Obezite Derecesinin Kronolojik ve Metabolik Yaş Açılarından Değerlendirilmesi

Aim: Obesity degree is the ratio of current weight to standart weight of the individual. Metabolic age (MA) compares the individual’s basal metabolic rate to an average for the individual’s age group. In this study, considering the close association of obesity with chronic diseases, the aim is to evaluate the association between obesity degree and chronological age (CA) as well as MA and to derive a more descriptive index related to age. Materials and Methods: In this study, 287 adults between 18 and 79 years of age [10 underweight, 86 individuals with normal body mass index (BMI), 90 overweight, 81 obese ve 20 morbid obese] were evaluated. Anthropometric measurements were performed. The values for BMI were calculated. Obesity degree, MA, visceral adiposity values were recorded using TANITA body composition monitor. Differences between CA and MA were calculated. Statistical analyses were performed. Results: The mean±SD values for CA and MA for the study population were calculated as 43.2±16.0 and 46.3±16.3 years, respectively. This value for visceral adiposity was 8.2±4.8. A weak correlation was observed between obesity degree and CA. No correlation was observed between obesity degree and MA. However, a strong negative correlation was found between CA-MA and obesity degree. There was also a strong correlation between this index and visceral adiposity. Conclusions: It is concluded that during the evaluation of obesity degree, this new index, considering the difference between CA and MA, would give much more useful information rather than CA or MA.Amaç: Obezite derecesi, bireyin mevcut ağırlığının ideal ağırlığına olan oranıdır. Metabolik yaş (MY), bireyin bazal metabolik hız (BMH)’ının, bireyin kronolojik yaş grubunun ortalama BMH’ı ile kıyaslanmasını sağlayan bir parametredir. Bu çalışmada, obezitenin kronik hastalıklarla olan yakın ilişkisi gözönüne alınarak, obezite derecesi ile kronolojik yaş (KY) ve MY arasındaki ilişkinin değerlendirilmesi ve yaşla ilgili daha belirleyici bir indeksin türetilmesi amaçlanmıştır. Klinisyenlerin antenatal fetal hareketlerde azalma gördükleri gebelerde, fetal kayıp olabileceği için tedirgin olup olmamaları gerektiğine, perinatal sonuçlar değerlendirilerek farkındalık yaratmak amaçlanmıştır. Materyal ve Metot: Çalışmada 18 ile 79 yaş arasında 287 yetişkin birey [10 düşük kilolu, 86 normal vücut kitle indeksi (VKİ)’ne sahip, 90 fazla kilolu, 81 obez ve 20 morbid obez] değerlendirildi. Antropometrik ölçümler kaydedildi. VKİ değerleri hesaplandı. Obezite derecesi, MY, viseral adipozite değerleri TANITA body composition monitor kullanılarak kaydedildi. KY-MY hesaplandı. İstatistiksel analizler gerçekleştirildi. Bulgular: Çalışma populasyonunun KY ve MY ortalama±SS değerleri sırasıyla 43.2±16.0 yıl ve 46.3±16.3 yıl olarak hesaplandı. Viseral adiposite için bu değer 8.2±4.8 idi. Obezite derecesi ile KY arasında zayıf bir korelasyon gözlendi. Obezite derecesi ile MY arasında herhangi bir ilişki saptanamadı. Obezite derecesi ile KY-MY arasında güçlü bir negatif ilişki bulundu. Bu indeks ile viseral adipozite arasında da güçlü bir ilişki hesaplandı. Sonuç: Obezite derecesinin değerlendirilmesinde KY ya da MY’ın değil, aralarındaki farkı göz önüne alan bu yeni indeksin çok daha yararlı bilgiler vereceği saptandı

Morbid Obez ve Metabolik Sendromlu Çocuklarda Yeni Nesil Enflamatuvar Belirteçlerin Değerlendirilmesi

Aim: Technological advancements, unbalanced nutrition, sedentary life style, are important factors in obesity. Obesity-inflammation relationis beingexamined. In this study, the relationships among new generation inflammatory markers in children with normal body mass index (C) as well as obese (OB), morbid obese (MO) children and those with metabolic syndrome (MetS) were investigated.Materials and Methods: A total of 172 children participated in the study.Group 1 comprised children with normal body-mass index (control group) (C). Obese (OB) children were in Group 2, MO children constituted Group 3 and Group 4 included MO children with MetS. The number of cases were 37, 34, 51 and 50 in groups 1, 2, 3 and 4, respectively. Anthropometric measurements were recorded. Serum spexin, adropin, adipolipin, fibroblast growth factor-21 and fetuin-A levels were determined. Statistical analyses were performed.Result: Spexin and adipolin levels were significantly lower in obese groups than C group (p<0.05). Although adropin and FGF-21 levels did not differ significantly between groups, levels were lower in OB, MO, and MetS groups than C group.There were no significant differences among fetuin- A levels of the groups. Correlations between spexin and adipolin were the highest. These cytokines werenegatively correlated with obesity parameters. The correlations between these cytokines were weakened from C group to MetS group.Conclusion: Decreasing spexin and adipolin levels in accordance with increasing obesity degrees and weakening of the correlation between these cytokines in MO group compared to C group may be helpful during the further investigation of obesity.Amaç: Teknolojideki gelişmeler, dengesiz beslenme, sedanter hayat tarzı gibi yaşam değişiklikleri obezitenin gelişmesi için önemli faktörlerdir. Enflamasyon-obezite ilişkisi güncel bir konu olarak halen incelenmektedir. Bu çalışmada obez (OB), morbid obez (MO), metabolik sendromlu morbid obez (MetS) çocuklar ile sağlıklı, normal vücut kitle indeksi (K) olan çocuklarda yeni nesil enflamatuar belirteçler arasındaki ilişkiler araştırılmıştır. Materyal ve Metot: Toplam 172 çocuk çalışma kapsamına alındı. Normal vücut kitle indeksine sahip çocuklar birinci grubu (kontrol grubu) (K) oluşturdu. Grup 2’de OB, Grup 3’te MO, Grup 4’te MetS’lu (MetS) çocuklar yer aldı. Olgu sayıları Grup 1,2, 3 ve 4 için sırasıyla 37, 34, 51 ve 50 olarak belirlendi. Antropometrik ölçümler alındı. Serum speksin, adropin, adipolin, fibroblast büyüme faktörü-21 ve fetuin-A düzeyleri ölçüldü. İstatistiksel analizler gerçekleştirildi. Bulgular: Speksin ve adipolin düzeyleri obez gruplardaK grubuna göre anlamlı düzeyde düşük bulundu (p<0.05). Adropin ve FGF-21değerlerindegruplar arasında anlamlı bir fark bulunmamasına rağmendüzeylerin, K grubuna göre OB, MO and MetS gruplarında azalmış olduğu saptandı. Fetuin-A düzeylerinde gruplar arasında anlamlı bir farklılık bulunamadı.En yüksek korelasyonlar speksin ve adipolin düzeyleri arasında bulundu. Bu sitokinler obezite parametreleri ile negatif bir ilişki içindeydi. Aynı sitokinler arasındaki ilişki K grubundan MetS grubuna doğru zayıflamakta idi. Sonuç: Artan obezite derecelerine paralel olarak speksin ve adipolin seviyelerindeki azalma ve bu iki parametre arasındaki korelasyonun K grubuna göre MO grupta zayıflaması, obezitenin ileri düzeyde araştırılmasında yardımcı olabileceği düşüncesini ortaya koymaktadır

Evaluation of Gender Difference in Pediatrıc Trauma Patients Admitted to The Emergency Department

Aim:A significant proportion of pediatric trauma patients admitted to the emergency department are injured by preventable causes. Accidental injuries are the most common causes of deaths in childhood. The purpose of this study was to analyze the demographic features of the parents and the gender difference of the cases in pediatric patients with trauma admitted to the emergency department (ED).Materials and Methods:Over a 1-year period (April 2015 through May 2016), a total of 502 consecutive paediatric patients who presented to our tertiary-care university hospital ED with symptoms of trauma of various causes (falling from a height, injury, burni traffic accident and physical abuse assault) were enrolled in this prospective clinical study.Results:In this study, the boy to girl gender ratio was found to be 1.52 (p = 0.868). The mean ages were 7.74 ± 4.97 in boys and 7.67 ± 5.25 in girls. 17.2% of the boys and 21.1% of the girls were detected fracture on direct radiographs (p=0.306). Upper extremity fractures were encountered more frequently than other fractures. The frequency of falling from a height was the first among all cases of trauma with the rate of 69.3%, 42.4% of which occurred in boys and 26.9% in girls (p=0.559). The rates of upper extremity injuries were 19.9% for boys and 15.7% for girls (p=0.126). The rates of head injuries were 22.5% for boys and 12% for girls (p=0.177). When the type of injury was evaluated, the rate of contusion was 60%, 36.3% of which occurred in boys and 23.7% in girls (p=0.952). When the parents of the pediatric trauma patients were classified according to their educational status, the largest group consisted of primary school graduated parents with rates of 41.4% for mothers (p=0.080) and 37.3% for fathers (p=0.008). 46.0% of the pediatric trauma patients were the first children of their families, 27.3% of which were boys and 18.7% were girls (p=0.657).Conclusion:We emphasized the importance of raising awareness about the issue at the individual and community-based level and the necessity of increasing the protective measures for indoor and outdoor accidents in order to be able to create a safe environment so that the pediatric trauma patients can be reduced in our country and in the world

Yağ Kütle ve Kantitatif İnsulin Sensitivite Kontrol İndekslerinden Türetilmiş Yeni Bir İnsulin Sensitivite İndeksi

Aim Obesity has recently become one of the most important health problems throughout the world. This fact led to the controversies on the clinical use of insulin sensitivity indices. Indices previously described or introduced in this study have been evaluated to choose one, which is capable of exhibiting significant distinctions between healthy children and those involved in the classes of childhood obesity. Material and Methods A total of 179 girls; 81 morbidly obese(MO), 42 obese(O), 16 overweight(OW) and 40 normal(N) participated in the study. Groups were constituted based upon age- and sex-specific body mass index percentiles tabulated by World Health Organization. Homeostasis Model Assessment of Insulin Resistance(HOMA-IR), HOMA-IR/BMI, log HOMA-IR, fasting glucose/fasting insulin ratio(FGIR), quantitative insulin sensitivity check index(QUICKI), Raynaud, reciprocal insulin indices and also new indices HOMAIR*BMI, HOMA-IR*fat mass index(FMI), QUICKI*BMI, QUICKI*FMI were calculated. The cut-offs 3.16 and 2.5 for HOMA-IR, 7 and 6 for FGIR, 0.357 and 0.328 for QUICKI were evaluated to estimate insulin resistance. Statistical analyses were performed with Predictive Analytics SoftWare(PASW) Statistics 18. Results and Conclusion QUICKI*FMI was able to make a clear-cut separation between the groups. A new trilogy for cut-offs (HOMA>2.5, FGIR2.5, FGIR<7, QUICKI<0.328) ortaya kondu. QUICKI nin çok yönlü özelliği gözlendi. QUICKI nin, 0.328 cut-off noktası kullanıldığında MO i O den, 0.357 cut-off noktası kullanıldığında ise O i OW den ayırt edebildiği belirlendi. QUICKI*FMI indeksinin, çocukluk çağı obezitesi bağlamında N-OW, OW-O ve O-MO gruplar arasındaki farklılıkların ileri düzeyde (p?0.005) tanımlanmasında eşsiz bir indeks olduğu sonucuna varıldı

Akut Bronşiolit Tanılı İnfantlarda Ortalama Platelet Hacmi, İkisi Arasında Bir Korelasyon Var Mı?

Aim: Acute bronchiolitis is the most common lowerrespiratory tract infection of children younger than 2 years ofage. There aren't any standardized diagnostic criteria andseverity assessment classifications for acute bronchiolitisavailable in literature. Mean platelet volume (MPV) has shownto be effected in inflammatory conditions and to ourknowledge there's only one recent study in children with acutebronchiolitis that demonstrated an association between MPVchange and acute brınchiolitis.Materials and Methods: In this retrospective study weenrolled 555 children diagnosed with Acute bronchiolitis and516 healthy infants with a matching age and sex.Results: MPV levels were found significantly higher in patientgroup (8,2 ± 0,8 fL) than the control group (7,9 ± 0,8 fL). Interms of hospitalization need, no significant difference wasdetected between the MPV values of the hospitalized groupand the outpatients (8,3±0,8 fL; 8,2±0.7 fL, respectively).Conclusions: In conclusion, our data show that MPV valuesare significantly elevated in acute bronchiolitis compared tohealthy infants. However, MPV can't be used as a guidance inattack severity nor can it predict hospitalization and systemicsteroid need.Amaç: Akut bronşiolit, 2 yaşından küçük çocuklarda en sık görülen alt solunum yolu enfeksiyonudur. Literatürde akut bronşiolit için standart tanı kriterleri ve şiddet değerlendirme sınıflamaları mevcut değildir. Ortalama platelet hacminin (MPV) lokal inflamasyondan etkilendiği gösterilmiştir ve akut bronşiolit ile MPV ilişkisini gösteren tek bir çalışma bulunmaktadır. Materyal ve Metot: Bu çalışmada MPV ile akut bronşiyolit arasındaki ilişkiyi belirlemeyi amaçladık, ayrıca hastalığın şiddetini değerlendirmede yararlı bir belirteç olup olmadığını araştırdık. Bu retrospektif çalışmada akut bronşiolitis tanısı alan 555 çocuğa ve eşleştirilmiş yaş ve cinsiyete sahip 516 sağlıklı bebek çalışma grubuna dahil edilmiştir. Bulgular: MPV düzeyleri hasta grubunda (8,2 ± 0,8 fL) kontrol grubuna (7,9 ± 0,8 fL) göre anlamlı olarak yüksek bulundu. Hastaneye yatış açısından hastaneye yatırılan grup ve poliklinik hastalarının MPV değerleri arasında anlamlı bir fark saptanmamıştır (sırası ile, 8,3 ± 0,8 fL; 8,2 ± 0,7 fL) Sonuç: Sonuç olarak, verilerimiz, akut bronşiolit varlığında MPV değerlerinin sağlıklı bebeklere göre anlamlı derecede yükseldiğini göstermektedir. Bununla birlikte, MPV atak şiddetinde bir rehber olarak kullanılamaz ve hastaneye yatışı ve sistemik steroid ihtiyacını tahmin edemez

Evaluation Of Skin Prick Test Results of Patients With Allergic Rhinitis Living in Tekirdağ

Aim:Allergic rhinitis is the most prevalent chronic disease of childhood with an increasing prevalence. Allergen distribution changes with geographic region and starting age of the disease. In this study we aim to determine the allergen distribution in patients with allergic rhinitis living in Tekirdağ.Material and Methods:We performed skin prick test to 78 (32 girls, 46 boys) patients with allergic rhinitis aged between 4-14 years old admitted to Namık Kemal University. Patients with asthma and atopic dermatitis were excluded.Results:We found sensitivity to at least one allergen in 31 (39,7%) patients. 16 (51,6%) patients had sensitivity to only one allergen. However, 15 (48,4%) patients had sensitivity to more than one allergen. The most sensitive group found was house dust mites with 18(58%) patients. 10 (32,25%) patients had sensitivity to weeds, 8 (25,8%) patients to tree pollens, 7 (22,5%) patients to molds, 2 (6,4%) patients to cats and 1 (3,2%) patient to foods.Conclusion:We found that the most sensitive allergens were house dust mites and tree pollens in our clinic. These findings were consistent with literature. Allergen sensitivity may change with geographic region and socio-economic status. To our knowledge this is the first study conducted in Tekirdağ, so our research may be used as a source in future studies

EVALUATİON OF SKİN PRİCK TEST RESULTS OF PATİENTS WİTH ALLERGİC RHİNİTİS LİVİNG İN TEKİRDAĞ

Allerjik rinit, görülme sıklığı giderek artan çocukluk çağının en sık allerjik solunum yolu hastalığıdır. Allerjen dağılımı coğrafi bölge ve hastalığın başlama yaşı ile değişiklik göstermektedir. Bu çalışmada Tekirdağ bölgesinde yaşayan allerjik rinit tanılı hastalarda allerjen dağılımının belirlenmesi hedeflenmiştir.Allergic rhinitis is the most prevalent chronic disease of childhood with an increasing prevalence. Allergen distribution changes with geographic region and starting age of the disease. In this study we aim to determine the allergen distribution in patients with allergic rhinitis living in Tekirdağ

Çocuklarda obezitenin endotel fonksiyonu ve subklinik ateroskleroz üzerine etkisi]

We aimed to measure flow-mediated dilation (FMD), carotid intima-media thickness (cIMT), and to evaluate the effects of waist circumference (WC), and body mass index Z (BMI-Z) score on these parameters in obese children. This case-control cross-sectional study included 70 obese and 40 non-obese children aged 7-14 years who presented with various complaints and had no concomitant diseases. FMD and cIMT were measured in all subjects and correlated with anthropometric and biochemical factors. WC, BMI-Z score, systolic and diastolic blood pressure (BP), triglyceride (TG) and insulin concentrations, and homeostatic model assessment (HOMA) index were significantly higher, whereas high density lipoprotein (HDL) -cholesterol concentration was significantly lower in the obese than in the non-obese group. FMD values were significantly lower, whereas cIMT values were significantly higher in obese than in non-obese subjects. FMD negatively correlated with WC, BMI-Z score, serum insulin level, HOMA, systolic BP, triglyceride but positively with HDL-cholesterol. cIMT positively correlated with WC, BMI-Z score, serum insulin level, HOMA, systolic BP, triglyceride but negatively with HDL-cholesterol. Increased WC, BMI-Z score, serum insulin level, HOMA, systolic BP, triglyceride and decreased HDL-cholesterol in obese children contribute to endothelial dysfunction and early subclinical atherosclerosis compared to their normal weight peers

A New Insulin Sensitivity Index Derived From Fat Mass Index and Quantitative Insulin Sensitivity Check Index

AimObesity has recently become one of the most important health problems throughout the world. This fact led to the controversies on the clinical use of insulin sensitivity indices. Indices previously described or introduced in this study have been evaluated to choose one, which is capable of exhibiting significant distinctions between healthy children and those involved in the classes of childhood obesity.Material and MethodsA total of 179 girls; 81 morbidly obese(MO), 42 obese(O), 16 overweight(OW) and 40 normal(N) participated in the study. Groups were constituted based upon age- and sex-specific body mass index percentiles tabulated by World Health Organization. Homeostasis Model Assessment of Insulin Resistance(HOMA-IR), HOMA-IR/BMI, log HOMA-IR, fasting glucose/fasting insulin ratio(FGIR), quantitative insulin sensitivity check index(QUICKI), Raynaud, reciprocal insulin indices and also new indices HOMA-IR* BMI, HOMA-IR*fat mass index(FMI), QUICKI*BMI, QUICKI*FMI were calculated. The cut-offs 3.16 and 2.5 for HOMA-IR, 7 and 6 for FGIR, 0.357 and 0.328 for QUICKI were evaluated to estimate insulin resistance. Statistical analyses were performed with Predictive Analytics SoftWare(PASW) Statistics 18.Results and ConclusionQUICKI*FMI was able to make a clear-cut separation between the groups. A new trilogy for cut-offs (HOMA>2.5, FGIR<7, QUICKI<0.328); each giving the similar results, has been suggested. Multifaceted character of QUICKI was also introduced. QUICKI was capable of discriminating MO from O when 0.328 cutoff was used, and O from OW when 0.357 cut-off was used. QUICKI*FMI index, a new one, was unique in detecting the advanced level of differences(p≤0.005) between N-OW, OW-O and O-MO groups during childhood obesity

Mean Platelet Volumes of Infants With Acute Bronchiolitis, is There a Correlation Between Them?

Aim:Acute bronchiolitis is the most common lower respiratory tract infection of children younger than 2 years of age. There aren't any standardized diagnostic criteria and severity assessment classifications for acute bronchiolitis available in literature. Mean platelet volume (MPV) has shown to be effected in inflammatory conditions and to our knowledge there's only one recent study in children with acute bronchiolitis that demonstrated an association between MPV change and acute brınchiolitis.Materials and Methods:In this retrospective study we enrolled 555 children diagnosed with Acute bronchiolitis and 516 healthy infants with a matching age and sex.Results:MPV levels were found significantly higher in patient group (8,2 ± 0,8 fL) than the control group (7,9 ± 0,8 fL). In terms of hospitalization need, no significant difference was detected between the MPV values of the hospitalized group and the outpatients (8,3±0,8 fL; 8,2±0.7 fL, respectively).Conclusions:In conclusion, our data show that MPV values are significantly elevated in acute bronchiolitis compared to healthy infants. However, MPV can't be used as a guidance in attack severity nor can it predict hospitalization and systemic steroid need