Big data in adolescent psychiatry: Do patients share their psychiatric symptoms on social networking sites?

Background: Fascinating developments in big data technologies and unprecedented diffusion of social networking sites (SNSs) generate unseen opportunities for scientific fields, including psychiatry. This study focuses on the use of SNSs by adolescent psychiatric patients and the potential use of SNS-generated data to help medical practitioners diagnose and treat patients’ mental health. Our objective is to understand and measure the psychiatric and individual conditions in which symptom-sharing occurs on SNSs and the frequency of these conditions. Based on literature, we hypothesized that the perceived value of social network sites positively affects adolescents’ sharing of symptoms on these sites. Subjects and methods: An empirical test of this hypothesis was conducted with a survey of 224 adolescents admitted to a psychiatry clinic in Turkey. The hypothesis was tested using a hierarchical multiple regression analysis. Results: The perceived value of SNSs explained an additional 37.8% of variation in symptom sharing on SNSs above and beyond the control variables, which are gender, age, type of disorder, and amount of internet and SNS use. The findings suggested that adolescents share symptoms on SNSs only if they attribute value to the SNSs that they use. We also found that 72% of adolescents in our sample shared their symptoms on SNSs. Conclusions: There is an attractive opportunity for information technology companies to develop, together with health professionals; data analytics that are able to detect symptoms to support psychiatric diagnoses and pave the way for big-data enabled personalized medicine

DNA damage in obesity: Initiator, promoter and predictor of cancer

Epidemiological evidence linking obesity with increased risk of cancer is steadily growing, although the causative aspects underpinning this association are only partially understood. Obesity leads to a physiological imbalance in the regulation of adipose tissue and its normal functioning, resulting in hyperglycaemia, dyslipidaemia and inflammation. These states promote the generation of oxidative stress, which is exacerbated in obesity by a decline in anti-oxidant defence systems. Oxidative stress can have a marked impact on DNA, producing mutagenic lesions that could prove carcinogenic. Here we review the current evidence for genomic instability, sustained DNA damage and accelerated genome ageing in obesity. We explore the notion of genotoxicity, ensuing from systemic oxidative stress, as a key oncogenic factor in obesity. Finally, we advocate for early, pre-malignant assessment of genome integrity and stability to inform surveillance strategies and interventions

Evaluation of delayed diagnosis in TYPE 1 diabetes mellitus

Tip 1 Diyabetes Mellitus (Tip 1 DM) çocukluk ve adölesan dönemde en sık görülen endokrin-metabolik bozukluktur. DM'nin erken tanısı ve metabolik kontrolün sağlanması ile birçok komplikasyonun önlenebileceği ve geciktirilebileceği bilinmektedir. Tip 1 DM'li hastalar daha çok poliüri, polidipsi, kilo kaybı gibi semptomlarla başvururlar. Bu çalışmada, tip 1 DM tanılı hastalarda tanıdaki gecikme oranını, gecikmenin nedenlerini ve sonuçlarını saptamak amaçlanmıştır. Bu çalışma Uludağ Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Çocuk Endokrinoloji Polikliniği'nde 2007-2016 tarihleri arasında tip 1 DM tanısı ile takip edilen gönüllü 175 olgu incelenerek yapılmıştır. Hastalara ve ebeveynlerine "Tip 1 DM'li Hastalarda Tanı Gecikmesinin Değerlendirilmesi Anketi" verilmiştir. Hastaların dosyaları retrospektif incelenerek kan gazı parametreleri, HbA1c, GAD 65 ve c-Peptid, tiroid ve çölyak otoantikorları ve uzun dönem izlemdeki komplikasyonlar incelenmiştir. Hastalara mevcut şikayetleriyle konulan ilk tanılar; 139 (%79,4) hasta Tip 1 DM, 14 (%8) hasta üriner sistem enfeksiyonu, 13 (%7,4) hasta üst solunum yolu enfeksiyonu, 5 (%2,9) hasta anemi, 1 (%0,6) hastada ensefalit ve/veya menenjit tanısı almıştı. Hastaların çoğunda semptomların başlangıcından sonraki ilk iki hafta içinde tanı konduğu saptandı. Tanı alma süresi ve HbA1c değerlerinde istatistiksel fark saptanmadı (p>0,05). Tip 1 DM tanı ve tedavisindeki gelişmelere rağmen; hastalarımızın hala önemli bir bölümünün diyabetik ketoasidoz (DKA) ile başvurması dikkat çekicidir. Erken tanı; mortalite ve morbidite oranının düşmesine ve acil tedavide daha yüz güldürücü sonuçlar elde edilmesine olanak vermektedir. Toplumun ve hekimlerin diyabet konusunda bilinçlendiği, hizmet kalitesinin arttığı, ulaşılabilir sağlık merkezlerinin çoğaldığı ve sosyoekonomik olanakların arttığı oranda tip 1 DM'de erken tanı ve tedavi olanaklarının da artacağı düşünülmektedir.Type 1 diabetes mellitus (type 1 DM) is the most common endocrine-metabolic disease in childhood and adolescence. Early diagnosis and optimum metabolic control can prevent and delay the complications. The most common symptoms at presentation of type 1 DM are polyuria, polydipsia, and weight loss. In this investigation, we aimed to study the frequency of delayed diagnosis as well as the reasons and consequences of the delay. This study was performed on 175 patients with type 1 DM who volunteeredto participate in the study and who were followed at Uludag University Department of Pediatric Endocrinology between 2007-2016. The questionnaire titled "Evaluation of Delayed Diagnosis in Type 1 DM" was given to patients and their parents.The charts of the patients were retrospectively evaluated to record the results of blood gases, HbA1c, GAD65, C-peptide, and autoantibodies for thyroid and celiac disease and the long-term complications were noted. The initial diagnosis of the patients were type 1 DM in 139 (79.4 %); urinary infection in 14 (8%), upper respiratory infection in 13 (7.4%), anemia in 5 (2.9%), and encephalitis and/or meningitis in 1 (0.6%). Most patients received the correct diagnosis in two weeks after the onset of symptoms. There was no correlation between the level of HbA1c and the time that elapsed from the onset of symptoms until diagnosis (p>0.05). Despite advances in diagnosis and treatment of diabetes, a considerable number of patients in our cohort were admitted to hospital with DKA at diagnosis. Early diagnosis enables prevention of mortality and morbidity and improves patient care. We articipate early diagnosis and treatment of type 1 DM will be fasilitated as the awareness of the community and health personel about diabetes is increased, as the number of health centers that the patients can reach is increased and as the socioeconomic status of the community rises

Pyoderma Gangrenosum With Common Variable Immunodeficiency

Pyoderma gangrenosum (PG) is a rare ulcerative skin disease of unknown etiology. It Tan be seen On normal skin or secondary to traumas such as injections and biopsies. Half of reported cases are associated with systemic diseases such as arthritis, inflammatory bowel diseases, hematological disorders,, hepatic disease, and necrotizing vasculitis. These lesions often occur on the trunk and extremities. Abscess drainage, debridement, or necrosectomy are contraindicated in PG, and false management of these indications aggravates the lesion. A diagnosis of PG is based on medical history as well as physical and laboratory examination according to standard criteria. Presented here is a case of a male patient with a medical history of recurrent abscess of injection and Splenectomy due to splenic abscess. The patient presented with a subcutaneous abscess which transformed rapidly to an ulcer after abscess drainage, Consequently, the patient received the final diagnosis of PG with common variable immunodeficiency and was treated accordingly

Irritability in children and adolescents: Validity and reliability of Turkish of affective reactivity index

İrritabilite, engellenmeye yanıt olarak öfke eşiğinin düşük olması, kendisinin ya da çevresinin zarar görebileceği düzeyde olan sinirliliğe eğilim, sinirlilik durumunun uzun sürmesi olarak tanımlanmaktadır. İrritabilite birden fazla tanı için bir semptom olarak listelenirken, irritabilitenin tanımı DSM-IV TR'de yer almamıştır. Birçok psikiyatrik hastalıkta olduğu gibi Anksiyete Bozuklukları'nda özellikle de Yaygın Anksiyete Bozukluğu'nda (YAB) irritabilite bir semptom olarak karşımıza çıkmaktadır. Bununla birlikte, DSM-5 çalışma grubunun yoğun ilgisine rağmen irritabilitenin ölçütleri üzerine araştırmalar sınırlı olmuştur. Bu boşluğu doldurmak maksadıyla çocuk-ergen ve onların ailelerinden irritabilite ile ilgili karşılaştırılabilir bilgi toplamamızı sağlayacak olan Duygusal Reaktivite İndeksi (DRİ) tasarlanmıştır. Bu çalışmada, çocuk ve ergenlerde irritabiliteyi değerlendiren DRİ'nin Türkçe'ye uyarlanması, geçerlilik ve güvenilirliğine yönelik verilerin toplanması amaçlanmıştır. Çalışmamızın örneklemini 2015-2016 öğretim yılında Bursa İl merkezindeki 3 lisede ve 3 ilköğretim okulunda eğitim gören 1300 öğrenci ve ebeveynleri oluşturmuştur. Araştırmanın verileri, Bilgi Toplama Formu¸ Çocukluk Çağı Anksiyete Tarama Ölçeği'nin (ÇATÖ) ebeveyn ve çocuk formu, DRİ'nin çocuk-ergen ve ebeveyn formu kullanılarak toplanmıştır. ÇATÖ çocukluk çağı anksiyete bozukluklarını tarama amacıyla kullanılan bir ölçektir. DRİ'nin kriter geçerliliğini belirlemek amacıyla (irritabilite ile anksiyete bozuklukları arasındaki ilişki düşünülerek) ÇATÖ kullanılmıştır. Çalışmamızın sonucunda ÇATÖ (ÇATÖ'nün YAB alt ölçeği de dahil) ile DRİ arasında korelasyon görülmesinden dolayı (p<0,001), DRİ'nin kriter geçerliliğini sağladığı kabul edilmiştir. Gerek iç tutarlılık, gerekse test-tekrar test güvenilirliği incelemesi sonucunda, DRİ'nin güvenilir bir ölçek olduğu görülmüştür. Sonuç olarak, DRİ Türkiye'deki çocuk ve ergenlerde irritabilite semptomlarını değerlendirmek için uygun yeni bir ölçektir. Bizim sonuçlarımız DRİ'nin Türkçe versiyonunun ölçümlerinin Türk toplumunda geçerlilik ve güvenilirlik açısından orjinal DRİ ile çok benzer olduğunu göstermiştir. Ayrıca çalışmamız Türk toplumunda klinik olmayan örneklemde doğrudan irritabiliteyi değerlendiren ilk çalışma olma özelliği de taşımaktadır.Irritability is defined as the low threshold of anger in response to be blocked, as a tendency to nervousness at a level that can damage himself/herself or his/her relatives around, or as a protracted period of nervousness. While irritability is listed as a symptom of multiple diagnoses, irritability definition was not included in DSM-IV TR. Irritability is encountered as a symptom in anxiety disorders, especially in generalize anxiety disorder, as in many psychiatric disorders. Furthermore, despite the strong interest of DSM-5 working group, research on irritability criteria stayed limited. In order to fill this gap, Affective Reactivity Index (ARI) which will provide us to collect comparable information from children-adolescents and their families about irritability was designed. In this study, Turkish adaptation of ARI which evaluates irritability in children and adolescents, and data collection intended for its validity and reliability was aimed. The sample of this study comprised 1300 students who study at 3 high schools and at 3 primary schools in the centre of Bursa, and their parents. The data of the research were collected by using Information Collecting Form, parent and children forms of The Screen for Child Anxiety Related Emotional Disorders (SCARED) and ARI's children-adolescent and parent forms. Childhood Anxiety Screening Scale is a scale using for the purpose of childhood anxiety disorders screening. In order to determine the criterion validity of ARI, Childhood Anxiety Screening Scale was used (with considering the relationship between anxiety disorders and irritability). As a result of our work, since a correlation between SCARED (including Generalized Anxiety Disorder subscale of SCARED) and ARI was seen (p<0,001), it was accepted that ARI provided the criterion validity. As a result of analysis of both internal consistency and test-retest reliability, it was seen that ARI was a reliable scale. Consequently, ARI is a new, appropriate scale to evaluate irritability symptoms in children and adolescents in Turkey. Our results showed that measurements of Turkish adaptation of ARI was similar with original ARI in Turkish society in terms of validity and reliability. Our study also bears the distinction of being the first study to evaluate irritability directly in non-clinical sample in the Turkish society

Inflammatory mediators in the diagnosis and treatment of acute pancreatitis: pentraxin-3, procalcitonin and myeloperoxidase

Introduction: Acute pancreatitis (AP) is the third most common gastrointestinal disease at hospital admission. The etiology and pathogenesis of this disease are not completely clear. Our study was intended to determine the systemic levels of pentraxin-3 (PTX-3), myeloperoxidase (MPO), procalcitonin (PCT), and C-reactive protein (CRP) as prognostic parameters in early stages of AP. We also determined the effects of treatment on PTX-3, MPO, PCT and CRP levels in AP

Effects of Laparoscopic Gastric Band Applications on Plasma and Fundic Acylated Ghrelin Levels in Morbidly Obese Patients

It has been proposed that laparoscopic adjustable gastric banding (LAGB) procedure might play a role in modulation of fundic ghrelin production. To test this hypothesis, we examined plasma and tissue concentrations of acylated ghrelin in morbidly obese patients before and 6 months after LAGB. Baseline levels of acylated ghrelin in morbidly obese patients were also compared with those in age-matched, healthy, non-obese controls

Inflammatory mediators in the diagnosis and treatment of acute pancreatitis: pentraxin-3, procalcitonin and myeloperoxidase

Introduction: Acute pancreatitis (AP) is the third most common gastrointestinal disease at hospital admission. The etiology and pathogenesis of this disease are not completely clear. Our study was intended to determine the systemic levels of pentraxin-3 (PTX-3), myeloperoxidase (MPO), procalcitonin (PCT), and C-reactive protein (CRP) as prognostic parameters in early stages of AP. We also determined the effects of treatment on PTX-3, MPO, PCT and CRP levels in AP