فهرست مطالب ozlem bostan gayret

Vitamin D deficiency is common in obese adolescents. It modulates the release of omentin 1 from adipose tissue. We believe that both vitamin D and omentin 1 affect each other in adipose tissue via inflammation.

This study aimed to examine serum omentin-1 levels in obese adolescents with vitamin D (Vit D) deficiency.

In this cross-sectional prospective study, 83 obese adolescents were included. Serum 25-hydroxy vitamin D (25(OH)D) concentrations, fasting glucose, and lipid profiles of obese adolescents were studied. At the same time, blood was drawn into a separate tube to study the omentin 1 level. Of the 83 obese cases, 45 with 25(OH)D concentrations below 20 ng/mL were considered as the study group, and 38 with 25(OH)D concentrations  20 ng/mL as the control group. Serum omentin-1 levels were evaluated and compared.

The average 25(OH)D value in the study and control groups was 17.14 ± 2.22 ng/mL and 45.29 ± 24.98 ng/mL, respectively. The average omentin-1 concentration of the control group was 262.5 ± 136.31 ng/mL, and the mean omentin-1 level of the study group was 113.23 ± 15.98 ng/mL. The mean omentin-1 concentrations of the study group were significantly lower compared to the control group (P = 0.0001). There was a significant and positive correlation between omentin-1 and 25(OH)D (r = 0.988, P = 0.0001). In univariate tests, linear regression analysis was carried out with 25(OH)D and omentin-1, and 25(OH)D displayed a significant positive correlation (P = 0.0001). The optimal cut-off point for the serum omentin-1 concentration was 135.01 ng/mL. No significant correlation was determined between omentin-1 and body mass index, lipid profile, glucose, and insulin variables (P > 0.05).

We showed significantly low concentrations of serum omentin-1 in obese adolescents with vitamin D deficiency. Serum omentin-1 can be employed as a biomarker in obese adolescents with vitamin D deficiency.

Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterised by recurrent fever, peritonitis, pleuritis, and arthritis. Three hundred and seventeen mutations and polymorphisms related to FMF have been identified to date.
The evaluation of the distribution of genetic mutations in children whose FMF study was conducted in Marmara region in Turkey and the relationship between clinical findings and the mutation was aimed in the study.
The files of all patients whose pre-diagnosis of FMF and MEFV gene mutation analysis were made, were evaluated retrospectively. The results of the MEFV gene mutation analysis of the patients were screened retrospectively. Common MEFV gene mutation analyses were studied. The age, gender, presenting complaints, and histories of the patients were obtained from the files and records.
A total of 150 patients were included in the study. The mean age of the cases was 9.37 ± 4.43 years; 78 were female and 72 were male. Sixty-seven (44.7%) of the cases had abdominal pain, 30 (20%) had arthralgia, 25 (16.7%) had fever, 2 (1.3%) had chest pain, and 30 (20%) had other complaints. While the mutation with the highest frequency was R202Q (37.2%), it was observed that allele frequencies following this were E148Q (23.4%), M694V (21.9%), V726A (5.1%), and M680I (2.9%). Abdominal pain was detected as the most frequent presenting complaint.
Although M694V gene mutation is the most frequently observed mutation in Turkey, we identified that the most frequent gene mutations were R202Q and E148Q in this study. This situation may be because most of our patients were from Anatolian regions where there are many ethnic groups. When the distribution of genotypes was examined by complaint, the most frequent complaint identified in all gene mutations was abdominal pain.

To assess serum osteopontin (OPN) concentrations and to evaluate the correlation between OPN levels and insulin resistance (IR) in obese dyslipidemic children.
The study featured 107 obese children with ages ranging between 3 - 17 years. Anthropometrical measurements and biochemical analyses were performed and serum OPN samples were obtained. IR was defined using the homeostasis model assessment-insulin resistance (HOMA-IR) protocol.
Of the 107 obese children that were recruited for the study, 63 were girls (58.9%) and 44 were boys (58.9%), with a mean age of 11.18 ± 3.41 years. Of them, 21 (19.6%) were diagnosed with dyslipidemia. No significant differences in age and gender were identified between the dyslipidemic and non-dyslipidemic groups. The mean body mass index (BMI), fasting blood glucose, insulin, and alanine transaminase levels were similar in both groups (P = 0.74). The average total cholesterol (TC), low-density lipoprotein cholesterol (LDL), and triglyceride (TG) levels were higher, while the high-density lipoprotein (HDL) and cholesterol levels were lower in the dyslipidemic group. Amongst the children with dyslipidemia, 28 (84.84%) had IR. The mean OPN levels in the dyslipidemic group were not found to be higher than the non-dyslipidemic group (46.94 ± 25.64 vs 48.92 ± 24.45; P = 0.70). Multivariate regression analysis confirmed that increased HOMA-IR levels (P = 0.01) are an important risk factor for dyslipidemia.
While serum OPN levels were found to be related to IR in obese children, OPN levels were not associated with dyslipidemia.

Osteoprotegerin (OPG) is a member of the tumor necrosis factor superfamily. Reduced OPG levels are related to obesity, insulin resistance, and non-alcoholic fatty liver disease (NAFLD).
The aim of this study was to evaluate the relationship between OPG levels, obesity, insulin resistance, and NAFLD in pediatric patients.
This was a prospective, cross-sectional, controlled study that was conducted in the department of pediatrics at Bagcilar training and research hospital in Istanbul, Turkey, between April and August 2015. The study was performed on 107 children with obesity and 37 controls aged 5 - 17 years. In the obese subset, 62 patients had NAFLD. Homeostatic model assessment-insulin resistance (HOMA-IR) was used to calculate insulin resistance. Insulin resistance was defined as a HOMA-IR value greater than 2.5. Plasma OPG levels were measured using enzyme-linked immunosorbent assays. NAFLD was diagnosed by hepatic ultrasound.
The mean age was 11.25 ± 3.38 years in the patient group and 10.41 ± 3.15 years in the control group. The OPG level in the obese group with the mean of 55.20 ± 24.55 pg/mL (median = 48.81 pg/mL) was significantly lower than that in the control group with the mean of 70.78 ± 33.41 pg/mL (median = 64.57 pg/mL) (P = 0.0001). The optimal cut-off point (sensitivity, specificity) of the OPG level for the diagnosis of obesity was ≤ 46, 19 pg/mL. According to logistic regression analysis, fasting insulin (P = 0.036) and OPG (P = 0.01) levels were most affected by obesity. In the obese patients, who had HOMA-IR We confirmed that serum OPG concentrations reduce in obese children. However, no correlation was identified between OPG and insulin resistance. OPG levels are not meaningful in the diagnosis of NAFLD in children with obesity.

Henoch-Schonlein Purpura (HSP) is the most widespread systemic vasculitis during childhood. Gastrointestinal tract retention and gastrointestinal bleeding are among its major complications. Neutrophil-Lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are indicators related to inflammatory diseases. This study evaluated the relationship between NLR or PLR and gastrointestinal bleeding in HSP.
The study consisted of 119 patients and 40 healthy children in the same age group. White Blood Cell (WBC) count, hemoglobin level, platelet count, mean platelet volume (MPV), neutrophil count and lymphocyte count were recorded. The NLR and PLR were calculated based on the results of complete blood count tests performed during the first visit to the hospital.
The average neutrophil count and NLR of the patients with HSP were found to be significantly increased compared to the control group (P = 0.0001). No significant difference was observed between the PLR average of HSP and control groups (P = 0.053). Platelet count average (P = 0.0001) and PLR (P = 0.001) of the patients with gastrointestinal system (GIS) bleeding were found to be statistically significantly increased compared to those who did not have gastrointestinal bleeding. No significant difference was found in the NLR of the patients with and without gastrointestinal bleeding (P = 0.060).
While the NLR was significantly increased in patients with HSP in this study, the PLR was found to be more significant in patients with gastrointestinal bleeding. Similar to NLR, PLR may also be used as an inflammatory indicator among children with HSP, who have gastrointestinal bleeding.

Matrix metalloproteinase-9 (MMP-9) is an enzyme implicated in the pathogenesis of renal diseases. Renal involvement is the principal cause of morbidity and mortality in children with Henoch-Schönlein purpura (HSP).
The aim of this study was to evaluate whether serum and urinary MMP-9 levels are associated with renal involvement in HSP
Patients and We evaluated 40 children with HSP (patient group) and 27 healthy volunteer children (control group). The patient group was divided into two subgroups based on the presence or absence of nephritis. Nephritis was defined as the existence of hematuria and/or proteinuria. All anthropometric data, physical examination findings, blood pressure, and laboratory parameters were recorded. The serum and urine samples were analyzed to determine the MMP-9 levels three days after the initial phase of the disease.
The mean age was 7.65 ± 3.41 (range 2 - 16) years in the patient group and 9.52 ± 3.91 (range 2 - 16) years in the control group. Henoch-Schonlein purpura nephritis (HSPN) was identified in eight patients. There was no significant difference in the serum MMP-9 levels between the HSPN subgroup and the controls (P > 0.05). However, there were significant differences in the urinary MMP-9 levels between the HSP subgroup and the control group (P The levels of MMP-9 in the urine were remarkably high in patients with HSPN. This non-invasive marker may therefore be an important indicator for the early diagnosis of nephritis in children with HSP.

Tuberculosis remains a major public health problem in developing countries. Diagnosing extrapulmonary tuberculosis can be difficult, as it requires a higher index of suspicion than primary tuberculosis. Extrapulmonary tuberculosis may mimic malignancies and many other diseases, so it should be included in the differential diagnosis. Here, we present a case of extrapulmonary tuberculosis associated with Pott’s disease and hip arthritis in a patient who recovered after 12 months of antituberculosis therapy.
A 16-year-old girl presented to the outpatient otolaryngology clinic with painless swelling of the neck, and to the physical medicine and rehabilitation clinic with complaints of hip and low back pain that mimicked spondyloarthropathy. She was eventually referred to the outpatient pediatric clinic. Her acute-phase reactants were high, and hilar lymphadenopathy was evident on chest x-ray. On computerized tomography, a Pott’s abscess involving the T8, T9, and T10 vertebrae was suspected. Magnetic resonance imaging of the dorsal vertebrae and hip was performed, and a Pott’s abscess and hip tuberculous arthritis were confirmed. The patient had been exposed to tuberculosis 10 years earlier, and her purified protein derivative (PPD) test was 16 mm. After antituberculosis treatment, our patient recovered and the Pott’s disease and hip tuberculous arthritis regressed.
Extrapulmonary tuberculosis may mimic many other diseases, so it should be kept in mind in the differential diagnosis. It is essential to diagnose osteoarticular tuberculosis early, as late diagnosis or inadequate treatment may cause permanent disability.

Homocystinuria is a hereditary disease caused by a defect in the enzymes involved in metabolizing methionine. Homocystinuria can influence many systems and may be mistaken for other diseases, including Moyamoya disease. Here, we report the case of a 10-year-old male patient with a diagnosis of Moyamoya disease who had been monitored for that for an extended period. The patient’s diagnosis was changed to homocystinuria as a result of lens subluxation and cataract findings.
A 10-year-old male patient presented with vomiting, headache, lethargy, muscular weakness, and eye redness. The patient was mentally retarded, his right pupil was hyperemic, and he had muscle weakness on his left side. In addition, his blood pressure was high. The patient’s history included a diagnosis of Moyamoya. A neck and cranial computed tomography (CT) angiography showed no flow bilaterally past the bifurcation of the carotid artery. The patient’s bilateral internal carotid arteries were determined to be occluded. It was considered that his eye findings could be compatible with a metabolic disease. On metabolic screening, the patient’s homocysteine level was very high. In addition, a heterozygous A1298C mutation was identified in MTHFR. Therefore, the patient was started on a diet free from homocysteine and methionine. In addition, his treatment regimen included vitamins B12 and B6. With these treatments, the patient’s complications regressed.
In cases of unusual vascular lesions, metabolic diseases must be considered. In homocystinuria, early diagnosis and treatment are important. Blood homocysteine levels can be returned to normal, and some complications can be prevented.