Browsing by Author "Mutluer, Tuba"

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Association of Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorders With Mean Platelet Volume and Vitamin D
(int Scientific information, inc, 2017) Garipardic, Mesut; Dogan, Murat; Bala, Keziban Asli; Mutluer, Tuba; Kaba, Sultan; Aslan, Oktay; Ustyol, Lokman
Background: The purpose of this study was to assess the values of the mean platelet volume (MPV) in children with attention deficit hyperactivity disorder (ADHD) and with autism spectrum disorders (ASDs) to determine the risk of cardiovascular disease in these 2 disorder groups. Material/Methods: The study included a total of 79 patients with ADHD or ASDs and controls in the Van region of Turkey. The control group included subjects of matching age and sex with no ADHD, ASDs, or chronic disease and taking no vitamins. The hematological parameters of the patients, including MPV, vitamin B12, and vitamin D, were assessed. Results: The study included a total of 79 children and adolescents aged 2-18 years (32 females and 47 males). Of the patients, 36 were in the ADHD group, 18 in the ASDs group, and 25 in the control group. There was no statistically significant difference in hematological parameters between the groups, but there were significant differences in terms of vitamin D and vitamin B12. The patient groups showed lower levels of vitamin B12 and vitamin D. In the ADHD group, there was a negative correlation between both vitamins and MPV (p<0.05). Partial correlation analysis of the ADHD group showed that MPV in particular was negatively correlated to vitamin D, and not to vitamin B12 (p: 0.03). Conclusions: Both ADHD and ASDs may accompany increased risk for cardiovascular disease due to the presence of vitamin B12 and D deficiency and their own characteristics. Therefore, these disorders should be closely followed up.
Hormone Disorder and Vitamin Deficiency in Attention Deficit Hyperactivity Disorder (Adhd) and Autism Spectrum Disorders (Asds)
(Walter de Gruyter Gmbh, 2016) Bala, Keziban Asli; Dogan, Murat; Kaba, Sultan; Mutluer, Tuba; Aslan, Oktay; Dogan, Sekibe Zehra
Background: The aim of this study was to analyze thyroid hormones and antibodies, ferritin, vitamins B12 and D, adrenal and gonadal steroid levels, and celiac antibodies in children diagnosed with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Methods: Between February 2014 and July 2014, a total of 77 children and adolescents (31 girls, 46 boys) who were admitted to the Van Training and Research Hospital were included in the study. The study population was divided into three groups including ADHD (n=34), ASD (n=16), and age-and sex-matched healthy controls (n=27). The diagnosis of ADHD was made on the basis of Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) and DSM-4 Turkish version with the diagnostic interview and Disruptive Behavior Disorder Rating Scale (DBDRS). The diagnosis of ASD was based on the DSM-4 and DSM-5 Turkish version with the diagnostic interview and the Childhood Autism Rating Scale (CARS). The blood samples were obtained between 8: 00 and 9: 00 A.M. Results: There was a statistically significant difference in vitamin B12 and D levels and ferritin values among the three groups. The ASD group had the highest ferritin and the lowest vitamins B12 and D levels. Vitamin D levels of the ADHD group were significantly lower compared to the healthy controls. Conclusions: Our study results highlight the importance of supplementation of vitamins B12 and D in the ASD and ADHD patients.
Lateralization of Neurobiological Response in Adolescents With Post-Traumatic Stress Disorder Related To Severe Childhood Sexual Abuse: the Tri-Modal Reaction (t-Mr) Model of Protection
(Routledge Journals, Taylor & Francis Ltd, 2018) Mutluer, Tuba; Sar, Vedat; Kose-Demiray, Cigdem; Arslan, Harun; Tamer, Sibel; Inal, Serap; Kacar, Anil S.
This study inquires into neurobiological response to stress and its clinical correlates among adolescents with post-traumatic stress disorder (PTSD). Structural magnetic resonance imaging (MRI) measures of cerebral anatomy were carried out on 23 female adolescents with PTSD related to severe childhood sexual abuse and 21 matched healthy controls. Clinician Administered PTSD Scale for Children and Adolescents, Adolescent Dissociative Experiences Scale, Childhood Trauma Questionnaire, Schedule for Affective Disorders and Schizophrenia for School Age Children, Beck Depression Scale, and a set of neuro-cognitive tests were administered to all participants. Compared to controls, PTSD group bilaterally had smaller amygdala, hippocampus, anterior cingulate, and thinner prefrontal cortex but normal thalamus. Further analyses within the PTSD group suggested an association between symptoms of PTSD and sizes of right brain structures including smaller amygdala but larger hippocampus and anterior cingulate. Thinner right prefrontal cortex and larger right thalamus seemed to be related to denial and response prevention, respectively. Being related to both hemispheres, dissociative amnesia was negatively associated with proportion of the right amygdala to right thalamus and to both left and right prefrontal cortex. Suggesting a neuro-protective effect against traumatic stress at least through adolescence, depersonalization-derealization and identity alteration were correlated with thicker left prefrontal cortex. Unlike the lateralization within PTSD group, correlations between regions of interest were rather symmetrical in controls. The graded response to stress seemed to be aimed at mental protection by lateralization of brain functions and possibly diminished connection between two hemispheres. A Tri-Modal Reaction (T-MR) Model of protection is proposed.
Türkiye'nin Doğu Anadolu Bölgesinde Yaşayan Cinsel İstismar Mağdurlarının Sosyodemografik ve Klinik Özelliklerinin Değerlendirilmesi
(2016) Durmaz, Onur; Gümüş, Orhan; Aşırdizer, Mahmut; Ozdemir, Pinar Guzel; Gencoğlan, Salih; Mutluer, Tuba; Nasıroğlu, Serhat
Amaç: Çalışmamızda cinsel istismar mağduru çocuk ve ergenlerin sosyodemografik özellikleri, istismar sonrası gelişen ruhsal tanıları, istismar süresi, istismar sıklığı, cinsel istismar ve istismarcı ile ilişkili özellikleri incelemesi amaçlanmıştır. Gereç ve Yöntem: Van adliyesi adli tıp şubesinde 01.01.2010 ile 30.06.2015 tarihleri arasında bilirkişi adli heyet raporu düzenlenmesi amacıyla yönlendirilen adli olguların (n=90) bilgileri geriye dönük olarak incelenmiştir. Genel fizik muayenesi adli tıp uzmanları tarafından yapıldı. Hasta ve ebeveynleri ile psikiyatrik görüşme çocuk ve ergen ruh sağlığı ve hastalıkları uzmanı ve yetişkin psikiyatri uzmanı tarafından yapılmıştır. Bulgular: Çalışmamız 4 ile 18 yaş aralığında (11,9±4,02) değişen 60 (%66,7) kız ve 30 (%33,3) erkek olmak üzere toplam 90 çocuk ve ergen mağdurlardan oluşmaktadır. En sık bildirilen cinsel istismar tipi kızlarda %48,3 ile vajinal penetrasyon, erkeklerde %90 ile anal penetrasyon olduğu belirlendi. Olguların %31,1'i (n=28) birden fazla cinsel istismara maruz kaldığını, %5,6'si (n=5) birden fazla istismarcının olduğu ve 12,2'sinin (n=11) de bir yıldan daha uzun süre cinsel istismara maruz kaldığı bulunmuştur. Olguların %64,4'inde (n=58) istismarcının tanıdık biri ve %21,1'ünde (n=19) aileden biri olduğu tespit edilmiştir. Çocuk ve ergenlerin %28,9'ında (n=26) travma sonrası stres bozukluğu (TSSB), %5,6'sında (n=5) akut stres bozukluğu (ASB), %8,9'inde (n=8) major depresif bozukluk (MDB) tespit edilmiştir. Sonuç: Cinsel istismar mağdurlarında başta TSSB olmak üzere psikopatoloji gelişme riskinin artığını göstermektedir. Kız cinsiyet ve ilköğretim çağında olmanın cinsel istismara maruz kalma açısından yüksek risk taşıdığı bulunmuştur. Çocuklar genellikle yakından tanıdığı ve güvendiği kişiler tarafından cinsel istismara uğradığı görülmektedir.