Person: SAĞLAM, HALİL
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SAĞLAM
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HALİL
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Publication Pseudopseudohypoparathyroidism: A case report(Karger, 2008-01-01) Sağlam, Halil; Yüce, Necla; Tarım, Ömer; SAĞLAM, HALİL; Yüce, Necla; TARIM, ÖMER FARUK; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Bölümü; 0000-0002-6598-8262; 0000-0002-5322-5508; C-7392-2019; CIK-2854-2022; CCU-8073-2022Publication Pediatric patients with pheochromocytoma: Experience of a tertiary health center(Wiley, 2015-10-01) Eren, Erdal; Sağlam, Halil; Çalışkan, Yusuf; Kiriştioğlu, İrfan; Tarım, Ömer; EREN, ERDAL; SAĞLAM, HALİL; Çalışkan, Yusuf; KIRIŞTIOĞLU, İRFAN; TARIM, ÖMER FARUK; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Endokrinolojisi Anabilim Dalı.; 0000-0002-1684-1053; 0000-0002-6598-8262; 0000-0002-5322-5508; JPK-3909-2023; C-7392-2019; GLN-8241-2022; JPO-3445-2023; ITE-9417-2023; CCU-8073-2022BackgroundThe aim of this retrospective study was to investigate pheochromocytoma (pheo), which is a rare endocrine tumor in the pediatric population.MethodsThe medical records of five children with pheo were studied. The age, gender, clinical presentation, family history, physical findings, coexisting pathology, laboratory evaluation, surgical treatment, and postoperative course were investigated.ResultsThe patients were four girls and one boy with a mean age of 13.2years (range, 9.57-15.95years). None of the patients had paroxysmal hypertension and one had normal blood pressure. No malign pheo was identified. Mean height and weight standard deviation scores (SDS), body mass index (BMI), and BMI SDS were -0.24, 0.04, 20.9kg/m(2), and 0.20 at the time of diagnosis, and 0.03, 0.43, 23.8kg/m(2) and 0.49 1year after operation, respectively. BMI increased significantly after operation. Three patients had normal epinephrine and metanephrine, but elevated norepinephrine and normetanephrine on 24h urine. Vanillylmandelic acid on 24h urine sample was elevated in all patients. Ultrasonography failed to visualize tumors in two patients with bilateral pheo. One patient had postoperative severe hypotension. Insulin resistance associated with severe acanthosis nigricans observed in one patient regressed postoperatively.ConclusionsPheo in children may present with different symptoms and findings. Decreased catecholamine in the postoperative period may lead to weight gain.Publication Does growth hormone treatment advance bone age?(Galenos Yayincilik, 2017-08-01) Sağlam, Halil; SAĞLAM, HALİL; Tarım, Ömer; TARIM, ÖMER FARUK; Salı, Enes; Eren, Erdal; EREN, ERDAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0002-6598-8262; 0000-0002-1684-1053; 0000-0002-5322-5508; JPK-3909-2023; C-7392-2019Introduction: Growth hormone (GH) treatment may have a stimulatory effect on bone maturation which raises concern about acceleration of bone maturation leading to early epiphyseal fusion. In this study, we aimed to investigate this possibility and determine whether or not accelerated bone maturation affects predicted or final height.Methods: A total of 230 patients who received GH treatment between 1995 and 2005 were retrospectively studied. The patients were classified as isolated growth hormone deficiency (GHD) (Group-1), Turner syndrome (Group-2), and others (Group-3). The previous X rays were obtained from the medical records and follow-up X rays were requested during the clinic visit. Bone age (BA) assessment was done according to the atlas of Greulich and Pyle. Based on BA, adult height prediction was calculated by the method of Bayley and Pinneau. The predicted height (PH) at baseline and after the first and second years of treatment were evaluated along with the change in chronological age (CA)-BA and CA/BA.Results: Height SDS significantly increased in all three groups (p<0.05). CA-BA decreased in Groups-1 and 2 during the first and second years of treatment (p<0.05). The BA acceleration was verified by the decrement in CA/BA ratio. However, predicted height was not negatively influenced despite BA advancement.Discussion and Conclusion: BA advances with GH treatment as evident from the reduction in CABA and CA/BA. However, predicted height is not adversely affected by accelerated bone maturation in our cohort over two years of treatment. This issue needs to be investigated in other patient groups such as precocious puberty where bone maturation is further accelerated.Publication Robinow syndrome(Galenos Yayıncılık, 2010-04-01) Gökalp, Gökhan; Eren, Erdal; Yazıcı, Zeynep; Sağlam, Halil; GÖKALP, GÖKHAN; EREN, ERDAL; YAZICI, ZEYNEP; SAĞLAM, HALİL; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-1684-1053; 0000-0002-6598-8262; C-7392-2019; AAI-2303-2021; AAI-2336-2021; JPK-3909-2023Introduction: Robinow syndrome is characterized by dwarfism demonstrating short-limbed extremities, vertebral malsegmentation/malformation (hemivertebra), costal dysplasia, genital hypoplasia, and fetal facial appearance (wide and prominent forehead, hypertelorism, small and wide nose, molar hypoplasia, and retrognathia). It is a rare genetic disease which may present with either mild autosomal dominant form or severe recessive form. Vertebral and costal abnormalities are common diagnostic signs that may be severe. The disease presents with kyphoscoliosis and chest abnormalities along with thoracic vertebral fusion and hemivertebral appearance. Ribs may demonstrate fusion. Based on those involvements, the disease can be categorized as spondylothoracic, spondylocostal, ischiovertebral dysplasia, and cervicofaciothoracic syndrome. Diagnosis is established by the help of clinical characteristics. Radiography might contribute to the diagnosis by revealing changes in the skeletal system. Case Report: A three-year-old male patient presented with operated left undescendent testis and buried penis. On physical examination, he also had a dysmorphic face characterized by macrocephaly, hypertelorism, prominent eyes, a flattened nasal bridge, triangular-fish mouth, gingival hypertrophy and left hand clinodactyly. Radiographic examination documented mesomelic shortening of the radius-ulna, malsegmentation of the thoracal spine and the ribs fusion. Conclusion: Robinow syndrome is a rare syndrome which can be diagnosed by typical facial appearance and radiologic findings.Publication Evaluation of late effects of postoperative radiotherapy in patients with medulloblastoma(Turkish J Pediatrics, 2015-03-01) Karadağ, Oya; Demiröz-Abakay, Candan; Özkan, Lütfi; Sağlam, Halil; Demirkaya, Metin; DEMİRÖZ ABAKAY, CANDAN; Özkan, Lütfi; SAĞLAM, HALİL; Demirkaya, Metin; Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Pediatrik Endokrinoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0003-0710-5422; GLN-8241-2022; C-7392-2019; ETY-3982-2022; JGQ-9310-2023; EUG-4353-2022We aimed to evaluate long-term toxicity in children with medulloblastoma treated with postoperative radiotherapy (RT).This study included 21 patients aged 4-16 who had been diagnosed with medulloblastoma. All of the patients in the study received postoperative craniospinal RT. Postoperative RT followed by chemotherapy was the treatment protocol. A total of 13 patients (62%) received chemotherapy concurrently with RT.Overall survival was 50 months (range, 1-169 months) and disease-free survival was 39 months (range, 4-171 months). In the data analysis, the heights of 11 patients (91.6%) were found to be below 50% on the height curve, and 8 (66.6%) patients had weights below 50% on the weight curve. Mean sitting height was 72.58 +/- 6.33 cm, and this was statistically correlated with parameters such as LH level (p=0.037), testosterone level (p=0.020), height (p=0.002), weight (p=0.033) and age at diagnosis (p=0.002).Radiation therapy for medulloblastoma seems to have a late toxic effect on long-term survivors. With the improving survival rate of medulloblastoma patients, RT doses should be as low as possible without sacrificing efficacy.Publication Diagnostic criteria of growth hormone deficiency needs to be reevaluated(Galenos Yayincilik, 2012-12-01) Salı, Enes; Tarım, Ömer; TARIM, ÖMER FARUK; Sağlam, Halil; SAĞLAM, HALİL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0002-6598-8262; 0000-0002-5322-5508; GLN-8241-2022; C-7392-2019Introduction: In this study, we aimed to investigate the factors that determine response to growth hormone (GH) treatment in children with isolated idiopathic GH deficiency treated in our university hospital.Materials and Methods: The data of 149 patients followed in our university hospital between January 1995 and December 2005 were evaluated in patient charts retrospectively.Results: The maximum GH response to clonidine and glucagon stimulation tests was 4.58 and 6.01 ng/ml respectively. The mean GH dose was 0.215 (0.18-0.25) mg/kg/week. Height SDS significantly increased after the first and second years of GH treatment (p<0.05). There was a negative correlation between the maximum response to stimulation tests and the response to GH treatment (p<0.05). When the patients were grouped according to the maximum response to stimuli as <3, 3-5, 5-7, and >7 ng/ml, the best response to therapy was observed in the group with the least response (<3ng/ml) to both clonidine and glucagon stimulation tests. A positive correlation was determined between height gain and GH dose, and a negative correlation between height gain and age at the beginning of therapy (p<0.05). There was no correlation between target height, baseline pubertal stage, relative weight and IGF-1 SDS with the response to GH treatment (p>0.05).Conclusions: Patients who were started treatment at an early age, whose response to GH stimulation tests were lower, and who were given higher doses benefited more from GH treatment. Therefore, we suggest that the diagnostic criteria for GH deficiency must be reevaluated and the random cut-off of <10ng/ml for stimulated GH level may lead to overdiagnosis. This issue must be further investigated in larger patient populations with consideration of final height as well.Publication Maltodextrin may be a promising treatment modality after near-total pancreatectomy in infants younger than six months with persistent hyperinsulinism: A case report(Galenos Publ House, 2023-03-01) Öngen, Yasemin Denkboy; EREN, ERDAL; DENKBOY ÖNGEN, YASEMİN; Eren, Erdal; SAĞLAM, HALİL; Sağlam, Halil; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; 0000-0002-1684-1053; 0000-0002-6598-8262; KHZ-1491-2024Persistent hypoglycemia in infants with congenital hyperinsulinism (CHI) can be challenging in approximately half of these cases, even after undergoing a near-total pancreatectomy. While maltodextrin has been recommended in the nutritional management of CHI cases younger than six months, information regarding its efficacy in managing hypoglycemia are not yet clear. Here, we present a male infant with CHI who experienced persistent hypoglycemia even after undergoing a near-total pancreatectomy and despite multiple medical treatments. The infant's hypoglycemic episodes were successfully controlled by adding maltodextrin to his diet.Publication A determination of the quality of life of children and adolescents with type 1 diabetes and their parents(Elsevier Science Bv, 2017-04-10) Avdal, Elif Unsal; ÖZYAZICIOĞLU, NURCAN; Sağlam, Halil; SAĞLAM, HALİL; Bursa Uludağ Üniversitesi/Veteriner Fakültesi/Pediatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Fakültesi/Hemşirelik Anabilim Dalı.; 0000-0001-9645-7221; 0000-0002-6598-8262; AAI-6835-2021; C-7392-2019; GLN-8241-2022Objective: Type 1 diabetes is a chronic illness which can have a negative effect on the health care and development of children and can put their lives in danger. This descriptive study aimed to determine the quality of life and the factors affecting it of children and adolescents with type 1 diabetes using the Pediatric Quality of Life Inventory (PedsQL).Methods: The study was conducted in the Child Endocrinology Unit of a University Hospital in Bursa, Turkey. Totally 64 children eight- 12 years and 85 adolescents aged 13-18 with type 1 diabetes and their parents were recruited. HbA1c measurements were obtained from the records of the endocrinology clinicare, which were made once every three months, and the average of the last three measurements was taken in the study. The PedsQL was used to measure quality of life of the children and adolescents. The data was analyzed using SPSS version 20.0 and P < 0.05 was considered significant. The demographic data of the children and parents were analyzed using means and percentiles. Pearson's correlation analysis was used to assess the relationship between two averages.Results: Of the sub-groups on the scale, affective and school function scores were somewhat low, and social function scores were high. The quality of life scores of the children and adolescents were found to correlate with those of their parents. A negative correlation was found between HbA1c levels and adolescent quality of life, a positive correlation was found between the child's age and the quality of life of the child and parents, and a negative correlation was found between the number of children in the family and the quality of life of the child and parents.Conclusions: An evaluation of the quality of life after a diagnosis of diabetes can be used to assess the problems which may be faced by children and adolescents and to combat these problems.Publication Retrospective evaluation of patients diagnosed with osteogenesis imperfecta(Galenos Yayıncılık, 2017-04-01) Aslan, Mustafa Törehan; Eren, Erdal; Sağlam, Halil; Tarım, Ömer; Aslan, Mustafa Törehan; EREN, ERDAL; SAĞLAM, HALİL; TARIM, ÖMER FARUK; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı/Çocuk Endokrinolojisi Bilim Dalı.; 0000-0002-1684-1053; 0000-0002-6598-8262; 0000-0002-5322-5508; GLN-8241-2022; C-7392-2019; AAS-8336-2020; JPK-3909-2023Introduction: Osteogenesis imperfecta (OI) is a hereditary disease that impairs the quality of life by frequent bone fractures. The objective of our study is to retrospectively evaluate patients diagnosed with OI and to come up with helpful data that will assist developing new diagnosis and treatment protocols.Materials and Methods: Twenty-eight cases with OI who were followed-up in our clinic were retrospectively evaluated. Clinical classification of OI was done. Age, sex, and oxologic data were evaluated. Height, weight and body mass index (BMI) data was given as standard deviation score (SDS). Family history of fracture and consanguineous marriage was sought. Blue sclera and presence of deformity was evaluated on physical examination.Results: Out of the 28 cases in our study, 14 (50%) were boys, 14 (50%) were girls, and mean age was 7.48 +/- 5.09 years. Mean age of diagnosis was 25.59 +/- 39.59 months. Ten cases (47.6%) had OI, and 7 cases (25%) had consanguineous marriage in their family history. The cases were separated into autosomal dominant 4 clinical types according to Sillence classification as follows; 13 cases (46.4%) type 1, 10 cases (35.7%) type 3, and 5 cases (17.9%) type 4. The mean average basal dual energy X-ray absorptiometry Z score, mean height SDS, mean weight SDS and BMI SDS significantly increased for the cases after treatment (p<0.001).Conclusions: Treatment of OI with pamidronate was observed to increase bone mineral density, decrease number of fractures and pain, and improve the patient's quality of life with inreasing mobility. Pamidronate is one of the most effective treatments of OI until a more effective treatment is found. On the other hand, since the long-term side effect of pamidronate on bones is not well-known, we think that randomised controlled studies still need to be done to determine the optimal time, interval and dose for bisphosphonate use.Publication Growth hormone deficiency(Galenos Yayıncılık, 2010-04-01) Tarım, Ömer; Sağlam, Halil; TARIM, ÖMER FARUK; SAĞLAM, HALİL; Uludağ Üniversitesi/Tip Fakültesi/Çocuk Sağlığı Hastalıkları Anabilim Dalı/Çocuk Endokrinoloji Bilim Dalı; 0000-0002-5322-5508; 0000-0002-6598-8262; C-7392-2019; CCU-8073-2022Growth hormone deficiency is the most promising entity in terms of response to therapy among the treatable causes of growth retardation. It may be due to genetic or acquired causes. It may be isolated or a part of multiple hormone deficiencies. Diagnostic criteria and therefore treatment indications are still disputed.
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