Yazar "Adal, Erdal" seçeneğine göre listele
Listeleniyor 1 - 10 / 10
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Assessment of retinal thickness as a marker of brain masculinization in children with congenital adrenal hyperplasia: A pilot study(De Gruyter, 2019) Önal, Hasan; Kutlu, Esra; Aydın, Banu; Ersen, Atilla; Topal, Neval; Adal, Erdal; Güneş, Hatice; Doktur, Hilal; Tanıdır, Canan; Pirhan, Dilara; Sayın, NihatTo investigate the relationship between brain masculinization and retinal thickness in children with congenital adrenal hyperplasia (CAH). Forty-five patients with CAH aged between 4 and 18 years and 30 age-matched healthy controls were included in this prospective study. Macular area was examined with optical coherence tomography (OCT); central subfield thickness (CST), cube volume (CV) and macular retinal thickness (MT) were measured in each subject. A gender identity questionnaire (GIQ) was used for the evaluation of gender happiness index. Girls with CAH had a higher CV (p = 0.002) and MT (p = 0.003) than healthy girls. No significant difference was found between boys with CAH and healthy boys regarding the retinal thickness measurements. Mean CST, CV and MT were significantly higher in boys than in girls in the control group (p = 0.013, p < 0.001, respectively), but there was no significant difference in those parameters between girls and boys with CAH. The gender happiness index was not different between healthy boys and boys with CAH, but was significantly lower in girls with CAH than healthy girls (p = 0.01). As retina is part of the brain, our finding appears to be a morphological evidence of the excess androgen exposure on brain structures in girls with CAH. In addition, we suggest using retinal thickness measurements as a marker of prenatal excess androgen exposure in future studies.Öğe Ceasing vitamin D replacement in infants with premature closure of front fontanelle: True or false?(Galenos Yayıncılık, 2020) Ünüvar, Tolga; Uygur Şahin, Türkan; Adal, ErdalObjective: The purpose of this study was to determine whether fontanelle closure in neonatal and early infantry periods was related to vitamin D levels and the prophylaxis of vitamin D intake. Moreover, our analysis was structured in a retrospective, controlled manner to evaluate our hypothesis.Materials and Methods: We considered 50 individuals who applied to our child endocrinology polyclinic with infants suffering from premature anterior closure. Further, 35 healthy infants of the same age and gender having open anterior fontanelles were taken as the control group.Results: The serum vitamin D level was found to be lower, and the parathormone level was significantly higher in the group with premature closure of the anterior fontanelle. In addition, there was a significant difference in serum calcium, alkaline phosphatase and parathormone levels in patients who had ceased vitamin D support compared with regular vitamin D users. While there was no significant difference in serum vitamin D levels, the level was lower in patients who had withdrawn vitamin D support.Conclusion: In our study, many infants have much lower vitamin D levels than normal levels, even though their anterior fontanelle is prematurely closed. Thus, physicians and other health workers are also warned of the continuity of vitamin D prophylaxis and that it is wrong to cease vitamin D support for reasons such as the premature closing of the anterior fontanelle.Öğe Children with hashimoto's thyroiditis have increased intestinal permeability: Results of a pilot study(Galenos Yayıncılık, 2020) Küçükemre Aydın, Banu; Yıldız, Melek; Akgün, Abdurrahman; Topal, Neval; Adal, Erdal; Önal, HasanIncreased intestinal permeability (IIP) precedes several autoimmune disorders. Although Hashimoto's thyroiditis (HT) is the most common autoimmune disorder, the role of HP in its pathogenesis had received little attention. Zonulin plays a critical role in IIP by modulating intracellular tight junctions. Rise of serum zonulin levels were shown to indicate HP in human subjects. In this case-control study, we examined the hypothesis that patients with HT have IIP. We studied 30 children and adolescents with HT, and 30 patients with congenital hypothyroidism (CH) matched for age, gender and body mass index (BMI). Serum zonulin levels, free thyroxine (fT4), thyroid stimulating hormone (TSH), anti-thyroglobulin antibody and anti-thyroid peroxidase antibody were measured. Zonulin levels were significantly higher in patients with HT than patients with CH (59.1 +/- 22.9 ng/mL vs. 43.3 +/- 32.9 ng/mL, p = 0.035). In patients with HT, zonulin levels were positively correlated with weight (r = 0.406, p= 0.03), BMI (r = 0.486, p = 0.006) and levothyroxine dose (r = 0.463, p = 0.02). In patients with CH, zonulin levels were positively correlated with age (r = 0.475, p = 0.008), weight (r = 0.707, p< 0.001), BMI (r =0.872, p <0.001) and levothyroxine dose (r =0.485, p = 0.007). After adjusting for age, weight, TSH and fT4 levels, serum zonulin was only associated with levothyroxine dose in patients with HT (R-2 =0.36, p =0.05). In patients with CH, only weight was associated with zonulin levels (R-2 =0.62, p <0.001). In conclusion, higher zonulin levels in children and adolescents with HT suggested IIP in these patients. Additionally, the association between zonulin levels and levothyroxine dose might imply a relationship between serum zonulin and disease severity.Öğe Incidence of type 1 diabetes in children aged below 18 years during 2013-2015 in northwest Turkey(Galenos Yayıncılık, 2018) Poyrazoğlu, Şükran; Bundak, Rüveyde; Yavaş Abalı, Zehra; Önal, Hasan; Sarıkaya, Sevil; Akgün, Abdurrahman; Baş, Serpil; Abalı, Saygın; Bereket, Abdullah; Eren, Erdal; Tarım, Ömer; Güven, Ayla; Yıldız, Metin; Karaman Aksakal, Derya; Yüksel, Ayşegül; Seymen Karabulut, Gülcan; Hatun, Şükrü; Özgen, Tolga; Cesur, Yaşar; Azizoğlu, Mehmet; Dilek, Emine; Tütüncüler, Filiz; Çakır, Esra Papatya; Özcabı, Bahar; Evliyaoğlu, Olcay; Karadeniz, Songül; Dursun, Fatma; Bolu, Semih; Arslanoğlu, İlknur; Yeşiltepe Mutlu, Gül; Kırmızıbekmez, Heves; İşgüven, Pınar; Üstyol, Ala; Adal, Erdal; Uçar, Ahmet; Cebeci, Nurcan; Bezen, Didem; Binay, Çiğdem; Semiz, Serap; Korkmaz, Hüseyin Anıl; Memioğlu, Nihal; Sağsak, Elif; Peltek, Havva Nur; Yıldız, Melek; Akçay, Teoman; Turan, Serap; Güran, Tülay; Atay, Zeynep; Akcan, Neşe; Çizmecioğlu, Filiz; Ercan, Oya; Dağdeviren, Aydilek; Baş, Firdevs; İşsever, Halim; Darendeliler, FeyzaObjective: To assess the incidence of type I diabetes mellitus (T1DM) in children under 18 years of age in the northwest region of Turkey during 2013-2015. Methods: All newly diagnosed T1DM cases were recorded prospectively during 2013-2015. Total, as well as gender and age group specific (0-4, 5-9. 10-14 and 15-17 age) mean incidences per 100,000 per year were calculated. Results: There were 1,773 patients diagnosed during 2013-2015 (588 cases in 2013, 592 cases in 2014, 593 cases in 2015). Of these, 862 (48.6 %) were girls and 911 (51.4%) were boys. The mean age at diagnosis was 9.2 +/- 4.2 years and it was not significantly different between girls (9.0 +/- 4.1 years) and boys (9.4 +/- 4.4 years) (p = 0.052). The crude mean incidence was 8.99/100.000 confidence interval (CI) (95% CI: 8.58-9.42). Although mean incidence was similar between boys [8.98/100.000 (CI: 8.40 to 9.58)] and girls [9.01/100.000 (CI: 8.42 to 9.63)], there was male predominance in all groups except for 5-9 year age group. The standardized mean incidence was 9.02/100.000 according to the World Health Organization standard population. The mean incidence for the 0-4, 5-9, 10-14 and 15-17 age groups was 6.13, 11.68, 11.7 and 5.04/1 00.000 respectively. The incidence of T1DM was similar over the course of three years (p = 0.95). A significant increase in the proportion of cases diagnosed was observed in the autumn-winter seasons. Conclusion: The northwest region of Turkey experienced an intermediate incidence of T1DM over the period of the study.Öğe Konjenital adrenal hiperplazi olgularımızın enzim eksikliği açısından dağılımı: Yüz kırk beş hasta ile tek merkez deneyimi(Logos Tıp Yayıncılık, 2019) Yıldız, Melek; Önal, Hasan; Aydın, Banu; Gezdirici, Alper; Akgün, Abdurrahman; Yılmaz Güleç, Elif; Belde Doğan, Beyza; Adal, ErdalAmaç: Konjenital adrenal hiperplazi (KAH), adrenal steroidogenez basamaklarından birinde gerçekleşen, enzim eksikliği nedeniyle ortaya çıkan, otozomal resesif geçişli genetik bir hastalıktır. En sık nedeni 21-hidroksilaz eksikliğidir. Bu çalışmada, bölümümüzde takipli KAH tanılı hastaların enzim eksikliği açısından dağılımlarının belirlenmesi ve klinik özelliklerinin ortaya konulması amaçlanmıştır. Yöntem: Ocak 1998-Ocak 2018 tarihleri arasında KAH tanısı alarak kliniğimizde izlenmiş olan 145 hastanın dosyası retrospektif olarak incelendi. Olguların başvuru yaşı, başvuru yakınması, cinsiyeti, izlemde puberte prekoks ve hipertansiyon gelişimi, testiküler adrenal rest tümör varlığı, hormonal değerlendirmeleri ve klinik tanıları kaydedildi. Bulgular: Çalışmaya 82 kız, 63 erkek hasta alındı. Bütün hastalar genetik cinsiyetlerine uygun yetiştirilmişti. Hastaların %87,6’sı 21-hidroksilaz eksikliği olup, bunların %80,9’u klasik (%76,3’ü tuz kaybettiren tip, %23,7’si basit virilizan tip), %19,1’i ise non-klasik (geç başlangıçlı) tip idi. Olguların %9,0’ı 11?hidroksilaz eksikliği, %2,8’i 3?-hidroksisteroid dehidrogenaz eksikliği, %0,7’si ise POR eksikliği idi. Olguların %73,8’inde akraba evliliği mevcuttu. Kız hastaların %70,7’si kuşkulu genital yapı ile erkek hastaların %73,0’ı ise tuz kaybı ile tanı almıştı. On beş hasta santral puberte prekoks nedeniyle GnRH analoğu kullanmıştı. Erkek olguların %14,3’ünde testiküler adrenal rest tümör, kız olguların %9,8’inde polikistik over sendromu mevcuttu. 11?-hidroksilaz eksikliği olgularının yaklaşık yarısında hipertansiyon mevcuttu. POR eksikliği saptanan tek hastaya sendromik özelliklerinden dolayı Antley-Bixler sendromu tanısı konulmuştu. Sonuç: Merkezimizdeki KAH hastalarında gözlenen enzim eksikliği dağılımı literatür ile uyumlu bulunmuştur. 21-hidroksilaz eksikliği açısından mutasyon saptanmayan, hipertansiyon ve sendromik görünüm benzeri klinik özellikleri bulunan ve hormonal açıdan ipucu olan hastalar nadir KAH formları açısından değerlendirilmelidir.Öğe Possible effects of neonatal vitamin B12 status on TSH-screening program: A cross-sectional study from Turkey(Walter de Gruyter GMBH, 2017) Önal, Zerrin; Balkaya, Seda; Ersen, Atilla; Mutlu, Neval; Önal, Hasan; Adal, ErdalBackground: In this study we evaluated whether vitamin B12 deficiency affects neonatal screening (NS) for congenital hypothyroidism (CH). Methods: A cross-sectional study conducted from 2010 to 2011. A total of 10,740 infants were born in our hospital in this period. Thyroid-stimulating hormone (TSH) was tested for NS and neonates with abnormal screening results (TSH > 20 mIU/L) were re-examined. Two hundred and twenty-nine re-called subjects (re-call rate 2.3%) were compared to 77 randomly selected newborns with normal TSH screening among these term newborns in terms of serum TSH, free T4, vitamin B12 and homocysteine status. Results: Of the 229 re-called subjects, 11 infants with CH and 21 infants with transient TSH elevation were detected. In the normal TSH screening group, only two infants were diagnosed with transient TSH elevation. Mean serum B12 levels were 126.4 +/- 48.7 pg/mL and 211.9 +/- 127.9 pg/mL in the positive TSH-screening group and the control group, respectively. There was a significant difference between positive and normal TSH-screening groups in regard to serum TSH, free T4, serum B12 and homocysteine levels. Conclusions: We found a significant vitamin B12 deficiency in positive TSH-screening infants. Beside the crucial role of vitamin B12 in newborns, deficiency seems to increase the recall rates of infants in an NS program for CH.Öğe Recognizing the psychosocial aspects of type 1 diabetes in adolescents(Galenos Publishing, 2015) Adal, Erdal; Önal, Zerrin; Ersen, Atilla; Yalçın, Koray; Önal, Hasan; Önal, HasanObjective: Considering the ever increasing population of diabetic adolescents and the association of the disease with psychosocial problems throughout its course, depression and/or anxiety and social support from parents are issues of special concern in these patients. The study aimed to identify the depression and anxiety state of diabetic adolescents and its impact on the management of diabetes mellitus (DM). Methods: 295 adolescents with type 1 DM and their parents attended our study. Psychological distress was assessed using the Children's Depression Inventory and the State-Trait Anxiety Inventory (STAI I-II) for Children, Perceived Social Support from Family (PSS-Fa) scale, Beck Depression Inventory for adults, STAI I-II for adults and the Multidimensional Scale of Perceived Social Support (MSPSS). Records of glycemic measurements, insulin dosage and hemoglobin A1c levels were used as glycemic control parameters. Results: Depression rate was 12.9%. State (p<0.001) and trait anxiety (p<0.001) levels were high; PSS-Fa (p<0.001) and MSPSS (p<0.006) scores were low in the depressive patients. Positive correlations were noted between depression, PSS-Fa, STAI-I and STAI-II. Conclusion: Therapeutic strategies of DM should include co-existing psychiatric conditions throughout the course of the disease. In diabetic adolescents, PSS-Fa, STAI-I and STAI-II appear to be effective tools in the evaluation of depression.Öğe Response to growth hormone treatment in very young patients with growth hormone deficiencies and mini-puberty(Walter de Gruyter Gmbh, 2018) Çetinkaya, Semra; Poyrazoğlu, Şükran; Baş, Firdevs; Ercan, Oya; Yıldız, Metin; Adal, Erdal; Bereket, Abdullah; Abalı, Saygın; Aycan, Zehra; Erdeve, Senay Savaş; Berberoğlu, Merih; Şıklar, Zeynep; Tayfun, Meltem; Darcan, Şükran; Mengen, Eda; Bircan, İffet; Jones, Filiz Mine Çizmecioğlu; Şimşek, Enver; Papatya, Esra Deniz; Özbek, Mehmet Nuri; Bolu, Semih; Abacı, Ayhan; Büyükinan, Muammer; Darendeliler, FeyzaBackground: The aim of the study was to assess the response to growth hormone (GH) treatment in very young patients with GH deficiency (GHD) through a national, multi-center study. Possible factors affecting growth response were assessed (especially mini-puberty). Methods: Medical reports of GHD patients in whom treatment was initiated between 0 and 3 years of age were retrospectively evaluated. Results: The cohort numbered 67. The diagnosis age was 12.4 +/- 8.6 months, peak GH stimulation test response (at diagnosis) as 1.0 +/- 1.4 ng/mL. The first and second years length gain was 15.0 +/- 4.3 and 10.4 +/- 3.4 cm. Weight gain had the largest effect on first year growth response; whereas weight gain and GH dose were both important factors affecting second year growth response. In the multiple pituitary hormone deficiency (MPHD) group (n = 50), first year GH response was significantly greater than in the isolated GH deficiency (IGHD) group (n = 17) (p = 0.030). In addition first year growth response of infants starting GH between 0 and 12 months of age (n = 24) was significantly greater than those who started treatment between 12 and 36 months of age (n = 43) (p <0.001). These differences were not seen in the second year. Delta Length/height standard deviation score (SDS), Delta body weight SDS, length/height SDS, weight SDS in MPHD without hypogonadism for the first year of the GH treatment were found as significantly better than MPHD with hypogonadism. Conclusions: Early onsets of GH treatment, good weight gain in the first year of the treatment and good weight gain-GH dose in the second year of the treatment are the factors that have the greatest effect on length gain in early onset GHD. The presence of the sex steroid hormones during minipubertal period influence growth pattern positively under GH treatment (closer to the normal percentage according to age and gender).Öğe Seroprotection status of hepatitis B and measles vaccines in children with type 1 diabetes mellitus(Walter De Gruyter Gmbh, 2016) Önal, Zerrin; Ersen, Atilla; Bayramoğlu, Elvan; Kazancı Yaroğlu, Selcen; Önal, Hasan; Adal, ErdalBackground: Type 1 diabetes mellitus (T1DM) is speculated to have an impaired immunological response to vaccines. This paper aimed to investigate the presence of specific antibodies against hepatitis B virus (HBV) and measles in diabetic children who had been immunized according to the standard national calendar of immunization. Methods: Two hundred and one diabetic children and 140 healthy controls were prospectively evaluated. Antibodies against hepatitis B (anti-HBs) and measles were detected in all individuals who completed the vaccination schedule. We noted onset of T1DM, duration of the disease, diabetes-related autoantibodies and mean HbA(1c) levels. Results: Some 72.6% of diabetics and 82.1% of controls had anti-HBs (+) (p=0.04). We found a reduced efficacy of measles vaccination in anti-HBs (-) diabetic children (p=0.009), even though there was no significant difference between the study and control groups. Onset of the disease was earlier in anti-HBs (-) diabetics than in controls (p=0.038). No difference with respect to other parameters was found. Conclusions: Our data showed a reduced seroprotection rate for HBV vaccination in diabetic children and for measles with anti-HBs (-) diabetics. Larger studies should be encouraged to confirm the vaccine efficacy in diabetic children and to elucidate possible pathogenic mechanisms.Öğe The factors relevant to partial remission in children with type 1 diabetes mellitus after measles vaccination: A retrospective study(Wiley, 2020) Bektaş, Gonca; Önal, Hasan; Adal, ErdalWe aimed to identify the determinants of partial remission in patients with type 1 diabetes mellitus (DM), and whether there is an influence of vaccination against measles on partial remission. This was a retrospective study consisting of consecutive patients diagnosed with type 1 DM followed-up from 1 September 2010, through 30 November 2011. The study included children vaccinated within 3 months after diagnosis, and children unvaccinated during the first 12 months of the disease. The daily insulin dose, hemoglobin A1c, and C-peptide levels, and whether children are in partial remission based on the insulin dose-adjusted HbA1c were recorded at diagnosis and 3, 6, 9, 12, 24, and 36 months. A total of 55 children with type 1 DM were analyzed. Thirty-one patients (56.4%) reached partial remission during the follow-up period, whereas 24 of them did not. Patients with diabetic ketoacidosis (DKA) at diagnosis were less likely to reach partial remission than patients without DKA (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.062-0.946;P = .038). Patients vaccinated against measles were more likely to be in partial remission than patients unvaccinated (OR, 4.2; 95% CI, 1.35-13;P = .011). Partial remission was significantly associated with the C-peptide level and insulin dosage at diagnosisP = .002;P = .013, respectively). The lack of DKA, higher C-peptide level, and lower insulin dosage at diagnosis, and vaccination against measles after diagnosis may have an influence on partial clinical remission in patients with new-onset type 1 DM.
