Vitamin D and Nerve Conduction In Pediatric Type-1 Diabetes Mellitus

Introduction: The aim of this study is to investigate a possible association between vitamin D deficiency and diabetic peripheral neuropathy in pediatric patients with type 1 diabetes mellitus.& nbsp;Materials-methods: Twenty-nine patients with type 1 diabetes mellitus and 19 healthy controls were included to the study. All individuals were evaluated for diabetic peripheral neuropathy with nerve conduction studies. Complete blood cell count, biochemical investigations, serum vitamin D levels, hemoglobin A1c levels were recorded.& nbsp;Results: No statistically significant differences between the diabetes and control groups in terms of gender, age, body weight, height, body mass index, systolic and diastolic blood pressures, laboratory investigations, serum vitamin D levels and nerve conduction studies was found. Patients with diabetes were grouped as patients with normal serum vitamin D levels and patients with vitamin D deficiency. Sensory nerve action potential of sural nerve and motor peroneal nerve velocity were statistically significantly lower in diabetic patients with vitamin D deficiency compared to diabetic patients with normal vitamin D levels (p 0.009 and 0.005 respectively).& nbsp;Conclusion: Our results suggested that hypovitaminosis D might lead to development of neuropathic changes particularly on the lower limb nerves even in the early stages of the disease. It should be kept in mind that patients with hypovitaminosis D should be elaborately examined and closely followed up for the development of diabetic neuropathic changes, even if glucose control is achieved.(C) 2022 Published by Elsevier B.V. on behalf of The Japanese Society of Child Neurology

Case report: GNRH treatment for hypersexual behaviour in a child with autism spectrum disorder

Inappropriate sexual behaviours observed in autism spectrum disorder (ASD) are difficult for both the family and the child, and they can significantly deteriorate social adaptation and functionality. Therefore, these behaviours need to be addressed and treated appropriately. Conventional treatments may be inadequate in a number of cases. In this case report, the treatment of inappropriate sexual behaviours using gonadotropin-releasing hormone (GnRH), despite the medical and behavioural treatment of a 13-year-old boy diagnosed with ASD with mental retardation comorbidity, is described. The use of hormonal therapy in inappropriate sexual behaviours is discussed

Transient Neonatal Diabetes with Fanconi Bickel Syndrome

Fanconi- Bickel Syndrome (FBS) is a rare glycogen storage disease (GSD) . Transient diabetes is rarely reported with FBS. We describe a patient with FBS diagnosed by diabetes findings and identification of a mutation in the GLUT2. A male infant, from a consanguineous marriage, presented with hyperglycemia and urinary system infections at 59 days and was given insulin therapy. At age 3 months, insulin was discontinued. Neonatal diabetes may be a first presentation of infants with FBS. [Med-Science 2017; 6(1.000): 111-3

The Effectiveness of Enteral Nutrition Support in the Growth of Children Patients with Cancer

WOS: 000376566600006Aim: The purpose of this study was to assess, through anthropometric and biochemical parameters, the positive effect on growth of enteral nutrition support in children with cancer receiving chemotherapy. Material and Method: Forty-three consecutive patients newly diagnosed with pediatric malignant disease and receiving intensive chemotherapy were included. Twenty-six patients received an enteral nutrition formula. Seventeen control patients did not receive enteral nutrition formula. Anthropometric parameters (weight, height, body mass index, triceps, subscapular and suprailiac skinfold thickness), serum albumin, prealbumin and transferrin levels and lipid profiles were measured at time of diagnosis and the 3rd month. Results: At the end of 3 months we determined a marked increase in subscapular and suprailiac skin fold thicknesses in the enteral nutrition group compared to at time of diagnosis (p= 0.01 and p= 0.014, respectively). Prealbumin and albumin values increased considerably after 3 months of enteral nutrition formula support (p= 0.005 and p= 0.006, respectively). Weight percentile increment was determined (69.2% of patients) in the enteral nutrition group compared to at time of diagnosis. At 3 months, albumin and suprailiac skinfold thicknesses values were higher in the enteral nutrition group as compared to controls (p= 0.012 and p= 0.017, respectively). There were no significant changes in anthropometric and biochemical parameters in the control group at the end of treatment compared to at time of diagnosis. Discussion: This study demonstrates an improvement in anthropometric and biochemical parameters in children with cancer receiving an enteral nutrition formula

Behavior of Sphingosine 1-Phosphate Receptor Gene Expression in Patients with Neuroblastoma

WOS: 000321597900003Sphingosine 1-phosphate receptor 4 (S1P4), which induces cellular migration and prevents apoptosis, was investigated in patients diagnosed with neuroblastoma in our study. The study included 37 neuroblastoma patients and 25 healthy children. After RNA isolation, cDNA were performed and Si P4 gene expression levels were measured in leukocytes. S1P4 gene expression levels presented as mean +/- SD were high in the study group. The difference was statistically significant between neuroblastoma patients (0.0387 +/- 0.0647) and healthy children (0.0366 +/- 0.0238) for S1P4 gene expression levels (p=0.028). Patients given no chemotherapy yet and and those who already completed chemotherapy showed no significant difference statistically (p=0.886). While decreased S1P4 gene expression levels (0.0188 +/- 0.0069) were seen in patients receiving maintenance therapy, patients completed chemotherapy had increased S1P4 gene expression levels (0.0322 +/- 0.0303). The difference was meaningful (p=0.048). Although S1P4 gene expression levels (0.0310 +/- 0.0201) estimated before the beginning of chemotherapy were higher than that of maintenance phase (0.0188 +/- 0.0069), the difference was not significant (p=0.158). Higher S1P4 gene expression levels were remarkable in neuroblastoma patients. The suppression of S1P4 gene expression levels during maintenance phase and the increasing of expression in following up without chemotherapy could bring to mind that the chemotherapy could cause to decreased cell migration and/or induction of apoptosis. The effect of S1P4 on the tumor progression and the association with chemotherapy should be investigated in cancer cases

Carotid intima media thickness is independently associated with urinary sodium excretion in patients with chronic kidney disease

Atherosclerosis-induced premature vascular diseases are the leading cause of mortality among patients with chronic kidney disease (CKD). The pathogenetic mechanism of atherosclerosis in patients with CKD has not been fully explained. Experimental studies have demonstrated that high dietary sodium intake not only increases circulatory volume and blood pressure, but also facilitates development of atherosclerosis by reducing production-bioavailability of nitric oxide due to oxidative stress and accordingly by enhancing endothelial and arterial stiffness. In this study, we investigated the relationship between sodium consumption and carotid artery intima-media thickness, which is the indicator of atherosclerosis, by determining daily urinary sodium excretion, which is a reliable indicator of sodium consumption, in our patient group. Our patient group included 193 patients with stage 2-4 non-diabetic CKD and without a history of atherosclerotic disease. We determined that 77% of our patients have been consuming more than 2 g of sodium per day, which is the upper limit of sodium consumption recommended for patients with CKD. We determined a positive linear correlation between carotid artery intima-media thickness and patient age (p < 0.001), C-reactive protein (p < 0.001), urinary sodium excretion (p < 0.001), body mass index (p = 0.002), systolic blood pressure (p = 0.002), hemoglobin (p = 0.030), triglycerides (p = 0.043), and diastolic blood pressure (p = 0.049). We also found a negative linear correlation between carotid artery intima-media thickness and glomerular filtration rate (p = 0.008). We found that urinary sodium excretion is the determinant of intima-media thickness even if all factors associated with intima-media thickness are adjusted, and that intima-media thickness increases by 0.031 (0.004-0.059) mm per 2 g increase in daily sodium excretion, independent from overall factors (p = 0.025). Our results reveal a relation between urinary sodium excretion and carotid artery intima-media thickness and suggest that excessive sodium consumption predisposes development of atherosclerosis in patients with CKD

ANTIOXIDANT, ANTI-INFLAMMATORY, ACETYLCHOLINESTERASE INHIBITORY AND ANTIMICROBIAL ACTIVITIES OF TURKISH ENDEMIC CENTAUREA ANTIOCHIA VAR-PRAEALTA

The antioxidant, anti-inflammatory, acetylcholinesterase (AChE) inhibitory and antimicrobial activities of extract from the Centaurea antiochia Boiss. var. praealta (Boiss. & Bal.) Wagenitz, an endemic plant species from Turkey, were investigated. The results indicated that the extract inhibits FeCl3/ascorbic acid-induced phosphatidylcholine liposome oxidation, scavenges stable 2,2-diphenyl-1picrylhydrazyl (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) cation radicals, and reduces Fe3+ to Fe2+ in the ferric-reducing antioxidant power (FRAP) assay. The extract inhibited AChE and both cyclooxygenase (COX)-1 and COX-2, which suggests this species might be a potential source of plant-derived anti-inflammatory and anti-AChE substances. The extract may also act as an antimicrobial agent because it inhibited the growth of Gram-positive and Gram-negative bacteria as well as yeast. These findings may scientifically explain some uses of this species in Turkish folk medicine as an antimicrobial, anti-inflammatory and wound healing agent

The relationship between mean platelet volume and neutrophil/lymphocyte ratio with inflammation and proteinuria in chronic kidney disease

Atherosclerosis, which develops as a result of inflammation, is the most important cause of morbidity and mortality in chronic kidney disease (CKD). In this study, we investigated the relationship of mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) with inflammation and proteinuria in patients with CKD Stage 3-4. Healthy individuals who applied to nephrology clinic for checkup purposes acted as controls. Fifty-three patients and 30 healthy controls were included in the study. Patients with diabetes mellitus, active infection, malignancy, and coronary artery disease were excluded from the study. Biochemistry values and hemograms were recorded for all patients and for control group. NLR was calculated. The relationship between MPV/NLR and protein, fibrinogen, and proteinuria was evaluated. Our study showed a statistically significant difference between CKD group and healthy control (HC) group in uric acid, fibrinogen, C-reactive protein, and NLR values (P < 0.01, P < 0.01, P = 0.01, P < 0.01, respectively). No statistically significant difference was found between CKD and HC groups for MPV (P = 0.307). Correlation analysis revealed a statistically significant relationship between NLR and creatinine (P < 0.00, r = 0.571), uric acid (P < 0.00, r = 0.436), glomerular filtration rate (P < 0.00, r = 0.418), 24 h urine protein (P = 0.004, r = 0.311), and 24 h urine microalbumin (P = 0.001, r = 0.354). A statistically significant relationship was detected between MPV and platelet count (P < 0.001, r = 0.422), age (P = 0.004, r = 0.312), uric acid (P = 0.04, r = 0.226), and fibrinogen (P = 0.023, r = 0.249). Whereas, a statistically significant relationship was detected between NLR and microalbuminuria/proteinuria, there was no statistically significant relationship between MPV and microalbuminuria/proteinuria. Our study showed that the NLR is high in CKD group and is correlated with uric acid and proteinuria, which are known to be associated with atherosclerosis, in patients with CKD. NLR may be a determinant of inflammation and atherosclerosis in patients with CKD

Fibroblast Growth Factor-23 and Carotid Artery Intima Media Thickness in Chronic Kidney Disease

Background: The cause of early-accelerated atherosclerosis development observed in Chronic Kidney Disease (CKD) is not fully understood. The determination of the relationship between the levels of fibroblast growth factor 23 (FGF-23) and the development of endothelial dysfunction, left ventricular hypertrophy, and myocardial infarction lends support to the possibility that FGF-23 plays a role in the development of atherosclerosis in CKD. Only a few studies, however, have been conducted that analyze the relationship between FGF-23 levels in the progression of CKD and the development of atherosclerosis, and these studies have generally been limited to those patients receiving dialysis therapy due to end stage renal disease (ESRD)

Clinical, biochemical and genetic features with nonclassical 21-hydroxylase deficiency and final height

WOS: 000408795100008PubMed ID: 28672743Background: The clinical, laboratory, genetic properties and final height of a large cohort of patients with nonclassical 21-hydroxylase deficiency (NC21OHD) in Turkey were analyzed. Methods: This multicenter, nationwide web-based study collected data. Results: The mean age was 9.79 +/- 4.35 years (229 girls, 29 boys). The most common symptoms were premature pubarche (54.6%) and hirsutism (28.6%). The peak cortisol was found below 18 mu g/dL in three (15.45%) patients. A mutation was detected in the CYP21A2 gene of 182 (87.5%) patients. The most common mutation was V281L. Final height in female patients who were diagnosed and treated before attaining final height or near final height was found to be shorter than the final height in female patients who were diagnosed after attaining final height or near final height. Conclusions: The final height of the patients who were treated during childhood was found to be shorter than the final height of patients during the adolescent period