Abstract Papillary thyroid cancer in children has been reported to be associated with both inadequately treated congenital hypothyrodism due to dyshormonogenesis and, Graves disease and autoimmune thyroiditis. Here we report two cases;... more
Abstract Papillary thyroid cancer in children has been reported to be associated with both inadequately treated congenital hypothyrodism due to dyshormonogenesis and, Graves disease and autoimmune thyroiditis. Here we report two cases; one with hypothyroidism and the other with hyperthyroidism in whom papillary thyroid cancer was diagnosed during medical treatment. Case 1 Female child, 11 years old, consangineous parents She presented with intrauterine goiter and severe hypothyroidism. After a period of suboptimal treatment , an isohyperechoic nodule of 15x8 mm with a thin hypoechoic rim was observed on ultrasound. FNAB was compatible with papillary thyroid carcinoma. Total thyroidectomy with left neck dissection was performed. Diagnosis: Multicentric Papillary thyroid carcinoma and metastases in the pretracheal, paratracheal,prelaryngeal and Delphian lymph nodes (pT1b N1a). Case 2 Male child, 16 years old He had been treated medically for hyperthyroidism due to Graves disease for 4,5 years. He had a big goiter and unmanageable hypertyroidism. Surgery was suggested as a new treatment option. Total thyroidectomy was performed. Diagnosis: Multifocal Papillary thyroid cancer (p T1a) Discussion Clinicians should consider the possibility of thyroid cancer occurrence during medical treatment of thyroid dysfunction.
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Bartter Sendromu hipokalemik metabolik alkaloz sekonder hiperaldosteronizm ve hiperreninemiye karsin normal sinirlarda kan basinci ve jukstaglomeruler hiperplazi ile belirgindir Cocuklarda somatik gelisme geriliginin nadir gorulen... more
Bartter Sendromu hipokalemik metabolik alkaloz sekonder hiperaldosteronizm ve hiperreninemiye karsin normal sinirlarda kan basinci ve jukstaglomeruler hiperplazi ile belirgindir Cocuklarda somatik gelisme geriliginin nadir gorulen nedenlerinden biridir Bartter sendromu’nun klinik ve genetik acidan uc farkli sekli bildirilmistir Neonatal Bartter sendromu klasik nbsp; Bartter sendromu ve Gitelman sendromu adi verilen bu varyasyonlar “Bartter benzeri sendrom” basligi altinda birlestirilmistir
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Research Interests: Biophysics, Biology, Cell Biology, Fluorescence Resonance Energy Transfer, Biological Sciences, and 15 moreCell line, Humans, Female, Male, Human Molecular Genetics, Endoplasmic Reticulum, Infant, Calcium Sensing Receptor, Glycosylation, Hyperparathyroidism, Golgi Apparatus, Hypercalcemia, Dimerization, Cell Membrane, and Colocalization
Research Interests: Endocrinology, England, Humans, Child, Internal Medicine, and 15 moreFemale, Body Composition, Inborn errors of metabolism, Leptin, Differential Diagnosis, Hyperphagia, Fat Mass, Genotype, Late onset hypogonadism, Adult, Immune function, Age of Onset, hypogonadism, Immunologic deficiency syndromes, and Basal Metabolism
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The determination of the protective and risk factors associated with Internet gaming disorder (IGD) is among the most important pathways to the development of prevention strategies for IGD. Previous research has shown that familial... more
The determination of the protective and risk factors associated with Internet gaming disorder (IGD) is among the most important pathways to the development of prevention strategies for IGD. Previous research has shown that familial factors are associated with IGD. In our study, we aimed to assess the parental attitude of adolescents with IGD and investigate psychiatric comorbidity.
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The aim of this study was to demonstrate the prevalence of iodine deficiency among schoolchildren and the risk factors influencing it. One thousand five hundred and seventy-three schoolchildren were chosen from 14 schools in seven... more
The aim of this study was to demonstrate the prevalence of iodine deficiency among schoolchildren and the risk factors influencing it. One thousand five hundred and seventy-three schoolchildren were chosen from 14 schools in seven different regions in Istanbul. After all data relating to sociodemographic factors and the use of iodized salt were recorded, iodine contents of urine samples were determined by the Sandell Kolthoff reaction. Chi-squared and multiple regression analysis were used for the investigation of the correlation between iodine deficiency and risk factors. The prevalence of goitre (> or = 2 grade) was 1.9 per cent. The median urine iodine level was in the normal range (10.5 microg/dl). In 46.2 per cent of the students the urine iodine levels were below 10 microg/dl and 13.9 per cent of the students had urine iodine levels below 5 microg/dl. The prevalence of iodine deficiency was significantly higher in younger (< or = 10 years) children, in children with less educated mothers and fathers, and with poorer and more crowded families (p < 0.01, p < 0.01 and p < 0.01, p < 0.001, respectively). The rate of iodine deficiency was significantly higher in females than in males and also higher in children who lived on the European side of Istanbul than on the Anatolian side of Istanbul (p < 0.0001, p < 0.0001, respectively). The rate of use of iodized salt was 44.4 per cent and the iodine deficiency rate was not affected by the use of iodized salt (p > 0.05). Although the median urine iodine level was in the normal range, in 46.2 per cent of the students urine iodine levels were low (< 10 microg/dl). As there seems to be no effect from the use of iodized salt in iodine deficiency, the use of a more stable potassium iodate for the fortification of salt may be required.
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BACKGROUND In this study, eating behaviors and alexithymia levels in obese adolescents are investigated. Relationships between alexithymia, eating behaviour and insulin resistance are studied. METHOD Patient group consists of 87 obese... more
BACKGROUND In this study, eating behaviors and alexithymia levels in obese adolescents are investigated. Relationships between alexithymia, eating behaviour and insulin resistance are studied. METHOD Patient group consists of 87 obese adolescents or overweight adolescents (O+OW). Comparison group consists of 101 normal weight adolescents (N). Alexithymia Questionnaire for Children (AQC), Dutch Eating Behavior Questionnaire (DEBQ) and Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) are used for assessing adolescents. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) are calculated to determine insuline resistance. RESULTS AQC scores are significantly higher in O+OWcompared to N (p:0,009). Both emotional and restrained eating scores are higher in O+OW (p<0,001 for both). On the other hand, external eating scores do not have any significant difference. In O+OW, external eating is positively associated with HOMA-IR (r:035, p:0,006), but is not associated with fasting blood glucose and HbA1c (r:-0,05, p:0,62; r:-0,05, p:0,73). Regression analysis shows that restrained and emotional eatings are predictors of O+OW (B:0,1, p<0,001; B:0,06, p:0,001). Emotional eating is positively correlated with AQC and RCADS-CV in O+OW (r: 0,29, p: 0,008; r:0,48, p<0,001) CONCLUSION: Obese and overweight adolescents are more alexithymic than normal weight adolescents. Also, alexithymia scores are positively associated with emotional eating. On the other hand,alexithymia is not a predictor of obesity/overweight. Restrained and emotional eatingsare predictors of obesity/overweight. Emotional and restrained eatingsare more common in obese and overweight adolescents compared to normal weighted adolescents. External eating is not significantly associated with obesity, but is related with insuline resistance.
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Hiperkalseminin klinik spektrumu hayati tehdit eden bir durumdan asemptomatik bir biyokimyasal bozukluga kadar uzanir Hiperkalsemik olgunun yasinin gozonune alinmasi ayirici taniyi kolaylastirir Ayirici taninin saglikli bir sekilde... more
Hiperkalseminin klinik spektrumu hayati tehdit eden bir durumdan asemptomatik bir biyokimyasal bozukluga kadar uzanir Hiperkalsemik olgunun yasinin gozonune alinmasi ayirici taniyi kolaylastirir Ayirici taninin saglikli bir sekilde yapilabilmesi icin hicbir tedavi baslanmadan once eszamanli olarak kan ve idrar orneklerinin alinmasi buyuk onem tasimaktadir Ozellikle uriner kalsiyum ekskresyonunun ve serum intakt paratiroid hormonu duzeyinin belirlenmesi taniya ulasilmasini buyuk oranda kolaylastirir Semptomatik hastalarda veya serum total kalsiyum duzeyi 13 mg dl i astiginda nonspesifik acil medikal tedavi endikasyonu vardir Acil tedaviyi takiben ilac tedavisi yaninda genel ve spesifik tedbirler uygulanir D vitamini ile iliskili hiperkalsemilerde glukokortikoidler ilk secilecek drog olma ozelligini korumakta olup ozellikle malign hastalik hiperkalsemisinde difosfonatlarin kullanimi ile deneyimler artmaktadir Primer hiperparatiroidizm olgularinda ise cerrahi eksplorasyon endikasyonu vardir Anahtar kelimeler: Hiperkalsemi Yenidogan Cocuk
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Growth retardation is a clinical feature of patients with thalassemia major, and endocrine studies have frequently revealed the presence of normal growth hormone (GH) secretion. The present study was undertaken in 14 prepubertal... more
Growth retardation is a clinical feature of patients with thalassemia major, and endocrine studies have frequently revealed the presence of normal growth hormone (GH) secretion. The present study was undertaken in 14 prepubertal thalassemic children (9 males and 5 females), aged 2(2/12) to 10(3/12) years, with the aim of evaluating GH response to i.v. arginine, oral L-dopa stimulation and insulin-like growth factor-1 (IGF-1) levels. Eleven patients had peak serum GH levels less than 7 ng/ml and two patients had peak serum GH levels of 7-10 ng/ml with arginine. Similarly, 10 patients had peak levels less than 7 ng/ml and one patient had a peak level of 7-10 ng/ml with L-dopa. Thus, nine of the patients had GH deficiency and two had partial GH deficiency. Three patients had elevated basal GH values. The serum IGF-1 levels in the patients were not statistically different from the levels in the controls, but three patients had low IGF-1 values. These findings suggest a defect in the regulatory mechanisms of GH secretion.
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Introduction: Primary adrenal insufficiency associated with cardiomyopathy has been rarely reported in children. We report a case of left ventricular (LV) systolic dysfunction related to adrenal insufficiency with autoimmune polyendocrine... more
Introduction: Primary adrenal insufficiency associated with cardiomyopathy has been rarely reported in children. We report a case of left ventricular (LV) systolic dysfunction related to adrenal insufficiency with autoimmune polyendocrine syndrome type 1 (APS1). Case Presentation: A 7-year-old girl presented with a loss of consciousness. She had hyperpigmentation over joints and enamel hypoplasia. Laboratory tests showed hypoglycemia, hyponatremia, hypocalcemia, and hyperphosphatemia. Endocrine evaluations revealed low serum parathyroid hormone, low cortisol, and high ACTH. Echocardiography showed moderate to severe mitral regurgitation and LV systolic dysfunction. Serum pro-brain natriuretic peptide (pro-BNP) level was high (2,348 pg/mL). Adrenal insufficiency, hypoparathyroidism, and enamel dysplasia suggested APS1. A novel homozygous variant in the AIRE gene, NM_000383, p.Cys322Arg (c.964T>C) confirmed the diagnosis. Calcium, calcitriol, and hydrocortisone treatments were star...
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OBJECTIVE A single-nucleotide polymorphism of the growth hormone 1 gene, GH1IVS4+90A>T (rs2665802), associated with short stature and a polymorphism of the growth hormone receptor gene, exon 3 deleted variant, associated with increased... more
OBJECTIVE A single-nucleotide polymorphism of the growth hormone 1 gene, GH1IVS4+90A>T (rs2665802), associated with short stature and a polymorphism of the growth hormone receptor gene, exon 3 deleted variant, associated with increased responsiveness to growth hormone have been reported previously. We aimed to investigate the frequency of both polymorphisms and their correlation to height in Turkish short children. Also, we aimed to evaluate the effect of exon 3 deleted variant on response to 1-year growth hormone therapy. MATERIALS AND METHODS Children with idiopathic isolated growth hormone deficiency (n = 39) and with idiopathic short stature (n = 10) and 50 control subjects were evaluated for anthropometric parameters, annual growth velocity, and annual height gain. Growth hormone receptor gene polymorphisms were analyzed via multiplex polymerase chain reaction; growth hormone 1 gene polymorphism was analyzed via polymerase chain reaction and single-strand conformation polymorphism techniques. RESULTS The frequency of genotypes carrying the "A" allele was not significantly higher in the idiopathic isolated growth hormone deficiency group than in the idiopathic short stature and control groups (P = .03 for each). The exon 3 deleted variant genotype was significantly lower in the idiopathic short stature group compared to the control group (P = .01). There was no effect of exon 3 deleted variant, on response to the first-year growth hormone therapy. CONCLUSION In Turkish population, no correlation was found between the "A" allele of GH1IVS4+90A>T polymorphism and idiopathic isolated growth hormone deficiency and short stature, and a significant negative correlation was found between exon 3 deleted variant and idiopathic short stature and short stature. Exon 3 deleted variant has no effect on response to growth hormone treatment.
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Objective: We hypothesized that diabetic kidney disease (DKD) begins early, before albuminuria occurs. We therefore aimed to assess potential early urinary biomarkers of DKD in normoalbuminuric and normotensive children and adolescents... more
Objective: We hypothesized that diabetic kidney disease (DKD) begins early, before albuminuria occurs. We therefore aimed to assess potential early urinary biomarkers of DKD in normoalbuminuric and normotensive children and adolescents with type 1 diabetes (T1D) to evaluate the relationship between these markers and clinical and laboratory risk factors for DKD. Methods: This cross-sectional study included 75 children and adolescents with T1D (62% females, mean age 13.9 ± 3.2 years) with normoalbuminuria (an albumin/creatinine ratio [ACR] below 30 mg/g creatinine). Fifty-five age- and sex-matched healthy children and adolescents served as controls. For the assessment of early DKD, urinary levels of angiotensinogen (AGT), transferrin, nephrin, vascular endothelial growth factor-A (VEGF-A), and kidney injury molecule-1 (KIM-1) were measured in adequately collected 24-h urine samples using enzyme-linked immunoassays. Results: The mean disease duration was 7.3 ± 3.2 (range 2.1–15.7) year...
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bayramoglu, elvan/0000-0002-6732-8823WOS: 000485922404112
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WOS: 00025978560058
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Silent corticotroph adenomas are adenomas composed of corticotrophs but are different from corticotroph adenomas because they are not associated with clinical and biochemical evidence of ACTH production or release in vivo. Despite being... more
Silent corticotroph adenomas are adenomas composed of corticotrophs but are different from corticotroph adenomas because they are not associated with clinical and biochemical evidence of ACTH production or release in vivo. Despite being silent, they show more aggressive behavior than other clinically nonfunctional adenomas. Adrenocortical choristomas in silent corticotroph adenomas (the presence of adrenocortical cells in the heterotopic location of the sella) were reported in three patients 16 years or older until now. Here we report, to our knowledge, the fourth and the youngest case of silent corticotroph adenoma with adrenocortical choristoma.
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3M syndrome is characterized by severe pre- and post-natal growth restriction, typical face, slender tubular bones, tall vertebral bodies, prominent heels and normal intelligence, caused by biallelic variants of CUL7, OBSL1 and, more... more
3M syndrome is characterized by severe pre- and post-natal growth restriction, typical face, slender tubular bones, tall vertebral bodies, prominent heels and normal intelligence, caused by biallelic variants of CUL7, OBSL1 and, more rarely, CCDC8. The aim of this study is to evaluate facial and skeletal findings in 3M patients from neonatal period to adulthood. A total of 19 patients with a median age of diagnosis of 9.2 months were included in this study and were followed for twı to 20 years. CUL7 and OBSL1 variants were found in 57.9% and 42.1% of patients, respectively, five of which are novel. Most of patients had triangular face, frontal bossing, short fleshy nose, full fleshy lower lip, transverse groove of rib cage, hyperlordosis and prominent heels. Three new early-diagnostic signs were observed in infants; two were infraorbital swelling of the lower lid and facial infantile hemangioma, both of which became less pronounced with aging. The third was the central tubercle of the upper lip that became more prominent with in time. While slender long bones did not change with aging, the tall vertebral bodies became more prominent radiologically. The mean birth length in patients was -4.3 SDS. Eight patients reached a mean final height of -4.9 SDS. Despite described GH insensitivity in 3M syndrome, 12 patients either with GH deficiency or with normal GH levels were treated with GH; seven patients responded with an increase in height SDS. This study not only provided early diagnostic signs of the syndrome, but also presented important follow-up findings.
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Objective: The aim of this study was to examine whether the presence of depression in adolescents who were overweight or obese increase the likelihood of cardiometabolic risk factors. Method: We performed a retrospective cross-sectional... more
Objective: The aim of this study was to examine whether the presence of depression in adolescents who were overweight or obese increase the likelihood of cardiometabolic risk factors. Method: We performed a retrospective cross-sectional analysis of the data from adolescents who were overweight or obese, aged 11-18 years, who were evaluated in our clinic from January 2012 to December 2015. Depression was evaluated by “Children’s Depression Inventory”. Hypertension, dyslipidemia, hyperinsulinemia, hyperglycaemia and insulin resistance were defined as cardiometabolic risk factors. The degree of obesity was calculated as the body mass index standard deviation score. Results: Among 283 adolescents 75 (26.5%) were overweight, and 208 (73.5%) had obesity, the mean age was 14.02±1.67 years and 168 (59.4%) of the subjects were girls. The body mass index standard deviation score was in median 2.36±0.62, Children’s Depression Inventory score was in median 12.72±6.5, and 47 (16.6%) of the parti...