Yazar "Kocabay, Kenan" seçeneğine göre listele
Listeleniyor 1 - 20 / 24
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Assessment of magnesium status in newly diagnosed diabetic children: measurement of erythrocyte magnesium level and magnesium tolerance testing(Turkish J Pediatrics, 2005) Şimşek, Enver; Karabay, Meltem; Kocabay, KenanThe aim of this study was to investigate the relationship between serum, erythrocyte and urine magnesium levels and retained magnesium percentage in newly diagnosed diabetic children. In a cross-sectional study, 34 children with insulin dependent diabetes mellitus (IDDM) and 21 healthy age- and sex-matched control subjects were screened for their serum, erythrocyte, and urine magnesium levels. Magnesium tolerance test was performed on diabetic and control subjects: Serum and erythrocyte magnesium levels in diabetic children were significantly lower than in healthy controls (plasma magnesium, p < 0.05; erythrocyte magnesium, p < 0.001); however, serum magnesium level was in normal range in diabetics and controls. Erythrocyte magnesium levels in diabetic children showed an inverse correlation with percentage of retained magnesium load (r=-0.44, p < 0.01). Urine magnesium excretion in diabetic children (7.12 +/- 2.18 mmol/g creatinine/24-hr) was significantly higher than in healthy controls (4.0 +/- 1.35 mmol/g creatinine/24-hr) (p < 0.001). There was a negative correlation between erythrocyte magnesium (2.07 +/- 0.62 mmol/L) and urine magnesium (7.12 +/- 2.18 mmol/g creatinine/24-hr) (r=-0.68 p < 0.01) in diabetic children. Magnesium tolerance test showed that percentage of retained magnesium in diabetic children (66 +/- 26%) was significantly higher than in controls (16 +/- 7%) (p < 0.001). This study is the first study to simultaneously investigate serum, erythrocyte and urine magnesium levels and magnesium tolerance test in newly diagnosed diabetic children. In conclusion, erythrocyte magnesium levels decrease earlier than serum magnesium in diabetic children. The follow-up parameters in diabetics may include the policy of monitoring magnesium status. Erythrocyte magnesium measurement is preferred to serum magnesium. Magnesium tolerance test is a reliable and sensitive method, which may be used as an alternative to erythrocyte magnesium measurement or in combination with it in hospitalized diabetic children.Öğe BCG aşılamasında neredeyiz?(2004) Yavuz, Taner; Arbak, Peri; Öztürk, Elif Cihadiye; Kocabay, KenanBCG aşısı tüberkülozdan korunma ve kontrol için yüksek riskli gelişmekte olan ülkelerde önerilmekte ve uygulanmaktadır. Türkiye'de 1997 yılından itibaren yeni "Bacillus Calmette-Guerin (BCG)" aşılama programına başlanmıştır. Çalışmadaki amacımız Düzce'deki BCG aşılama durumunu değerlendirmek ve aşılama programına etkili faktörleri analiz etmektir. Düzce merkez ve yedi ilçede bulunan toplam dokuz okul sekizinci sınıf öğrencilerinde BCG aşılılık oranına bakıldı. Aşı durumunu değerlendirmede BCG skar varlığı kriter olarak alındı. BCG aşılılık oranı %94 olarak bulundu. Öğrencilerin 1030'unda BCG skarı bulunmakla birlikte, 478'inde bir skar, 536'sında iki skar, 16'sında ise üç aşı skarı saptandı. BCG aşıldık oranı ile sağlık personeli başına düşen 15 yaş altı nüfus arasında anlamlı negatif korelasyon gözlendi. Ayrıca, BCG aşılama durumunun Türkiye'deki bölgesel farklılıkları da makalede tartışılmıştır.Öğe Biotinidase deficiency in a four-week-old infant with infantile spasms(2006) Şenses, Dursun Ali; Şimşek, Enver; Yar, Neşe Ersöz; Keskin, Mahmut; Kocabay, KenanProfound biotinidase deficiency was diagnosed in a 28-day old infant with seizures-like infantile spasms, alopecia and erythematous rash. Clinical signs improved dramatically with biotine treatment. Clinical features of biotinidase deficiency are discussed.Öğe Breastfeeding practices in Duzce, Turkey(2008) Yesildal, Nuray; Aytar, Gulsen; Kocabay, Kenan; Senih Mayda, Atilla; Cetin Dagli, Sinemis; Bahcebasi, TalatExclusive breastfeeding among infants less than or equal to 6 months old and continued breastfeeding (20-23 months) are high-priority indicators of infant health. We aimed to assess breastfeeding practices, using standardized breastfeeding indicators, and to determine the causes of early discontinuation of breastfeeding (? 6 months) in children aged 0 to 24 months in Duzce, Turkey. In this cross-sectional study, the study group consisted of 158 children, and questionnaires were completed by face-to-face interviews with the mothers. The rate of exclusive breastfeeding (? 6 months) was 22.4%. The rate of continued breastfeeding (20-23 months) was 10.0%. The 2 primary causes of early discontinuation of breastfeeding were inadequate milk supply (38.1%) and baby not latching on (14.3%). Half of the individuals who recommended infant formula to mothers with infants less than or equal to 6 months old were physicians. © Copyright 2008 International Lactation Consultant Association.Öğe Can acute rheumatic fever and acute poststreptococcal glomerulonephritis occur simultaneously?(2002) Özyürek, Hamit; Uyan, Ayten P.; Korkut, Sabriye; Kocabay, KenanAcute rheumatic fever (ARF) and acute poststreptococcal glomerulonephritis (APSGN) are nonsuppurative complications of streptococcal infection. In many parts of the world, especially in developing countries, the two poststreptococcal sequelae continue to be prevalent and to be major public health problems. We report a case diagnosed as ARF associated with APSGN.Öğe Can Both of the Acute Rheumatic Fever and Acute Poststreptococcal Glomerulonephritis Occur Simultaneously? [2](2004) Özyürek, Hamit; Uyan, Ayten P.; Korkut, Sabriye; Kocabay, Kenan[No abstract available]Öğe Çocuklarda toraks ampiyeminde streptokinaz tedavisi(2003) Yavuz, Taner; Ersöz, Neşe; Aktaş, Alev; Kocabay, KenanAmaç: Çocuklarda toraks ampiyeminin tedavisinde intraplevral streptokinazın rolünü değerlendirmek. Gereç ve Yöntem: Mayıs 2002 ile Haziran 2003 arasında toraks ampiyemi olan 9 çocuk kapalı tüp drenajı ve antibiyotikle tedavi edildi. Bu çocuklardan 4'ü medikal tedaviye yanıtsızdı ve intraplevral Streptokinaz uygulandı. 100 mL serum fizyolojikle sulandırılan 250,000 ünite Streptokinaz günde tek doz olarak 3 gün süreyle interkostal tüpten verildi. Tedavi yanıtı klinik seyir, drene edilen sıvının ölçümü ve takipte çekilen toraks grafisi, ultrasonografi ve/veya bilgisayarlı tomografi ile değerlendirildi. Bulgular: Tüm vakalar 3 günlük Streptokinaz tedavisine interkostal tüp drenajında artış, semptomlarda gerileme ve takipte çekilen görüntüleme teknikleriyle gösterilen ampiyemin tam rezolüsyonu ile yanıt verdiler. Vakaların hepsinde kısa süren ateş için oral analjezik gereksinimi oldu. Hiçbir vakada başka bir yün etki gelişmedi. Sonuç: Çalışma konservatif tedaviye yanıtsız toraks ampiyemli seçilmiş vakalarda intraplevral Streptokinaz uygulamasının etkili olduğunu göstermektedir. Streptokinaz tedavisi cerrahi tedavi gereksinimini azaltmak için dekortikasyon adaylarında düşünülmelidir. Bununla birlikte, ilacın verilme zamanı, dozajı ve uzun dönem yan etkilerini değerlendirmek için kontrollü çalışmalara gereksinim vardır.Öğe Comparison of imaging studies and diagnostic tests for the diagnosis and follow-up of recurrent urinary tract infection in children(2004) Şimşek, Enver; Koloğlu, Nuri; Yugunt, İbrahim; Kocabay, KenanObjective: To compare the imaging studies and diagnostic tests for the diagnosis and follow-up of urinary tract infection (UTI) in children. Methods: Ninety-two children with recurrent urinary tract infection were studied. Urinalysis, dipstick examination of urine for leukocyte-esterase (LE) and nitrite reaction, urine culture, sedimentation rate, C-reactive protein, renal ultrasonography, and voiding cystourethrography (VCUG) were performed. The renal cortical 99mTC dimercaptosuccinic acid (DMSA) scanning was performed during the acute phase of infection for the localization of UTI in some patients and after six months of the treatment in all patients. VCUG was performed six months later again in children who had vesicoureteral reflux (VUR). Intravenous pyelography (IVP) was used for selected cases to screen for urinary obstruction or malformations. Results: All children were followed-up until 39 months. Of the 92 patients, the prevalence of pyuria and bacteriuria were found in 74 (80.4%) and 78 (85%), respectively; hematuria in 62 (67%); and positive LE and nitrite on dipstick in 48 (52%) and 30 (33%) children, respectively. Sedimentation rate was higher than 20 mm/hour in 76 (83%) children. Positive C-reactive protein (CRP) level (> 10 mg/dl) was found in 68 (74%) children. Of the 92 children, 82 (89%) had positive culture result: 64 (78%) females and 18 (22%) males. Renal ultrasonography (US) was abnormal in 28 (30%) children. Renal scarring was revealed by DMSA scanning in 56 (61%) children. DMSA was abnormal in 34 (37%) children who had normal renal ultrasonography, and in 22 (24%) children who had normal VCUG. Ultrasound was abnormal in 2 (2%) children who had normal DMSA. VCUG showed grade I reflux in one (1%) patient who had normal DMSA. IVP revealed VUR in 4 (4%) children who had normal US. DMSA was abnormal in all patients who had abnormal IVP findings. Conclusion: Using the combination of urinalysis, dipstick examination for leukocyte esterase, sedimentation rate, and CRP as screening tests in symptomatic patients, prevents overdiagnosis of UTI and unnecessary treatment. Renal ultrasonography, VCUG, and renal cortical DMSA scanning should be the minimum imaging studies for the evaluation of recurrent UTI in children. IVP is recommended only for selected cases when anatomic detail is required.Öğe Comparison of two different bronchodilators in the treatment of acute bronchiolitis(2002) Özyürek, Hamit; Uyan, Ayten P.; Keskin, Mahmut; Afşar, Yılmaz; Kocabay, KenanBronchiolitis is an acute inflammatory respiratory illness of children less than two years of age. Therapies used in the treatment of bronchiolitis include adequate hydration, supplementary oxygen, bronchodilators, ribavirin, corticosteroids, immune globulin, interferon alfa and vitamin A. We enrolled 34 infants who were hospitalized for bronchiolitis to evaluate the efficacy of two different bronchodilators. Thirty-four infants under two years of age were randomized to receive either nebulized salbutamol (Group I) or nebulized ipratropium bromide (Group II). Clinical severity was scored on admission and 12-hour intervals after the start of nebulization. The symptom score evaluated five items: respiratory rate, presence of wheezing, presence of retraction, presence of nasal flaring, and general appearance. No difference was observed between the two groups in the clinical improvement on hospital admission and at the 12th, 24th, 36th and 48th hours during treatment. The mean duration of hospital stay was not significantly different between the two groups. When the groups were evaluated independently, there was a significant difference in scores before treatment and at the 48th hour of nebulization. We conclude that, ipratropium bromide and salbutamol are equally effective in the clinical recovery of bronchiolitis. Because of the side effects of salbutamol, ipratropium bromide may be primarily preferred as a bronchodilator.Öğe Congenital hypothyroidism and iodine status in Turkey: A comparison between the data obtained from an epidemiological study in school-aged children and neonatal screening for congenital hypothyroidism in Turkey(2003) Şimşek, Enver; Karabay, Meltem; Şafak, Alper; Kocabay, KenanBackground: Congenital hypothyroidism and endemic iodine deficiency are the most common cause of mental retardation. However in both cases retardation is of non-preventable nature. Objective: The aim of the study was to investigate whether epidemiological study in school-aged children or neonatal screening of congenital hypothyroidism (CH) was useful to assess iodine status and monitor the preventive measures of iodine deficiency disorders (IDD). Subjects: To study the epidemiology, 1046 school children, aged 8 to 12 years from 23 primary schools in rural and urban areas from three cities in Turkey were included. Neonatal screening for congenital hypothyroidism (CH) was carried in. Methods: Goiter and thyroid volume were assessed by palpation and ultrasound, respectively. Thyroid stimulating hormone (TSH), total thyroxine (T4), and urinary iodine excretion (UIE) were measured. Neonatal screening for CH was adjusted according to the guidelines of Pediatric Endocrinology of the European Society for Pediatric Endocrinology. Results: There was no significant difference between the median TSH in school-aged children and the cities of Bolu and Düzce (p>0.05). Median TSH of Zonguldak was significantly different from the median TSH of Bolu (p=0.046) and Düzce (p=0.028). There was no significant difference between the median T4 levels of Bolu and Düzce (p>0.05). The median T4 of Zonguldak showed a significant difference from the median T4 value of Bolu (p=0.018), but an insignificant difference from the median T4 of Düzce (p>0.05). The overall goiter prevalence in 1046 children was 52%. In two years, 18606 newborns were screened. With a cut-off point at TSH >20 ?U/ml, the recall rate was 1.6% and the incidence of CH 1/2326. There was 26.7% children with TSH >5 ?U/ml. Both data of the epidemiological study in school-aged children and neonatal screening for CH indicated that the West Black Sea Region is affected by mild to moderate iodine deficiency. Conclusion: the implementation of neonatal screening for congenital hypothyroidism using TSH measurement has many advantages. It can detect congenital hypothyroidism and transient primary hypothyroidism, and can also be used for monitoring tools of preventive measures of IDD. Countries, such as Turkey, which has not begun national screening for CH yet, should make implementation of neonatal screening for CH using primary TSH measurement a political priority.Öğe Deprem bölgesindeki çocukluk çağı pnömonilerinin epidemiyolojik özellikleri(2004) Şimşek, Enver; Yılmaz, Ebru; Karabay, Meltem; Avşar, Yılmaz; Kocabay, KenanAmaç: İki büyük depreminin gerçekleştiği Düzce ve çevre illerde görülen çocukluk çağı pnömonileri üzerine etkili risk faktörlerinin irdelenmesi. Gereç ve Yöntem: Nisan 1998 ile Mart 2003 tarihleri arasında Düzce Tıp Fakültesi Çocuk Kliniği'nde alt solunum yolu infeksiyonu tanısı konulan 172 (98 [57%] erkek, 74 [43%] kız) çocuk hasta çalışmaya alındı. Alt solunum yolu infeksiyonu tanısı ve tedavisi Dünya Sağlık Örgütü kriterlerine göre yapıldı. Vakalar yaş, cinsiyet, getirildikleri bölge, yaşam koşulları, beslenme şekli, gelişim özelliklerine göre irdelendi. Bulgular: Yüz yetmiş iki hastanın 124'ü (%72) hastaneye yatırılarak, 48'i (%28) ayaktan tedavi edildi. Hastaneye yatırılan 124 hastanın 89'unu (%72) Bolu, Düzce, Adapazarı ve Zonguldak il merkezlerinden, 35'ini (%28) bu illerin kırsal kesimlerinden gelen hastalar oluşturuyordu. Ayaktan izlenen hastaların 32'sini (%66) kırsal kesimden gelen, 16'sını (%34) şehir merkezinden gelen hastalar oluşturuyordu. Hastaların tanı anındaki yaşları 2 hafta ile 17.4 yıl arasında olmak üzere, ortalama (± S.E.M) tanı yaşı 37 (± 7.4) hafta olarak bulundu. Yüz yetmiş iki çocuğun 54'ünde (%31) ağırlık yaşa göre ağırlığın %60 ile %75'i arasında, 26'sında (%15) ise yaşa göre ağırlığın %60'ın altında saptandı. Tanı konulan mevsimlere göre, 84 (%49) çocukta kış, 46 (%27) çocukta ilkbahar, 23 (%13) çocukta yaz ve 19 (%11) çocukta sonbahar mevsiminde tanı konuldu. Ortalama (± S.E.M) pnömoni tedavi süresi, plevral effüzyonu olmayan vakalarda 13 ± 5 gün, ampiyemi olan vakalarda ise 21 ± 8 gündü. Çalışmaya alınan hastalardan 19'u (%11) kaybedildi. Bu vakaların 17'sini (%89) 2 yaş altındaki çocuklar oluşturuyordu. Mortalite ile yaş arasında negatif korelasyon saptandı (r=-0.33, p<0.001). Yaşamın erken döneminde pnömoni olması yanında, annenin yaşlı olması, tanı anında lökosit sayısı ve sedimentasyon hızı yüksekliği ile birlikte akciğerlerde yaygın infiltrasyonun bulunması prognozun olumsuz olabileceğine işaret eden parametrelerdi. Sonuç: Sağlıksız yaşam koşulları, halen deprem bölgesinde çocukluk çağı pnömonileri için en önemli risk faktörü olma özelliğini korumaktadır. Deprem bölgesindeki çocukluk çağı pnömonilerinin prognozu üzerine olumsuz etkisi olan risk faktörlerinin çoğu önlenebilir özelliktedir. Sağlıksız ortamlardan kalıcı ve hijyenik ev koşullarına geçiş, bölgedeki çocukluk çağı pnömoni insidansının azalmasına etkili önemli faktörlerden birisidir. Aşılama programlarının düzenli yapılması, pnömoni gelişiminde önemli risk faktörü olan mikroorganizmalara karşı yeni jenerasyon aşıların da ülke rutin aşı programına alınması ve anne sütü kullanım oranının istenen seviyelere çıkarılması pnömoni sıklığını azaltabilecek diğer önemli faktörlerdir.Öğe Düzce ve çevresinde hipokrom mikrositer eritrositleri olan çocuklarda HbA2 tayini ile beta-talasemi taşıyıcılığı taraması(2006) Yavuz, Taner; Öztürk, Cihadiye Elif; Yavuz, Özlem; Korkut, Sabriye; Karakaş, Zeynep; Kocabay, KenanAmaç: Hipokrom mikrositer eritrositleri olan çocuklarda HbA2 düzey tayiniyle b-talasemi taşıyıcı sıklığını araştırmak. Yöntem: Düzce merkez ve ilçelerinde okuyan 1,148 ilköğretim 8. sınıf öğrencisinden kan örnekleri alındı. Alınan örneklerin 122'sinde eritrosit ortalama volümü (EOV: MCV) < 79 fL veya eritrosit ortalama hemoglobin (EOH: MCH) < 27 pg saptandı ve b-talasemi taşıyıcılığı araştırıldı. Bu örneklerde high-performance liquid chromatography (HPLC) yöntemi ile hemoglobin A2 (HbA2) tayini yapıldı. Ayrıca, hipokromi ve/veya mikrositer örneklerden b-talasemi taşıyıcısı ve taşıyıcı olmayanlar kendi içinde iki gruba ayrıldı ve test sonuçları karşılaştırıldı. Bulgular: HbA2 düzeyi 7 (% 0.6) vakada % 3.5'e eşit veya yüksekti ve b-talasemi taşıyıcısı kabul edildi. b-talasemi taşıyıcı olan grup taşıyıcı olmayanlarla kıyaslandığında; taşıyıcı grubun ortalama MCV (p< 0.001), MCH (p< 0.001), Mentzer indeksinin (p< 0.001) daha düşük, eritrosit sayısı (p< 0.001) ve HbA2 (p< 0.001) değerlerinin ise daha yüksek olduğu saptandı. Sonuç: Batı-Karadeniz bölgesinde yer alan Düzce'de gerçekleştirdiğimiz bu ön çalışmayla, Düzce'de b-talasemi taşıyıcılığı sıklığının Türkiye geneline göre daha düşük olduğu sonucuna varılmıştır. Tarama programlarının etkinliğini arttırmak için, MCV ve MCH değerlerinin yanısıra RBC ve Mentzer indeksi kullanışlı parametreler olabilir.Öğe Hipertiroidi, hiperkortizolizm ve püberte prekoks ile seyreden McCune-Albright sendromu: İki vaka sunumu(2003) Şimşek, Enver; Yavuz, Taner; Kocabay, KenanMcCune-Albright sendromu (MCAS) kemiğin fibrodisplas-tik lezyonu, düzensiz, sütlü kahve lekeleri şeklinde cilt lezyonları ( "cafe au lait"), hiperfonksiyon ile seyreden bir veya birden fazla endokrinopati ile karakterizedir. Sendrom Ga proteininde aktivasyon mutasyonu sonucu ortaya çık-maktadır. Erken puberte, hipertiroidi, Cushing sendromu, akromegali veya jigantizm sıklıkla eşlik eden endokrinopatilerdir. Endokrin hiperfonsiyonlar hipotalamohipofizer aksdan bağımsızdır. Kliniğimizde MCAS tanısı konulan iki vaka (14 aylık erkek sütçocuğu, 7 yaşında kız) sunuldu. Endokrinopati olarak 14 aylık vakada hipertiroidi ve hiperkortizolizm, 7 yaşındaki vakada periferik erken puberte bulguları saptandı. Çocukluk çağında birden fazla hiperfonksiyon ile seyreden endokrinopatinin eşlik ettiği olgularda ve periferik erken pubertesi olan vakalarda, sütlü kahve lekeleri şeklinde kenarları, düzensiz cilt lezyonları görülürse, ayırıcı tanıda MCAS'nün da dikkate alınması açısından iki vakanın sunumu yapıldı.Öğe Hypogonadotropic hypogonadism and growth hormone deficiency in a patient with primary hypothyroidism associated with pituitary hyperplasia mimicking pituitary macroadenoma(Karger, 2006) Şimşek, Enver; Şimşek, Tülay; Erdoğmuş, Beşir; Döşoğlu, Murat; Kocabay, KenanBackground: ATSH secreting pituitary macroadenoma is only 5% of all pituitary adenomas and it is extremely rare in children. Long standing untreated primary hypothyroidism may be cause pituitary hyperplasia which will be simulating macroadenoma.Öğe Insulin-like growth factor (IGF-I) in Mauriac syndrome or diabetic dwarfism(2002) Şimşek, Enver; Kocabay, KenanMauriac syndrome is characterized by the development of dwarfism, obesity and hepatomegaly in patients with insulin dependent diabetes mellitus (1). Growth retardation and hepatomegaly in diabetes mellitus should alert physicians over the insufficient management of diabetes mellitus and the related development of Mauriac syndrome. The cause of growth failure in Mauriac syndrome has remained obscure, although it is presumably related to the poor metabolic control of diabetes (2). Growth hormone deficiency has not been found in reported cases of Mauriac syndrome (3,4). The most important growth promoting effect of growth hormone is mediated by IGF-I (5). The determination of IGF-I and insulin-like growth factor binding protein 3 (IGF-3) had become a widely used tool in the diagnostic evaluation of growth disorders. Although IGF-I levels are commonly considered an indication of growth hormone (GH) secretion or action, its synthesis and secretion are regulated by a multifactorial and complex mechanism. Nutrition, insulin, sex steroids, cortisol, and thyroxin have positive stimulatory effects on the release of IGF-I (6). We report on two cases of diabetes mellitus associated with Mauriac syndrome and limited joint mobility.Öğe Investigating for Insulin Resistance and Type 2 Diabetes Mellitus in Obese Children(Galenos Yayincilik, 2005) Simsek, Enver; Karabay, Meltem; Aras, Sukru; Kocabay, KenanThe incidence and prevalence of type 2 diabetes mellitus within the childhood period has increased in the worldwide, particularly among obese children. The aim of this study was to investigate impaired glucose tolerance and insulin resistance in obese children. Thirty-six children (18 girls and 18 boys) aged between 7.4 and 17 years with a body mass index (BMI) > 95th percentile and referred to our hospital between 1998 and 2003. Control group consisted of 30 children (13 girls and 17 boys) aged between 7.2 and 17.8 years with a body mass index between 5th and 95th percentile. Fasting and oral glucose tolerance test (OGTT) 120th min serum glucose and insulin levels were measured. The glucose results were characterized according to the World Health Organizations criteria. Insulin resistance (IR) was defined by homeostasis model assessment (HOMA) as IRHOMA. Fasting glucose levels were in normal limits in all obese and control subjects. OGTT revealed that 9 of 36 obese children (25 %) had diagnosed impaired glucose tolerance and 2 children (6%) diabetes mellitus. Plasma glucose levels in OGTT were in normal limits in all control subjects. IRHOMA revealed insulin resistance in 17 of 36 obese children (47%) and significantly correlated puberty (r=0.418, p=0.0217), BMI (r=0.507, p=0.002), age (r=0.513, p=0.001), and insulin level at 120th min of OGTT (r=0.821, p<0.001). Overall mean IRHOMA in obese and control subjects were 4,1 +/- 1.0 and 1,5 +/- 0.9, respectively. The difference of mean IRHOMA levels between obese and control subjects was significantly different (p<0,001). IRHOMA levels of 5 control subjects (16%) were above the level of cut-off point (2,5), however OGTT were normal in these subjects. In conclusion, the childhood obesity is one of the important risk factors for the early beginning of type 2 diabetes mellitus. An OGTT is more sensitive at identifying impaired glucose tolerance or diabetes mellitus than fasting glucose alone. Body-mass index (BMI) was strongest predictor of fasting and glucose stimulated insulin levels.Öğe Kistik tiroid teratomu(2000) Şimşek, Enver; Alper, Murat; Özyürek, Hamit; Berk, Derya; Gözükara, Aynur; Kocabay, KenanTeratomlar konjenital tümörlerdir ve en sık sakrokoksigeal bölge olmak üzere birçok yerleşimde ortaya çıkabilirler. Tiroid yerleşimli teratomlar çok nadir ölüp, çocukluk çağında sık görülüp, çoğu kistik ve benign karakterlidir. Burada liistopatpjojik olarak tanısı konulan tiroid yerleşimli bir kistik teratom olgusu sunuldu.Öğe Neonatal screening for congenital hypothyroidism in West Black Sea area, Turkey(Blackwell Publishing Ltd, 2005) Şimşek, Enver; Karabay, Meltem; Kocabay, KenanThe aim of this study was to investigate the incidence of congenital hypothyroidism (CH) in the West Black Sea Area, a mild-to-moderate iodine deficient area in Turkey. Neonatal screening for CH was performed using blood specimens collected onto filter paper. Thyrotropin [thyroid-stimulating hormone (TSH)] was measured by radioimmunoassay, and a value >20 mu U/ml was considered as cut-off point for re-examining. Venous serum was obtained to measure TSH, thyroxin (T4), free T4 (FT4) and thyroglobulin (TG). To determine the iodine status of the study area, median urinary iodine was measured in 212 randomly selected neonates and their mothers. A total of 18606 neonates were screened from three cities (Bolu, Duzce, and Zonguldak) between 2000 and 2002. With a cut-off point of TSH value >20 mu U/ml, the recall rate was found 1.6%. Eight cases of CH were diagnosed (incidence 1/2,326).There were three cases of transient hypothyroldism, with an incidence of 1/6202. Twenty-six percent of the TSH values was greater than 5 mu U/ml. Median urinary iodine concentrations in neonates and their mothers were 85 mu g/l and 40 mu g/l, respectively. The incidences of CH, transient hypochyroidism and the recall rate were higher in our study area than many countries in Europe. The study area has been affected by mild-to-moderate iodine deficiency. Neonatal screening for CH should be introduced in Turkey without delay. A national comprehensive infantile hypothyroidism and iodine prophylaxis policies should be developed.Öğe Nipple and areola diameter in Turkish pubertal girls(Elsevier Science Inc, 1998) Aygün, A. Denizmen; Akarsu, Saadet; Güvenç, Hüseyin; Kocabay, KenanThe nipple and areola diameter of 498 girls aged 8-17 years were studied with the aim of finding measurable criteria for sexual maturation, including breast and pubic hair development during female puberty. All measurements were made holding a transparent ruler on both sides by the same observer. The smaller of the two measurements was used in the analysis. Significantly nipple and areola development occurred between breast stages BI (2.56 and 14.35 mm), B2 (3.32 and 20.26 mm), B3 (5.21 and 28.84 mm), and B4 (6.28 and 32.03 mm). The nipple and areola diameter were also significantly greater in pubic hair stage (PH)3 (5.05 and 25.24 mm) with respect to PH2 and PH1 (3.46, 2.62 mm and 19.32 15.37 mm, respectively), in PH5 (6.79 and 35.62 mm) with respect to PH4 (6.55 and 32.56 mm). A significant increase in nipple and areola diameter occurs between premenarchal girls and girls-older than 0-2 years postmenarche. Sexual maturation staging by nipple size and by areola size appears to be feasible for female adolescent However, staging by nipple size does not appear to be feasible for B4 and B5 stage, because the incremental gradations are small.Öğe Sensitivity of iodine deficiency indicators and iodine status in Turkey(Freund Publishing House Ltd, 2003) Şimşek, Enver; Şafak, Alper; Yavuz, Özlem; Aras, Şükrü; Doğan, Semih; Kocabay, KenanBackground. Iodine deficiency is a major health problem worldwide. Goiter prevalence and the median urinary iodine concentration in a population usually define endemic iodine deficiency. In addition to goiter prevalence and median urinary concentration, thyroid stimulating hormone (TSH) and thyroxine have been used as iodine deficiency indicators. Objective: To evaluate endemic goiter prevalence in Western Anatolia, Turkey, and to evaluate the sensitivity of thyroglobulin and height percentile as iodine deficiency indicators. Subjects: We examined 727 school-children (378 girls, 349 boys) in two cities (Bolu and Duzce) and six mountainous rural areas, in West Anatolia. Of the 727 children, 234 were from four urban schools, and 493 were from eight rural schools. Methods: Clinical examination and ultrasonography were used to evaluate goiter prevalence. Iodine in spot urine, serum total thyroxine (T-4), serum free thyroxine (FT4), thyroid stimulating hormone (TSH), and thyroglobulin (Tg) were measured. Iodine deficiency severity was classified based on thyroid volume measurements by ultrasonography and urinary iodine excretion. Results: The degree of iodine deficiency according to concentration of urinary iodine was severe in 2 76 children (38%), moderate in 151 (20.8%), mild in 114 (15.7%), and within normal levels in 186 (25.4%). Although urban areas showed normal or mild urinary iodine excretion, four rural areas showed from mild to severe iodine deficiency (p <0.001). Thyroid volumes of the severe iodine deficiency group were significantly higher than those of moderate and mild iodine deficiency groups (p <0.001). There was no significant difference between thyroid volumes in moderate and mild iodine deficiency groups. FT4 levels of the severe iodine deficiency group were significantly lower than in moderate and mild iodine deficiency groups (p <0.001). There was no significant correlation between TSH and iodine excretion (r = 0.01, p >0.05). Thyroglobulin (Tg) levels were significantly different between all groups (p <0.001). There was a significant negative correlation between Tg and urinary iodine excretion (r -0.27, p <0.001). Conclusions: Severe and moderate iodine deficiency areas are more prevalent in Turkey than mild and normal iodine concentration areas. In addition to urinary iodine concentration and thyroid volume, height percentile and Tg are also sensitive markers for endemic iodine deficiency. TSH screening should be performed nationwide in Turkey. We recommend compulsory iodination of table and industrial salt.
