9 research outputs found
Clinical and Laboratory Characteristics of Hyperprolactinemia in Children and Adolescents: National Survey
Conclusion: We present the largest cohort of children and adolescents with hyperprolactinemia in the literature to date. Hyperprolactinemia is more common in females and cabergoline is highly effective and practical to use in adolescents, due to its biweekly dosing. Indications for surgery in pediatric cases need to be revised
Effect of Telehealth System on Glycemic Control in Children and Adolescents with Type 1 Diabetes
Objective: A close diabetes team-patient relationship is required for
establishing satisfactory metabolic control. The purpose of this study
was to investigate the effect of a telehealth system on diabetes
control.
Methods: The study was carried out between June 2015 and January 2016 at
the Gazi University Faculty of Medicine, Pediatric Endocrinology
Department. The telehealth system was developed by the diabetes team.
The demographic characteristics, frequency of use and hemoglobin A1c
(HbA1c) changes of type 1 diabetic (T1DM) patients using this
communication network were analysed.
Results: Eighty two patients {[}43 (52.4\%) females, mean (+/- standard
deviation) age 10.89 +/- 4 years] used the telehealth system. Fourteen
(17.1 \%) of the cases were on pump therapy and 59 (72.0 \%) were
counting carbohydrates. The individuals with diabetes or their families
preferred WhatsApp communication. Whatsapp provided a means for instant
messaging in most instances (57.3 \%), contact with diabetes education
nurse (32.9\%) and consultation with the diabetes team about insulin
doses and blood glucose regulation (42.7 \%). HbA1c values after six
months were significantly lower in patients/parents calling frequently
(p <0.001) compared with HbA1c values recorded at the beginning of the
study.
Conclusion: Increase in frequency of counselling by the diabetes team
led to improved blood glucose control in T1DM patients. A telehealth
system is useful for early detection of the need for changes in
treatment and for intervention. It also promoted better self care
A Synopsis of Current Practice in the Diagnosis and Management of Patients with Turner Syndrome in Turkey: A Survey of 18 Pediatric Endocrinology Centers
Objective: A comprehensive survey was conducted to evaluate the
shortcomings of clinical care in patients with Turner syndrome (TS) in
Turkey.
Methods: A structured questionnaire prepared by the Turner study group
in Turkey, which covered relevant aspects of patient care in TS was sent
to 44 pediatric endocrinology centers.
Results: Eighteen centers (41\%) responded to the questionnaire. In the
majority of the centers, diagnostic genetic testing, screening for Y
chromosomal material, protocols regarding the timing and posology of
growth hormone (GH) and estrogen, thrombophilia screening, fertility
information and screening for glucose intolerance, thyroid, and coeliac
diseases in patients with TS were in line with the current consensus.
Thirteen centers (72.2\%) performed GH stimulation tests. Only four
centers (22.2\%) used oxandrolone in patients with TS with very short
stature. The majority of the centers relied on bone age and breast
development to assess estrogen adequacy, though together with variable
combinations of oestrogen surrogates. Two centers (11.1\%) reported
performing serum estradiol measurements. Eight centers (44.4\%)
routinely conducted cardiac/thoracic aorta magnetic resonance imaging.
Screening for hearing, dental and ophthalmologic problems were performed
by thirteen (72.2\%), six (33.3\%) and ten (55.6\%) centers,
respectively. Psychiatric assessments were made by four centers (22.2\%)
at diagnosis, with only one center (5.6\%) requiring annual
reassessments.
Conclusion: Although we found some conformity between the current
consensus and practice of the participating centers in Turkey regarding
TS, further improvements are mandatory in the multi-disciplinary
approach to address co-morbidities, which if unrecognized, may be
associated with reduced quality of life and even mortality
CLINICAL AND LABORATORY CHARACTERISTICS OF HYPERPROLACTINEMIC CHILDREN AND ADOLESCENTS: NATIONAL SURVEY
CLINICAL AND LABORATORY CHARACTERISTICS OF HYPERPROLACTINEMIC CHILDREN AND ADOLESCENTS: NATIONAL SURVEY
CLINICAL AND LABORATORY CHARACTERISTICS OF HYPERPROLACTINEMIC CHILDREN AND ADOLESCENTS: NATIONAL SURVEY
Clinical and Laboratory Characteristics of Hyperprolactinemia in Children and Adolescents: National Survey
Objective: We aimed to report the characteristics at admission,
diagnosis, treatment, and follow-up of cases of pediatric
hyperprolactinemia in a large multicenter study.
Methods: We reviewed the records of 233 hyperprolactinemic patients,
under 18 years of age, who were followed by different centers. The
patients were divided as having microadenomas, macroadenomas,
drug-induced hyperprolactinemia and idiopathic hyperprolactinemia.
Complaints of the patients, their mode of treatment (medication and/or
surgery) and outcomes were evaluated in detail.
Results: The mean age of the patients with hyperprolactinemia was 14.5
years, and 88.4\% were females. In terms of etiology, microadenomas were
observed in 32.6 \%, macroadenomas in 27 \%, idiopathic
hyperprolactinemia in 22.7\% and drug-induced hyperprolactinemia in 6.4
\%. Other causes of hyperprolactinemia were defined in 11.3\%. Common
complaints in females (n = 206) were sorted into menstrual
irregularities, headaches, galactorrhea, primary or secondary amenorrhea
and weight gain, whereas headache, gynecomastia, short stature and
blurred vision were common in males (n = 27). Median prolactin levels
were 93.15 ng/mL, 241.8 ng/ml, 74.5 ng/mL, 93.2 ng/mL, and 69 ng/mL for
microadenomas, macroadenomas, idiopathic hyperprolactinemia,
drug-induced hyperprolactinemia, and other causes of hyperprolactinemia,
respectively. Of 172 patients with hyperprolactinemia, 77.3 \% were
treated with cabergoline and 13.4 \% with bromocriptine. 20.1 \% of the
patients with pituitary adenomas underwent pituitary surgery.
Conclusion: We present the largest cohort of children and adolescents
with hyperprolactinemia in the literature to date. Hyperprolactinemia is
more common in females and cabergoline is highly effective and practical
to use in adolescents, due to its biweekly dosing. Indications for
surgery in pediatric cases need to be revised