Ibrahim Erkul

Oxidative stress in childhood obesity.

OBJECTIVE To measure products of free radical damage in childhood obesity. METHODS Plasma free radicals were assayed in 24 children with exogenous obesity and 24 non-obese healthy controls. A new colorimetric method was used that measures the generation of peroxy radicals (D-Roms), first products of the reaction between free radicals and oxygen. RESULTS D-Roms levels were higher in the obese children than in the non-obese group (33.3+/-10.1 mg% of H2O2 vs 22.8+/-2.8 mg% of H2O2; p <0.001). Moreover, D-Roms levels were higher in children with hyperlipidemia than in children with normolipidemia (49.6+/-3.1 mg% of H2O2 vs 27.8+/-3.2 mg% of H2O2; p <0.001). D-Roms level was positively correlated with waist-hip ratio, serum total cholesterol, serum triglycerides, serum low-density lipoprotein-cholesterol, systolic blood pressure, diastolic blood pressure and fasting blood glucose in obese children. In a multivariate regression model for obese children, the independent correlates for D-Roms level were systolic blood pressure (p <0.001) and serum total cholesterol (p <0.001), with the total variance explained being 82%. CONCLUSION Our study demonstrates for the first time that there was increased D-Roms levels in obese children and adolescents and suggests that increased systolic blood pressure associated with hyperlipidemia may independently contribute to increased oxidative stress in childhood obesity.

Prevalence of anti-HAV and anti-HEV antibodies in Konya, Turkey

OBJECTIVE To determine the prevalence of antibodies to hepatitis A (HAV) and E (HEV) viruses in the different areas of Konya. METHODS Anti-HAV and anti-HEV antibodies were investigated in 210 healthy children randomly selected (100 from rural areas and 110 from urban areas of Konya). None gave a history of previous icterus nor other signs of hepatitis, had received blood transfusion and HAV vaccine, or had been on hemodialysis. RESULTS Evidence of HAV infection occurred in children under the age of 6 years. The seroprevalence rate was 67.8% in rural areas and 25.8% in urban areas. This increased rapidly with age and became universal after 11 years of age in both areas. In contrast, HEV infections were not detected until children were 6-11 year olds, and the 5.2% seroprevalence rate in urban areas and 8.5% seroprevalence rate in rural areas in this age group did not significantly increase in older age group. The prevalence of anti-HAV as well as anti-HEV was significantly higher in children with poor socio-economic conditions in both areas. CONCLUSIONS These results suggest that HAV infection in rural areas of Konya is widespread and that environmental and socio-economic factors play a major role in its transmission. In contrast, hepatitis E is not a public health problem in Konya.

Different clinical features of amitraz poisoning in children

Objective: To evaluate clinical experience of amitraz poisoning in children. Methods: In this study, the clinical and laboratory features of amitraz poisoning in 14 children are presented and compared with previous studies. Results: This study revealed that clinical manifestations of poisoning by oral and dermal routes appeared within 30–150 min, and that central nervous system (CNS) depression, which is the most important sign, improved within 6–24 hours and other signs within 24–72 hours. Unlike the findings in other studies, three severe cases in our study had reversible mydriasis and one of them required resuscitation because of cardiopulmonary arrest occurring as a result of serious respiratory depression. In addition, hepatic function test levels had increased in these three cases, and aspiration pneumonitis existed because of emesis in two of them. Conclusion: There is little information in the literature about dermal poisoning. The signs and symptoms of dermal poisoning were relatively mild compared with oral poisoning, and there were no topical signs. The classical signs of¬small2small-adrenergic stimulation such as marked sinusal bradycardia and mydriasis as reported in many poisoning cases of animals have not been reported before our three severe cases among children.

Acute rheumatic fever in Konya, Turkey.

Abstract Background: Patients with acute rheumatic fever (ARF), who were admitted to Pediatric Cardiology Unit of Selçuk University Faculty of Medicine from July 1993 to 1998, were studied retrospectively to verify the clinical profile of the disease and to compare the results with those from other countries.

Serum cardiac troponin-I in active rheumatic carditis.

Objective :The study was performed to investigate the level of serum cardiac troponin I (cTnl), a specific marker for myocardial cell damage, in the acute rheumatic carditis (RC).Methods : Twenty seven consecutive patients with acute RC and 23 healthy children were enrolled.Result: cTnl level in both groups showed no statistical difference (p > 0.05).Conclusion: Serum cTnl level did not gain clinical use.

Increased Cardiac Troponin I Concentration in Diabetic Ketoacidosis

OBJECTIVE To examine the hypothesis that diabetic ketoacidosis may be associated with some degree of induced injury to heart muscle, related either to acidosis or hyperglycemia. METHODS Nineteen diabetic patients with acute ketoacidosis and 19 healthy children were enrolled in this study. Cardiac troponin I (cTnI), creatine kinase (CK)-MB and myoglobin levels were analyzed soon after admission and after 24 h. Patients were subdivided into two groups according to blood pH. RESULTS At the time of admission, the diabetic patients had significantly higher values than the controls for cTnI (0.193+/-0.008 vs 0.176+/-0.006 ng/dl; p <0.001), CK-MB (24.1+/-2.1 vs 22.7+/-1.2 U/l; p = 0.02), and myoglobin (85.5+/-7.4 vs 52.5 +/-8.3 microg/dl; p <0.001). The diabetic patients also had significantly higher values than the controls for CK-MB (24+/-2.1 vs 22.7+/-1.2 U/l; p = 0.02) and for myoglobin (78.5+/-2.5 vs 52.5+/-8.3 microg/dl; p <0.001) at 24 h. cTnI had normalized in patients at 24 h. All parameters were significantly different between patients with pH > or =7.0 and patients with pH <7.0. In addition, serum cTnI levels correlated negatively with blood pH (r = -0.57, p = 0.026) and HCO3- (r = -0.65, p = 0.008) in the patients with diabetic ketoacidosis on admission. CONCLUSION Our findings suggest that diabetic ketoacidosis, particularly when severe, has a detrimental effect on the myocardium.

Plasma Homocysteine Concentrations in Adolescents with Subclinical Hypothyroidism

OBJECTIVE Hyperhomocysteinemia is a risk factor for premature atherosclerotic vascular disease and venous thrombosis. The aim of the present study was to assess plasma total homocysteine (tHCys) concentrations in adolescent patients with subclinical hypothyroidism. PATIENTS AND METHODS Nineteen patients with subclinical hypothyroidism and 19 healthy children were studied. Fasting plasma concentrations of tHCys and its putative determinants (plasma concentrations of free thyroxine [FT4], folate, vitamin B12 and renal function) were measured. RESULTS tHCys concentrations showed no statistical difference between patients and controls (p > 0.05). Moreover, the difference in tHCys and total cholesterol concentrations was not significant between patients with mild TSH elevations (< or = 10 mIU/l) and patients with prominent TSH elevations (> 10 mIU/l). No correlation was found between tHCys concentrations and its putative determinants. CONCLUSIONS We concluded that plasma tHCys concentrations were not increased in adolescent patients with subclinical hypothyroidism.

Effects of phototherapy on the growth plate in newborn rats.

The aim of the present study was to evaluate the effect of phototherapy and oxidative stress on the growth plate of newborn rats. Forty newborn Sprague-Dawley rats were randomized into a phototherapy group and a control group. Twenty of the rats received phototherapy for 7 days. All zones of the growth plate were assessed with quantitative histomorphometric analysis. Individual zonal lengths were measured for the reserve zone (RZ), the proliferative zone (PZ), the hypertrophic zone (HZ), ossifying cartilage (OC), and total zone (TZ) of the growth plate. Levels of plasma malondialdehyde (MDA), an index of oxidative stress, were also evaluated. Compared with zonal lengths on day 7 after phototherapy between the two groups, the phototherapy group had significantly lower values than those of controls for RZ (5.13 ± 0.36 vs. 6.4 ± 0.85 mm × 10−2; P < 0.001), PZ (20.6 ± 3.0 vs. 29.25 ± 1.68 mm × 10−2; P < 0.001), HZ (15.4 ± 1.44 vs. 20.87 ± 1.12 mm × 10−2; P < 0.001), OC (47.08 ± 4.25 vs. 62.06 ± 3.7 mm × 10−2; P < 0.001), and TZ (88.15 ± 6.56 vs. 118.48 ± 4.50 mm × 10−2; P < 0.001). Plasma MDA levels were correlated with the size of the PZ in the phototherapy group (r = −0.53, P = 0.01). In a multivariate regression model for all rats, being in the phototherapy group was the best predictor of the size of the TZ (β = −0.94, P < 0.001), with the total variance explained being 88%. These results suggest that in newborn rats, receiving phototherapy is associated with early impairment of growth plate structure, and oxidative stress may be the main risk factor for growth plate injury.

Conn syndrome in a child, caused by adrenal adenoma

Hyperaldosteronism owing to aldosterone-producing adenoma (Conn syndrome) is a rare but potentially curable form of pediatric hypertension. The authors report on a 5-year-old girl who had symptoms of polyuria, polydipsia, and fatigue, and for whom the diagnosis of hyperaldosteronemia was suggested by a low serum potassium level and persistent hypertension. The diagnosis was confirmed by increased levels of plasma aldosterone and decreased levels of plasma renin. The tumor was localized with ultrasonography and computed tomography, which showed a 2-cm mass in the left adrenal gland. The left adrenal gland was excised, and pathological assessment showed an adenoma. Only 14 other pediatric cases (< 16 years of age) have been reported in the English-language literature.

Prevalence of hepatitis A, B, C and E virus in adolescents with type-1 diabetes mellitus.

UNLABELLED The hypothesis for this study was that hepatitis virus infection could be associated with diabetes, because of the high frequency of injections. In this study, we aimed to determine the prevalence of hepatitis A, B, C and E viruses in type-1 diabetes mellitus. METHODS Sixty-three patients with the diagnosis of insulin-dependent diabetes mellitus and 63 healthy controls were included in this study. Serological markers of four different types of hepatitis (Anti-HAV IgM, total, anti-HAV, HbsAg, anti-HBs, total anti-HBc, antiHBc IgM, anti-HCV and anti-HEV) were studied in all cases. None of the patients had a history of previous icterus or other signs of hepatitis, had received blood transfusions, or were on hemodialysis. RESULTS There was no difference between the patients and controls with respect to hepatitis A, B, C and E virus serology. The rate of seropositivity of patients within a month of the diagnosis was smaller than those of the patients whose diagnosis were older than one month, but the difference was not found to be statistically significant (p > 0.05). Moreover, hepatitis virus infections did not seem to be related to duration of disease, nor age of onset, ketoacidosis, HbA1c, and insulin regimen. All of the sera were negative for anti-HCV in both patients and controls. CONCLUSION Serological evidence of previous HAV, HBV, HCV and HEV infections was not significantly different between type-1 diabetes patients and healthy controls. Hepatitis virus infection was not associated with diabetes in spite of the high frequency of injections.