Browsing by Author "Cakir, B"

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    Cognitive functioning of adolescents using Methamphetamine: The impact of inflammatory and oxidative processes
    Cakir, B; Cakir, ADU; Sapmaz, SY; Bilac, O; Taneli, F; Kandemir, H
    BackgroundMethamphetamine is a substance that causes neurotoxicity and its use is increasing in recent years. Literature highlights cognitive impairment resulting from Methamphetamine use. The aim of the present study is to evaluate the relationship between cognitive impairment and inflammatory processes in adolescents with Methamphetamine use disorder.MethodsThe study included 69 adolescents aged 15-19 years, comprising 37 participants with Methamphetamine Use Disorder and 32 healthy controls. Central Nervous System Vital Signs was used to detect cognitive impairment. Childhood Trauma Questionnaire-33 and The Children's Depression Inventory scales were used. In addition, venous blood was collected from the volunteers. Biochemical parameters (IL-1beta, IL-6, TNF-a, BDNF, FAM19A5, TAS, TOS) were analyzed.ResultsOur study showed that (I) IL-6 and TNF-a levels of Methamphetamine users were lower than the healthy group; (II) BDNF levels of Methamphetamine users were higher than the healthy group; (III) mean Neurocognitive Index in cognitive tests of Methamphetamine using adolescents was negatively correlated with duration of Methamphetamine use and BDNF levels.ConclusionsOur study suggests that Methamphetamine use may have a negative effect on cognitive functions.
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    Use of Antipsychotics: The Experiences, Views, and Monitoring Practices of Child and Adolescent Psychiatrists in Turkey
    Cakir, B; Sapmaz, SY; Kandemir, H
    Objectives:The aim of this study is to evaluate the antipsychotics prescribed by child psychiatrists and their applications on the follow-up of these drugs. Methods:The universe of this research included consultant physicians and child psychiatry residents working in the field. A questionnaire has been created that assesses the use of antipsychotics and follow-up processes of physicians. The survey involved 19 questions. Contents of the survey were sociodemographic data, short-term and long-term follow-up of antipsychotic drugs, side-effect intervention strategies, and diagnoses of the most commonly preferred antipsychotic medications. The survey was delivered via e-mail and sent as a message to the child and adolescent psychiatrists in Turkey. Results:One hundred sixty-one physicians working in the field of child and adolescent psychiatry participated in the study. Aripiprazole (32.2%), risperidone (30.4%), and quetiapine (14.9%) were three most commonly prescribed antipsychotics. Disruptive behavior-related disorders (28.9%), behavior problems related to autism spectrum disorder (20.7%), behavior problems related to intellectual disability (14.5%), and attention-deficit/hyperactivity disorder (12.4%) were the most common diagnoses requiring antipsychotics medications. Before starting antipsychotic treatment, the most commonly evaluated parameters were body mass index (BMI) (47.2%), waist circumference (10.5%), blood pressure (28.5%), lipid profile (37%), and blood glucose level (41.6%). When the evaluations made at least in a year after starting antipsychotic drug therapy were examined, 80.2% of physicians reported blood glucose, 79.6% lipid profile, 65.7% BMI, 59.1% blood pressure, and 26.6% waist circumference measurement almost always done. Conclusions:The results showed that the adherence to recommendations in guidelines for the screening of antipsychotic-related side effects was low. This study suggests that interventions should be made about antipsychotic monitoring training to physicians.
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    Prevalence and predictors of current wheezing in turkish school children, using isaac phase II protocol
    Civelek, E; Cakir, B; Uysal, SO; Orhan, F; Bingol, BA; Uner, A; Yuksel, H; Sekerel, B
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    Extent and Burden of Allergic Diseases in Elementary Schoolchildren: A National Multicenter Study
    Civelek, E; Cakir, B; Boz, AB; Yuksel, H; Orhan, F; Uner, A; Sekerel, BE
    Background: Scarcity of standardized, comparable data on allergic diseases in schoolchildren in Turkey requires further multicenter studies based on the use of objective tools in addition to parent-completed questionnaires to improve the validity and reliability of results. Methods: Using International Study of Asthma and Allergies in Children (ISAAC) Phase II tools, elementary schoolchildren aged 9 to 11 years were surveyed in 5 city centers in different regions of Turkey. Results: We surveyed 6963 children from 70 schools and found that 35% had had at least 1 symptom of allergic diseases in the past year. Based on parental reports, the overall prevalence rates for wheezing, rhinoconjunctivitis, and eczema in the past year were 15.8%, 23.5%, and 8.1%, respectively. The overall frequencies of atopy, flexural dermatitis, and bronchial hyperreactivity were 18.9%, 3.6%, and 24.2%, respectively. There were large variations in the prevalence of both symptoms and objective signs between study centers. Absence from school for at least 1 day was reported for 34.2% of children with a diagnosis of asthma or allergic rhinitis. Conclusions: Approximately one third of elementary schoolchildren reported symptoms compatible with allergic diseases in the past year. The interregional differences in both symptoms and objective test results are possibly due to differences in environmental conditions. Unfortunately, serious problems are still encountered in the timely and proper diagnosis and treatment of allergic diseases.
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    Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)
    Sonmez, A; Yumuk, V; Haymana, C; Demirci, I; Barcin, C; Kiyici, S; Güldiken, S; Örük, G; Saydam, BO; Baldane, S; Kutlutürk, F; Küçükler, FK; Deyneli, O; Çetinarslan, B; Sabuncu, T; Bayram, F; Satman, I; Ayturk, S; Yilmaz, M; Asik, M; Dinccag, N; Cakmak, R; Turker, F; Idiz, C; Hacisahinogullari, H; Bagdemir, E; Yildiz, B; Haliloglu, O; Sancak, S; Ozsari, L; Cagiltay, E; Imre, E; Sait Gonen; Boysan, SN; Altuntas, Y; Ozturk, FY; Mert, M; Piskinpasa, H; Aydin, H; Imamoglu, S; Ersoy, C; Oz Gul, O; Selek, A; Dogru, T; Kirik, A; Kebapci, N; Efe, B; Kaya, A; Cordan, I; Kirac, CO; Capa, Z; Cesur, M; Yetkin, I; Corapcioglu, D; Canlar, S; Yildiz, OB; Sendur, SN; Cakir, B; Ozdemir, D; Corakci, A; Kutlu, M; Bascil Tutuncu, N; Bozkus, Y; Cakal, E; Demirbas, B; Ertek, S; Altay, M; Dagdeviren, M; Abedi, AH; Cetinkalp, S; Ozisik, H; Yener, S; Guney, E; Unubol, M; Yaylali, GF; Topsakal, S; Hekimsoy, Z; Akbaba, G; Aslan, I; Balci, MK; Dalkiran, S; Akbay, E; Gul, K; Agbaht, K; Yilmaz, MO; Bozkirli, E; Tetiker, BT; Cetinkaya Altuntas, S; Atmaca, A; Durmus, ET; Mete, T; Dikbas, O; Akin, S; Nuhoglu, I; Ersoz, HO; Bayraktaroglu, T; Sisman, P; Sahin, I; Cetin, S; Capoglu, I; Akbas, EM; Ucler, R; Eren, MA; Tuzcu, AK; Pekkolay, Z; Ozkaya, M; Araz, M; Salman, S; Dizdar, OS; Gurkan, E; Kargili Carlioglu, A
    Background: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro-and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity. (c) 2019 The Author(s) Published by S. Karger AG, Basel
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    Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study)
    Sonmez, A; Haymana, C; Bayram, F; Salman, S; Dizdar, OS; Gurkan, E; Carlioglu, AK; Barcin, C; Sabuncu, T; Satman, I; Guldiken, S; Ayturk, S; Yilmaz, M; Asik, M; Dinccag, N; Cakmak, R; Turker, F; Idiz, C; Hacisahinogullari, H; Bagdemir, E; Yildiz, B; Yumuk, VD; Haliloglu, O; Sancak, S; Ozsari, L; Cagiltay, E; Deyneli, O; Imre, E; Gonen, S; Boysan, SN; Altuntas, Y; Ozturk, FY; Mert, M; Piskinpasa, H; Aydin, H; Imamoglu, S; Ersoy, C; Ozgul, O; Kiyici, SK; Cetinarslan, B; Selek, A; Dogru, T; Kirik, A; Kebapci, N; Efe, B; Kaya, A; Cordan, I; Baldane, S; Kirac, CO; Demirci, I; Capa, Z; Cesur, M; Yetkin, I; Corapcioglu, D; Canlar, S; Yildiz, OB; Sendur, SN; Cakir, B; Ozdemir, D; Corakci, A; Kutlu, M; Tutuncu, NB; Bozkus, Y; Cakal, E; Demirbas, B; Ertek, S; Altay, M; Dagdeviren, M; Abedi, AH; Cetinkalp, S; Ozisik, H; Oruk, GG; Yener, S; Saydam, BO; Guney, E; Unubol, M; Yaylali, GF; Topsakal, S; Hekimsoy, Z; Akbaba, G; Aslan, I; Balci, MK; Dalkiran, S; Akbay, E; Gul, K; Agbaht, K; Yilmaz, MO; Bozkirli, E; Tetiker, BT; Altuntas, SC; Atmaca, A; Durmus, ET; Mete, T; Kutluturk, F; Kucukler, FK; Dikbas, O; Akin, S; Nuhoglu, I; Ersoz, HO; Bayraktaroglu, T; Sisman, P; Sahin, I; Cetin, S; Capoglu, I; Akbas, EM; Ucler, R; Eren, MA; Tuzcu, AK; Pekkolay, Z; Ozkaya, M; Araz, M
    Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c <7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dL. Achieving all parameters indicated triple metabolic control. Results: HbA1c levels of patients (n = 5211) were 8.6 +/- 1.9% (71 +/- 22 mmol/mol) and 7.7 +/- 1.7% (61 +/- 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, nonsmoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. Conclusions: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease. (C) 2018 Elsevier B.V. All rights reserved.
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    Reliability and Validity of the Bipolar Prodrome Symptom Interview and Scale-Full Prospective in Its Turkish Translation
    Sapmaz, SY; Ermis, C; Cakir, B; Oztekin, S; Guinart, D; Guney, SA; Correll, CU; Inal, N; Aydemir, O
    Background: No scale exists to assess patients at-risk for bipolar disorder (BD) in Turkey. We aimed to assess the psychometric properties of the Turkish version of the Bipolar Prodrome Symptom Interview and Scale-Full Prospective (BPSS-FP). Method: Psychiatric service users aged 11-18 years old were interviewed using the BPSS-FP translated into Turkish and the Kiddie Schedule for Affective Disorders and Schizophrenia. Youth with major depressive disorder (MDD, n = 63), bipolar-spectrum disorder (n = 47), and healthy controls (n = 122) were included. Cronbach's alpha was calculated to assess internal consistency. The Young Mania Rating Scale (YMRS) and Children's Depression Rating Scale-Revised (CDRS-R) were administered to test convergent/discriminant validity. Discriminant validity was further tested using one-way ANOVA and receiver operating characteristic (ROC) curves. Inter-rater reliability was tested using correlation coefficients. Findings: Across 232 youth, Cronbach's alpha values were 0.932 for the BPSS-FP total score, 0.878 for the Mania Symptom Index, 0.887 for the Depression Symptom Index, and 0.797 for the General Symptom Index. Correlation coefficients for inter-rater reliability were high for the Mania Symptom Index (r = 0.989), Depression Symptom Index (r = 0.973), and General Symptom Index (r = 0.981). There were high correlations between the BPSS-FP Mania Symptom Index subscore and YMRS (r = 0.732), and the BPSS-FP Depression Symptom Index subscore and CDRS-R (r = 0.754), whereas cross-polarity correlations were non-significant. ROC analysis cut-off value was >= 21 for the BPSS-FP Mania Symptom Index between patients with BD and MDD (specificity = 85.7%, sensitivity = 78.7%). Conclusion: The Turkish version of the BPSS-FP has good psychometric properties and can be used in research. Longitudinal studies are needed to confirm the predictive value of the BPSS-FP.
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    Rate of Overlap between ICD-11 Gaming Disorder and DSM-5 Internet Gaming Disorder along with Turkish Reliability of the Gaming Disorder Scale for Adolescents (GADIS-A)
    Tuncturk, M; Karacetin, G; Ermis, C; Ciray, RO; Can, M; Yesilkaya, C; Atay, A; Alkas, GE; Kasap, D; Guney, O; Alarslan, S; Cakir, B; Halac, E; Tonyali, A; Elmas, FN; Turan, S
    Introduction: The main aims of the current study were (i) to explore the overlap between Internet gaming disorder (IGD) and gaming disorder (GD) diagnoses, (ii) to identify clinical characteristics in clinical settings, and (iii) to measure psychometric properties of the Gaming Disorder Scale for Adolescents (GADIS-A). Methods: 222 adolescents who were followed up within a tertiary-care mental health hospital, were included (IGD/GD group [n = 111], clinical comparison group [n = 90], healthy controls [n = 21]). The tools used were the GADIS-A, Internet Gaming Disorder Scale - Short-Form, The Difficulties in Emotion Regulation Scale (DERS-36), Children's Global Assessment Scale, and a semistructured interview for DSM-5 diagnoses. Results: The overlap rate of IGD and GD is 73%. Comorbid ADHD diagnoses were more commonly found in the IGD group compared to the clinical comparison group. Patients who met GD and IGD diagnoses revealed higher scores in DERS-36. Turkish GADIS-A Item-total score correlation coefficients were between 0.627 and 0.860. In the sample, there was a high level of correlation between the number of DSM-5 and ICD-11 diagnostic criteria met and GADIS-A scale scores. The Cronbach's alphas if item deleted ranged between 0.942 and 0.954. In addition, treatment refusal was more frequent in the IGD group than in the clinical comparison group. Conclusion: The GADIS-A had good to excellent psychometric properties in Turkish adolescents. Despite having a stricter diagnostic criterion, GD overlapped with IGD in a clinical population.
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    Effects of High Altitude on Sleep and Respiratory System and Theirs Adaptations
    San, T; Polat, S; Cingi, C; Eskiizmir, G; Oghan, F; Cakir, B
    High-altitude (HA) environments have adverse effects on the normal functioning body of people accustomed to living at low altitudes because of the change in barometric pressure which causes decrease in the amount of oxygen leading to hypobaric hypoxia. Sustained exposure to hypoxia has adverse effects on body weight, muscle structure and exercise capacity, mental functioning, and sleep quality. The most important step of acclimatization is the hyperventilation which is achieved by hypoxic ventilatory response of the peripheral chemoreceptors. Hyperventilation results in increase in arterial carbondioxide concentration. Altitude also affects sleep and cardiac output, which is the other determinant of oxygen delivery. Upon initial exposure to HA, the resting pulse rate increases rapidly, but with acclimatization, heart rate and cardiac output tend to fall. Another important component that leads to decrease in cardiac output is the reduction in the stroke volume with acclimatization. During sleep at HA, the levels of CO2 in the blood can drop very low and this can switch off the drive to breathe. Only after the body senses a further drop in O-2 levels breathing is started again. Periodic breathing is thought to result from instability in the control system through the hypoxic drive or the response to CO2.
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    Risk Factors for Current Wheezing and Its Phenotypes Among Elementary School Children
    Civelek, E; Cakir, B; Orhan, F; Yuksel, H; Boz, AB; Uner, A; Sekerel, BE
    Background Accumulating evidence suggests, asthma includes many phenotypes with varying clinical and prognostic features. Epidemiological surveys documented a number of environmental risk factors for the development of asthma and interestingly these differ between and within countries, suggesting that the differences may be related with the different distribution of asthma phenotypes. This study aimed to investigate risk factors of current wheezing (CW) and different wheezing phenotypes in elementary school children. Methods Six thousand nine hundred sixty-three 9- to 11-year-old children of a previous multicenter survey where the methodology of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase-II was used were analyzed. Wheezing phenotypes were defined as wheezing with rhinitis (RW), wheezing with rhinoconjunctivitis (RCW), atopic wheezing (AW), non-atopic wheezing (NAW), and frequent wheezing (FW) (>= 4/year wheezing episodes). Results The prevalence of CW was 15.8% and among these, 22.4%, 67.3%, 45.9%, 20.5%, and 79.5% were classified as FW, RW, RCW, AW, and NAW, respectively. History of parental asthma/allergic rhinitis, coexistence of other allergic diseases, presence of mold and dampness in the house lived during the first year of life and maternal smoking in pregnancy were found to be risk factors for most phenotypes (odds ratio (OR) ranged from 1.43 to 3.56). Number of household in the last year (OR = 1.14), prematurity (OR = 2.08), and duration of breastfeeding (OR = 1.02) per additional month were found to be risk factor for FW, AVV, and RCW, respectively. Conclusion Beside common risk factors for the development of asthma and its phenotypes, certain risk factors appeared to play a role in the development of phenotypic characteristics of asthma. These findings support our hypothesis that each phenotype has not only different clinical characteristics but also has different roots. Pediatr Pulmonol. 2011; 46:166-174. (C) 2011 Wiley-Liss, Inc.
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    Epidemiology and burden of rhinitis and rhinoconjunctivitis in 9-to 11-year-old children
    Civelek, E; Yavuz, ST; Boz, AB; Orhan, F; Yuksel, H; Uner, A; Cakir, B; Sekerel, BE
    Background: Rhinoconjunctivitis (RC) is regarded as the most common chronic disease of childhood; however, the currently available epidemiological studies on prevalence, burden, and risk factors of RC are insufficient. This analysis aimed to investigate potential risk factors, symptom frequency, and burden of RC. Methods: Using the International Study of Asthma and Allergies in Childhood Phase II questionnaires, 6963 elementary school children aged 9-11 years were surveyed in five different city centers of Turkey. All participants were skin-prick tested with common aeroallergens. Results: The prevalence of ever rhinitis, physician-diagnosed rhinitis, current rhinitis, and current RC were 51.6, 31.0, 43.5, and 23.1%, respectively; 19.8% of children with RC symptoms were atopic to at least one allergen. Among students with RC symptoms, 42.2, 23.9, 35.8, and 28.2% reported moderate severe interference of daily activities, at least 1 day of absence from school, visit to a health care professional, and any drug usage for rhinitis, respectively. Nasal decongestants and oral antihistamines were the most frequently used treatment. Approximately 70% of RC patients reported perennial symptoms and 42.8% were classified as mild to intermittent. Multivariate logistic regression analysis revealed family history of asthma and/or allergic rhinitis (odds ratio [OR] = 1.863; confidence interval, [CI] = 1.583-2.191; p < 0.001), living in a house with mold and dampness in the 1st year of life (OR = 1.651; CI = 1.356-2.01; p < 0.001), maternal smoking in pregnancy (OR = 1.425; CI = 1.089-1.864; p = 0.011), low monthly income (OR = 1.685; CI = 1.422-1.998; p = 0.001), current wheezing (OR = 2.543; CI = 2.151-3.006; p = 0.001), and current atopic eczema (OR = 2.503; CI = 1.96-3.196; p = 0.001) as significant risk factors for current RC. Conclusion: Along with the high prevalence of RC in childhood, underdiagnosis and undertreatment of the disease are also frequent. The socioeconomic burden of the disease can be reduced by increasing awareness and proper diagnosis/treatment. (Am J Rhinol Allergy 24, 364-370, 2010; doi: 10.2500/ajra.2010.24.3484)