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Öğe Çocuklar için özel gereksinim raporunda fiziksel tıp ve rehabilitasyon hekiminin rolü(2022) Büyükavcı, Raikan; Buyukavci, Mehmet Akif; Aktürk, SemraAmaç: Bu çalışmanın amacı ‘Çocuklar İçin Özel Gereksinim Raporu (ÇÖZGER)’ için 3. basamak üniversite hastanesine başvuran çocuk ve ergen olgularda hareket gelişimi alanında tanı dağılımını ve buna bağlı gereksinim düzeylerini saptamak ve fiziksel tıp ve rehabilitasyon (FTR) hekiminin (fiziatrist) hekiminin rolünü vurgulamaktır. Yöntemler: Çalışma kapsamında Nisan 2019-Şubat 2022 tarihleri arasında hastanemiz sağlık kuruluna ÇÖZGER için başvuran 0-18 yaş arası hastalara ait veriler retrospektif olarak tarandı. Olguların demografik verileri, hareket alanındaki özel gereksinim ve tanıları, değerlendirme yapan diğer bölümler ile ek özel gereksinimleri, rapor sonuçları ve süreleri analiz edildi. Bulgular: Çalışmaya 547’si kız (%38,3) olmak üzere 1428 hasta dâhil edildi. 1252’si (%87,7) ilk başvuru- sunu yaparken, 179 hasta rapor yenilemesi yapmak üzere başvurmuştu. Tüm hastaların yaş ortalaması 95.47±56.59 (min 2-max 216) aydı. FTR polikliniğine başvuru sayısı Çalışmaya dâhil edilen hastalar içinde FTR polikliniğine başvuranların sayısı 199'u kız olmak üzere 469 (%32.8) idi. FTR’ye başvuran hastaların yaş ortalaması 80.54±2.64 ay olmak üzere başvurmayanlara oranla daha erken yaştı (p<0.001). ÇÖZGER’de yer alan FTR tanıları arasında en sık serebral palsi ve Down sendromu yer almıştı. FTR polikliniğine başvu- ran hastaların sadece 8’i ‘Özel Gereksinim Yok’ olarak değerlendirilirken; 336 hastanın raporu ‘Özel Koşul Gereksinimi Var’ olarak sonuçlanmıştı. FTR bölümüyle birlikte en sık rapor veren bölümler sırasıyla çocuk ve ergen ruh sağlığı hastalıkları, çocuk nöroloji ve gelişimsel pediatri olarak saptandı. Sonuç: ÇÖZGER için başvuran hastaların yaklaşık üçte biri FTR hekimine başvurmaktadır. Henüz tanı almasa da erken yaş grubundan itibaren hareket gelişim alanında destek gerektirecek düzeyde zorluk saptanan hastaların değerlendirilmesine ve desteklenmesine faydası olan ÇÖZGER’de FTR hekimi anahtar role sahiptir.Öğe Cognitive home environment of infants, toddlers and preschoolers: A study from a hospital setting(2021) Kortay Canaloglu, Sinem; Gumus Dogan, Derya; Buyukavci, Mehmet Akif; Arslan, Feyzullah NecatiAim: The purpose of this study was to determine the Cognitive Home Environment (CHE) of young children who apply to the hospital for various reasons. Material and Methods: In total 121 mothers participated. CHE was measured by The StimQ – (Infant, Toddler and Preschool) Home Environment Assessment Tools and sociodemographic characteristics of the families were noted. Results: Averages of total StimQ scores were lowest in Infant Group (IG) with 13.7 points out of 43; 15.9 points out of 39 in Toddler Group (TG); 27.78 points out of 49 in Preschool Group (PG). There was a significant difference in the Total StimQ scores of mothers with high level of education in Toddler (p=.005) and Preschool (p=.000) groups. Looking at childrens' books increased with age. Only 15% of the mothers in the IG, 32.5% in the TG, and 90% in the PG were looking at children's books with their children. Conclusion: The CHE of young children is not enough to serve for optimal development, especially the infants. High maternal education iseffects CHE positively. Applying STIMQ can be a good opportunity to explore CHE of children in hospital settings.Öğe Cognitive home environment of infants, toddlers and preschoolers: A study from a hospital setting(2021) Kortay Canaloglu, Sinem; Gumus Doğan, Derya; Buyukavci, Mehmet Akif; Arslan, Feyzullah NecatiAbstract: Aim: The purpose of this study was to determine the Cognitive Home Environment (CHE) of young children who apply to the hospital for various reasons. Material and Methods: In total 121 mothers participated. CHE was measured by The StimQ – (Infant, Toddler and Preschool) Home Environment Assessment Tools and sociodemographic characteristics of the families were noted. Results: Averages of total StimQ scores were lowest in Infant Group (IG) with 13.7 points out of 43; 15.9 points out of 39 in Toddler Group (TG); 27.78 points out of 49 in Preschool Group (PG). There was a significant difference in the Total StimQ scores of mothers with high level of education in Toddler (p=.005) and Preschool (p=.000) groups. Looking at childrens' books increased with age. Only 15% of the mothers in the IG, 32.5% in the TG, and 90% in the PG were looking at children's books with their children. Conclusion: The CHE of young children is not enough to serve for optimal development, especially the infants. High maternal education iseffects CHE positively. Applying STIMQ can be a good opportunity to explore CHE of children in hospital settings.Öğe Comparison of developmental outcomes in children with permanent and transient congenital hypothyroidism(Walter De Gruyter Gmbh, 2023) Buyukavci, Mehmet Akif; Dundar, IsmailObjectives: Congenital hypothyroidism (CH) is still one of the most common causes of preventable cognitive impairment in children, and its early detection and treatment prevent irreversible neurodevelopmental delay. Depending on the underlying cause, cases with CH may be transient or permanent. This study aimed to compare the developmental evaluation results of transient and permanent CH patients and to reveal any differences.Methods: A total of 118 patients with CH, who were followed up jointly in pediatric endocrinology and developmental pediatrics clinics, were included. The patients' progress was evaluated per the International Guide for Monitoring Child Development (GMCD).Results: Of the cases, 52 (44.1%) were female, and 66 (55.9%) were male. While 20 (16.9%) cases were diagnosed with permanent CH, 98 (83.1%) were diagnosed with transient CH. According to the results of the developmental evaluation made with GMCD, the development of 101 (85.6%) children was compatible with their age, while 17 (14.4%) children had delays in at least one developmental area. All 17 patients had a delay in expressive language. Developmental delay was detected in 13 (13.3%) of those with transient CH and 4 (20%) with permanent CH.Conclusions: There is difficulty in expressive language in all cases of CH with developmental delay. No significant difference was found between the developmental evaluations of permanent and transient CH cases. The results revealed the importance of developmental follow-up, early diagnosis and interventions in those children. GMCD is thought to be an important guide to help monitoring the development of patients with CH.Öğe Developmental characteristics of Williams-Beuren syndrome and evaluation of adaptive behavioral skills(Tubitak Scientific & Technological Research Council Turkey, 2023) Guven Baysal, Senay; Arslan, Feyzullah Necati; Buyukavci, Mehmet Akif; Yagin, Fatma Hilal; Ekici, Cemal; Esener, Zeynep; Gumus Dogan, DeryaBackground/aim: Williams-Beuren syndrome (WBS) is a rare genetic disorder with delays in language and cognitive development, but, with increased awareness of clinical features and a reliable diagnostic test, WBS is becoming more widely recognized in childhood. Adaptive behavior skills and/or maladaptive behavior are important for the prognosis of individuals with WBS. The aim of this study was to investigate the clinical and developmental characteristics of patients with WBS and further increase awareness about it by evaluating the adaptive skills and maladaptive behaviors of the patients.Materials and methods: The data of WBS patients followed-up at the Developmental Behavioral Pediatrics Unit were reviewed. Patient data on perinatal and postnatal history, developmental stages, physical and neurological examination findings were collected. The International Guide for Monitoring Child Development (GMCD) was administered to each child. In addition, semistructured interviews were conducted with the parents using the Vineland Adaptive Behavior Scales, Second edition (Vineland-II).Results: A total of 12 patients diagnosed with WBS via detection of the 7q11.23 deletion, of whom 6 were girls, were retrospectively reviewed. The mean age at the time of review was 54.6 +/- 32.5 months. The mean age at first presentation to the Developmental Behavioral Pediatrics Outpatient Clinic was 15 +/- 11.5 months. In the first developmental evaluation using the GMCD, there was a delay in fine and gross motor domains in 6 patients, in the language domains in 4 patients, and in all of the domains in 2 patients. Findings with Vineland-II showed socialization and communication domains as strengths, but the daily living skills and motor skills domains were weaknesses. In terms of maladaptive behavior, the patients tended to frequently have behavioral problems, neurodevelopmental disease, anxiety disorders, eating problems, and sleeping problems.Conclusion: This retrospective review of 12 patients indicated a general delay in overall development, and confirmed impairment in both adaptive and maladaptive functioning in WBS.Öğe Effects of parent- and child-related behavioral feeding problems in early childhood on malnutrition(Elsevier France-Editions Scientifiques Medicales Elsevier, 2023) Gungor, Sukru; Buyukavci, Mehmet Akif; Acipayam, CanObjective: Children's responses to food and their caregivers during normal developmental periods are known as feeding behavior. For the healthy development of these behaviors, parent and child relationships must also be healthy. Therefore, we aimed to investigate the effect of behavioral feeding problems on primary malnutrition (PM).Method: The Behavioral Pediatric Nutrition Assessment Scale (BPFAS) was administered to 300 malnourished and 300 control pediatric patients aged from 9 months to 4 years who were referred to our pediatric gastroenterology outpatient clinic. Pre-and posttreatment data were compared between the two groups.Results: There was no statistically significant difference between patients with and without malnutrition in terms of gender and age (p = 0.191, p = 0.128, respectively). Total behavioral frequency (TBF) and total behavioral problem (TBP) scores were significantly higher in the malnutrition group (p < 0.001). In the logistic regression analysis of risk factors that may affect malnutrition we found that a total TBF score of >85 increases the risk of developing malnutrition 3.731 times, a child TBF score of >62 increases it 2.644 times, and a parental TBF score of >21 increases it 4.82 times (p < 0.001). When anthropometric measurements and BPFAS scores of 127 PM patients who received behavioral therapy with enteral products and who attended follow-up were compared with their pretreatment data, there was a significant improvement (p < 0.05).Conclusion: Our study showed that behavioral feeding problems may increase the risk of PM and that behavioral therapy together with enteral products has a positive effect on treatment. Therefore, in addition to nutritional support in patients with PM, offering behavioral feeding therapy to parents will positively affect both the child's physical development and the relationship between the parents and their child.& COPY; 2022 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.Öğe Effects of ultrasound-guided botulinum toxin type-A injections with a specific approach in spastic cerebral palsy(Springer Heidelberg, 2018) Buyukavci, Raikan; Buyukavci, Mehmet AkifThe aim of this study was to detect effects of ultrasound-guided botulinum toxin type-A (US-guided BoNT-A) injections prepared according to lower extremity innervation zones on spasticity and motor function in 3-16 years children with diplegic and hemiplegic spastic cerebral palsy. This study included 25 patients between 3 and 16 years of age who admitted to our clinic in 2017, were being followed in our clinic with a diagnosis of cerebral palsy, had BoNT-A injections due to lower extremity spasticity. The US-guided BoNT-A injections were administered into the spastic muscles using a specific approach according to innervation zones of muscle. Modified Ashworth Scale (MAS) and Gross Motor Functional Classification System (GMFCS) were assessed at the baseline, and 4 and 12 weeks after the BoNT-A injections. Minimum and maximum ages of the patients were 45 and 192 months, and gender distribution was 8 females and 17 males. Significant decreases in the MAS scores of the knee and ankle tones were measured 4 and 12 weeks after the BoNT-A injection when compared to the baseline scores (p < 0.025). Hip muscle tonus only decreased 12 weeks after the injection (p < 0.025). In parallel with a reduction in spasticity GMFCS improved from 3 to 2 in the 4th and 12th weeks. US-guided BoNT-A injections with Euro-musculus approach is a practical and effective method to perform injections into proper points of proper muscles in children with spastic cerebral palsy.Öğe Etiological, clinical, and laboratory evaluation of congenital hypothyroidism and determination of levothyroxine (LT4) dose at treatment interruption in differentiating permanent vs. transient patients(Tubitak Scientific & Technological Research Council Turkey, 2022) Dundar, Ismail; Buyukavci, Mehmet Akif; Ciftci, NurdanBackground/aim: Congenital hypothyroidism (CH) is the most common cause of preventable but irreversible mental retardation in children, although the risk has been widely abolished by national neonatal screening programs. The aim of this study was to determine, (a) the cause of CH, (b) the etiological cause of persistent CH and (c) to investigate the role of laboratory and clinical data in predicting persistent and transient CH. Materials and methods: Patients diagnosed with CH, who started L-thyroxine treatment and were followed up for at least three years were included. Patient data were reviewed retrospectively. Serum thyroid hormones were measured four weeks after discontinuation of therapy at age three or earlier. Cases with a thyroid-stimulating hormone (TSH) value of >10 mIU/mL were accepted as permanent hypothyroidism, while cases with normal TSH values for six months after cessation were accepted as transient hypothyroidism. Results: There were 232 treated cases, of whom 108 (46.6%) were female, and 169 (72.8%) were eventually diagnosed with transient CH. The best cut-off point for predicting permanent status was determined as LT4 cut-off dose >= 1.45 mcg/kg/day. The median (range) duration of L-thyroxine treatment in transient hypothyroid cases was 24 (range: 6-36) months, and treatment was discontinued before the age of three years in 64%. Conclusion: It has been shown that the most common etiologic cause of CH is transient hypothyroidism. The thyroxine dose at the time of discontinuation of treatment and free thyroxine and TSH levels at the time of diagnosis are essential determinants in distinguishing permanent/transient CH.Öğe The Impact of COVID-19 Pandemic on Patient Admissions to the Developmental Pediatrics Unit: An Outpatient Clinic in Eastern Turkey(Aves, 2023) Ahat, Tugba Karaca; Gencer, Tugba Yilmaz; Baysal, Senay Guven; Baz, Halise Metin; Durak, Umut; Canaloglu, Sinem Kortay; Buyukavci, Mehmet AkifObjective: The aim of this study was to analyze the impact of coronavirus disease 2019 pandemic on the number and diagnosis of patients admitted to the Developmental Pediatrics Unit. Materilas and Methods: We compared the number and the diagnosis of patients admitted to the Developmental Pediatrics Unit by using International Classification of Diseases and Related Health Problems 10th revision (ICD-10) codes of our institution's electronic health data before and after 18 months from March 16 2020, when coronavirus disease 2019 pandemic was declared in Turkey. Statistical analyses were performed by using International Business Machines Statistical Package for Social Sciences for windows version 22.0 (Armonk, NY) program. Results: We found that the number of patients admitted to the Developmental Pediatrics Unit decreased during the pandemic period (pre-coronavirus disease 2019 n = 1107, during coronavirus disease 2019 n = 761). There was no significant difference between the ratio of the most common diagnosis (prematurity) before and during the pandemic period (32% and 30.6% respectively). It was observed that the ratio of children with speech delay (17.4%-23%, P =.003) increased during the pandemic, while there was a significant decrease in the ratio of admissions with Down syndrome (11.6%-6.6%, P <.001). Conclusion: We found that the number of admissions to the Developmental Pediatrics Unit with developmental difficulties decreased significantly during the pandemic. The ratio of admissions of speech delay increased during the same period, while admissions with Down syndrome decreased. This increase may be due to lockdown, increase in electronic screen exposure, and lack of stimuli and the decrease may be due to the risk of severe illness from coronavirus disease 2019. The decrease in admissions of patients who require developmental follow-up reveals the need for additional efforts such as implementing tele-health to our daily practice.Öğe Nutritional rickets in Turkish and refugee children aged 0-2: an increasing problem despite vitamin D prophylaxis(Turkish J Pediatrics, 2023) Dundar, Ismail; Buyukavci, Mehmet AkifBackground. Nutritional rickets (NR) is still a major problem and is exacerbated by an increasing influx of immigrants. In this study, Turkish and immigrant cases followed with the diagnosis of NR in our pediatric endocrinology clinic were retrospectively evaluated. Methods. Detailed data of cases diagnosed with NR between 2013 and 2020 and followed for at least six months were reviewed. Results. In the study period, 77 cases of NR were identified. Turkish children constituted 76.6% (n=59) while 18 (23.4%) were immigrant children. The mean age at diagnosis was 8.1 & PLUSMN;7.8 months, 32.5% (n=25) were female, and 67.5% (n=52) were male. The 25-hydroxyvitamin D3 was below normal in all patients, with a mean value of 4.3 & PLUSMN;2.6 ng/mL. Parathyroid hormone (PTH) was above normal in all and the mean value was 301.7 & PLUSMN;139.3 pg/ mL. While there were 3.9 cases of NR in 10,000 endocrine clinic patients in 2013, this rate increased more than four-fold to 15.7 patients in 2019. Conclusions. Despite the vitamin D prophylaxis program in Turkiye, NR is seen significantly more frequently in recent years, which may be associated with an increasing number of refugees. High PTH levels indicate the severity of NR cases admitted to our clinic. However, clinically significant NR is only the tip of the iceberg and the true burden of subclinical rickets is unknown. Increasing compliance with the vitamin D supplementation in and Turkish children is for the of nutritional rickets.Öğe The relationship between motor performance and femoral cartilage thickness in children with Down syndrome(Springer Heidelberg, 2021) Buyukavci, Raikan; Buyukavci, Mehmet Akif; Akturk, Semra; Arslan, Feyzullah Necati; Dogan, Derya; Canaloglu, Sinem KortayDown syndrome (DS) is a genetic disorder associated with mental and motor developmental delays in childhood. The aim of this study was to investigate the relationship of the femoral cartilage thickness with motor performance in children with Down syndrome (DS). A total of 39 children with DS in the age range of 12-42 months were included in the study (female/male: 21/18; mean age: 23.4 +/- 8.2 months). Femoral cartilage thickness was measured with ultrasound in the medial and lateral condyles and intercondylar areas of both knees. Gross motor subtest scaled scores of the Bayley Scales of Infant and Toddler Development III were used for the motor performance assessment. There was a positive correlation between the gross motor scaled scores and the femoral cartilage thickness in both knee joints (p < .05; r = 0.415 for the right medial condyle; r = 0.323 for the right lateral condyle; r = 0.339 for the right intercondylar area; r = 0.369 for the left medial condyle; r = 0.364 for the left lateral condyle, and r = 0.590 for the left intercondylar area). The study demonstrated that the femoral cartilage thickness was positively correlated with gross motor functioning in children with DS.Öğe Shared Reading of the Families With the Children With Chronic Disease(Sage Publications Inc, 2024) Baysal, Senay Guven; Buyukavci, Mehmet Akif; Akdemir, Esra; Yagin, Fatma Hilal; Dogan, DeryaThe aim of the study is to evaluate shared reading of families of children with chronic diseases. The mothers of children aged 2 to 6 years with chronic health problems who applied to the pediatric outpatient clinic between January and May 2022 were the study group, and the mothers of children with an acute health problem were the control group. The sociodemographic information form and Child-Parent Shared Reading Activities Scale were applied. At the end of the interview, 3 questions about shared reading were asked. A total of 187 children were enrolled in the study: 92 and 95 in the chronic disease group and control group, respectively. 57.6% of mothers of chronically ill children reported that the parents almost never did shared reading with their child. It was found that all mothers knew the importance of reading, but they could not support especially in the risky chronic disease group.
