Mukadder Ayşe Selimoğlu

Coeliac disease and reproductive disorders.

Abstract Reproductive problems, such as delayed menarche, amenorrhea, early menopause, infertility, impotence, hypogonadism, recurrent abortions, and low-birth-weight or preterm deliveries, are now known to be among the atypical symptoms of coeliac disease (CD). The pathogenesis of reproductive disorders in CD is unclear, but some hypotheses have been suggested, including autoimmunity and macro- and/or micronutrient deficiency. Recent investigations which have focused on tissue transglutaminase are promising with respect to the clarification of the mechanism of infertility and poor pregnancy outcomes in CD. In this review, the effects of CD on male and female reproductive disorders and pregnancy outcomes are discussed and the need for CD screening in the case of reproductive problems is emphasized.

Malnutrition and Obesity in Children With ADHD

Objective: Low threshold of dissatisfaction and frustration in child and adolescent patients with ADHD lead to changes in dietary pattern with contribution to the development of obesity and other nutritional disorders. Methods: A total of 362 patients with the diagnosis of ADHD and 390 children without any chronic disease were included to the study. We evaluated the anthropometric measurements for all cases. Results: The overweight/obese cases according to weight for height (WFH) and body mass index scores were more likely in ADHD cases than control group. Malnourished cases according to WFH were more common in ADHD cases. Patients with weight standard deviation scores between <−2 and >2 were significantly higher in ADHD cases than the control group patients. Conclusion: Frequency of malnutrition and overweight/obese patients was found higher in ADHD cases compared with control group, and this situation suggested that ADHD is a risk factor for the development of eating disorders.

Prevalence of Demodex folliculorum and Demodex brevis in childhood malnutrition and malignancy.

Hair follicle mites, Demodex folliculorum and Demodex brevis, are known to accompany immune‐deficiency states, however no study so far has investigated their presence in malnutrition. In this study we aimed to determine the prevalence of those mites in childhood malnutrition, malignancy and risk factors.

Plasma Leptin, Adiponectin, Neuropeptide Y Levels in Drug Naive Children With ADHD

Objective: ADHD is one of the most common childhood psychiatric disorders. Research indicates that there is some link between obesity/overweight and ADHD, though the mechanism of this association remains uncertain. It is the aim of the present study to explore the association between ADHD, obesity, and plasma leptin, neuropeptide Y (NPY), and adiponectin levels. Method: Thirty-six patients diagnosed with ADHD were included in the study. The control group consisted of 40 healthy children and adolescents who had similar age and gender features with the patient group. Plasma leptin, adiponectin, NPY levels were measured, and body mass index (BMI), weight for height, and standard deviation scores (SDS) of height, weight, and BMI were calculated. Results: No significant difference was found between patients and healthy children in terms of BMI and BMI percentile. Participants were classified into three groups according to their weight to height values. There was no significant difference between the two groups, but 10% of the control group and 30.6% of the ADHD group were classified as overweight, which was 3 times higher than the control group. The adiponectin plasma level was significantly lower and leptin/adiponectin (L/A) ratio was significantly higher in the ADHD group. There was no significant difference between serum NPY levels. In the ADHD group, the mean leptin plasma level was high, but was not statistically significant. Conclusion: We think that a low adiponectin level and high L/A ratio may be the underlying mechanism of the obesity in ADHD patients.

Prevalence of celiac disease in parents of preterm or low birthweight newborns.

Aim:  Celiac disease (CD) may present with atypical symptoms, including poor pregnancy outcomes, such as preterm and low birthweight (LBW) deliveries, thus we aimed to investigate the frequency of CD in mothers and fathers of preterm or LBW newborns.

Is Urolithiasis in Children Associated With Obesity or Malnutrition

BACKGROUND Although it is known that obesity predisposes to urolithiasis, a tendency for malnutrition in children with urolithiasis owing to recurrent urinary infections and abdominal pain also makes sense. AIMS In this study, we aimed to determine the nutritional status of infants and children with urolithiasis, and to observe whether obesity or malnutrition is more prevalent in that population. METHODS One hundred eighty-seven children aged 4 months to 17 years (mean, 4.9 ± 4.4 years) with urolithiasis, and 278 age- and sex-matched children without any chronic diseases were included. Anthropometric evaluations, including weight and height standard deviation score (SDS), body mass index, and triceps and subscapular skinfold thickness (SFT), were performed. RESULTS Mean weight SDSs of the patients was statistically lower than that of the control subjects (P < .0001). Malnutrition rate was statistically higher in the patients with urolithiasis when evaluated according to weight SDS and percentiles of body mass index and SFT. When the age factor was taken into account, the percentage of malnutrition, determined by the percentiles of triceps and subscapular SFT measurements, was found to be higher in children younger than 2 years. Short stature was more prevalent in older children. CONCLUSION Malnutrition among children with urolithiasis is not as rare as thought previously. A careful anthropometric evaluation should be included in the clinical assessment of those children.

Evaluation of renal functions in pediatric liver transplantation.

AKI is an important complication after LT. As our LT series contains a quite high number of children with ALF unlike published studies, we aimed to determine pre‐LT and long‐term renal functions in children both with ALF and with CLD. Demographic and disease‐related data of 134 transplanted children were evaluated retrospectively. Pre‐LT and follow‐up GFR and pediatric RIFLE scores were determined. Mean pre‐LT GFR was not dependent on the disease presentation or severity of chronic disease. While there was an initial decline until first week of post‐LT in CLD children, an increase was observed in ALF. Neither mean GFR nor the pRIFLE on follow‐up was different with respect to the type of LT or disease presentation. Mean GFR at first and sixth months were lower in children on cyclosporine compared to tacrolimus (p = 0.001 and p = 0.002, respectively). In conclusion, GFR–time curve was different in children with or without ALF. Type of LT, and severity of the CLD were not risk factors for CKD in any time, but younger age at LT, CLD, and cyclosporine usage were at sixth months of follow‐up.

Celiac Disease in Infants: Prevention and Dietary Treatment

Celiac disease (CD) is the most common malabsorption in the world, and is a major healthcare issue. It is an immune-mediated gluten-dependent enteropathy, which has a wide range of clinical manifestations and variable severity. It is triggered by the ingestion of gluten, which is found in wheat, rye, and barley, in genetically susceptible individuals. While typical clinical manifestations of CD include failure to thrive, chronic diarrhea, and anemia, a significant proportion of patients present with atypical symptoms, such as skin lesions, isolated hypertransaminasemia, dental or neurological problems [1–3]. A changing pattern in the presentation of pediatric CD, such as a more frequent diagnosis in older children, mostly presents with atypical symptoms, is reported [4]. Typical (classical) CD is more common in younger children (mainly between 6 and 18 months of age) and frequently is associated with more severe intestinal injury [5].

Do children with Wilson's disease have distinct craniofacial morphology? A cephalometric study

OBJECTIVES Patients with Wilsons disease (WD) develop osseous changes such as osteoporosis, spontaneous fractures, areas of sclerosis and demineralization of maxillary and mandibular bones, and neurologic symptoms including swallowing dysfunctions, which may affect dento-facial growth. However, dento-maxillo-facial structures of these patients have never been investigated. The present study aimed to discover if subjects with WD have different dentofacial structures. METHODS Lateral cephalometric films of 13 children (5 males and 8 females) with WD and of 15 normal subjects (6 males and 9 females) were evaluated. Mean ages of the patients and controls were 12.62 ± 3.09 years and 12.01 ± 1.38 years, respectively. Lateral cephalometric cranial films of all subjects were taken in the same cephalostat in a habitual and unstrained body posture. Thirteen linear and 11 angular parameters were measured to describe the craniofacial characteristics of the subjects. RESULTS Statistical analysis showed that there is no statistically significant difference between parameters of normal children and children with WD, with the exception of palatal plane inclination. The inclination of palatal plane was higher in children with WD than in normal subjects. CONCLUSIONS Children with WD and healthy children have approximately the same dento-maxillo-facial structures. However, increased palatal plane inclination may be a finding of WD.