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İpar N, Boran P, Barış HE, Us MC, Aygün B, Haliloğlu B, Gökçe T, Can E, Eviz E, İnan NG, Mutlu GY, Bereket A, Hatun Ş. Corrigendum to "Associations between sleep characteristics and glycemic variability in youth with type 1 diabetes" [Sleep Med. 109 (2023) 132-142]. Sleep Med 2024; 113:422. [PMID: 37739817 DOI: 10.1016/j.sleep.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Affiliation(s)
- Necla İpar
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, Turkey; Department of Pediatrics, Koç University School of Medicine, Turkey.
| | - Perran Boran
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, Turkey; Department of Pediatrics, Division of Social Pediatrics, Marmara University School of Medicine, Turkey.
| | - Hatice Ezgi Barış
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, Turkey; Department of Pediatrics, Division of Social Pediatrics, Marmara University School of Medicine, Turkey
| | - Mahmut Caner Us
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, Turkey
| | - Burcu Aygün
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, Turkey
| | - Belma Haliloğlu
- Department of Pediatrics, Division of Pediatric Endocrinology, Marmara University School of Medicine, Turkey
| | - Tuğba Gökçe
- Department of Pediatrics, Division of Pediatric Endocrinology, Koç University School of Medicine, Turkey
| | - Ecem Can
- Department of Pediatrics, Division of Pediatric Endocrinology, Koç University School of Medicine, Turkey
| | - Elif Eviz
- Department of Pediatrics, Division of Pediatric Endocrinology, Koç University School of Medicine, Turkey
| | - Neslihan Gökmen İnan
- College of Engineering Department of Computer Engineering, Koç University, Turkey
| | - Gül Yeşiltepe Mutlu
- Department of Pediatrics, Division of Pediatric Endocrinology, Koç University School of Medicine, Turkey
| | - Abdullah Bereket
- Department of Pediatrics, Division of Pediatric Endocrinology, Marmara University School of Medicine, Turkey
| | - Şükrü Hatun
- Department of Pediatrics, Division of Pediatric Endocrinology, Koç University School of Medicine, Turkey
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İpar N, Boran P, Barış HE, Us MC, Aygün B, Haliloğlu B, Gökçe T, Can E, Eviz E, İnan NG, Mutlu GY, Bereket A, Hatun Ş. Associations between sleep characteristics and glycemic variability in youth with type 1 diabetes. Sleep Med 2023; 109:132-142. [PMID: 37437493 DOI: 10.1016/j.sleep.2023.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE This study aimed to determine sleep characteristics and their associations with glycemic variability in youth with type 1 diabetes (T1D). MATERIAL AND METHODS This cross-sectional study conducted at two pediatric diabetes centers in Istanbul, Turkey, included 84 children with T1D (mean age 10.5 years). Sleep characteristics and glycemic variability were determined by actigraphy, DSM-5 Level 2-Sleep Disturbance Scale Short Form and continuous glucose monitoring. Circadian preference was evaluated by the Children's Chronotype Questionnaire. Sleep disturbances were assessed by the. The sleep quality was determined by actigraphy-derived sleep measures. RESULTS Eighty-eight percent of participants had insufficient age-appropriate total sleep time (TST) (<9 h for 6-13-year-olds and <8 h for 14-17-year-olds). Chronotype was classified as intermediate in 50%, evening in 45.2%, and morning in 4.8%. A higher chronotype score indicating a stronger eveningness preference was associated with more time spent in hypoglycemia (β = 0.433, p = 0.002). On nights when participants had lower sleep efficiency and longer sleep onset latency, they had significantly higher overnight glycemic variability (β = -0.343, p = 0.016, β = 0.129, p = 0.017, respectively). Prolonged nocturnal wake duration was significantly associated with more time spent in daytime hypoglycemia (β = 0.037, p = 0.046) and higher overnight glycemic variability (J index, β = 0.300, p = 0.015). The associations between TST and glycemic variability indices were not significant. CONCLUSIONS Sleep quality rather than TST was significantly associated with glycemic variability in children with T1D. Eveningness preference might contribute to an increased risk of hypoglycemia. Addressing sleep patterns and chronotypes can be crucial in management plans for youth with T1D.
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Affiliation(s)
- Necla İpar
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, Istanbul, Turkey; Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey.
| | - Perran Boran
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, Istanbul, Turkey; Department of Pediatrics, Division of Social Pediatrics, Marmara University School of Medicine, Istanbul, Turkey.
| | - Hatice Ezgi Barış
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, Istanbul, Turkey; Department of Pediatrics, Division of Social Pediatrics, Marmara University School of Medicine, Istanbul, Turkey.
| | - Mahmut Caner Us
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, Istanbul, Turkey.
| | - Burcu Aygün
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, Istanbul, Turkey.
| | - Belma Haliloğlu
- Department of Pediatrics, Division of Pediatric Endocrinology, Marmara University School of Medicine, Istanbul, Turkey.
| | - Tuğba Gökçe
- Department of Pediatrics, Division of Pediatric Endocrinology, Koç University School of Medicine, Istanbul, Turkey.
| | - Ecem Can
- Department of Pediatrics, Division of Pediatric Endocrinology, Koç University School of Medicine, Istanbul, Turkey.
| | - Elif Eviz
- Department of Pediatrics, Division of Pediatric Endocrinology, Koç University School of Medicine, Istanbul, Turkey.
| | - Neslihan Gökmen İnan
- College of Engineering, Department of Computer Engineering, Koc University, Istanbul, Turkey.
| | - Gül Yeşiltepe Mutlu
- Department of Pediatrics, Division of Pediatric Endocrinology, Koç University School of Medicine, Istanbul, Turkey.
| | - Abdullah Bereket
- Department of Pediatrics, Division of Pediatric Endocrinology, Marmara University School of Medicine, Istanbul, Turkey.
| | - Şükrü Hatun
- Department of Pediatrics, Division of Pediatric Endocrinology, Koç University School of Medicine, Istanbul, Turkey.
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Altınkılıç EM, Bayrakdar S, Seymen Karabulut G, Haliloğlu B, Attar R. The role of circulating miRNAs in leptin resistance in obese children. J Pediatr Endocrinol Metab 2022; 35:761-766. [PMID: 35452574 DOI: 10.1515/jpem-2022-0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/30/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Leptin resistance is one of the important causes of obesity in children. Besides known causes of leptin resistance like mutations in leptin and leptin receptor genes, overexpression of SOCS3 in arcuate nucleus is a potential cause of leptin resistance. We aimed to determine the effects of circulating miRNAs on leptin resistance in obese children by targeting SOCS3 pathway. METHODS miRNAs potentially targeting SOCS3 were determined by using online target prediction databases. Polymorphisms in miRNA target sequences were determined by using online genome browsers. miRNA expression levels of obese (n=35) and non-obese (n=30) children were determined by qPCR method, genotyping were performed by real-time PCR method and serum leptin, leptin receptor and SOCS3 levels were measured by ELISA method. RESULTS miRNA profiling have shown that serum miR-218-5p levels are significantly (p<0.05) increased in accordance with serum leptin levels in obese children. CONCLUSIONS In this study we used target prediction methods for evaluating potential miRNAs which may involve in development of leptin resistance. We have shown that miR-218-5p might be taking part in leptin resistance in obese children.
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Affiliation(s)
- Emre Murat Altınkılıç
- Department of Molecular Medicine, Health Sciences Institude, Yeditepe University, Istanbul, Turkey
| | - Selami Bayrakdar
- Department of Pediatric Endocrinology, School of Medicine, Yeditepe University, Istanbul, Turkey
| | - Gülcan Seymen Karabulut
- Department of Pediatric Endocrinology, İstanbul Ümraniye Training and Research Hospital University of Health Sciences, İstanbul, Turkey
| | - Belma Haliloğlu
- Department of Pediatric Endocrinology, School of Medicine, Yeditepe University, Istanbul, Turkey
| | - Rukset Attar
- Department of Obstetrics and Gynecology, School of Medicine, Yeditepe University, Istanbul, Turkey
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Demirbilek H, Cayir A, Flanagan SE, Yıldırım R, Kor Y, Gurbuz F, Haliloğlu B, Yıldız M, Baran RT, Akbas ED, Demiral M, Ünal E, Arslan G, Vuralli D, Buyukyilmaz G, Al-Khawaga S, Saeed A, Al Maadheed M, Khalifa A, Onal H, Yuksel B, Ozbek MN, Bereket A, Hattersley AT, Hussain K, De Franco E. Clinical Characteristics and Long-term Follow-up of Patients with Diabetes Due To PTF1A Enhancer Mutations. J Clin Endocrinol Metab 2020; 105:5902291. [PMID: 32893856 PMCID: PMC7526731 DOI: 10.1210/clinem/dgaa613] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 09/02/2020] [Indexed: 12/13/2022]
Abstract
CONTEXT Biallelic mutations in the PTF1A enhancer are the commonest cause of isolated pancreatic agenesis. These patients do not have severe neurological features associated with loss-of-function PTF1A mutations. Their clinical phenotype and disease progression have not been well characterized. OBJECTIVE To evaluate phenotype and genotype characteristics and long-term follow-up of patients with PTF1A enhancer mutations. SETTING Twelve tertiary pediatric endocrine referral centers. PATIENTS Thirty patients with diabetes caused by PTF1A enhancer mutations. Median follow-up duration was 4 years. MAIN OUTCOME MEASURES Presenting and follow-up clinical (birthweight, gestational age, symptoms, auxology) and biochemical (pancreatic endocrine and exocrine functions, liver function, glycated hemoglobin) characteristics, pancreas imaging, and genetic analysis. RESULTS Five different homozygous mutations affecting conserved nucleotides in the PTF1A distal enhancer were identified. The commonest was the Chr10:g.23508437A>G mutation (n = 18). Two patients were homozygous for the novel Chr10:g.23508336A>G mutation. Birthweight was often low (median SDS = -3.4). The majority of patients presented with diabetes soon after birth (median age of diagnosis: 5 days). Only 2/30 presented after 6 months of age. All patients had exocrine pancreatic insufficiency. Five had developmental delay (4 mild) on long-term follow-up. Previously undescribed common features in our cohort were transiently elevated ferritin level (n = 12/12 tested), anemia (19/25), and cholestasis (14/24). Postnatal growth was impaired (median height SDS: -2.35, median BMI SDS: -0.52 SDS) with 20/29 (69%) cases having growth retardation. CONCLUSION We report the largest series of patients with diabetes caused by PTF1A enhancer mutations. Our results expand the disease phenotype, identifying recurrent extrapancreatic features which likely reflect long-term intestinal malabsorption.
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Affiliation(s)
- Huseyin Demirbilek
- Hacettepe University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
- Diyarbakır Children’s Hospital, Clinics of Pediatric Endocrinology, Diyarbakir, Turkey
- Correspondence and Reprint Requests: Huseyin Demirbilek, MD, Hacettepe University Faculty of Medicine, Department of Paediatric Endocrinology, 06130; Ankara, Turkey. E-mail:
| | - Atilla Cayir
- Erzurum Training and Research Hospital, Clinics of Pediatric Endocrinology, Erzurum, Turkey
| | - Sarah E Flanagan
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Ruken Yıldırım
- Diyarbakır Children’s Hospital, Clinics of Pediatric Endocrinology, Diyarbakir, Turkey
| | - Yılmaz Kor
- Adana Training and Research Hospital, Clinics of Pediatric Endocrinology, Adana, Turkey
| | - Fatih Gurbuz
- Cukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Belma Haliloğlu
- Diyarbakır Children’s Hospital, Clinics of Pediatric Endocrinology, Diyarbakir, Turkey
- Yeditepe University School of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey
| | - Melek Yıldız
- Kanuni Sultan Suleyman Training and Research Hospital, Clinics of Pediatric Endocrinology, Istanbul, Turkey
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey
| | - Rıza Taner Baran
- Diyarbakır Children’s Hospital, Clinics of Pediatric Endocrinology, Diyarbakir, Turkey
| | - Emine Demet Akbas
- Adana Training and Research Hospital, Clinics of Pediatric Endocrinology, Adana, Turkey
| | - Meliha Demiral
- Gazi Yasargil Training and Research Hospital, Pediatric Endocrinology, Diyarbakır, Turkey
| | - Edip Ünal
- Gazi Yasargil Training and Research Hospital, Pediatric Endocrinology, Diyarbakır, Turkey
| | - Gulcin Arslan
- University of Health Science, Behcet Uz Training and Research Hospital, Department of Pediatric Endocrinology, Izmir, Turkey
| | - Dogus Vuralli
- Hacettepe University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Gonul Buyukyilmaz
- Ankara City Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Sara Al-Khawaga
- College of Health & Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Amira Saeed
- Department of Pediatrics, Division of Endocrinology, Sidra Medicine, Doha, Qatar
| | - Maryam Al Maadheed
- Department of Pediatrics, Division of Endocrinology, Sidra Medicine, Doha, Qatar
| | - Amel Khalifa
- College of Health & Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Hasan Onal
- Cukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Bilgin Yuksel
- Cukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Mehmet Nuri Ozbek
- Diyarbakır Children’s Hospital, Clinics of Pediatric Endocrinology, Diyarbakir, Turkey
- Gazi Yasargil Training and Research Hospital, Pediatric Endocrinology, Diyarbakır, Turkey
| | - Abdullah Bereket
- Maramara University Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey
| | - Andrew T Hattersley
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Khalid Hussain
- Department of Pediatrics, Division of Endocrinology, Sidra Medicine, Doha, Qatar
| | - Elisa De Franco
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
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Atmış B, Melek E, Haliloğlu B, Karabay Bayazıt A, Anarat A. Aquaporin 2 mutasyonu saptanan konjenital nefrojenik diabetes insipiduslu bir olgu. Cukurova Medical Journal 2018. [DOI: 10.17826/cumj.379198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Haliloğlu B, Tüzün H, Flanagan SE, Çelik M, Kaya A, Ellard S, Özbek MN. Sirolimus-Induced Hepatitis in Two Patients with Hyperinsulinemic Hypoglycemia. J Clin Res Pediatr Endocrinol 2018; 10:279-283. [PMID: 29217498 PMCID: PMC6083472 DOI: 10.4274/jcrpe.5335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Sirolimus has been reported to be effective in the treatment of the diffuse form of congenital hyperinsulinism (CHI), unresponsive to diazoxide and octreotide, without causing severe side effects. Two newborns with CHI due to homozygous ABCC8 gene mutations were started on sirolimus aged 21 and 17 days, due to lack of response to medical treatment. A good response to sirolimus was observed. At follow-up after ten and two months of treatment, liver enzymes were found to be increased [serum sirolimus level 1.4 ng/mL (normal range: 5-15), aspartate aminotransferase (AST): 298U/L, alanine aminotransferase (ALT): 302U/L and serum sirolimus level: 9.9 ng/mL, AST: 261U/L, ALT: 275U/L, respectively]. In Case 1, discontinuation of the drug resulted in normalization of liver enzymes within three days. Two days after normalization, sirolimus was restarted at a lower dose, which resulted in a repeated increase in transferases. In Case 2, a reduction of sirolimus dose caused normalization of liver enzymes within ten days. When the dose was increased, enzymes increased within three days. Sirolimus was discontinued in both cases. The rapid normalization of liver enzyme levels after sirolimus withdrawal or dose reduction; elevation of transaminases after restart or dose increase and rapid normalization after sirolimus withdrawal were findings strongly suggestive of sirolimus-induced hepatitis. To the best of our knowledge, this is the first report of sirolimus-induced hepatitis in CHI. Sirolimus is a promising drug for CHI patients who are unresponsive to medical treatment, but physicians should be vigilant for adverse effects on liver function.
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Affiliation(s)
- Belma Haliloğlu
- Yeditepe University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey,* Address for Correspondence: Yeditepe University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey Phone: +90 505 267 01 97 E-mail:
| | - Heybet Tüzün
- Diyarbakır Child Health Hospital, Clinic of Neonatology, Diyarbakır, Turkey
| | - Sarah E. Flanagan
- University of Exeter Medical School, Institute of Biomedical and Clinical Science, Exeter, United Kingdom
| | - Muhittin Çelik
- Diyarbakır Child Health Hospital, Clinic of Neonatology, Diyarbakır, Turkey
| | - Avni Kaya
- Diyarbakır Child Health Hospital, Clinic of Neonatology, Diyarbakır, Turkey
| | - Sian Ellard
- University of Exeter Medical School, Institute of Biomedical and Clinical Science, Exeter, United Kingdom
| | - Mehmet Nuri Özbek
- University of Health Sciences, Diyarbakır Gazi Yaşargil Training and Research Hospital, Clinic of Pediatric Endocrinology, Diyarbakır, Turkey
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Haliloğlu B, Abalı S, Buğrul F, Çelik E, Baş S, Atay Z, Güran T, Turan S, Bereket A. The Distribution of Different Types of Diabetes in Childhood: A Single Center Experience. J Clin Res Pediatr Endocrinol 2018; 10:125-130. [PMID: 29175806 PMCID: PMC5985381 DOI: 10.4274/jcrpe.5204] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Type 1 diabetes (T1D) is the most common cause of diabetes in childhood but type 2 diabetes (T2D) and maturity onset diabetes of the young (MODY) are emerging as noteworthy causes of diabetes at young ages. The aim is to determine the distribution, trends and clinical features of the different types of diabetes in childhood in one tertiary center. METHODS The records of children and adolescents aged 0-18 years who were diagnosed as “diabetes/persistent hyperglycemia” between January 1999 and December 2016, were reviewed. Clinical and laboratory characteristics of the patients at diagnosis and type of diabetes were recorded. RESULTS The mean ± standard deviation age of 835 patients (48.7% females) at diagnosis was 8.8±4.4 years. Eighty-four percent of the patients were diagnosed as T1D, 5.7% as T2D, 5.3% as clinical MODY and 5% as being cases of other types of diabetes. The frequency of diabetic ketoacidosis (DKA) and severe DKA in T1D were 48.4% and 11.6%, respectively. Fourteen patients (29.2%) with T2D presented with ketosis and two of them (4.2%) had DKA at diagnosis. Antibody positivity was 83.1% in T1D and 14.8% in T2D. A statistically significant increase in the frequency of T2D has clearly been demonstrated in recent years with a frequency of 1.9%, 2.4% and 7.9% in 1999-2004, 2005-2010 and 2011-2016, respectively (p<0.001). In MODY, genetic analysis was performed in 26 (59%) patients and HNF1A and GCK gene mutations were detected in 3 (11.5%) and 14 (53.8%) patients, respectively. CONCLUSION Although the most frequent cause of DM is T1D in childhood, a trend towards increase in the frequency of T2D in recent years is notable in our population.
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Affiliation(s)
- Belma Haliloğlu
- Yeditepe University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey,* Address for Correspondence: Yeditepe University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey Phone: +90 505 267 01 97 E-mail:
| | - Saygın Abalı
- Acibadem University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Fuat Buğrul
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Enes Çelik
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Serpil Baş
- Necip Fazıl City Hospital, Clinic of Pediatric Endocrinology, Kahramanmaraş, Turkey
| | - Zeynep Atay
- Medipol University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Tülay Güran
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Serap Turan
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Abdullah Bereket
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
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Ulu I, Celik A, Haliloğlu B, Ilter E, Midi A. Comparison of the histopathological results of the endometrial thickness detected by transvaginal ultrasound of symptomatic and asymptomatic postmenopausal women. EUR J GYNAECOL ONCOL 2016; 37:474-477. [PMID: 29894069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The purpose of the study was to assess the reliability of transvaginal ultrasound (TVUSG) in endometrial pathologies by comparing the ultrasonographic and histopathologic findings in symptomatic and asymptomatic postmenopausal women. MATERIALS AND METHODS In this retrospective study the data of 129 postmenopausal women that underwent dilatation and curettage was reviewed by dividing them two groups as symptomatic and asymptomatic. Symptomatic group was divided into subgroups according to the value of endometrial thickness obtained by TVUSG. RESULTS Among all subjects the cancer rate was found statistically 3.043 times higher in patients with the endometrial thickness of 15 mm and greater and atrophic endometrium rate was 75% in patients with the endometrial thickness of less than five mm. Endometrial thickness was found significantly higher in cancer patients than the others (p < 0.05). Among the patients with endometrial thickness of 15 mm and greater, the cancer rate was found higher in symptomatic group than in the asymptomatic group. The cancer rate was found statistically higher in patients with bleeding compared to asymptomatic ones with the endometrial thickness between 5-14.99 mm (p < 0.05). Cancer was not detected in any of the symptomatic patients with the endometrial thickness of less than five mm. CONCLUSION Postmenopausal patients with the symptom of bleeding should undergo detailed gynecological and ultrasonographic examination. The authors believe that this study may be a strong support to the success of TVUSG as a screening method in both symptomatic and asymptomatic postmenopausal women. Furthermore if the patient is symptomatic with a thick endometrium, to exclude the malignancy, endometrial biopsy must be performed.
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Abalı S, Turan S, Atay Z, Güran T, Haliloğlu B, Bereket A. Higher insulin detemir doses are required for the similar glycemic control: comparison of insulin detemir and glargine in children with type 1 diabetes mellitus. Pediatr Diabetes 2015; 16:361-6. [PMID: 25039448 DOI: 10.1111/pedi.12167] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/25/2014] [Accepted: 05/21/2014] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE We aimed to compare hemoglobin A1c (HbA1c), total and basal insulin doses, basal insulin injection frequencies, and body mass index (BMI) in children with type 1 diabetes mellitus (T1DM) who are receiving detemir and glargine as basal insulin in a basal-bolus therapy. METHOD This retrospective study included 117 (53 females) children and adolescents with T1DM older than 4 yr of age, minimum diabetes duration of 2 yr, and receiving basal-bolus insulin regimen (at least 4 injections/d, insulin aspart or lispro as bolus insulin). Comparisons were made for those receiving insulin detemir (n = 32) or glargine (n = 85) as the basal insulin. RESULTS Age, pubertal status, BMI standard deviation scores, and diabetes duration were similar in detemir and glargine groups. Glycemic control was similar in both groups (HbA1c levels 8.9 ± 2.1% vs. 8.5 ± 1.7% for detemir and glargine, respectively; p = 0.497). Both mean basal insulin (0.52 vs. 0.41 U/kg/d, p < 0.001) and mean total daily insulin (1.11 vs. 0.93 U/kg/d, p < 0.001) doses were higher in the detemir group. Furthermore, higher ratio of twice-daily basal insulin injection was detected in the detemir group (62.5 vs. 32.9% p = 0.004). Subgroup analysis according to pubertal status, or the number of daily basal injections showed similar results. CONCLUSION Insulin detemir provides similar glycemic control with glargine, but, approximately 27% higher mean basal and 19% higher mean total insulin doses with two-fold more twice-daily basal insulin injection requirement.
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Affiliation(s)
- Saygın Abalı
- Department of Paediatric Endocrinology and Diabetes, Marmara University, School of Medicine, Istanbul, Turkey
| | - Serap Turan
- Department of Paediatric Endocrinology and Diabetes, Marmara University, School of Medicine, Istanbul, Turkey
| | - Zeynep Atay
- Department of Paediatric Endocrinology and Diabetes, Marmara University, School of Medicine, Istanbul, Turkey
| | - Tülay Güran
- Department of Paediatric Endocrinology and Diabetes, Marmara University, School of Medicine, Istanbul, Turkey
| | - Belma Haliloğlu
- Department of Paediatric Endocrinology and Diabetes, Marmara University, School of Medicine, Istanbul, Turkey
| | - Abdullah Bereket
- Department of Paediatric Endocrinology and Diabetes, Marmara University, School of Medicine, Istanbul, Turkey
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