Person: SAĞLAM, HALİL
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SAĞLAM
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HALİL
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Publication Comparison of plasmapheresis with medical apheresis in terms of efficacy and cost in the acute treatment of hypertriglyceridemia in children with(Walter, 2021-11-01) Erdöl, Şahin; Bilgin, Hüseyin; Sağlam, Halil; ERDÖL, ŞAHİN; BİLGİN, HÜSEYİN; SAĞLAM, HALİL; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı/Metabolizma Bilim Dalı; 0000-0002-6598-8262; GLN-8241-2022; JMQ-9930-2023; HSF-7083-2023Objectives: We aimed to compare plasmapheresis and medical apheresis as lipid-lowering therapies in children with familial lipoprotein lipase (LPL) deficiency. Methods: The data of 13 patients who were followed up after a diagnosis of LPL deficiency were retrospectively analyzed. Plasma triglyceride, cholesterol, amylase, and lipase values and complications were recorded before and after each patient underwent plasmapheresis or medical apheresis. Results: The mean follow-up period of the patients was 99.64 +/- 52.92 months in the medical apheresis group and 118 +/- 16.97 months in the plasmapheresis group. While the mean triglyceride level before plasmapheresis was 1,875.38 +/- 547.46 mg/dL, it was 617 +/- 228.28 mg/dL after plasmapheresis. While the mean triglyceride level before medical apheresis was 1,756.86 +/- 749.27 mg/dL, it was found to be 623.03 +/- 51.36 mg/dL after medical apheresis. Triglyceride levels were decreased by 59.62% with medical apheresis and 65.57% with plasmapheresis. The cost of treatment for medical apheresis was found to be lower compared to plasmapheresis 296.93 +/- 29.94 Turkish lira (USD 43.34 +/- 4.01) vs. 3,845.42 +/- 156.17 Turkish lira (USD 561.37 +/- 20.93; p<0.001). Conclusions: Although there is no standardized strategy for the acute treatment of hypertriglyceridemia due to LPL deficiency, medical apheresis is a safe and effective treatment with a low risk of side effects. Unlike plasmapheresis, medical apheresis can be performed in any center, which is another important advantage of the procedure. A greater catabolism. diabetes, tions gene the titis, xhantoms acute zil, familial and these there treatment. tingPublication Telemedicine experiences at a pediatric endocrinology clinic during the COVID-19 pandemic(Springer, 2021-06-07) Denkboy Öngen, Yasemin; Eren, Erdal; Şahin, Kadriye Cansu; Buhur Pirimoğlu, Meltem; Sağlam, Halil; Tarim, Ömer; DENKBOY ÖNGEN, YASEMİN; EREN, ERDAL; ŞAHİN, KADRİYE CANSU; BUHUR PİRİMOĞLU, MELTEM; SAĞLAM, HALİL; TARIM, ÖMER FARUK; Bursa Uludağ Üniversitesi/Çocuk Endokrinolojisi Anabilim Dalı; 0000-0002-1684-1053; 0000-0002-6598-8262; 0000-0002-5657-4260; KHZ-1491-2024; JPK-3909-2023; GLN-8241-2022; CCU-8073-2022Background The coronavirus 19 (COVID-19) pandemic has affected all aspects of life, including the routine follow-up of patients with chronic illnesses. In this study, we aim to share our experience of telemedicine in our pediatric endocrinology clinic during the pandemic. Methods We were able to continue caring for children with endocrine disorders using various communication methods such as e-mail and e-message. Results A total of 267 patients received telemedicine care over the course of 608 contacts. The number of hospital visits and physical contact was effectively reduced to help protect against the COVID-19 infection. The patients were supported in terms of receiving their prescriptions and patient education also continued. No complications were observed. Conclusion The advantages and disadvantages of telemedicine were discussed and consequently, we propose that telemedicine can be utilized to maintain and continue the care of children with endocrine disorders during and even after the pandemic. Further studies are needed to standardize this method for general use.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 Turner syndrome and associated problems in Turkish children: A multicenter study(Galenos Yayıncılık, 2015-03-01) Yeşilkaya, Ediz; Bereket, Abdullah; Darendeliler, Feyza; Bas, Firdevs; Poyrazoğlu, Şükran; Aydın, Banu Kuçükkemre; Darcan, Sukran; Dündar, Bumin; Büyükınan, Muammer; Kara, Cengiz; Sarı, Erkan; Adal, Erdal; Akınciı Ayşehan; Atabek, Mehmet Emre; Demirel, Fatma; Celik, Nurullah; Ozkan, Behzat; Ozhan, Bayram; Orbak, Zerrin; Ersoy, Betul; Dogan, Murat; Atas, Ali; Turan, Serap; Goksen, Damla; Tarim, Omer; Yuksel, Bilgin; Ercan, Oya; Hatun, Sukru; Simsek, Enver; Okten, Aysenur; Abaci, Ayhan; Doneray, Hakan; Ozbek, Mehmet Nuri; Keskin, Mehmet; Onal, Hasan; Akyurek, Nesibe; Bulan, Kezban; Tepe, Derya; Emeksiz, Hamdi Cihan; Demir, Korcan; Kizilay, Deniz; Topaloglu, Ali Kemal; Eren, Erdal; Ozen, Samim; Abali, Saygin; Akin, Leyla; Eklioglu, Beray Selver; Kaba, Sultan; Anik, Ahmet; Bas, Serpil; Unuvar, Tolga; Saglam, Halil; Bolu, Semih; Ozgen, Tolga; Dogan, Durmus; Cakir, Esra Deniz; Sen, Yasar; Andiran, Nesibe; Cizmecioglu, Filiz; Evliyaoglu, Olcay; Karaguzel, Gulay; Pirgon, Ozgur; Catli, Gonul; Can, Hatice Dilek; Gurbuz, Fatih; Binay, Cigdem; Bas, Veysel Nijat; Fidanci, Kursat; Polat, Adem; Gul, Davut; Acikel, Cengizhan; Demirbilek, Huseyin; Cinaz, Peyami; Bondy, Carolyn; TARIM, ÖMER FARUK; EREN, ERDAL; SAĞLAM, HALİL; Doğan, Durmuş; Çakır, Esra Deniz; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Endocrinoloji Bölümü; 0000-0002-1684-1053; 0000-0003-0710-5422; JHM-8761-2023; JPK-3909-2023; C-7392-2019; AID-3610-2022; GQO-9634-2022Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population.Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014.Results: The most common karyotype was 45, X (50.7%), followed by 45, X/46, XX (10.8%), 46, X, i(Xq) (10.1%) and 45, X/46, X, i(Xq) (9.5%). Mean age at diagnosis was 10.2 +/- 4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45, X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%.Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespan.Publication Novel mutation of the electron transferring flavoprotein dehydrogenase (ETFDH) gene in the isolated myopathic form of coenzyme q10 deficiency(Medecine Et Hygiene, 2015-01-01) Görükmez, O.; Görükmez, Orhan; Sağ, Şebnem Özemri; Erdöl, Şahin; Sağlam, Halil; Yakut, T.; Görükmez, Orhan; ÖZEMRİ SAĞ, ŞEBNEM; ERDÖL, ŞAHİN; SAĞLAM, HALİL; Yakut, T.; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Bölümü; 0000-0002-9241-0896; 0000-0002-9241-0896; 0000-0002-6598-8262; GLN-8241-2022; AFZ-0764-2022; AAH-8355-2021; C-7392-2019Publication 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 Growth curves for Turkish girls with Turner syndrome: Results of the Turkish Turner syndrome study group(Galenos Yayıncılık, 2015-04-21) Darendeliler, Feyza; Yeşilkaya, Ediz; Bereket, Abdullah; Baş, Firdevs; Bundak, Rüveyde; Sarı, Erkan; Aydın, Banu Küçükemre; Darcan, Şükran; Dündar, Bumin; Büyükinan, Muammer; Kara, Cengiz; Mazicioğlu, Mümtaz M.; Adal, Erdal; Akıncı, Ayşehan; Atabek, Mehmet Emre; Demirel, Fatma; Çelik, Nurullah; Özkan, Behzat; Özhan, Bayram; Orbak, Zerrin; Ersoy, Betül; Doğan, Murat; Ataş, Ali; Turan, Serap; Göksen, Damla; Tarım, Ömer; Yüksel, Bilgin; Ercan, Oya; Hatun, Sükrü; Şimşek, Enver; Ökten, Ayşenur; Abacı, Ayhan; Döneray, Hakan; Özbek, Mehmet Nuri; Keskin, Mehmet; Önal, Hasan; Akyürek, Nesibe; Bulan, Kezban; Tepe, Derya; Emeksiz, Hamdi Cihan; Demir, Korcan; Kızılay, Deniz; Topaloğlu, Ali Kemal; Eren, Erdal; Özen, Samim; Demirbilek, Hüseyin; Abalı, Saygın; Akın, Leyla; Eklioğlu, Beray Selver; Kaba, Sultan; Anık, Ahmet; Baş, Serpil; Ünüvar, Tolga; Sağlam, Halil; Bolu, Semih; Özgen, Tolga; Doğan, Durmuş; Çakır, Esra Deniz; Şen, Yaşar; Andiran, Nesibe; Çizmecioğlu, Filiz; Evliyaoğlu, Olcay; Karagüzel, Gülay; Pirgon, Özgür; Çatlı, Gönül; Can, Hatice Dilek; Gürbüz, Fatih; Binay, Çiğdem; Baş, Veysel Nijat; Sağlam, Celal; Gül, Davut; Polat, Adem; Açıkel, Cengizhan; Çınaz, Peyami; Can, Hatice Dilek; Doğan, Durmuş; Çakır, Esra Deniz; SAĞLAM, HALİL; EREN, ERDAL; TARIM, ÖMER FARUK; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Endokrinolojisi Anabilim Dalı.; 0000-0002-1684-1053; 0000-0003-0710-5422; 0000-0003-4664-7435; JHM-8761-2023; JPK-3909-2023; C-7392-2019; AID-3610-2022; GQO-9634-2022; IRJ-2200-2023Objective: Children with Turner syndrome (TS) have a specific growth pattern that is quite different from that of healthy children. Many countries have population-specific growth charts for TS. Considering national and ethnic differences, we undertook this multicenter collaborative study to construct growth charts and reference values for height, weight and body mass index (BMI) from 3 years of age to adulthood for spontaneous growth of Turkish girls with TS.Methods: Cross-sectional height and weight data of 842 patients with TS, younger than 18 years of age and before starting any therapy, were evaluated.Results: The data were processed to calculate the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentile values for defined ages and to construct growth curves for height-for-age, weight-for-age and BMI-for-age of girls with TS. The growth pattern of TS girls in this series resembled the growth pattern of TS girls in other reports, but there were differences in height between our series and the others.Conclusion: This study provides disease-specific growth charts for Turkish girls with TS. These disease-specific national growth charts will serve to improve the evaluation of growth and its management with growth-promoting therapeutic agents in TS patients.Publication Evaluation of the endocrine functions in pediatric patients with cyanotic congenital heart disease(Scientific Publishers India, 2013-01-01) Eren, Erdal; Çakır, Esra Deniz Papatya; Bostan, Özlem; Sağlam, Halil; Tarım, Ömer; EREN, ERDAL; Çakır, Esra Deniz Papatya; BOSTAN, ÖZLEM MEHTAP; SAĞLAM, HALİL; TARIM, ÖMER FARUK; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Endokrinolojisi Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Kardiyoloji Bilim Dalı.; 0000-0002-1684-1053; 0000-0003-4664-7435; 0000-0001-7707-2174; 0000-0002-6598-8262; 0000-0002-5322-5508; GQO-9634-2022; AAG-8558-2021; JPK-3909-2023; C-7392-2019; GLN-8241-2022; CCU-8073-2022Our aim was to investigate effects of chronic hypoxia on endocrine function in pediatric patients with cyanotic congenital heart disease (CHD). Thirty patients with cyanotic CHD (16 boys, 14 girls), and 35 control subjects (22 boys, 13 girls) were enrolled. Age means of patients and controls were 4.37 +/- 4.51 and 4.28 +/- 4.96 years, respectively. Standard deviation scores (SDS) of height and weight were significantly lower among patients compared to controls. Mean fasting glucose levels were 75 +/- 15 mg/dL and 83 +/- 12 mg/dL among patients and controls, respectively (p=0.033). Insulin-like growth factor (IGF) 1 and its SDS were significantly lower among patients (p=0.010). There was no significant difference in ACTH and cortisol levels between groups. ACTH levels were very low in six patients. Oxygen saturation level was positively correlated with ACTH (p=0.041, r=0.439) and negatively correlated with HOMA-IR (p=0.046, r=-0.420) and insulin (p=0.017, r=-0.494). There was no difference in insulin resistance between groups. Chronic hypoxia has negative impact on growth by reducing IGF-1 along with the nutritional deficiency in children with cyanotic CHD. ACTH-adrenal axis is also affected. While cyanotic CHD has decreased serum glucose level, it had no effect on insulin level and insulin resistance. Negative correlations between oxygen saturation, and HOMA-IR, fasting insulin levels, have suggested that these patients should be monitorized for insulin resistance.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 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.