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Aim: The purpose of this study was to examine the effects of antiepileptics on thyroid function tests and to compare these effects among different antiepileptics. Materials and Methods: Two hundred and twenty patients (102 female and 118 male) aged 1-17 years indicated for antiepileptic drug (AED) therapy for epilepsy were enrolled in this study which was performed in a child neurology clinic between January 2014 and January 2018. Those patients using a single AED and with complete seizure control were included. In this study period, according to the local protocol, we measured free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels at the beginning of treatment and at the 12th month of AED therapy. Results: The mean age of the patients was 10.2 +/- 4.4 years. TSH elevation was observed in only eight patients. These eight patients' thyroid autoantibodies were negative and their thyroid ultrasonography were normal. Subclinical hypothyroidism (TSH: 5-10, fT4 normal) was present in three of these eight patients, and they were therefore not started on medication. The other five were started on L-thyroxine. Four of these were using valproic acid and one was using carbamazepine. We found no significant difference between TSH and fT4 levels measured before the start and at the 12th month of drug therapy, nor among the different AEDs used. Conclusion: AEDs have no marked effects on thyroid function, and may therefore be safely used from that perspective. WOS:000718894700005

Background Decreased vitamin D levels lead to an increase in infectious diseases, including urinary tract infections (UTIs). Objective To assess serum vitamin D levels in children with renal parenchymal injury secondary to UTIs. Methods Forty-three upper UTI patients and 24 controls, aged 1–15 years, were included. Vitamin D levels and other laboratory tests were obtained when they first admitted to hospital. 99mTc-labeled dimercaptosuccinic acid (DMSA) scans were performed to evaluate renal parenchymal injury. Results Mean serum 25-hydroxyvitamin D (25(OH)D) was lower in the upper UTI group compared to the control group [18 (SD 9) vs. 23 (SD 10.6) ng/mL, respectively; P=0.045]. The upper UTI group was sub-divided into two groups, those with 22 (51.1%) and without 21 (48.8%) renal parenchymal injury. Mean 25(OH)D was significantly lower in patients with renal parenchymal injury [15.1 (SD 7.1) vs. 21 (SD 9.9) ng/mL, respectively; P=0.03]. The renal parenchymal injury cases were further sub-divided into two groups: 8 patients (36.3%) with acute renal parenchymal injury and 14 (63.6%) with renal scarring (RS), but there was no significant difference in 25(OH)D between these two groups [12.5 (SD 8.9) vs. 16.6 (SD 5.7) ng/mL, respectively; P=0.14). Conclusion Decreased vitamin D is associated with renal parenchymal injury in children with upper UTIs. However, vitamin D is not significantly decreased in renal scarring patients compared to acute renal parenchymal injury patients.

Amaç: ACTH tedavisi alan West sendromlu hastalarımızın ileri dönemdeki nörogelişimsel prognozu ve nöbet prognozunun saptanması ve bunlara katkı sunan faktörlerin belirlenmesidir.Gereç ve Yöntem: Kliniğimizde 3-24.aylarında West sendromu tanısı alarak ACTH tedavisi uygulanan 34 hastanın demografik faktörleri, nöbet şekilleri, öncesindeki nöbet öyküleri, ACTH kullanımı ve yanıt süreleri, etyolojik faktörlerini belirledik. Bunların nörolojik gelişim ve nöbet prognozuna etkisini araştırdık.Bulgular: Hastaların tanı öncesinde nöbeti olmasının ilerideki nöbet prognozu ile ilişkisini anlamlı bulduk. Ayrıca semptomatik etyolojili hastalarda ACTH yanıtını daha geç; nörogelişim ve nöbet prognozunu ise daha kötü saptadık. Tüm hastaların %76’ sında global developmental delay, % 62’sinde antiepileptik ilaclara rağmen devam eden nöbetler belirledik.Sonuç: West sendromunda semptomatik etyolojik faktörler nörogelişimsel süreci ve ileriki dönemdeki nöbet prognozunu olumsuz etkilemektedir., Objective: To determine neurodevelopmental and seizure prognoses in our patients with West syndrome receiving adrenocorticotropic hormone (ACTH) therapy, and to identify the factors affecting these.Materials methods:We determined the demographic factors, previous seizure histories, ACTH use and response times, and etiological factors of 34 patients diagnosed with West syndrome in our clinic at 3-24 months and receiving ACTH therapy. We also investigated their neurological development and its effect on seizure prognosis.Results: We found a significant relationship between patients experiencing seizures before diagnosis and subsequent seizure prognosis. We also found a later response to ACTH and poorer neurodevelopmental and seizure prognoses in patients with symptomatic etiologies. Global developmental delay was determined in 76% of all cases, and seizures persisted despite antiepileptic drugs in 62%.Conclusions: Symptomatic etiological factors in West syndrome adversely affect the neurodevelopmental process and subsequent seizure prognosis.

Aim: Research into the different treatment methods based on the intrauterine lipopolysaccharide (LPS)-induced Periventricular leukomalacia (PVL) model, as one of the main causes of morbidity in preterm infants still continues to be relevant. The present study investigates the effect on PVL of salidroside obtained from Rhodiola Rosea (golden root, orpin rose), which is a plant with known for its medicinal qualities. Method: To develop an induced PVL model, a 500 microgram/kg dose of LPS (Escherichia coli, serotype 055:B5, Sigma) was applied to two pregnant rats intraperitoneally on day 18, day 19 and day 20 of gestation. One of the LP applied rats was given 25 mg/kg Salidroside (250 mg Rhodiola root extract capsules, which include 3 mg Salidroside) by oral gavage (LPS+Salidroside), and a physiological saline solution was given to the control group. After delivery, 10 offspring of the LPS-applied mother, nine offspring of the LPS+Salidrosideapplied mother and seven offspring of the control mother were sacrificed on postnatal Day 7 with ether anesthesia. The caspase enzyme located in apoptosis pathways of 10 percent neutral-buffered formalin fixed brain tissue was stained immunohistochemically, and apoptotic cells were counted. Results: No statistically significant difference was noted between the LPS+Salidroside group and the control group, while a statistically significant difference was noted between the LPS and LPS+Salidroside groups. It was observed that Salidroside reduced LPS induced apoptosis. Conclusion: The intended experimental neuroprotective effect of Salidroside usage was provided through the inhibition of apoptosis in a PVL-damaged brain.

Aim: The effects of gestational exercise on potential pathological conditions is not known yet. Therefore, in the present study, it was aimed to evaluate the effects of forced running exercise on LPS-induced brain damage in pregnant rats. Method: Pregnant females in the experimental group were forced to exercise 30 min daily for five days a week. Lipopolysaccharide (LPS) induced brain injury model was created by administering 500 µg/kg body weight of LPS on gestational days 18 and 19. To evaluate injury histopathologically, brain tissues were fixed at the postnatal day seven through transcardial perfusion (n=4 pups/group). When the remaining pups reached 30-day of age, Morris water maze test (MWM) was performed to assess memory and learning, open filed (OP) and elevated plus maze (EPM) for testing anxiety, and Porsolt test (PT) for evaluating depression. The groups were defined as brain injury group (BI, n=13) and exercise+brain injury group (E+BI, n=7). Results: The results obtained from MWM test indicated that animals found the platform in a shorter duration and distance at the day five compared to the day three. However, there was no significant difference between the groups. No significant difference was found in OP test regarding the distance traveled, time spent at the margins, movement at the center and the time spent as immobile. However, in the EPM test, the offspring at the BI group displayed higher mobility and increased number of entry to the open arms compared to the E+BI groups (p=0.01). There was no significant difference regarding mobility duration and total distance traveled in the PT test. Conclusion: In the present study, we tested the impact of gestational exercise using the brain injury model. The results of the EPM test suggests that the gestational exercise can suppress the stress factors in the pregnant females with brain injury leading to the prevention of hyperactivity-induced negative learning behavior.

HizliS, Ozdemir O, Abaci A, Razi CH and Kabakus N. Relation of subepicardial adipose tissue thickness and clinical and metabolic parameters in obese prepubertal children. Background: The measurement of subepicardial adipose tissue thickness (SATT) has been found to be related to insulin resistance (IR) in adults. Until now, the association between SATT and IR has not been evaluated in obese prepubertal children. We aimed to determine the relation of SATT with clinical anthropometric and metabolic parameters and to provide cutoff value of SATT associated with IR in obese prepubertal children. Methods: Fifty-two obese (mean age: 9.5 ± 1.6 years, 29 female) and 31 lean prepubertal age- and gender-matched subjects (mean age: 9.2 ± 1.4 years, 12 female) were evaluated by echocardiography. SATT was measured by transthoracic echocardiography. Results: SATT (6.54 ± 1.38 mm) and homeostatic model assessment-insulin resistance (HOMA-IR) (3.2 ± 2) values of obese prepubertal subjects were significantly higher than those of the lean subjects (3.72 ± 0.57 mm and 1.6 ± 1) in the control group (both p < 0.001). Bivariate correlation analysis showed significant correlation between SATT, age, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), mid-arm circumference (MAC), triceps skin fold (TSF) thickness, insulin, and HOMA-IR (r = 0.547, r = 0.524, r = 0.543, r = 0.431, r = 0.289, r = 0.402, r = 0.400, r = 0.328, r = 0.289, p < 0.05, respectively). As an optimal cutoff point, an SATT of 4.33 mm determined IR with 93.3% sensitivity and 51% specificity. Conclusions: Our study on obese prepubertal children showed that SATT was significantly correlated with age, BMI, WC, HC, MAC, TSF, insulin, and HOMA-IR.

WOS: 000081093000004, PubMed: 10726002, To evaluate platelet function in iron deficiency anemia, using impedance (in whole blood) and optic tin platelet-rich plasma methods, platelet aggregation analyses were performed in 42 children with iron deficiency anemia at the time of diagnosis and after iron therapy. Collagen-induced platelet aggregation was decreased in patients before therapy compared to after therapy and control levels as indicated by the two methods while adenosine diphosphate (ADP)-induced platelet aggregation was decreased only by the whole blood method. Platelet aggregation with epinephrine, performed only by the optic method, was not altered in patients with iron deficiency anemia. Platelet counts were found to be increased in patients with iron deficiency anemia, and decreased with therapy. These results indicate that some platelet functions are decreased in patients with iron deficiency anemia. These decreased functions may be compensated by increased platelet numbers.