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Öğe An approach to the surgical management of total oculomotor nerve palsy(2001) Köse S.; Üretmen Ö.; Pamukçu K.The goal of the procedure was to keep the eyes of patients with total oculomotor palsy in the straight ahead position by means of surgery on the horizontal and inferior rectus muscles in one session, without involving the superior oblique muscles. Six patients underwent surgery for total oculomotor nerve palsy. All of the surgical procedures were carried out on the muscles of the paralytic eye. We performed hemi-hangback recession of the lateral rectus and resection of the medial rectus for exotropia in all patients. Depending on the magnitude of vertical deviation, the insertions of the horizontal rectus muscles were moved upward, alone or in combination with hemi-hangback recession of the inferior rectus. The mean preoperative horizontal deviation was 66.6 PD. Two years after the operation, the horizontal deviation was measured to be 11.6 PD. Similarly, the mean preoperative vertical deviation of 16 PD decreased to 6.6 PD in two years. This procedure did not disturb normally functioning superior oblique and lateral rectus muscles. Subjectively, all of the patients were satisfied with their alignment two years after the operation. We are of the opinion that this technique is a safe, simple and effective procedure and can be regarded as a first-choice operation in total oculomotor palsy. If one fails to maintain the eye position with this procedure, one can still perform a second operation on the superior oblique muscle, which remains untouched in our procedure.Öğe Binocular visual function in congenital esotropia after bilateral medial rectus recession with loop suture(2002) Üretmen Ö.; Pamukçu K.; Köse S.; Uçak E.PURPOSE: Our aim was to evaluate the binocular visual function in congenital esotropia after bimedial rectus recession with loop suture and to address the factors that could take part in the attainment of binocular function. SUBJECTS AND METHODS: Forty children with congenital esotropia who were operated on between 12 and 48 months of age were included in the study group. Postoperative follow-up ranged from 2 to 10 years. In order to determine the factors affecting the sensory results in congenital esotropia, we classified our patients into two groups according to their fusion status. We compared the preoperative and postoperative characteristics of patients in these two groups. RESULTS: Twenty-one of 40 patients (52.5%) fused the Worth four-dot at near (Group 1), 19 patients (47.5%) did not (Group 2) at the final examination. No patient showed evidence of stereopsis. We found significant differences between these two groups in respect to the final angle of vertical deviation, the age at surgery, the presence of postoperative inferior oblique overaction, dissociated vertical deviation and abnormal head position. Correlation analysis revealed that early alignment of the eyes and the absence of postoperative vertical deviation were associated with increased incidence of achieving some degree of binocular vision. CONCLUSION: In congenital esotropia, not all infants may have the potential for normal binocular function owing to yet unknown constitutional factors. We determined that achieving some degree of binocular function may be related to early alignment of the eyes. Additionally, close follow-up and precise treatment of the accompanying vertical deviation, especially inferior oblique overaction and dissociated vertical deviation, in a timely manner may enhance the attainment of binocular sensory function.Öğe Blue-on-yellow perimetry versus achromatic perimetry in type 1 diabetes patients without retinopathy(Elsevier Ireland Ltd, 2003) Afrashi F.; Erakgün T.; Köse S.; Ardiç K.; Menteş J.In this study, we compared the blue-on-yellow perimetric parameters with conventional automated static threshold perimetric parameters in the detection of psychophysical abnormality in patients with type 1 diabetes mellitus (DM) without diabetic retinopathy. Forty-three patients with type 1 DM without diabetic retinopathy were included this study. Thirty subjects served as age-matched control group. Blue-on yellow perimetry was performed and the results compared to white-on-white perimetry. The values of mean deviation by blue-on-yellow perimetry in the diabetic group were significantly higher than in the control group (P = 0.0001). The indices of short fluctuation, pattern standard deviation, corrected pattern standard deviation and foveal sensitivity which all relate to localized depression in sensitivity were similar in both groups. The achromatic perimetric parameters were not different between the groups. We conclude that the short-wavelength-sensitive cones are vulnerable to damage from hyperglycemia and this influence can be detected early by blue-on-yellow perimetry in diabetic patients without retinopathy. © 2003 Elsevier Science Ireland Ltd. All rights reserved.Öğe A case of bilateral papilloedema and left abducens nerve palsy on the base of brucella infection [Brusella enfeksiyonu zemininde bilateral papilödem ve sol gözde abdusens sinir felci gelişen bir olgu](2011) Kirikkaya E.; Menteš J.; Afrashi F.; Köse S.; Güven S.Best corrected visual acuity of a 19-year-old female patient, who was referred to our clinic with decreased visual acuity and diplopia complaints while being treated with antibrucella therapy, was 10/10 in the right eye and 8/10 in the left eye with the Snellen acuity chart. The anterior segment evaluation and intraocular pressure levels were bilaterally normal. The fundus examination revealed bilateral obscuration of the optic disc (OD) margins and swelling and peripapillary retinal splinter-shaped haemorrhages. There were intravitreal haemorrhage cells in the right eye. She had 15° esodeviation and lateral gaze palsy in the left eye. Bilateral best corrected visual acuity returned to 10/10 with antibrucella and corticosteroid therapy, and the diplopia, lateral gaze palsy, and tropia resolved. Right OD margins were distinct, but left OD margins were still indistinct during the fundoscopic examination. Papilloedema and abducens nerve palsy can be seen due to central nervous system involvement on the base of Brucella infection, and with antibrucella therapy and high dose corticosteroid therapy ophthalmological findings can return to normal.Öğe Chlamydia trachomatis in conjunctival specimens [Konjonktival örneklerde Chlamydia trachomatis araştirilmasi.](1993) Dereli D.; Ertem E.; Serter D.; Köse S.; Haznedaroglu G.One hundred two patients with signs and symptoms of conjunctivitis and 45 asymptomatic subjects were screened for Chlamydia trachomatis using a direct fluorescent antibody test. 26.5% of the symptomatic and 6.6% of the asymptomatic patients were positive for C.trachomatis. The follicular response rate was significantly higher (p < 0.05) in the symptomatic group than in the asymptomatic population (48.1% and 29.3% respectively). This finding correlated well with chlamydial conjunctivitis.Öğe Coexistante of intraocular eyelashes and anterior chamber cyst after penetrating eye injury: a case presentation(Kluwer Academic Publishers, 1994) Köse S.; Kayikçioglu O.; Akkin C.; Yagci A.; Bašdemir G.We herein describe a patient in whom two intraocular eyelashes and an anterior chamber cyst embedded into the anterior surface of the iris was detected following penetrating eye injury. After a one year asymptomatic period, the patient was hospitalized because of uveitic reaction in the anterior chamber which may be due to cyst development. The lashes and cyst were removed surgically, and examined pathologically. There was no complication in one year follow-up period. © 1995 Kluwer Academic Publishers.Öğe Determination of clinical and socio-demographical differences of adolescents applying to a treatment center with family encouragement or the decision of the probation office and determination of predictive factors in maintaining soberness among probation cases(Turkish Neuropsychiatric Society, 2016) Yüncü Z.; Aydın R.; Aydın C.; Özbaran B.; Köse S.Introduction: This study has two objectives. The first objective of this study was the determination of some basic clinical and sociodemographical differences among the adolescents with substance abuse who apply to a treatment center with support from their family or by order of the probation office. The other objective of this study was the determination of the predictive factors in maintaining soberness among adolescents who successfully complete the probation treatment process. Methods: The target population of this study is young adults under 19 years of age who apply to a substance addiction center for adolescents as a result of encouragement from their family or ordered by the Probation Office between 2005 and 2013. These two groups were analyzed in terms of socio-demographical characteristics such as age, the age at which they tried the substance, the age at which they applied to the treatment center, sex, substances they used, education period, employment history, and street life experience. The Statistical Package for the Social Sciences (SPSS) 18.0 software was used for the statistical analysis. Results: It was detected that among the cases who applied to the treatment center with family support, their education period was longer than probation (PR) cases (p<0.0001), and the rates of previous treatment, their mother being alive, and having street life experiences were more frequent (p values: <0.0001; =0.010; =0.027; <0.0001, respectively) and employment history was higher among PR cases (p<0.0001). In terms of the substances used, ecstasy, alcohol, inhalants, and volatile substances are more common among those applying with family support (p=0.018; 0.001; <0.0001, respectively). However, use of cannabis was found to be more common among PR cases (p<0.0001). It was found that PR cases who successfully completed their treatment process had married parents (p=0.008) and had more years of education (p=0.004). It can be predicted that if the subject is well educated and does not use multiple substances or have an alcohol history, the treatment process for PR cases can be successfully completed. (R2=0.176; p<0.0001). Conclusion: The rates of completing the treatment among cases analyzed in this study were higher than those among cases from adults. In the studies conducted, the results of the treatment efficiency among PR cases were inconsistent. This inconsistency may result from, except for legal obligations, having different circumstances such as socio-economic factors during the treatment period. © 2016 by turkish association of neuropsychiatry.Öğe Does the quality of life in autism spectrum disorder differ from other chronic disorders and healthy children? [Otizm spektrum bozukluğunda yaşam kalitesi diğer kronik hastalıklardan veya sağlıklılardan farklı mıdır?](Cukurova University, Faculty of Medicine, 2016) Öztürk Ö.; Erermış S.; Ercan E.S.; Gülen F.; Kabukçu Başay B.; Başay Ö.; Köse S.; Özgün Öztürk F.; Alacam H.; Aydin C.Objective: Autism spectrum disorder (ASD) is characterized by deficits in social interaction, communication, re-stricted interests, and repetitive patterns of behavior. This study examined quality of life (QoL) and related clinical factors in children with ASD, compared to children with Attention Deficit Hyperactivity Disorder (ADHD), children with asthma, and healthy controls (HC). Methods: QoL was assessed by the Pediatric Quality of Life Inventory 4.0 (PedsQLTM 4.0). Additionally, parents of the children provided sociodemographic information and filled out an evaluation questionnaire, child behavior check list (CBCL), and Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S). Results: The physical health, psychosocial health, social functioning, and scale total score of the ASD group were significantly lower than those of the three comparison groups. The school functioning score domain was lower in the ASD group than in the asthma and HC groups. In contrast, the emotional functioning domain assessments did not reveal statistically significant differences between the ASD group and the comparison groups. In the ASD group, the total problem score, inattention, and hyperactivity scores were significantly higher than both the asthma and HC groups, and the internalizing scores were higher than the healthy group. Conclusion: The poor QoL is most likely due to functional losses and problem behaviors related to ASD and may negatively affect not only children with ASD but also the whole life of the family. © 2016, Cukurova University, Faculty of Medicine. All rights reserved.Öğe Effect of bimedial rectus recession with a loop on the deviation in essential infantile esotropia(Informa Healthcare, 1994) Köse S.; Pamukçu K.; Akkin C.; Cengiz H.Thirty-two patients with essential infantile esotropia were treated by using a 2.5 millimeter loop, added to a 4 millimeter medial recti recession bilaterally. Objective deviation was more than 45 prism diopters (PD) in all of the patients preoperatively. After surgery the deviation ranged between -10 PD and +IO PD in 26 (81.2% patients, and limitation of abduction disappeared in all of the cases. A slight limitation of adduction was encountered in two (6.2% patients. The authors concluded that bimedial rectus recession with a loop is an effective method as an early surgical procedure in patients with infantile esotropia with a large deviation. © 1994 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.Öğe Effects of intraocular Lens malposition on binocular single vision in bilaterally pseudophakic patients(Informa Healthcare, 1994) Akkin C.; Cengiz H.; Köse S.; Pamukçu K.Purpose: To investigate the relationship between intraocular lens (IOL) malposition and quality of binocular single vision following uncomplicated extracapsular cataract extraction and posterior chamber IOL implantation. Methods: Fifty-two bilaterally pseudophakic patients were included. The main outcome measures were visual acuity, stereoscopic acuity, horizontal and vertical amplitudes of fusion and heterophoria, tilting angle and decentration amount of the pseudophacos and summation of these values in somewhat vectorial manner to define the total decentration and tilt of IOLS. Results: The mean total horizontal decentration was 0.19 mm and vertical decentration was 0.90 mm, mean total horizontal tilt being 1.55 degrees and vertical tilt 7.52 degrees. The mean stereoscopic acuity was found to be 1020 seconds of arc. Although the stereoscopic acuity threshold increased as decentration and tilt of IOLS increased, only the horizontal tilt was found to be statistically significantly correlated with stereoscopic acuity (pc0.01). Conclusion:The quality of binocular single vision may be affected by IOL malposition in pseudophakic patients. Therefore, when an IOL implantation is planned, the most appropriate IOL design and surgical technique causing least decentration and tilt should be preferred. © 1994 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.Öğe Evaluation of cornea and anterior chamber using pentacam in pediatric cases [Pediatrik olgularda kornea ve ön kamarani{dotless}n pentacam ile degerlendirilmesi](2011) Onay M.P.; Egilmez S.; Üretmen Ö.; Yagci A.; Köse S.Purpose: To evaluate the anterior segment structures using Pentacam in pediatric cases. Material and Method: One hundred sixty-two eyes (study group) of 81 healthy children who attended our clinic were compared with 114 eyes (control group) of 57 healthy adults. The central corneal thickness, anterior chamber volume, and anterior chamber depth of all cases were evaluated with Pentacam. Independent t-test and Pearson's correlation analysis were used for statistics. Results: The mean age of the study group (40 male, 41 female) was 9.99±2.80 (range: 6-16) years. The mean central corneal thickness in the right eyes was 580.74±42.04 (range: 492-669) micrometers and in the left eyes was 586.52±43.51 (range: 495-699) micrometers. The mean anterior chamber depth, volume, and anterior chamber angle were 3.02±0.29 (range: 2.39-3.9) mm, 176.43±31.77 (range: 117-272) mm3 and 36.23±5.41 (range: 25.8-50.7) degree, respectively. When the right and the left eyes were compared, significant differences were observed between central corneal thickness (p=0.001) and anterior chamber angles (p=0.05). The mean left eye keratometry was found to be significantly flatter in children (p=0.002). The mean anterior chamber depth, anterior chamber volume, and anterior chamber angle values were higher in children than in adults (p<0.001). Discussion: Pentacam is an easy-to-use and noninvasive technique that can be used for the evaluation of central corneal thickness and anterior chamber even in pediatric cases. Significant differences were detected in measurements with this device between adults and pediatric cases, and between the right and left eyes. Being aware of these differences in normal eyes will be a guide in correct evaluation of pathologic eyes.Öğe Factors affecting contrast sensitivity in healthy individuals: A pilot study(Turkish Ophthalmology Society, 2017) Karatepe A.S.; Köse S.; Eğrilmez S.Objectives: To determine the demographic and ocular features affecting contrast sensitivity levels in healthy individuals. Materials and Methods: Seventy-four eyes of 37 subjects (7-65 years old) with refractive errors less than 1.0 diopter, no history of ocular surgery, and 20/20 visual acuity were included in the study. The participants were divided by age into three groups: group 1, 7-19 years, n=11; group 2, 20-49 years, n=15; and group 3, 50-65 years, n=11. All subjects underwent anterior and posterior segment evaluation, intraocular pressure measurements, refraction measurements, and clinical evaluation for strabismus. Contrast static test was performed using Metrovision MonPack 3 vision monitor system after measuring pupil diameter. Photopic and mesopic measurements were taken sequentially from right eyes, left eyes, and both eyes together. Results: Contrast sensitivity at intermediate and high spatial frequencies was lower with increasing age. Binocular measurements were better than monocular, and mesopic measurements were better than photopic measurements at all spatial frequencies. Contrast sensitivity at higher spatial frequency was lower with hyperopic refraction values. Conclusion: Increasing age, small pupil diameter, hyperopia, and photopic conditions were associated with lower contrast sensitivity in healthy individuals. Binocular contrast sensitivity measurements were better than monocular contrast sensitivity measurements in all conditions and spatial frequencies. © 2017 by Turkish Ophthalmological Association.Öğe The forensic cases applied to an education and research hospital's child psychiatry department [Bir egitim ve araştirma hastanesi çocuk psikiyatrisi poliklinigine yönlendirilen adli olgular](2011) Köse S.; Aslan Z.; Senem Başgül Ş.; Şahin S.; Yilmaz Ş.; Çitak S.; Ertan Tezcan A.Objective: The stressful experiences, especially sexual abuse, damage the child's psychology, mental health and quality of life. Forensic psychiatric evaluation includes the expertness, provides information for judicial decision and also is important to diagnose the psychiatric disorder of the child and protect him. Because of these reasons we were aimed to examine the characteristics of children applied to our department for criminal report. Methods: The files of 73 cases aged 4-18 years have been examined retrospectively who referred to Erenkoy Psychiatry Hospital Child Psychiatry Outpatient Department between January 2007 and December 2009 for criminal reports. Beside the sociodemographic characteristics, psychopathology, intelligence levels and crime characteristics of these children were also examined. Results: The prosecutor's request was the evaluation of the psychiatric status in 86.3% of cases. Eighty-nine percent (65 cases) of 73 cases were applied for evaluation after sexual abuse. The rates of psychiatric diagnoses in sexually abused children were 32.3% posttraumatic stress disorder, 20% adjustment disorders, 16.9% acute stress disorder, 13.8% depressive disorders. We did not find any active psychiatric disorder in 16.9% of the cases. Intelligence Quotient were normal in 64.6% of the cases (n=42). 56.6% of the sexual offenders were acquaintance (9 incest cases-13.8%), 17% were friend-related people, 26.4% were stranger, 20.4% were under 18 years of age. Discussion: The psychiatric evaluation after sexual abuse was the most frequent request of the prosecutors'. 83.1% of the children had active psychiatric disorders that were evaluated because of sexual abuse. The most common diagnosis was posttraumatic stress disorder and this result is consistent with earlier findings. It is clear that stressful experiences especially sexually abuse damage the child's psychology, mental health and quality of life.Öğe Improving knowledge and attitudes of health care providers following training on HIV/AIDS related issues: A study in an urban Turkish area [Saglı k çalı şanları nı n HIV/AIDS ile ilgili konularda egitildikten sonra artan bilgi vetutumları : Türkiye'de kentsel alanda yapnılmnış bir çalnışma](Turkiye Klinikleri, 2012) Köse S.; Mandiracioglu A.; Kaptan F.; Özbel Y.; Mermut G.Objective: The objective of the study was to assess HIV/AIDS related knowledge, attitu-des and risk perception among health care providers in İzmir. Material and Methods: A pretest and posttest patterned intervention study was conducted in 2007 among health care providers participa-ting in a training course on HIV/AIDS and universal precautions. The participants consisted of 158 he-alth care professionals from 7 public hospitals and 2 public dental clinics. Information was collected regarding demographic details, HIV/AIDS related knowledge, attitudes and perceptions about patients at the beginning and the end of the course. Pre- and post-training dichotomous point scale scores we-re compared. Results: Of the participants, 72.6 % were females. Only 30.0 % of the respondents re-ported a scalpel or needle stick injury at least once last year. Some of the participants (40%) thought that it was necessary to take extra infection control precautions for patients with HIV. The average pre- and post-training mean knowledge scores were 9.32 ± 2.1 (3-13) and 12.76 ± 2.3 (5-17), respec-tively. The mean pre- and post-training beliefs scores were 12.37 ± 3.1 (3-19) and 15.57± 3.8 (6-22), respectively. There were significant differences in the pre-and post-training mean scores of the res-ponses related to attitudes toward patients with AIDS. Conclusion: There was improvement in knowl-edge and negative attitudes on patients with AIDS at the end of the training. The results of this study suggested that the negative attitudes of health care providers towards individuals with AIDS due to the fear of transmission and inadequate knowledge could be improved with training. © 2012 by Türkiye Klinikleri.Öğe Investigation of bacterial and viral etiology in community acquired central nervous system infections with molecular methods [Toplum Kökenli Santral Sinir Sistemi Enfeksiyonlarinda Bakteriyel ve Viral Etiyolojinin Moleküler Yöntemlerle Degerlendirilmesi](Ankara Microbiology Society, 2017) Kahraman H.; Tünger A.; Şenol S.; Gazi H.; Avci M.; Örmen B.; Türker N.; Atalay S.; Köse S.; Ulusoy S.; Taşbakan M.I.; Sipahi O.R.; Yamazhan T.; Gülay Z.; Çavuş S.A.; Pullukçu H.In this multicenter prospective cohort study, it was aimed to evaluate the bacterial and viral etiology in community-acquired central nervous system infections by standart bacteriological culture and multiplex polymerase chain reaction (PCR) methods. Patients hospitalized with central nervous system infections between April 2012 and February 2014 were enrolled in the study. Demographic and clinical information of the patients were collected prospectively. Cerebrospinal fluid (CSF) samples of the patients were examined by standart bacteriological culture methods, bacterial multiplex PCR (Seeplex meningitis-B ACE Detection (Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes, Group B streptococci) and viral multiplex PCR (Seeplex meningitis-VI ACE Detection kits herpes simplex virus-1(HSV1), herpes simplex virus-2(HSV2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein Barr virus (EBV) and human herpes virus 6 (HHV6)) (Seeplex meningitis-V2 ACE Detection kit (enteroviruses)). Patients were classified as purulent meningitis, aseptic meningitis and encephalitis according to their clinical, CSF (leukocyte level, predominant cell type, protein and glucose (blood/CSF) levels) and cranial imaging results. Patients who were infected with a pathogen other than the detection of the kit or diagnosed as chronic meningitis and other diseases during the follow up, were excluded from the study. A total of 79 patients (28 feMale, 51 Male, aged 42.1 ±18.5) fulfilled the study inclusion criteria. A total of 46 patients were classified in purulent meningitis group whereas 33 were in aseptic meningitis/encephalitis group. Pathogens were detected by multiplex PCR in 41 patients. CSF cultures were positive in 10 (21.7%) patients (nine S.pneumoniae, one H.influenzae) and PCR were positive for 27 (58.6%) patients in purulent meningitis group. In this group one type of bacteria were detected in 18 patients (14 S.pneumoniae, two N.meningitidis, one H.influenzae, one Lmonocytogenes). Besides, it is noteworthy that multiple pathogens were detected such as bacteria-virus combination in eight patients and two different bacteria in one patient. In the aseptic meningitis/encephalitis group, pathogens were detected in 14 out of 33 patients; single type of viruses in 11 patients (seven enterovirus, two HSV1, one HSV2, one VZV) and two different viruses were determined in three patients. These data suggest that multiplex PCR methods may increase the isolation rate of pathogens in central nervous system infections. Existence of mixed pathogen growth is remarkable in our study. Further studies are needed for the clinical relevance of this result.Öğe Long-term results in pediatric developmental cataract surgery with primary intraocular lens implantation(Turkish Ophthalmology Society, 2018) Biler E.D.; Yıldırım Ş.; Üretmen Ö.; Köse S.Objectives: The aim of this study was to evaluate the outcomes of pediatric developmental cataract surgery with primary intraocular lens (IOL) implantation. Materials and Methods: Patients between 2 and 16 years old who underwent cataract surgery with primary IOL implantation were retrospectively evaluated. Age at time of surgery, pre- and postoperative best corrected visual acuities, postoperative ocular complications, and any accompanying ocular pathologies were obtained from the patients’ charts. Mean refractive changes and degree of myopic shift were analyzed according to the age groups. Operated eyes were also compared with the fellow eyes in unilateral cases. Results: A total of 101 eyes of 65 patients were included. The average age at time of surgery was 76±40 months and the average follow-up period was 44±30 months. Among the 78 eyes that could be assessed for visual acuity improvement, 66 (84.6%) of them showed ?2 lines of improvement. The difference in the mean refractive change between the 2-5 years old and 8-16 years old age groups was found to be statistically significant. However, the mean refractive change per year was not found to be significant between the same age groups. In unilateral cases, the operated eyes showed a greater myopic change than the fellow eyes, with no statistically significant difference. The most common postoperative complication was visual axis opacity. Conclusion: Good visual outcomes can be achieved following pediatric cataract surgery with primary IOL implantation. Optic axis opacities were the most common postoperative complications. Overall, refractive changes following surgery are inevitable, and more prominent in younger age groups. © 2018 by Turkish Ophthalmological Association Turkish Journal of Ophthalmology, published by Galenos Publishing House.Öğe Long-term results of cataract surgery in patients with unilateral childhood cataract [Tek tarafli{dotless} çocukluk çagi{dotless} kataraktli{dotless} olgulari{dotless}mi{dotless}zda katarakt cerrahisinin geç dönem sonuçlari{dotless}](2012) Yilmaz S.G.; Bozbiyik D.I.; Köse S.; Üretmen O.Purpose: To evaluate the long-term visual outcome and to determine the surgical complications after cataract surgery in patients with unilateral childhood cataract. Material and Method: We retrospectively reviewed the records of 18 cases with unilateral childhood cataract who had undergone cataract surgery before the age of seven. Primary intraocular lens (IOL) implantation was made in children who were older than 1 year of age. Secondary IOL implantation was made after 18 months in children who were operated before the age of 1 year and were left aphakic. Occlusion therapy was performed to all children for amblyopia postoperatively. Visual acuity and complications were evaluated in a mean follow-up period of 4.8 years. Results: The mean age of the 18 patients (9 female/9 male) at the time of surgery was 43.6±33.7(1-84) months. Eleven (61%) patients had cataract surgery after 1 year of age. Secondary IOL implantation was performed at mean 28th month in 4 of 7 aphakic patients (57%) who had cataract surgery before one year of age. In 3 (43%) aphakic patients, secondary IOL implantation could not be performed because of ocular pathologies such as microophthalmia. Final visual acuity was 0.5 or better in 7 eyes (39%), between 0.1 and 0.5 in 6 eyes (33%), and worse than 0.1 - in 5 eyes (28%). Of 5 eyes that had visual acuity worse than 0.1, 4 (80%) had at least one additional ocular pathology such as microphthalmia, strabismus and nystagmus. Nd:YAG laser posterior capsulotomy was performed at mean 8th month in 7 of 8 (87%) children whose posterior capsules were left intact at surgery. Discussion: Favorable visual outcomes can be achieved with surgical intervention and complementary amblyopia treatment in children with unilateral cataract. Preoperative microphthalmia, nystagmus and strabismus are not entirely an obstacle to visual development, but they are important factors leading to low visual acuity.Öğe Meta-analysis of theory of mind in anorexia nervosa and bulimia nervosa: A specific İmpairment of cognitive perspective taking in anorexia nervosa?(John Wiley and Sons Inc., 2016) Bora E.; Köse S.Objective: Deficits in theory of mind (ToM), ability to infer mental states of others, can play a significant role in interpersonal difficulties and/or unawareness of illness observed in AN and other eating disorders including bulimia Nervosa (BN). Method: Current meta-analysis aimed to summarize available evidence for deficits in ToM in AN and BN and examine the effects of number of study-level variables on observed findings. In this meta-analysis, 15 studies (22 samples with eating disorders) investigating ToM performances of 677 individuals with AN or BN and 514 healthy controls were included. Results: AN was associated with significant deficits in ToM (d = 0.59) which were more pronounced in the acute patients (d = 0.67). Small sized deficits in ToM were observed in BN (d = 0.34) and recovered AN (d = 0.35). Both cognitive perspective-taking (ToM-PT) (d = 0.99) and decoding mental states (ToM-decoding) (d = 0.61) aspects of ToM were impaired in acute AN. ToM-decoding impairment in BN was modest. There was no evidence for significant ToM-PT deficit in BN. Several study-level variables including longer duration of illness, lower BMI, and depressive symptoms were associated with more severe deficits in ToM in AN. Discussion: ToM deficits, particularly in ToM-PT, can be a specific feature of AN but not BN. ToM impairment can contribute to poor insight, treatment resistance, and social impairment in AN. © 2016 Wiley Periodicals, Inc. RESUMEN Meta análisis de la teoría de la mente en anorexia nervosa y bulimia nervosa: ¿Un deterioro de la toma de perspectiva cognitiva en Anorexia Nervosa?. Objetivo: Las deficiencias en la teoría de la mente (ToM), la habilidad parar inferir los estados mentales de otros, pueden jugar una función significativa en las dificultades interpersonales y/o falta de reconocimiento de la enfermedad observada en Anorexia Nervosa (AN) y otros trastornos de la conducta alimentaria incluyendo la Bulimia Nervosa (BN). Método: Los meta análisis actuales dirigidos a resumir la evidencia disponible sobre el déficit en ToM en AN y BN y examinar los efectos de un número de variables a nivel estudio en los resultados observados. En este meta análisis fueron incluidos 15 estudios (22 muestras con trastornos alimenticios) investigando la función de ToM de 677 individuos con AN o BN y 514 controles sanos. Resultados: La AN fue relacionada con déficit significativo en ToM (d=0.59) los cuales fueron pronunciados en los pacientes agudos (d=0.67). Se observaron déficits de tamaño pequeño en BN (d=0.34) y AN recuperada (d=0.35). La toma de perspectiva cognitiva (ToM-PT) (d=0.99) y la descodificación de los procesos mentales (descodificación de ToM) (d=0.61) fueron deteriorados en la AN aguda. El deterioro en la descodificación de ToM en BN fue moderado. No se encontró evidencia significativa de déficit en ToM-PT en BN. Algunas variables a nivel estudio incluyendo la larga duración de la enfermedad, índice de masa corporal (IMC) bajo y síntomas depresivos fueron asociados con mayores déficit severos en ToM en AN. Discusión: El déficit en ToM, particularmente en ToM-PT puede ser una característica específica en la AN pero no en la BN. El deterioro en la descodificación de ToM puede contribuir a mala percepción, resistencia al tratamiento y deterioro social en AN. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:739–749). © 2016 Wiley Periodicals, Inc.Öğe The naturalistic follow-up of pervasive developmental disorders–not otherwise specified cases(Taylor and Francis Ltd., 2017) Köse S.; Ocakoğlu F.T.; Ocakoglu B.K.; Özbaran B.OBJECTIVES: Pervasive developmental disorders (PDDs) are neurodevelopmental disorders characterized by deficits in social interactions, communication impairments, and the presence of restricted interests and stereotyped behaviours. The issue of diagnostic stability, course, and prognosis of PDDs is an increasing focus of research studies. The aim of this study is to evaluate the individuals who were previously diagnosed with pervasive developmental disorders–not otherwise specified (PDD–NOS) (one of the sub-diagnoses of PDDs) under age six years with respect to their current diagnoses. METHODS: The participants were selected among the patients who were diagnosed with PDD– NOS under six years of age in our outpatient clinic. We obtained 208 patients’ file records. We were able to reach 92 patients’ parent by telephone and 58 parents accepted to voluntarily participate. After the excluded cases, finally 51 patients were evaluated in this cross-sectional naturalistic follow-up study. Children Autism Rating Scale (CARS) and Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) were administered to participants; Autism Behavior Checklist (ABC) was completed by their parents. RESULTS: There were 44 (86.3%) male and 7 (13.7%) female participants in the study. The current mean age was 8.62 years (SD = 2.25). The mean age at the time of first diagnosis was 3.56 years (SD = 1.22). The mean duration of the follow-up period was 5.05 years (SD = 2.27). Forty-five (88.2%) of 51 patients remained to have one of the PDDs (23 autistic disorder, 22 PDD–NOS) according to DSM-IV-TR. Six patients (11.8%) did not meet the diagnostic criteria of any PDDs. Two of these six patients diagnosed with attention-deficit/hyperactivity disorder and one with mild-level intellectual disability. CONCLUSIONS: It was observed that 11.8% patients who diagnosed as PDD–NOS less than six years old were found to be off the PDD spectrum. PDD–NOS diagnosis stability was found 43.1% and 45.1% of the patients moved to another PDD diagnosis. These findings should be supported with further studies in Turkey, by increasing sample size, and follow-up duration for understanding the course. © 2017 The Author(s).Öğe Neurodevelopmental Disorders and Sensory Processing; [Nörogelişimsel Bozukluklar ve Duyusal İşlemleme](Galenos Publishing House, 2023) Türer F.; Köse S.Sensory processing is defined as the coordination and integration of the sensory inputs received by the brain through the tactile, visual, auditory, olfactory, gustatory, vestibular, proprioceptive and interoceptive senses, and generating appropriate responses. Although interpersonal differences in sensory processing exist among healthy individuals, specific differences in sensory profile and sensory processing problems are encountered in some of the psychopathologies. Variations in sensory processing and associated clinical conditions are present among many neurodevelopmental disorders (NDDs) including principally autism spectrum disorder and others such as attention-deficit/hyperactivity disorder, intellectual disability, tic disorder and Tourette’s syndrome. In this article, studies on sensory processing in NDDs are reviewed. According to studies; symptom severity, comorbidities, adaptive behaviors, functionality, daily life activities, and participation in activities are associated with sensory processing differences and difficulties in NDDs. The sensory processing difficulties are posited to be based on differences in the activity of peripheral and central sensory systems. Neurophysiological and neuroimaging studies have tried to explain and enlighten the mechanisms underlying these problems. In this context, the main mechanisms are thought to be related to somatosensory inhibition, sensory gating, multiple sensory integration defects, and differences in gamma aminobutyric acid concentrations. There have been an increasing number of recent studies on sensory processing in NDDs. In this field, further randomized controlled studies supported by neurophysiological and neuroimaging techniques are needed. Due to the relationships between sensory processing features and the clinical symptoms of NDDs that they accompany, those features should be borne in mind in clinical evaluations and in treatment programs of children and adolescents. © 2023, Galenos Publishing House. All rights reserved.
