Nilgun Col Araz

Childhood Obesity and the Role of Dopamine D2 Receptor and Cannabinoid Receptor-1 Gene Polymorphisms

AIMS The dopaminergic and endocannabinoid systems are involved in regulation of feeding behavior. The aim of the study is to examine the possible relation between polymorphisms of the dopamine D2 receptor (DRD2) and cannabinoid receptor-1 (CNR1) genes and childhood obesity. METHODS A hundred obese children and 100 healthy controls were analyzed for DRD2 Taq1A and Taq1B and CNR1 1359G/A polymorphisms. Genotyping was performed by polymerase chain reaction and restriction fragment length polymorphism. RESULTS There were no statistically significant differences in DRD2 Taq1A and DRD2 Taq1B genotypes or allelic frequencies between obese children and controls (p>0.05). In patients with Taq1B2 allele, morbid obesity was less frequent (p=0.010). The frequency of the A allele of CNR1 1359G/A polymorphism was significantly higher in obese children than in controls (21.0% vs. 13.0%, p=0.0166). The frequency of genotypes AG and GG of the CNR1 1359G/A SNP was different between obese children and control subjects (for AG: 34.0% vs. 22.0%, p=0.0294; for GG: 62.0% vs. 76.0%, p=0.0162, respectively). CONCLUSIONS No significant difference was found between genotypes and alleles of DRD2 Taq1A and DRD2 Taq1B polymorphism in patients and controls, while the CNR1 receptor 1359G/A polymorphism and the presence of the A allele may be one risk factor for susceptibility to obesity.

FREQUENCY OF NEONATAL HYPOGLYCEMIA IN LARGE FOR GESTATIONAL AGE INFANTS OF NON-DIABETIC MOTHERS IN A COMMUNITY MATERNITY HOSPITAL

Large for gestational age (LGA) infants are at increased risk for hypoglycemia. The aim of the study was to determine the frequency of neonatal hypoglycemia in LGA infants of non-diabetic mothers in a Community Maternity Hospital in Gaziantep, Turkey. Hospital records of 5229 infants of non-diabetic mothers were examined retrospectively. Newborns with birth weight more than 4000 g were defined as LGA. The control group consisted of 100 appropriate for gestational age (AGA) newborns. Capillary blood glucose was measured at the second hour of life. Glucose values lower than 40 mg/dL (2.2 mmol/L) were defined as hypoglycemia. Ninety-six (1.8%) of the 5229 infants were found to be LGA. The mean capillary glucose levels of the LGA newborns were significantly lower than those of the AGA newborns (54 mg/dL (3.0 mmol/L) vs. 95 mg/dL (5.2 mmol/L), p < 0.0001). Neonatal hypoglycemia was established in 16 of 96 LGA infants (16.7%). In the control group hypoglycemia was absent. The rate of hypoglycemia in LGA infants was significantly higher than the rate in the AGA infants (p = 0.0000). As hypoglycemia is not rare in LGA infants and can have serious consequences, blood glucose levels should be screened routinely in LGA infants.

Delays in Diagnosis of Childhood Cancer in Southeastern Turkey and the Associated Factors

In childhood cancer patients, early diagnosis may have an impact on survival that reduces the potential morbidity. This study aimed to identify the factors associated with delay in diagnosis in children with cancer in southeastern Turkey. The clinical records of 682 patients with childhood cancer were evaluated. Study variables were classified as factors related to the patient, their disease, and the health care system. The median parental delay, physician delay, and total delay were determined as 20, 23, and 60 days, respectively. There was a significant relationship between parental delay, physician delay, and total delay and age at diagnosis (P = .005, P = .008, and P = .004, respectively). Long parental delay was least frequent in children younger than 1 year (P = .001). Parental, physician, and total delay were longer in patients with solid tumors than in patients with leukemias (P = .007, P = .000, and P = .000, respectively). Patients with tumors of the genitalia had longer physician delay and total delay than patients with other solid tumors (P = .001 and P = .000, respectively). Patients with solid tumor and early-stage disease had longer physician delay and total delay (P = .016 and P = .013, respectively). According to the first physician contacted, long physician delay was less frequent among pediatricians (P = .003). Delayed diagnosis was associated with age, type/localization and stage of tumor, the first physician consulted, and area of residence. A sustained effort should be made to raise the level of awareness of childhood cancer among parents and to sensitize all physicians, especially those who treat pediatric patients infrequently, with regard to the warning signs of the disease.