The Importance of Extended High Frequencies in Hearing Evaluation of Pediatric Patients with Type 1 Diabetes

INTRODUCTION: Type 1 diabetes (T1D), one of the most common childhood diseases worldwide, can cause hearing loss through systemic effects. Diabetes-induced hearing loss is considered a progressive sensorineural hearing loss with a gradual onset, typically occurring at high frequencies (HFs). Extended HF (EHF) hearing sensitivity in children with T1D who did not complain of hearing loss was investigated as an early marker for hearing loss at the standard/conventional frequency range of hearing. METHODS: Forty-two children (21 with T1D and 21 healthy controls) were evaluated in a case-control design. Conventional and EHF (14,000, 16,000, and 18,000 Hz) audiometry were performed. The diabetes group underwent routine blood biochemistry and glycated hemoglobin A1c measurements. The data were analyzed by the Student’s t-test, Mann-Whitney U test, chi-square test, and logistic regression analysis. RESULTS: The mean hearing thresholds were significantly higher (p15 dB HL at 14,000-18,000 Hz but ≤15 dB HL at 500-4,000 Hz was significantly higher in the diabetes group than in the control group (p=0.049). DISCUSSION AND CONCLUSION: Children with diabetes showed normal hearing thresholds within the conventional audiometric frequency range but they had higher hearing thresholds during EHF audiometry when compared with controls. Audiometry in these children should be performed using frequencies above 8,000 Hz combined with the conventional frequency range. EHF audiometry may be an effective method for identifying subclinical hearing loss in children with diabetes. Thus, diabetic children with an EHF mean hearing threshold above 15 dB HL should be monitored more closely in terms of blood glucose regulation to prevent diabetes-related hearing loss at the conventional frequency range

Fibrodysplasia ossificans progressiva: Case report

Fibrodisplazi ossifikans progressiva (FOP), oldukça nadir görülen bir genetik hastalıktır. FOP olgularında az sayıda hastada otozomal dominant genetik geçiş bildirilmekle birlikte genellikle sporadik mutasyonlarla oluşmaktadır. Hastalığın önlenmesinde ve tedavisinde kesin bir yaklaşım yoktur. Erken tanı konulması, hastalığın progresyonunu hızlandıran gereksiz tanı ve tedavi prosedürlerinin engellenmesi açısından çok önemlidir. Burada, ilk semptomları 9 aylıkken yapılan aşı sonrasında sol deltoid bölgede görülen şişlik ve sertlik olarak başlayan, lezyon bölgesinden yapılan eksizyonel biyopsi ve sağ kolundan yapılan kemik biyopsisi sonrası sık oluşan alevlenmeler ile ilerleyici karakterde klinik sergileyen bir olgu sunuldu. Semptomatik tedavi ve profilaktik önlemler ile hastanın yaşam süresi ve kalitesinin arttırılması amaçlandı. Hastamızın takibinde, alevlenme dönemlerinde oral prednizolon, alendronat ve pamidronat tedavileri uygulandı.Fibrodysplasia ossificans progressiva (FOP) is a very rare genetic disorder. Most cases of FOP arise as a result of spontaneous mutation. A few patients with an autosomal dominant genetic transmission are reported. There is no definitive approach to the prevention and treatment of disease. Early diagnosis prevents unnecessary diagnostic and therapeutic procedures which lead to the progression of the disease. Here, we present a case whose first symptoms began at 9 months of age with swelling and stiffness at the vaccinated region and progressed with exacerbations after the excisional biopsy of the lesion and the bone biopsy of the right arm. Symptomatic treatment and prophylactic measures aimed to improve the quality of life. Exacerbations during follow up were treated with oral prednisolone, alendronate and pamidronate

Serum Irisin and Oxytocin Levels as Predictors of Metabolic Parameters in Obese Children

Objective: Irisin and oxytocin can affect energy homeostasis and it has been suggested that they may play an important role in reducing obesity and diabetes. In this study, we aimed to determine the relationship between metabolic parameters (including irisin and oxytocin levels) and anthropometric parameters in obese children. Methods: Ninety obese children (mean age, 13.85 +/- 1.63 years) and 30 healthy controls (mean age, 14.32 +/- 1.58 years) were enrolled in this study. Anthropometric and laboratory parameters (glucose, insulin, lipid, oxytocin, and irisin levels) were analyzed. The serum irisin and oxytocin levels were measured by enzyme-linked immunosorbent assay. Bioelectrical impedance was used to determine body composition. Results: Irisin level was higher in the patients than in the controls (p = 0.018), and this higher irisin level was correlated with increased systolic blood pressure, body mass index, waist/hip ratio, fat percentage, fat mass, glucose level, insulin level, and homeostasis model assessment of insulin resistance. Serum oxytocin level was significantly decreased in obese children compared to the controls (p = 0.049). Also, among the 60 obese patients, oxytocin level was significantly lower in patients with than in those without metabolic syndrome (8.65 +/- 2.69 vs. 10.87 +/- 5.93 ng/L, respectively), while irisin levels were comparable (p = 0.049 and p = 0.104, respectively). There were no statistically significant relationships between oxytocin or irisin levels and lipid levels (p > 0.05). Conclusion: Obese children had significantly higher irisin levels than the healthy controls. Additionally, this study shows for the first time that oxytocin level is significantly lower in obese compared with non-obese children and also lower in obese children with metabolic syndrome compared to those without

Management of Thyrotoxicosis in Children and Adolescents: A Turkish Multi-center Experience

To determine the demographic and biochemical features of childhood and juvenile thyrotoxicosis and treatment outcome