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Objective: The aim of this study is to look at the relationship between hyperthyrotropinemia and anthropometric measurements as well as cardiometabolic risk factors in obese children and adolescents. Materials and Methods: A total of 100 patients with isolated hyperthyrotropinemia and 124 patients with normal thyroid functions, between 10 and 18 years of age, were included in the study. Anthropometric and blood pressure measurements and biochemical parameters were recorded. Non-high-density lipoprotein cholesterol, total cholesterol/high-density lipoprotein cholesterol, and triglyceride/high-density lipoprotein cholesterol ratios were calculated. Results: The subjects' mean age was 12.6 +/- 1.9 years and their mean body mass index was 29.8 +/- 4 kg/m2. The isolated hyperthyrotropinemia group had considerably greater levels of triglyceride, non-high-density lipoprotein cholesterol, and the triglyceride/high-density lipoprotein cholesterol ratio. Higher prevalences of hypertriglyceridemia and increased triglyceride/ high-density lipoprotein cholesterol ratio were found in the group with isolated hyperthyrotropinemia. Thyroid-stimulating hormone had a statistically significant positive relationship with triglyceride, non-high-density lipoprotein cholesterol, total cholesterol/high-density lipoprotein cholesterol ratio, and triglyceride/high-density lipoprotein cholesterol ratio, as well as an inverse relationship with high-density lipoprotein cholesterol. Thyroid-stimulating hormone was positively correlated with triglyceride and triglyceride/high-density lipoprotein cholesterol ratio in both females and males; however, only in females, thyroid-stimulating hormone was positively correlated with non-high-density lipoprotein cholesterol and total cholesterol/highdensity lipoprotein cholesterol ratio. The triglyceride/high-density lipoprotein cholesterol ratio, as well as the rates of hypertriglyceridemia were higher in children with isolated hyperthyrotropinemia in the female subgroup. Male children with isolated hyperthyrotropinemia had significantly higher triglyceride levels in comparison with males with normal thyroid-stimulating hormone. Conclusion: The present study suggested that isolated hyperthyrotropinemia is associated with the deterioration of lipid metabolism, especially in females. Since dyslipidemia is accepted as a cardiovascular disease risk factor, isolated hyperthyrotropinemia might negatively influence cardiovascular functions in obese children and adolescents.

Objective: The present study aimed to evaluate the clinical and laboratory findings in obese and non-obese girls diagnosed with Polycystic Ovary Syndrome.Methods: The total sample size was obese and non-obese 54 adolescents diagnosed with Polycystic Ovary Syndrome aged between 13-18 years. Demographic, clinic, laboratory, and pelvic ultrasonography findings of both groups were compared. Results: Both obese and non-obese adolescents with PCOS features have shown similarities in the levels of serum Follicle-stimulating hormone (FSH), luteinizing hormone (LH), free testosterone, dehydroepiandrosterone sulfate, 17-OH progesterone, androstenedione, fasting blood glucose, low-density lipoprotein levels and pelvic ultrasonography. Fasting insulin level, HOMA-IR score, and triglyceride level were significantly higher in obese patients, though high-density lipoprotein was found to be low. There was no correlation between androgen levels and waist circumference, arm circumference, subcutaneous fat thickness, body fat ratio, and ovarian volume. A positive correlation was found between LH / FSH ratio and free testosterone, 17-OH progesterone and androstenedione levels. Conclusions: Adolescents diagnosed with the Polycystic Ovary Syndrome should be evaluated in terms of metabolic syndrome. In cases with metabolic syndrome risk, healthy balanced diet accompanied by regular exercise play an important role in reducing the frequency of comorbid diseases that can occur in adulthood.Key Words: Polycystic ovary syndrome, Adolescent, Obesity, Hirsutism., ÖZAmaç: Bu çalışmanın amacı, obez ve obez olmayan Polikistik Over Sendromu tanılı kız çocuklarındaki klinik ve laboratuvar bulgularının değerlendirilmesidir.Yöntem: Çalışmaya yaşları 13-18 arasında değişen 54 Polikistik Over Sendromu tanılı adolesan olgu dahil edildi. Obez ve obez olmayan Polikistik Over Sendromu tanılı olguların klinik, demografik, laboratuvar ve pelvik ultrasonografi bulguları karşılaştırıldı.Bulgular: Obez ve obez olmayan gruplar karşılaştırıldığında serum; folikül stimule edici hormon (FSH), lüteinleştirici hormon (LH), serbest testosteron, dehidroepiandrosteron sülfat, 17-OH progesteron, androstenedion, açlık kan şekeri, düşük dansiteli lipoprotein düzeyleri ve pelvik ultrasonografi iki grupta benzer bulundu. Obez olgularda, açlık insülin düzeyi, HOMA-IR skoru, trigliserid düzeyi anlamlı olarak daha yüksek iken, yüksek dansiteli lipoprotein ise düşük saptandı. Androjen düzeyleri ile bel çevresi, kol çevresi, derialtı yağ kalınlığı, vücut yağ oranı ve over volümleri arasında ilişki saptanmaz iken LH/FSH oranı ile serbest testosteron, 17-OH progesteron ve androstenedion düzeyleri arasında pozitif korelasyon saptandı.Sonuç: Adolesan dönemde Polikistik Over Sendromu tanısı konulduğunda mutlaka metabolik sendrom açısından değerlendirme yapılmalıdır. Metabolik sendrom riski saptanan olgularda bu dönemde dengeli diyet ve düzenli egzersiz alışkanlığı edinmek erişkinlik döneminde eşlik edebilecek komorbid hastalıklar sıklığının azaltılmasında anahtar rol oynamaktadır.Anahtar Sözcükler: Polikistik over sendromu, Adolesan, Obezite, Hirsutizm

FK, çocuklarda en sık görülen nöbet tipi olup, çocukluk çağı nörolojikbozuklukları arasında en üst sıradadır. FK'lar iyi karakterde olmasına rağmen, ailelertarafından şahit olunduğunda duygusal olarak travmatik ve korkutucudur.Çalışmamızı, FK geçirmiş 113 (% 65.7), ve kontrol grubu olarak FK geçirmemişancak yaş itibari ile risk grubunda olan 59 (% 34.3) olmak üzere toplam 172 çocuğunailesi ile görüşerek yaptık. Çalışmada ebeveynlerin ateş ve FK hakkındaki bilgi,yaklaşım, anksiyete durumlarını ve FK hakkındaki gereksinimlerini belirlemeyi,eğitimin ailelerin FK'ya yaklaşımı ve anksiyeteleri üzerine olan etkisini saptamayıamaçladık.Çalışma sonuçlarına baktığımızda, ailelerin ateş ölçümü, ateşe nasıl müdahaleetmeleri gerektiği konusunda bilgilerinin yetersiz olduğunu; ayrıca FK hakkında yanlışbilgilere sahip olduklarını gördük. Tutumlarının bilgisizlikten kaynaklanan endişeyleilişkili olduğunu saptadık.FK hakkında ailelere bilgi verilirken; FK' nın çocuklarının gelişimine etkisiolmadığının vurgulanması ancak tekrarlama riskinin olduğunun belirtilmesigerekmektedir. Yeterli bilgilendirilen ve moral destek sağlanan ailelerin ateş ve nöbethakkında daha az endişe duyduğu, daha iyi ilk yardım pratiği sergileyecekleri veböylece gereksiz koruyucu tedavi isteklerinin azalacağı varilan sonuclar arasindadir.Bu çalışma ile, ailelerin ateş ve FK konusunda bilgilendirilmelerinin öneminivurgulamak istedik. Febrile convulsions (FC) are the most common seizure type in children and hasoutmost importance among neurological disorders of childhood. Despite FC?s have abening character; it is emotionally traumatic and alarming when witnessed by families.This study is conducted by interviewing with a total number of 172 families. 113(65.7 %) families whose children had a FC; and as a control group 50(34.3%) familieswhose children don?t have a history of FC but are under risk of FC due to their agegroup are selected for the study. It is aimed to determine parents? knowledge andanxiety about fever and FC, their approach to FC, parents? requirements about thedisease; and also the effect of education on parents? anxiety and approach.The results show that families have insufficient knowledge about propertemperature measurement and managing fever, besides; parents have incorrectinformation about FC. It has been clearly determined that parents? attitudes are relatedto anxiety due to lack of knowledge.When informing parents, it should be emphasized that FC do not have anyinfluence on children?s development; however, there is risk of recurrence. It isconcluded that families who are well informed and morally supported are not only lessconcerned about fever and seizures, but also better performers of first aid; hence theirdemand for unnecessary preventive treatments would be reduced.In this study, we intended to emphasize the importance of informing familiesabout fever and FK. 107

Bu çalışmanın amacı; non-kardiyak cerrahi geçirecek kardiyak sorunu olan hastalarda, sugammadeks ile neostigmin-atropin kombinasyonunun hemodinamik etkilerinin karşılaştırılmasıdır. Kardiyovasküler rahatsızlığı New York Heart Association sınıflandırmasına göre II-III olan, non kardiyak cerrahi geçirecek, 18-75 yaş arası, her iki cinsten 90 adet hasta uygulanacak ilaçlara göre rasgele iki eşit gruba ayrıldı: Grup N' (n=45) deki hastalara cerrahi girişim bitiminde, sinir-kas stimülatörü ile takip edilen kas gevşekliğinde T2 düzeyi belirlendiğinde, 0,03 mg/kg neostigmin i.v. olarak uygulandı. Hastalara kalp atım sayısı, ilaç uygulama öncesi değerinden 5 atım (± 10 atım ) düşük değere ulaşınca i.v. olarak 0,5 mg atropin sülfat uygulaması yapıldı. Grup S' (n=45) deki hastalara cerrahi girişim bitiminde, sinir-kas stimülatörü ile takip edilen kas gevşekliğinde T2 düzeyi belirlendiğinde 3 mg/kg sugammadeks i.v. olarak uygulandı. Hastaların kalp hızı, sistolik, diyastolik ve ortalama kan basınçları ile Qtc (Qt Fridericia ve Qt Bazett) değerlerinin incelendiği elektrokardiyogram değişiklikleri kaydedildi. Grup içi ve gruplar arası karşılaştırmalarda QtcF değerlerinde anlamlı fark bulunmadı. Kan basınçları ve kalp atım hızları anestezi indüksiyonundan sonra her iki grupta da azaldı. Sugammadeks grubunda ilaç uygulamasından sonraki 5.dk'da ve postoperatif ölçümlerde kan basınçları ile kalp hızında yükselme kaydedildi (p

Barnidipin lipofilik karakterde, L-tipi kalsiyum kanallarına yüksek afinite gösteren uzun etkili dihidropiridin türevi kalsiyum kanal blokeridir. Deneysel hipertansif modellerde Barnidipin'in renal hemodinamik parametreler üzerinde olumlu etkilerinin olduğu ayrıca izole damarlarda direkt gevşetici etkisinin olduğu gösterilmiştir. Çalışmamızda non selektif Nitrik Oksit Sentaz (NOS) inhibitörü L-NAME ile hipertansiyon oluşturulan sıçanlarda, uzun süreli Barnidipin uygulamasının mezenterik ve renal arter reaktivitesi ve hipertansiyon ile ilişkili renal hasar gelişimi üzerindeki etkilerinin incelenmesi hedeflenmiştir. Deneysel hipertansiyon, Wistar Albino erkek sıçanların (200-250 g) içme suyuna 5 hafta boyunca L-NAME (60 mg/kg/gün) ilavesiyle oluşturulmuştur. L-NAME uygulanan sıçanlara 2. haftadan itibaren Barnidipin (3 mg/kg/gün p.o) uygulanmaya başlanmış ve 5. haftanın sonuna kadar devam edilmiştir. 5 hafta süre ile vücut ağırlıkları ve sistolik kan basınçları ölçülen sıçanlar, bu süre sonunda deneye alınarak mezenterik ve renal arterleri izole edilmiş ve myograf sisteminde endotel ve düz kas fonksiyonları ile noradrenalin aracılı kasılma yanıtları değerlendirilmiştir. Hipertansif mezenterik ve renal arterlerin noradrenalin aracılı kasılma yanıtlarda kontrol grubuna göre anlamlı bir azalma meydana gelmiştir. Endotel aracılı gevşeme yanıtları hipertansif mezenterik arterlerde azalırken, renal arterlerde değişmemiştir. Her iki arterde de düz kas aracılı gevşeme yanıtlarında gruplar arası farklılık gözlenmemiştir. Barnidipin uygulaması hipertansiyona bağlı olarak vasküler düz kas tonusu (mezenterik ve renal arterler) ve endotel fonksiyonunda (mezenterik arterler) meydana gelen değişiklikleri geriye döndürmüştür. Histopatolojik ve immünohistokimyasal incelemeler, Barnidipin uygulamasının hipertansiyona bağlı olarak mezenterik ve renal arterler ile böbrek dokusunda oluşan yapısal değişiklikleri önemli ölçüde geriye döndürdüğünü ve eNOS ekspresyonunu arttırdığını göstermiştir. Sonuç olarak, hipertansiyona bağlı olarak gelişebilecek patofizyolojik değişiklikler uzun süreli Barnidipin uygulaması ile büyük ölçüde engellenmiştir. Barnidipine is a long acting, lypophilic dihydropyridine calcium channel blocker which exerts high affinity for L-type calcium channels. In the experimental hypertension models, it is determined that Barnidipine has beneficial effects on renal hemodynamic parameters and direct vasorelaxing effect on isolated vessels. Herein, we aimed to investigate the effect of long term Barnidipine treatment on mesenteric and renal arteries reactivity and hypertension induced renal damage in rats. Experimental hypertension was induced by giving L-NAME (60 mg/kg/day), a non-selective Nitric Oxide Synthase (NOS) inhibitor, to Wistar Albino rats (200-250 g) for 5 weeks. Rats were received Barnidipine (3 mg/kg/day p.o) followed by 2 weeks L-NAME administration, for subsequent 3 weeks concomitantly with L-NAME. Weights and systolic blood pressures of the rats were recorded weekly. After 5 weeks, endothelial and smooth muscle functions and vascular reactivity to noradrenaline were determined on isolated mesenteric and renal arteries in a wire myograph system. Contraction responses to noradrenaline were significantly reduced in hypertensive mesenteric and renal arteries. Additionally, endothelium-dependent relaxations were singnificantly reduced in hypertensive mesenteric arteries whereas, no change was determined in hypertensive renal arteries. Impaired vascular tone (in mesenteric and renal arteries) and endothelial functions (in mesenteric arteries) were restored by Barnidipine administration. Endothelium-independent relaxations were found similar between groups in both arteries. Histopathological and immunohistochemical examinations showed that, Barnidipine treatment significantly restored hypertension induced structural and functional alterations in mesenteric and renal arteries and kidney tissue, also increased eNOS expression. Consequently, Barnidipin was able to reverse L-NAME-exacerbated hypertensive pathophysiological alterations. 157

WOS: 000360842500004, PubMed: 26831551, Objective: Children with Turner syndrome (TS) have a specific growth pattern that is quite different from that of healthy children. Many countries have population-specific growth charts for TS. Considering national and ethnic differences, we undertook this multicenter collaborative study to construct growth charts and reference values for height, weight and body mass index (BMI) from 3 years of age to adulthood for spontaneous growth of Turkish girls with TS. Methods: Cross-sectional height and weight data of 842 patients with TS, younger than 18 years of age and before starting any therapy, were evaluated. Results: The data were processed to calculate the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentile values for defined ages and to construct growth curves for height-for-age, weight-for-age and BMI-for-age of girls with TS. The growth pattern of TS girls in this series resembled the growth pattern of TS girls in other reports, but there were differences in height between our series and the others. Conclusion: This study provides disease-specific growth charts for Turkish girls with TS. These disease-specific national growth charts will serve to improve the evaluation of growth and its management with growth-promoting therapeutic agents in TS patients., Turkish Pediatric Endocrinology and Diabetes Society [012013], This work was supported by the Turkish Pediatric Endocrinology and Diabetes Society (Grand number: 012013).

WOS: 000351307200005, PubMed ID: 25800473, Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population. Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014. Results: The most common karyotype was 45, X (50.7%), followed by 45, X/46, XX (10.8%), 46, X, i(Xq) (10.1%) and 45, X/46, X, i(Xq) (9.5%). Mean age at diagnosis was 10.2 +/- 4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45, X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%. Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespan.