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Bilginer Y.,Hacettepe University | Topaloglu R.,Hacettepe University | Alikasifoglu A.,Hacettepe University | Kara N.,Ankara Diskapi Childrens Hospital | And 3 more authors.
Clinical Rheumatology

The aim of our study was to evaluate the neuroendocrine system in patients with juvenile idiopathic arthritis (JIA) regarding the activity of disease. Twenty-one JIA patients (mean age±standard deviation 10.5±4.1 years) were included. None of the patients was taking steroids or antitumor necrosis factor-α therapy during this study. Ten healthy volunteers and ten volunteers with upper respiratory tract infection composed the control groups. Furthermore, ten of the 21 JIA patients were also evaluated during the remission period. Erythrocyte sedimentation rate, C-reactive protein, adrenocorticotropic hormone (ACTH), cortisol, prolactin, insulin-like growth factor-1 (IGF-1), insulin-like growth factor-binding protein 3, free T3, free T4, thyroid-stimulating hormone, interleukin-6 (IL-6) levels, and 24-h urinary cortisol were evaluated both during the active period and remission. The median levels of ACTH and cortisol at 08:00 a.m. were significantly lower in patients with active JIA than patients in remission period and the control groups (p<0.05). Furthermore, the median level of urine cortisol in active JIA patients was significantly lower than remission period and control groups (p<0.05). The median level of IGF-1 was significantly lower in active patients than that of remission (p<0.05). The median level of IL-6 in active JIA patients was significantly higher than those in remission and control groups (p<0.05). Our preliminary study suggested that impaired secretion of adenohypophyseal hormones and distorted bilateral interactions between the immune and endocrine systems in JIA. Further studies are needed to clarify the consequences of the impaired hormone secretion in JIA. © 2009 Clinical Rheumatology. Source

Topcu H.O.,Dr Zekai Tahir Burak Womens Health Education And Research Hospital | Topcu S.,Ankara Diskapi Childrens Hospital | Kokanali D.,Dr Zekai Tahir Burak Womens Health Education And Research Hospital | Memur T.,Dr Zekai Tahir Burak Womens Health Education And Research Hospital | Doganay M.,Dr Zekai Tahir Burak Womens Health Education And Research Hospital
Journal of Pediatric and Adolescent Gynecology

Background: Membranous dysmenorrhea is a rare entity. It involves the sloughing of the endometrium in 1 cylindrical or membranous piece, retaining the shape of the uterine cavity. Herein, we report the first case of spontaneous membranous dysmenorrhea in an adolescent girl. Case: A 17-year-old girl was admitted to the emergency clinic with severe painful menstrual bleeding and passage of tissue via the vagina. Bloody endometrial tissue resembling the endometrial cavity expulsed from the vagina was seen on inspection. The pathologic diagnosis of the mass was membranous dysmenorrhea. Summary and Conclusion: To our knowledge, this is the first case of the spontaneous occurrence of membranous dysmenorrhea. The relationship between membranous dysmenorrhea and endogenous or exogenous progesterone should be investigated further. A review of the literature on membranous dysmenorrhea is presented. © 2015 North American Society for Pediatric and Adolescent Gynecology. Source

Subasioglu Uzak A.,Erciyes University | Subasioglu Uzak A.,University of Miami | Cakar N.,Ankara Diskapi Childrens Hospital | Comak E.,Akdeniz University | And 3 more authors.
Renal Failure

Distal renal tubular acidosis (DRTA) is characterized by tubular defects in urinary acidification and hyperchloremic metabolic acidosis, hypokalemia, hypercalciuria, hypocitraturia, nephrocalcinosis and nephrolithiasis. Mutations in ATP6V1B1 cause DRTA associated with sensorineural hearing loss. The objective of this multicenter study is to screen DRTA patients with sensorineural hearing loss for ATP6V1B1 gene mutations and present genotype/phenotype correlation. Clinical data in five unrelated consanguineous families with DRTA and hearing loss were obtained in Turkey. For mutation screening, all coding exons of ATP6V1B1 were PCR-amplified and sequenced from genomic DNA. In our cohort of five families, there were four different homozygous ATP6V1B1 mutations in affected individuals: c.91C>T (p.R31X), c.232G>A (p.G78R), c.497delC (p.T166RfsX9) and c.1155dupC (p.I386HfsX56). Our study shows that rare and family-specific variants in ATP6V1B1 are responsible for DRTA and sensorineural hearing loss syndrome in Turkey. While firm genotype-phenotype correlations are not available, detailed clinical and molecular analyses provide data to be used in genetic counseling. © 2013 Informa Healthcare USA, Inc. Source

Adaletli H.,Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders | Gunes H.,Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders | Tanidir C.,Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders | Mutlu C.,Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders | And 5 more authors.
Anadolu Psikiyatri Dergisi

Objective: Trichotillomania (TTM) is characterized by the repetitive pulling out of one's own hair from the scalp, eyebrows, eyelashes, or other areas of the body and is often associated with other psychiatric disorders. In this study we aimed to investigate the clinical and sociodemographic characteristics and comorbid psychiatric disorders in children with TTM. Methods: Twenty-three children and adolescents (15 females and 8 males, median age: 12, range: 6-18 years), who were followed at our outpatient clinic with the diagnosis of TTM, were included in the study. The Turkish version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children- Present and Lifetime version was used to detect the comorbid psychiatric disorders. Depression and anxiety levels were measured by Childhood Depression Inventory (CDI) and State-Trait Anxiety Inventory for Children, respectively. Results: The most commonly affected areas were; the scalp (n=13). Nine cases have been affected more than two areas. Median duration of the symptoms were 7±20.01 months (range: 7 days-72 months) at admission. 65.2% of the cases reported precipitating stress factors before the beginning of TTM symptoms. Nineteen (82.6%) subjects suffered from at least one psychiatric disorder and 14 (60.8%) from at least two psychiatric disorders. The most common comorbid disorders were anxiety disorders (n=15), disruptive behavioral disorders (n=6), tic disorder (n=3) and enuresis nocturna (n=3). The mean score in the CDI was 13.25±8.45. Mean state and trait anxiety scores were 37.19±8.01 and 37.62±7.61, respectively. There was a significant relationship between the time passed until admis-sion to a psychiatry clinic and having multiple comorbid psychiatric disorders. Conclusion: High rates of comorbid psychiatric disorders were found in children and adolescents with TTM. Delay in psychiatric help-seeking seems to be associated with other psychiatric disorders. Early intervention may decrease comorbid psychiatric disorders, which may affect treatment options and prognosis. © 2016, Cukurova University, Faculty of Medicine. All rights reserved. Source

Acute disseminated encephalomyelitis (ADEM) is a monophasic, immune-mediated demyelinating disease that can arise spontaneously, however it most frequently follows an infectious illness (acute central nervous system infection), or immunization. As there are important variations with regard to treatment and prognosis, it is important to differentiate between ADEM and acute infections of the central nervous system, however it may not be easy in all cases. We report a 9-year-old case of atypical ADEM involving the brainstem following the Herpes Simplex Encephalitis Type 1; who has been initially misdiagnosed, and had high fever till the initiation of corticosteroid treatment. © 2010 by Türkiye Klinikleri. Source

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