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Öğe The 46XX Ovotesticular Disorders of Sexual Development with Dismorphic Features(Elsevier Science Inc, 2015) Eklioglu, Beray Selver; Atabek, Mehmet Emre; Akyurek, Nesibe; Yuca, Sevil Ari; Piskin, MesutBackground: Ovotesticular disorders of sexual development (OT-DSD) represent a rare sex development disorder characterized by the presence of both ovarian and testicular tissues in the same or the contralateral gonad. Case: We present the case of a 14-year-old female patient with signs of virilization at a pubertal age and with dysmorphic features, diagnosed as 46, XX OT-DSD. Conclusion: We want to point out that patients with 46 XX OT-DSD may present with virilization at puberty and may be accompanied by dysmorphic features.Öğe Ailevi Testotoksikoz: Olgu Sunumu(2014) Akyürek, Nesibe; Atabek, Mehmet Emre; Eklioğlu Selver, BerayAilevi Testotoksikoz LH reseptöründe aktive edici mutasyon nedeniyle testislerin otoaktivasyon kazanması sonucu or- taya çıkan gonodotropin bağımlı olmayan yalancı erken puberte nedenidir. 2 yaş 3 aylık erkek hasta, kliniğimize genital bölgede kıllanma şikayetiyle başvurdu. Babada ve babanın erkek kuzenlerinde erken puberte öyküsü mevcuttu. Cilt ve sistem muayeneleri normal olan hastanın testis hacimleri bilateral 4 ml, gerilmiş penis boyu 4.5 cm, pubik kıllanması Tan- ner evre 2di. Testosteron seviyeleri pubertal düzeyde olmasına rağmen bazal ve uyarılmış LH seviyeleri prepubertaldi. Hasta aile öyküsü ile birlikte değerlendirildiğinde klinik ve biyokimyasal olarak ailevi testotoksikoz tanısı aldı. Olgu nadir görülmesi nedeni ile sunuldu.Öğe Akut romatizmal ateş etyopatogenezinde serbest radikallerin rolü(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 1998) Atabek, Mehmet Emre; Oran, BülentBu çalışmada çocukluk çağında Akut Romatizmal Ateş (ARA) etyopatogenezinde serbest oksijen radikallerinin rolü ve klinik bulgularla ilişkileri araştırılmıştır. Bu çalışmayı Selçuk Üniversitesi Tıp Fakültesi Pediatrik Kardioloji Ünitesinde 1996 ile 1997 yıllan arasında yaptık. 5 ile 15 yaşlarında 23 hasta ve 25 sağlam çocuk araştırmaya dahil edildi. Hastaların 17'sinde kardit gözlendi. ROM düzeyleri tanımında ve daha sonra da periyodik olarak belirlendi. Serbest oksijen radikalleri ve ürünleri dROM kiti (d-ROMs test, Diacron s.r.I. Diagnostics Division, Via Zircone n.8-58100 Grosseto-İtaly) kullanılarak ve kolorimetrik olarak ölçüldü. Tanı anındaki plazma ROM düzeyi kontrol grubundaki ile karşılaştırıldığında istatistiksel olarak anlamlı yüksek bulundu (P<0.05). 15, 30 ve 90. günlerde plazma ROM düzeylerinin giderek azaldığını gözledik. Karditi olmayanlarla kıyaslandığında karditli hastaların plazma ROM düzeyleri istatistik olarak anlamlı bir farklılık göstermiyordu. Anlamlı olmamakla birlikte, 90. günde plazma ROM düzeyi hâlâ yüksekti. Biz bu çalışmada serbest oksijen radikallerinin ARA etyopatogenezinde önemli bir rol oynadıkları sonucuna vardık.Öğe Ambulatory Blood Pressure and Subclinical Cardiovascular Disease in Children With Turner Syndrome(Springer, 2014) Akyurek, Nesibe; Atabek, Mehmet Emre; Eklioglu, Beray Selver; Alp, HayrullahPatients with Turner syndrome (TS) have an increased risk of cardiovascular morbidity. 29 TS and 25 healthy control subjects (CS) were included in the study. We investigated body mass index, waist circumference, fasting glucose and insulin, homeostatic model assessment (HOMA) index, serum lipids, oral glucose tolerance test, 24-h ambulatory blood pressure (BP) monitoring, and carotid intima-media thickness (CIMT) and compared them with CS. 28 % (N = 7) of TS had insulin resistance (IR), and 36 % (N = 9) had IGT. Mean systolic BP and diastolic BP (DBP) dip were 7.24 +/- A 3.97 % and 11.84 +/- A 6.2 %, respectively. CIMT was greater in TS than in CS (p = 0.00). CIMT was correlated positively with fasting insulin, HOMA index, and insulin-sensitivity check index (r = 0.563, p = 0.015; r = 0.603, p = 0.008; and r = 0.623, p = 0.006, respectively) and negatively with fasting glucose-to-insulin ratio and DBP dipping (r = -0.534, p = 0.022; r = -0.534, p = 0.00, respectively) in the two groups combined. These results provide additional evidence for the presence of subclinical cardiovascular disease and its relation to hypertension in TS. They also indicate a significant relation between DBP dipping and increased arterial stiffness. It is also important to note that our findings show significant relationships between insulin sensitivity and cardiovascular changes and underline the importance of insulin resistance for predicting cardiovascular disease.Öğe Ambulatory Blood Pressure and Subclinical Cardiovascular Disease in Patients with Congenital Adrenal Hyperplasia: A Preliminary Report(2015) Akyürek, Nesibe; Atabek, Mehmet Emre; Eklioğlu, Beray Selver; Alp, HayrullahObjective: There is an increased risk of cardiovascular morbidity in children and adolescents with classical congenital adrenal hyperplasia (CAH), presumably associated with obesity, hypertension, impaired glucose tolerance and dyslipidemia. This study was designed to evaluate the metabolic and cardiovascular profile of a group of children with classical CAH from the perspective of cardiovascular risk.Methods: Twenty-five CAH patients and 25 healthy controls were included in the study. Metabolic and anthropometric parameters were investigated and compared in these two groups. Results: Subjects in the CAH group were shorter than the controls (p0.001) and had higher body mass index values (p0.033). Diastolic blood pressure (DBP) (p0.027) and carotid intima-media thickness (CIMT) values (p0.006) were also higher in the patient group. In 24% (n6) of CAH patients, 24-h ambulatory BP monitoring showed arterial hypertension. CIMT was significantly higher in the hypertensive patients than in those with no hypertension (p0.013). Twenty percent (n5) of CAH patients had nocturnal hypertension. CIMT was significantly greater in the nocturnal hypertensive group (p0.02). Mean systolic BP (SBP) and DBP dipping were significantly different in the CAH patients (p>0.001). CIMT correlated negatively with DBP dipping (r-0632, p0.037) in these patients.Conclusion: These results provide additional evidence for the presence of subclinical cardiovascular disease in classical CAH patients and its relationship with hypertensionÖğe The appropriate use of sensitive tests of hypothalamic-pituitary-adrenal-axis suppression(Walter De Gruyter Gmbh, 2012) Atabek, Mehmet Emre[Abstract Not Availabe]Öğe The appropriate use of sensitive tests of hypothalamic-pituitary-adrenal-axis suppression(Walter De Gruyter Gmbh, 2012) Atabek, Mehmet Emre[Abstract Not Availabe]Öğe Aromatase deficiency in an adolescent girl misdiagnosed as congenital adrenal hyperplasia in infancy and childhood(Walter De Gruyter Gmbh, 2014) Eklioglu, Beray Selver; Atabek, Mehmet Emre; Akyurek, Nesibe; Piskin, Mehmet M.; Kilinc, Mehmet[Abstract Not Availabe]Öğe Aromatase deficiency in an adolescent girl misdiagnosed as congenital adrenal hyperplasia in infancy and childhood(Walter De Gruyter Gmbh, 2014) Eklioglu, Beray Selver; Atabek, Mehmet Emre; Akyurek, Nesibe; Piskin, Mehmet M.; Kilinc, Mehmet[Abstract Not Availabe]Öğe Assessment of Cardiovascular Parameters in Obese Children and Adolescents with Non-Alcoholic Fatty Liver Disease(2015) Eklioğlu, Beray Selver; Atabek, Mehmet Emre; Akyürek, Nesibe; Alp, HayrullahObjective: The aim of this study was to evaluate the periaortic fat thickness (PAFT) using conventional echocardiography in obese children and adolescents with non-alcoholic fatty liver disease (NAFLD).Methods: Two hundred and ninety-seven obese children and adolescents were included in the study. Anthropometric measurements were made in all subjects, and fasting venous blood samples were taken for determination of glucose, insulin, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Ultrasonography of the liver was used for assessment of NAFLD and the subjects were grouped as NAFLD and non-NAFLD. Echocardiography was performed in all subjects.Results: PAFT was higher in patients with NAFLD compared with the nonNAFLD group. In patients with NAFLD, PAFT was positively correlated with waist circumference and with total cholesterol levels. In multiple regression analysis, waist circumference (?0.28, p>0.001) was found to be the best predictor of PAFT.Conclusion: Conventional echocardiography may be used to determine increased PAFT at an early stage in obese children and adolescents with NAFLD for careful monitoring of cardiovascular riskÖğe Association Between Nonalcoholic Fatty Liver Disease and Cardiovascular Risk in Obese Children and Adolescents(Elsevier Science Inc, 2013) Alp, Hayrullah; Karaarslan, Sevim; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Altin, Hakan; Baysal, TamerBackground: The recent rise in the prevalence of obesity likely explains nonalcoholic fatty liver disease (NAFLD) epidemic worldwide. We evaluated cardiac functions, cardiovascular risk, and associated parameters with grades of NAFLD in obese children. Methods: Four hundred obese children were enrolled in the study. Obese children with NAFLD were classified in 2 subgroups according to ultrasonographic visualizing. Ninety-three obese children with NAFLD (mean age 11.73 +/- 2.72 years in group 2 and 12.69 +/- 2.61 years in group 3) were compared with 307 age- and sex-matched non-NAFLD obese children and 150 control subjects. Laboratory parameters were measured during the fasting state. Pulsed and tissue Doppler echocardiography were performed. Intima-media (IMT) and epicardial adipose tissue (EAT) thicknesses were measured. Results: NAFLD groups had a significantly higher body mass index (29.15 +/- 3.42 and 30.46 +/- 4.60; P < 0.001), total adipose tissue mass (37.95 +/- 4.46% and 46.57 +/- 6.45%; P < 0.001), higher insulin, alanine aminotransferase, and aspartate aminotransferase levels. Increased end-systolic thickness of the interventricular septum (P < 0.001), larger left ventricular mass (P < 0.003) and index (P < 0.003) were found in NAFLD groups. Children with NAFLD had higher Tei index values. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Waist and hip circumference, total cholesterol level, total adipose tissue mass, and interventricular septum were statistically different in NAFLD groups. Conclusions: Children with NAFLD had mildly altered left and right ventricular functions and all obese children had increased IMT and EAT thickness. Also, grade of liver steatosis was positively correlated with total adipose tissue mass and interventricular septum systolic thickness.Öğe Bone mineral density in obese children with prediabetes(2018) Atabek, Mehmet Emre; Üstyol, AlaAim: The aim of this study was to evaluate the relationships between bone mineral density (BMD) vs metabolic risk factors in obese adolescents with prediabetes. Materials and Methods: A total of 131 obese children and adolescents, aged 6-18 years of age were enrolled the study. Prediabetes was determined by a fasting blood glucose level of ≥100 to 125 mg/dL or 2-hour oral glucose tolerance test value of ≥140 to 199 mg/dL. Five patients who were diagnosed as having type 2 diabetes were excluded and remaining participants were classified as normal glucose tolerance (NGT) and prediabetic. BMD was measured on calcaneus using quantitative ultrasound. BMD and metabolic parameters were investigated and compared in these two groups. Results: There was no significant difference in BMD between children and adolescents with prediabetes (n=37) or NGT (n=89). The parameters of prediabetes did not affect BMD and these results did not change when we adjusted for weight, height, age, sex, pubertal status. The multivariate linear regression analysis revealed that the only independent factor associated with higher BMD was higher body mass index (BMI) (OR=0.007, 95%CI: 0.002-0.013, p=0.013). No significant associations were found between BMD and waist circumference or biochemical measurements. Conclusion: Plasma glucose within the prediabetic range is not associated with bone mineral density in obese children. Thus, the positive association of BMI with BMD may be by means of alternative pathways.Öğe Carotid intima media thickness and echocardiography in risk stratification of obese adolescents with non-alcoholic fatty liver disease: what is the right approach?(Walter De Gruyter Gmbh, 2014) Atabek, Mehmet Emre[Abstract Not Availabe]Öğe Carotid intima media thickness and echocardiography in risk stratification of obese adolescents with non-alcoholic fatty liver disease: what is the right approach?(Walter De Gruyter Gmbh, 2014) Atabek, Mehmet Emre[Abstract Not Availabe]Öğe Coexistence of testicular microlithiasis with parathyroid adenoma in an obese child(Walter De Gruyter Gmbh, 2014) Eklioglu, Beray Selver; Atabek, Mehmet Emre; Akyurek, Nesibe[Abstract Not Availabe]Öğe Coexistence of testicular microlithiasis with parathyroid adenoma in an obese child(Walter De Gruyter Gmbh, 2014) Eklioglu, Beray Selver; Atabek, Mehmet Emre; Akyurek, Nesibe[Abstract Not Availabe]Öğe Corticosterone Methyl Oxidase Deficiency Type 1 with Normokalemia in an Infant(2016) Üstyol, Ala; Atabek, Mehmet Emre; Taylor, Norman; Yeung, Matthew Chun-Wing; Chan, Angel O. K.Isolated aldosterone synthase deficiency may result in life-threatening saltwasting and failure to thrive. The condition involves hyperkalemia accompanying hyponatremia. Two types of aldosterone synthase deficiency may be observed depending on hormone levels: corticosterone methyl oxidase type 1 (CMO 1) and CMO 2. Herein, we describe a Turkish infant patient with aldosterone synthase deficiency who presented with failure to thrive and salt wasting but with normal potassium levels. Urinary steroid characteristics were compatible with CMO I deficiency. Diagnosis of aldosterone synthase deficiency was confirmed by mutational analysis of the CYP11B2 gene which identified the patient as homozygous for two mutations: c.788TÖğe Diagnosis of non-alcoholic fatty liver disease in obese children(Walter De Gruyter & Co, 2012) Atabek, Mehmet Emre[Abstract Not Availabe]Öğe Diagnosis of non-alcoholic fatty liver disease in obese children(Walter De Gruyter & Co, 2012) Atabek, Mehmet Emre[Abstract Not Availabe]Öğe Does treatment with L-selenomethionine reduce thyroid volume in euthyroid children with autoimmune thyroiditis?(Walter De Gruyter Gmbh, 2013) Atabek, Mehmet Emre[Abstract Not Availabe]
