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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 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 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 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 Association between vitamin D level and cardiovascular risk in obese children and adolescents(Walter De Gruyter Gmbh, 2014) Atabek, M. E.; Eklioglu, Beray Selver; Akyurek, Nesibe; Alp, HayrullahBackground: The aim of our study was to evaluate the associations between vitamin D deficiency, the atherosclerosis and metabolic syndrome. Methods: Two hundred and forty-seven obese children and adolescents, 8-16 years of age (body mass index>95 p) were included in the study. Anthropometric measurements, blood pressure measurements, lipid profile, vitamin D level and carotid intima media thickness (c-IMT) were measured. MS was diagnosed according to IDF criteria. Results: The prevalance of vitamin D deficieny in obese children and adolescent was 46.6%. Low levels of vitamin D were associated with increased carotis intima media thickness and metabolic syndrome (p=0.03, p=0.04, respectively). For clinical cardiovascular risk factors, mutivariable regression analyses showed that low vitamin D level was best predictor of c-IMT. Conclusions: In this study we showed an association between low vitamin D status and atherosclerosis independent of traditional risk factors in obese children and adolescents.Öğe Association between vitamin D level and cardiovascular risk in obese children and adolescents(Walter De Gruyter Gmbh, 2014) Atabek, M. E.; Eklioglu, Beray Selver; Akyurek, Nesibe; Alp, HayrullahBackground: The aim of our study was to evaluate the associations between vitamin D deficiency, the atherosclerosis and metabolic syndrome. Methods: Two hundred and forty-seven obese children and adolescents, 8-16 years of age (body mass index>95 p) were included in the study. Anthropometric measurements, blood pressure measurements, lipid profile, vitamin D level and carotid intima media thickness (c-IMT) were measured. MS was diagnosed according to IDF criteria. Results: The prevalance of vitamin D deficieny in obese children and adolescent was 46.6%. Low levels of vitamin D were associated with increased carotis intima media thickness and metabolic syndrome (p=0.03, p=0.04, respectively). For clinical cardiovascular risk factors, mutivariable regression analyses showed that low vitamin D level was best predictor of c-IMT. Conclusions: In this study we showed an association between low vitamin D status and atherosclerosis independent of traditional risk factors in obese children and adolescents.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 Common Obesity Syndromes in Childhood(Galenos Yayincilik, 2016) Albayrak, Hatice Mutlu; Eklioglu, Beray SelverSyndromic obesity occurs with different genetic or chromosomal disorders. Obesity is accompanied by dysmorphic features, mental retardation and developmental abnormalities. Prader-Willi syndrome, Bardet-Biedl syndrome and Alstrom syndrome are the most commonly encountered obesity syndromes, in clinical practice. Prader-Willi syndrome is an obesity syndrome, characterized by hypotonia, hyperphagia, hypogonadism and short stature due to genomic imprinting defect. Bardet-Biedl syndrome is a genetically heterogeneous ciliopathy syndrome caused by autosomal recessive genes, characterized by retinal dystrophy, truncal obesity, postaxial polydactyly, learning difficulties, renal anomalies, and hypogonadotropic hypogonadism only in males, Alstrom syndrome is an autosomal recessive syndrome, characterized by progressive cone-rod dystrophy, obesity and sensorineural hearing loss accompanied by multi-organ involvement. If exogenous and monogenic obesity is excluded, not only hormonal evaluation but also additional dysmorphic features, ophthalmic, dental, cardiac, renal, and neurological systems should also be evaluated to approach syndromic obesity. Genetic diagnostic analysis should be utilized for confirming the diagnosis and providing genetic counseling to families.Öğe Evaluation of Electrocardiographic Markers for the Risk of Cardiac Arrhythmia in Children with Obesity(Galenos Publ House, 2023) Dagli, Hatice Yilmaz; Sap, Fatih; Oflaz, Mehmet Burhan; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Baysal, TamerAim: This study was conducted to examine the electrocardiographic markers used in the risk assessment of cardiac arrhythmia in children with obesity.Materials and Methods: In this prospective study, 60 children aged 3-17 years with exogenous obesity and 60 age and sex-matched healthy controls were included. Demographic data, assessment of atrial and ventricular arrhythmia risk markers in electrocardiography, and standard echocardiography measurements were performed. Values of p<0.05 were considered significant.Results: The mean ages of the study and control groups were 11.51 +/- 3.48 years and 10.74 +/- 3.72 years, respectively. Both groups had 30 males and 30 females. The study group had significantly higher average mean body mass index (BMI) compared to the control group. In electrocardiographic examinations, P-wave dispersion, QT dispersion (QTd), corrected QTd (QTcd), Tpeak-Tend (Tp-e), Tp-e/QT, and Tp-e/QTc values were significantly higher in the obese group compared to the control group. In echocardiographic examinations, the dimensions of the heart chambers and vascular structure and wall thicknesses were found to be significantly higher in those children with obesity.Conclusion: The electrocardiographic risk markers used to predict cardiac arrhythmias were found to be increased in those children with obesity. This may suggest that increased body weight and adiposity may have unfavorable effects on the cardiac conduction system.Öğe Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents(Walter De Gruyter Gmbh, 2014) Alp, Hayrullah; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Karaarslan, Sevim; Baysal, Tamer; Altin, Hakan; Karatas, ZehraBackground: Childhood obesity is a cardiovascular risk factor. Objective: Epicardial adipose tissue (EAT) thickness, carotid intima-media thickness (IMT) and cardiac functions of obese children and their correlations were evaluated. Subjects: Five hundred obese children and 150 age-and sex-matched healthy controls. Methods: Anthropometric, laboratory data and echocardiographic measurements of IMT, EAT and cardiac functions were determined. Results: Increased M-mode echocardiographic measurements, E/e' ratios, Tei index values and decreased E/A and e'/a' ratios (where E and A are early and late mitral/tricuspid diastolic velocities, respectively, and e' and a' are peak early diastolic and peak atrial systolic myocardial velocities, respectively), were determined in the obese group. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Carotid artery IMT, EAT thickness and left ventricular mass (LVM) were found to be strongly associated with Tei index values. Conclusion: Obesity is a major risk factor for cardiovascular diseases. In our study, we showed that obese children have early subclinical systolic and diastolic dysfunctions. Also, these cardiac impairments are correlated with the increase in IMT, EAT thickness and LVM.Öğe Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents(Walter De Gruyter Gmbh, 2014) Alp, Hayrullah; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Karaarslan, Sevim; Baysal, Tamer; Altin, Hakan; Karatas, ZehraBackground: Childhood obesity is a cardiovascular risk factor. Objective: Epicardial adipose tissue (EAT) thickness, carotid intima-media thickness (IMT) and cardiac functions of obese children and their correlations were evaluated. Subjects: Five hundred obese children and 150 age-and sex-matched healthy controls. Methods: Anthropometric, laboratory data and echocardiographic measurements of IMT, EAT and cardiac functions were determined. Results: Increased M-mode echocardiographic measurements, E/e' ratios, Tei index values and decreased E/A and e'/a' ratios (where E and A are early and late mitral/tricuspid diastolic velocities, respectively, and e' and a' are peak early diastolic and peak atrial systolic myocardial velocities, respectively), were determined in the obese group. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Carotid artery IMT, EAT thickness and left ventricular mass (LVM) were found to be strongly associated with Tei index values. Conclusion: Obesity is a major risk factor for cardiovascular diseases. In our study, we showed that obese children have early subclinical systolic and diastolic dysfunctions. Also, these cardiac impairments are correlated with the increase in IMT, EAT thickness and LVM.Öğe Evaluation of general characteristics of children with hypothyroidism(Karger, 2021) Bulut, Eman; Eklioglu, Beray Selver; Atabek, Mehmet Emre[Abstract Not Availabe]Öğe Evaluation of serum myostatin levels in patients with insulin dependent diabetes mellitus(Karger, 2021) Selver, Muhammed Burak; Atabek, Mehmet Emre; Eklioglu, Beray Selver; Kurban, Sevil[Abstract Not Availabe]Öğe First Evaluation of P Dispersion and Tp-e Parameters in Electrocardiograms of Children with Diabetic Ketoacidosis(Galenos Yayincilik, 2022) Egil, Oguz; Sap, Fatih; Eklioglu, Beray Selver; Oflaz, Mehmet Burhan; Atabek, Mehmet Emre; Baysal, TamerObjective: Diabetic ketoacidosis (DKA) is an important complication of type 1 diabetes mellitus. We aimed to evaluate the effect of metabolic disorders of DKA on electrocardiography (ECG) parameters in children. Methods: This study was performed between December 2018 and March 2020 and included 39 children with DKA and 40 healthy children. Three ECGs (one before and two after treatment) were obtained from the patient group. P-wave dispersion (Pd), QT dispersion (QTd), QTc dispersion (QTcd), Tp-e intervals, and the ratios of Tp-e/QT and Tp-e/QTc were measured electrocardiographically. ECG parameters from children with DKA and healthy controls were compared statistically. Results: The mean age of the patient group was 10.50 +/- 4.12 years. There was no significant difference in terms of age, gender, weight, height and body mass index between patients and controls. In the patient group, a statistically significant increase was found in Pd, QTd and QTcd in the initial ECG compared to the second and third ECGs. Also, when the first and third ECGs were compared, a significant increase in Tp-e and Tp-e/QT was evident in the first ECG. There was a significant difference in the values of Pd, QTd, QTcd, Tp-e and Tp-e/QT in the first ECGs, obtained before DKA treatment, and those values obtained from the control group. Conclusion: This is the first article evaluating Pd and Tp-e parameters in children with DKA. Cardiac arrhythmia risk markers were increased in children with DKA compared to controls. Therefore, clinicians should be aware of the possibility of developing new arrhythmias during DKA treatment.Öğe Frequency of Vaginal Candida Colonization and Relationship between Metabolic Parameters in Children with Type 1 Diabetes Mellitus(Elsevier Science Inc, 2013) Atabek, Mehmet Emre; Akyurek, Nesibe; Eklioglu, Beray SelverObjectives: Patients with diabetes mellitus (DM) are at risk for vulvovaginal candidasis. The aim of this study was to determine the species-specific prevalence rate and risk of candidiasis in patients with type 1 DM. Methods: Children aged between 8-16 years were included in the study. Clinical and laboratory features of diabetes and evidence of genital symptoms were recorded. Vaginal swabs were taken from patients and placed on Sabouraud's dextrose agar and incubated. Following fasting overnight for 12 hours venous blood samples were taken simultaneously for analyses of blood glucose, HbA1c, and lipid profile. A simple 1-time fiuconazole treatment regimen was used to treat patients with vulvo-vaginal candidiasis. Results: Candida species were isolated in 30 of 76 (39%) swabs of patients with type 1 DM. Subjects who had candida colonization and candidiasis were all acute. The predominant candida species isolated from patients with type 1 DM were C.albicans 50%, C. glabrata 36.6%, C.crusei 3.3%, C.spesies 6.6%, and C.dubliniensis 3.3%. 42 patients had symptoms. The prevalence of candidiasis in symptomatic patients was 59.2%. Subjects with vulvo-vaginal candidiasis had higher mean HbA1c when compared to those who had no such infection (P = .047). Conclusions: There seems to be a significant link between hyperglycemia and vulvo-vaginal candidiasis in patients with type 1 DM. Improving glucose control may reduce the risk of candidiasis and potentially symptomatic infection among children with diabetes. Because of high rate of colonization with candida species in diabetes, patients should undergo periodic screening for genital candidiasis.Öğe General Characteristics of Autoimmune Thyroid Diseases and Evaluation of Accompanied Morbiditis(Karger, 2018) Ibili, Aysel Burcu Palandokenlier; Eklioglu, Beray Selver; Atabek, Mehmet Emre[Abstract Not Availabe]Öğe General properties of autoimmune thyroid diseases and associated morbidities(Walter De Gruyter Gmbh, 2020) Ibili, Aysel Burcu Palandokenlier; Eklioglu, Beray Selver; Atabek, Mehmet EmreBackground: Autoimmune thyroid diseases (ATDs) can be classified into two basic diseases: Graves' disease (GD) and Hashimoto's thyroiditis (HT). Here, we review the effectiveness of laboratory and imaging methods used for the early diagnosis of ATD and draw attention to methods that may improve screening. Methods: Retrospective data of 142 patients diagnosed with ATD between January 2010 and December 2015 at our paediatric endocrinology clinic were used. Sociodemographic characteristics, clinical findings, treatments and follow-up data of patients were statistically evaluated. Results: Of the ATD cases, 81% (n = 115) were female. The median age was 12.5 +/- 3.5 (range 1-17) years and 91% (n = 129) of patients were in puberty. There was a significant positive correlation between the height (standard deviation score) and follow-up time for patients with HT (r = 0.156, p < 0.01). Thyroglobulin antibody (TgAb) positivity was found in 75% (45/60) of females with a positive maternal ATD history ( p = 0.045). Thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) values were significantly altered during the treatment follow-up period in female patients with GD and HT, while only fT4 values were found to be significantly altered in boys with HT. Conclusion: Although GD and HT have similar mechanisms, they differ in terms of treatment duration and remission and relapse frequencies. Ultrasonography (USG) screening is a non-invasive procedure that is suitable for all patients with ATD. Based on our results, TgAb could be useful in the screening of girls with a history of maternal ATD.Öğe General properties of autoimmune thyroid diseases and associated morbidities(Walter De Gruyter Gmbh, 2020) Ibili, Aysel Burcu Palandokenlier; Eklioglu, Beray Selver; Atabek, Mehmet EmreBackground: Autoimmune thyroid diseases (ATDs) can be classified into two basic diseases: Graves' disease (GD) and Hashimoto's thyroiditis (HT). Here, we review the effectiveness of laboratory and imaging methods used for the early diagnosis of ATD and draw attention to methods that may improve screening. Methods: Retrospective data of 142 patients diagnosed with ATD between January 2010 and December 2015 at our paediatric endocrinology clinic were used. Sociodemographic characteristics, clinical findings, treatments and follow-up data of patients were statistically evaluated. Results: Of the ATD cases, 81% (n = 115) were female. The median age was 12.5 +/- 3.5 (range 1-17) years and 91% (n = 129) of patients were in puberty. There was a significant positive correlation between the height (standard deviation score) and follow-up time for patients with HT (r = 0.156, p < 0.01). Thyroglobulin antibody (TgAb) positivity was found in 75% (45/60) of females with a positive maternal ATD history ( p = 0.045). Thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) values were significantly altered during the treatment follow-up period in female patients with GD and HT, while only fT4 values were found to be significantly altered in boys with HT. Conclusion: Although GD and HT have similar mechanisms, they differ in terms of treatment duration and remission and relapse frequencies. Ultrasonography (USG) screening is a non-invasive procedure that is suitable for all patients with ATD. Based on our results, TgAb could be useful in the screening of girls with a history of maternal ATD.
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