Complementary and Alternative Medicine in Children with Type 1 Diabetes Mellitus

Objective: Complementary and alternative medicine (CAM) is increasingly utilized in adults and children for treatment of various conditions. Studies on CAM in diabetes have mainly focused on the adult population and its application in children has not been well established. The aim of this study was to examine the prevalence and characteristics of CAM use in Turkish children with type 1 diabetes mellitus (T1DM)

Evaluation of Permanent Growth Hormone Deficiency (GHD) in Young Adults with Childhood Onset GHD: A multicenter study

Background: Reconfirming the diagnosis of childhood onset growth hormone deficiency (GHD) in young adults is necessary to demonstrate the need for continuation of GH therapy

Serum IGF-1 and IGFBP-3 Levels in Healthy Children Between 0 and 6 Years of Age

Objective: Along with growth hormone (GH) levels, measurements of serum insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 (IGFBP-3) are used in the diagnosis of GH deficiency and in monitoring the efficacy and safety of long-term GH treatment. The purpose of the present study was to establish reference values for serum IGF-1 and IGFBP-3 in healthy Turkish children less than 6 years of age

Approach to obesity in children and adolescents

WOS: 000272580400003Obesity is a disease caused by excess body fat deposition which can give rise to a series of physical and mental complications as well as to public economic problems Although it may be secondary to genetic, endocrine or other diseases the most prevalent form is so called exogenous obesity which is attributed to the imbalance of energy intake and expenditure. The management comprises life style changes such as nutritional planning and close follow-up, preventation, on the other hand. actions at sociopolitical level Medical and surgical therapy plays ignorable role in childhood obesity if any. (Turk Arch Ped 2009; 44: 115-9

A Rare Cause of Female Gender Dysphoria: Report of Three Cases with Low Percentage of Turner Mosaicism

Gender dysphoria is a condition caused by a mismatch between the gender assigned at birthand gender identity. Gender development disorders include situations where congenitalchromosomal, gonadal, or anatomically gender-related physical features are atypical. In thestudies conducted mostly by karyotype analysis, it is reported that the rate of chromosomalabnormality is very low in people with gender dysphoria. In Turner mosaicism, genderdysphoria is not a common finding. In this case series, we examined the phenotype andgenotype characteristics of the three cases identified as Turner mosaicism, who applied withgender dysphoria. The patients’ complaints were feeling like a male, negative thoughts aboutbeing a female, being uncomfortable with feminine body image, wanting to have a male body.None of our 3 cases had Turner stigmata however their chromosomal or FISH analyses showedthat one of them was 45,X/46 XX/47,XXX and two of them were 45 X/46 XX karyotype.Cinsiyet disforisi, doğumda belirlenen cinsiyet ile cinsiyet kimliği arasındaki uyumsuzluğun neden olduğu bir durumdur. Cinsiyet gelişim bozuklukları, konjenital kromozomal, gonadal veya anatomik olarak cinsiyetle ilişkili fiziksel özelliklerin atipik olduğu durumları içerir. Çoğunlukla karyotip analizi ile yapılan çalışmalarda cinsiyet disforisi olan kişilerde kromozomal anormallik oranının çok düşük olduğu bildirilmektedir. Turner mozaisizminde cinsiyet disforisi yaygın bir bulgu değildir. Bu olgu serisinde, cinsiyet disforisi ile başvuran Turner mozaisizmi olarak tanımlanan üç olgunun fenotip ve genotip özelliklerini inceledik. Hastaların şikayetleri erkek gibi hissetmek, kadın olmakla ilgili olumsuz düşünceler, kadın beden imajından rahatsız olmak, erkek bedene sahip olmak istemek şeklindeydi. 3 olgumuzun hiçbirinde Turner stigmatası yoktu ancak kromozomal veya FISH analizleri, birinde 45,X/46 XX/47,XXX ve ikisinde 45 X/46 XX olarak tespit edildi.2-s2.0-8509876604

Internipple Distance and Internipple Index in Prepubertal Turkish Girls

Objective: To determine internipple distance and internipple index in prepubertal Turkish girls.Methods: The internipple distance and chest circumference of 667 healthy prepubertal Turkish girls aged 6 to 11 years were measuredin a school screening program in Düzce. Measurements were performed at the end of expiration with a standard non-stretch tapemeasure graduated in millimeters with the arms hanging in a relaxed position on the sides of the body. The internipple distance wasmeasured between the centers of both nipples, and chest circumference was measured across the internipple line. The internipple indexwas calculated by dividing the internipple distance (cm) x100 by the chest circumference (cm). Age specific internipple index referencecurves were constructed and smoothed with the Lambda-Mu-Sigma method. Mean and standard deviations of internipple distance andinternipple index were calculated according to decimal ages.Results: Age was found to be positively correlated with internipple distance and chest circumference, while it was negatively correlatedwith internipple index. The reference values of internipple index, including 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles, andstandard deviations were calculated for prepubertal girls.Conclusion: The reference ranges provided by this study might be helpful for the evaluation of syndromic cases by serving as normativedata for internipple index in prepubertal girls aged 6-11 years in Turkey although ethnic differences may affect applicability to othercountries.WOS:0005658661000072-s2.0-8509009382

What does the insulin pump change in children with type 1 diabetes? One-year clinical follow-up

WOS: 000485922405057

Evaluating the Effects of Insulin Resistance And Hypertension in Obese Children On Cardiac Functions Using Echocardiography

Amaç: Bu çalışmada obez çocukların kardiyak işlevlerinin ekokardiyografi ile değerlendirilmesi, ayrıca bulunan sonuçlara insülin direnci ve hipertansiyonun ne şekilde etki ettiğinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Yaşları 4-19 arasında değişen (ortalama 11,63,70 yıl) ve VKİ 95 persantil ve üzerindeki 52 çocuk (Erkek: 32, Kız: 20) çalışmaya dahil edildi. VKİ normal sınırlarda olan, yaş (4-19, ortalama 11,04,1 yıl) ve cinsiyeti (Erkek: 25, Kız: 19) uyumlu 44 sağlıklı çocuk kontrol grubunu oluşturdu. Obezlerde açlık kan şekeri, tiroit hormonları, lipit profili, insülin ve kortizol düzeyleri ölçüldü. Obez hastalar ayrıca hipertansiyon ve/veya insülin direnci olup olmamasına göre 4 alt gruba da ayrılarak kıyaslandı. Hasta ve kontrol grubunun hem sağ hem de sol ventrikülün M mod, iki boyutlu ve Doppler ekokardiyografi ölçümleri yapıldı. Sağ ve sol ventrikülün MPİ değerleri hesaplandı. Grupların karşılaştırılmasında bağımsız örneklem t-testi, Tek Yönlü Varyans Analizi Testi (One-Way ANOVA) kullanıldı, Post Hoc testinde Sidak yöntemi kullanıldı, p0.05 anlamlı olarak kabul edildi.Bulgular: Obez çocukların VKİ ortalaması 29,375,08 kg/m2 kontrol grubunun VKİ ortalaması ise 26,667,84 kg/m2 bulundu (p0.05). Obez çocukların hem SKB ortalaması (115,913,2 mmHg) hem de DKB ortalaması (70,610,1 mmHg) kontrol grubunun ortalamalarından (sırasıyla 110,88,8 ve 65,77,8 mmHg) anlamlı olarak yüksek idi. Obez grubun SVDSÇ, IVSd, SVK, SVK/boy2.7, SV, IVGZ, EF ve KF değerleri kontrol grubunkinden anlamlı olarak yüksek bulundu. Kontrol grubu ile alt gruplar kıyaslandığında bu istatistiksel farklılığın tek başına İR ve hem İR hem de HT'nun birlikte olduğu obez alt gruplarda daha belirgin olduğu saptandı. Kontrol grubuyla obez çocuk grubunun hem sağ ventrikül ve hem de sol ventrikülün erken ve geç dolum hızları, E/A oranları arasında istatiksel anlamlı farklılık saptanmadı. Buna karşın hem sol ventrikülün hem de sağ ventrikülün İVGZ ve MPİ değerleri obezlerde kontrole göre anlamlı olarak artmıştı. Sol ventrikülün MPİ değeri obez alt grupları arasında farklılık göstermez iken, sağ ventrikül MPİ değerinin kontrollere göre asıl anlamlı farklılığının ise tek başına İR olan ve hem İR hem de HT olan iki obez alt gruptan kaynaklandığını saptadık.Sonuç: Obezite ile İR ve/veya HT birlikteliği kardiyak işlev bozukluğunu belirginleştirebilir. MPİ ve İVGZ değerlerinin, diğer birçok hastalıklarda olduğu gibi obezitede de ve henüz hastalığın asemptomatik evresinde kalp işlev bozukluğunu göstermede kullanışlı ve değerli parametreler olduğu kanısındayız.Objective: The purpose of this research was aimed to evaluate the cardiac functions of obese children by echocardiography and in addition to find out the affects of insulin resistance and/or hypertension on cardiac functions.Material and Method: The Obese group included 52 children in this study (32 boys and 20 girls) with ages ranged between 4-19 years old (mean 11.6±3.7 years) and BMI > 95 percentiles. Children with appropriate for age (4-19 years, mean 11.0±4.1 years), sex (25 boys and 19 girls), and with normal BMI were selected as control group. Serum fasting glucose, thyroid functions, lipid profile, insulin and cortisole levels were measured in the obese group. The patients were also divided into 4 subgroups according to existing of hypertension and/or insulin resistance, and they were also compared between each other. Echocardiographic measurements of both groups were made by using M-mode, 2-D and PW Doppler techniques and MPI values of the left and the right ventricles were calculated. The student's t test was used to compare the main groups, and Analysis of variance (ANOVA) was used for comparisons of the different groups. Sidak test as a posthoc test was used for comparisons of the subgroups. Probability values of p <0.05 in all tests were considered significant.Results: The mean BMI value of obese children was 29.37±5.08 kg/m2 whereas mean BMI of controls was 26.66±7.84 kg/m2 (p<0.05). The mean SBP (115.9±13.2 mmHg) and also the mean DBP (70.6±10.1 mmHg) values of the obese group were significantly higher from the control group values (respectively 110.8±8.8 and 65.7±7.8 mmHg). LVDd, IVSd, LVM, LVM/height2.7, SV, IVRT, EF and FS values of the obese group were significantly higher than the values of control group. It was revealed that these parameters were higher in the subgroup with IR alone and the subgroup with HT&IR, when compared to the control group. There was no significant difference between the values of E, A, and E/A of the control and the obese groups On the other hand, both IVRT and MPI values of right and left ventricle were significantly higher in children with obesity than controls. No differences of MPI values of the left ventricle were noted between obese subgroups. Finally, it was found out that the significant difference between obese and control groups for the MPI values of right ventricle was originated from obese subgroups with IR alone and with HT&IR.Conclusion: HT and/or IR accompanying to obesity could worsen the present cardiac dysfunction. We suggest that the measurement of MPI and IVRT values in children with obesity, as it used in many other diseases, can reveal the cardiac dysfunction at the early stages, and should be considered as a useful and valuable parameters

The case of cystic fibrosis presenting with Pseudo-Bartter sydnrome

Psödo-Bartter sendromu (PBS), hipokalemik, hipokloremik metabolik alkaloz ile karakterize klinik bir tablodur. PBS, Bartter sendromunun aksine idrar elektrolit düzeylerinin normal olması ile ayrılır. Huzursuzluk, kilo alamama yakınması ile getirilen iki buçuk aylık kız hastada inatçı hiponatremi, hipokalemi, hipokloremi ve metabolik alkaloz tespit edildi. Yapılan araştırma sonunda hastadaki bulgular Pseudo-bartter sendromuyla uyumlu olarak değerlendirildi. Bu tablonun sık nedenlerinden biri olan kistik fibrozis (KF) düşünülerek iki kez yapılan ter testinin sonucu pozitif olarak saptandı. Gen analizinde G85E/G542X bileşik heterozigot mutasyonlarının gösterilmesi üzerine hasta KF tanısıyla takibe alındı. KF'e bağlı Pseudo-Bartter sendromu, erken sütçocukluğu döneminde hastalığın ilk bulgusu olarak ortaya çıkabilmektedirPseudo-Bartter syndrome (PBS) is a clinical condition characterized by hypokalemic, hypochloremic metabolic alkalosis. PBS is discriminated from the Bartter syndrome with normal urine electrolyte levels. Persistent hyponatremia, hypokalemia, metabolic alkalosis and hypocalcemia was detected in a two and a half month-old girl patient brought with complaints of weight loss.and restlessness. At the end of the researches the findings were evaluated to be consistent with Pseudo-Bartter syndrome. In consideration of cystic fibrosis (CF) which is one of the common causes of this condition, Alındığı tarih: 02.09.2015 two times sweat test was performed which yielded positive results. After the demonstration of G542X/G85E combined heterozygous mutations in the patient were followed with the diagnosis of CF. Pseudo-Bartter's syndrome related CF, may occur as the first sign of the disease in early infancy

Effects of an educational intervention program on weight control in overweight and obese children

WOS: 000270489900452