduct disorder (p=0.016) were detected more frequently in the substance abuser group. Cannabis was the most frequently used substance (79.4%) in the group using drugs.Conclusion:Adolescents who are monitored with in the scope of under legally required health care and who use substances are different from the non-substance use group in terms of some socio-demographic and clinical characteristics. Knowing these features can contribute to the prevention and treatment studies of forensic medicine and child and adolescent mental health clinics working with patients who receive legally required treatment. Therefore, it is recommended to increase cooperation between the clinics

Factors related to diagnostic persistence of attention deficit/hyperactivity disorder in Turkish children and adolescents

Ayaz, Muhammed (Arel Author)Objective: Attention-deficit/hyperactivity disorder (ADHD) is one of the most frequently occurring mental disorders in children and adolescents. The purpose of this study was to determine diagnostic persistence three years after the first clinical evaluation and to investigate the factors relating to diagnostic persistence in children and adolescents with ADHD. Methods: The study included 183 children and adolescents who were evaluated in the first admission. Of 183 children and adolescents, 142 children and adolescents were evaluated in the second admission and only the data of 142 children and adolescents were analysed in the study. Diagnostic persistence was defined as having met the full criteria for ADHD on second evaluation. Symptom severity of ADHD was determined using the Turgay DSM-IV-based Child and Adolescent Behavior Disorders Screening and Rating Scale-Parents Form (T-DSM-IV-S). Intelligence level was assessed through the Wechsler Intelligence Scale for Children-Revised. Results: Of the children included in the study, 77.5% (n?=?110) were determined to have ADHD diagnostic persistence. Low intelligence levels, younger age and higher T-DSM-IV-S inattention and conduct disorder scores were associated with diagnostic persistence. ADHD diagnosis in children and adolescents tends to continue at high rates. Conclusions: Determination of the risks related to ADHD diagnostic persistence may contribute to improved treatment planning and interventions

Cinsel istismara uğrayan çocuk ve ergenlerde klinik özellikler ve intihar girişimi ile ilişkili risk etmenleri

Amaç: Çalışmamızda kliniğimize adli rapor istemi ile yönlendirilen cinsel istismara uğramış çocuk ve ergenlerin sosyodemografik özellikleri, zeka düzeyleri, istismar sonrası gelişen ruhsal bozuklukların, intihar girişimi varlığının ve ilişkili risk etmenlerinin değerlendirilmesi amaçlanmıştır. Yöntem: Adli makamlarca Temmuz 2011-Haziran 2012 tarihleri arasında cinsel istismara uğramış ve adli rapor düzenlenmesi istemi ile çocuk ve ergen psikiyatrisi polikliniğine yönlendirilen 3-17 yaşları arasındaki 157 olgunun dosya bilgileri geriye dönük olarak incelenmiştir. Bulgular: Cinsel istismara uğramış 157 çocuk ve ergenin %83,4’ı kız, %16.6’sı erkektir. Olguların başvuru sırasında yapılan değerlendirilmelerinde % 87.9 oranında ruhsal bozukluk belirlenmiştir. En sık görülen ruhsal bozukluk travma sonrası stres bozukluğudur (TSSB) (%36.9). Toplam 22 (% 14) olguda istismar sonrası intihar girişimi saptanmıştır. Zorlama ile vajinal-anal-oral penetrasyon şeklinde cinsel istismara uğrama, depresif bozukluk ve TSSB tanılarının varlığının intihar girişimi riskini anlamlı oranda artırdığı belirlenmiştir (sırasıyla OR: 3.24, 4.05, 6.78 p= 0.045, 0.03, 0.004). Sonuç: Olguların büyük bir kısmında bir ruhsal bozukluk geliştiği görülmüştür. En sık görülen ruhsal bozukluk TSSB’dir. Cinsel istismar mağduru çocuk ve ergenlerin ruhsal değerlendirmesinde intihar riskinin sorgulanıp müdahale yaklaşımlarının buna göre belirlenmesi gerekmektedir

Treatment and clinical results in cases with postoperative endophthalmitis

AMAÇ: Postoperatif endoftalmi göz cerrahisinde en çok korkulan komplikasyonların başında gelmektedir. Bu çalışmada postoperatif endoftalmi görülme sıklığı, klinik özellikler, risk faktörleri, tedavi yaklaşımları ve prognoz araştırılmıştır. GEREÇ VE YÖNTEM: Çalışmaya Ankara Eğitim ve Araştırma Hastanesi Göz Kliniği'nde postoperatif endoftalmi tanısı alan olgular dahil edildi. Postoperatif endoftalmi görülme sıklığı, hastaların oküler ve sistemik hastalıkları, başvuru semptomları, göz muayene bulguları, bakteriyel kültür sonuçları, uygulanan medikal ve cerrahi tedaviler ve prognoz incelendi. BULGULAR: Çalışmaya postoperatif endoftalmi tanısı alan 41 olgu dahil edildi. Olguların yaş ortalaması 62.8 ± 22.4 yıl idi. Endoftalmi 38 gözde (%92.8) katarakt cerrahisi ve/veya göz içi mercek implantasyonu sonrasında, 1 gözde (%2.4) trabekülektomi, 1 gözde (%2.4) penetran keratoplasti ve 1 gözde (%2.4) pars plana vitrektomi sonrası gelişmişti. Olgularda ameliyat sonrasında hastaneye başvuru süresi ortalama 15.7 ± 17.5 (2-60) gündü. Vitreus / hümör aköz kültürü olguların %46.3’ünde pozitifti. Tüm olgulara en az bir kez intravitreal antibiyotik enjeksiyonu ve 15 (%36.6) olguya pars plana vitrektomi yapıldı. Işık hissini kaybeden 7 olgudan 3’üne evisserasyon uygulandı. Olgular ortalama 11.1 ± 4.9 (6-25) ay takip edildi. Takip sonucunda 7 (%17.1) olguda ışık hissi kaybı görülürken, 12 (%29.3) olgu ışık hissi-el hareketi, 11 (%26.8) olgu 1 metreden parmak sayma - <0.1 arasında, 10 (%24.4) olgu 0.1 ve üzerinde görme keskinliği ile sonuçlandı. Bir (%2.4) olguda yaşından ötürü görme keskinliği ölçülemedi. Çalışmamızda PPV'nin sonuç görme keskinliği üzerine etkisi saptanmadı (T test, p = 0.560). SONUÇ: Postoperatif endoftalmili olgularda acilen intravitreal antibiyotik yapılması, gerektiğinde tekrarlanması ve gereken olgularda doğru zamanda uygun cerrahi tedavi ile kabul edilebilir görsel ve anatomik sonuç elde etmek mümkündür.INTRODUCTION: Postoperative endophthalmitis is one of the most frustrating complications of ophthalmic surgery. In this study we aimed to evaluate the postoperative endophthamitis incidence, clinical features, risk factors, treatment strategies and prognosis in patients with postoperative endophthalmitis. MATERIAL AND METHOD: We evaluated postoperative endophthalmitis cases in Ankara Training and Research Hospital, Department of Ophthalmology. Postoperative endophthamitis incidence, ocular and systemic illness, initial symptoms, eye examination findings, bacteriologic culture results, medical and surgical treatments and prognosis were investigated. RESULTS: Forty-one patients with postoperative endophthalmitis were included in the study. The mean age was 62.8 ± 22.4 years (range 2 months - 90 years). Endophthalmitis developed in 38 eyes (92.8%) after cataract surgery and/or intraocular lens implantation, in 1 eye (2.4%) after glaucoma surgery, in 1 eye (2.4%) after penetrating keratoplasty and in 1 eye (2.4%) after pars plana vitrectomy. The mean duration of admission to the hospital postoperatively was 15.7 ± 17.5 (2-60) days. Cultures from vitreous / aqueous humor specimens were positive in %46.3 of the patients. All the cases had at least one intravitreal antibiotic injection. Pars plana vitrectomy was performed in 15 cases (36.6%). Evisceration was performed to 3 of 7 patients who lost their sense of light. The mean follow-up was 11.1 ± 4.9 (6-25) months. Light perception was lost in 7 cases (17.1%). Visual acuity was between light perception-hand motion in 12 cases (29.3%), counting finger from a meter – <0.1 in 11 cases (26.8%), 0.1 and above in 10 cases (%24.4). We couldn’t measure visual acuity in one (2.4%) preverbal patient. Pars plana vitrectomy didn’t change functional outcome in our series (T test, p = 0.560). CONCLUSION: It is possible to obtain acceptable visual and anatomical results in postoperative endophthalmitis by performing intravitreal antibiotics immediately, repetition if necessary, and performing surgical treatment when necessar

EFFECT OF MATERNAL MIGRAINE ON CHILDREN'S QUALITY OF SLEEP

Discussion and conclusion - In our study, the presence of migraine-type headache in mothers was observed to have a positive effect on reducing sleep disorders in the children. Recurrent headaches of the migraineur mothers with or without sleep disorders and psychiatric comorbidities did not influence the quality of sleep in their children directly, but the sleep anxiety of the children may have had an impact on it

EFFECT OF MATERNAL MIGRAINE ON CHILDREN'S QUALITY OF SLEEP

Backround and aim - Sleep disorders are common problems associated with migraine. These sleep disorders are known to have a debilitating impact on daily lives of migraine patients. The purpose of this study is to assess the effects of sleep disorders experienced by individuals suffering from migraine on their children as well as the presence of sleep disorders in their children