Browsing by Author "Unal, F"

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    The Role of Fecal Calprotectin in Investigating Pediatric Ulcerative Colitis
    Unal, F; Semizel, E; Serdar, M; Ecevit, CÖ; Karaca, Y; Yilmaz, EM; Kocaefe, H; Kasirga, HE
    introduction: Fecal calprotectin (FCP) can be found in high concentrations in inflammatory bowel disease due to the increase in leucocyte turnover in intestinal wall or increase of migration of neutrophils into the lumen. In this study, we aimed to determine the FCP values of the ulcerative colitis (UC) patients at the time of diagnosis and to investigate the applicability and effectiveness of this non-invasive method in the diagnosis of the disease, routinely. Materials and Methods: A total of 19 patients with UC (10 females, 9 males, age: 11.5 +/- 3.5 years old) whoose stool samples collected during the diagnosis period and 20 healthy controls (10 female, 10 male, age: 10.3 +/- 4.5 years old) were included in the study. Stool samples were collected for FCP analysis by ELISA method at the time of diagnosis and before the treatment period. Results: FCP values of the UC group were statistically higher than the control group. FCP values of the UC and control groups were 398.4 mu g /gr stool (56.7-2450) and 19.4 mu g/gr stool (2-81), respectively (p<0.005). FCP values of the patient group with mild activity index (n=8), and moderate-severe activity index (n=11) according to the Pediatric Ulcerative Colitis Activity Index were 267.6-mu g/gr stool, and 435.2 mu g/gr stool, respectively (r2: 0.40, p<0.05). There was not statistical difference between the FCP values of the patients with pancolitis (422.6 mu g/gr stool) and with left-sided colitis, proctitis/sigmoiditis (371.7 mu g/gr stool) (p>0.05). High CRP values (89.4%), elevation of erythrocyte sedimentation rate (84.2%), leukocytosis (73.6%), thrombocytosis (68.4%), anemia (89.4%), and hypoalbuminemia (52.6%) were found. Conclusions: FCP values of the UC patients were found to be statistically higher than the control group, and increase in FCP values has been observed with increasing disease activity. Therefore, we believe that the determination of FCP could be useful at the time of diagnosis and during follow-up of the patients with UC.
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    Clinical significance of low transaminase levels in children with inflammatory bowel disease
    Cakir, M; Sag, E; Dogan, G; Unal, F; Kasirga, E
    BackgroundLow alanine aminotransaminase (LALT) levels may be seen in patients with inflammatory bowel disease (IBD), but there has been no study about the frequency and its clinical significance. We aimed to analyze the frequency of LALT, and its clinical significance in children with IBD.MethodsThe study included the 89 patients with IBD without hepatobiliary involvement. LALT was defined as ALT levels <5 U/L. Demographic and clinical findings and outcome of the patients with and without LALT were compared.ResultsLALT was found 47.1% of the patients. At initial examination, it was more common in female patients (92.3 vs. 41.3%, P<0.001) and patients with CD (57.7 vs. 30.2%, P=0.01). 75% of the patients with penetrating Crohn's disease (CD) had LALT (P=0.002). Hemoglobin (10.42.1 vs. 11.7 +/- 1.9g/dL, P=0.01), folic acid (5.2 +/- 3.3 vs. 8.6 +/- 5.9ng/mL, P=0.02) and serum albumin levels (3.6 +/- 0.8 vs. 4.7 +/- 5g/dL, P=0.002) were significantly low in patients with LALT. LALT was associted with the disease relapse within 2weeks in 12 of the 16 patients with LALT whereas it was seen in 16 of the 73 patients without LALT during the follow-up (75 vs. 21.9%, P<0.001). Additionally, steroid dependency was more common in patients with LALT during the follow-up (62.5 vs. 12.3%, P<0.001).ConclusionsLALT is common in children with IBD especially in CD and associated with low hemoglobin, albumin and folic acid levels. It may be a marker of relapse and steroid dependency.
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    RELIABILITY AND VALIDITY OF THE CYSTIC FIBROSIS QUESTIONNAIRE-REVISED FOR CHILDREN AND PARENTS IN TURKEY
    Yuksel, H; Yilmaz, O; Dogru, D; Karadag, B; Unal, F; Quittner, A
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    Prevalence of Childhood Affective disorders in Turkey: An epidemiological study
    Karacetin, G; Arman, AR; Fis, NP; Demirci, E; Ozmen, S; Hesapcioglu, ST; Oztop, D; Tufan, AE; Tural, U; Aktepe, E; Aksu, H; Ardic, UA; Basgul, S; Bilac, O; Coskun, M; Celik, GG; Demirkaya, SK; Dursun, OB; Durukan, I; Fidan, T; Gencoglan, S; Gokcen, C; Gokten, ES; Gorker, I; Gormez, V; Gundogdu, OY; Gurkan, CK; Herguner, S; Kandemir, H; Kilic, BG; Kilincaslan, A; Mutluer, T; Nasiroglu, S; Ozcan, OO; Ozturk, M; Sapmaz, SY; Suren, S; Sahin, N; Tahiroglu, AY; Toros, F; Unal, F; Vural, P; Yazici, IP; Yazici, KU; Yildirim, V; Yulaf, Y; Yuce, M; Yuksel, T; Akdemir, D; Altun, H; Ayik, B; Bilgic, A; Bozkurt, OH; Cakir, ED; Ceri, V; Demir, NU; Dinc, G; Irmak, MY; Karaman, D; Kinik, MF; Mazlum, B; Memik, NC; Ozdemir, DF; Sinir, H; Tasdelen, BI; Taskin, B; Ugur, C; Uran, P; Uysal, T; Uneri, OS; Yilmaz, S; Yilmaz, SS; Acikel, B; Aktas, H; Alaca, R; Alic, BG; Almbaidheen, M; Ari, FP; Aslan, C; Atabay, E; Ay, MG; Aydemir, H; Ayranci, G; Babadagi, Z; Bayar, H; Bayhan, PC; Bayram, O; Bektas, ND; Berberoglu, KK; Bostan, R; Cakan, Y; Canli, MA; Cansiz, MA; Ceylan, C; Coskun, N; Coskun, S; Demir, I; Demir, N; Demirdogen, EY; Dogan, B; Donmez, YE; Donder, F; Efe, A; Eray, S; Erbilgin, S; Erden, S; Ersoy, EG; Eseroglu, T; Firat, SK; Gok, EE; Goksoy, SC; Guler, G; Gules, Z; Gunay, G; Gunes, S; Gunes, A; Guven, G; Horozcu, H; Irmak, A; Isik, U; Kahraman, O; Kalayci, BM; Karaaslan, U; Karadag, M; Kilic, HT; Kilicaslan, F; Kinay, D; Koc, EB; Kocael, O; Mutlu, RK; San, Z; Nalbant, K; Okumus, N; Ozbek, F; Ozdemir, FA; Ozdemir, H; Ozgur, BG; Ozkan, S; Ozyurt, EY; Polat, B; Polat, H; Sekmen, E; Sertcelik, M; Sevgen, FH; Sevince, O; Shamkhalova, U; Suleyman, F; Simsek, NE; Tanir, Y; Tekden, M; Temtek, S; Topal, M; Topal, Z; Turk, T; Ucar, HN; Ucar, F; Uygun, D; Uzun, N; Vatansever, Z; Yazgili, NG; Yildiz, DM; Yildiz, N; Ercan, ES
    Aim: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. Methods: This study was conducted as a part of the The Epidemiology of Childhood Psychopathology in Turkey (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. Results: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. Conclusion: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.
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    Inflammatory bowel disease in Turkish children
    Cakir, M; Unal, F; Dinler, G; Baran, M; Yuksekkaya, HA; Tumgor, G; Kasirga, E; Kalayci, AG; Aydogdu, S
    This study was undertaken to evaluate demographics, clinical manifestations, laboratory findings and outcomes of children with inflammatory bowel disease (IBD) in Turkey. We analyzed the medical records of 127 children diagnosed with IBD (under 18 years old) between January 2004 and January 2012 in 8 pediatric gastroenterology centers. Of the 127 patients, 90 (70.9%) suffered from ulcerative colitis (UC), 29 (22.8%) from Crohn's disease (CD), and 8 (6.3%) from IBD unclassified. The mean age of the 127 patients was 11.6 +/- 4.1 years, and 11.8% of the patients were below 5 years old. Of the patients, 49.6% were male, and males were more predominant in patients with CD than in those with UC (72.4% vs. 42.2%, P=0.008; a male/female ratio of 2.62 in CD, P=0.0016). Approximately one fifth of the patients had extra-intestinal manifestations and 13.3% of the patients had associated diseases. Extraintestinal manifestations and associated diseases were more common in early onset disease [P=0.017, odds ratio (OR)=4.02; P=0.03, OR=4.1]. Of the patients, 15% had normal laboratory parameters including anemia, high platelet count, hypoalbuminemia, hypoferritinemia, and high sedimentation rate. Area under receiver operation characteristics was used to predict pancolitis in patients with UC. The values of C-reactive protein, sedimentation rate and pediatric ulcerative colitis activity were 0.61 (P=0.06), 0.66 (P=0.01) and 0.76 (P=0.0001), respectively. Four (4.4%) patients with UC underwent colectomy, and finally two (1.5%, 95% confidence interval: 0-3.7%) patients died from primary disease or complications. IBD is an increasing clinical entity in Turkey. Features of IBD are similar to those in other populations, but prospective multicenter studies are needed to analyze the true incidence of IBD in Turkish children.
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    Reliability and validity of the Cystic Fibrosis Questionnaire-Revised for children and parents in Turkey: cross-sectional study
    Yuksel, H; Yilmaz, O; Dogru, D; Karadag, B; Unal, F; Quittner, AL
    The purpose of study was to translate Cystic Fibrosis Questionnaire-Revised (CFQ-R) into Turkish for children with cystic fibrosis (CF) and evaluate its reliability and validity. This is the first CF-specific health-related quality of life (HRQOL) measure validated in a Muslim country. Fifty-one children aged 6-13 years treated at four centers in Turkey and 30 parents participated in this cross-sectional study. Demographic characteristics and disease severity parameters were recorded for all participants. All participants completed the parent or child versions of CFQ-R and KINDL questionnaires at enrollment. Reliability and construct validity analysis were carried out. Both children and parents endorsed a range of responses, with no evidence of floor or ceiling effects. Item-to-total correlations indicated that most items were more highly correlated with their intended scale than competing scales. Good internal consistency was found for majority of child and parent scales. CFQ-R scales correlated significantly with clinical indices of disease severity. Good evidence of convergent validity with a generic HRQOL scale was found. Turkish versions of CFQ-R Child and Parent instruments have demonstrated adequate reliability and validity and can be utilized in clinical trials or integrated into clinical evaluation and follow-up of Turkish children with CF.
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    Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological study
    Mutluer, T; Gorker, I; Akdemir, D; Ozdemir, DF; Ozel, OO; Vural, P; Tufan, AE; Karacetin, G; Arman, AR; Fis, NP; Demirci, E; Ozmen, S; Hesapcioglu, ST; Oztop, D; Tural, U; Aktepe, E; Aksu, H; Ardic, UA; Basgul, S; Bilac, O; Coskun, M; Celik, GG; Demirkaya, SK; Dursun, OB; Durukan, I; Fidan, T; Gokcen, C; Gormez, V; Gundogdu, OY; Herguner, S; Kandemir, H; Kilic, BG; Kilincaslan, A; Nasiroglu, S; Sapmaz, SY; Sahin, N; Tahiroglu, AY; Toros, F; Unal, F; Yazici, IP; Yazici, KU; Isik, U; Ercan, ES
    Purpose The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. Methods This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years. Results The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. Conclusion Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment.