Sociodemographic Characteristics, Anxiety, Depression Levels, and Emotional and Behavioral Problems in Hospitalized COVID-19-Positive Children and Adolescents.

ABSTRACT: This study aimed to investigate anxiety, depression levels, and emotional/behavioral problems of children and adolescents while being treated in the COVID-19 unit. The present study included 50 children who were COVID-19 positive, aged 7-18 years, and 50 age- and gender-matched healthy controls. The sociodemographic data form and Revised Child Anxiety and Depression Scale-Child Version (RCADS-C) were applied to all children, and all families were asked sociodemographic data form, Revised Child Anxiety and Depression Scale-Parent Version (RCADS-P), and Strengths and Difficulties Questionnaire (SDQ). There was no significant difference between the patient and control groups in terms of anxiety, depression levels, and emotional/behavioral problems. The conduct problems subscale score of SDQ in the patient group was found to be significantly lower than the control group (p = 0.037). Separation anxiety subscale scores of RCADS (p = 0.034) and the rate of accompanying companions (p = 0.01) in the patient group were found to be significantly higher in preadolescents than in adolescents. In conclusion, this study demonstrated that children and adolescents who were COVID-19 positive were not different from healthy children in terms of anxiety and depression levels, and emotional and behavioral problems in the acute period during inpatient treatment.

Decreased levels of L-selectin and platelet-endothelial cell adhesion molecule-1 in children with autism spectrum disorder.

OBJECTIVE: This study aimed to ascertain the serum levels of selectins (E, L, P) and platelet-endothelial adhesion molecule-1 (PECAM-1) in preschool children with autism spectrum disorder (ASD) and to establish a comparison with the levels observed in healthy controls. METHODS: The study included 34 children aged 2-7 years diagnosed with ASD (ASD group) and 34 randomly selected healthy children matched for age and sex to the ASD group. The children were free of any genetic or physical disease, clinically active infection, or medication use. The sociodemographic data form was completed by all parents. The Childhood Autism Rating Scale (CARS) and the Autism Behavior Checklist (ABC) were administered to the patient group, and the Aberrant Behavior Checklist (AbBC) was completed by the families of all children. Serum selectin (E, L, P) and PECAM-1 levels were measured using enzyme-linked immunosorbent assay (ELISA) kits. RESULTS: The results showed that the levels of both L-selectin (p = 0.007) and PECAM-1 (p = 0.019) were significantly lower in the ASD group than in the control group. No significant difference was observed between the groups concerning E-selectin and P-selectin levels (p > 0.05). It was observed that P-selectin variables were statistically significant in predicting the presence of ASD (p = 0.019). A remarkable inverse correlation was found between the AbBC irritability subscale score and L-selectin (r = -0.296, p = 0.014) and PECAM-1 (r = -0.276, p = 0. 023); the AbBC Lethargy-Social Withdrawal subscale score and E-Selectin (r = -0.239, p = 0.049), L-Selectin (r = -0.297, p = 0.014) and PECAM-1 (r = -0.264, p = 0.029); L-Selectin levels and the AbBC stereotypic behavior subscale (r = -0.248, p = 0.042). No statistically significant relationship was observed between selectins (E, L, P) and PECAM-1 levels and CARS scale, ABC subscale or total scores and age variables (p > 0.05). CONCLUSIONS: These study results suggest that L-selectin, P-selectin and PECAM-1 may play a role in the pathophysiology of ASD.

Posterior Quadratus Lumborum Block or Thoracolumbar Interfascial Plane Block and Postoperative Analgesia after Spinal Surgery: A Randomized Controlled Trial.

INTRODUCTION: The management of postoperative pain following lumbar disc herniation (LDH) surgery is crucial for the quality of recovery. The effectiveness of multimodal analgesia plans increases when interfascial plane blocks are included. This study sought to compare the analgesic efficacy of preoperative ultrasound-guided TLIP (thoracolumbar interfascial plane) blocks and posterior QLBs (quadratus lumborum blocks) in patients undergoing LDH surgery. METHODS: Patients undergoing elective LDH surgery under general anesthesia were randomized into two groups: thoracolumbar interfascial plane block (Group T) and posterior quadratus lumborum block (Group Q). Block applications were performed 30 min before anesthesia induction. In the postoperative period, analgesia control was provided with a patient-controlled analgesia device. The patients' 24 h cumulative opioid consumption was examined. Pain scores were evaluated in the 0th, 3rd, 6th, 9th, 12th, and 24th hours. RESULTS: The mean 24 h cumulative morphine consumption for patients was statistically insignificant when Groups T and Q were compared (9.14 ± 7.03 mg vs. 8.66 ± 6.58 mg, p = 0.788). Pain scores at rest and during movement as well as morphine consumption were similar between groups in the 0th, 3rd, 6th, 9th, 12th, and 24th hours (p > 0.05). CONCLUSIONS: The study determined that the utilization of TLIP blocks and posterior QLBs prior to anesthesia induction yielded comparable outcomes in terms of reducing postoperative analgesic consumption and enhancing the efficacy of multimodal analgesia in individuals undergoing single-distance lumbosacral spine surgery under general anesthesia.

functional outcome in late adolescence/early adulthood of patients with autism spectrum disorder and its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional study.

The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported "good" or "very good" outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education.

The Effect of Cold Application to the Lateral Neck Area on Peripheral Vascular Access Pain: A Randomised Controlled Study.

INTRODUCTION: Various types of vagus nerve stimulation are employed in the treatment of a range of conditions, including depression, anxiety, epilepsy, headache, tinnitus, atrial fibrillation, schizophrenia, and musculoskeletal pain. The objective of this study was to apply vagal stimulation to the neck area using standardised cold, and then analyse the level of vascular access discomfort experienced by individuals who underwent venous cannulation from the dorsal side of the hand prior to anaesthesia. MATERIALS AND METHODS: A total of 180 patients, aged 18-75, who were scheduled to undergo elective surgery, were categorised into three distinct groups: the Sham group (Group S), the Control group (Group K), and the Cold group (Group M), with each group consisting of 60 individuals. Bilateral cold application to the lateral side of the neck was performed prior to the commencement of vascular access in Group M patients, followed by the subsequent opening of vascular access. The alterations in heart rate among patients was assessed subsequent to the application of cold and following the establishment of vascular access. The participants were instructed to assess their level of vascular access pain on a numerical pain scale (NRS) ranging from 0 to 10. RESULTS: A statistically significant difference (p = 0.035) was seen when comparing the pain ratings of patients during vascular access. The study revealed that the NRS values exhibited a statistically significant decrease in Group M compared to both Group K (p = 0.038) and Group S (p = 0.048). Group M had a higher prevalence of individuals experiencing mild pain compared to other groups, and the difference was statistically significant (p = 0.029). In Group M, the average heart rate following vagal stimulation exhibited a statistically significant decrease compared to the average heart rate observed at the beginning of the study (p < 0.05). Upon comparing the original heart rate measurements with the heart rate values following vascular access, it was observed that there was an elevation in heart rate for both Group S and Group K. Conversely, Group M exhibited a decrease in heart rate after vascular access when compared to the initial heart rate values. CONCLUSIONS: In the present investigation, it was discovered that the application of cold to the neck region resulted in a drop in heart rate among the patients, which persisted throughout the process of vascular access. Furthermore, the level of pain experienced by these individuals was reduced during vascular access procedures.

Can Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio, or Systemic Immune Inflammation Index Be an Indicator of Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy?

AIM: Through this study, we aim to investigate whether biomarkers like the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII) might predict the postoperative first 24 hours analgesic requirement and pain scores of patients undergoing laparoscopic cholecystectomy.  Material & Method: After receiving the local ethical board approval, records of 67 patients, aged between 18 and 75 years, with ASA classifications I-III who underwent elective laparoscopic cholecystectomy were retrospectively evaluated to record postoperative analgesic requirements and numerical pain scale (NRS) scores. NLR, PLR, and SII scores were calculated from preoperative hemograms and compared with analgesic requirements and NRS scores. RESULTS: The data of 67 patients were evaluated. There was no correlation between postoperative tramadol use and NRS scores, PLR, or SII values (p>0.05). NRS scores and the cumulative 24-hour postoperative tramadol use were correlated (p=0.0001), as it was observed that patients with high NRS scores used higher amounts of tramadol. Additionally, a poor statistically significant correlation was found between PDW (Platelet distribution width) value and tramadol dose (AUC = 0.611). CONCLUSION: No significant association between NLR, PLR, SII, pain scores, and tramadol use was detected.

Automatic Diagnosis of Attention Deficit Hyperactivity Disorder with Continuous Wavelet Transform and Convolutional Neural Network.

Objective: The attention deficit hyperactivity disorder has a negative impact on the child's educational life and relationships with the social environment during childhood and adolescence. The connection between temperament traits and The attention deficit hyperactivity disorder has been proven by various studies. As far as we know, there is no machine learning study to diagnose. The attention deficit hyperactivity disorder in a dataset created using temperament characteristics. Methods: Machine learning-based semi-automatic/fully automatic expert decision support systems are frequently used for the diagnosis of various diseases. In this study, it was aimed to reveal the success of a semi-automatic expert decision support system in the diagnosis of attention deficit hyperactivity disorder by using temperament characteristics. The high classification success achieved is a resource for a potential diagnosis of attention deficit hyperactivity disorder expert decision support system. In this respect, this study includes original qualities and innovations. Results: Many different deep learning methods were used in the research. Deep learning methods are models that achieve high success by using a large number of images in various image processing competitions. The images of the signals in the data set were first obtained by Continuous Wavelet Transform. The highest classification success in our data set was obtained with the Squeeze Net model with 88.33%. Conclusion: The model we propose shows that an automatic system based on artificial intelligence can be created, as well as revealing the relationship between temperament characteristics in the diagnosis of attention deficit hyperactivity in the data set we created.

Effect of Impairment on the Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder in a National Survey: Nation-Wide Prevalence and Comorbidities of ADHD.

OBJECTIVE: This study aimed to determine the prevalence and comorbidities of attention-deficit hyperactivity disorder (ADHD) by evaluating a large-scale nation-wide sample of children. METHOD: The inclusion criterion was being enrolled as a 2nd, 3rd, or 4th-grade student. A semi-structured diagnostic interview (K-SADS-PL), DSM-IV-Based Screening Scale for Disruptive Behavior Disorders, and assessment of impairment (by both parents and teachers) were applied to 5,842 participants. RESULTS: The prevalence of ADHD was 19.5% without impairment and 12.4% with impairment. Both ADHD with and without impairment groups had similar psychiatric comorbidity rates except for oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses. Impairment in the ADHD group resulted in significantly higher ODD and CD diagnoses. CONCLUSION: Even when impairment is not described, other psychiatric disorders accompany the diagnosis of ADHD and may cause impairment in the future. Impairment in the diagnosis of ADHD significantly increases the likelihood of ODD and CD.

Diagnostic Performance of Erythropoietin and Erythropoietin Receptors Levels in Children with Attention Deficit Hyperactivity Disorder.

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is a heterogeneous, highly heritable, a common childhood neurobehavioural disorder resulting from complex gene-gene and gene-environment interactions. The erythropoietin (Epo)/erythropoietin receptors (EpoR) system turned out to have additional important functions in nonhematopoietic tissue. In this study, we aimed to investigate the levels of Epo and and EpoR, and also their diagnostic values in children with ADHD. METHODS: A total of 70 children were included in the study, 35 drug-naive patients with ADHD (age: 6-12 years; male/female: 20/15) and 35 healthy controls (age: 6-12 years; male/female: 22/13). Serum Epo and EpoR levels was determined using a commercial sandwich enzyme-linked immunosorbent assay kit. RESULTS: The results indicated that the levels of Epo decreased in patients with ADHD compared to control (p < 0.05). On the other hand, EpoR levels increased in these patients (p < 0.05). Furthermore, the ratio of Epo/EpoR was significantly lower in ADHD patients than controls (p < 0.05). Receiver operator characteristic curve analysis showed high diagnostic performance for Epo and EpoR, areas under curve were 0.980 and 1.000, respectively. CONCLUSION: This is the first report to investigate the association between serum Epo and EpoR levels in ADHD patients. Our results indicated that Epo may play a role in the etiology of ADHD, and Epo therapy may be beneficial in these disorders if given in addition to the routine treatment of children with ADHD. Furthermore, our results reveal possible diagnostic value of Epo and EpoR.

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T).

AIM: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. METHOD: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. RESULTS: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. CONCLUSION: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.

The Levels of Vitamin D, Vitamin D Receptor, Homocysteine and Complex B Vitamin in Children with Autism Spectrum Disorders.

OBJECTIVE: Autism spectrum disorder (ASD) is a complex neurodevelopmental syndrome with an increasingly prevalent etiology, yet not fully understood. It has been thought that vitamin D, complex B vitamin levels and homocysteine are associated with environmental factors and are important in ASD. The aim of this study was to examine serum vitamin D, vitamin D receptor (VDR), homocysteine, vitamin B6, vitamin B12 and folate levels in ASD. METHODS: In this study, serum vitamin D and VDR, homocysteine, vitamins B6, B12 and folate levels were determined in 60 patients with ASD (aged 3 to 12 years) and in 45 age-gender matched healthy controls. In addition, calcium, phosphorus and alkaline phosphatase, which are associated with vitamin D metabolism, were measured from serum in both groups. ASD severity was evaluted by the Childhood Autism Rating Scale (CARS). RESULTS: Serum vitamin D and VDR were substantially reduced in patients with ASD in comparision to control group. However, homocysteine level was significantly higher and vitamin B6, vitamin B12 and folate were also reduced in patients with ASD. Total CARS score showed a positive association with homocysteine and a negative correlation with vitamins D,B6, B12, folate and VDR. CONCLUSION: This comprehensive study, which examines many parameters has shown that low serum levels of vitamins D, B6, B12, folate and VDR as well as high homocysteine are important in the etiopathogenesis of ASD. However, further studies are required to define the precise mechanism(s) of these parameters and their contributions to the etiology and treatment of ASD.

Quetiapine Induced Autoimmune Hemolytic Anemia in a Child Patient: A Case Report.

Autoimmune hemolytic anemia is a disease characterized with destruction of erythrocytes as a result of antibody produce against patient's own erythrocytes and anemia. Autoimmune hemolytic anemia can be roughly stratified into two groups according to serological features and secondary causes including drugs induced hemolytic anemia. Drugs induced autoimmune hemolytic anemia is very rare in pediatric patients. Even though hematological side effects such as leucopenia, agranulocytosis, eosinophilia, thrombocytopenic purpura and aplastic anemia might occur due to psychotropic drug use; to the best of our knowledge there is no autoimmune hemolytic anemia case due to quetiapine, an atypical antipsychotics, in literature. We hereby describe the first child case of autoimmune hemolytic anemia during quetiapine treatment.We also are pointing out that one should keep in mind serious hematological side effects with atypical antipsychotic drug use with this case report.

Homocysteine, Pyridoxine, Folate and Vitamin B12 Levels in Children with Attention Deficit Hyperactivity Disorder.

BACKGROUND: In our study, we aimed to evaluate the serum homocysteine levels, pyridoxine, folate and vitamin B12 levels in children with attention deficit hyperactivity disorders (ADHD). SUBJECTS AND METHODS: This study included 30 newly diagnosed drug-naive children with ADHD (23 males and 7 female, mean age 9.3±1.8 years) and 30 sex-and age matched healthy controls. The diagnosis of ADHD was made according to DSM-V criteria. Children and adolescents were administered the Schedule for Affective Disorders and Schizophrenia for School Aged Children, Present and Lifetime Version, the Conners' Parent Rating Scale-Revised, Long Form, the Conners' Teacher Rating Scale and the Wechsler Intelligence Scale for Children Revised (WISC-R) for all participants. Homocysteine, pyridoxine, folate and vitamin B12 levels were measured with enzyme-linked immunosorbent assay. RESULTS: Homocysteine, pyridoxine, folate and vitamin B12 levels were significantly lower in children with ADHD compared with their controls (p<0.05). A positive significant correlation was observed between the all WISC-R scores and vitamin B12 level in patients (r=0.408, p=0.025). CONCLUSIONS: The results obtained in this study showed that reduced homocysteine, pyridoxine, folate and vitamin B12 levels could be a risk factor in the etiology of ADHD.

Prevalence of Childhood Affective disorders in Turkey: An epidemiological study.

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.

Risk of mild head injury in preschool children: relationship to attention deficit hyperactivity disorder symptoms.

AIM: To investigate whether there is an association between mild head injury (MHI) and attention deficit hyperactivity disorder (ADHD) symptoms in preschool children. METHODS: The study included a patient group of 30 children aged 3-6 years with mild head trauma and a control group of 30 healthy and age- and sex-matched children. The symptoms of ADHD were evaluated using the Conners' Parent Rating Scale-Revised Long (CPRS-RL) form. RESULTS: The mean age was 4.73 ± 1.13 years in the patient group and 4.65 ± 0.99 years in the control group. No significant differences were determined between the groups in terms of age, gender, parents' age and education (p > 0.05). The total subscale points as reported by the parents of the children with MHI were significantly higher than those for the control group in terms of the following subscales: oppositional, cognitive problems/inattention, hyperactivity, social problems, ADHD index, Conners' Global Index (CGI)-Irritability-Impulsiveness, CGI-Emotional Lability, CGI-Total and DSM-IV ADHD symptoms (p < 0.05). A history of previous trauma treated in emergency services was determined in eight of the 30 patients (26.7%). CONCLUSIONS: The findings of this study suggest that preschool children with MHI have more pre-injury ADHD symptoms and oppositional and emotional-behavioural symptoms than healthy children without trauma. Clinicians should screen children with MHI for ADHD symptoms and refer them for treatment when necessary. Evaluation of children presenting with MHI by a child psychiatrist may prevent repetition of injuries.

Evaluation of estrogen and G protein-coupled estrogen receptor 1 (GPER) levels in drug-naïve patients with attention deficit hyperactivity disorder (ADHD).

Estrogen has a crucial role in the regulation of reproductive and neuroendocrine function and exerts its effects through two classes of receptors, nuclear and membrane estrogen receptors (mERs). G protein-coupled estrogen receptor 1 (GPER) is a member of mERs, and despite limited research on the levels of GPER in patients with psychiatric diseases, a role of GPER in such conditions has been suggested. Here we evaluated serum estrogen and GPER levels in children with attention deficit hyperactivity disorder (ADHD) in relation to their age- and gender-matched healthy controls. A total of 82 children were included in the study, 47 drug- naïve patients with ADHD (age: 6-12 years; male/female: 34/13) and 35 healthy controls (age: 6-12 years; male/female: 19/16). The subgroups according to ADHD types were inattentive, hyperactive/impulsive, and combined. Serum estrogen was measured using an immunoassay system, while serum GPER was determined using a commercial sandwich enzyme-linked immunosorbent assay kit. Estrogen levels in children with ADHD were similar as in control group, while GPER levels were significantly lower in ADHD group compared to controls (p < 0.05). Logistic regression analysis showed a significant association between GPER levels and ADHD (p < 0.05), and no association between estrogen levels and ADHD (p > 0.05). No significant differences were found in GPER and estrogen levels between ADHD subgroups (p > 0.05). To the best of our knowledge, this study is the first to investigate estrogen and GPER levels in ADHD. Our preliminary findings suggest a relationship between serum GPER levels and ADHD, and this should be further investigated.

Vitamin D and vitamin D receptor levels in children with attention-deficit/hyperactivity disorder.

OBJECTIVE: In this study, we aimed to evaluate vitamin D and vitamin D receptor levels in children with attention-deficit/hyperactivity disorder (ADHD). PATIENTS AND METHODS: In this cross-sectional study, a total of 80 children including 40 ADHD patients (aged 6-12 years; 28 males and 12 females) and 40 age-, sex-, and season of blood collection-matched controls (aged 6-12 years; 25 males and 15 females) were enrolled. Serum vitamin D and vitamin D receptor levels and calcium, phosphorus, and alkaline phosphatase were measured. The vitamin D receptor levels in the serum were measured using the quantitative sandwich enzyme immunoassay technique. RESULTS: Serum vitamin D and vitamin D receptor levels were found to be significantly lower in children with ADHD compared to healthy controls. No significant differences were found in serum calcium, phosphorus, and alkaline phosphatase levels. No significant differences were found among the ADHD subtypes in terms of serum vitamin D, vitamin D receptor, calcium, phosphorus and alkaline phosphatase levels. CONCLUSION: This study suggests that children with ADHD have lower levels of vitamin D and vitamin D receptor. According to the authors' knowledge, this is the first study to describe vitamin D receptor levels in ADHD.

Antibiotic resistance patterns of urinary tract pathogens in Turkish children.

BACKGROUND: Knowledge of local antimicrobial resistance patterns is essential for evidence- based empirical antibiotic prescribing. We aimed to investigate the distribution and changes in causative agents of urinary tract infections in children and the resistance rates, and to recommend the most appropriate antibiotics. METHODS: In this retrospective study, we evaluated causative agents and antimicrobial resistance in urine isolates from the positive community from September 2014 to April 2016 in a single hospital in Ankara, Turkey. RESULTS: A total of 850 positive urine cultures were identified, of which 588 (69.2%) were from girls and 262 (30.8%) were from boys. Their mean age was 36.5 ± 45.0 months. The most common causative agent was Escherichia coli (64.2% of cases) followed by Klebsiella pneumoniae (14.9%). The overall resistance to ampicillin (62.6%), cephalothin (44.2%), co-trimoxazole (29.8%) and cefuroxime (28.7%) was significant. No resistance to imipenem was detected in the isolates. The least resistance was for amikacin, ceftriaxone, ciprofloxacin and cefepime (0.1, 2.4, 7.5 and 8.3%, respectively). Imipenem was the most active agent against E. coli followed by amikacin (0.2%), ceftriaxone (2.7%) and nitrofurantoin (5.1%). High resistance rates to nitrofurantoin were detected in K. pneumoniae, Proteus and Enterobacteriae. CONCLUSIONS: E. coli was the most common causative agent of urinary tract infection in children. Ampicillin, trimethoprim-sulfometaxazole, cephalothin and cefuroxim had the highest resistance rates against urinary tract pathogens in our center. For oral empirical antibiotherapy, cefixime is the most appropriate choice so as to include Klebsiella strains.

Increased Serum G Protein-coupled Estrogen Receptor 1 Levels and Its Diagnostic Value in Drug Naïve Patients with Major Depressive Disorder.

OBJECTIVE: The facts that depression is more prevalent in females than in males and females are exposed to depression more commonly during certain hormonal fluctuating periods indicate the role of sex hormones in physiopathology. Estrogen acts over estrogen receptors alpha and beta and recently identified G protein-coupled estrogen receptor 1 (GPER1). The present study aimed, for the first time, to evaluate serum GPER1 levels in drug-naïve major depressive disorder (MDD) patients. METHODS: The study included 56 newly diagnosed drug-naïve MDD patients aged between 18 and 50 years and 42 age- and gender-matched healthy volunteers. Medical history was obtained and physical examinations, laboratory tests, and the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) were performed. The serum GPER1 levels were measured. RESULTS: The HAM-D score was significantly higher in the MDD patients than in the controls. The GPER1 level was significantly higher in the MDD patients than in the controls. A positive correlation was found with GPER1 levels and depression scores. The receiver operating characteristic analysis revealed sensitivity, specificity, positive predictive value, and negative predictive value as 82.1%, 90.5%, 92.0%, and 79.2%, respectively, for the presence of depression, when the serum GPER1 value was ≥0.16. CONCLUSION: This study demonstrated significantly higher serum GPER1 levels in the MDD patients than in the controls, a positive correlation was found between GPER1 levels and depression scores and serum GPER1 level was valuable in predicting the presence of depression.

Decreased levels of G protein-coupled estrogen receptor in children with autism spectrum disorders.

Sex hormones, specially estrogen, and it is receptors plays a critical role in the pathogenesis of psychiatric disorders including autism spectrum disorders (ASD). The aim of this study was to investigate the relationship between ASD and G protein-coupled estrogen receptor (GPER), a recently discovered estrogen receptors, and also to study the relation of serum GPER levels with the severity of autistic symptoms. The present study included 45 children with drug naive ASD diagnosed by DSM-V criteria, aged between 3 and 12 years and 40 age- and gender-matched healthy controls. The severity of ASD was evaluated with the Childhood Autism Rating Scale (CARS) total score. The GPER levels in the serum were measured using the quantitative sandwich enzyme immunoassay technique. The serum GPER level was significantly lower in the ASD patients than in the controls. There was a negative significant correlation between the GPER level and the CARS score. There were no significant correlations between GPER level with estradiol and age. In conclusion, this study demonstrated that the decreased serum GPER levels were associated with ASD and GPER may play an important role in the etiology of ASD.