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Background/aim: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder in children. Determination of risk factors for the development of OSA is essential for early diagnosis and treatment of the disease and decreases the risk of negative consequences. This study aimed to investigate the predictive values of Mallampati score, tonsillar size, and BMI z-score in the presence and severity of OSA in children. Materials and methods: This prospective cross-sectional study included 114 children with OSA symptoms. All children were assessed by BMI z-score, Mallampati score, and tonsillar size and underwent overnight polysomnography. They were consecutively selected and assigned to 4 groups as follows: Group 1 included normal-weight with a low Mallampati score; Group 2 involved normal-weight with a high Mallampati score; Group 3 included obese with a low Mallampati score; and Group 4 involved obese with a high Mallampati score. Results: Of the 114 included children, 58 were female and 56 were male, with a mean age of 13.1 ± 2.9 years. OSA frequency and apnea-hypopnea index were significantly higher in group 4 compared with other groups (p = 0.003 and p < 0.0001, respectively), whereas average and minimum spO2 were significantly lower (for both, p = 0.001). Mallampati score and BMI z-score were found to be significant for predicting OSA (odds ratio = 4.147, 95% CI: 1.440-11.944; p = 0.008 and odds ratio = 1.760, 95% CI: 1.039-2.980; p = 0.035, respectively). Among OSA patients, the Mallampati score, tonsillar size, and BMI z-score were found to be significant for predicting OSA severity (odds ratio = 4.520, 95% CI: 1.332-15.335, p = 0.015, odds ratio = 9.177, 95% CI: 2.513-33.514, p = 0.001, and odds ratio = 2.820, 95% CI: 1.444-5.508; p = 0.002, respectively). Conclusion: The coexistence of the Mallampati score and BMI z-score significantly increases the presence of OSA in children. Mallampati score, tonsillar size, and BMI z-score are promising parameters for predicting OSA severity. [ABSTRACT FROM AUTHOR]

Objective: The frequency of using the internet and social media increases in childhood, which leads to a decrease in physical activity. We aimed to investigate the effects of such technological applications on the internet and food addiction in obese and nonobese children. Materials and Methods: A total of 180 obese and 180 nonobese children were included in this study. Turkish version of the Parent-Child Internet Addiction Scale and Dimensional Yale Food Addiction Scale Version 2.0 for Children were applied. Results: The frequency of internet addiction in the sample was 1.7%. The mean internet addiction scores of males were found to be significantly higher than females (34.9 ± 20.6, 26 ± 17.2; P < .001). Children, who used the internet for information and homework had significantly lower internet addiction scores and food addiction scores, respectively (P = .002, P = .009). Watching movies, TV series, or sports events (P < .001, P = .009); following food recipes, campaigns, or advertisements (P = .04, P < .001); and eating snacks in front of the screen (P < .001, P < .001) were found to cause higher internet addiction scores and food addiction scores. It was observed that body mass index showed a positive and significant correlation with internet addiction scores and food addiction scores. Conclusions: Internet addiction and social media applications were found to be significantly related. Considering the relationship between body mass index and addiction, the effect of internet usage style and internet addiction and food addiction on obesity is striking. [ABSTRACT FROM AUTHOR]

Objective: Some factors (age, weight, height, body mass index, body surface area, puberty stage, and iodine nutrition status) may affect thyroid volume (TV). We aimed to investigate the differences between chronological age and height age in interpreting goiter. Materials and Methods: The thyroid ultrasonography records of 420 children aged 1--18 years were evaluated. We searched the difference between the interpretations of goiter by recalculating the TV standard deviation score (SDS) in terms of both chronological ages and corrected for height age. We also evaluated those with negative thyroid autoantibodies and normal thyroid hormone levels by subgroup analysis. The evaluation of TV according to chronological age and height age and the change of goiter interpretation were compared with the McNemar test. Results: A total of 180 children who had euthyroid and negative thyroid autoantibodies were analyzed. A weak correlation was detected between TV and age (r=0.29, p<0.001), body weight (r=0.35, p<0.001), height (r=0.32, p<0.001), height age (r=0.32, p<0.001), body weight SDS (r=0.20, p=0.008) and height SDS (r=0.21, p=0.005). When the changes of goiter interpretation were compared, a statistically significant difference was determined in the whole group (p=0.029); however, there was no significant difference in children who were both euthyroid and found to have negative thyroid auto-antibodies (p=0.375). Conclusion: We observed that the interpretation of goiter changed according to chronological age and height age if thyroid hormone level and/or thyroid autoantibody positivity were included. [ABSTRACT FROM AUTHOR]

The aim of this study is to determine the clinical and molecular characteristics enabling differential diagnosis in a group of Turkish children clinically diagnosed with MODY and identify the cut-off value of HbA1c, which can distinguish patients with GCK variants from young-onset type 1 and type 2 diabetes. The study included 49 patients from 48 unrelated families who were admitted between 2018 and 2020 with a clinical diagnosis of MODY. Clinical and laboratory characteristics of the patients at the time of the diagnosis were obtained from hospital records. Variant analysis of ten MODY genes was performed using targeted next-generation sequencing (NGS) panel and the variants were classified according to American Collage of Medical Genetics and Genomics (ACMG) Standards and Guidelines recommendations. A total of 14 (28%) pathogenic/likely pathogenic variants were detected among 49 patients. 11 variants in GCK and 3 variants in HNF1A genes were found. We identified four novel variants in GCK gene. Using ROC analysis, we found that best cut-off value of HbA1c at the time of diagnosis for predicting the subjects with a GCK variant among patients suspected to have MODY was 6.95% (sensitivity 90%, specificity 86%, AUC 0.89 [95% CI: 0.783–1]). Most of the cases without GCK variant (33/38 [86%]) had an HbA1c value above this cutoff value. We found that among participants suspected of having MODY, family history, HbA1c at the time of diagnosis, and not using insulin therapy were the most differentiating variables of patients with GCK variants. Family history, HbA1c at the time of diagnosis, and not receiving insulin therapy were found to be the most distinguishing variables of patients with GCK variants among subjects suspected to have MODY. [ABSTRACT FROM AUTHOR]

Objective: C1q/tumor necrosis factor-related proteins (CTRPs) are recently described members of the adipokine family. CTRP-13, a new member of this family, has been shown to increase insulin sensitivity and had an anorexigenic effect on food intake in experimental studies. The aim was to investigate serum CTRP-13 levels in children with obesity, and its relationship with other adipokines, metabolic parameters, or binge eating disorder (BED). Methods: A cross-sectional study was conducted with 105 pubertal children attending a single center. Clinical (metabolic syndrome, BED) and biochemical (glucose, insulin, lipids, leptin, adiponectin, CTRP-13 levels) parameters were assessed. Results: Sixty children with obesity [24 males (40%); median age 14.7 (13.0-16.4) years] and 45 healthy controls [15 males (33.3%); median age 15.2 (14.1-16.5) years] were included. Serum adiponectin and CTRP-13 levels were significantly lower in children with obesity than controls (7.1 vs 20.1 µg/mL, p<0.001; 64.7 vs 103.8 ng/mL, p<0.001, respectively). CTRP-13 levels correlated negatively with body mass index (Spearman rho=-0.230, p=0.018) and positively with high-density lipoprotein-cholesterol levels (Spearman rho=0.218, p=0.026). There was no significant difference in serum CTRP-13 concentrations in terms of the presence of metabolic syndrome or BED. Conclusion: Childhood obesity seems to be causing dysregulation in adipokine production and function, including the down-regulation of CTRP-13. The positive correlation between CTRP-13 and HDL-C levels suggested a possible effect of this adipokine on lipid metabolism. Thus CTRP-13 may be a novel biomarker for dyslipidemia in childhood obesity. [ABSTRACT FROM AUTHOR]

Cases with adrenal insufficiency may either present with adrenal crisis, which is characterized by life-threatening shock, or nonspecific symptoms. It is vital to diagnose and treat patients before adrenal crisis, which is associated with high mortality and morbidity. In this report, a 16-year-old girl who was diagnosed Addison's disease following weight loss, fatigue, and skin darkening while being followed-up due to Hashimoto's thyroiditis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Current Pediatrics / Guncel Pediatri is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The use of alendronate, one of the bisphosphonates that can be used orally in the treatment of osteoporosis, has become widespread in recent years. In this study, we aimed to compare the efficacy of these two different treatment regimens such as weekly and daily oral alendronate in patients with secondary osteoporosis. Method: Twenty-eight children and adolescent who were treated with oral daily or weekly alendronate with the diagnosis of secondary osteoporosis were included in this study. Clinical and laboratory features, bone mineral density (BMD) measurements of cases were retrieved from file records. Results: This study included 28 children who were diagnosed with secondary osteoporosis due to various chronic diseases and who received weekly (n=15) or daily (n=13) alendronate. BMD z-score increased from -3.41±0.50 to -0.50±0.67 in the group receiving daily treatment (p<0.001) and from -3.03±0.86 to -0.22±0.62 in the group receiving weekly treatment (p<0.001). In both groups, the increase in BMD z-score and the percentage increase in density in g/cm2 were similar (p=0.490 and p=0.271). Conclusion: This study demonstrated that both weekly and daily single dose of oral alendronate treatment provide similar and significant improvement in BMD. Daily or weekly alendronate treatment regimens can be used effectively and reliably in the treatment of secondary osteoporosis. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the demographical, clinical and laboratory features of patients with type 1 diabetes mellitus aged 0.5-18 years. Material and Methods: This study included 282 pediatric cases (133 females, 149 males) diagnosed with type 1 diabetes mellitus between January 1999 and June 2014. Patients were divided into three groups according to age at onset (0.5 to 5.99 years, 6.0 to 10.99 years, 11.0 to 18.0 years) and date of onset (January 1999-December 2003, January 2004-December 2008, and January 2009-June 2014). Date and age of diagnosis, seasons of diagnosis, gender, symptoms at admission, and laboratory findings were analyzed and compared in these groups. Results: A total of 282 children diagnosed with type 1 diabetes mellitus (mean age 8.5±4.0 years), 133 (47.2%) female (mean age 7.8±3.7 years) and 149 (52.8%) male (mean age 9.0±4.2 years) were included in the study. The most frequent symptoms were polyuria, polydipsia, and weight loss, respectively. The frequency of diabetic ketoacidosis at onset was 43.3%. The patients were diagnosed most frequently (64.2%) in the autumn and winter. The peak age range at onset was 4-6 years (18.1%) and 8-10 years (17.0%). Conclusion: This study, in line with the literature, suggests that the incidence of type 1 diabetes has increased and the age of diagnosis at onset has decreased over the years in our country. These results were found in line with other studies carried out in our country as well although reflecting regional characteristics. [ABSTRACT FROM AUTHOR]

Background/aim: Galanin is a neuropeptide that is shown to be involved in the regulation of food intake and glucose homeostasis. The objective of this study was to evaluate the relation of serum galanin levels with anthropometric and metabolic parameters in obese and healthy children. Material and methods: The cross-sectional study consisted of 38 obese children (mean age: 11.9 ± 3.0 years) and 30 healthy children (mean age: 11.4 ± 2.0 years). Clinical and biochemical parameters [glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR), lipids, galanin, and leptin levels] were assessed. Results: Serum galanin and leptin levels were significantly higher in obese children. In obese children, galanin levels were positively correlated with fasting glucose (r = 0.398, p = 0.013), insulin (r = 0.383, p = 0.018), HOMA-IR (r = 0.375, p = 0.020), and triglycerides (r = 0.391, p=0.015). Multivariate backward regression analysis revealed that galanin levels were significantly associated with fasting glucose, insulin, HOMA-IR, and triglyceride, which explained 42.0% of the variance (r2 = 0.483, P < 0.001). Conclusions: Serum galanin levels were significantly higher in obese children than healthy controls and positively correlated with insulin resistance and triglycerides in obese children. This study suggests that galanin is associated with glucose homeostasis and lipid metabolism in childhood obesity [ABSTRACT FROM AUTHOR]

Persistent müllerian duct syndrome (PMDS) is a relatively rare form of a 46,XY disorders of sex development and clinically characterized by undescended testes and the presence of mullerian duct derivatives such as a uterus and fallopian tubes in males with normal external genitalia. The disease is frequently caused either by the genetic defect of the anti-müllerian hormone (AMH) or its receptor AMH receptor type 2 (AMHR2) gene. AMHR2 mutations have been reported in 45% of genetically proven cases with PMDS. The most common referral findings are bilateral cryptorchidism or transverse testicular ectopia. The presence of uterus and tubes is usually detected during surgery for cryptorchidism. Herein we have presented a PMDS patient with previously reported homozygous AMHR2 mutation, in whom müllerian structures (uterus and fallopian tubes) were detected during laparoscopic intervention performed with the indication of bilateral undescended testis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Research is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)