Person: TORUN, EMEL
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Publication Open Access Assessment of motor development using the Alberta Infant Motor Scale in full-term infants.(2020-01-01T00:00:00Z) Kepenek-Varol, B; Hoşbay, Z; Varol, S; Torun, EMEL; TORUN, EMELThe Alberta Infant Motor Scale (AIMS) is a well-known, norm-referenced scale that evaluates the gross motor development of children from birth to 18 months. The aim of the study was to compare the Canadian norms with the AIMS scores of a Turkish sample of infants, and to investigate whether the current reference values of the AIMS are representative for Turkish full-term infants. The study was conducted with 411 Turkish infants of both sexes (195 girls and 216 boys), born with gestational age 38 weeks and older, weighing ≥2500 g at birth. Motor performance of all the cases at different ages were assessed with the AIMS which was used by a physiotherapist. The mean AIMS scores of Turkish infants were compared with the norm values of the original AIMS established in a Canadian sample of infants. The results showed no statistically significant differences between the AIMS scores of Turkish and Canadian infants during the first 18 months of life except at 0-<1 and 2-<3 months of age. The AIMS scores were significantly lower in Turkish infants than in Canadian infants at 0-<1 (p=0.025) and 2-<3 (p=0.042) months of age. In conclusion, the AIMS can be used in Turkish children to assess gross motor development, especially after 4 months of age. However, this paper was presented as a preliminary study to compare AIMS results between Turkish and Canadian infants, and further studies are needed to realize the Turkish validation of AIMS.Publication Open Access Evaluation of 563 children with chronic cough accompanied by a new clinical algorithm(2015-10-06) GEDIK, Ahmet Hakan; BAHALI, Kayhan; KUCUKKOC, Mehmet; NURSOY, Mustafa; GOKCE, Selim; Cakir, ERKAN; Ozkaya, EMİN; Uzuner, SELÇUK; Erenberk, UFUK; Torun, EMEL; DEMIR, Aysegul Dogan; AKSOY, Fadlullah; ÇAKIR, ERKAN; TORUN, EMEL; ERENBERK, UFUK; UZUNER, SELÇUK; NURSOY, MUSTAFA ATİLLA; ÖZKAYA, EMİN; AKSOY, FADLULLAHBackground: This study aims to evaluate the children with chronic cough and to analyze their etiological factors according to the age groups. Method: Five hundred sixty-three children with chronic cough were included. The last diagnosis were established and were also emphasized according to the age groups. Results: The mean age was 5.4 ± 3.8 years (2-months–17-years) and 52 % of them were male. The most common final diagnosis from all the participants were: asthma (24.9 %), asthma-like symptoms (19 %), protracted bacterial bronchitis (PBB) (11.9 %), and upper airway cough syndrome (9.1 %). However, psychogenic cough was the second most common diagnosis in the subjects over 6 years of age. Conclusion: Asthma and asthma-like symptoms were the most common diagnosis in children. Different age groups in children may have a different order of frequencies. Psychogenic cough should be thought of in the common causes especially in older children.Publication Open Access The comparition of the efficacy of two different probiotics in rotavirus gastroenteritis in children.(2012-01-01T00:00:00Z) Erdoğan, O; Tanyeri, B; Torun, EMEL; Gönüllü, E; Arslan, H; Oktem, F; TORUN, EMEL; ERENBERK, UFUKThe aim of the study is to compare the clinical effectiveness of the probiotics—Saccharomyces boulardii and Bifidobacterium lactis—in children who had been diagnosed with rotavirus gastroenteritis. Materials and methods. Seventy five patients aged between 5 months–5 years diagnosed as rotavirus gastroenteritis were included in the study. The patients diagnosed as rotavirus gastroenteritis by latex agglutination test in stool were divided into 3 groups of twenty-five patients each: First group was given oral rehydration therapy and rapid refeeding with a normal diet with Saccharomyces boulardii (spp. I-745), second group was given oral rehydration therapy and rapid refeeding with a normal diet with Bifidobacterium lactis (spp. B94, culture number: N◦118529) and third group received only oral rehydration therapy and rapid refeeding with a normal diet. Results. The duration of diarrhea was shorter in the group given oral rehydration therapy and rapid refeeding with a normal diet with Bifidobacterium lactis and Saccharomyces boulardii than the group given only oral rehydration therapy and rapid refeeding with a normal diet. Conclusion. Bifidobacterium lactis has a complemental role in the treatment of rotavirus gatroenteritis and other probiotics may also have a beneficial effect in rotavirus gastroenteritis compared with the therapy included only oral rehydration therapy and rapid refeeding with a normal diet.Publication Open Access Thyroid Hormone Levels in Obese Children and Adolescents with Non-Alcoholic Fatty Liver Disease(2014-01-01) Torun, EMEL; Ozgen, Ilker Tolga; Gokce, Selim; Aydin, SİNEM; Cesur, YAŞAR; TORUN, EMEL; ÖZGEN, İLKER TOLGA; VEHAPOĞLU TÜRKMEN, AYSEL; AYDIN, SİNEM; CESUR, YAŞARObjective: We aimed to determine the association of thyroid functions with the components of metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD) in pediatric obese patients. Methods: The study included 109 obese children (aged 9-15 years) and a control group of 44 healthy age and gender-matched children of normal weight. NAFLD was diagnosed by conventional ultrasound examination. We assessed the anthropometric data and serum biochemical parameters including lipid profile, alanine aminotransferase (ALT), fasting glucose and insulin levels and thyroid stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) levels. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as a measure of IR. Results: The mean age and gender distributions in the groups were similar (p=0.23). The mean body mass index (BMI) z-scores of obese children with grade 2-3 NAFLD were significantly higher than those of the obese children without hepatic steatosis (p<0.001). Mean ALT, triglyceride (TG) and LDL cholesterol increased and HDL-cholesterol significantly decreased as the hepatic steatosis increased (p<0.05). HOMA-IR levels in obese subjects with grade 2-3 NAFLD were significantly higher than those in both obese children without NAFLD and grade 1 NADFL (p=0.05 and 0.001, respectively). In the obese subjects, TSH levels were increased significantly as the degree of steatosis increased (p=0.04) but fT3 and fT4 levels were not different. In correlation analysis, TSH was significantly correlated with ALT, BMI SDS and the degree of steatosis. Conclusions: Obese children demonstrate an increase in TSH levels as the degree of steatosis increased.Publication Open Access Renal tubular function and urinary N-acetyl-beta-d-glucosaminidase and kidney injury molecule-1 levels in asthmatic children(2016-12-01) DEMIR, Aysegul Dogan; GOKNAR, Nilufer; OKTEM, Faruk; Ozkaya, EMİN; Yazici, MEBRURE; Torun, EMEL; Vehapoglu, Aysel; KUCUKKOC, Mehmet; ÖZKAYA, EMİN; YAZICI, MEBRURE; TORUN, EMEL; VEHAPOĞLU TÜRKMEN, AYSELBackground: Asthma is a chronic inflammatory disorder of the airways which results in chronic hypoxia. Chronic hypoxia and inflammation can affect renal tubular function. Objectives: The aim of this study was to investigate renal tubular function and early kidney injury molecules such as urinary N-acetyl-betaglucosaminidase (NAG) and kidney injury molecule-1 (KIM-1) excretion in children with asthma. Methods: Enrolled in the study were 73 children diagnosed with asthma and 65 healthy age- and gender-matched control subjects. Urine pH, sodium, phosphorus, potassium, microalbumin, creatinine, NAG, KIM-1, and serum creatinine, sodium, phosphorus were evaluated. The diagnosis of asthma and classification of mild or moderate were done according to the Global Initiative for Asthma guidelines. Results: Serum sodium, phosphorus, creatinine, and urinary microalbumin were within normal levels in the both groups. Urinary pH, sodium, potassium, phosphorus, microalbumin, and KIM-1 excretions were similar between the control and study groups. Tubular phosphorus reabsorption was within normal limits in two groups. Urine NAG was elevated in the study group (P = 0.001). Urinary KIM-1 and NAG levels were positively correlated (r = 0.837; P = 0.001). When children with mild and moderate asthma were compared, all of the parameters were similar (P >0.05). Conclusions: This study showed that chronic asthma can lead to subtle renal impacts. We suggest that in children with asthma, urinary NAG level is a more valuable parameter to show degree of renal tubular injury than markers such as microalbumin and KIM-1. Chronic hypoxy and inflammation probably contributes to these subclinical renal effects.Publication Open Access Vitamin D Deficiency and Insufficiency in Obese Children and Adolescents and Its Relationship with Insulin Resistance(2013-01-01) Torun, EMEL; GONULLU, Erdem; Ozgen, Ilker Tolga; CINDEMIR, Ergul; OKTEM, Faruk; TORUN, EMEL; ÖZGEN, İLKER TOLGAObjectives. We aimed to determine the relationship between insulin resistance and serum 25-hydroxyvitamin D (25-OHD) levels in obese children and their nonobese peers. Materials and Methods. Included in the study group were 188 obese children (aged 9-15 years), and 68 age- and gender-matched healthy children of normal weight as control group. Anthropomorphic data were collected on patients and fasting serum glucose, insulin, serum lipids, alanine aminotransaminase (ALT) and 25-OHD were measured. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated in both groups. Results. The levels of 25-OHD in the obese group were significantly lower than those of the nonobese (P = 0.002). HOMA-IR, triglycerides, low-density lipoprotein, and ALT levels in the obese group were significantly higher than values of control group (P < 0.001 and P = 0.002, resp.). In the obese group, vitamin D deficiency, insufficiency, and sufficiency (25-OHD < 10 ng/dl, < 20, >10 ng/dl; > 20 ng/dl, resp.) were not correlated with HOMA-IR (r : -0.008, P = 0.935). HOMA-IR was negatively correlated with BMI, BMI SDS, and BMI%, and triglycerides, low-density lipoprotein, and ALT levels (P < 0.001). Conclusion. The insulin resistance of the obese subjects who were vitamin D deficient and insufficient did not statistically differ from those with vitamin D sufficiency. Low 25-hydroxyvitamin D levels were not related with higher insulin resistance in obese children and adolescents. In obese subjects, insulin resistance was affected more from BMI, BMI SDS, and BMI% than from 25-hydroxyvitamin D levels.Publication Open Access A Remarkable Age-Related Increase in SIRT1 Protein Expression against Oxidative Stress in Elderly: SIRT1 Gene Variants and Longevity in Human(2015-03-18) Elibol-Can, BİRSEN; Kilic, Ulkan; Gok, Ozlem; DUNDAR, TOLGA TURAN; DUNDAROZ, Mehmet Rusen; Torun, EMEL; Erenberk, UFUK; Uysal, Omer; ERENBERK, UFUK; TORUN, EMEL; ELİBOL, BİRSEN; UYSAL, ÖMER; DÜNDAR, TOLGA TURANAging is defined as the accumulation of progressive organ dysfunction. Controlling the rate of aging by clarifying the complex pathways has a significant clinical importance. Nowadays, sirtuins have become famous molecules for slowing aging and decreasing age-related disorders. In the present study, we analyzed the SIRT1 gene polymorphisms (rs7895833 A>G, rs7069102 C>G and rs2273773 C>T) and its relation with levels of SIRT1, eNOS, PON-1, cholesterol, TAS, TOS, and OSI to demonstrate the association between genetic variation in SIRT1 and phenotype at different ages in humans. We observed a significant increase in the SIRT1 level in older people and found a significant positive correlation between SIRT1 level and age in the overall studied population. The oldest people carrying AG genotypes for rs7895833 have the highest SIRT1 level suggesting an association between rs7895833 SNP and lifespan longevity. Older people have lower PON-1 levels than those of adults and children which may explain the high levels of SIRT1 protein as a compensatory mechanism for oxidative stress in the elderly. The eNOS protein level was significantly decreased in older people as compared to adults. There was no significant difference in the eNOS level between older people and children. The current study is the first to demonstrate age-related changes in SIRT1 levels in humans and it is important for a much better molecular understanding of the role of the longevity gene SIRT1 and its protein product in aging. It is also the first study presenting the association between SIRT1 expression in older people and rs7895833 in SIRT1 gene.Publication Open Access Oxidative Stress Status in Childhood Obesity: A Potential Risk Predictor(2016-10-13) Kılıç, Elif; Ozer, Omer Faruk; Erek, Aybala Toprak; ERMAN, HAYRİYE; Torun, EMEL; AYHAN, Siddika Kesgin; Caglar, HİFA GÜLRU; Selek, Sahbettin; Kocyigit, ABDÜRRAHİM; ÖZER, ÖMER FARUK; TORUN, EMEL; ÇAĞLAR, HİFA GÜLRU; SELEK, ŞAHABETTİN; KOÇYİĞİT, ABDÜRRAHİMBackground: Childhood obesity characterized by excessive fat in the body is one of the most serious health problems worldwide due to the social, medical, and physiological complications. Obesity and associated diseases are triggering factors for oxidative stress and inflammation. The aim of this study was to explore the possible association between childhood obesity and inflammatory and oxidative status. Material/Methods: Thirty-seven obese children and 37 healthy controls selected from among children admitted to BLIND University Paediatrics Department were included in the study. Anthropometric measurements were performed using standard methods. Glucose, lipid parameters, CRP, insulin, total oxidant status (TOS), total anti-oxidant status (TAS) levels, and total thiol levels (TTL) were measured in serum. HOMA index (HOMA-IR) were calculated. The differences between the groups were evaluated statistically using the Mann-Whitney U test. Results: Body mass index was significantly higher in the obese group (median: 28.31(p<0.001). Glucose metabolism, insulin, and HOMA-IR levels were significantly higher in the obese group (both p<0.001). Total cholesterol, HDL cholesterol, LDL cholesterol, and triglyceride levels were significantly higher in the obese group (p<0.001). TAS (med: 2.5 µmol Trolox eq/L (1.7–3.3)) and TOS (med: 49.1 µmol H2 O2 eq/L (34.5–78.8)) levels and TTL (med: 0.22 mmol/L (0.16–0.26)) were significantly higher in the obese group (p=0.001). CRP levels showed positive correlation with TOS and negative correlation with TTL levels (p=0.005, r=0.473; p=0.01, r=–0.417; respectively). TTL levels exhibited negative correlation with TOS levels (p=0.03, r=–0.347). Conclusions: In conclusion, obese children were exposed to more oxidative burden than children with normal weight. Increased systemic oxidative stress induced by childhood obesity can cause development of obesity-related complications and diseases. Widely focussed studies are required on the use of oxidative parameters as early prognostic parameters in detection of obesity-related complicationsPublication Open Access The Effect of Obesity Degree on Childhood Pulmonary Function Tests(2014-09-01) Torun, EMEL; Cakir, ERKAN; OZGUC, Fatma; Ozgen, Ilker Tolga; TORUN, EMEL; ÇAKIR, ERKAN; ÖZGEN, İLKER TOLGABackground: Childhood obesity has become a global epidemic. It is related to several chronic diseases such as essential hypertension, type 2 diabetes mellitus, and renal disease. The relationship between the degree of obesity and lung functions is well defined in adults, but limited information is available about the childhood period. Aims: This study aims to determine the impact of the degree of obesity on the pulmonary functions of school children and adolescents. Study Design: Cross sectional study. Methods: Included in the study were a total of 170 school children and adolescents (9-17 years old) referred to our paediatric outpatient clinic. Of these subjects, 42 were lean and non-obese (BMI % <85), 30 subjects were overweight (BMI % ˃85, <95), 34 subjects were obese (BMI % ˃95, <97), and 64 subjects were morbidly obese (BMI % ˃97). Anthropometric measurements were taken and spirometry was performed on all subjects. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1 ), forced vital capacity 25-75 (FEV25-75) and peak expiratory flow (PEF) were used to measure the ventilatory functions for all the subjects. Results: The groups showed no significant differences in age or gender. Despite no statistically significant differences in FEV1 , FVC, or FEV1 /FVC, there were significant reductions in PEF (p<0.001) and FEV25-75 (p<0.001) in the overweight, obese and morbidly obese subjects, when compared with those who were non-obese. Conclusion: Overweight, obese and morbidly obese children have no obstructive abnormalities compared with healthy lean subjects.