Person: SAĞLAM, HALİL
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SAĞLAM
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HALİL
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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; Tıp Fakültesi; Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı; Çocuk Endokrinolojisi 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 Evaluation of diagnosis and treatment results in children with graves' disease with emphasis on the pubertal status of patients(Freund Publishing House Ltd, 2008-08-01) Poyrazoğlu, Sükran; Saka, Nurcin; Baş, Firdevs; İşgüven, Pınar; Doğu, Ayşegül; Turan, Serap; Turan, Abdullah; Sarıkaya, Sevil; Adal, Erdal; Çizmeci, Filiz; Sağlam, Halil; Ercan, Oya; Memioğlu, Nihal; Guenoz, Hülya; Bundak, Ruveyde; Darendeliler, Feyza; Yıldız, Metin; Güran, Tülay; Akçay, Teoman; Akın, Leyla; Hatun, Şükrü; SAĞLAM, HALİL; Tıp Fakültesi; 0000-0003-0710-5422 ; C-7392-2019This retrospective study evaluated the clinical and laboratory characteristics at presentation and treatment results of patients with Graves' disease (GD) with respect to pubertal status. Records of 143 patients (108 F, 35 M) were reviewed in a multicenter study. At diagnosis., 38% of patients were prepubertal. Anti-thyroid drugs (ATD) were used as initial therapy. There was no significant difference in clinical and laboratory characteristics at diagnosis, during treatment and adverse reaction to ATD with respect to pubertal status. Twenty patients (7 prepubertal, 13 pubertal) reached remission on ATD. Surgery was performed in seven and radioiodine (RAI) in four patients. Duration of treatment needed to achieve remission was longer in prepubertal (4.2 +/- 1.0 yr) than in pubertal patients (3.1 +/- 1.3 yr) (p = 0.02). The rate of remission was not different between prepubertal (25.9%) and pubertal patients (33.3%) (p = 0.59). ATD were associated with low remission rate in pediatric GD and required longer duration of therapy in prepubertal patients. For definitive treatment in older children, RAI could be evaluated as the initial therapy.Publication Clinical and laboratory characteristics of the children with diabetic ketoacidosis(Galenos Yayıncılık, 2008-12-01) Sağlam, Halil; Eren, Erdal; Çakır, Esra Deniz; Yüce, Necla; Yıldız, Nalan; Çakır, Seher; Özgür, Taner; Tarım, Ömer; SAĞLAM, HALİL; EREN, ERDAL; Çakır, Esra Deniz; Yüce, Necla; Yıldız, Nalan; Çakır, Seher; ÖZGÜR, TANER; TARIM, ÖMER FARUK; Tıp Fakültesi; Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı; 0000-0002-6598-8262; 0000-0002-1684-1053; 0000-0003-4664-7435; 0000-0003-0710-5422; C-7392-2019; JPK-3909-2023; GQO-9634-2022; JKN-1212-2023; IPY-4170-2023; EPI-7647-2022; AAG-8381-2021; EBM-1323-2022Aim: Diabetic ketoacidosis (DKA) is a serious condition with the highest rates of morbidity and mortality in children with type 1 diabetes mellitus (T1 DM). Hospitalization due to DKA constitutes about 2 to 8 percent of all-cause admissions. About 25% of children with newly diagnosed T1DM present with DKA. In this study, we aimed to evaluate sociodemographic and clinical characteristics of children admitted with DKA.Materials and Method: Records of 490 children admitted with T1DM between January 2003 and October 2008 were retrospectively reviewed and data on sociodemographic, clinical and laboratory characteristics of 163 children with the diagnosis of DKA was investigated in detail.Results: Of 490 children with T1DM, 163 (33.2%) had the diagnosis of DKA and total number of DKA episodes was 190. The recurrence rate was 14.2% and 85% (6 out of 7) of those with recurrent episodes were girls. The mean age was 11.02 4.57 years and DKA episodes were most frequently seen in 10-15 (39.3) age-group. DKA episodes peaked in the periods of January-February-March and children (i.e, 0-5 age group) (54 5%) The mean duration of recoveiy from acidosis was 14.29+/-12.14 hours the mean blood glucose level at baseline was 473.09 +/- 141,07 mg/dI and the mean initial HbAl c level vvas 12.04+/-2.42%, In this approximately six-year-penod, only one patient was lost and the mortality rate was 0,5% (1 tit of 190 episodes).Conclusion: Increasing the knowledge of primary care physicians who see the patients first on DKA and al3plying the DKA treatment protocol more slowly and cautiously in younger children (0-5 age group) will definitely loldver the morbidity and mortalibt of DKA.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; 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 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; Tıp Fakültesi; Pediatri Ana Bilim 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 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; Sağlık Bilimleri Fakültesi; Hemşirelik Ana Bilim 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 Growth hormone deficiency(Galenos Yayıncılık, 2010-04-01) Tarım, Ömer; Sağlam, Halil; TARIM, ÖMER FARUK; SAĞLAM, HALİL; Tip Fakültesi; Çocuk Sağlığı Hastalıkları Ana Bilim 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.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; Tıp Fakültesi; Çocuk Sağlığı ve Hastalıkları Ana Bilim 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 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; Tıp Fakültesi; Çocuk Sağlığı ve Hastalıkları Ana Bilim 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 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; Tıp Fakültesi; Endokrinoloji Ana Bilim 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.
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