Fatoş Tanzer

Effect of Antiepileptic Drugs on Bone Mineral Density in Children Between Ages 6 and 2 Years

We assessed the effects of sodium valproate and carbamazepine monotherapy on bone mineral density (BMD) in children. BMD at the lumbar vertebrae (L1-L4) and radius-ulna was measured by the dual-energy x-ray absorptiometry (DEXA) method in 19 children (9 girls, 10 boys) with uncomplicated epilepsy and in 57 healthy children (28 girls, 29 boys), between the ages of 6 and 12 years. The study patients had been receiving either sodium valproate (n=13) or carbamazepine (n=6) monotherapy for more than 6 months. There were no significant differences between the control and study patients in age, height, weight, physical activity, or of serum concentrations of calcium, phosphate, and transaminases (aspartate aminotransferase, alanine aminotransferase). However, the serum alkaline phosphatase concentration was greater in the patient group as compared with the control group. BMD values were lower in girl patients (L1-L4; 0.497 0.08 vs 0.566 0.07 g/cm2, p<0.05), but not in boys (0.534 0.06 vs 0.530 0.08 g/cm2). While BMD reduction was 8% in valproate therapy (midregion of radius-ulna; 0.287.03 vs 0.312 04 g/cm2, p<0.04), it was reduced only 4.5% in the carbamazepine-treated group (0.298 01 vs 0.312 04 g/cm2, statistically not significant), although the mean durations of monotherapy with valproate (1.8 7 years) and carbamazepine (1.7 8 years) were similar. Thus decreased bone mineralization was observed in children with epilepsy, treated with sodium valproate even though treatment was for a rather short time.

Asymptomatic hypercalciuria : Prevalence and metabolic characteristics

Hypercalciuria is of continuing interest as a risk factor for kidney stones in children. We screened 592 healthy Turkish children (308 boys, 284 girls, aged 3 month-16 years) for hypercalciuria by measurement of urinary calcium/creatinine (UCa/Cr) ratio in the second-morning urine samples. Hypercalciuria was noted in 17 children (2.9 %), 9 of them were boy and 8 of them were girl. Oral calcium-loading test could only be done in 7 children who were diagnosed as having hypercalciuria, and it revealed absorptive hypercalciuria in 2 cases and renal hypercalciuria in no cases. The frequency of a family history of urolithiasis in asymptomatic hypercalciuric children was 50%. Median UCa/Cr ratios and urinary magnesium/creatinine (UMg/Cr) ratios were 0.11 and 0.10 and the 97th percentiles were 0.32 and 0.23 respectively. The UCa/Cr ratio in second-morning urine samples was correlated with the UMg/Cr ratio (r = 0.44) and was independent of age and sex.

Type I cystinuria and its genetic basis in a population of Turkish school children

Objectives:  Cystinuria is a common inherited disorder characterized by an abnormal urinary excretion of cystine and dibasic amino acids resulting in nephrolithiasis. The SLC3A1 gene, which encodes a dibasic amino acid transporter protein, is involved in the pathogenesis of cystinuria. In the present study we aimed to investigate the prevalence of cystinuria among children in Sivas province (Central Anatolia, Turkey) and to study M467T and M467K mutations and 231T/A polymorphism in patients with cystinuria.

Serum zinc level and its effect on anthropometric measurements in 7-11 year-old children with different socioeconomic backgrounds.

This study was performed in order to determine the serum zinc (Zn) level of primary school students, to show the effect of socioeconomic status (SES) on the zinc level, and finally to show the effect of zinc deficiency on the anthropometric parameters. Ten different primary schools were included in the study according to SES. Four-mL venous blood samples were obtained under fasting conditions using disposable plastic syringes. Four hundred thirty-two randomly chosen students between 7 and 11 years of age were investigated. All the children were living in Sivas, a city located in the middle eastern part of Turkey. Serum Zn level was measured by atomic absorption spectrophotometry (Hitachi 2-800). The weight and height of each child was recorded. The SES of children included in this study was as follows: 43.1% low (n = 186), 34.3% middle (n = 148), and 22.7% high (n = 98). Mean serum Zn levels of low and middle SES subjects were 56.3 +/- 17.50 micrograms/dL and 86.6 +/- 26.8 micrograms/dL respectively, while in children with high SES the mean serum Zn was 110.7 +/- 24.50 micrograms/dL. The difference between the groups was found to be statistically significant (F = 19.545, p < 0.05). When height-for-age z-scores were calculated according to SES, 105 of 186 children (56.4%) with low SES were found to have a z-score of -2 or lower and 14 of 147 children with middle SES had a z-score of -2 or lower. None of the children in the high SES group had a z-score of -2 or lower.

Umbilical Serum Insulin-like growth Factor 1 (IGF-1) in Newborns: Effects of Gestational Age, Postnatal Age, and Nutrition

AIM The aim of this study was to determine the relationship between nutrition, gestational age, and birth weight, and serum insulin-like growth factor 1 (IGF-1) levels in newborns. METHOD The first study group consisted of sixty newborns: thirty were fed with human breast milk and the others were fed with infant formula. Serum samples were obtained from all the newborns on days one and seven of life. Seventy-two pregnant women and their neonatal cord blood serum samples were obtained in a labor ward in the study group. All the serum samples were analyzed for IGF-1 by immunoassay. RESULT Newborns fed with human milk had higher serum IGF-1 concentrations compared to formula-fed controls (p < 0.05). Cord IGF-1 levels showed a negative correlation with birthweight (p < 0.05) and a positive correlation with gestational age (p < 0.05). CONCLUSION These findings suggest that IGF-1 levels during the neonatal period are influenced by gestational age, birth weight, and nutrition.

Gyrate atrophy of the choroid and retina with hyperornithinemia, cystinuria and lysinuria responsive to vitamin B6.

In this report, an 8-year-old girl is presented with the complaint of progressive night blindness. The authors have performed eye funduscopy, which showed chorioretinal atrophy in gyrate shape. A high level of plasma ornithine was determined. Urinary excretion of ornithine as well as lysine and cystine were increased. Patient was treated with high dose pyridoxine supplement (500 mg/dl). The night blindness condition of the patient improved. After 1 month of pyridoxine therapy ornithine level of her plasma was successfully reduced and blindness improved.

Analysis of a 1-year-old cystinuric patient with recurrent renal stones

Abstract  Cystinuria is a hereditary disorder of cystine and dibasic amino acids (lysine, arginine, ornithine) transport across the luminal membrane of renal tubules and intestine, resulting in recurrent nephrolithiasis. Cystine stones frequently occur in the second or third decade of life with an occasional occurrence in infancy and in old age. Herein is presented the case of a 1‐year‐old girl with cystinuria and recurrent urolithiasis; the genetic basis of the disease was investigated by mutational analysis of the SLC3A1 gene. The data show that the present patient has an increased cystine (923.08 µg/mL) level and was heterozygote for M467T mutation.

Sivas il merkezinde kreş ve anaokullarında sekretuvar otitis media prevalansı

Bu calismada sekretuvar otitis media prevalansini ve ilgili risk faktorlerini belirlemeyi amacladik Sivas ta kres ve anaokullarinda 2 6 yas arasi 606 cocukta sekretuvar otitis media prevalansi arastirildi Sekretuvar otitis media tanisi otoskopik muayene ve timpanometri ile konuldu Ortalama prevalansi 18 8 olarak bulundu Daha once ve son bir yilda orta kulak iltihabi oykusu sik ust solunum yolu enfeksiyonu oykusu ailede kulak iltihabi ve allerjik hastalik oykusu kalabalik aile odasini birden fazla kisi ile paylasma dusuk dogum agirlikli dogma yetersiz anne sutu alma lt;5 ay ile sekretuvar otitis media arasi anlamli bir iliski bulundu Sekretuvar otitis media sikligi 2 yasta en yuksek iken 5 yasta ikinci bir pik goruldu Cinsiyet ve sigara ile sekretuvar otitis media arasi anlamli bir iliski saptanmamakla birlikte sigaraya maruz kalan cocuklarda sekretuvar otitis media sikligi daha yuksekti Sekretuvar otitis mediaya bagli isitme kayipli cocuklarin 63 unun ailelerince 89 unun ogretmenlerince fark edilmedigi saptandi Sekretuvar otitis media tespit edilen cocuklarin okul basarilarinin dusuk oyun ders ve aktivitelere ilgilerinin az oldugu bulundu Anahtar kelimeler: Sekretuvar otitis media prevalans risk faktorleri

Bir Yenidoğanda Florokinolon Artropatisi

Florokinolonlar genis spektrumlu ve hucre ici penetrasyonu kuvvetli olan DNA replikasyonunu onleyen bakterisid etkili bir antibiyotik grubudur Uzun yillardir kinolonlara bagli kikirdak toksisitesi deneysel olarak immatur hayvanlarda ispatlanmis ve prepubertal hastalarda kullanim kontrendikasyonu yaratmis olmakla birlikte multirezistan Enterobacter cloace septisemili ve ventrikulitisli prematur yenidoganlarda basarili sonuclar elde edilmistir Bu makalede Cumhuriyet Universitesi Pediatri Bolumu Neonatoloji Unitesinde neonatal sepsis tanisi konan ve florokinolon ile tedavi edilen bir olgu sunulmustur Anahtar kelimeler: Florokinolonlar Artropati

Bir Aglossi Adaktili Sendromu Olgusu Anal Darlıkla Birlikte

The syndrome of aglossia adactylia is an uncommon syndrome characterized by micrognathia hypoglossia or aglossia and absence of one or more of the extremities The patient was admitted with the complaints of lack of right hand and distal left leg below the knee In addition to these findings physical examination revealed mild micrognathia and hypoglossia large and low set ears telecantus high palate and anal stenosis Anal atresia is uncommon with this syndrome for that reason we have presented this case of Hanhart s syndrome with anal stenosis Key words: Aglossia Adactylia