2021 Cilt 19 Sayı 3

Permanent URI for this collectionhttps://hdl.handle.net/11452/27894

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Analysis of new biomarkers for the diagnosis of polycystic ovary syndrome in adolescents
(Galenos Yayıncılık, 2021-10-28) Tunç, Selma; Özkan, Behzat
Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine problem with complex diagnosis in adolescents. Therefore, it is important to identify reliable biomarkers that can be used in the diagnosis of PCOS in adolescents. To investigate the diagnostic value of anti-Müllerian hormone (AMH) and inhibin-A (INH-A) and insulin-like peptide-3 (INSL3) in adolescents with PCOS, and to explain the relationship between these hormones and the clinical / laboratory findings of hyperandrogenism. Materials and Methods: Fifty-five girls aged 15-20 years who were diagnosed with PCOS were included in the present study. The control group consisted of healthy adolescents who had regular menstrual cycles for at least two years and were compatible with the study group according to age and body mass index (BMI). The hormonal profile was assessed in the PCOS and control group. Transabdominal pelvic ultrasonography was performed only in the PCOS group. Results: AMH and INH-A levels were found to be significantly higher in the PCOS group than control group. While the INSL3 did not correlate with anthropometric or laboratory parameters, AMH level showed a positive correlation with the WC SDS, waist / hip ratio, FAI, LH, fT and INH-A. Moreover, INH-A level showed a positive correlation with WC SDS, LH, LH / FSH ratio, SHBG and AMH. In receiver-operating characteristic analysis, the cut-off value for AMH for the diagnosis of PCOS in adolescents was 5.8 ng / mL that for INH-A was 9.3 pg/mL (the specificity and sensitivity were 86% and 70% and 66% and 82% respectively). When AMH and INH-A were used in combination, the specificity and sensitivity were 74% and 88%, respectively. Conclusion: INH-A and AMH can be used as new biomarkers for the diagnosis of PCOS in adolescents, while INSL3 has no diagnostic value in this regard.
Are indications and findings of upper gastrointestinal system endoscopy changing in children over the years?
(Galenos Yayıncılık, 2021-09-03) Arslan, Melike; Işık, Hilal; Balamtekin, Necati
Introduction: There are few studies of diagnostic endoscopy indications in children, despite the fact that it is a commonly performed procedure. The aim of the present study was to determine the relation between indications for upper gastrointestinal system (GIS) endoscopy and endoscopic and histopathologic findings in children in an effort to minimize unnecessary procedures. Materials and Methods: The hospital files of 501 children and adolescents 1-18 years of age who underwent diagnostic upper GIS endoscopy examinations between June 2017 and June 2020 were evaluated retrospectively. Results: The mean age of the 501 patients was 14.5±3.1 years and 311 (62.0%) were female. The most common indications for esophagogastroduodenoscopy (EGD) were epigastric pain (38.7%) and abdominal pain (29.3%) with abnormal endoscopic and histopathologic findings of 88.6% and 92.6%, respectively. The co-detection rates of endoscopic and histologic abnormalities for the esophagus, stomach, and duodenum were 71.8%, 97.6%, and 55.8%, respectively. The most commonly detected endoscopic findings were antral gastritis (66.4%), pangastritis (18.0%), bile reflux (12.6%), and duodenitis (9.4%). The most commonly detected histopathologic findings were chronic gastritis (45.3%), chronic Helicobacter pylori gastritis (37.3%), edematous gastric mucosa (5.4%), coeliac disease (4.4%), and esophagitis (4.4%). No complications were associated with the procedure itself or the required sedation. Conclusion: Diagnostic endoscopy indications may vary between countries and centers. It has been established by many studies that the rates of negative endoscopic procedures and complications associated with EGD are high; therefore, the determination of accurate indications for this procedure is important.
Demographic and laboratory findings of symptomatic and asymptomatic COVID-19 in children
(Galenos Yayıncılık, 2021-10-21) Çelik, Binnaz; Doğan, Murat; İnan, Doğan Bahadır; Sunkak, Süleyman; Saatçi, Esma; Tubaş, Filiz
Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a newly described pathogen that is usually transmitted by droplets between person to person. Although the clinical spectrum of COVID-19 ranges from asymptomatic disease to the development of severe acute respiratory distress, children are generally milder than adults. It was aimed to compare the clinical and laboratory values of symptomatic and asymptomatic children followed up with a diagnosis of COVID-19 in this study. Materials and Methods: The records of children with nasopharyngeal swab SARS-CoV-2 Reverse Transcriptase-Polymerase Chain Reaction test positive were analyzed retrospectively. Children with symptoms such as fever, cough, shortness of breath, diarrhea and/or vomiting were accepted as symptomatic, and children with positive SARS-CoV-2 PCR in a nasopharyngeal swab taken only due to contact history and have no symptoms were considered asymptomatic. Results: A total of 197 patients, 47 (23.8%) symptomatic and 150 (76.2%) asymptomatic, were included in the study. The mean age of the children was 9.1±5.2 years (range, 1 month-17 years). Cough (8.6%) was the most common symptom at admission. When the symptomatic and asymptomatic children were compared in terms of white blood cell (WBC), WBC subgroups, C-reactive protein there was no statistically significant difference. No significant increase was found in the CRP values of symptomatic patients. Ground-glass opacities compatible with COVID-19 was detected in only 10 (30%) of 33 symptomatic patients who underwent thoracic tomography. Conclusion: COVID-19 is usually mild in children. At the same time, a significant change in laboratory parameters and imaging findings may not be observed in symptomatic and/or asymptomatic children with positive SARS-CoV-2 PCR.
The effect of obesogenic environment and socio- demographic characteristics on obesity awareness levels of children
(Galenos Yayıncılık, 2021-08-31) Sarıalioğlu, Arzu; Küçükoğlu, Sibel; Özdemir, Aynur Aytekin; Köse, Semra; Çelebioğlu, Ayda
Introduction: The purpose of the study is to determine the effect of obesogenic environment and sociodemographic characteristics on children’s obesity awareness levels. Materials and Methods: The sample of the study was composed of a total of 540 children studying at the 5 th grade (63), 6 th grade (73), and 7 th grade (79) in the private school and at the 5th grade (131), 6th grade (108), and 7th grade (86) in the public school specified between the dates when the study was conducted. “Descriptive Information Form”, “Obesogenic Environmental Evaluation Form (OEEF)” and “Obesity Awareness Scale (OAS)” were used to collect the data. Results: It was determined that OEEF mean score was higher in children studying in the public school (10.50±2.23) than those studying in the private school (7.77±2.36) and the difference between them was significant. OAS “physical activity” subscale mean score was significantly higher in children studying in the public school. Conclusion: When OEEF and OAS mean scores were examined according to sociodemographic variables, it was found that there was a significant difference between the groups in terms of some variables. It was determined in the study that the children studying in the public school were affected more by the obesogenic environmental conditions and gender increased the obesity awareness level of the children. Within the scope of the fight against obesity, it is recommended to conduct consciousness-raising and awareness programs related to obesogenic environment in all educational institutions primarily in public schools.
Evaluation of thyroid nodules in children and adolescents: Multicenter study in Turkey
(Galenos Yayıncılık, 2021-10-23) Kaplan, Emel Hatun Aytaç; Çakır, Aydilek Dağdeviren; Esen, İhsan; Akbaş, Emine Demet; Bitkin, Eda Çelebi; Akyürek, Nesibe; Özcabı, Bahar; Kılınç, Suna; Kırel, Birgül; Okdemir, Deniz; Evliyaoğlu, Olcay; Keskin, Mehmet
Introduction: Ultrasonography and fine needle aspiration biopsy are reliable diagnostic methods used to predict malignancy in thyroid nodules. They are useful in identifying patients for therapy or preventing unnecessary surgery. Materials and Methods: The aim of this study was to compare clinical and ultrasonographic findings with fine needle aspiration biopsy and histopathological examination results in children with thyroid nodules. Retrospective study. This multicentre study included pediatric patients with thyroid nodules, followed up between July 2002 and November 2019 in nine Turkish Pediatric Endocrinology Units. Clinical, ultrasonographic, cytological and histopathological findings (malignant or benign) were analyzed retrospectively. Fine needle aspiration biopsy findings were classified according to American Thyroid Association criteria. Results: A total of 203 children were included, of whom 82.3% (n=167) were female. Mean±standard deviation age was 14.06±2.26 (range 3.7-19) years. Cytological diagnoses were: non–diagnostic or unsatisfactory 1.9%; benign 59.6%; atypia or follicular lesion of undetermined significance, suspicious for follicular neoplasm in 2.4%; suspicious for malignancy 12.8%; and malignant in 1.9%. Surgery was performed in 59 (29.1%) patients. In total 33 (16.3%) patients were diagnosed with malignancy. In patients with benign fine needle aspiration biopsy results, malignancy was detected in 17.6% when they underwent surgery. Malignancy was present in 44.4% of the patients with cytologically determined atypia or follicular lesion of undetermined significance. The diagnostic accuracy of fine needle aspiration biopsy was 79%. Conclusion: This study is first multicentre study investigating thyroid nodules in children and adolescents in Turkey. In this population fine needle aspiration biopsy has an important role in diagnosis, but ultrasonographic features of nodule should also be taken into consideration. Atypia or follicular lesion of undetermined significance may be of greater clinical significance than has previously been reported.
Patterns of myocardial involvement during COVID-19 pandemic; From newborn to adolescents
(Galenos Yayıncılık, 2021-11-11) Tunçer, Tunç; Varol, Fatih; Coşkun, Şenay; Güzel, Bülent; Güven, Şirin; Çam, Halit
Introduction: Coronavirus 2 (SARS-CoV-2) has infected people of all ages all across the world, with children accounting for 1.7 percent of cases. Despite the fact that over 90% of children with COVID-19 had asymptomatic, mild, or moderate disease, new worries about hyperinflammatory states or Kawasaki-like disease have surfaced. Materials and Methods: We would like to present 17 patients with different patterns of myocardial involvement. They were selected from our database of 214 patients (19 newborns) hospitalized for SARS-CoV-2 infection treatment in our pediatrics clinic from March 2020 to October 2020. Selection criteria involved cardiac involvement in terms of positive laboratory findings (elevated troponin I) electrocardiographic and echocardiographic findings. Results: Cardiac involvement was detected in only 17 (7.9%) of the 214 hospitalized patients. Patients were grouped into three categories according to their hospitalization units which were neonatal intensive care, pediatric intensive care and pediatric inpatient clinic. Most of our patients (88.2%) had elevated troponin I levels whereas 12 patients (70.5%) had abnormal electrocardiograms and echocardiographic exams. Fourteen (82.3%) of patients with high troponin I levels had also abnormal electrocardiograms whereas 13 (76.4%) of them had abnormal echocardiographic exams. Conclusion: Although we did not observe cardiac involvement in most of the patients (92.1%) hospitalized for SARS-CoV-2 infection treatment in our pediatrics clinic, subjects with involvement had quite diverse patterns ranging from only troponin I elevation to the multisystem inflammatory syndrome in children needing arteriovenous extracorporeal membrane oxygenation therapy.
Psychometric and psychosocial evaluation of adolescents with Turner syndrome in a multidisiplinary approach: A preliminary study
(Galenos Yayıncılık, 2021-10-21) Karakök, Burak; Akdemir, Devrim; Yalçın, Sıddıka; Özusta, Hacer Seniz; Utine, Gülen Eda; Doğan, Özlem; Kiper, Pelin Özlem Şimşek; Demir, Gizem Ürel
Introduction: The aim of this study is to compare neurocognitive and psychosocial characteristics in adolescents with Turner Syndrome (TS) and age-matched adolescents with short stature (SS) and normal karyotypes. Materials and Methods: Seven patients with TS and 7 patients with SS and normal karyotypes were included in the study. Their comorbid psychopathologies, cognitive functioning, quality of life, self-esteem, emphatic tendencies, mentalizing abilities and coping strategies were investigated. Results: Although the adolescents with SS had higher levels of anxiety and conduct problems, there were no significant differences between the TS and SS groups in terms of comorbid psychopathologies, social cognition skills, quality of life, self-esteem and coping strategies. However, the cognitive functioning of adolescents with TS was found to be lower than both of the adolescents with SS and community samples. Conclusions: According to this preliminary study, anxiety/conduct problems and cognitive functioning of patients with TS should be evaluated in order to prevent subsequent negative outcomes.
Retrospective evaluation of cases with cow’s milk allergy
(Galenos Yayıncılık, 2021-11-10) Efe, Hülya Poyraz; Canıtez, Yakup; Sapan, Nihat; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Alerjisi Anabilim Dalı.; 0000-0002-2226-7035; 0000-0001-8929-679X; 0000-0002-7601-8392
Introduction: Cow’s milk allergy (CMA) is described as immunological reaction against to one or more milk proteins. It is known that CMA which affects about 1-3% of the general population is the most commonly seen food allergy in infants and children. It is well known that a tolerance develops and prognosis is better during the first three years of the life. In the present study, we aimed to investigate the natural course of cases diagnosed with CMA and to determine the factors which have impact on the tolerance development. Materials and Methods: Medical records of cases who have been followed for CMA were retrospectively reviewed. Gender, age at first symptom, breastfeeding duration, family atopy history, multiple food allergies, concomitant allergic diseases, inhalant allergy sensitivity and clinical manifestation of cases were assessed. Also, prick test results, milk-specific IgE, casein-specific IgE and the reactions that developed during food challenge test were evaluated. Results: The age at first symptom was mean 4±2,3 months. Twenty-two percent of patients had a positive family history of atopy and 30% had multiple food allergies. There were concomitant allergic disorders in 58% of patients. Skin (93.8%), gastrointestinal system (GIS) (24.7%) and respiratory system (18.5%) symptoms were most commonly seen. The percentage of tolerance development by the years was determined as 41% for the first year, 64% for the second year and 75% for the third year. Milk-specific IgE level at the time of diagnosis (p=0.010) and asthma presence (p=0.010) were found significant risk factors for persistent CMA. Conclusion: Clinical parameters and allergy tests may help to predict the prognosis of CMA. Milk-specific IgE level at the time of diagnosis is the risk factor for persistent CMA.

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