Browsing by Author "Özen, S"
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Item The Effect of Diabetes Camp on Glycemic Variability in Children and Adolescents with Type 1 Diabetes MellitusAta, A; Ari, G; Isiklar, H; Demir, G; Altinok, YA; Ersoy, B; Özen, S; Darcan, S; Göksen, DAim: Glycemic variability can be affected in diabetes camps as a result of sports, social activities and nutrition. Close glucose monitoring is necessary to reduce glycemic variability, especially hypoglycemia. The aim assessment of glycemic variability and time in range by use of the flash glucose monitoring system (FGMS) in children and adolescents with type 1 diabetes. Materials and Methods: Thirty-three children and adolescents between 10-18 years of age who participated in the 2018 diabetes camp of Ege University were included. Their glycemic variability indexes were recorded. Results: The mean age and duration of diabetes mellitus in the study group was 13.3 +/- 0.5 and 4.9 +/- 0.7 years respectively. Twelve (43%) of the participants were boys and 16 (57%) were girls. Ten (35.7%) of the participants used continuous subcutaneous insulin infusion (CSII) pump therapy while 18 (64.3%) used multiple dose insulin therapy. When the participants were evaluated according to time in range (TIR), the duration of TIR increased, and level 1 and level 2 hyperglycemia decreased during the camp. Participants using CSII had spent more time in level 2 hypoglycemia before camp, but during and after the camp, similar values were reached for both groups. Before the camp, participants with good metabolic control had a longer duration of hypoglycemia than those participants with poor metabolic control. During and after the camp, level 1 and level 2 hypoglycemia periods were similar between the two groups. Conclusion: In diabetes camp, healthy diet, regular exercise, and close glycemic control improve glycemic variability. By using FGMS, normoglycemia periods can be increased without increasing hypoglycemic attacks. As a result, using FGMS had a positive effect on diabetes management and the control of hypoglycemia periods during the diabetes camp.Item Biallelic variant at 5' UTR DMRT1: A novel 46,XY DSD syndrome?Solmaz, AE; Ersoy, B; Özen, S; Kilimci, DD; Kizilay, DÖ; Akin, HItem Acute generalized exanthematous pustulosis due to amoxicilline-clavulanatetSögüt, A; Yilmaz, Ö; Yildirim, S; Özen, S; Temiz, P; Yüksel, HAcute generalized exanthematous pustulosis is an uncommon clinical condition characterized by an acute onset of pustular eruptions. A case of acute generalized exanthematous pustulosis after the use of amoxicilline-clavulanate is presented. The patient presented with pustular and pruritic eruptions after use of drug. The diagnosis was confirmed with pathological data. This condition leading to various clinical manifestations should be thought in the differential diagnosis of pustular dermatosis. (Turk Arch Ped 2010; 45: 150-2)Item The Frequency and Associated Factors of Diabetic Ketoacidosis at Diagnosis in Children with Type 1 DiabetesDemir, K; Büyükinan, M; Dizdarer, C; Simsek, DG; Özen, S; Asar, G; Can, S; Altincik, A; Özhan, B; Ersoy, B; Böber, E; Darcan, SIntroduction: In this study, it was aimed to assess the frequency and associated factors of diabetic ketoacidosis (DKA) at diagnosis in patients with newly diagnosed type 1 diabetes who were admitted to pediatric endocrinology clinics in tertiary referral hospitals in lzmir and Manisa provinces. Materials and Method: The files of the patients were evaluated retrospectively. Data regarding sex, date of birth, family history for diabetes, and health insurances of the patients were recorded and compared with respect to the form of clinical presentation. Results: It was noted that 139 patients (M/F:74/65, mean age 8.7 +/- 3.9 years) were diagnosed in 2008. At the time of diagnosis, the clinical picture of the majority of the patients were ketosis (n=58, 41.7%) or DKA (n=57, 41%). Mortality or severe morbidity developed in none of the patients. It was detected that lack of family history for type 1 diabetes and being less than 5 years of age were associated with DKA at the time of diagnosis. When logistic regression analysis was used to perform risk analysis, only being less than 5 years of age was found to be a risk factor for DKA (p=0.008, Odds Ratio 3.3, 95% confidential interval 1.4-8.1). Conclusion: These results led us consider that large-scale campaigns/studies are needed to be performed to reduce the ratio of DKA at the time of diagnosis by making the society conscious of diabetes in childhood.Item Analysis of the GCK gene in 79 MODY type 2 patients: A multicenter Turkish study, mutation profile and description of twenty novel mutationsAykut, A; Karaca, E; Onay, H; Göksen, D; Çetinkalp, S; Eren, E; Ersoy, B; Çakir, EP; Büyükinan, M; Kara, C; Anik, A; Kirel, B; Özen, S; Atik, T; Darcan, S; Özkinay, FMaturity onset diabetes is a genetic form of diabetes mellitus characterized by an early age at onset and several etiologic genes for this form of diabetes have been identified in many patients. Maturity onset diabetes type 2 [MODY2 (#125851)] caused by mutations in the glucokinase gene (GCK). Although its prevalence is not clear, it is estimated that 1%-2% of patients with diabetes have the monogenic form. The aim of this study was to evaluate the molecular spectrum of GCK gene mutations in 177 Turkish MODY type 2 patients. Mutations in the GCK gene were identified in 79 out of 177. All mutant alleles were identified, including 45 different GCK mutations, 20 of which were novel.Item Assessment of pulmonary artery pressure and right ventricular function in children with adenotonsillar hypertrophy using different parametersÇetin, M; Yilmaz, M; Özen, S; Bozan, N; Coskun, SObjective: Our aim was comparison of preoperative and postoperative right ventricular functions of children with adenotonsillar hypertrophy (ATH) who have findings of upper airway obstruction, using new echocardiographic parameters. Methods: Forty-one children who have admitted to our hospital with symptoms suggestive of upper airway obstruction, whose history and physical examination findings suggest upper airway obstruction and who have undergone adenoidectomy/adenotonsillectomy and 40 healthy children, all of whom between 2 and 12 years of age, were included in the study. Patient group was evaluated by pulsed wave tissue Doppler echocardiography as well as with conventional echocardiography before the operation and 6 months after the operation. Results: Of 41 children in study group, 26 (63.4%) had adenotonsillectomy and 15 (36.6%) had adenoidectomy. Tricuspid annular plane systolic excursion (TAPSE) was significantly lower in preoperative group compared to control group (18.46 +/- 1.67, 19.77 +/- 1.62; p = 0.000, respectively). Myocardial performance index (MPI) was significantly higher in preoperative group than postoperative and control group (0.40 +/- 0.07, 0.36 +/- 0.06, 0.35 +/- 0.07; p = 0.032, respectively). Tricuspid isovolumic acceleration (TIVA) was significantly lower in preoperative group than preoperative and control group (2.97 +/- 0.8, 3.43 +/- 0.7, 3.43 +/- 0.9; p = 0.020, respectively). Disappearance of this difference was found between postoperative and control groups (p = 0.984). Pulmonary acceleration time (PAcT) was found to be significantly lower in preoperative group compared to postoperative and control group (109.68 +/- 18.03, 118.93 +/- 17.46, 120.0 +/- 14.07; p = 0.010, respectively). Mean pulmonary artery pressure (mPAP) was significantly higher in preoperative group than control group (29.64 +/- 8.11, 24.95 +/- 6.33; p = 0.010, respectively). In postoperative group mPAP was found to be similar to control group (25.48 +/- 7.85, 24.95 +/- 633; p = 0.740, respectively). Conclusions: TAPSE, PAcT, MPI and TIVA are useful markers for evaluation of preoperative and postoperative ventricular function in children with ATH who have findings of upper airway obstruction. We think that using these practical and easy-to perform parameters may be relevant for evaluation and postoperative follow-up of patients with ATH who have findings of upper airway obstruction. Besides adenotonsillectomy is a beneficial treatment option for these patients. (C) 2014 Elsevier Ireland Ltd. All rights reserved.Item Anthropometric findings from birth to adulthood and their relation with karyotpye distribution in Turkish girls with Turner syndromeSari, E; Bereket, A; Yesilkaya, E; Bas, F; Bundak, R; Aydin, BK; Darcan, S; Dündar, B; Büyükinan, M; Kara, C; Adal, E; Akinci, A; Atabek, ME; Demirel, F; Çelik, N; Öakan, B; Özhan, B; Orbak, Z; Ersoy, B; Dogan, M; Atas, A; Turan, S; Göksen, D; Tarim, Ö; Yüksel, B; Ercan, O; Hatun, S; Simsek, E; Ökten, A; Abaci, A; Döneray, H; Özbek, MN; Keskin, M; Önal, H; Akyürek, N; Bulan, K; Tepe, D; Emeksiz, HC; Demir, K; Kizilay, D; Topaloglu, AK; Eren, E; Özen, S; Demirbilek, H; Abali, S; Akin, L; Eklioglu, BS; Kaba, S; Anik, A; Bas, S; Unuvar, T; Saglam, H; Bolu, S; Özgen, T; Dogan, D; Çakir, ED; Sen, Y; Andiran, N; Çizmecioglu, F; Evliyaoglu, O; Karagüzel, G; Pirgon, Ö; Çatli, G; Can, HD; Gürbüz, F; Binay, Ç; Bas, VN; Fidanci, K; Gül, D; Polat, A; Acikel, C; Cinaz, P; Darendeliler, FTo evaluate the anthropometric features of girls with Turner syndrome (TS) at birth and presentation and the effect of karyotype on these parameters. Data were collected from 842 patients with TS from 35 different centers, who were followed-up between 1984 and 2014 and whose diagnosis age ranged from birth to 18 years. Of the 842 patients, 122 girls who received growth hormone, estrogen or oxandrolone were excluded, and 720 girls were included in the study. In this cohort, the frequency of small for gestational age (SGA) birth was 33%. The frequency of SGA birth was 4.2% (2/48) in preterm and 36% (174/483) in term neonates (P<0.001). The mean birth length was 1.3cm shorter and mean birth weight was 0.36kg lower than that of the normal population. The mean age at diagnosis was 10.1 +/- 4.4 years. Mean height, weight and body mass index standard deviation scores at presentation were -3.1 +/- 1.7, -1.4 +/- 1.5, and 0.4 +/- 1.7, respectively. Patients with isochromosome Xq were significantly heavier than those with other karyotype groups (P=0.007). Age at presentation was negatively correlated and mid-parental height was positively correlated with height at presentation. Mid-parental height and age at presentation were the only parameters that were associated with height of children with TS. The frequency of SGA birth was found higher in preterm than term neonates but the mechanism could not be clarified. We found no effect of karyotype on height of girls with TS, whereas weight was greater in 46,X,i(Xq) and 45,X/46,X,i(Xq) karyotype groups. (c) 2016 Wiley Periodicals, Inc.Item Growth curves for Turkish Girls with Turner Syndrome: Results of the Turkish Turner Syndrome Study GroupDarendeliler, F; Yesilkaya, E; Bereket, A; Bas, F; Bundak, R; Sari, E; Aydin, BK; Darcan, S; Dündar, B; Büyükinan, M; Kara, C; Mazicioglu, MM; Adal, E; Akinci, A; Atabek, ME; Demirel, F; Çelik, N; Özkan, B; Özhan, B; Orbak, Z; Ersoy, B; Dogan, M; Atas, A; Turan, S; Göksen, D; Tarim, Ö; Yüksel, B; Ercan, O; Hatun, S; Simsek, E; Ökten, A; Abaci, A; Döneray, H; Özbek, MN; Keskin, M; Önal, H; Akyürek, N; Bulan, K; Tepe, D; Emeksiz, HC; Demir, K; Kizilay, D; Topaloglu, AK; Eren, E; Özen, S; Demirbilek, H; Abali, S; Akin, L; Eklioglu, BS; Kaba, S; Anik, A; Bas, S; Ünüvar, T; Saglam, H; Bolu, S; Özgen, T; Dogan, D; Çakir, ED; Sen, Y; Andiran, N; Çizmecioglu, F; Evliyaoglu, O; Karagüzel, G; Pirgon, Ö; Çatli, G; Can, HD; Gürbüz, F; Binay, Ç; Bas, VN; Saglam, C; Gül, D; Polat, A; Açikel, C; Cinaz, PObjective: 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.Item Turner Syndrome and Associated Problems in Turkish Children: A Multicenter StudyYesilkaya, E; Bereket, A; Darendeliler, F; Bas, F; Poyrazoglu, S; Aydin, BK; Darcan, S; Dündar, B; Büyükinan, M; Kara, C; Sari, E; Adal, E; Akinci, A; Atabek, ME; Demirel, F; Çelik, N; Özkan, B; Özhan, B; Orbak, Z; Ersoy, B; Dogan, M; Atas, A; Turan, S; Göksen, D; Tarim, Ö; Yüksel, B; Ercan, O; Hatun, S; Simsek, E; ÖOkten, A; Abaci, A; Döneray, H; Özbek, MN; Keskin, M; Önal, H; Akyürek, N; Bulan, K; Tepe, D; Emeksiz, HC; Demir, K; Kizilay, D; Topaloglu, AK; Eren, E; Özen, S; Abali, S; Akin, L; Eklioglu, BS; Kaba, S; Anik, A; Bas, S; Ünüvar, T; Saglam, H; Bolu, S; Özgen, T; Dogan, D; Çakir, ED; Sen, Y; Andiran, N; Çizmecioglu, F; Evliyaoglu, O; Karagüzel, G; Pirgon, Ö; Çatli, G; Can, HD; Gürbüz, F; Binay, C; Bas, VN; Fidanci, K; Polat, A; Gül, D; Açikel, C; Demirbilek, H; Cinaz, P; Bondy, CObjective: 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.Item Clarithromycin-Induced Long QT Syndrome: A Case ReportCetin, M; Yildirimer, M; Özen, S; Tanriverdi, S; Coskun, SLong QT syndrome develops for a number of reasons. The number of non-antiarrhythmic drugs reported to induce QT interval prolongation with or without torsade de pointes continues to increase. Clarithromycin is a macrolide antibiotic being increasingly used for the treatment of atypical pneumonia. In this paper, we describe a patient who developed long QT prolongation syndrome after receiving clarithromycin for the treatment of atypical pneumonia.