ÇOCUKLUK ÇAĞI KANSERLERİNDE RİSK FAKTÖRLERİ VE ANNE SÜTÜNÜN ROLÜ

Bu çalışmada Kasım 2005-2007 yıllarında, çocukluk çağı kanseri tanısıyla izlenen 300 hasta ile aynı yaş grubu ve cinsiyetten, onkolojik bir hastalığı olmayan 316 çocukta, çocukluk çağı kanserlerinin olası risk faktörleri araştırılmıştır. Yapılan vaka-kontrol epidemiyolojik araştırmada, annenin gebeliğine ait özelliklerden, gebelik komplikasyonları, gebelik sırasında kullanılan ilaçlar, röntgen çekimi, sigara ve/veya alkol kullanımı ile doğum sonrasında bebeğe; ne kadar süre anne sütü verildiği, inek sütüne başlama yaşı, mama alıp almadığı, ek gıdaya başlama yaşı sorgulanmıştır. Sosyoekonomik düzey açısından; anne-babaların öğrenim durumları ve meslekleri, aylık gelir düzeyleri değerlendirilmiştir. Anne-baba arasında akrabalık ve ailede kanser öyküsü olup olmadığı da sorgulanmıştır. Anne sütü ile beslenmiş olma (p=0,001) ve anne sütü ile beslenme süresinin mümkün olduğunca uzun tutulmasının (p=0,002) kanser gelişimine karşı koruyucu bir etken olduğu ve anne sütü alımının kansere karşı 7,5 kat koruyucu olduğu saptanmıştır. Hasta grubunda anne sütü alımı daha az ve inek sütü ile maruziyetin daha erken yaşta olduğu görülmüştür. Ailede kanser görülme sıklığı ve üç ve daha üzeri sırada doğmuş olmanın, hasta grubunda daha fazla olduğu saptanmıştır . Sonuç olarak bu çalışmada, çocukluk çağı kanserlerinin ortaya çıkmasına neden olabilecek risk faktörleri üzerinde durulmuş ve özellikle anne sütü alma ve uzun süre anne sütü ile beslenmenin kansere karşı koruyucu olabileceği gösterilmiştir.In this study, possible risk factors of childhood cancers have been investigated among 300 children who have already been diagnosed with cancer and sex and age matched 316 otherwise healthy children between November 2005 and 2007. In this epidemiologic case control study, pregnancy complications, medicine used throughout the pregnancy, X-ray exposure, habits of smoking and/or drinking; as well as the duration of the breastfeeding period, the beginning age of cow-milk consumption, the presence of formula consumption and the time of presentation of additional nutrients in diet to the child have been interrogated. Parents’ education levels and professions, monthly levels of income have been analyzed to get a better understanding in socioeconomic status. Consanguinity between parents and cancer history of the family have been interrogated. It has been observed that breastfeeding (p=0,001) and keeping the period of breastfeeding as long as possible (p=0,002) lowers the risk of cancer development. We have found that breastfeeding is 7,5 times protective against cancer. It has been observed that in the patients’ group of the breastfeeding period is shorter and use of cow milk earlier. Also, it has also been found that positive family history for cancer is more frequent in patiets’ group compared to the healthy group. The patients’ group had higher birth order than controls’ group, that is important transmission of infection. As a result in this study, the risk factors which can cause childhood cancer have been analyzed and it has been proved that long periods of breastfeeding can be preventative against cancer

Association Between Soluble CD40 Ligand and Hypercholesterolemia in Children and Adolescents

Aim: Coronary heart disease is one of the most common causes of death around the world. The pathological process of coronary heart disease like atherosclerosis starts in childhood. During this period thrombosis constitutes a high-risk factor. In this study, we investigated the effect of soluble CD40 ligand (sCD40L) and clotting activation on children and adolescents with hypercholesterolemia. Materials and Methods: Plasma levels of sCD40L, P-selectin, 8-hydroxy-2-deoxyguanosine (8-OHdG), and prothrombin fragment 1+2 [(F) 1+2] were determined in thirty-five hypercholesterolemic patients (20 girls and 15 boys; age, median: 13 years) and forty healthy normocholesterolemic subjects (28 girls and 12 boys; age, median: 13 years). Results: No significant differences were observed between the patient group and controls in terms of age, high-density lipoprotein (HDL) cholesterol, 8-OHdG, F1+2 (p>0.05). However, there were significant differences between the two groups with respect to total cholesterol, low-density lipoprotein (LDL) cholesterol, very LDL cholesterol, triglycerides, sCD40L and P-selectin (p0.05). Conclusion: We believe that future prospective studies to determine the increase in the level of sCD40L with a larger sample size of a pediatric population with dyslipidemias may be more helpful in predicting the risk of cardiovascular disease

Alkaptonuria in turkey: Clinical and molecular characteristics of 66 patients

Alkaptonuria (AKU) is an inborn error of metabolism caused by the deficiency of homogentisate 1,2-dioxygenase (HGD) as a result of a defect in the HGD gene. HGD enzyme deficiency results in accumulation of homogentisic acid (HGA) in the body, which in turn leads to multisystemic clinical symptoms. The present study aimed to investigate the presenting symptoms, age at diagnosis, and clinical and genetic characteristics of AKU patients followed-up in different centers in Turkey. In this cross-sectional, multicenter, descriptive study, medical records of 66 AKU patients were retrospectively evaluated. Patients? data regarding demographic, clinical and genetic characteristics were recorded. HGD database (http://hgddatabase.cvtisr.sk/) was used to identify HGD gene variants. Of the patients, 37 (56.1%) presented with isolated dark urine and 29 (43.9%) were diagnosed based on the clinical symptoms or family screening. One of these patients was on follow-up for 2 years due to Parkinsonism and was diagnosed with AKU on further analyses. Signs of ochronosis such as joint pain, low back pain and renal stones developed in childhood in 7 patients. Eight patients were diagnosed with depression via psychiatric evaluation. There were 14 (21.2%) patients operated on for ochronosis. The most frequent mutation observed in the patients was c.175delA, which was followed by c.674G > A and c.1007-2A > T mutations. Four novel mutations (c.189G > A, c.549+1G > T, c.1188+1G > A, and c.334 T > G) were identified in the patients included in the study. In addition to the known signs such as dark urine and skin pigmentation, symptoms involving different systems such as neurological findings and depression can also be encountered in AKU patients. The presence of a change in urine color needs to be questioned in patients presenting with different symptoms such as arthralgia/arthritis, renal stones or low-back pain, particularly in childhood, when skin ochronosis is not pronounced, and further examination should be performed