24 research outputs found

    Evaluation of the COVID-19 pandemic process effect on the increase of Precocious Puberty and Premature Thelarche

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    Objective :To determinate COVID-19 pandemic process effect on the increase of Precocious Puberty and Premature Thelarche Material and Methods: Total 60 girls, younger than 8 years old, who complaint with breast development. Medical history and physical examination findings, bone age, free T4, TSH, FSH, LH, estradiol levels of patients were recorded in their first visits. According to LHRH test results patients were divided to subgroups such as PT and CPP. Differences in the use of technological tools were recorded before and during the pandemic Results: Higher Body Mass Index (BMI) (P=0.033), bone age (P<0.001) basal LH (P<0.001), basal FSH (P<0.001), basal estradiol (P<0.001) in cases with central puberty precocious level was detected. There was no difference between the two groups in terms of age and weight. Compared to the pre-pandemic period, there was a significant increase in the use of technological tools (smartphone, computer, television) in both groups. In cases with PT, it was 2.54 ±0.65 hours/day before the pandemic and 6.22±1.25 hours/day during the pandemic (p<0.001), in cases with Spp it was 2.7 ±0.46 hours/day before the pandemic, 7.36±1.36 hours/day during the pandemic (p<0.001). The main reason for using technological tools was school lessons (4.6 ± 1.2 hours/day in cases with Pt, 5±1.2 hours/day in cases with Spp p =0.393). Conclusion: In our study, it was observed that there was a significant increase in the use of technological devices and puberty symptoms started at a younger age in both groups after the pandemic. It was thought that environmental factors such as weight and increased use of electronic devices triggered the onset of puberty and the rate of progression

    Yeni başlangıçlı Tip 1 Diyabet ile Akut Hepatit B Muhtemel İlişkisi: Olgu Sunumu

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    Tip 1 diyabet gelişiminde esas faktör pankreasın beta hücrelerinin genetik ve çevresel nedenlerle tahribatıdır. Virüslerin tip 1 diyabetin tetiklenmesinde rol oynadığı bilinmektedir. Hepatit B virusu otoimmünite ile ilişkilidir. Bu yazıda Hepatit B virusünün tetiklediği tip 1 diyabet'li bir vaka sunulmuştur.Type 1 diabetes (T1D) results from the destruction of pancreatic beta cells, and genetic and environmental factors are believed to be the major components in the development of the disease. Viruses have long been suspected to contribute to the onset of T1D. Hepatitis B (HBV) is associated with the development of autoimmunity. We describe a case of type 1 diabetes that was triggered by HBV

    Long Term Monitoring of Patients with Type 1 Diabetes Mellitus: A Single Center Experience

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    Amaç: Tip 1 diyabetes mellitus (DM) çocukluk yaş grubunda sık görülen, pankreasın beta hücrelerinin tahrip olması sonucu gelişen insülopeni ve hiperglisemi ile karakterize kronik metabolik bir hastalıktır. Çalışmada, Tip 1 DMli hastaların klinik ve laboratuvar bulgularının değerlendirilmesi ve bulguların literatür eşliğinde tartışılması amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma 2010-2013 Ocak tarihleri arasında Pediatrik Endokrinoloji Kliniğinde takip edilen, Tip 1 DMli 162 hastanın değerlendirildiği tanımlayıcı kesitsel bir araştırmadır. Bulgular: Çalışmamıza 162 hasta dahil edildi (Yaş ortalaması 12.3 4.2 yıl). Olguların ortalama diyabet süresi 3.92.3 yıl, son 1 yıldaki ortalama Hba1c değerleri%9.74 2.5di. Tip 1 DMye ek olarak olguların % 6.7sinde (n11) çölyak hasta- lığı , %18.52inde (n30) de otoimmüntiroid hastalığı mevcuttu. Olguların %9.2sinde (n15) hipertansiyon, %7. 4ünde (n12) dislipidemi saptandı. Mikrovasküler komplikasyon olarak % 6.1inde (n10) 24 saatlik idrarda mikroalbüminüri, %15.4ünde (n25) EMGde sinir ileti hızında yavaşlama tespit edildi. Sonuç: Tip 1 DMli hastaların izleminde eşlik edebilecek otoimmün hastaların tespiti ve diyabete bağlı gelişebilecek komplikasyonların erken dönemde saptanması ve koruyucu önlemlerin alınması hastaların hayat kalitesinin arttırılması açısından önemlidir.Objective: Type 1 diabetes mellitus (DM) is a chronic metabolic disease of childhood characterized by insulin insufficiency and hyperglycemia due to the destruction of the beta cells of the pancreas. The aim of this study was to determine the laboratory and clinical characteristics of patients with type 1 diabetes mellitus and to compare the findings with the literature. Material and Methods: This is a descriptive study of 162 patients with type 1 diabetes mellitus followed by the Pediatric Endocrinology department between January 2010 and 2013. results: A total of 162 patients were included in this study (mean age, 12. 3 ±4. 2 years). The mean duration of diabetes was 3.89 ± 2.3 years and mean HbA1c was 2.5 ± 9.74%. In addition to Type 1 DM, 6.7% of cases (n 11) had celiac disease and 18.52% of the cases (n 30) had autoimmune thyroid disease. Hypertension was present in 9.2% of the cases (n 15) while 7.4% (n 12) had dyslipidemia. We found had 24-hour urine microalbuminuria in 6.1% of the cases (n 10) and decreased EMG nerve conduction velocity in 15.4% of the cases (n 25). conclusion: It is important to detect any concurrent autoimmune disorders and diabetes-related potential complications in the early stages and to take preventive measures to increase the quality of life during follow-up of patients with Type 1 DM

    Familial Testotoxicosis: A Case Report

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    Ailevi Testotoksikoz LH reseptöründe aktive edici mutasyon nedeniyle testislerin otoaktivasyon kazanması sonucu or- taya çıkan gonodotropin bağımlı olmayan yalancı erken puberte nedenidir. 2 yaş 3 aylık erkek hasta, kliniğimize genital bölgede kıllanma şikayetiyle başvurdu. Babada ve babanın erkek kuzenlerinde erken puberte öyküsü mevcuttu. Cilt ve sistem muayeneleri normal olan hastanın testis hacimleri bilateral 4 ml, gerilmiş penis boyu 4.5 cm, pubik kıllanması Tan- ner evre 2di. Testosteron seviyeleri pubertal düzeyde olmasına rağmen bazal ve uyarılmış LH seviyeleri prepubertaldi. Hasta aile öyküsü ile birlikte değerlendirildiğinde klinik ve biyokimyasal olarak ailevi testotoksikoz tanısı aldı. Olgu nadir görülmesi nedeni ile sunuldu.Testotoxicosis arises from testicular autoactivation due to LH receptor activating mutations and is a cause of false gonadotropin-independent precocious puberty. A male child aged 2 years and 3 months was admitted to our clinic with pubic hair in the genital area. He had a family history of precocious puberty in the father and the fathers male cousins. On physical examination skin and systemic findings were normal, bilateral testis volume was 4 ml, stretched penile length was 4.5 cm, and pubic hair was Tanner stage 2. Although the testosterone levels were pubertal, baseline and stimulated LH levels were prepubertal.The patient was diagnosed with testotoxicosis with the family history, and clinical and biochemical evaluation.The case was presented because of its rarity

    Prediabetes and Cardiovascular Parameters in Obese Children and Adolescents

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    Objective: In this study, our aim was to determine cardiovascular risk and cardiac function in prediabetic obese children and adolescents. Methods: The study was conducted on 198 obese children and adolescents 6-18 years of age. Anthropometric measurements, blood pressure measurements, oral glucose tolerance test, lipid profile, and HbA1c levels of patients were assessed. Prediabetes was defined according to American Diabetes Association criteria. Left ventricular mass index (LVMi), carotid intima-media thickness (c-IMT), and tissue Doppler measurements records were used.Results: LVMi was found to be significantly higher in the prediabetes group (p0.03). There were no statistically significant differences in right ventricular tissue Doppler measurements between the prediabetic and non-prediabetic groups. Left ventricular tissue Doppler measurements were significantly higher in the prediabetes group: LVEEM (left ventricular E/e ratio) (p0.04); LVEM (left ventricular myocardial velocity cm/s) (p0.035). LVMi was found to positively correlate with triglyceride level, diastolic blood pressure, waist circumference, body weight standard deviation score and to negatively correlate with high-density lipoprotein cholesterol (p0.043, r0.15; p0.039, r0.15; p0.025, r0.17; p0.009, r0.19; p0.038, r-0.15, respectively). LVEM was correlated with glucose (p0.046, r0.15) and LVEEM was correlated with systolic blood pressure (p0.035, r0.15). In linear regression analysis for clinical cardiovascular risk factors, fasting glucose level was the best predictor of LVEM.Conclusion: In this study, deterioration of cardiac function in prediabetic obese children and adolescents was shown. We recommend determining cardiovascular risk and cardiac dysfunction at early stages in prediabetic obese children and adolescents

    Parvovirus Infection in a Child Complicated with Diabetic Ketoacidosis and Acute Fulminant Hepatitis: A Case Report

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    Tip 1 diabetes mellitus (T1DM) pankreatik beta hücrelerinin harabiye- tiyle ortaya çıkmaktadır. Genetik ve çevresel faktörlerin hastalığın geli- şimindeki ana faktörler olduğu düşünülmektedir. Virüslerin hastalığın başlangıcında etkili olduğu düşünülmektedir. Bu olguda asemptomatik parvovirus B19 (PB19) enfeksiyonunu takiben ortaya çıkan diyabetik ke- toasidoz ve akut fulminan hepatit birlikteliğinin olduğu bir olgu sunul- muştur. Diyabetik ketoasidozda karaciğer enzimlerinin de yakın izlen- mesini ve kötüleşme olduğunda dikkat edilmesini önermekteyiz.Type 1 diabetes mellitus (T1DM) results from the destruction of pan- creatic beta cells. Genetic and environmental factors are believed to be the major component for the development of the disease. Viruses have been suspected to contribute to the onset of T1DM. In this case report, a patient who had diabetic ketoacidosis with acute fulminant hepatitis following asymptomatic infection with parvovirus B19 virus (PB19) is presented. To our knowledge this is the first report of diabetic ketoaci- dosis (DKA) and acute fulminant hepatitis due to PB19. We suggest close monitoring of the liver functions in DKA and taking care when the liver functions deteriorate

    Evaluation of Periaortic Adiposity and Metabolic Disorders in Obese Children

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    Objective: To evaluate the relationship between periaortic fat thickness (PAFT) and parameters involved in the development of metabolic complications of the cardiovascular system in obese children and to assess the usefulness of echocardiographic measurements of PAFT in correlation with cardiovascular risk factors.Methods: The study was conducted with 263 obese and 100 healthy children and adolescents. PAFT was measured with echocardiography method which was recently performed in obese children and adolescents.Results: PAFT was significantly higher in the obese group (0.258±0.031 mm) than in the control group (0.137±0.032 mm) (p>0.001). In multivariable regression analysis, body mass index-standard deviation score and total body fat were predictors of PAFT. The area under the receiver operating characteristic curve was 0.989 and was quite significant at p>0.001. PAFT above 0.179 mm was determined as the cut-off value in obese children and adolescents (sensitivity1, specificity0.97). Conclusion: The measurement of PAFT in obese children and adolescents may be a good method to reveal the presence of early cardiovascular risk

    with the Findings of Puberty to the Pediatric Endocrinology Clinic The Etiologic Distribution and Clinical Features of Cases Presenting

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    Amaç: Çalışmamızda ergenlik bulgularının başlaması şikayeti ile başvuran kız hastaların etiyolojik nedenlere göre değerlendirilmesi ve bulguların literatür eşliğinde tartışılması amaçlanmıştır.Gereç ve Yöntemler: Çocuk Endokrinolojisi polikliniğine başvuran 96 kız hasta çalışmaya dahil edildi. Hastaların antropometrik ölçümleri, puberte durumları değerlendirildi. Erken puberte şüphesi olan hastaların değerlendirilmesinde Folikül stimüle edici hormon (FSH), Lüteinize edici hormon (LH), estradiol (E2), dehidroepiandrosteron sülfat (DHEA-SO4), 17 hidroksiprogesteron (17OHP) değerleri, luteinize edici hormon releasing hormon (LHRH) uyarı testi sonuçları kullanıldı. Yapılan kemik yaşı değerlendirilmesi, pelvik ultrasonografi sonuçları kaydedildi.Bulgular: Hastaların yaş ortalaması 8.38 1.72 yıldı. Hastaların % 14.6'sında (n14) prematüre telarş,% 4.2'sinde (n4) prematüre pubarş, %3.1'inde (n3) prematüre menarş, %8.3'ünde (n8) erken puberte tespit edildi. Normalin varyantı pubertal gelişim hastaların %21.9'unu (n21) oluşturmaktaydı. Başvuran olguların %46.9'u (n45) normal pubertal gelişime,% 22.9'u (n22) sekiz yaşın üzerinde pubertal gelişimde hızlanmaya sahipti. %21.9 (n21) hastada pubertal gelişim atipik başlangıçlıydı.Sonuç: Günümüzde puberte bulgularının başlama yaşının düşmesiyle endokrinoloji kliniklerine başvuru artmıştır. Başvuruların çoğunu ise normal puberte varyantları oluşturmaktadır. Bu çalışma ile hastaların tanı aşamasında iyi değerlendirilmesini vurgulamak istedik.Objective: In our study we aimed to evaluate the findings of female patients presenting with a complaint of the onset of puberty according to the etiological factors and to discuss the findings in the literature.Material and Methods: Ninety-six girls presenting to the pediatric endocrinology clinic patients were enrolled in the study. Anthropometric measuremNecmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Konya, Türkiyeents and pubertal status of the patients were evaluated. In the evaluation of patients with suspected early puberty, follicle stimulating hormone (FSH), Luteinising Hormone (LH), estradiol (E2), dehydroxyepiandrostenedione sulfate (DHEA-SO4), 17-hydroxyprogesterone (17OHP) levels, and luteinizing hormone releasing hormone (LHRH) stimulation test results were used. The bone age and pelvic ultrasound results were recorded.Results: The mean age of the patients was 8.38 ± 1.72 years. We found premature thelarche in 14.6% of the patients (n 14), premature pubarche in 4.2% (n 4), premature menarche in 3.1% (n 3), and precocious puberty in 8.3% (n 8) while 21.9% (n 21) were normal variants of pubertal development. 46.9% of admitted patients (n 45) had normal pubertal development, 22.9% (n 22) had an acceleration in pubertal development over eight years. 21.9% (n 21) of patients had atypic pubertal development.Conclusion: The decrease in the age of the onset of puberty has increased applications to the endocrine clinic. Most of the applications are normal variants of puberty. We wanted to highlight the good diagnostic evaluation of these patients in this study
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