Fatma Taneli

Electrical status epilepticus during slow-wave sleep (ESES) is a childhood-onset epilepsy syndrome characterized by prominent epileptiform activity during non-rapid eye movement sleep and is freque...

Luteinizing hormone (LH) levels may occasionally be elevated in individuals without any clinical manifestations. One possible explanation for this finding is the presence of macro LH, an immunoglobulin-bound form of LH that forms immune complexes and is cleared slowly from circulation. An eight-year-old boy with no clinical signs of puberty was found to have elevated LH levels for his age. To investigate the possibility of macro LH, serum samples were treated with polyethylene glycol (PEG) to precipitate high-molecular-weight complexes. Following PEG precipitation, a marked decrease in LH concentration was observed, confirming the presence of macro LH. The detection of macro hormones such as macro LH is essential to avoid misdiagnosis and unnecessary treatments. This case emphasizes the importance of interpreting laboratory findings in the context of the patient’s clinical presentation.

Microalbuminuria indices may miss early diabetic kidney disease (DKD) and can regress. Urinary podocyte and tubular injury biomarkers may detect subclinical kidney injury before albuminuria. We evaluated urinary podocyte- and tubule-derived biomarkers in adolescents/young adults with type 1 diabetes mellitus (T1DM) and compared 12-year prognostic performance with albuminuria. A total of 130 participants with T1DM were screened; 109 were eligible and included in the baseline analysis, and 30 age-matched healthy controls were enrolled. Baseline urinary podocalyxin (u-PCX), nephrin (u-nephrin), and liver-type fatty acid-binding protein (u-LFABP) were measured by ELISA and indexed to creatinine; albuminuria was assessed by 24-h albumin excretion rate (u-AER) and spot albumin-to-creatinine ratio (u-ACR). Fifty-one participants were reassessed after 12 years; measurements were obtained at baseline and at the 12-year follow-up visit. Incident DKD (micro-/macroalbuminuria) was the primary outcome. Discrimination was assessed by ROC curves and Youden thresholds. At baseline, 90% had normoalbuminuria. Participants with normoalbuminuria had higher u-PCX/Cr, u-nephrin/Cr, and u-LFABP/Cr vs. controls (all p ≤ 0.001). Over 12 years, 7/51 developed DKD. Baseline u-PCX/Cr discriminated incident DKD (AUC 0.96; 95% CI 0.91-1.00): <78 ng/mgCr (NPV 100%) and ≥193 ng/mgCr had specificity 95.5%; DKD incidence across <78, 78-193 and ≥193 ng/mgCr strata was 0%, 20% and 75%, respectively (p-trend < 0.001). Baseline spot u-ACR also performed well (AUC 0.87; 95% CI 0.74-1.00). Baseline u-PCX/Cr and u-LFABP/Cr were elevated in those who developed micro-/macroalbuminuria at 12 years. Spot u-ACR remains a practical prognostic tool, while u-PCX/Cr provides complementary, actionable long-term risk cut-points requiring external validation.

In cat sensitized children, decision to eliminate exposure to cats depends on the clinical outcome. In this study, we aimed to examine the relationship between molecular cat allergen sensitization and exhaled breath condensate (EBC) IL‐4, IL‐5, and IL‐13 as markers of allergic airway inflammation. We enrolled subjects with skin prick test diagnosis of cat allergen sensitization aged 4–17 years. Age, sex, diagnosis, and clinical symptoms as well as family history of allergic diseases were recorded at enrollment along with the association of symptoms and cat exposure. Asthma severity and allergic rhinitis symptom score were recorded. Blood samples were collected for Fel d1 based component resolved diagnosis (CRD/FEL D1) and exhaled breath samples were collected for measurement of IL‐4, IL‐5, and IL‐13. Among the 80 subjects (40 boys) enrolled, antibody positivity for Fel d1 was 74%. Cat exposure outdoors was more common in children with Fel d1 positivity (37% vs. 14%, p = 0.02). Asthma respiratory symptom severity score was significantly higher in Fel d1 antibody positive subjects ( p = 0.01). On the other hand, EBC levels of IL‐4, IL‐5 or IL‐13 were not found to be significant different between subjects with and without Fel d1 positivity (48.8 vs. 63.3, p = 0.59; 6.9 vs. 14.4, p = 0.62; 4.0 vs. 5.3, p = 0.83, respectively) The results of our study suggest a possible association between CRD/FEL D1 positivity and more severe respiratory symptoms in asthmatic children but not airway inflammation emphasizing the importance of interpretation of CRD results in the context of clinical findings.

Objective: The objective of this study was to examine the serum levels of vasoactive neuropeptides (calcitonin gene‐related peptide [CGRP], pituitary adenylate cyclase‐activating peptide‐38 [PACAP‐38], substance P [SP], and vasoactive intestinal peptide [VIP], which have been linked to the pathophysiology of migraine in adults) in pediatric migraine without aura during both pain attacks and pain‐free periods and in a control group, with a view of evaluating their diagnostic value in pediatric migraine. Background: The diagnosis of migraine is based on clinical features described by patients and pediatric patients may not be able to express migraine symptoms as clearly as adults. The fact that objective biological markers of migraine have not yet been fully defined makes diagnosis difficult, especially in children. Methods: This prospective cross‐sectional case–control study included 39 children and adolescents (aged 8–18 years) diagnosed with migraine without aura and 40 healthy control children between May 2022 and March 2023. The 39 patients with migraine were evaluated both during the course of their migraine attacks and during periods of pain‐free status. Plasma vasoactive peptides were measured using an enzyme‐linked immunosorbent assay. Results: The comparison of serum SP, PACAP‐38, and CGRP neuropeptide levels in the 39 patients with migriane during the ictal and interictal periods revealed no significant differences between the two periods. VIP neuropeptide levels in the ictal period (mean [standard deviation, SD] 291.6 [118.5] pg/mL) in the migraine cohort were found to be significantly higher than the levels observed in both the interictal (mean [SD] 263.6 [100.9] pg/mL, p = 0.019) and healthy control groups (mean [SD] 229.7 [109.3] pg/mL, p = 0.018) ( p < 0.05). The level of the neuropeptide SP (mean [SD] 150.5 [29] pg/mL) in the interictal period was found to be lower than that observed in the healthy control group (mean [SD] 174.6 [39.4] pg/mL, p = 0.030) ( p < 0.05). Furthermore, the CGRP level in the interictal period (mean [SD] 395.6 [197.6] pg/mL) was found to be significantly higher than that observed in the healthy control group (mean [SD] 320.3 [126.6] pg/mL, p = 0.049) ( p < 0.05). No significant differences were observed in the levels of the other neuropeptides. Conclusions: The present study revealed elevated VIP levels during the ictal period and elevated CGRP levels during the interictal period in patients with migraine without aura when compared to controls. In addition, VIP serum levels were significantly higher in the ictal period compared to both the interictal period and healthy controls. The findings of our study lend support to the use of these neuropeptides as biomarkers for migraine. Nevertheless, further studies and standardization are necessary to ascertain the diagnostic value of single or combinations of SP, PACAP‐38, VIP, and CGRP neuropeptides in diagnosing pediatric migraine and differentiating pediatric migraine from non‐migraine headaches.

The Brazilian Journal of Psychiatry is the official publication of Brazilian Psychiatric Association (Associação Brasileira de Psiquiatria - ABP)

Purpose The aim of the study was to investigate how 8-week strength training affects adolescent athletes’ basal hormone concentrations, sex hormone binding globulin (SHBG), insulin-like growth factor binding protein-3 (IGFBP-3), cytokine, and oxidative stress markers. Methods Twenty adolescent handball players participated in this study. The participants were randomly divided into the strength training group (ST, n = 10) and the control group (C, n = 10). ST participates in strength training 3 sessions a week for 8 weeks and C participates only in handball training. We quantified serum basal hormone concentration, SHBG, IGFBP3, oxidative stress markers, and IL-6 in each subject’s blood samples before and after 8 weeks of strength training. Results Interestingly, while insulin-like growth factor-1 (IGF-1) concentration declined in group C (p < 0.05), it did not in ST (p > 0.05). Furthermore, the basal concentration of growth hormone (GH), total testosterone (T), cortisol (Cor), total antioxidant status (TAS), and serum-free androgen index (FAI) basal concentration did not change in ST and C. Basal IGFBP-3 and SHBG concentrations decreased only in ST (p < 0.05), but not in C (p > 0.05). Serum-free testosterone (FT) levels increased in ST and C (p > 0.05). Total oxidant status (TOS) and oxidative stress index (OSI) reduced ST and C (p < 0.05). Serum interleukin-6 (IL-6) levels did not alter groups ST and C. Conclusion Strength training did not affect basal serum concentrations of T, GH, IGF-1, COR, IL-6, and TAS, but it caused a decrease in SHBG and IGFBP3 concentrations in ST. Increased basal FT concentration and improved serum TOS may not depend on strength training.

Thiol-disulfide homeostasis (TDH), one of the most important antioxidants, is involved in the non-enzymatic removal of reactive oxygen molecules in the body and is one of the many methods to measure the level of oxidative stress (OS). In the present study, TDH is investigated in adolescent depression, and its relationship to clinical variables is examined. Thirty-two (50.0%) patients diagnosed with major depressive disorder (MDD) and without psychotropic drug use and 32 (50.0%) healthy controls were included in the present study. The subjects MDD and control groups were between 13 and 18 years old. Participants completed the DSM-5 Level-2 scales for depression and irritability. A colorimetric method proposed by Erel and Neselioglu was used to analyze the TDH parameters of serum samples. Biochemical analyses of samples from the MDD and control groups showed significant differences between the groups in native thiol (SH) levels (P = .002), disulfide (SS) levels (P = .021), disulfide/total thiol (SS/ToSH) (P = .009), and disulfide/native thiol (SS/SH) (P = .003) levels. Analysis of receiver operating characteristic showed that the area under the curve values with “acceptable discrimination potential” for the TDH parameters were significantly able to discriminate individuals with MDD from healthy controls. Thiol-disulfide homeostasis, one of the OS parameters, was found to be impaired in adolescents with depression. Our results suggest that TDH may contribute to the etiopathogenesis of adolescent MDD and that TDH may be a novel approach to assess OS in adolescent depression.

Methamphetamine is a substance that causes neurotoxicity and its use is increasing in recent years. Literature highlights cognitive impairment resulting from Methamphetamine use. The aim of the present study is to evaluate the relationship between cognitive impairment and inflammatory processes in adolescents with Methamphetamine use disorder. The study included 69 adolescents aged 15-19 years, comprising 37 participants with Methamphetamine Use Disorder and 32 healthy controls. Central Nervous System Vital Signs was used to detect cognitive impairment. Childhood Trauma Questionnaire-33 and The Children's Depression Inventory scales were used. In addition, venous blood was collected from the volunteers. Biochemical parameters (IL-1beta, IL-6, TNF-a, BDNF, FAM19A5, TAS, TOS) were analyzed. Our study showed that (I) IL-6 and TNF-a levels of Methamphetamine users were lower than the healthy group; (II) BDNF levels of Methamphetamine users were higher than the healthy group; (III) mean Neurocognitive Index in cognitive tests of Methamphetamine using adolescents was negatively correlated with duration of Methamphetamine use and BDNF levels. Our study suggests that Methamphetamine use may have a negative effect on cognitive functions.

Aims: Early diagnosis and treatment affect mortality in hospital-acquired pneumonia (HAP). Therefore, clinicians need some objective parameters for guiding treatment. The aim of this study was to determine the course of ‘‘clinical pulmonary infection score’’ (CPIS), C-reactive protein (CRP) and procalcitonin (PCT) in patients under treatment as well as the relationship of these parameters with each other and mortality. Methods: This single-center, prospective, cross-sectional study focused on cases of HAP in hospitalized patients. In patients with HAP; CPIS, CRP and PCT assays were assessed on the first day. Appropriate treatment was initiated according to Turkish Thoracic Society HAP Task Force recommendations. On the 3rd day, CPIS evaluation and on the 4th day CRP and PCT analysis were repeated. All the patients’ one month mortality rates were recorded. Results: Among the 25 patients, there were 14 females. The mean age was 66±15 years. The mean duration for HAP development was 9.4±8.2 days. With a cutt-off value of 65 for age CPIS, CRP, PCT, length of hospital stay and mortality rate was not found different (p>0.05), however as the age increased HAP development duration significantly decreased (r=-0.416, p=0.03). We demonstrated a significant change between the first and the follow-up values of fever (p=0.046), leukocyte (p<0.001), PaO2/FiO2 (p=0.016), secretion presence (p<0.001), culture positivity (p<0.001) as well as total CPIS (p=0.030). However, there wasn’t a significant difference in CRP and PCT levels. We couldn’t show any relation between CPIS domains, total CPIS, CRP, PCT, HAP development duration and mortality rates. Conclusion: Monitoring HAP treatment according to CPIS was found better than CRP and PCT. However, these parameters had no effect on mortality. For more accurate comments, studies with more patients are needed.