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    Decreased brain-derived neurotrophic factor levels may predict early perioperative neurocognitive disorder in patients undergoing coronary artery bypass surgery: A prospective observational pilot study
    (Elsevier Science Inc, 2021) Miniksar, Okkes Hakan; Cicekcioglu, Ferit; Kilic, Mahmut; Honca, Mehtap; Miniksar, Dilsad Yildiz; Gocmen, Ayse Yesim; Kacmaz, Osman
    Study objective: To determine the prognostic value of the change in intraoperative BDNF (Brain-derived neurotrophic factor) levels during cardiac surgery with cardiopulmonary bypass (CPB) on early perioperative neurocognitive disorder (PND). Design: Prospective observational pilot study. Setting: The study was performed in the Medical Faculty Hospital, from January 2020 to August 2020. Patients: 45 adult patients undergoing elective coronary artery bypass surgery (CABG) with CPB. Interventions: None. Measurements: Cognitive function was evaluated 1 day before and 4 days after the surgery. Serum BDNF levels were measured at four time points (T1: after induction; T2: with aortic cross-clamp; T3: without aortic crossclamp; T4: 4 days after surgery) by enzyme-linked immunosorbent assay. Main results: The incidence of PND was 37.8% four days after surgery. Serum BDNF (T2 and T4) levels were significantly lower in PND group compared to non- PND group (p = 0.003 and p = 0.016, respectively). Moreover, lactate, rSO2 (regional cerebral oxygen saturation), aortic cross-clamp time, CPB duration, and the amount of blood transfusion differed between the groups. Logistic regression analysis identified serum BDNF-T2, age, cross-clamp time, and rSO2-T2 as independent risk factors for PND. Based on the ROC analysis, the area under curve (AUC) of BDNF-T2 concentration for prediction of PND was 0.759 with sensitivity of 71.4% and specificity of 64.7% (p < 0.01). Conclusion: Intraoperative BDNF serum levels may be a useful biomarker in predicting PND in patients undergoing CABG surgery. More comprehensive studies is needed in order to confirm the effect of decreasing intraoperative BDNF serum levels on the development of PND. Trial registration number: NCT04250935 www.clinicaltrials.gov.
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    Psychiatric morbidity in children and adolescents with dermatological disorders
    (Exeley Inc, 2021) Miniksar, Dilsad Yildiz; Ozcan, Ozlem Ozel; Cenk, Hulya; Kapicioglu, Yelda; Polat, Aysegul
    Background: Understanding the existence of a cycle, where psychological disturbances cause skin diseases and in turn, skin diseases cause psychological disorders, provides the basis for good dermatological practice. Objective: The aim of this case-control study is to examine the psychiatric morbidity of dermatological disorders in children and adolescents with no history of psychiatric disorders. Method: In this study, 502 participants (251 patients and 251 healthy individuals) were evaluated according to DSM-IV criteria. All participants were interviewed and evaluated using the Turkish version of the Kiddie Schedule for Affective Disorders and Schizophrenia -Present and Lifetime Version (K-SADS-PL) and the State-Trait Anxiety Inventory for Children (STAI-1 and STAI-2), the Childhood Depression Inventory (CDI), adolescent and parent forms of the Strengths and Difficulties Questionnaire (SDQ-A and SDQ-P) and a questionnaire evaluating child's level of school success. Results: Our results indicated that the rates of general psychiatric comorbidity, mood disorders, anxiety disorders, and adjustment disorders were significantly higher in the study group compared to the control group. The CDI, STAI-1, STAI-2, and SDQ (and subscales) scores were significantly higher in the study group. Moreover, psychiatric comorbidity was higher in inflammatory and allergic dermatoses compared to other dermatological subgroups. Having a dermatological disease restricts physical activity thus increasing the risk of psychiatric comorbidity. Conclusions: Investigating the education, attitudes, and awareness of dermatologists about psychocutaneous disorders might contribute to the development of new educational strategies and elicit appropriate biopsychosocial approaches.