Levent Kayaalp

EEG abnormalities in West syndrome: Correlation with the emergence of autistic features

Autism may develop in children with West syndrome. This study was conducted to determine if EEG abnormalities in patients with West syndrome predict the later onset of autism. Two groups of patients with West syndrome, older than 6 years of age, were studied. One group consisted of those with a past history of West syndrome plus autism (N=14); the control group consisted of those with a past history of West syndrome but without autism (N=14). Patients were followed at regular intervals and video-EEG recordings were done. A total of 108 (autistic group) and 123 (non-autistic group) video-EEGs were examined. The two groups were compared with respect to age, presence or absence of hypsarrhythmia, and characteristics and localization of the epileptogenic foci. chi2 and Fishers exact tests were used. The number of patients with at least one hypsarrhythmic EEG at the age of one year or later was significantly higher in autistic subjects (86%) than in non-autistic controls (29%). The incidence of EEGs with hypsarrhythmia was also higher in the autistic group, especially in older children (autistic, 49% versus non-autistic, 18% at age 3 years and later). Frontal predominance of the primary foci on EEGs with or without hypsarrhythmia was seen in 95.3% of the autistic group and 28.8% of the non-autistic group (p=0.001). Frontal abnormalities on the EEGs, which were mainly bilateral, and the persistence of hypsarrhythmia were significantly related to the emergence of autistic behavior in patients with West syndrome. These findings suggest that paroxysmal discharges in the cortical areas undergoing rapid maturation may be involved in the development of autistic features.

Psychological effects of repeated general anesthesia in children

Background:  Although methods for reducing preoperative anxiety have been a major interest of pediatric anesthesiologists, there are no reports of the effects of repeated anesthesia on psychological development of children.

Emotional effects of hypospadias surgery on Turkish boys

PURPOSE The aim of this study is to investigate in Turkish boys the emotional effects of hypospadias repair before and after the optimal age for repair. MATERIALS AND METHODS Forty hypospadias patients treated in our department were included in this study. Group 1 consisted of 13 patients operated on at less than 30 months of age. Group 2 consisted of 27 patients operated on at over 30 months of age. Age at time of study, severity of hypospadias, age at repair and number of operations were evaluated for both groups retrospectively. Socio-economic and socio-demographic characteristics of these patients including place of residence, educational level of their parents and parental occupations were determined. The Turkish versions of the Childrens Depression Inventory and the State-Trait Anxiety Inventory for Children A-State scale were used to evaluate the emotional effects of hypospadias surgery. For statistical analysis, the Mann-Whitney U test, Students t test and Chi-squared test were used. RESULTS There was a significant difference in the age at repair between Groups 1 and 2. No significant differences existed in severity of hypospadias and number of operations between the two groups. All 40 patients had the same socio-economic and socio-demographic characteristics. Group 1 did not significantly differ from Group 2 in regard to the educational level of their parents and parental occupations. Age at repair, which was the only difference between the two groups, did not affect the level of depression and anxiety-state symptoms. CONCLUSIONS There is a close relationship between emotional effect of hypospadias surgery and age at repair. Possibility of depression and anxiety, which were dominating emotional symptoms among boys operated on for hypospadias, was found not to be high after the recommended age. It is concluded that, as hypospadias surgery creates a circumcised penis, the degree of emotional trauma is lower in Turkish boys than in other nationalities.

Doğuştan Görme Engeli Olan Çocuk ve Ergenlerde Bağlanma Özellikleri ve Davranışsal Sorunlar

INTRODUCTION This study aimed to assess the behavioral problems and the attachment characteristics of children and adolescents with congenital blindness (CB). METHOD Forty children and adolescents aged 11-14 years with CB were included as the case group. Forty healthy children and adolescents who were matched for age, gender, and socioeconomic status with the case group served as the comparison group. Behavioral problems were assessed by the Child Behavior Checklist for ages 4-18 (CBCL 4/18). Attachment characteristics were assessed via the Short Form of Inventory of Parent and Peer Attachment (s-IPPA). RESULTS The case group had lower CBCL total problems scores as well as anxiety/depression, withdrawal/depression, and attention problems subscales scores with respect to the comparison group. There were no significant differences between the two groups in s-IPPA scores. CONCLUSION Children and adolescents with CB did not differ from the comparison group in terms of attachment, whereas, they had lower scores on behavioral problems than the comparison group. Although previous studies indicate that children and adolescents with CB may be at the risk of insecure attachment, our study suggested that adaptive mechanisms of their families together with professional help from specialized teachers and services provided by schools for children and adolescents with CB may play compensatory roles.

Endoskopik izlem gerektiren korozif yanıkları olan çocuk ve ergenlerde kazanın meydana gelişşekli ve aile özelliklerinin değerlendirilmesi Orijinal Araştırma

Endoskopik izlem gerektiren korozif yaniklari olan cocuk ve ergenlerde kazanin meydana gelissekli ve aile ozelliklerinin degerlendirilmesi Orijinal Arastirma

Otistik Bozuklukta Prenatal ve Perinatal Etkenler

Bu calismada otistik bozuklugu olan 2 1 2 yaslari arasindaki 85 cocukta etyolojik bakimdan anlamli olabilecek prenatal ve perinatal etkenler arastirilmistir Olgu grubundaki cocuklar DSM IV olcutlerine gore otistik bozukluk tanisi almislardir Kontrol grubundaki cocuklarsa yas ve cinsiyet bakimindan olgu grubundaki cocuklarla eslestirilmis bulunan psikiyatrik bozuklugu ya da kronik hastaligi olmayan cocuk sagligi ve hastaliklari poliklinigine basvurmus cocuklardan olusmaktadir Olgu grubunda komplike dogum oraninin dismaturasyonun ve dusuk dogum tartisinin anlamli bicimde daha fazla goruldugu; buna karsilik hamilelikte olumsuz olaylarin ve evde dogumun kontrol grubunda daha siki goruldugu bulunmustur Anahtar kelimeler: Otistik Bozukluk Etyoloji; Prenatal ve Perinatal Etkenler