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Biomedical subjects

Selim Kurtoglu

Publications and source records attributed to Selim Kurtoglu.

At least 37 records · Page 2Linked to original sources
PubMed2006

Effect of carbamezapine and valproic acid on bone mineral density, IGF-I and IGFBP-3.

OBJECTIVE: To examine the effect of carbamezapine and valproate on bone mineral density (BMD), IGF-I and IGFBP-3 levels in children. METHODS: The effects of at least 2 years valproic acid and carbamazepine therapy on BMD were evaluated in a cross-sectional and retrospective study. All children were ambulatory, prepubertal, and had normal activity and nutritionally adequate diets. Ambulatory epileptic patients were divided into two groups. Thirty-three patients (group 1; 17 boys, 16 girls; mean age: 8.8 +/- 2.0 years) were treated with valproic acid and 33 patients were treated with carbamazepine (group 2; 20 boys, 13 girls; mean age: 9.7 +/- 1.6 years). The control group consisted of 22 healthy children (13 boys, 9 girls; mean age: 8.9 +/- 2.3 years), who were age- and sex-matched with the patient groups. Children with metabolic bone disease, growth and neurological impairment, signs of malnutrition, or any chronic disease were excluded from the study. RESULTS: BMD values at lumbar spine in both the carbamazepine (-1.69 +/- 0.85 mean L1-4 BMD z-scores, mean 35.5 +/- 12.8 months treatment, and 19,478.6 +/- 6,301.3 mg/kg cumulative dose) and valproic acid (-1.28 +/- 0.80 mean L1-4 BMD z-scores, mean 33.7 +/- 15.0 months treatment, and 22,852.4 +/- 12,477.4 mg/kg cumulative dose) groups were significantly lower than that of the control group (-0.23 +/- 0.87 mean L1-4 BMD z-score). Serum ALP and PTH levels were significantly higher in the carbamazepine-treated group (65.4 +/- 21.1 pg/ml, 767 +/- 267 U/l, respectively) than those of the valproic acid-treated (39.1 +/- 12.8 pg/ml, 561 +/- 166 U/l, respectively) and control groups (36.3 +/- 4.9 pg/ml, 487 +/- 82 U/l, respectively). Serum 25-hydroxyvitamin D of the carbamazepine-treated group (9.8 +/- 3.2 microg/l) was significantly lower than the other groups (15.1 +/- 3.5, 16.6 +/- 4.7 microg/l, respectively). There were eight and 13 patients with plasma intact PTH above reference values in groups 1 and 2, respectively. Valproic acid and carbamazepine therapy results in a hyperparathyroid state and altered vitamin D metabolism, respectively. CONCLUSION: BMD values at lumbar spine were significantly reduced in both carbamezapine and valproic acid treated groups. Valproic acid and carbamazepine therapy do not change IGF-I and IGFBP-3 levels. Altering the hepatic conversion of vitamin D may be the mechanism of carbamazepine-associated reduction in BMD, but the mechanism of decreased BMD in valproate therapy remains unclear.

Alkaline Phosphatase↗
PubMed2005

Prevalence of metabolic syndrome in obese Turkish children and adolescents.

OBJECTIVE: The aim of our study was to assess the prevalence of metabolic syndrome and the other metabolic features in obese children. METHODS: We have studied 169 obese children and adolescents (body mass index>95th percentile), 100 prepubertal and 69 pubertal, aged between 7 and 18 years. Each subject was submitted to an oral glucose tolerance test. The diagnosis of impaired glucose tolerance, type 2 diabetes and metabolic syndrome were defined according to modified WHO criteria adapted for children. RESULTS: Metabolic syndrome was found in 27.2%, with a significantly higher rate among adolescents aged 12-18 years (37.6%) than among children aged 7-11 years (20%) (p < 0.001). There were no significant differences in the prevalence of metabolic syndrome by sex. The prevalences of insulin resistance, glucose intolerance and type 2 diabetes were 29, 19 and 2% among prepubertal children and 56.5, 27.5 and 4.3% among pubertal group, respectively. The prevalence of fasting hyperinsulinemia in pubertal group was significantly higher than prepubertal children (p < 0.001). Hyperinsulinemia was also more frequent in pubertal children with significant difference (20% versus 43.7%, p < 0.001). Hypertension was significantly more common in adolescents (31.8%) than children (15%) with obesity, as expected (p < 0.013). Overall, dyslipidaemia in prepubertal and pubertal groups was identified in 42 and 55%, respectively, with no significant differences (p = 0.085). CONCLUSIONS: Type 2 diabetes mellitus and metabolic syndrome prevalences among adolescents are quite high in the urban area of Konya, central Anatolia, with abnormal lipid profiles, obesity and nutritional mistakes.

Adolescent↗
PubMed2005

Serum magnesium concentrations in type 1 diabetic patients: relation to early atherosclerosis.

Hypomagnesemia and sub-clinical atherosclerosis are common in type 1 diabetic patients, and are especially common in poorly controlled and chronically treated diabetics. The aim of this study was to evaluate the relationships between serum magnesium (Mg) and intima-media thickness (IMT), and functions of common carotid artery (CCA), accepted as markers of early carotid atherosclerosis in type 1 diabetic patients. Serum magnesium levels were measured in 51 diabetic patients (26 girls and 25 boys). Age, duration of diabetes as well as major cardiovascular risk factors, including anthropometric and metabolic parameters were matched between girls and boys. CCA structure and functions were measured by ultrasonography as IMT, cross-sectional compliance (CSC), cross-sectional distensibility (CSD), diastolic wall stress (DWS), and incremental elastic modulus (IEM). The difference for serum Mg was significant between diabetic girls and boys (0.75+/-0.09 mmol/l versus 0.86+/-0.14 mmol/l; p=0.02). Mg levels were correlated with IMT (r=-0.58, p=0.004) and DWS (r=-0.49, p=0.01) in girls and with IMT (r=-0.55, p=0.007) and DWS (r=-0.46, p=0.03) in boys. In a multivariate regression model, Mg, systolic blood pressure and waist-hip ratio emerged as independent correlates for mean IMT in girls with the total variance explained being 63%, and Mg and triglycerides emerged as independent correlates for mean IMT in boys with the total variance explained being 68%. Mg did not emerge as independent correlates for mean DWS in both girls and boys. Serum magnesium levels in children and adolescent patients with type 1 diabetes are associated with early atherosclerosis.

Adolescent↗
PubMed2005

Severe hyperinsulinaemic hypoglycaemia in a baby born to a mother taking oral ritodrine therapy for preterm labour.

Hyperinsulinism of infancy is a major cause of persistent hypoglycaemia in the newborn period. Transient mild self-limiting hyperinsulinaemia and hypoglycaemia have been described in neonates born to mothers taking ritodrine therapy for premature labour. Ritodrine crosses the placental barrier and enters the fetal circulation readily but the mechanism of how it causes hyperinsulinaemia and hypoglycaemia is unclear. We report the case of severe prolonged hyperinsulinaemic hypoglycamia in a neonate born to a mother taking ritodrine therapy from 16 weeks' gestation for preterm labour. The hyperinsulinaemic hypoglycaemia was managed with oral nifedipine as diazoxide was contraindicated due to fluid overload. Possible mechanisms of ritodrine-induced hypoglycaemia and insulin secretion are discussed.

Adult↗
PubMed2005

Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents.

OBJECTIVE: Simple fasting methods to measure insulin resistance, such as the homeostasis model assessment (HOMA), fasting glucose/insulin ratio (FGIR), and quantitative insulin sensitivity check index (QUICKI) methods, have been widely promoted for adult studies but have not been evaluated formally among children and adolescents. The aim of this study was to compare the HOMA, FGIR, and QUICKI methods for measuring insulin resistance, expressed by oral glucose tolerance test (OGTT) results, among obese children and adolescents. METHODS: Fifty-seven pubertal obese children and adolescents (30 girls and 27 boys; mean age, 12.04 +/- 2.90 years; mean BMI: 29.57 +/- 5.53) participated in the study. All participants underwent an OGTT. Blood samples were obtained 0, 30, 60, 90, and 120 minutes after oral glucose administration for glucose and insulin measurements, and 2 separate groups were studied, according to the presence or absence of insulin resistance. HOMA, FGIR, and QUICKI methods were studied for validation of insulin resistance determined with the OGTT for these groups. RESULTS: The groups consisted of 25 obese children and adolescents with insulin resistance (14 girls and 11 boys; mean age: 12.88 +/- 2.88 years; mean BMI: 31.29 +/- 5.86) and 32 subjects without insulin resistance (16 girls and 16 boys; mean age: 11.38 +/- 2.79 years; mean BMI: 28.23 +/- 4.94). There were significant differences in the mean HOMA (6.06 +/- 4.98 and 3.42 +/- 3.14, respectively) and QUICKI (0.313 +/- 0.004 and 0.339 +/- 0.004, respectively) values between the 2 groups. Sensitivity and specificity calculations based on insulin resistance with receiver operating characteristic curve analysis indicated that HOMA had high sensitivity and specificity for measuring insulin resistance. CONCLUSIONS: As a measure of insulin resistance among children and adolescents, HOMA is more reliable than FGIR and QUICKI. The present HOMA cutoff point for diagnosis of insulin resistance is 3.16. The HOMA cutoff point of >2.5 is valid for adults but not for adolescents.

Adolescent↗
PubMed2004

Iodine status remains critical in mother and infant in Central Anatolia (Kayseri) of Turkey.

BACKGROUND: Severe iodine deficiency disorders have been eradicated in many parts of the world, but milder forms still exist and may escape detection. Turkey has long been known to be a mild to moderate iodine deficiency area. AIM OF THE STUDY: The aim of this study was to assess the iodine nutritional status and the thyroid function of pregnant women and their neonates in the region of Kayseri (central Anatolia of Turkey) that appeared to be iodine deficient in previous studies performed before the introduction of mandatory salt iodization. METHODS: A cross-sectional voluntary screening study was performed in the Maternity Unit of a university hospital. A total of 70 mothers and their healthy full-term neonates were included in this study. Urinary iodine concentration was estimated in spot urine samples obtained from mothers and their neonates on day 5. All the neonates were breastfed. The iodine content was determined in the breast milk of all mothers on day 5. Serum concentrations of TSH, thyroglobulin (Tg), free triiodothyronine (FT3) and free thyroxine (FT4) were investigated in the cord serum of neonates and compared to those of mothers immediately after parturition RESULTS: The median urinary iodine on day 5 in mothers and their babies were 30.20 and 23.80 microg/l, respectively. These figures are much lower than normal for these age groups (150-200 microg/l). The median iodine content of breast-milk was 73 microg/l. It is again much lower than in iodine sufficient areas, indicating that the status of iodine nutrition of pregnant and lactating women is clearly insufficient. The median concentrations (and ranges) of neonatal TSH, Tg, FT3 and FT4 were 7.44 mU/l, 71.62 ng/ml, 1.30 pg/ml and 1.34 ng/dl respectively. The corresponding levels for the mothers during labor were 2.19 mU/l, 25.65 ng/ml, 1.31 pg/ml and 1.23 ng/dl respectively. The median neonatal serum concentrations of TSH and Tg were significantly higher than the corresponding maternal levels (P < 0.0001, P < 0.0001, respectively) and 27.1% of the neonates had serum TSH concentrations above 10 mU/l and 57.1 % had cord blood serum Tg concentrations above 54 ng/ml. None of the mothers showed TSH concentrations above 5 mU/l and 41.4% had serum Tg concentrations above 30 ng/ml. CONCLUSION: Iodine deficiency with low urinary iodine excretion and high serum Tg and TSH concentrations were recognized among pregnant women and their babies in Kayseri in spite of the program of salt iodization. National measures are urgently required for improving the correction of iodine deficiency in Turkey. This includes regular supplementation with iodine, starting at preconception or in early pregnancy and continuing during the period of nursing in this region.

Adolescent↗
PubMed2004

Vulvovaginal candidiasis in children and adolescents with type 1 diabetes mellitus.

In this prospective study we investigated the frequency of vulvovaginal candidiasis, the results of yeast cultures and detection of ketoconazole resistance in female children and adolescents with type 1 diabetes mellitus (DM1). The study consisted of 35 patients with DM1 (age 1.7-20 years) and 22 controls (age 1.5-18 years). Age, duration of DM1 and evidence of genital symptoms were recorded initially. After a pelvic examination, two separate swabs and samples for blood glucose and hemoglobin A1c (HbA1c) were taken. One of the swabs was used for direct examination and the second was placed on Sabouraud's dextrose agar and incubated. In vitro susceptibility of Candida species to ketoconazole was established by using Etest (AB B1ODISC). Candida species were isolated in 32 of 61 (52.5%) swabs of patients with DM1 and five of 22 (18.2%) of the control group. The predominant Candida species isolated from patients with DM1 were C. albicans (72.7%), C. glabrata (22.7%), C. tropicalis (2.3%), and C. parapsilosis (2.3%). The mean HbA1c in diabetic patients from whom Candida species were isolated was significantly higher than that of patients without Candida infection (p = 0.002). Most of the C. glabrata isolates were significantly resistant to ketoconazole. During the follow-up of patients with DM1, genital candidiasis is generally overlooked. It should not be forgotten that species other than C. albicans might cause genital candidiasis.

Adolescent↗
PubMed2004

Increased cardiac troponin I concentration in diabetic ketoacidosis.

OBJECTIVE: To examine the hypothesis that diabetic ketoacidosis may be associated with some degree of induced injury to heart muscle, related either to acidosis or hyperglycemia. METHODS: Nineteen diabetic patients with acute ketoacidosis and 19 healthy children were enrolled in this study. Cardiac troponin I (cTnI), creatine kinase (CK)-MB and myoglobin levels were analyzed soon after admission and after 24 h. Patients were subdivided into two groups according to blood pH. RESULTS: At the time of admission, the diabetic patients had significantly higher values than the controls for cTnI (0.193+/-0.008 vs 0.176+/-0.006 ng/dl; p <0.001), CK-MB (24.1+/-2.1 vs 22.7+/-1.2 U/l; p = 0.02), and myoglobin (85.5+/-7.4 vs 52.5 +/-8.3 microg/dl; p <0.001). The diabetic patients also had significantly higher values than the controls for CK-MB (24+/-2.1 vs 22.7+/-1.2 U/l; p = 0.02) and for myoglobin (78.5+/-2.5 vs 52.5+/-8.3 microg/dl; p <0.001) at 24 h. cTnI had normalized in patients at 24 h. All parameters were significantly different between patients with pH > or =7.0 and patients with pH <7.0. In addition, serum cTnI levels correlated negatively with blood pH (r = -0.57, p = 0.026) and HCO3- (r = -0.65, p = 0.008) in the patients with diabetic ketoacidosis on admission. CONCLUSION: Our findings suggest that diabetic ketoacidosis, particularly when severe, has a detrimental effect on the myocardium.

Adolescent↗
PubMed2004

Prevalence of overweight and obesity among children and adolescents in Thessaloniki-Greece and Kayseri-Turkey.

The aim of this study was to investigate the prevalence of overweight and obesity among children and adolescents in the city of Thessaloniki, Greece and in the Kayseri area of Turkey and compare the results. For this purpose, data concerning the weight and height of 2458 Greek school children aged 6-17 years (1226 6-10 years, 1232 11-17 years) and 3703 Turks (1032 6-10 years, 2671 11-17 years) were collected. BMI was calculated. The prevalence of overweight Greek schoolchildren was 22.2% while that of Turks was 10.6%. The obesity prevalence was 4.1% and 1.6%, respectively (total overweight and obese children 26.3% and 12.2%, respectively). In the analyses, the estimations of the prevalence of overweight and obesity are based on the international BMI percentile curves and cut-off points in subjects aged 2-18 years recently established. A significant gender difference was found, males being more overweight and obese compared to females. Finally, the prevalences for both Greeks and Turks were higher in children when compared to adolescents. In conclusion, Greece (as represented by the Thessaloniki area) has one of the highest prevalences of overweight schoolchildren recorded in Europe while Turkey (as represented by Kayseri area) one of the lowest recorded among developed and developing countries. Differences in lifestyle and socioeconomic status in the two regions are most probably responsible for these results.

Adolescent↗
PubMed2003

Growth hormone deficiency, situs inversus, hypertrichosis and brachydactyly.

A 6 year-old female showed growth hormone deficiency, situs inversus totalis, short stature, blue sclerae, facial dismorphism, brachydactyly, developmental delay and hypertrichosis. The described phenotype represents a new syndromic situs inversus with a characteristic phenotype. Here, we present the first patient with this association in the literature.

Abnormalities, Multiple↗
PubMed2002

Amitraz poisoning in children.

There is no information available in the general paediatric literature about amitraz poisoning. In the present study, which is the largest series in the literature, we report 24 children with amitraz poisoning.

Child↗
PubMed2002

TRMA syndrome (thiamine-responsive megaloblastic anemia): a case report and review of the literature.

Thiamine-responsive megaloblastic anemia syndrome (TRMA) is an autosomal recessive disorder with features that include megaloblastic anemia, mild thrombocytopenia and leukopenia, sensorineural deafness and diabetes mellitus. In this disease, the active thiamine uptake into cells is disturbed. Treatment with pharmacological doses of thiamine ameliorates the megaloblastic anemia and diabetes mellitus. Previous studies have demonstrated that the disease is caused by mutations in the SLC19A2 gene encoding a high-affinity thiamine transporter. We present a 5-yr-old-boy with TRMA and, because of its rarity, we review the literature.

Journal Article↗
PubMed2002

Our experience with aplasia cutis congenita.

Aplasia cutis congenita is a rare disorder characterized by developmental absence of skin on the scalp as multiple or solitary, noninflammatory, well demarcated, oval or circular 1- to 2-cm ulcers. The disease may be isolated or associated with anomalies of the skin, eyes, ear-nose-neck and limbs, developmental defects of the cardiovascular, gastrointestinal, genitourinary and central nervous systems, and malformation syndromes such as chromosomal abnormalities, Adams-Oliver syndrome, Bart's syndrome, and Johanson-Bilzzard syndrome. In this article, five newborn infants with aplasia cutis congenita (one associated with Adams-Oliver syndrome and another concomitant with Bart's syndrome) are reported because of their rare presentation in the literature.

Ectodermal Dysplasia↗
PubMed2002

Insulin-like growth factor-I and insulin-like growth factor binding protein-3 levels of children living in an iodine- and selenium-deficient endemic goiter area.

Serum insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) levels were investigated in 31 children living in an endemic goiter area and 33 healthy subjects living in an nonendemic area. Serum IGF-I and IGFBP-3 levels of iodine- and selenium-deficient children were found to be lower than those of control subjects (p<0.001). There was a positive correlation between the IGF-I with chronological age and body mass index. There was also positive correlation between the IGF-I and IGFBP-3. No significant difference was found between the goitrous and nongoitrous children. These results suggest that IGF-I and IGFBP-3 levels are affected by thyroid dysfunction as a result of iodine and selenium deficiency. However, IGF-I and IGFBP-3 levels are not associated with goiter.

Child↗