Biomedical subjects

Orhan Derman

Publications and source records attributed to Orhan Derman.

25 records · Page 2Linked to original sources

PubMedDate not supplied

Refeeding problems in a severe anorexia nervosa case.

Anorexia Nervosa (AN) is an eating disorder of puberty or adolescence. It is characterized by self-induced weight loss; various psychological disturbances including distorted body image, fear of obesity, active pursuit of thinness and loss of recognition of a number of body enteroreceptive sensations; and secondary physiological abnormalities. The treatment of AN includes individual psychotherapy, family therapy, and nutritional rehabilitation. Hospital treatment is required when the patient's medical condition is in danger due to hypovolemia or hypotension. If cardiac arrhythmias occur without electrolyte disturbances or if oral therapy fails, nutrition should be repleted by the safest method available. This can be done by nasogastric tube or intravenous hyperalimentation. The management of AN is challenging, because the treatment process and anticipated outcome is in direct conflict with the sufferer's own wishes. A comprehensive treatment plan including both psychiatric and medical approaches is necessary. We report a severe AN case, who has refeeding problems after a three months' hospitalisation period. She was admitted to the child intensive care unit due to deterioration of her vital signs. We tried to solve her problems as a team, and believe that AN has a number of crucial problems thus requiring a multi-faceted treatment approach.

Adolescent↗

PubMedDate not supplied

Coagulation disorders as the cause of menorrhagia in adolescents.

This study was undertaken to assess the frequency of coagulation disorders as a cause of menorrhagia in adolescents. A retrospective chart review was conducted of all adolescents with menorrhagia admitted to the Adolescent Unit of Ihsan Doğramaci Childrens Hospital of Hacettepe University Faculty of Medicine in Ankara, Turkey from May 1999 to April 2002. 47 admissions for menorrhagia were identified, 44 were dysfunctional uterine bleeding due to anovulation, while a primary coagulation disorder was found in three patients. Two had Von Willebrand disease and one factor 11 deficiency. We suggest that pediatricians, gynecologists and other adolescent health care providers should be aware of the primary coagulopathy as a cause of menorrhagia in adolescence.

Adolescent↗

PubMedDate not supplied

Iron deficiency anemia in a group of Turkish adolescents: frequency and contributing factors.

Need for iron increases rapidly during adolescence. In girls, this is primarily due to the beginning of menstruation and dieting to loose weight, while in boys increased erythropoetic activity during pubertal period is the major cause. Between November 1999 and June 2000, 2,900 patients, between 9-17 years of age were screened for the presence of anemia in our Adolescent Outpatient Clinic. Tanner's scale of sexual maturation was used to categorize genital development. Those patients diagnosed with anemia were further examined for bone age, history of pica, parasitosis and gastrointestinal symptoms. Complete blood count showed anemia in 44 patients. Twenty one patients (15 girls and 6 boys) were diagnosed with iron deficiency anemia, 19 (15 girls and 4 boys) were diagnosed with anemia associated with infections, 3 (two girls and one boy) were carriers for beta-thalasemia and one girl had acute myeloblastic leukemia. Laboratory parameters alone were not enough in the diagnosis of iron deficiency, but age, sex, growth rate and sexual maturation stage in the pubertal period must be taken into consideration. We suggest that the reason for the lower rate of iron deficiency anemia in our patients, than expected for this age group, could be due to our patient population being more aware and careful about a balanced diet compared to the feeding behaviour of the general population in Turkey. Further studies that include lower socio-economic groups are necessary to conclude the prevalance of iron deficiency anemia among adolescents.

Adolescent↗

PubMedDate not supplied

Measles seroprevalence of an adolescent population vaccinated with a single dose of measles vaccine before their first birthday.

This study determined the age-specific measles seroprevalence of an adolescent population in Ankara vaccinated with a single dose of measles vaccine before their first birthday. The study sample included 440 adolescents (227 female, 213 male) aged 9-16 years admitted to the Adolescent Outpatient Clinic of Hacettepe University Faculty of Medicine. For each participant, a questionnaire was completed and measles specific IgG antibodies screened quantitatively by the enzyme linked immunosorbent assay. Of the 440 subjects screened for measles antibodies, 114 (25.9 %) were seronegative. Measles seronegativity according to sex and age groups were, 32.6, 24.7, 13.3% in females and 29.5, 30.1, 6.3% in males in the age groups of 9-11, 12-14, 15-16 years, respectively. In countries where the two dose vaccination schedule against measles has not been incorporated to the national immunization program, the adolescent health maintenance visit at age 11-12 years should serve as an opportunity to evaluate vaccination status and administer MMR vaccine to all adolescents who have not received two doses at the recommended ages.

Adolescent↗

PubMedDate not supplied

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

This study aimed to detect the age-specific mumps seroprevalence of an unvaccinated population of adolescents in Ankara, Turkey and to compare the prevaccination epidemiology of mumps with those of some other countries. Four hundred and forty adolescents (227 females, 213 males) aged 9 - 16 years who were admitted to the Adolescent Unit were included in this study. For each participant, a questionnaire was completed and mumps-specific IgG antibodies were screened quantitatively by enzyme-linked fluorescent assay. Of the 440 patients screened for mumps antibodies, 48 (10.9%) were seronegative. Mumps seronegativity according to sex and age groups were 13.6, 9.9, and 10.4% in females and 18, 10.2, and 6.2% in males in the age groups of 9 - 10, 11 - 13, and 14 - 16, respectively. Mumps immunization models similar to those of European countries might be acceptable for Turkey, but since a low vaccination coverage may shift mumps infection to older ages, mumps immunization of adolescents is important until a national mumps vaccination program with a high coverage could be sustained. The routine health supervision visit at ages 11 to 12 years is an ideal time to immunize unvaccinated adolescents.

Adolescent↗

PubMedDate not supplied

Correlation of sex steroids with IGF-1 and IGFBP-3 during different pubertal stages.

Insulin-like growth factor 1 (IGF-1) is the major factor that affects linear bone growth. Also, androgens and estrogens are necessary for increasing longitudinal bone growth during sexual maturation. The aim of this study was to investigate the relationships among IGF-1 axis and sex steroids during pubertal development in healthy adolescents. In this cross-sectional study, IGF-1, IGF binding protein-3 (IGFBP-3) and sex steroid levels (estradiol in girls, testosterone in boys) of 205 healthy adolescents (101 female, 104 male) aged 9-17 years were measured. All subjects were apparently healthy, with no growth retardation and with skeletal ages appropriate for chronological ages, and none were taking medications known to influence calcium homeostasis. Greulich and Pyle's Radiographic Atlas of Skeletal Development of the Hand and Wrist was used for determination of skeletal ages. Tanner's classification was used to determine the pubertal developmental stage. Fasting blood samples were obtained from subjects between 09:00-10:00 h. Serum IGF-1 and IGFBP-3 levels differed significantly between pubertal developmental stages. Serum IGF-1 levels and IGF-1/IGFBP-3 ratios increased with proceeding stages and maximum mean values were found at stages III-IV in girls and at stage IV in boys. Estradiol levels of girls and testosterone levels of boys differed significantly between stages, and in both sexes, serum IGF-1 levels and IGF-1/IGFBP-3 ratios were significantly correlated with sex steroid levels. Increase in growth hormone secretion increases IGF-1 levels. Furthermore, increasing sex steroids with pubertal development increase the IGF-1 levels and IGF-1/IGFBP-3 ratios that affect bone growth.

Adolescent↗

PubMedDate not supplied

The evaluation of desmopressin in treatment of adolescent nocturnal enuresis.

This study was designed to determine the effectiveness of desmopressin in the treatment of adolescent nocturnal enuresis and factors that may predict responsiveness. Eighteen adolescents (14 boys, 4 girls) with monosymptomatic nocturnal enuresis were treated with oral desmopressin for three months, starting with 0.2 mg at night and controlling the symptoms every two weeks. After this period, desmopressin was used every other day and the dose was reduced gradually. The treatment was completed at the end of six months. As factors that may predict response before treatment, a range of variables (family history of enuresis, educational levels of parents, number of children, first child in family, birth weight) and urine osmolality was evaluated. Disappearance of bedwetting by using desmopressin has been observed in adolescents who have a high urine osmolality. We did not observe any relapse during reducing desmopressin dose gradually, but on complete cessation of the treatment, relapses were seen. Six months after the end of the therapy, we could not find any patient who recovered completely. Desmopressin seems to be effective in the treatment of primary nocturnal enuresis while on therapy but during the long-term follow-up, all cases relapsed.

Administration, Oral↗