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Pehlivanturk-Kizilkan M, Akgül S, Güven AG, Düzçeker Y, Derman O, Kanbur N. Binge eating symptomatology in adolescents with polycystic ovary syndrome. Physiol Behav 2024; 279:114532. [PMID: 38552708 DOI: 10.1016/j.physbeh.2024.114532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 02/29/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024]
Abstract
Several factors may contribute to binge eating behaviors in PCOS. However, findings are contradictory and studies in the adolescence are limited. We aimed to evaluate the eating attitudes of adolescents with PCOS and the possible etiological factors underlying the association between PCOS and binge eating symptomology. Between 2019 and 2022, 46 newly diagnosed adolescents with PCOS and 56 controls matched for age and BMI z-score were included. The Eating Disorder Examination Questionnaire, Three Factor Eating Questionnaire-R18, and a questionnaire assessing postprandial reactive hypoglycemia symptom severity were given. Binge eating symptomology, in terms of over, uncontrolled, and emotional eating, were more prevalent in the PCOS group. Uncontrolled, emotional, and binge eating were positively correlated with postprandial reactive hypoglycemia symptom score. Overeating was also associated with clinical hyperandrogenism. Improving the disease outcome and reducing the future complications requires early recognition and management of emotional and uncontrolled eating behaviors in adolescents with PCOS.
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Affiliation(s)
- Melis Pehlivanturk-Kizilkan
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ayşe Gül Güven
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yasemin Düzçeker
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Orhan Derman
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Aygün Ari D, Pehlivantürk Kizilkan M, Derman O, Akgül S. Menstrual characteristics of atypical anorexia nervosa. Eur Eat Disord Rev 2024; 32:493-502. [PMID: 38265941 DOI: 10.1002/erv.3065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/20/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE While menstrual irregularities are acknowledged in restrictive-type eating disorders (EDs), the menstrual characteristics specific to atypical anorexia nervosa (AAN) remain inadequately defined. This study aims to compare the menstrual features of anorexia nervosa (AN) and AAN. METHOD Adolescents diagnosed with AN or AAN who exhibited secondary amenorrhoea at presentation and had their menstrual cycles restored during follow-up were eligible for this study. Clinical and menstrual data at admission and during follow-up were obtained from patient files, and compared between the AN and AAN cohorts. RESULTS The study included a total of 77 patients (38 with AN and 39 with AAN). The extent of weight loss and the disease duration until the onset of amenorrhoea were comparable in the two groups. However, the duration of illness and the time since the last menstrual period at admission were shorter in the AAN group. Moreover, amenorrhoea manifested at a higher body mass index, and the return of menses occurred more rapidly with less weight gain in the AAN group after the onset of clinical follow-up. Additionally, the AAN group exhibited a shorter overall duration of amenorrhoea. CONCLUSIONS This study highlights the significance of recognising amenorrhoea in restrictive disorders, even when individuals maintain a normal weight. The faster return of menstrual cycles and shorter duration of amenorrhoea observed in adolescents with AAN emphasise the significance of early diagnosis and prompt initiation of treatment. Regardless of the patient's presenting complaint and weight status, obtaining a comprehensive ED history is essential when addressing concerns regarding amenorrhoea or menstrual irregularities.
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Affiliation(s)
- Demet Aygün Ari
- Department of Pediatrics, University of Health Sciences Ankara Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Melis Pehlivantürk Kizilkan
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Orhan Derman
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Akgül S, Pehlivantürk Kızılkan M, Yıldırım A, Derman O. Prevalence of suicide attempt, suicide ideation and self-harm at diagnosis in adolescents with eating disorders. Int J Psychiatry Clin Pract 2024:1-5. [PMID: 38592409 DOI: 10.1080/13651501.2024.2337796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Data concerning the suicide prevalence of eating disorder (ED) subtypes and predictive factors are lacking in youth. This study aimed to examine suicide attempts (SA), suicide ideation (SI) and self-harm (SH) upon diagnosis in adolescents with EDs. METHODS The prevalence of SA, SI and SH in ED subtypes was evaluated by retrospectively assessing the Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicidal ideation and Safety (HEEADSSS) instrument of adolescents diagnosed with an ED. Clinical predictors of SI in anorexia nervosa (AN) and atypical AN (AAN) were assessed. RESULTS Among all participants (398), 41 (10.3%) reported SA, 126 (31.7%) SI and 60 (15.1%) SH. While SA did not differ statistically between ED subgroups (p = .123), they were two times more prevalent in the bulimia nervosa (BN) group (17.5%) than in the AN group (8.5%). In the BN group, SI was 2.3 times more prevalent than in the AN group (p = .001). The AN and ARFID groups exhibited substantially less SH (p = .036). Having a higher body mass index (BMI) was the only significant predictor of SI. CONCLUSIONS This study demonstrates that adolescents with EDs are at an increased risk for suicidality, highlighting the need for close screening, particularly in those with BN, AN-BP and AN with a higher BMI.Key pointsAdolescents with eating disorders have higher rates of suicidality than the general population.Bulimia nervosa had the highest risk for a suicide attempt, suicide ideation and self-harm at diagnosis.A higher body mass index (BMI) percentage was associated with an increased risk of suicidality in the anorexia nervosa group.
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Affiliation(s)
- Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | | | - Ayşegül Yıldırım
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
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Güven AG, Kızılkan MP, Taşar MA, Akgül S. An Assessment of the Quality of YouTube Videos as a Resource for Adolescents Experiencing Abnormal Uterine Bleeding. J Pediatr Adolesc Gynecol 2024; 37:137-141. [PMID: 38122960 DOI: 10.1016/j.jpag.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/11/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
STUDY OBJECTIVE YouTube, the largest accessible media-sharing platform, has become an important tool for pursuing health-related information. Adolescents may find it challenging to seek counseling or access adolescent-friendly services for menstruation-related problems, so YouTube may be a useful resource. The aim of this study was to examine the reliability, quality, and accuracy of YouTube videos concerning abnormal uterine bleeding in adolescents. METHODS A YouTube search using the key words "adolescent, teens, heavy period, abnormal uterine bleeding, heavy menstrual bleeding" yielded 109 videos. Video features (duration, time since upload, likes, views, comments), sources of upload, and content were recorded. All the videos were reviewed by 2 adolescent medicine specialists and scored using the Journal of the American Medical Association, the 5-point modified DISCERN tool, and the Global Quality Scale. RESULTS Fifty-eight videos met the inclusion criteria. Most (62.1%) were created by non-professionals, and a significant portion (81%) contained general descriptions. On the basis of the DISCERN classification, 50% exhibited poor quality. Similarly, the Journal of the American Medical Association assessment indicated that only 36.2% satisfied the requirements for good quality. The videos uploaded by professionals exhibited notably superior quality in comparison with those uploaded by non-professionals. Additionally, higher-quality videos were longer (P = .040) and more recent (P = .011). CONCLUSION Mot YouTube videos about adolescent abnormal uterine bleeding provide low-quality information. We believe that increasing the number of videos tailored by health care providers specializing in adolescent gynecology to address the specific physical and psychosocial needs of adolescents with menstrual problems would be beneficial.
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Affiliation(s)
- Ayşe Gül Güven
- University of Health Sciences, Ankara Training and Education Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey.
| | - Melis Pehlivantürk Kızılkan
- Division of Adolescent Medicine, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Medine Ayşin Taşar
- University of Health Sciences, Ankara Training and Education Hospital, Department of Pediatrics, Division of Social Pediatrics, Ankara, Turkey
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Pehlivanturk Kizilkan M, Akgül S, Kanbur N, Derman O. Reply to the commenting letter by Panda PK, et al. Eur J Pediatr 2024; 183:1471-1472. [PMID: 38300365 DOI: 10.1007/s00431-024-05453-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Affiliation(s)
| | - Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Türkiye
| | - Nuray Kanbur
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Türkiye
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Türkiye
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Torun ŞE, Akgül S, Kızılkan MP, Nalbant K, Kanbur N, Akdemir D, Alan BE, Tüzün Z, Derman O. The impact of the prolonged COVID-19 pandemic on adolescents with eating disorders: a follow-up study from Türkiye. Turk J Pediatr 2024; 66:42-56. [PMID: 38523378 DOI: 10.24953/turkjped.2023.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
BACKGROUND At the onset of the pandemic, we conducted a study on adolescents with eating disorders (EDs) and found no deterioration in ED symptoms. The objective of this subsequent study was to conduct a follow-up evaluation of the same cohort and investigate the consequences of the prolonged pandemic. METHODS This longitudinal study was conducted one year after the first study between May 2021 and June 2021 with 37 adolescents aged 12-18 years (pre-existing EDs). The reassessment included an evaluation of sociodemographic and clinical characteristics, the impact of pandemic-related restrictions on ED behaviors, well-being, and quality of life. All the participants underwent a re-administration of the ED examination questionnaire (EDE-Q), Beck Depression Inventory, the State Anxiety Inventory for Children, and the Maudsley Obsessive Compulsive Inventory. RESULTS No significant difference was observed in the EDE-Q scores or the ED examination questionnaire scores between the initial (T1) and subsequent (T2) study. The ED-related quality of life was seen to have slightly improved in the later stage. While depression (T1: 18, T2: 15, p=0.883) and obsession scores (T1: 11, T2: 14, p: 0.536) showed no disparity between the studies, anxiety scores (T1: 38, T2: 43, p:0.011) exhibited a significant increase. CONCLUSIONS Consistent with the early phase, no exacerbation of ED symptoms in adolescents was observed during the later stages of the pandemic. Close clinical monitoring during the pandemic might have been protective against the deteriorating effects of the pandemic. During social isolation, it is important to monitor adolescents with EDs continously for depression and anxiety.
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Affiliation(s)
- Şeyma Erdem Torun
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University, Ankara
| | | | - Kevser Nalbant
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | | | - Devrim Akdemir
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Burcu Ersöz Alan
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Zeynep Tüzün
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University, Ankara
| | - Orhan Derman
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University, Ankara
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Erdem Torun Ş, Pehlivantürk Kızılkan M, Derman O, Akgül S. Suicidal ideation and attempts among adolescents from a tertiary hospital in Turkey: A comparative study of pre and postpandemic periods. Clin Child Psychol Psychiatry 2023:13591045231210171. [PMID: 37917530 DOI: 10.1177/13591045231210171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
AIM This study aims to compare changes in rates of suicidal ideation (SI) and attempts (SA) among adolescents during pre, mid and later periods of the pandemic. MATERIAL AND METHOD This study included adolescents who presented to the adolescent medicine clinic in Turkey between March-May 2019 (prepandemic = T0), March-May 2021(mid period of the pandemic = T1) and March-May 2022 (late period year of the pandemic = T2). SI and SA data were assessed through the electronic hospital records of the "HEEADSSS" inventory. RESULTS The charts of 2113 adolescents were evaluated. The rates of both SI (p = .015) and SA (p = .026) were determined to be higher during the pandemic (T1+T2) compared to the pre-pandemic period, with a 1.4-fold increase in SI and a 1.5-fold increase in SA. The rates of SI did not differ according to gender, (p = .090). In contrast, SA rate was significantly higher in females (7.3%) than males (3.6%) (p = .001). CONCLUSION This study reveals an increase in SI and SA among adolescents during the first 2 years of the pandemic. In challenging times, health professionals should prioritize the identification and treatment of mental health issues, including screening for depression and suicide risk.
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Affiliation(s)
- Şeyma Erdem Torun
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | | | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
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Gündoğdu C, Akgül S. Radiopacity evaluation of different types of resin restorative materials using a digital radiography system. Oral Radiol 2023; 39:646-653. [PMID: 36920599 DOI: 10.1007/s11282-023-00679-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/02/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES The aim of the study was to evaluate and compare the radiopacity of 20 current dental resin composites with digital radiography. METHODS Ten specimens, 10-mm in diameter and 1-mm thickness, were prepared and radiographed using phosphor plates close to Al step wedges and tooth sections. The mean grey values (MGVs) were measured using an ImageJ software program and converted to equivalent Al thickness. Data were analyzed using one-way analysis of variance (ANOVA) and Tamhane post hoc test (p < 0.05). Correlation between mean radiopacity and filler content (wt% and vol%) of the tested materials was analyzed with linear regression analysis. RESULTS The radiopacity of all composites ranged from 1.32 mm Al (Estellite Flow Quick) to 3.41 mm Al (Charisma Classic). All the tested materials, except four restorative materials, had a radiopacity equal or higher than the enamel (p < 0.05). Linear regression revealed low correlation between the radiopacity and filler content of the composite. CONCLUSION Majority of the materials has appropriate radiopacity for dental restorations. There was great variation in radiopacity level, may clinically affect the diagnosis.
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Affiliation(s)
- Ceyda Gündoğdu
- Department of Restorative Dentistry, Faculty of Dentistry, İstanbul Medipol University, TEM Avrupa Otoyolu Göztepe çıkışı no:1, 34214, Bağcılar-Istanbul, Turkey.
| | - Sinem Akgül
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Emek-Ankara, Turkey
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Hazar A, Akgül S, Hazar E. Effect of chlorhexidine and benzalkonium chloride on the long-term push-out bond strength of fiber posts. Niger J Clin Pract 2023; 26:1242-1248. [PMID: 37794535 DOI: 10.4103/njcp.njcp_434_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background and Aim Fiber posts are widely used in endodontically treated teeth with extensive loss of coronal structure. The purpose of this study was to investigate immediate and the long-term effects of chlorhexidine (CHX) and benzalkonium chloride (BAC) application, on the push-out bond strength of fiber posts. Material and Methods Sixty mandibular premolars were decoronated, and root canal treatment was performed. After post space preparation, the specimens were divided into three groups according to the post space-surface pretreatment (n = 20); no surface treatment (control group-Group 1), 2% CHX application (Group 2), and 1% BAC application (Group 3). A self-curing adhesive cement and an etch and rinse adhesive were used for the cementation of posts. Three sections (one cervical, one middle, and one apical) of 1 mm thickness were prepared from each specimen. A push-out test was performed immediately on the half of the specimen sections (n = 10). The other half of the specimen sections were subjected to 20.000 thermal cycles before applying the push-out test (n = 10). The failure mode of each specimen was observed under a stereomicroscope at ×40 magnification. Results The data were analyzed by one-way analysis of variance (ANOVA), Tukey Honestly significant difference (HSD), and Tamhane tests (P = 0.05). The cervical thirds displayed the highest, and the apical thirds showed the lowest values in all groups (P < 0.05), except the control-aged group (P = 0.554). The aged control groups' values were found to be significantly lower than the aged CHX and BAC groups (P < 0.001). Aging significantly reduced the bond strength values of specimens in control groups (P < 0.001). However, aging did not significantly affect the push-out bond strength values of CHX and BAC groups (P > 0.050). The failure types were adhesive between the post and cement (type 1) in all groups, except control-aged group (type 2). Conclusion The application of 2% chlorhexidine or 1% BAC may be an essential step that can be taken to preserve the bond strength of fiber posts.
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Affiliation(s)
- A Hazar
- Faculty of Dentistry, Department of Restorative Dentistry, Zonguldak Bülent Ecevit University, Faculty of Dentistry, Ankara, Turkey
| | - S Akgül
- Department of Restorative Dentistry, Gazi University, Faculty of Dentistry, Ankara, Turkey
| | - E Hazar
- Department of Endodontics, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
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Akgül S, Torun Ş, Çınar HÜ, Pehlivantürk Kızılkan M, Derman O. Eating disorder visits increase among adolescents during the COVID-19 pandemic. Early Interv Psychiatry 2023; 17:837-840. [PMID: 36680467 DOI: 10.1111/eip.13400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/04/2022] [Accepted: 01/01/2023] [Indexed: 01/22/2023]
Abstract
AIM The study aimed to assess changes in adolescent visits due to eating disorders (EDs) during the pandemic. METHOD A retrospective evaluation of adolescents diagnosed with an ED during two periods: June 2019-February 2020 (pre-pandemic) and June 2021-February 2022 (during the pandemic) at an adolescent medicine clinic in Tukey was conducted. The number of patients diagnosed with an ED between these dates was compared with the number of overall attended outpatient appointments. Baseline data for patients with Anorexia Nervosa (AN) and the requirement of hospitalization for all cases were compared. RESULTS Of the 3708 visits in the pre-pandemic period 46 (1.2%) were diagnosed with an ED. This was 69 (2.2%) of 3149 visits during the pandemic which was statistically significant (p = 0.003). The percentage of males to females changed from 2.2% to 11.6% (p = 0.065). Distribution of the type of ED did not change (p = 0.280), although the percentage of atypical AN increased from 6.5% to 17.4%. Mean age, BMI, calorie intake and hospital admissions did not significantly change. CONCLUSION Our findings support the increase in adolescent EDs during COVID-19. Particular attention should be given to males and Atypical AN cases.
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Affiliation(s)
- Sinem Akgül
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Şeyma Torun
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | | | - Melis Pehlivantürk Kızılkan
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Orhan Derman
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
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Sabancı E, Pehlivantürk-Kızılkan M, Akgül S, Derman O, Kanbur N. Tamoxifen Treatment for Pubertal Gynecomastia: When to Start and How Long to Continue. Breast Care (Basel) 2023; 18:249-255. [PMID: 37900549 PMCID: PMC10601691 DOI: 10.1159/000530408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/24/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Pubertal gynecomastia is a common clinical condition among male adolescents, and in most cases, it regresses spontaneously. However, tamoxifen treatment is recommended in selected cases. We aimed to evaluate the indications, safety, and efficacy of tamoxifen treatment in adolescents with pubertal gynecomastia. Methods The data of 83 adolescents with pubertal gynecomastia who were treated with tamoxifen between 2006 and 2018 were evaluated retrospectively. The clinical and laboratory data, initial complaint, tamoxifen treatment indication, duration, and dose were recorded along with the treatment outcome. Results The gynecomastia disc diameter's monthly reduction rate was significantly higher in adolescents with an initial disc diameter ≥3 cm. The significant reduction of the disc started after the fourth month of tamoxifen treatment and continued to significantly reduce, extending to the sixth month. Conclusion Tamoxifen treatment in pubertal gynecomastia was found to be effective and safe. One of the current indications for tamoxifen treatment is having a disc size ≥4 cm, and the recommended treatment duration is 4-6 months. However, this study suggests that treatment should be continued for at least 6 months to achieve the optimal effect. In addition, we recommend that the disc diameter threshold for starting tamoxifen needs to be ≥3 cm.
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Affiliation(s)
- Elif Sabancı
- Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Melis Pehlivantürk-Kızılkan
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Orhan Derman
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Tüzün Z, Akgül S, Işıklı S, Taş D, Kanbur N. Beliefs and Predictors of Negative Attitudes Toward Obesity Among Turkish Healthcare Professionals: Assessing the Bias with Sub-group Analysis. Florence Nightingale J Nurs 2023; 31:115-121. [PMID: 37404214 PMCID: PMC10440927 DOI: 10.5152/fnjn.2023.22306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/14/2023] [Indexed: 07/06/2023]
Abstract
AIM This study aimed to examine Turkish healthcare professionals' beliefs and predictors of negative attitudes toward obesity and to investigate whether those beliefs and negative attitudes differ per their profession and sociodemographic and familial variables. METHOD In this cross-sectional study, healthcare professionals (n = 495) working in four hospitals of Ankara completed a sociodemographic questionnaire and two self-report scales: the Attitudes Toward Obese Persons Scale and the Beliefs About Obese Persons Scale. Data were collected during May, 2018. RESULTS Female healthcare professionals had significantly higher (p = 0.03) positive attitude scores than males, and nurses had significantly higher (p = 0.04) Beliefs About Obese Persons Scale scores than physicians, representing their belief that obesity is not under the control of the individual. The Attitudes Toward Obese Persons Scale scores of university hospital healthcare professionals were significantly higher (p = 0.00) than those of public hospital and private hospital healthcare professionals, and Attitudes Toward Obese Persons Scale scores of healthcare professionals who have a family member with a chronic disease were significantly higher (p = 0.027) than those who do not. CONCLUSION The work experience, spending more time with a patient, and having a member of the family with a chronic illness lead to a more positive attitude toward people with obesity. This result emphasizes the importance of interventions that promote sensitive and empathic communication skills.
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Affiliation(s)
- Zeynep Tüzün
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University İhsan Dogramacı Children’s Hospital, Ankara, Turkey
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University İhsan Dogramacı Children’s Hospital, Ankara, Turkey
| | - Sedat Işıklı
- Department of Psychology, Hacettepe University, Ankara, Turkey
| | - Demet Taş
- Department of Pediatrics, Yıldırım Beyazıt University, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University İhsan Dogramacı Children’s Hospital, Ankara, Turkey
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Akgül S, Torun Ş, Pehlivantürk-Kızılkan M. The Protective Role of Family Mealtime in Anorexia Nervosa. J Adolesc Health 2023; 72:643. [PMID: 36933943 DOI: 10.1016/j.jadohealth.2022.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 03/20/2023]
Affiliation(s)
- Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Şeyma Torun
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
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Çınar HÜ, Kızılkan MP, Akalın A, Kiper PÖŞ, Utine GE, Derman O, Kanbur N, Akgül S. Assessing the menstrual cycle and related problems in adolescents with a Genetic Syndrome associated with Intellectual Disability. J Pediatr Adolesc Gynecol 2023:S1083-3188(23)00278-4. [PMID: 36889454 DOI: 10.1016/j.jpag.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/28/2023] [Accepted: 02/25/2023] [Indexed: 03/10/2023]
Abstract
STUDY OBJECTIVE This study aimed to assess the experience and quality of life related to menstruation in adolescents with a genetic syndrome accompanying intellectual disability (ID). METHODS This prospective cross-sectional study was conducted on 49 adolescents with a genetic syndrome accompanied by ID, which was defined by the Wescher Intelligence scale for children-Revised and 50 unaffected controls. In a survey created by the authors, demographic information, menstrual history, and information regarding menstrual difficulties, school abstinence, dysmenorrhea, and premenstrual changes were collected. The Childhood health assessment questionnaire was utilized to evaluate physical impairment, whereas the QoL scale was utilized to evaluate QoL in general and during menstruation. Data was collected from caregivers and additionally from the participants with mild ID, whereas in the control group, data was collected from the participants. RESULTS Menstrual history were similar between the two groups. Menstruation related school absenteeism was higher among the ID group (8%vs.40.5%, p<0.001). Mothers reported that 73% of their daughters need help with menstruation care. Social, school, psychosocial functioning, and total QoL scores during menstruation were significantly lower in the ID group when compared with the controls. A significant decrease in physical, emotional, social, psychosocial functioning and total QoL score occurred during menstruation in the ID group. None of the mothers requested menstrual suppression. CONCLUSION Although menstrual patterns in two groups were similar, QoL decreased significantly while menstruating in the ID group. Despite a decrease in QoL, an increase in school absenteeism and a high percentage of needing assistance while menstruating none of the mothers requested menstrual suppression.
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Affiliation(s)
| | | | - Akçahan Akalın
- Hacettepe University, Division of Pediatric Genetics, Ankara, Turkey
| | | | - Gülen Eda Utine
- Hacettepe University, Division of Pediatric Genetics, Ankara, Turkey
| | - Orhan Derman
- Hacettepe University, Division of Adolescent Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Hacettepe University, Division of Adolescent Medicine, Ankara, Turkey; Ottawa University, Division of Adolescent Medicine, Ottawa, Canada
| | - Sinem Akgül
- Hacettepe University, Division of Adolescent Medicine, Ankara, Turkey.
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15
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Altınışık H, Akgül S, Nezir M, Özcan S, Özyurt E. The Effect of In-Office Bleaching with Different Concentrations of Hydrogen Peroxide on Enamel Color, Roughness, and Color Stability. Materials (Basel) 2023; 16:ma16041389. [PMID: 36837018 PMCID: PMC9961799 DOI: 10.3390/ma16041389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 05/13/2023]
Abstract
The aim of this study is to evaluate the effectiveness of in-office bleaching in esthetic dentistry on the roughness and color stability of the enamel surface, using different concentrations of hydrogen peroxide (HP). Fifty human incisors were randomly divided into 5 groups (n = 10). No bleaching was performed in the control group. For these groups, concentrations of 40% HP with fluoride (F), 35% HP with calcium (Ca), 25% HP with nano-hydroxyapatite (nHA) and 18% HP with nHA were used for bleaching in the test groups. Surface roughness was assessed at baseline after bleaching occurred. Color measurements were first obtained at baseline, then after the first and second sessions of bleaching, and, finally, after the staining protocol. Scanning electron microscopy and atomic force microscopy were performed. Statistical analysis was conducted with a one-way ANOVA, followed by a post hoc Tukey's test and a paired-samples t-test (p < 0.05). All the bleaching gels used exhibited a similar color change (p > 0.05). Bleaching gels containing 18% HP with nHA and that containing 35% HP with Ca caused less surface roughness of the enamel. Of these concentrations, 25% HP with nHA caused the most surface roughness and no significant difference was observed, compared with 40% HP with F. The highest coloration after bleaching was observed in 40% HP with F and 25% HP with nHA. The lowest coloration was obtained in 35% HP with Ca and 18% HP with nHA but no significant difference was observed between them and the control group. A concentration above 18% HP does not increase the bleaching effectiveness. The results show that 18% HP with nHA and 35% HP with Ca resulted in the least increase in enamel surface roughness when compared to high-concentrate HP; however, it also prevented recoloration after bleaching.
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Affiliation(s)
- Hanife Altınışık
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Ankara 06510, Turkey
- Correspondence: or ; Tel.: +90-555-880-64-18
| | - Sinem Akgül
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Ankara 06510, Turkey
| | - Merve Nezir
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Ankara 06510, Turkey
| | - Suat Özcan
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Ankara 06510, Turkey
| | - Esra Özyurt
- İzmir Training Dental Hospital, İzmir 35160, Turkey
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16
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Düzova A, Akgül S, Utine GE, Yıldız Y. The Türkiye-Syria Earthquake: a response from the editors of the Turkish Journal of Pediatrics. Turk J Pediatr 2023; 65:1-2. [PMID: 36866979 DOI: 10.24953/turkjped.2023.e001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Affiliation(s)
- Ali Düzova
- The Turkish Journal of Pediatrics Editorial Office, Hacettepe University İhsan Doğramacı Children's Hospital, 06100 Ankara
| | - Sinem Akgül
- The Turkish Journal of Pediatrics Editorial Office, Hacettepe University İhsan Doğramacı Children's Hospital, 06100 Ankara
| | - Gülen Eda Utine
- The Turkish Journal of Pediatrics Editorial Office, Hacettepe University İhsan Doğramacı Children's Hospital, 06100 Ankara
| | - Yılmaz Yıldız
- The Turkish Journal of Pediatrics Editorial Office, Hacettepe University İhsan Doğramacı Children's Hospital, 06100 Ankara
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17
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Dut R, Akgül S, Dönmez G, Ulkar B, Kanbur N, Derman O. Adolescent male soccer players have higher growth rates and risk of injury is associated with biological maturity. Turk J Pediatr 2023; 65:990-1001. [PMID: 38204314 DOI: 10.24953/turkjped.2023.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND The objective of this study was to ascertain disparities in growth and maturation between male adolescents engaged in soccer and their non-athletic counterparts, as well as to examine the injury features specific to young soccer players. METHODS A total of 206 soccer players between the ages of 11-16 years, and 208 non-athletic peers were enrolled. Height, weight, body mass index (BMI), annual growth rate, and skeletal age evaluated using a left handwrist x-ray were determined. Biological and sexual maturation were evaluated using skinfold thickness, body composition, and Tanner stages. The game positions, initial age for playing soccer, the number of games per/ week, the number of sports injuries, date of injury, duration for return to activity, the site, nature, mechanism, and rate of injury were recorded for soccer players. Using an injury card, the characteristics of soccer player injuries were recorded. RESULTS The mean age of the participants was 13.6 ± 1.5 years. There was no difference in the growth rates between the groups at the ages of 11.0, 12.0, and 15.0 but at the ages of 13.0 and 14.0 years growth rates were higher in the soccer group. The soccer players were taller than the controls. For all Tanner stages, soccer players had a lower BMI and total body fat percentage, as well as a faster growth rate. Injuries occurred at a rate of 39.3% per year among soccer players. The most common being toe injuries, and playing soccer increased the risk of multiple injuries. Additionally, injuries occurred more frequently in soccer players who were taller, heavier, with higher total body fat and/or higher growth rate, and most commonly occurred during Tanner stage 4. Futhermore, Tanner stage 4 had a higher incidence of two or more injuries than the other stages. CONCLUSIONS Adolescent male soccer players have higher growth rates than their non-athletic peers, and their biological maturity status is associated with an increased risk of injury.
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Affiliation(s)
- Raziye Dut
- Department of Pediatrics and Adolescent Health Medicine, Istanbul Training and Research Hospital, Istanbul
| | - Sinem Akgül
- Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara
| | - Gürhan Dönmez
- Department of Sports Medicine, Hacettepe University Faculty of Medicine, Ankara
| | - Bülent Ulkar
- Department of Sports Medicine, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Nuray Kanbur
- Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara
| | - Orhan Derman
- Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara
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18
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Akgül S, Özön ZA. Gender affirming care is an evidence-based approach and misinformation harms patients and clinicians. Turk J Pediatr 2023; 65:707-708. [PMID: 37661689 DOI: 10.24953/turkjped.2023.622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Affiliation(s)
- Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara
| | - Zeynep Alev Özön
- Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Türkiye
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19
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Akgül S, Tüzün Z, Pehlivantürk Kızılkan M, Özön ZA. Menstrual Suppression in Gender Minority Youth. J Clin Res Pediatr Endocrinol 2022; 14:463-468. [PMID: 34044500 PMCID: PMC9724054 DOI: 10.4274/jcrpe.galenos.2021.2020.0283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The purpose of this case series was to evaluate menstrual suppression in sex assigned at birth female adolescents identifying as male or gender non-conforming. A retrospective chart review of four gender minority youth (GMY), age 14-17, was performed for gender identity history, type and success of menstrual suppression, method satisfaction, side effects and improvement in menstrual distress. Menstrual suppression was successful in three patients, one patient discontinued use due to side effects that caused an increase in gender dysphoria. Menstrual distress and bleeding pattern improved in the majority of GMY in this series but side effects, as well as contraindications, may limit their use. In conclusion, menstrual dysphoria can be life-threatening for GMY and it is important that clinicians consider menstrual suppression in GMY with menstrual dysphoria. This series emphasizes the importance of individualized treatment plans.
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Affiliation(s)
- Sinem Akgül
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey,* Address for Correspondence: Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey Phone: +90 312 305 11 60 E-mail:
| | - Zeynep Tüzün
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Melis Pehlivantürk Kızılkan
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Zeynep Alev Özön
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey
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20
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Akgül S, Bonny AE, Manos BE, Jackson K, Holland-Hall C. Rapid refeeding does not worsen anxiety in adolescents with anorexia nervosa: a pilot study. Eat Disord 2022; 30:587-601. [PMID: 34184971 DOI: 10.1080/10640266.2021.1939920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The study aimed to describe the progression of state anxiety in adolescents with anorexia nervosa (AN) hospitalized on a high calorie refeeding (HCR) protocol. Participants, 12-21 years, admitted for malnutrition due to AN were placed on a HCR protocol in which calories were advanced by 300 kcal/day. The State-Trait Anxiety Inventory for Children (STAIC) was given to participants within 24 hours of hospitalization and the state anxiety component of the STAIC was administered daily immediately before and after breakfast until discharge. Of 22 patients enrolled, 86% were female, mean age was 14.9 ± 2.0 years, and 95% had AN-restrictive type. The median state and trait anxiety scores at time of admission were 37.0 (28-55) and 35.5 (23-51), respectively. There was no significant difference in median pre-meal state anxiety from hospital day 1 to 6 (34.0(26-55) vs. 38.5(25-55), p-value = 0.079) or in median post-meal state anxiety from hospital day 1 to 6 (35.5(29-56) vs. 37(24-56), p-value = 0.484). Similarly, we found minimal correlation between change in caloric intake and change in pre-meal S-anxiety (Spearman correlation coefficient = -0.032) or post-meal S-anxiety (Spearman correlation = 0.032). While this was a small sample observing anxiety over one week, we found no evidence that state anxiety increased with advancing calories, providing additional support for the use of more rapid refeeding protocols.
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Affiliation(s)
- Sinem Akgül
- Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Andrea E Bonny
- Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,The Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA.,The Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Brittny E Manos
- The Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kenneth Jackson
- Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, Ohio, USA.,Biostatistics Resource at Nationwide Children's Hospital, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Cynthia Holland-Hall
- The Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
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21
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Akgül S, Chan B, Manders P. EP05.01-026 Carboplatin Dose Calculations for Patients with Lung Cancer: Significant Dose Differences Found Depending on Dosing Equation. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Akgül S, Gündoğdu C. Color Change Evaluation of Three Universal Resin Composites after Storage in Water: An In Vitro Study. Journal of Advanced Oral Research 2022. [DOI: 10.1177/23202068221099100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: The aim of this in vitro study was to evaluate the color changes of three different universal resin composites after immersion in distilled water for one month. Materials and Methods: Omnichroma, Estelite Σ Quick, and Filtek Universal Restorative were investigated. Ten disk shaped specimens (6 mm diameter, 2 mm thickness) were prepared according to the manufacturers’ instructions for each material. After polishing, initial color measurements were taken followed by individual storage of the specimens in distilled water at 37 °C for one month when color measurements were repeated. The change in the color of each resin composites (Δ E00) was calculated with a digital method, using the CIEDE2000 color difference formula. The data were analyzed using one-way ANOVA followed by Tukey post-hoc test ( P < .05). Results: All resin composites exhibited acceptable color change after one month. Omnichroma exhibited the highest color change (2.26 ± 0.48) value while Filtek Universal Restorative showed the lowest (1.14 ± 0.38) value. All color parameters influenced the Δ E00 values in all groups except Filtek Universal for Δ L* and Δ b values. Conclusion: When performing composite resin restorations, especially for esthetic purposes, polymerization may lead to change in the color of restorative material over time, but it should be considered whether this is within acceptable limits.
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Affiliation(s)
- Sinem Akgül
- Faculty of Dentistry, Restorative Dentistry Department, Gazi University, Emek-Ankara, Turkey
| | - Ceyda Gündoğdu
- Restorative Dentistry Department, Faculty of Dentistry, Medipol University, Bagcılar-Istanbul, Turkey
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23
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Akgül S, Akdemir D, Nalbant K, Derman O, Ersöz Alan B, Tüzün Z, Kanbur N. The effects of the COVID-19 lockdown on adolescents with an eating disorder and identifying factors predicting disordered eating behaviour. Early Interv Psychiatry 2022; 16:544-551. [PMID: 34263541 PMCID: PMC8444904 DOI: 10.1111/eip.13193] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/23/2021] [Accepted: 07/04/2021] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the impact of the COVID-19 lockdown on adolescents with eating disorders (ED) and identify factors predicting ED behaviour. METHOD This study took place during an age-stratified lockdown for those under 20 years in Turkey. Participants completed a survey developed to evaluate the effects of the lockdown on ED behaviour, well-being and quality of life (QoL) and additionally the eating disorder examination questionnaire (EDE-Q), and scales for depression, anxiety and obsessive-compulsive behaviour. The relationship between the EDE-Q-global score and other variables related to ED was examined. Linear regression analysis was performed to examine the predictive power of these variables on ED behaviour. RESULTS Thirty-eight ED patients with a mean age of 15.12 ± 1.56 years were included in the study. Of participants, 42.1% reported feeling an improvement in ED symptomatology, 71.0% reported none or rare conflict with parents due to eating, 39.5% reported often or always complying with their meal plan. Of participants, 92.0% agreed to 'understanding the value of being healthy' and stated realizing that 'they were in control' due to the pandemic. Of participants 36.9% scored 'bad' for both overall and ED related QoL. In the stepwise regression analysis depression score had the highest predictive value for ED behaviour. CONCLUSION Almost half of the participants felt an improvement in their ED and a majority reported rare parental conflict. However, less than half reported meal plan compliance. As depression had the highest positive predictive value for ED behaviour additional screening for depression during the pandemic maybe warranted in ED patients.
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Affiliation(s)
- Sinem Akgül
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Devrim Akdemir
- Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Kevser Nalbant
- Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Orhan Derman
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Burcu Ersöz Alan
- Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Zeynep Tüzün
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Nuray Kanbur
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
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24
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Hazar A, Akgül S, Koçak S, Murat Koçak M. Effect of Brushing Time with a Whitening Dentifrice on Surface Roughness of Anterior Composite ResinsRoughness of Anterior Composite Resi. J Dent Indones 2022. [DOI: 10.14693/jdi.v29i1.1213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives: This study aimed to compare the surface roughness of three anterior composite resins with different filler size, rate, and shape after brushing for 5000, 10000, and 20000 cycles with a whitening dentifrice. Methods: 44 disk-shaped specimens of each material (5mm diameter, 2mm depth) G-aenial Anterior, Harmonize, Asteria were prepared and divided into four groups according to the brushing cycles (Initial, 5000, 10000, and 20000 cycles). Initial surface roughness values (Ra-values) were assessed using a profilometer and measurements were repeated after each brushing cycle. 4 specimens from each composite resin were observed by scanning electron microscopy before and after brushing. The data were analyzed by Shapiro Wilk., ANOVA, Tukey, Friedman, and Wilcoxon tests (p<0.05). Results: The Ra-values of all groups increased in proportion to the number of brushing cycles (p<.05). The Ra-values of both Asteria and Harmonize were significantly lower than the G-aenial after all brushing cycles (p<0.05). Conclusion: All of the materials demonstrated surface irregularities after 20.000 brushing cycles corresponding to 24 months. The degree of surface alteration increased with brushing time and depends on the composite’s filler rate, size, and shape.
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Tüzün Z, Başar K, Akgül S. Social Connectedness Matters: Depression and Anxiety in Transgender Youth During the COVID-19 Pandemic. J Sex Med 2022; 19:650-660. [PMID: 35249840 DOI: 10.1016/j.sxm.2022.01.522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/24/2022] [Accepted: 01/31/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND Gender-affirming and supportive relations for transgender youth are considered protective in terms of mental health. AIM To describe how transgender youth perceived changes in their gender expression, in the course of the gender-affirming path, and the effect of social connectedness and social support on depression and anxiety during the pandemic. METHODS In this cross-sectional study, transgender youth completed an online survey developed to evaluate the perceived changes in gender expression and affirmation path that occurred during COVID-19 and the age-stratified lockdown. Furthermore, we aimed to investigate the effect of social connectedness and social support on depression and anxiety in this population during the pandemic. The participants completed the following scales: Social Connectedness Scale Revised (SCS-R), Multidimensional Scale of Perceived Social Support (MSPSS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI). The effect of lockdown on life conditions, gender expression, social and medical gender-affirming path, social connectedness, social support, depression, and anxiety levels were examined. Linear regression analyses were performed to evaluate the relationships between BDI and STAI scores and other variables. OUTCOMES The relationship between the levels of perceived social connectedness, and social support, the pandemic-related changes in living conditions and depression and anxiety scores were calculated. RESULTS A total of 49 transgender youth with a mean age of 20.53 ± 1.86 years were enrolled. Participants reporting discomfort at the place they live and who had difficulties concerning gender expression and affirmation had higher depression and anxiety scores and perceived lower social support from their family. Social connectedness score was a significant negative predictor of depression severity, whereas social connectedness and social support were both significant negative predictors of anxiety severity. CLINICAL IMPLICATIONS Our results show increased adversity for transgender youth when connectedness with supportive people is diminished. During the COVID-19 pandemic, social connectedness and social support perceived by transgender youth are associated with better mental health. STRENGTHS AND LIMITATIONS This is one of the first studies to evaluate the changes that occurred during the COVID-19 pandemic in transgender youth with relation to social support and connectedness, during an age-stratified lockdown. The main limitations were the small study size, skewed gender ratio and that the study sample came from a single gender clinic. CONCLUSION As social connectedness and social support are significant predictors of depression and anxiety severity, special attention is needed to increase contact and support for transgender youth during the pandemic. Tüzün Z, Başar K, Akgül S. Social Connectedness Matters: Depression and Anxiety in Transgender Youth During the COVID-19 Pandemic. J Sex Med 2022;19:650-660.
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Affiliation(s)
- Zeynep Tüzün
- Hacettepe University, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Koray Başar
- Hacettepe University, Department of Psychiatry, Ankara, Turkey
| | - Sinem Akgül
- Hacettepe University, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey.
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26
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Tüzün Z, Başar K, Akgül S. Social Connectedness Matters: Depression and Anxiety in Transgender Youth During the COVID-19 Pandemic. J Sex Med 2022; 19:650-660. [PMID: 35249840 PMCID: PMC8818343 DOI: 10.1016/j.jsxm.2022.01.522] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/24/2022] [Accepted: 01/31/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Gender-affirming and supportive relations for transgender youth are considered protective in terms of mental health. AIM To describe how transgender youth perceived changes in their gender expression, in the course of the gender-affirming path, and the effect of social connectedness and social support on depression and anxiety during the pandemic. METHODS In this cross-sectional study, transgender youth completed an online survey developed to evaluate the perceived changes in gender expression and affirmation path that occurred during COVID-19 and the age-stratified lockdown. Furthermore, we aimed to investigate the effect of social connectedness and social support on depression and anxiety in this population during the pandemic. The participants completed the following scales: Social Connectedness Scale Revised (SCS-R), Multidimensional Scale of Perceived Social Support (MSPSS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI). The effect of lockdown on life conditions, gender expression, social and medical gender-affirming path, social connectedness, social support, depression, and anxiety levels were examined. Linear regression analyses were performed to evaluate the relationships between BDI and STAI scores and other variables. OUTCOMES The relationship between the levels of perceived social connectedness, and social support, the pandemic-related changes in living conditions and depression and anxiety scores were calculated. RESULTS A total of 49 transgender youth with a mean age of 20.53 ± 1.86 years were enrolled. Participants reporting discomfort at the place they live and who had difficulties concerning gender expression and affirmation had higher depression and anxiety scores and perceived lower social support from their family. Social connectedness score was a significant negative predictor of depression severity, whereas social connectedness and social support were both significant negative predictors of anxiety severity. CLINICAL IMPLICATIONS Our results show increased adversity for transgender youth when connectedness with supportive people is diminished. During the COVID-19 pandemic, social connectedness and social support perceived by transgender youth are associated with better mental health. STRENGTHS AND LIMITATIONS This is one of the first studies to evaluate the changes that occurred during the COVID-19 pandemic in transgender youth with relation to social support and connectedness, during an age-stratified lockdown. The main limitations were the small study size, skewed gender ratio and that the study sample came from a single gender clinic. CONCLUSION As social connectedness and social support are significant predictors of depression and anxiety severity, special attention is needed to increase contact and support for transgender youth during the pandemic. Tüzün Z, Başar K, Akgül S. Social Connectedness Matters: Depression and Anxiety in Transgender Youth During the COVID-19 Pandemic. J Sex Med 2022;19:650-660.
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Affiliation(s)
- Zeynep Tüzün
- Hacettepe University, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Koray Başar
- Hacettepe University, Department of Psychiatry, Ankara, Turkey
| | - Sinem Akgül
- Hacettepe University, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey.
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Düzçeker Y, Pehlivantürk-Kızılkan M, Akgül S, Özgül RK, Kanbur N, Derman O. Investigation of androgen receptor gene CAG repeat length polymorphism in pubertal gynecomastia. J Pediatr Endocrinol Metab 2022; 35:349-354. [PMID: 34954930 DOI: 10.1515/jpem-2021-0441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/01/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Androgen receptor gene CAG repeat, AR (CAG)n, polymorphism is thought to have an effect on male reproductive functions and a relationship between long AR (CAG)n and decreased androgenic activity has been shown. Therefore, we hypothesized that in adolescents with long AR CAG repeat the prevalence of pubertal gynecomastia (PG) will be higher and we aimed to investigate the association between AR (CAG)n polymorphism and PG in Turkish adolescents. METHODS Adolescents with PG between 11 and 19 years of age were enrolled as the study group and healthy individuals without a history of PG, who were at least 14 years of age and Tanner 4 or 5 were enrolled as the control group. The AR (CAG)n length was detected by direct DNA sequencing analysis and reproductive hormones were measured by standardized analyses. RESULTS The mean AR (CAG)n was 22.3 ± 2.6 (mean ± SD) in the PG group (n=101) and 21.9 ± 3.1 (mean ± SD) in the control group (n=88) (p=0.276). The adolescents with short AR (CAG)n had lower body mass index standard deviation scores (BMI SDS) compared to the adolescents with intermediate and long repeat numbers (p=0.029). CONCLUSIONS The results of this study showed a lack of direct association between AR (CAG)n and PG. However, the significant relationship between the AR (CAG)n quartiles and BMI SDS suggests that long AR (CAG)n might cause PG indirectly. Further studies are needed to better clarify this relationship.
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Affiliation(s)
- Yasemin Düzçeker
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Melis Pehlivantürk-Kızılkan
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Rıza Köksal Özgül
- Department of Pediatric Metabolism, Institute of Child Health, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Akgül S, Gündoğdu C, Bala O. Effects of storage time and restoration depth on instrumental color adjustment potential of universal resin composites. J Oral Sci 2021; 64:49-52. [PMID: 34911896 DOI: 10.2334/josnusd.21-0290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE To determine the instrumental color adjustment potential (CAP-I)of 3 universal composites at 2 time intervals and 2 depths. METHODS Omnichroma, Estelite Sigma Quick, and Filtek Universal Restorative were tested. Two types of specimens were prepared. For dual specimens, Class V restorations were created in anterior denture teeth and restored with resin composites. For single specimens, replications were fabricated with resin composites (n = 10). Unrestored teeth were used for comparison. Color was measured with a spectrophotometer at 24 h and 1 month, and CAP-I was calculated. Data were compared by analysis of variance followed by the Student t-test and paired sample t-test. RESULTS The CAP-I of tested materials ranged from 0.11 to 0.27 at 24 h and from 0.60 to 0.76 at 1 month. At 24 h, Omnichroma yielded the highest values, followed by Estelite Sigma Quick and Filtek Universal Restorative (P < 0.05). CAP-I was significantly higher at 1 month than at 24 h in all groups. In all groups, restorations with a depth of 3.0 mm yielded better results than restorations with a depth of 2.0 mm (P < 0.05). CONCLUSION Storage time and restoration depth were positively associated with CAP-I. Single-shade and multi-shade universal composites are good alternatives for color-matched, esthetically satisfying restorations.
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Affiliation(s)
- Sinem Akgül
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University
| | - Ceyda Gündoğdu
- Department of Restorative Dentistry, Faculty of Dentistry, Istanbul Medipol University
| | - Oya Bala
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University
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Akgül S, Kedici Alp C, Bala O. Repair potential of a bulk-fill resin composite: Effect of different surface-treatment protocols. Eur J Oral Sci 2021; 129:e12814. [PMID: 34309074 DOI: 10.1111/eos.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 06/03/2021] [Indexed: 11/30/2022]
Abstract
This study evaluated the effect of different surface-treatment protocols on the repair bond strength of a bulk-fill resin composite. One-hundred and forty specimens (Filtek Bulk-fill) were created (5 mm diameter, 4 mm depth) and allocated to one of 14 groups according to surface treatment (no treatment, tribochemical silica coating, sandblasting with aluminum oxide), adhesive application (no adhesive, total-etch, self-etch), and type of repair resin (bulk-fill, universal resin) (n = 10 per group). Twenty specimens were selected for measuring the cohesive strengths of non-aged resin composites and used as reference. Other specimens were thermocycled. Shear bond-strength testing was performed. Data were analyzed using linear regression of bond strength as a function of the surface treatment, type of adhesive and whether or not adhesive was applied, and type of repair resin. The failure modes were analyzed using logistic regression of failure mode (cohesive failure vs. other types, or adhesive failure vs. other types) on the type of surface treatment, adhesive application, and repair resin used. Surface treatment, regardless of whether this was tribochemical silica coating (mean difference = 5.44 MPa; 95% CI = 4.77-6.11) or sandblasting with aluminum oxide (mean difference = 4.22 MPa; 95% CI = 3.55-4.88), resulted in higher shear bond strength than no treatment. Application of adhesive resulted in a substantial and statistically significant decrease of shear bond strength (by 8.77 MPa, for self-etch and by 7.26 MPa for total-etch) relative to no adhesive. Conversely, the type of repair resin did not influence the shear bond strength to any appreciable extent.
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Affiliation(s)
- Sinem Akgül
- Restorative Dentistry Department, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Cemile Kedici Alp
- Restorative Dentistry Department, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Oya Bala
- Restorative Dentistry Department, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Kanbur N, Akgül S, Akdemir D. The role of culture on parenting boys as a potential risk factor in the development of male eating disorders during adolescence in Turkey. Turk J Pediatr 2021; 63:533-537. [PMID: 34254502 DOI: 10.24953/turkjped.2021.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Devrim Akdemir
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Hadland SE, Aalsma MC, Akgül S, Alinsky RH, Bruner A, Chadi N, Galagali PM, Kreida EC, Robinson CA, Wilson JD. Medication for Adolescents and Young Adults With Opioid Use Disorder. J Adolesc Health 2021; 68:632-636. [PMID: 33485735 PMCID: PMC7902443 DOI: 10.1016/j.jadohealth.2020.12.129] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
Opioid-related morbidity and mortality have risen in many settings globally. It is critical that practitioners who work with adolescents and young adults (AYAs) provide timely, evidence-based treatment for opioid use disorder (OUD). Such treatment should include medications for opioid use disorder (MOUD), including buprenorphine, naltrexone, and methadone. Medication treatment is associated with reduced mortality, fewer relapses to opioid use, and enhanced recovery and retention in addiction care, among other positive health outcomes. Unfortunately, the vast majority of AYAs with OUD do not receive medication. The Society for Adolescent Health and Medicine recommends that AYAs be offered MOUD as a critical component of an integrated treatment approach. Barriers to receipt of medications are widespread; many are common to high-, middle-, and low-income countries alike, whereas others differ. Such barriers should be minimized to ensure equitable access to youth-friendly, affirming, and confidential addiction treatment that includes MOUD. Robust education on OUD and medication treatment should be provided to all practitioners who work with AYAs. Strategies to reduce stigma surrounding medication-and stigma experienced by individuals with substance use disorders more generally-should be widely implemented. A broad research agenda is proposed with the goal of expanding the evidence base for the use and delivery of MOUD for AYAs.
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Affiliation(s)
- Scott E. Hadland
- Grayken Center for Addiction and Department of Pediatrics, Boston Medical Center, One Boston Medical Center Place, Boston, MA, 02118, USA,Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine, 801 Albany Street, Room 2055, Boston, MA, 02119, USA
| | - Matthew C. Aalsma
- Adolescent Behavioral Health Research Program, Department of Pediatrics, Indiana University, 410 West 10th Street, Suite 1001, Indianapolis, IN, 46202, USA
| | - Sinem Akgül
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey, 06100
| | - Rachel H. Alinsky
- Johns Hopkins University School of Medicine, Division of General Pediatrics and Adolescent Medicine, Rubenstein Child Health Building, 200 N. Wolfe Street, Room 2085, Baltimore, MD, 21287, USA
| | - Ann Bruner
- Mountain Manor Treatment Center, 3800 Frederick Ave, Baltimore, MD, 21229, USA
| | - Nicholas Chadi
- Division of Adolescent Medicine, Department of Pediatrics, Sainte-Justine University Hospital Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC, Canada, H3T 1C5
| | - Preeti M Galagali
- Bangalore Adolescent Care and Counselling Centre, 528, 2nd block Rajainagar, Bangalore 560010, India
| | - Ellen C. Kreida
- Department of Psychiatry, Boston Medical Center, 850 Harrison Avenue, 9th Floor, Boston, MA, 02118, USA
| | - Camille A. Robinson
- Johns Hopkins University School of Medicine, Division of General Pediatrics and Adolescent Medicine, Rubenstein Child Health Building, 200 N. Wolfe Street, Room 2085, Baltimore, MD, 21287, USA
| | - J. Deanna Wilson
- University of Pittsburgh School of Medicine, University of Pittsburgh School of Medicine, Divisions of General Internal Medicine and Adolescent and Young Adult Medicine, 3420 Fifth Avenue, Pittsburgh, PA, 15213, USA
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Abstract
This study aimed to examine the cross-sectional relationship between Ramadan fasting as a spiritual factor with prolonged hunger and disordered eating behaviors. The study was conducted in June 2016 (11th-29th days of Ramadan) and consisted of 238 fasting and 49 non-fasting adolescents. Risk of disordered eating was evaluated using the Eating Attitudes Test-26 (EAT-26) and Three Factor Eating Questionnaire-R18 (TFEQ-R18). Body image dissatisfaction was rated with Stunkard's Figure Rating Scale (FRS). Nutritional status was assessed using a 24-hour dietary recall. There was no significant difference between energy intake, EAT-26 and TFEQ-R18 scores (except the emotional eating sub-scores) between the groups. FRS revealed that the comparisons of their "ideal" and self were not significantly different between the groups whereas the gap between the figures they think healthy and closest to self was significantly higher amongst non-fasting adolescents. Two-hundred and two (97.5%) adolescents reported fasting for religious purposes whereas only 8 (3.4%) for losing weight. The EAT-26 total scores were in the pathological range in 39 (16.8%) adolescents who fasted for religious purposes. This study suggests that motivation of adolescents to fast during Ramadan was due to spiritual decisions rather than weight control or other factors and Ramadan fasting was not correlated with disordered eating behaviors or body image dissatisfaction.
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Affiliation(s)
- Yasemin Düzçeker
- Department of Paediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine , Ankara, Turkey
| | - Sinem Akgül
- Department of Paediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine , Ankara, Turkey
| | - Yaşar Durmaz
- Department of Paediatrics, Kütahya Dumlupınar University Faculty of Medicine , Kütahya, Turkey
| | - Melek Yaman
- Department of Paediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine , Ankara, Turkey
| | - Sine Örs
- Hacettepe University, Ihsan Doğramacı Children's Hospital, Dietician , Ankara, Turkey
| | - Zeynep Tüzün
- Department of Paediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine , Ankara, Turkey
| | - Zehra Büyüktuncer
- Department of Nutrition and Dietetics, Hacettepe University Faculty of Health Science , Ankara, Turkey
| | - Nuray Kanbur
- Department of Paediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine , Ankara, Turkey
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Aycan Z, Akgül S, Gençay S, Kanbur N, Derman O. Retraction of: Assessment of academic performance of licensed athletes. Int J Adolesc Med Health 2020; 32:ijamh-2020-2140. [PMID: 33581012 DOI: 10.1515/ijamh-2020-2140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Tas D, Ekinci S, Akgül S, Düzçeker Y, Derman O, Kanbur N. Bladder and voiding dysfunction in adolescents with anorexia nervosa: a novel finding and potential causes. Eat Weight Disord 2020; 25:1755-1762. [PMID: 31813115 DOI: 10.1007/s40519-019-00827-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/02/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aimed to investigate the bladder capacity (BC) and bladder dynamics of adolescents with anorexia nervosa (AN). METHODS The participants consisted of 15 adolescents newly diagnosed with AN according to the DSM 5 criteria and in the acute weight loss period who were questioned about the symptoms of lower urinary tract (LUT) dysfunction. Functional bladder capacity (FBC) and voided volume with uroflowmetry were measured for each subject; the larger volume of the two was chosen for the bladder capacity. Uroflowmetry was used to obtain uroflow curves for the participants whose patterns were labeled as pathologic if they were outside the bell-shape. RESULTS Fourteen (93.3%) of the patients exhibited at least one of the LUT dysfunction symptoms (pathologic voiding symptom/urinary incontinence/pathologic uroflow pattern). BC was observed to increase in 86.6% (n = 13) of the patients. Eighty% of the patients (n = 12) showed pathological uroflow patterns. In patients with pathological uroflow patterns, which showed insufficiency of bladder contraction, assistance of abdominal muscles was needed during voiding. CONCLUSION The novel findings presented in this study are the increase of BC in adolescents with AN, the presence of at least one type of voiding or bladder dysfunction, and the pathology of uroflow patterns of most patients show that the bladder dynamics is affected in AN. The most important contribution of this study to the literature is that impaired bladder dynamics was determined to be a medical complication of AN. LEVEL OF EVIDENCE Case-control analytic study, Level III.
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Affiliation(s)
- Demet Tas
- Children Hospital Department of Pediatrics, Ankara City Hospital, Ankara, Turkey
| | - Saniye Ekinci
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Yasemin Düzçeker
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Orhan Derman
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey.
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Aliyev U, Pehlivantürk-Kızılkan M, Düzçeker Y, Kanbur N, Aycan Z, Akgül S, Derman O. Is There Any Association Between Hirsutism and Serum Zinc Levels in Adolescents? Biol Trace Elem Res 2020; 198:403-409. [PMID: 32124229 DOI: 10.1007/s12011-020-02086-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Zinc has shown to have an anti-androgenic effect through 5 alpha-reductase enzyme activity inhibition in skin. However, there are contradicting findings concerning the effect of zinc on hirsutism mainly from studies including adult women with polycystic ovary syndrome (PCOS). The aim of our study was to investigate the association between serum zinc levels and hirsutism in adolescents. Between October 2017 and June 2018, 51 female adolescents with hirsutism (mean age: 16.11 ± 1.47 years) and 51 healthy female controls were included in the study (mean age: 15.5 ± 1.40 years). Adolescents with hirsutism were classified under two groups; PCOS (n = 34, 66.7%) and idiopathic causes of hirsutism (idiopathic hirsutism (n = 9, 17.6%) and idiopathic hyperandrogenemia (n = 8, 15.7%)). The serum zinc levels were measured via atomic absorption spectrophotometry. The mean zinc levels of adolescents with hirsutism (102.02 ± 11.64 μg/dl) and the control group (101.72 ± 16.71 μg/dl) were similar (p = 0.915). Additionally, there was no significant difference among the mean zinc levels of the hirsutism sub-groups and the control group (p = 0.979). While some studies demonstrated low zinc levels in women with hirsutism, some studies similar to ours showed no association. Adolescence is a developmental phase where generally isolated mild hirsutism is not associated with hyperandrogenism and more studies are needed to evaluate the effect of zinc on hirsutism in this age group.
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Affiliation(s)
- Ulvi Aliyev
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey
| | - Melis Pehlivantürk-Kızılkan
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey.
| | - Yasemin Düzçeker
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey
| | - Nuray Kanbur
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey
| | - Zehra Aycan
- Department of Pediatrics, Division of Pediatric Endocrinology, Ankara University Medical School, Ankara, Turkey
| | - Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Medical School, 06610, Ankara, Turkey
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Aycan Z, Akgül S, Gençay S, Kanbur N, Derman O. Assessment of academic performance of licensed athletes. Int J Adolesc Med Health 2020; 33:429-436. [PMID: 33125339 DOI: 10.1515/ijamh-2019-0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 09/15/2019] [Indexed: 11/15/2022]
Abstract
Objectives Physical activity and sports can be used to reduce stress and anxiety by increasing aerobic capacity and muscle endurance, gain positive behavioral changes and improve their self-discipline, use time well, adopt positive lifestyle such as regular eating and sleeping, which will result in an increase in school success. There are no comprehensive study that examines the academic performance of licensed student athletes and the factors influencing their success rates. The aim of this study was to evaluate the academic performance and related factors in licensed athletes. Methods One hundred eleven licensed athletes at junior high school level were enrolled. Participants filled out questionnaires specifically designed to assess for factors affecting academic performance, where personal and familial factors as well as school performance was taken into consideration. Their academic success rates were evaluated out of mean grade points before as well as after professional sports activities. Academic fields that were graded were, namely, mathematics, life sciences, language, and grammar studies as well as social sciences. Fifty one of participants lived in Ankara (Group 1) and the other 60 lived in Kahramanmaraş (Group 2). The effects of sport and other factors that may affect school success in all groups and between the groups were evaluated before and after sports. Results The age of the athletes were 14.1 ± 2.3 years, 49.5% were male. The grades of athletes before they started competing in professional sports were 80.4 ± 10.6 for mathematics, 80.5 ± 12.5 for sciences, 82.7 ± 9.5 for language studies, and 83.6 ± 9.3 for social sciences. Following a mean period of 4.3 ± 3.1 years of professional sports, the grades of athletes were, with the same order for respective discipline were, 81.6 ± 10.9, 82.4 ± 11.9, 84.3 ± 9.4, and 85.5 ± 8.5. Following sports activities, academic performance in life sciences, language, and grammar studies as well as social sciences showed a significant improvement where grades for mathematics did not show any significant change (p=0.054). The most important factor that improves school performance is the financial status of the family. In Group 1 demonstrated grade improvements following sports activities only in social sciences, whereas Group 2 athletes showed such an improvement for all the disciplines (p<0.05). Conclusions Licensed athletes' school success during the junior high school period showed a significant increase after sports in this study. The most important factors that affected the academic performance were the socioeconomic status of the family.
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Affiliation(s)
- Zehra Aycan
- Clinics of Pediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey
| | - Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Selçuk Gençay
- Kahramanmaraş Sütçü Imam University Physical Education and Sports Teaching, Kahramanmaraş, Turkey
| | - Nuray Kanbur
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Gümüş E, Akgül S, Kanbur N, Derman O. A comparison of bone mineral density in adolescent swimmers, pentathletes and figure skaters. Turk J Pediatr 2020; 61:831-838. [PMID: 32134575 DOI: 10.24953/turkjped.2019.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Gümüş E, Akgül S, Kanbur N, Derman O. A comparison of bone mineral density in adolescent swimmers, pentathletes and figure skaters. Turk J Pediatr 2019; 61: 831-838. Physical activity accounts for up to 17% of the variance in bone mineral density (BMD). Specifically, weight bearing exercises are of critical importance in increasing BMD. The aim of the present study was to evaluate the influence of three different sports with different mechanical loading properties on BMD of young athletes. This was an observational retrospective cohort study. All available medical records of adolescent athletes who have been followed at the Division of Adolescent Medicine at Hacettepe University were reviewed. Bone mineral content (BMC) and BMD of lumbar spine (L1-L4) and left femoral region were compared between young athletes participating in swimming (n=50), pentathlon (n=18), and figure skating (n=7). Femur total and lumbar spine (L1-L4) BMC values of figure skaters (29.1±8.1 g and 51.5±19.0 g, respectively) were found to be higher than swimmers (21.5±6.6 g and 36.1±11.7 g, respectively) and pentathletes (21.6±6.2 g and 41.7±19.4 g, respectively). However, there were no significant differences between any of the groups in lumbar spine and left proximal femur measurements. Regarding BMD, figure skaters (1.1±0.2 g/cm2) had significantly higher femur total BMD values than pentathletes (0.9±0.1 g/cm2) and swimmers (0.9±0.1 g/cm2, p < 0.05). The type of sport has an impact on BMD. Weight bearing and high impact loading activities seem to be associated with a better bone density in a region specific manner. Recommendation of high impact loading exercises may be considered to improve bone health in young athletes especially participating in low impact and non-weight bearing sports.
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Affiliation(s)
- Ersin Gümüş
- Department of Pediatric Gastroenterology, Balıkesir Atatürk City Hospital, Balıkesir
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Orhan Derman
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Abstract
Akgül S, Hüsnü Ş, Derman O, Özmert E, Bideci A, Hasanoğlu E. Mental health of Syrian refugee adolescents: how far have we come? Turk J Pediatr 2019; 61: 839-845. Among the consequences of war, its impact on the mental health of children and adolescents is one of the most significant. A previous study from our team evaluated the psychiatric symptoms of Syrian refugee adolescents living in one of Turkey`s Temporary Accommodation Centers (TACs) in 2016. Findings suggested that mental health had been compromised in these teens. Since then many measures have been taken to address this problem. The aim of the current study was to re-assess the mental health status of adolescents living in the same center. A total of 76 adolescents (35 female, 41 male) aged between 12-18 years (14.2 ± 0.83 years) received the Brief Symptom Inventory (BSI) which assessed their anxiety, depression, negative self-concept, somatization and hostility levels in addition to a Global Severity Index (GSI). Results > 1.0 indicated psychopathological symptoms. All BSI sub-scores decreased from 2016 to 2019 showing significant improvement in psychopathological symptoms. The most significant change was in the GSI score which decreased from 2.15 to 0.8. For the 2019 participants a significant correlation was found between years of stay at the camp and the depression subscale. Evaluation to assess gender differences found that adolescent girls reported significantly higher scores than males in anxiety, depression, somatization and the global severity index. This study has shown that interventions designed to tackle post-traumatic stress symptomology may have been effective in improving the mental health status of these teens and can provide a roadmap for tackling existing issues in vulnerable conditions. Additionally, females are under higher risk for psychopathology so gender targeted interventions may specifically be necessary to deal with such issues.
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Affiliation(s)
| | - Şenel Hüsnü
- Department of Psychology, Eastern Mediterranean University, Magosa, Cyprus
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Apalı ÖC, Baba İ, Bayrakcı F, Değerli D, Erden A, Peker MS, Perk FG, Sipahi İS, Şenoğlu E, Yılmaz S, Zengin NY, Akgül S. Experience of sexual and gender minority youth when accessing health care in Turkey. Int J Adolesc Med Health 2020; 33:445-448. [PMID: 32549160 DOI: 10.1515/ijamh-2019-0206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/27/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Lesbian, gay, bisexual, transgender and questioning (LGBTQ) patients report alarming rates of identity-based discrimination in healthcare settings. Despite the health risks and challenges impacting LGBTQ young adults, little is known about their healthcare experience, especially in Turkey. This study aimed to increase the knowledge base on LGBTQ young individuals' experiences when accessing health care in an attempt to address the myriad of health disparities they might face. METHODS Participants were recruited from the division of Adolescent Medicine at Hacettepe University, and also from an LGBTQ support group. Participants' responded to open-ended items asking about their experiences in the healthcare setting, in particular to any case of discrimination and reasons for non-disclosure of gender identity/orientation. RESULTS A total of 24 LGBTQ youth completed the interview, mean age 21.1 years. Overall participants reported alarming rates of identity-discrimination and non-disclosure when accessing health care. Additionally, participants reported high rates of postponing care as they felt they would be subjected to LGBTQ-based discrimination. Furthermore results suggest that transgender individuals face additional healthcare challenges compared with their LGB and cisgender counterparts. CONCLUSIONS To the best of our knowledge this is the first study in Turkey to evaluate the experiences of LGBTQ youth accessing medical care. This study shows that similar to barriers observed in previous studies on LGBTQ individuals, discrimination when accessing healthcare is a serious problem. Increasing knowledge concerning the discrimination LGBTQ people face when accessing healthcare is essential to decreasing healthcare disparities.
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Affiliation(s)
- Özge Ceren Apalı
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - İkra Baba
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Fatma Bayrakcı
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Deniz Değerli
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Arda Erden
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - M Sacit Peker
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Fatma Gül Perk
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - İrem Sibel Sipahi
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Ezgi Şenoğlu
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Salih Yılmaz
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Nur Yıldız Zengin
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Sinem Akgül
- Hacettepe Univeristy Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
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Tas D, Tüzün Z, Düzçeker Y, Akgül S, Kanbur N. The effects of parental and peer factors on psychiatric symptoms in adolescents with obesity. Eat Weight Disord 2020; 25:617-625. [PMID: 30806924 DOI: 10.1007/s40519-019-00660-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/19/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study was to examine the relationships among psychiatric symptoms, effect of beliefs and attitudes of parents about obese people and victimization or bullying in obese adolescents. METHODS The study group included 110 obese or overweight adolescents and 55 adolescents of normal weight as the control group. All adolescents completed the Brief Symptom Inventory (BSI) and Traditional Bullying Scale. The parents completed the Attitudes Toward Obese Persons (ATOP) Scale and Beliefs About Obese Persons (BAOP) Scale. RESULTS The BSI subscale scores for depression were significantly higher in the study group. There was no significant relationship found between psychiatric symptoms of obese or overweight adolescents and the ATOP and BAOP scores of parents. When victims, bullies/victims, bullies and those not included in any group among obese or overweight adolescents were examined, psychiatric symptoms of victims and bullies/victims were significantly higher. CONCLUSIONS The results of this study suggest that the clinical treatment of obesity is not just a matter of diet and exercise but additionally dealing with issues of depression and anxiety. A very satisfactory result of the study was that parents of obese or overweight adolescents did not show an increased weight bias. This study has also shown the association between negative social and psychological ramifications, as the study group was more likely to be the victims and perpetrators of bullying behaviors than their normal-weight peers. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Demet Tas
- Department of Pediatrics, University of Health Sciences Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Zeynep Tüzün
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Yasemin Düzçeker
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey.
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Taş D, Akman Öden A, Akgül S, Metin ZE, Pınar A, Kanbur N. The Effect of Pubertal Stage on the Concentrations of the Novel Adipomyokine, Irisin, in Male Adolescents. J Clin Res Pediatr Endocrinol 2020; 12:168-174. [PMID: 31514491 PMCID: PMC7291403 DOI: 10.4274/jcrpe.galenos.2019.2019.0119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Irisin is a recently discovered protein and is defined as an adipomyokine. The relation of irisin with carbohydrate metabolism and other hormone parameters have been investigated. However, studies evaluating the relationship between irisin and puberty are limited and inconclusive. The aim was to evaluate serum concentrations of irisin during different pubertal stages in male adolescents. METHODS The study included normal weight pubertal male adolescents between the ages of 136/12-1411/12 who had entered puberty. Fasting serum irisin concentrations were evaluated, and bioelectrical impedance analysis was used to measure body fat ratio (BFR) and fat-free mass (FFM). BFR was also calculated by caliper measurement of subcutaneous fat at the triceps. RESULTS Sixty-eight adolescents were enrolled. The number of adolescents in pubertal stage 2, 3, 4 and 5 were n=17 (25%), n=13 (19.1%), n=21 (30.1%) and n=17 (25%), respectively. The median values of the irisin are 8.80, 8.20, 9.15 and 7.24 ng/mL according to the 2-5 pubertal stages, respectively. The levels of circulating irisin did not differ according to the pubertal stage. Additionally, there was no significant relationship between irisin levels and body fat percentage or FFM. CONCLUSION Irisin levels do not differ after the onset of puberty or with progressing pubertal maturation. This study strengthens the evidence that there is no change in irisin concentration as puberty progresses. This may have important implications when using this adipomyokine in the future for diagnosis or treatment of obesity-related diseases.
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Affiliation(s)
- Demet Taş
- University of Health Sciences Turkey Child Health and Diseases Hematology Oncology Training and Research Hospital, Clinic of Pediatrics, Ankara, Turkey
| | - Alkım Akman Öden
- University of Health Sciences Turkey Child Health and Diseases Hematology Oncology Training and Research Hospital, Clinic of Pediatrics, Ankara, Turkey
| | - Sinem Akgül
- Hacettepe İhsan Doğramacı Children’s Hospital, Clinic of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Ziya E. Metin
- University of Health Sciences Turkey Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Aslı Pınar
- Hacettepe University Faculty of Medicine, Department of Medical Biochemistry, Ankara, Turkey
| | - Nuray Kanbur
- Hacettepe İhsan Doğramacı Children’s Hospital, Clinic of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey,* Address for Correspondence: Hacettepe İhsan Doğramacı Children’s Hospital, Clinic of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey Phone: +90 312 305 11 60 E-mail:
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Ari DA, Akgül S, Kanbur N. Letter to the Editor: "The Use of Norethisterone for the Treatment of Severe Uterine Bleeding in Adolescents: An Audit of Our Experience". J Pediatr Adolesc Gynecol 2020; 33:315. [PMID: 31981621 DOI: 10.1016/j.jpag.2020.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/09/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Demet Aygun Ari
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey.
| | - Sinem Akgül
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
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Akgül S, Yıkılgan İ, Ömürlü H. Dentists’ Decision to Conduct CRA in Adult Patients in Turkey: A Questionnaire-based Survey. Journal of Advanced Oral Research 2020. [DOI: 10.1177/2320206820913731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: The concept of minimal intervention in dentistry is one of the most important stages of the preventive dentistry, and caries risk assessment (CRA) is an application that needs to be primarily evaluated in order to perform minimal intervention approaches. This study was aimed to evaluate the awareness of CRA and whether CRA is included in daily practice by dentists in Turkey. Materials and Methods: This study used a questionnaire survey. A survey was prepared and sent to the dentists who were registered with the Turkish Dental Association via e-mail. A total of 790 dentists returned and 95 respondents were excluded. All the registered dentists filled and returned their survey. Descriptive and logistic regression analyses were performed (n = 695). Results: A total of 86.9 percent dentists who took the survey said that they performed CRA in daily practice. “Lack of time” was specified as the most important factor by the respondents who did not perform CRA in daily practice (61.5%). Current oral hygiene status (96.4%) and the presence of one or more active caries lesions (74.5%) were considered the most important risk factors for not performing CRA. Results of multiple logistic regression analysis showed that clinical experience, number of patients treated per day, and type of practice were mostly associated with whether or not performing CRA ( P = .012, .018, and .035, respectively). Conclusions: It can be concluded that most of the dentists are aware of the importance of conducting CRA and, with differences in the factors considered, CRA is required in their daily practice in Turkey. The concept of minimal intervention in dentistry is one of the most important stages of preventive dentistry, and CRA is an application that needs to be primarily evaluated in order to perform minimal intervention approaches.
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Affiliation(s)
- Sinem Akgül
- Restorative Dentistry Department, Faculty of Dentistry, Gazi University, Emek-Ankara, Turkey
| | - İhsan Yıkılgan
- Restorative Dentistry Department, Faculty of Dentistry, Gazi University, Emek-Ankara, Turkey
| | - Hüma Ömürlü
- Restorative Dentistry Department, Faculty of Dentistry, Gazi University, Emek-Ankara, Turkey
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İnan-Erdoğan I, Akgül S, Işgın-Atıcı K, Tuğrul-Yücel T, Boduroğlu K, Derman O, Kanbur N. Effects of vitamin D and estrogen receptor polymorphisms on bone mineral density in adolescents with anorexia nervosa. J Pediatr Endocrinol Metab 2019; 32:1377-1384. [PMID: 31714887 DOI: 10.1515/jpem-2019-0240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/02/2019] [Indexed: 11/15/2022]
Abstract
Background Anorexia nervosa (AN) is a serious eating disorder that is associated with decreased bone mineral density (BMD) and greater lifetime risk for fractures. The aim of this study was to determine the correlation between BMD and genetic polymorphisms in AN. Methods This case-control study analyzed vitamin D receptor (VDR) (VDRBsml, VDRFokl) and estrogen receptor (ESR) (ESR1Xbal, ESR1Pvull) polymorphisms in 45 adolescents diagnosed with AN and 46 age-matched healthy controls. BMD values of the AN group were classified as low or normal, and polymorphisms were compared between cases and controls. The effects of body mass index (BMI), duration of disease and amenorrhea on BMD were also evaluated. Results In girls with AN, a positive effect of the bb genotype of VDRBsmI polymorphism on femur Z-scores (p = 0.103) and of the Ff genotype of VDRFokI polymorphism on vertebra Z-scores (p = 0.097) was observed. In boys with AN, a positive effect of the Ff genotype of VDRFokI polymorphism on vertebra BMD (g/cm2) was detected (p = 0.061). No association was detected between ESR polymorphisms. An inverse relationship was observed between BMD and duration of illness and amenorrhea. A direct relationship was detected between BMD and BMI. Conclusions Specific VDR gene polymorphism genotypes may have positive effects on BMD in patients with AN. Additionally, the lack of association between ESR gene polymorphisms on BMD could be attributed to the low estrogen status of the patient.
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Affiliation(s)
- Işıl İnan-Erdoğan
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Ankara, Turkey
| | - Sinem Akgül
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Kübra Işgın-Atıcı
- Hacettepe University, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Tuğba Tuğrul-Yücel
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Pediatric Genetics, Ankara, Turkey
| | - Koray Boduroğlu
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Pediatric Genetics, Ankara, Turkey
| | - Orhan Derman
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
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Akgül S, Sur Ü, Düzçeker Y, Balcı A, Kızılkan MP, Kanbur N, Bozdağ G, Erkekoğlu P, Gümüş E, Kocer-Gumusel B, Derman O. Bisphenol A and phthalate levels in adolescents with polycystic ovary syndrome. Gynecol Endocrinol 2019; 35:1084-1087. [PMID: 31219355 DOI: 10.1080/09513590.2019.1630608] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Endocrine disruptors have been proposed in the etiology of polycystic ovary syndrome (PCOS) as they have the potency to interfere with hormone-sensitivity systems. The aim of this study was to evaluate the levels of bisphenol A (BPA) and phtalates in adolescents with PCOS. Sixty-two girls with PCOS and 33 controls, age 12-18 years were enrolled in the study. The diagnosis of PCOS was made using modified Rotterdam criteria. Urinary BPA levels were measured using high-performance liquid chromatography. Di-(2-ethylhexyl)-phthalate (DEHP), the most commonly used phthalate and mono-(2-ethylhexyl)-phthalate (MEHP), its main metabolite were measured by using high-performance liquid chromatography. Adolescents with PCOS had markedly increased BPA levels (15.89 μg/g creatine ± 1.16) when compared with the control group (7.30 μg/g creatine ± 1.38) (p = .016). In adolescents with PCOS, BPA was significantly correlated with polycystic morphology on ultrasound but not with obesity androgen levels, or other metabolic parameters. Patients with PCOS (DEHP: 0.40 ppm ± 0.24, MEHP: 0.13 ppm ± 0.23) and controls (DEHP: 0.49 ppm ± 0.27, MEHP: 0.14 ppm ± 0.3) had similar serum phtalate concentrations (p = .7 and p = .3, respectively). Exposure to specific endocrine disruptors such as BPA could modify neuroendocrine, reproductive, and metabolic regulation favoring PCOS development in adolescents.
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Affiliation(s)
- Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Ünzile Sur
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey
| | - Yasemin Düzçeker
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Aylin Balcı
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey
| | | | - Nuray Kanbur
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Gürkan Bozdağ
- Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Pınar Erkekoğlu
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey
| | - Ersin Gümüş
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Belma Kocer-Gumusel
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
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Nalbant K, Kalaycı BM, Akdemir D, Akgül S, Kanbur N. Emotion regulation, emotion recognition, and empathy in adolescents with anorexia nervosa. Eat Weight Disord 2019; 24:825-834. [PMID: 31473987 DOI: 10.1007/s40519-019-00768-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 08/12/2019] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Emotional functions may play an important role in anorexia nervosa (AN). The onset of the disorder generally occurs during adolescence, which is a critical period of emotional development. However, most studies that evaluated emotional functions in AN were conducted in adult patients. The aim of this study was to evaluate emotion regulation, emotion recognition, and empathy skills in adolescent girls with AN by controlling for the effects of depression and anxiety symptoms, childhood traumatic experiences, and attachment security on emotional functions. METHODS Thirty-two adolescent girls with AN and 32 healthy counterparts completed the Difficulties in Emotion Regulation Scale, the Reading the Mind in the Eyes Test, Toronto Alexithymia Scale-20, and the Child and Adolescent KA-SI Empathic Tendency Scale-Adolescent Form. RESULTS The results revealed that adolescents with AN were found to have more difficulties in emotion regulation, higher alexithymic tendencies, and lower empathy skills compared with the control group. However, emotion recognition was not found to be significantly different between the two groups. These results were the same when controlling for the effects of depression and anxiety symptoms, childhood traumatic experiences, and attachment security except for empathy skills. Alexithymia and depressive symptoms were significantly related to emotion regulation difficulties in adolescents with AN. CONCLUSIONS Considering the results, it seems that emotion regulation and alexithymia may play a crucial role in the development and maintenance of AN. Accordingly, it is necessary to focus on the improvement of these skills during the treatment of AN. Furthermore, interventions promoting these skills during adolescence may be preventive. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
- Kevser Nalbant
- Department of Child and Adolescent Psychiatry, Medical Faculty, Hacettepe University, Ankara, Turkey.
| | - Bilge Merve Kalaycı
- Department of Child and Adolescent Psychiatry, Medical Faculty, Training and Research Hospital, Yildirim Beyazıt University, Ankara, Turkey
| | - Devrim Akdemir
- Department of Child and Adolescent Psychiatry, Medical Faculty, Hacettepe University, Ankara, Turkey
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Medical Faculty, Hacettepe University, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Medical Faculty, Hacettepe University, Ankara, Turkey
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Akgül S, Bonny AE. Metabolic Syndrome in Adolescents with Polycystic Ovary Syndrome: Prevalence on the Basis of Different Diagnostic Criteria. J Pediatr Adolesc Gynecol 2019; 32:383-387. [PMID: 30710625 DOI: 10.1016/j.jpag.2019.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/15/2019] [Accepted: 01/19/2019] [Indexed: 10/27/2022]
Abstract
STUDY OBJECTIVE Existing literature on the prevalence of metabolic syndrome (MBS) in adolescents with polycystic ovary syndrome (PCOS) is inconsistent, likely because of the application of differing diagnostic criteria. The objective was to assess the prevalence of MBS in adolescents with PCOS depending on the PCOS diagnostic criteria used. DESIGN, SETTING, AND PARTICIPANTS A retrospective chart review of female patients (N = 37), ages 11-22 years, diagnosed with PCOS between January 2013 and December 2017. Patients were included only if they had received screening allowing comparison across all PCOS diagnostic criteria: National Institutes of Health, Rotterdam, Androgen Excess Society, Amsterdam, Endocrine Society, and the Pediatric Endocrine Society (PES). The presence of MBS was established using the International Diabetes Federation criteria. The proportion of patients having MBS was then calculated for each PCOS diagnostic criteria subgroup. INTERVENTIONS AND MAIN OUTCOME MEASURES For the entire study cohort, MBS was present in 17/37 patients (45.9%). The highest prevalence of MBS was among the subgroup of patients meeting the PES PCOS diagnostic criteria (13/25; 52.0%), whereas the lowest prevalence was in the subgroup meeting the Amsterdam PCOS criteria (6/15; 40.0%). Those diagnosed using the PES criteria also had the highest percentage of patients with 3 or more risk factors for MBS. RESULTS AND CONCLUSION The prevalence of MBS varied according to the specific PCOS diagnostic criteria and was highest when PES guidelines were used. The PES criteria are adolescent-specific and have thus refined the diagnosis of PCOS for this population. Our results highlight the importance of validated adolescent-specific PCOS diagnostic criteria.
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Affiliation(s)
- Sinem Akgül
- Nationwide Children's Hospital, Division of Adolescent Medicine, 700 Children's Drive, Suite LA3A, Columbus, Ohio.
| | - Andrea E Bonny
- Nationwide Children's Hospital, Division of Adolescent Medicine, 700 Children's Drive, Suite LA3A, Columbus, Ohio
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Kalaycı BM, Nalbant K, Akdemir D, Akgül S, Kanbur N. Social functioning and its association with accompanying psychiatric symptoms in adolescents with anorexia nervosa. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1595867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Bilge Merve Kalaycı
- Department of Child and Adolescent Psychiatry, Yildirim Beyazıt University, Yenimahalle Trainig and Research Hospital, Ankara, Turkey
| | - Kevser Nalbant
- Medical Faculty, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Devrim Akdemir
- Medical Faculty, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Sinem Akgül
- Medical Faculty, Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Nuray Kanbur
- Medical Faculty, Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
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Isgin-Atici K, Kanbur N, Akgül S, Buyuktuncer Z. Diet quality in adolescents with premenstrual syndrome: A cross-sectional study. Nutr Diet 2019; 77:351-358. [PMID: 30729645 DOI: 10.1111/1747-0080.12515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 10/31/2018] [Accepted: 12/09/2018] [Indexed: 12/24/2022]
Abstract
AIM Premenstrual syndrome (PMS) is a complex of symptoms that can seriously affect the quality of life in women. It has been suggested that the nutritional status of adult women may influence the presence and/or severity of PMS symptoms. However, little is known about this association in adolescents. The present study aimed to examine the relationship between diet quality and the presence/severity of PMS symptoms in adolescents. METHODS A case-control study of 272 female students, aged 13-18 years, was conducted in a high school. PMS was diagnosed and the symptoms were recorded using Premenstrual Syndrome Scale (PMSS)-2006 in 2 consecutive months. Dietary intake was assessed with 24-hour-dietary intake recall method and Healthy Eating Index-2010 (HEI-2010) score was calculated as an indicator of diet quality. Anthropometric measurements, including body weight, height, waist circumference and hip circumference were taken. RESULTS PMS was diagnosed in 56.9% of the study sample. The mean HEI-2010 score was significantly lower in the PMS group (47.5 ± 23.95) when compared to the control group (53.5 ± 20.98), P = 0.034. The PMS symptoms, anxiety (P = 0.009), depressive feelings (P = 0.016) and changes in sleeping pattern (P = 0.000) were associated with lower diet quality scores in the PMS group. No significant difference in anthropometric measurements was observed between the groups. CONCLUSIONS The present study suggested that adolescents with a high-quality diet might experience depressive feelings, anxiety or changes in sleeping less when compared to those with a low quality diet. Therefore, the causal relationship between diet quality and presence/severity of PMS should be investigated in further studies.
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Affiliation(s)
- Kubra Isgin-Atici
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Hacettepe University, Ankara, Turkey
| | - Nuray Kanbur
- Faculty of Medicine, Department of Paediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Sinem Akgül
- Faculty of Medicine, Department of Paediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Zehra Buyuktuncer
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Hacettepe University, Ankara, Turkey
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