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Biomedical subjects

Orhan Derman

Publications and source records attributed to Orhan Derman.

At least 19 recordsLinked to original sources
PubMed2006

The relationships between dental age, chronological age and bone age in Turkish adolescents with constitutional delay of growth.

The aim of this study was to investigate the relationships between dental age and bone age in Turkish adolescents with constitutional delay of growth and compare them with a group of normal, healthy adolescents. Left hand and wrist radiographs and dental panaromic radiographs of 33 adolescents (25 boys and 8 girls) aged between 10 and 16 years with constitutionally delayed growth were assessed. The control group comprised 41 healthy adolescents (24 boys, 17 girls) aged between 10 and 16 years. Bone age was determined according to Greulich and Pyle; dental age was assessed using the Demirjian method. In the control group, no statistical difference was found between chronological, bone and dental ages. In the group of adolescents with constitutional growth delay, there was no significant difference between chronological age and dental age, but the differences between dental age and bone age and between chronological age and bone age were found to be statistically significant. It was found that Demirjian's dental age assessment is a valid method for scoring dental age in Turkish adolescents. Adolescents with constitutional delay of growth had dental maturation appropriate for chronological age, but not for bone age.

Adolescent↗
PubMed2005

The relationships between pubertal development, IGF-1 axis, and bone formation in healthy adolescents.

As IGF-1 is the major factor that affects bone growth, and both osteocalcin and bone-specific alkaline phosphatase are important markers of bone formation during puberty, there must be a relationship between these markers that does not change according to sex. The aim of this study was to investigate the relationships between pubertal development, the IGF-1 axis, and bone formation in healthy adolescents. Two hundred and five healthy children and adolescents were included in this cross-sectional study. Tanner's classification was used to determine the pubertal developmental stage. Serum IGF-1 levels and IGF-1/IGFBP-3 ratios increased with advancing pubertal stages, and maximum mean values were found at stages III-IV in girls and at stage IV in boys. Serum IGF-1 and IGFBP-3 levels were significantly correlated with osteocalcin and bone-specific alkaline phosphatase levels in boys, but not in girls. This difference between the sexes, and the relation of the IGF-1 axis to increased bone formation during puberty in both sexes, can be explained by the rate of increase of the IGF-1/IGFBP-3 ratio. We conclude that the timing of the increased bone formation rate during puberty; that is, the timing of the pubertal growth spurt, is determined by the maximum increase rate of the IGF-1/IGFBP-3 ratio. But this new hypothesis needs to be supported by longitudinal studies.

Adolescent↗
PubMed2005

Occupational asthma in apprentice adolescent car painters.

Occupational asthma (OA) is one of the leading causes of pulmonary diseases and has been extensively studied in adults. Childhood employment, a significant problem in many developing countries, should be studied to determine and evaluate its effects on psychosocial and lung health. In order to investigate the presence of work-related asthma-like symptoms and OA in apprentice adolescent car painters, 72 adolescents between the ages of 15-20 yr studying in Vocational Training Centres of Ankara were investigated using questionnaire, pulmonary function test (PFT), serial peak expiratory flow (PEF) measurements and methacholine inhalation tests. As a control group, 72 adolescents studying in Industrial and Commercial Training Centres located in the same environment were investigated with questionnaire and PFT. Almost 50% of the study group had work-related asthma-like symptoms for which occupational dermatitis history was predictive [odds ratio: 2.9 (1.026-8.13) (95% confidence interval)]. Seventeen of 22 with serial PEF measurements showed a variability of > or =20% and three (4.2%) of 12 tested with methacholine inhalation test had a PC20 < or = 8 mg/ml, which led to the diagnosis of OA. There was no statistically significant difference between study and control groups in terms of PFT. In conclusion, the high prevalence of work-related asthma-like symptoms among adolescent car painters clearly indicates the need for routine follow-up of adolescent workers for lung health.

Adolescent↗
PubMed2005

Psychiatric symptoms of adolescents with physical complaints admitted to an adolescence unit.

SUMMARY: The aim of this study was to evaluate the psychiatric symptoms among adolescents who were seen in the outpatient clinic for their physical complaints. Two hundred and ninety adolescent outpatients (154 males and 136 females) between 13 and 17 years of age (mean 14.3+/-1.2) are included in this study. Patients with known psychiatric disorders, mental retardation, organic brain diseases, or chronic organic problems were excluded. The Brief Symptom Inventory, which measures the psychiatric symptoms under the categories of anxiety, depression, negative self, somatization, and hostility, was given to all subjects. Symptoms of urinary and cardiovascular systems were related to hostility. Patients with obesity, hirsutism, problems of external genitalia, enuresis nocturna, abdominal pain, chest pain, and lack of weight gain showed psychiatric symptoms at pathological levels. Hostility symptom was found to be high in all groups.

Adolescent↗
PubMed2005

Evaluation of mandibular bone density to predict osteoporosis in adolescents with constitutional delayed growth.

OBJECTIVE: The aim of this study is to evaluate the correlation between constitutional delayed growth (CDG) and mandibular bone trabeculation as well as bone density on panoramic radiographs using a computer software program. METHODS: Panoramic radiographs obtained from 25 patients with CDG and 25 healthy adolescents were evaluated for this study. Patients were selected from admission to Hacettepe University, Faculty of Medicine, Section of Adolescent Medicine in the first half of the year 2002. All panoramic radiographs were taken under standard conditions, and were randomized and then converted to digital images for density analysis using a scanner. The images were transferred to Osiris computer software program for the evaluation of bone density from 4 different regions on the mandible (right and left mandibular angle and condyle). RESULTS: The CDG group had higher values for the risk of osteoporosis considering the right (t=3.360, p=0.002) and the left condyle (t=3.620, p=0.001) (t-test for independent samples). It was also seen that the CDG group was again at higher risk in comparison to the control group when left mandibular angle values were measured (z=-2.447, p=0.014) (Mann Whitney-U test). CONCLUSION: We suggest that panoramic radiographs, which are transformed into digital format, can be valuable and economic tools for detecting the risk of osteoporosis in adolescents with CDG.

Adolescent↗
PubMed2004

Premenstrual syndrome and associated symptoms in adolescent girls.

OBJECTIVE: To investigate the frequency of premenstrual syndrome (PMS) associated symptoms and effects of nutrition on PMS in adolescent girls. PATIENTS AND METHODS: One hundred and seventy-one adolescent girls who had menstrual cycles were included in this study. They were given a questionnaire on criteria for PMS, dysmenorrhea and regularity of menstrual cycle. Modified Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria were used for the diagnosis of PMS. We also investigated which nutritional supplements affect the PMS-associated symptoms and signs. RESULTS: One hundred and five adolescent girls out of 171 (61.4%) met DSM-IV criteria for PMS. There was an association between dysmenorrhea and PMS in 60 (57.1%). Half of the girls, i.e. 52 (49.5%) had mild, 39 (37.1%) had moderate and 14 (13.4%) had severe PMS. The most common symptom of PMS was negative affect particularly in the form of stress (87.6%) and nervousness (87.6%). There was a statistically significant negative relationship between milk consumption and the following: abdominal bloating, cramps, craving for some foods and increased appetite. CONCLUSION: PMS and dysmenorrhea are frequently overlapping. We also found that PMS is associated with dietary habits.

Adolescent↗
PubMed2004

Diastematomyelia: a case with familial aggregation of neural tube defects.

Intrauterine neural tube defects, meningomyelocele, and diastematomyelia are developmental errors at different stages of the closure of the neural tube. The familial aggregation of these neural tube defects is not previously reported in the literature and should make one think about a common embryogenesis and a possible common mechanism of etiopathogenesis leading to anomalies at different stages of this embryogenesis. This paper presents a 12-year-old Turkish boy with diastematomyelia who was suspected with a demonstrative dermatologic finding without any neurologic sign and diagnosed with magnetic resonance imaging (MRI). He has a positive family history of a stillbirth with neural tube defect, an exitus with meningomyelocele, and an epileptic child in his female siblings.

Adult↗
PubMed2004

Poland's syndrome and premature ovarian failure.

A 19-year-old female with Poland's Syndrome with associated left amastia, scoliosis, and left Sprengel deformity developed secondary amenorrhea from premature ovarian failure. Her menarche was at 13 years of age, and periods were regular and monthly until 15 years of age when her periods suddenly stopped. Her hormonal evaluation was significant for elevated FSH (46.5 mIU/ml) and LH (28.5 mIU/ml), and low estradiol (23 pg/ml). Anti-ovarian antibody level was less than 2 units (normal < 4 units). Her chromosomes were 46XX, by both standard karyotype and by fluorescence in situ hybridization. On transabdominal and transvaginal ultrasonography, ovaries were not visualized, the uterus was of normal size and anteverted and both kidneys were normal. The patient began hormone replacement therapy with conjugated estrogen (Premarin) 0.625 mg po daily and progestin (Provera) 5 mg on days 20 to 25. Because of menopausal symptoms, she was switched to a combination oral contraceptive (OC) with 20 mcg ethinyl estradiol that was eventually increased to 30 mcg. Her menopausal symptoms (hot flashes and sweating) improved on the continuous 30 mcg ethinyl estradiol combination OC. Following a comprehensive review of the literature, this is the first reported case of Poland's Syndrome associated with premature ovarian failure; however, this association may be coincidental.

Adult↗
PubMed2004

The effect of tamoxifen on sex hormone binding globulin in adolescents with pubertal gynecomastia.

We investigated the relationship between sex hormone binding globulin (SHBG) and pubertal gynecomastia in 21 adolescents evaluated longitudinally. Thirteen patients were given tamoxifen treatment after grading according to the Nydick classification (group 1). Group 2 consisted of eight patients followed without treatment. Gynecomastia existed bilaterally in 15 patients. There was a statistically significant breast size reduction in both groups. There was a significant decrease in serum SHBG only in group 2. These findings suggest that serum SHBG is increased by tamoxifen treatment in male adolescents. There was a decrease in SHBG levels through the duration of follow up in patients who recovered with or without treatment. However, this decrease was statistically significant in the untreated group, but not in the tamoxifen treated group. In conclusion, we suggest that the pubertal fall in SHBG levels is attenuated by tamoxifen treatment given for pubertal gynecomastia since tamoxifen increases SHBG levels in male adolescents.

Adolescent↗
PubMed2003

Age specific rubella seroprevalence of an unvaccinated population of adolescents in Ankara, Turkey.

This study was designed to detect the age-specific rubella seroprevalence of an unvaccinated population of adolescents in Ankara, Turkey. Four hundred and forty adolescents (227 females, 213 males), aged 9-16 years, who were admitted to the Adolescent Unit from July to August 2000 were included in this study. For each participant, a questionnaire was completed and rubella-specific IgG antibodies were screened quantitatively by enzyme-linked fluorescent assay. Of the 440 patients screened for rubella antibodies, 32 (7.3%) were seronegative. Rubella seronegativity values according to sex and age groups were as follows: 15.3, 6.6, and 1.3% in females, and 12.0, 6.1, and 6.2% in males, in the age groups of 9-10, 11-13, and 14-16 years, respectively. The routine health supervision visit recommended between the age of 11 and 12 is an ideal time to immunize unvaccinated adolescents.

Adolescent↗
PubMedDate not supplied

A pediatric patient with recurrent pseudotumor cerebri and vitamin B12 deficiency.

Pseudotumor cerebri is a syndrome of increased intracranial pressure, normal cerebrospinal fluid values, and a normal cerebral ventricles on brain imaging studies. A patient with a diagnosis of pseudotumor cerebri was admitted to the authors' hospital twice within a 2.5-year interval and treated with vitamin B12 (vit-B12). At the second admission she also presented with a cerebral venous thrombosis that might have been explained by vit-B12 deficiency, homocysteinemia, and an increased level of lipoprotein-a.

Adolescent↗
PubMedDate not supplied

The influence of the sexual stages of adolescent boys on the circumference of the arm, muscle area and skinfold measurements.

The purpose of this study was to detect the changes in the circumference of the arm, skinfold thickness (SFT), arm muscle area (AMA) and arm fat area (AFA), during the sexual development of healthy adolescent boys. This study was done with 74 adolescent boys, aged 9-17 years, with no chronic diseases, no developmental delay, no current medication with height ages appropriate for their bone ages, and body mass indexes between 50-75 percentiles. Body weight and height, the circumference of the arm and the SFT were measured. Body mass index, AMA and AFA were calculated. The mean arm circumference and AMA increased significantly from Tanner stage 1 to 5. AMA was significantly and positively correlated with age, weight, height, body mass index, arm circumference, SFT. After adjusting for Tanner stages, AMA was not correlated with age. A significant negative correlation was found between AMA and arm fat area. In the present study, it was seen that the sexual stages affected the circumference of arm, AMA, and the skinfold thickness in healthy adolescent boys, who were appropriate for their bone ages, and had good nutritional status. Further studies are required to detect the effect of pubertal stage on arm anthropometry in different nutritional status including obesity and malnutrition.

Adolescent↗
PubMedDate not supplied

Prevalence of obesity in adolescents and the impact of sexual maturation stage on body mass index in obese adolescents.

OBJECTIVE: Puberty is a high-risk period for the development of obesity. The aim of this study was to determine the prevalence of obesity in adolescents admitted to an outpatient adolescent clinic and investigate the relationships between the increase of body mass index and sexual maturation stages in obese adolescents. MATERIAL AND METHODS: We recruited 6,462 adolescents, aged 9-16 years, admitted to the outpatient clinic of our Adolescent Unit, between May 1999 and September 2000. BMI was calculated as weight per height with weight in kilograms and height in meters. Adolescents with a BMI > or = 95th percentile for age and sex were defined as obese, with BMI's > or = 90th percentile but < 95th percentile were defined as overweight and considered at risk for obesity. Obese adolescents, with endocrine problems identified to cause obesity, were excluded from this study. Pearson correlation coefficients were used to assess the relationships between BMI and age. The differences between the sexual maturation stages were evaluated with Mann-whitney U Test. RESULTS: Out of 6,462 cases screened, 151 obese adolescents were found. Prevalence of obesity for the total sample surveyed was estimated at 2.3%. BMI values were significantly correlated with age in both sexes. In girls, only the increase of BMI values from stage I to stage II was found to be statistically significant. In boys, BMI values did not differ significantly between the sexual maturation stages but the number of obese cases were high in stages I and II. DISCUSSION AND CONCLUSION: The pubertal growth spurt (timing determined by sexual maturation stage) effects the amount of fat accumulation and the distribution of fat in different ways in boys and girls. So, not only the age and sex but also the sexual maturation stage has to be taken into account while evaluating the BMI values for investigating the risk of obesity in puberty.

Adolescent↗
PubMedDate not supplied

The importance of the measurement of the circumference of arm, arm muscle area and skinfold thickness during puberty.

Several methods are available to study lean and adipose tissue component of the upper arm, but the use of a specific technique is mostly determined by time and financial expense. Besides, anthropometric techniques (arm muscle area, mid-arm circumference and the triceps skinfold thickness), which are the most practical, simple, inexpensive and noninvasive, x-ray, ultrasound scanning, computed tomography (CT), or magnetic resonance images (MRI) are also used to determine separate measures of muscles, adipose tissue, and bone area. These radiographic methods are expensive and suitable only for research studies. This short review will try to stress the importance of the measurement of the circumference of arm, arm muscle area and skinfold thickness during puberty and adolescence.

Adolescent↗
PubMedDate not supplied

Osteocalcin. A biochemical marker of bone turnover during puberty.

During bone remodelling, osteocalcin is produced by osteoblasts and its level increases during the events characterized by rapid bone turnover. Osteocalcin is a bone matrix protein, which is specific for bone metabolism and it is not influenced by metabolic bone disorders. Osteocalcin is an important marker of bone turnover in physiological and pathological conditions. Physiologically, serum osteocalcin was increased in children, particularly during the first year of life and during puberty, when evolution of the concentration was related to rapidity of physical growth. Evidence of a correlation with growth rates comes from the observation that serum osteocalcin levels parallel the height velocity curve, with higher values in childhood and during adolescence, that later fall to adult values. There are previous studies reporting that there is age- and sex-dependent change in serum osteocalcin levels in children and adolescents with a pattern resembling height velocity curves for children and serum osteocalcin elevation coincides with the pubertal growth spurt. These findings demonstrate that pubertal development and sex should be taken into account rather than chronological age when serum levels of osteocalcin are evaluated. In most of the studies relationships among osteocalcin and chronological age and bone age, but not pubertal developmental stage (sexual maturation stage) were investigated. The aim of our study was to determine whether osteocalcin is a useful marker for the pubertal growth spurt period. In this study, osteocalcin levels in male adolescents were examined in relation to their sexual maturation stage and age. According to our findings, the follow up of osteocalcin levels in relation to sexual maturation stages could be a new method to determine the phase of the pubertal growth spurt. An increase or decrease in osteocalcin levels on consecutive measurements may indicate the child's entering accelerated or decelerated stages of the growth spurt, respectively. We emphasize that the follow up of adolescent growth is made by determination of the sexual maturation stage, and not by age. Osteocalcin is a highly specific, reliable and useful marker for evaluation of the growth spurt and is not influenced by nonosseous disorders.

Adolescent↗
PubMedDate not supplied

Menorrhagia at menarche: a case report.

Dysfunctional uterine bleeding is defined as abnormal endometrial bleeding without any underlying disease. It is particularly a common problem for adolescents and a majority are caused by immature hypothalamic-pituitary-ovarian axis. Usually, it presents as minor alterations of the cycle flow length, but occasionally can be severe enough to require hospitalization. A 12 year-old girl with menorrhagia at menarche was admitted to our Adolescent Unit. She had heavy bleeding for 16 days causing a hemoglobin level of 5.5 gr/dl. She was first treated with blood transfusion and hemostasis was achieved rapidly through high doses of combination oral contraceptives. Whenever menorrhagia occurs at menarche, it is important to exclude an underlying hematologic disease. If there is no response to hormonal therapy in 48 hours there is a need for reevaluation of coagulopathy. In this report, we show how an acute and heavy anovulatory bleeding episode can be controlled and followed-up in an adolescent girl.

Acute Disease↗
PubMedDate not supplied

Tamoxifen treatment for pubertal gynecomastia.

We evaluated the efficacy of the tamoxifen treatment in 37 patients with pubertal gynecomastia. All had distinct, easily palpable breast swellings with a diameter of over three cm. Pain, tenderness, and swelling associated with gynecomastia were reported by six patients. Eight of the patients were obese. One patient also suffered from varicocele. Pain and size reduction was seen in all patients with tamoxifen treatment. No long-term side effects of tamoxifen were observed. The dose of tamoxifen was increased in three patients due to poor response. Two of the treatment group had recurrence problem at follow-up. We did not need to refer any patient to surgery. Tamoxifen treatment is relatively non-toxic, may be beneficial and we think it should be considered for pubertal gynecomastia.

Adolescent↗