Exfoliative cheilitis is a hardly diagnosed disease by pediatricians. We have presented this report to draw the attention of clinicians because the child is the youngest patient with complete relief ...from using tacrolimus ointment in the literature. We present the three-year-old child with scaled, crusted, and sensitive upper and lower lips. He was admitted to different centers from the beginning of the complaints without any relief despite different treatments. The clinicians may encounter exfoliative cheilitis in different age groups. There are some approaches to management and therapy of the disease. But consensus has not yet occurred on definitive treatment, especially in childhood.
Objective: Early puberty is development of secondary sex characteristics earlier than the expected normal age range. We subjectively observed an increased frequency of early puberty during the ...Coronavirus disease-2019 (COVID-19) lockdown and aimed to show the clinical, demographic characteristics of the cases and the change in its incidence. Methods: Female patients with central precocious puberty (CPP, n=28) and rapidly progressive early puberty (RPEP, n=61), presenting to our clinic before (January 2019-March 2020) and during the COVID-19 pandemic (April 2020-June 2021) were included. Results: Among 28 CPP cases, six (21%) presented before the pandemic lockdown, whereas 22 (79%) were diagnosed during the COVID-19 pandemic lockdown. While RPEP was seen in 16 (26%) patients before the pandemic, 45 (74%) patients were diagnosed during the lockdown period. Presentation with menarche was seen in 15 RPEP patients; two (13%) were in the prepandemic period and 13 (87%) were in the lockdown period. Chronological age, bone age, bone age to chronological age ratio, height, weight, and body mass index standard deviation scores of patients with RPEP and CPP were similar between the prepandemic and pandemic period. Conclusion: In this cohort, the frequency of CPP and RPP cases were significantly (p<0.001) increased during the COVID-19 pandemic, possibly due to environmental changes. Keywords: LHRH, physical inactivity, distance education, school closures, quarantine
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Purpose
Binge eating disorder (BED) is characterized by frequent and persistent overeating episodes of binge eating without compensatory behaviors. The aim was to evaluate regional gray matter volume ...(GMV) abnormalities and appetite-regulating hormone levels (NPY and Leptin) in obese subjects either with or without BED compared to healthy controls (HC).
Methods
Twenty-six obese patients with BED, 25 obese patients without BED and 27 healthy subjects as an age-matched control group with neuroimaging and appetite-regulating hormone levels were found eligible for regional GMV abnormalities. A structural magnetic resonance scan and timely blood samples were drawn to assess the appetite-regulating hormone levels.
Results
The BED obese patients had a greater GMVs of the right medial orbitofrontal cortex (OFC) and the left medial OFC compared to the non-BED obese patients. BED patients were characterized by greater GMV of the left medial OFC than HCs. Relative to the HCs, higher serum NPY levels were found in BED obese and non-BED obese groups. Serum leptin levels (pg/mL) had positively correlations with GMV in right medial OFC, left medial OFC, right lateral OFC, and left anterior cingulate cortex.
Conclusion
Among the reward processing network, which is largely associated with feeding behaviours in individuals with obesity and binge eating disorder, the OFC volumes was correlated with serum leptin concentrations. The results of our study may provide a rationale for exploring the link between regional grey matter volumes and appetite-related hormone levels in people with BED.
Level of evidence
Level III, case–control analytic study.
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EMUNI, FZAB, GEOZS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
This study aimed to examine the psychometric properties of the Turkish version of the Collaborative Parent Involvement Scale for youths with type-1 diabetes. This methodological ...descriptive-correlational study was carried out on 200 youths with type-1 diabetes, between November 2018 and November 2019. Factor analysis, Cronbach’s alpha coefficient, and item-total correlation were used to evaluate the data. The total Cronbach’s alpha coefficient of the Turkish scale was 0.958. From the confirmatory factor analysis, the results of model-fit index are: goodness-of-fit index = 0.94, comparative fit index = 0.99. Therefore, the Turkish version of the Collaborative Parent Involvement Scale, designed for youth with diabetes, was found to be a valid and reliable measurement tool for the Turkish population.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Congenital hypothyroidism (CH) is the most frequent endocrine disorder during the neonatal period, and a delay in diagnosis and treatment leads to irreversible complications. A high L-thyroxine (LT4) ...dose is recommended for treatment, while the optimal starting dose is still a matter of debate. The objective of this study was to determine the effects of various starting doses of LT4 on serum thyroid stimulating hormone (TSH) and thyroxine (fT4) at the end of the first month of treatment.
A total of 71 patients (37 males, 52.1%) with CH were included in the study. The patients were designated into three sets of subgroups according to the following categorical variables: (i)
: 6–9.9 μg/kg/day, 10–11.9 μg/kg/day and 12–17 μg/kg/day; (ii)
: 6–9.99 μIU/mL, 10–75 μIU/mL and >75 μIU/mL; and (iii)
: dyshormonogenesis and dysgenesis. A fT4 level >2.3 ng/dL±a TSH level <0.5 μIU/mL were considered as overtreatment.
The mean age of the study population was 22.3±13.2 days at diagnosis. At diagnosis, the mean fT4 was 0.84±0.32 ng/dL, and TSH was 39.3±30 μIU/mL. The mean initial dose of LT4 was 10.9±2.9 μg/kg/day. Overtreatment rates were significantly higher in the highest dose group (12–17 μg/kg/day) compared with the lowest dose group (6–9.9 μg/kg/day) (61.5% and 25%, respectively, p<0.05). None of the patients was undertreated.
In this study, we found that the rate of overtreatment was significantly higher in patients who were given LT4 doses of 12–17 μg/kg/day. Thus, monitoring thyroid functions earlier than one month of treatment is necessary.
The hypothalamic-pituitary-gonadal axis is active during minipuberty, the timing of which coincides with infantile colic. To the best of our knowledge, the relationship between these entities has not ...been previously investigated.
Saliva samples were collected from 15- to 60-day-old term infants (n=139) between 9 am and 5 pm. Group 1 included infants with infantile colic (n=68, 54.4% female) while the remaining healthy infants constituted Group 2 (n=71, 47.9% female). Salivary levels of estradiol (E
) in females and testosterone (T
) in males were measured by ELISA in duplicate.
The median (25
-75
centile) age and birth week for all infants were 33 (29-43) days and 39 (38.1-40) weeks, respectively. Levels of T
in males Group 1, 73.35 (59.94-117.82) pg/mL vs Group 2, 77.66 (56.49-110.08) pg/mL, p=0.956 and E
in females Group 1, 3.91 (2.76-5.31) pg/mL vs Group 2, 4.03 (1.63-12.1) pg/mL, p=0.683 were similar. However, in subjects with infantile colic (Group 1), E
and body mass index (BMI) standard deviation scores of females were slightly correlated (Group 1, r
= 0.393, p=0.016 vs. Group 2, r
= 0.308, p=0.076) and there was a significant correlation between the sampling time and T
in males (Group 1, r
= 0.469, p=0.009 vs. Group 2, r
= -0.005, p=0.976).
Random salivary sex steroid levels were similar in infants with and without infantile colic. However, in subjects with infantile colic, E
levels in females were positively correlated with BMI and T
levels were higher later in the day among males. Thus, sex steroid production may be altered during minipuberty in subjects with infantile colic.
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Body weight (BW) and body surface area (BSA)-based dosing regimens have been recommended for recombinant human growth hormone (rhGH) replacement, with the assumption that they are equally ...efficacious. We wanted to determine if higher or lower treatment may result from either of the two regimens based on the initial prescribed doses and the growth responses of the patients throughout the first year of therapy.
The retrospective study included 60 children from two different centers, aged 1-18 years, with the diagnosis of idiopathic isolated growth hormone deficiency(IGHD). BW-based dosing in mcg/kg/day, which is routinely employed in our clinical practice, was converted to BSA in mg/m2 /day to determine the equivalent amounts of the given rhGH. Those with a BSA-to-BW ratio of more than 1 were allocated to the "relatively higher-dosed group", while the remaining patients were assigned to the "relatively lower-dosed" group. Patients with a height gain greater than 0.5 standard deviation (SD) score at the end of one year were classified as the height at goal (HAG), whereas those with a height gain of less than 0.5 SD score were assigned as the height not at goal (NHAG).
The study included 60 patients (18 girls, 42 boys) with IGHD. Thirty-six (60%) patients had HAG after one year of treatment. The ratio of dosing based on BSA to BW was negatively correlated both with the ages and BMI levels of the patients, leveling off at the age of 11.7 at a BMI of 18.3 kg/m2 . The relative dose estimations (relatively higher-, lower-dosed groups) differed significantly between the patients with HAG and NHAG (p= 0.006). If dosing had been based on BSA rather than BW, the majority of patients with HAG (61%) would have been dosed relatively higher, whereas those with NHAG (75%) would have been dosed relatively lower.
We have evaluated BSA and BW-based strategies among a homogenous cohort of patients with IGHD. GH doses based on BSA compared to BW-based dosing may result in the administration of higher doses to children younger than 11.7 years of age with BMI levels less than 18.3 kg/m2 and lower doses to children older than 11.7 years of age with BMI levels more than 18.3 kg/m2 . Dosing based on BW rather than BSA may be preferable in children younger than 12 years old who are not obese.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Objective: The aim was to evaluate the adverse events seen after Coronavirus disease-2019 (COVID-19) vaccination in pediatric patients with diagnosed endocrinological problems and to compare them ...with healthy controls. Methods: In this cross-sectional study, patients aged 12-18 years who attended a single department between January and May 2022 and were followed up for at least six months due to endocrine diseases, and healthy subjects in the same age group, all of whom had received a COVID-19 vaccine BNT162b2 mRNA or inactivated vaccine were included. Adverse events experienced after the vaccination were evaluated by questionnaire. Results: A total of 160 subjects (85 patients, 75 healthy controls) with a median (25-75p) age of 15.5 (14.1-16.9) years were included. The frequency of adverse events was higher in those vaccinated with the mRNA vaccine compared to the inactivated one after the first dose (p=0.015). The incidence of adverse events observed after the first and second doses of both COVID-19 vaccines was similar in the patient and control groups (p=0.879 and p=0.495, respectively), with local reactions being the most common. The frequency of adverse events was similar among the patients who did or did not receive any endocrinological treatment (p>0.05). The incidence and severity of systemic reactions were similar to those in healthy subjects for both vaccine doses, regardless of the underlying diagnosis, autoimmunity state, or treatment regimen used in patients with endocrine diseases. Conclusion: The incidence and severity of adverse events associated with COVID-19 vaccinations in adolescents with endocrinological disorders were similar to healthy subjects, in the early post-vaccination period. Keywords: Coronavirus, vaccination, endocrine, pandemic, pediatrics
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Genetic, hormonal, and anatomical factors are believed to be involved in the etiology of undescended testes. Due to increased risk of infertility, testicular cancer, torsion and/or accompanying ...inguinal hernia (>90%) as well as cosmetic concerns, all these patients require treatment. In this review paper, we aimed to evaluate the success rates of treatment modalities used in undescended testes, beginning from 1930 to the present, and to draw attention to the possible risks and benefits and also the efficacy of hormonal therapy in the management of the disorder, which is still a controversial issue. Hormonal therapy may lead to penile growth, painful erection, and behavioral changes while on treatment. In recent years, it has been reported that human chorionic gonadotropin (hCG) treatment was associated with interstitial edema due to increased vascular permeability, inflammation-like changes, and several adverse effects on germ cells by increasing pressure and apoptotic process. It has also been reported that LHRH analogues have positive effects on germ cells by increasing fertility in patients undergoing unilateral or bilateral orchiopexy. In some studies, the success rate of hCG treatment was reported to be higher following buserelin. In some other studies, hCG treatment was recommended before orchiopexy to reduce the risk for surgical ischemia. There are a limited number of randomized controlled studies, so evidence showing the efficacy of hormonal therapy is insufficient. According to the 2007 Consensus Report of Nordic countries, it is recommended that surgery is the first-line treatment modality in undescended testes and that it should be performed by pediatric surgeons and urologists at the age of 6-12 months.
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Objective: Monogenic diabetes is a heterogeneous disease that causes functional problems in pancreatic beta cells and hyperglycemia. The aim of this study was to determine the clinical and laboratory ...features, the admission characteristics and distribution of monogenic form of diabetes in childhood in Turkey. Methods: Patients aged 0-18 years, who were molecularly diagnosed with monogenic diabetes, and consented to participate, were included in the study. Results: Seventy-seven (45.6%) female and 92 male cases with a mean age of 8.18+ or -5.05 years at diagnosis were included. 52.7% of the cases were diagnosed with monogenic diabetes by random blood glucose measurement. The reason for genetic analysis in 95 (56.2%) of cases was having a family member diagnosed with diabetes under the age of 25. At the time of diagnosis, ketone was detected in urine in 16.6% of the cases. Mean hemoglobin A1c on admission, fasting blood glucose, fasting insulin, and c-peptide values were 7.3+ or -2.1%, 184.9+ or -128.9 mg/dL, 9.4+ or -22.9 IU/L, 1.36+ or -1.1 and ng/L respectively. GCK-MODY was found in 100 (59.2%), HNF1A-MODY in 31 (18.3%), and variants in ABCC8 in 6 (3.6%), KCNJ11 in 5 (3%), HNF4A in 2 (1.2%), and HNF1B in 2 (1.2%). Conclusion: Recent studies have indicated HNF1A-MODY is the most frequent of all the MODY-monogenic diabetes cases in the literature (50%), while GCK-MODY is the second most frequent (32%). In contrast to these reports, in our study, the most common form was GCK-MODY while less than 20% of cases were diagnosed with HNF1A-MODY. Keywords: Monogenic diabetes, early-onset diabetes, next-generation sequencing, GCK, HNF1A
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