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

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

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

Evaluation of epicardial adipose tissue and carotid intima-media thickness as a marker of atherosclerosis in patients with inflammatory bowel disease

Background and aim: this study aimed to compare carotid intima media (CIMT) and epicardial adipose tissue (EAT) measurements, which are considered as markers for the detection of early atherosclerosis in healthy controls and inflammatory bowel disease (IBD) cases. Methods: a total of 60 IBD patients (25 Crohn’s disease and 35 ulcerative colitis) and 60 healthy patients (as a control group) were included in the study. The measurements of CIMT and EAT were performed using echocardiography and ultrasonography, respectively. Statistical analysis was used to determine the relationship between the parameters. Results: the thickness of bilateral (right and left) CIMT and EAT were significantly higher in IBD than in the control group (p < 0.05). There was a positive correlation between EAT and bilateral (right and left) CIMT in IBD patients (p < 0.05)

Serum Endocan Levels in Children with Community-Acquired Pneumonia

In this study, it was aimed to compare the levels of serum endocan with commonly used markers, and also to define the suitability for determination of disease severity in patients with community-acquired pneumonia (CAP). The study included 60 patients and 28 healthy subjects. Pneumonia severity was determined according to British Thoracic Society guidelines for the management of CAP in children. Serum levels of endocan and C-reactive protein (CRP) and white blood cell (WBC), and neutrophil count were measured. Serum endocan levels were increased in patients with CAP. CRP levels, WBC count, neutrophil count and neutrophil lymphocyte ratio were also higher in the CAP group than healthy control group. Endocan was correlated with CRP and WBC count and disease severity. For the identification of CAP, the area under the receiver operating characteristic (ROC) curve of CRP was acceptable for CRP, but not for endocan (0.812 and 0.649, respectively). ROC analysis for endocan to differentiate between severe CAP (n = 29) and mild-moderate CAP (n = 31) gave an area under the curve of 0.769 compared to 0.667 for CRP. Serum endocan levels increase in patients with CAP and can therefore be a useful marker in diagnosis and as a particular indicator of the treatment in the clinical assessment of CAP disease severity. Serum endocan levels of patients with severe CAP were higher compared with patients with mild-moderate CAP. These results revealed that endocan might be a useful indicator of severity of CAP

Serum Endocan Levels in Children with Community-Acquired Pneumonia

In this study, it was aimed to compare the levels of serum endocan with commonly used markers, and also to define the suitability for determination of disease severity in patients with community-acquired pneumonia (CAP). The study included 60 patients and 28 healthy subjects. Pneumonia severity was determined according to British Thoracic Society guidelines for the management of CAP in children. Serum levels of endocan and C-reactive protein (CRP) and white blood cell (WBC), and neutrophil count were measured. Serum endocan levels were increased in patients with CAP. CRP levels, WBC count, neutrophil count and neutrophil lymphocyte ratio were also higher in the CAP group than healthy control group. Endocan was correlated with CRP and WBC count and disease severity. For the identification of CAP, the area under the receiver operating characteristic (ROC) curve of CRP was acceptable for CRP, but not for endocan (0.812 and 0.649, respectively). ROC analysis for endocan to differentiate between severe CAP (n = 29) and mild-moderate CAP (n = 31) gave an area under the curve of 0.769 compared to 0.667 for CRP. Serum endocan levels increase in patients with CAP and can therefore be a useful marker in diagnosis and as a particular indicator of the treatment in the clinical assessment of CAP disease severity. Serum endocan levels of patients with severe CAP were higher compared with patients with mild-moderate CAP. These results revealed that endocan might be a useful indicator of severity of CAP

Trakya Bölgesinde Pediatrik Yoğun Bakım Ünitesinde Akut Zehirlenme Vakalarının Retrospektif Analizi

Amaç: Bu çalışmadaki amacımız, Trakya bölgesinde çocuk yoğun bakım ünitesinde takip ve tedavileri yapılan zehirlenme vakalarının özelliklerini belirlemek ve önlemlerin alınmasına rehberlik etmektir.Gereçler ve Yöntem: Namık Kemal Üniversitesi Tıp fakültesi hastanesi çocuk yoğun bakım ünitesinde Ocak 2012-Ağustos 2016 tarihleri arasında zehirlenme nedeniyle takip ve tedavi edilmiş çocuklar çalışmaya dahil edildi. Bilgiler hasta kayıtları geriye dönük taranarak toplandı. Yaş, cinsiyet, zehirlenme etkeni, yeri ve nedeni, hastaneye başvuru şekli ve tedavi yöntemleri değerlendirildi. Veriler tanımlayıcı yöntemler ve ki-kare testi kullanılarak değerlendirildi; p değeri <0.05 olan istatistiksel farklılıklar anlamlı kabul edildi.Bulgular: Yaşları 6 ay-18 yaş arasında olan 172 hastanın kayıtları retrospektif olarak tarandı, 113 (%65,70) hasta kız, 59 (%34,30) hasta erkekti ve ortalama yaşları 6,61±5,36 yaş arasındaydı. Zehirlenme vakalarının büyük çoğunluğu (%52) 0-4 yaş arasında bulundu. Çoğu vakada (%91,90) zehirlenme evde ve oral yol ile (%95,90) gerçekleşmişti. Mevsimlere göre bakıldığında zehirlenme vakalarının birçoğu yaz ayında meydana gelmişti. Zehirlenme nedenlerine bakılacak olursa %70,30’ü kaza sonucu meydana gelmişti, intihar amacı ile oluşan zehirlenmelerin %98’i kız çocuklarındaydı. Zehirlenmeler en sık ilaçlar ile gerçekleşmiş (%78,60), ikinci en sık neden korozif maddeler (%10,80) ve vakaların %3,80’inde temizlik maddeleri takip etmekteydi. İlaçlar arasında antidepresanlar en sık (%25,85) zehirlenme etkeni olarak bulundu ve akut zehirlenme nedeni ile takip edilen 172 hastada ölüm bildirilmedi.Sonuç: Zehirlenmelerin en sık 0-4 yaş arası çocuklarda görülmesi ailelerin bu konuda eğitilmelerinin ne kadar önemli olduğunu göstermektedir. Bölgemizde hem kaza sonucu hem de intihar amaçlı gelişen zehirlenmeler kız çocuklarda daha fazla görülmüştür. Özellikle kaza sonucu gelişen zehirlenmelerin literatürden farklı olarak bu bölgede kız çocuklarda daha fazla görülmüş olması dikkat çekicidir. Çocukluk çağı zehirlenmelerinin önlenmesinde, kapsamlı araştırmalar yapılması ve ailelerin eğitilmesinin mortalite ve morbiditenin azaltılmasında etkili olacağı inancındayız.Objective: The aim of this study is to determine the properties of intoxication cases in Thrace region that were followed-up and treated in Pediatric İntensive Care Unit (PICU) and to be a guide for precautions. Material and Methods: Children who were hospitalised in PICU of the Namık Kemal University School of Medicine between January 2012 and August 2016 were included in the study.The necessary data were collected retrospectively by analysing the records of cases. Age, gender, poisoning effect, location and cause, application to hospital and treatment methods were evaluated. Data were evaluated using descriptive methods and chi-square test, statistical differences of p <0.05 were considered significant. Results: For the study, the files of 172 patients aged from 6 months to 18 years (mean 6.61 ± 5.36 years) were scanned; 113 (65.70 %) cases were female, 59 (34.30 %) were male. A high proportion (52 %) of intoxication cases were between 0 and 4 years of age. Most poisonings occurred at home (91.90 %) via the oral route (95.90 %). The season in which poisonings were most seen was summer. In 70.30 % of cases, the reason for intoxication was accidentally. 98 % of cases that were intoxicated as a result of a suicide attempt were girls. The most common substance for intoxication was drugs (78.60 %), followed by corrosives (10.80 %) and cleaning substances (3.80 %). Antidepressant drugs were the most common drug group (25.85 %) that caused intoxication. There was no report of mortality in those 172 acute childhood poisoning cases. Conclusion: The most frequent occurrence of poisonings in children between one and six years of age indicates how important it is for families to be trained. In our region, both accidental and suicidal poisonings were more common in girls. It is noteworthy that the poisonings that developed especially after the accident were seen more in girls in this region than in the literature. We believe that extensive research and training of families to prevent childhood poisoning will be effective in reducing mortality and morbidity

Retrospective Analysis of Acute Poisoning Cases in Pediatric Intensive Care Unit in Thrace Region

Amaç: Bu çalışmadaki amacımız, Trakya bölgesinde çocuk yoğun bakım ünitesinde takip ve tedavileri yapılan zehirlenme vakalarının özelliklerini belirlemek ve önlemlerin alınmasına rehberlik etmektir.Gereçler ve Yöntem: Namık Kemal Üniversitesi Tıp fakültesi hastanesi çocuk yoğun bakım ünitesinde Ocak 2012-Ağustos 2016 tarihleri arasında zehirlenme nedeniyle takip ve tedavi edilmiş çocuklar çalışmaya dahil edildi. Bilgiler hasta kayıtları geriye dönük taranarak toplandı. Yaş, cinsiyet, zehirlenme etkeni, yeri ve nedeni, hastaneye başvuru şekli ve tedavi yöntemleri değerlendirildi. Veriler tanımlayıcı yöntemler ve ki-kare testi kullanılarak değerlendirildi; p değeri <0.05 olan istatistiksel farklılıklar anlamlı kabul edildi.Bulgular: Yaşları 6 ay-18 yaş arasında olan 172 hastanın kayıtları retrospektif olarak tarandı, 113 (%65,70) hasta kız, 59 (%34,30) hasta erkekti ve ortalama yaşları 6,61±5,36 yaş arasındaydı. Zehirlenme vakalarının büyük çoğunluğu (%52) 0-4 yaş arasında bulundu. Çoğu vakada (%91,90) zehirlenme evde ve oral yol ile (%95,90) gerçekleşmişti. Mevsimlere göre bakıldığında zehirlenme vakalarının birçoğu yaz ayında meydana gelmişti. Zehirlenme nedenlerine bakılacak olursa %70,30’ü kaza sonucu meydana gelmişti, intihar amacı ile oluşan zehirlenmelerin %98’i kız çocuklarındaydı. Zehirlenmeler en sık ilaçlar ile gerçekleşmiş (%78,60), ikinci en sık neden korozif maddeler (%10,80) ve vakaların %3,80’inde temizlik maddeleri takip etmekteydi. İlaçlar arasında antidepresanlar en sık (%25,85) zehirlenme etkeni olarak bulundu ve akut zehirlenme nedeni ile takip edilen 172 hastada ölüm bildirilmedi.Sonuç: Zehirlenmelerin en sık 0-4 yaş arası çocuklarda görülmesi ailelerin bu konuda eğitilmelerinin ne kadar önemli olduğunu göstermektedir. Bölgemizde hem kaza sonucu hem de intihar amaçlı gelişen zehirlenmeler kız çocuklarda daha fazla görülmüştür. Özellikle kaza sonucu gelişen zehirlenmelerin literatürden farklı olarak bu bölgede kız çocuklarda daha fazla görülmüş olması dikkat çekicidir. Çocukluk çağı zehirlenmelerinin önlenmesinde, kapsamlı araştırmalar yapılması ve ailelerin eğitilmesinin mortalite ve morbiditenin azaltılmasında etkili olacağı inancındayız.Objective: The aim of this study is to determine the properties of intoxication cases in Thrace region that were followed-up and treated in Pediatric İntensive Care Unit (PICU) and to be a guide for precautions. Material and Methods: Children who were hospitalised in PICU of the Namık Kemal University School of Medicine between January 2012 and August 2016 were included in the study.The necessary data were collected retrospectively by analysing the records of cases. Age, gender, poisoning effect, location and cause, application to hospital and treatment methods were evaluated. Data were evaluated using descriptive methods and chi-square test, statistical differences of p <0.05 were considered significant. Results: For the study, the files of 172 patients aged from 6 months to 18 years (mean 6.61 ± 5.36 years) were scanned; 113 (65.70 %) cases were female, 59 (34.30 %) were male. A high proportion (52 %) of intoxication cases were between 0 and 4 years of age. Most poisonings occurred at home (91.90 %) via the oral route (95.90 %). The season in which poisonings were most seen was summer. In 70.30 % of cases, the reason for intoxication was accidentally. 98 % of cases that were intoxicated as a result of a suicide attempt were girls. The most common substance for intoxication was drugs (78.60 %), followed by corrosives (10.80 %) and cleaning substances (3.80 %). Antidepressant drugs were the most common drug group (25.85 %) that caused intoxication. There was no report of mortality in those 172 acute childhood poisoning cases. Conclusion: The most frequent occurrence of poisonings in children between one and six years of age indicates how important it is for families to be trained. In our region, both accidental and suicidal poisonings were more common in girls. It is noteworthy that the poisonings that developed especially after the accident were seen more in girls in this region than in the literature. We believe that extensive research and training of families to prevent childhood poisoning will be effective in reducing mortality and morbidity