The relationship between osteocalcin levels and sexual stages of puberty in male children.

Osteocalcin is a specific and reliable marker which increases with rapid bone turnover and gives data about bone metabolism. The pubertal growth spurt is also known as a good example of rapid bone turnover. The aim of this study was to determine whether osteocalcin is a useful marker for the pubertal growth spurt period. In this study, osteocalcin levels in male adolescents were examined in relation to their sexual maturation stage and age. The osteocalcin levels and alkaline phosphatase levels were compared during the pubertal growth spurt. Serum osteocalcin and alkaline phosphatase levels were evaluated in 100 eligible healthy male children and adolescents (aged 10 to 17 years). Five groups (n: 20 each) of children and adolescents were formed according to their sexual maturation stages. Finally, the subjects were divided into three main groups in relation to the pubertal growth spurt and sexual maturation stages. Data were evaluated and compared among these three groups: First group = Stage 1 (prepuberty) + Stage 2 (early puberty) consisted of 40 (20 + 20) children and adolescents. Their mean osteocalcin value was 17.2 +/- 6.3 ng/ml and alkaline phosphatase 573.8 +/- 143.9 IU/L. Second group: Stage 3 + Stage 4 consisted of 40 (20 + 20) children and adolescents. These groups were known as the pubertal growth spurt groups. Their mean osteocalcin value was 29.4 +/- 10.6 ng/ml and alkaline phosphatase 728.4 +/- 233.9 IU/L. Third group: In this group, there were 20 children and adolescents who reached Stage 5 of sexual maturation and whose pubertal growth spurt was slowing. Their mean osteocalcin value was 15.3 +/- 5.8 ng/ml and alkaline phosphatase 435.8 +/- 184.8 IU/L. During the pubertal growth spurt, there is a relationship between bone remodelling and increasing osteocalcin and alkaline phosphatase levels. When sexual maturation reaches Stage 4 at 14 years old, osteocalcin and alkaline phosphatase levels make a peak, associated with the rapid growth in height. As sexual maturation reaches Stage 5, osteocalcin and alkaline phosphatase levels gradually decrease with growth maturation and their levels decline to the level of adults at the completion of this period. Our study showed that osteocalcin and alkaline phosphatase levels can be used as markers for evaluation of the growth spurt period.

The impact of the sexual maturation stage on body mass index in adolescent girls.

Body mass index (BMI) is used in the clinical assessment of adiposity in children and adolescents. Population-based, race-specific and age-specific curves of BMI for children and adolescents exist, but there are noknown sexual maturation-based BMI curves. The aim of this study was to investigate the effects of pubertal development (assessed according to the Tanner breast stage) on BMI in adolescent girls in a cross-sectional study. The study group comprised 167 healthy girls, between the ages of nine and 16 years, attending school near a hospital in Gerede, Bolu. A significant positive correlation was found between the Tanner stage of breast development and BMI (r = 0.79, p < 0.001). Age also had a significant influence on BMI (r = 0.69, p < 0.001). After controlling the effects of age, BMI was highly correlated with weight (r = 0.82, p < 0.001) and the Tanner breast stage (r = 0.49, p < 0.001), but not with height. The correlation between BMI and the sexual stage was also found to increase with increasing age. But when breast development was taken as a control parameter, BMI was not statistically associated with age or height. As a result, there was a significant variation in BMI with the Tanner breast stage in addition to the well known change with increasing age in adolescent girls. Developmental differences occurring in the same age may require that BMI be evaluated only within the same sexual stages in adolescence. This study indicates that the curves of BMI need to take into account the sexual maturation stage of adolescents.

Height and weight measurements of male Turkish adolescents according to biological maturation.

Eight hundred and seventy-nine Turkish male adolescents aged between 11 and 19 years were investigated with respect to their physical development. Bone ages were considered as well as chronological ages in determining biacromial (BAC), biiliac lengths (BIC) and chest circumference (CC). Different bone and chronological ages were obtained at the same chronological age (CA) and bone age (BA) columns. The importance of bone ages in evaluating an adolescent's physical development was shown to be as important as the chronological ages. In this study, the mean BAC, BIC and CC values between the same CA but different BA groups showed statistically significant differences (P < 0.001). When the measurements of two consecutive age groups who had the same CA and BA and who were found to be statistically significant (P < 0.05) were compared, the maximum increments in BAC and BIC values which were between 13 and 14 years of age (2 and 1.4 cm, respectively) were similar to the maximum increment in height and weight of Turkish male adolescents found between 13 and 14 years of BA. The maximum increment in CC values which were between 14 and 15 years and 15 and 16 years (4.1 cm each) was 1 year after the maximum increment in height and weight for BA of Turkish male adolescents (13-14 years) and was similar to maximum weight increment for CA which was between 15 and 16 years.

Biacromical and biiliac length and chest circumference measurements of male Turkish adolescents according to biological maturation.

Adolescence is a period which is characterized by rapid physical growth and development of secondary sex characteristics. Male adolescence begins at 11-12 years of age and lasts approximately 5 years. During this interval, there is a growth spurt period which is observed any time between 11 and 16 years of age, lasting 2-3 years. Some authors claim that a male may have nearly 20-25% of his adult height and 50% of his adult weight during adolescence. When evaluating the maturational aspects of adolescence, it is essential to consider bone age (BA) as well as chronological age (CA). Bone age is the mean CA at which the skeletal maturation is normally attained. It is influenced by genetic, endocrinological and nutritional factors. An adolescent may not demonstrate the expected maturational steps if his BA is retarded. This report examines the relationship between CA, biological maturation and some anthropometrical measurements.

Lipids and lipoproteins in the sexual maturation stages of male adolescents.

The study population consisted of 144 healthy, non-obese male adolescents, aged between 11-18 years, who were in different stages of sexual maturation as described by Tanner. The fasting plasma cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (C-HDL), low density lipoprotein cholesterol (C-LDL), and very low density lipoprotein cholesterol (C-VLDL) levels were calculated for each subject. There were significant differences observed in the following: mean TC levels between G1 and G2; mean C-HDL levels between G2 and G3 and between G3 and G4; mean TG levels between G1 and G2 and between G2 and G3; mean C-LDL levels between G1 and G2, and mean C-VLDL levels between G1 and G2 and between G2 and G3. There were no significant differences for lipids and lipoproteins between the prepubertal (G1) and postpubertal (G5) stages. It is generally believed that testosterone may play a role in mediating lipid and lipoprotein levels in the pubertal phase, but, since we found no significant differences in the levels of lipids and lipoproteins between G1 and G5, and also because these levels fluctuated from G1 to G5, it strongly suggests that the effect of testosterone on lipids and lipoproteins is dependent on other factors such as hormones, dietary habits, age, race, etc.

[Acute maxillary sinusitis treated with cefaclor]. / Akut maksiller sinüzit tedavisinde cefaclor.

26 girls (54.2%) and 22 boys (45.8%) total 48 patients with clinically and radiologically proven acute maxillary sinusitis have been treated with cefaclor. The dosage of the drug was 40 mg/kg/daily and the duration of the therapy was 10 days. Total cure have been achieved in 37 patients (77.1%) and no side effects of the drug has been detected.

Sotos syndrome presenting with epilepsy.

A fourteen and a half year-old boy of tall stature presenting with epilepsy was diagnosed as having Sotos syndrome (cerebral gigantism) at the Hacettepe University Children's Hospital. Since EEG abnormalities are known manifestations in this syndrome, a case presenting with epilepsy is very rare. We believe that a presumed cerebral defect could create convulsions and would thus be the cause of cerebral gigantism whose etiology is still unclear. Thus patients with this syndrome should be followed up for the risk of epilepsy.

Nipple development in female puberty.

Nipple diameters of 230 girls aged between 11-17 were calculated with the aim of finding measurable criteria for breast development during female puberty. There was a significant increment in nipple diameters in each breast and pubic hair stage with respect to the previous stages. The maximum increment was found to be from B 1 to B 2 (2.44 mm), and from PH 1 to PH 2 (2.69 mm). With respect to menstrual status, the greatest growth in nipple diameter occurred from the premenstrual period (M(-)) to one year postmenarche (M +1) (2.35 mm). These results are compared with other studies in the literature, and it was concluded that increments in nipple size in each pubertal stage is related to the hormonal status as well as to race, nutrition and genetics. More longitudinal and cross-sectional data are needed in order to find a measurable criteria for the Tanner breast stages.

The incidence of pubertal gynecomastia in boys living in the Ankara region.

The incidence of pubertal gynecomastia was determined in 646 Turkish boys in Ankara. A marked increase in the incidence was observed at Pubertal Stage 4 (60.2%) and age 14 years (61.1%). The incidence of gynecomastia during puberty at various pubertal stages and ages was 34.6%. Although the incidence of unilateral gynecomastia was 19.6%; there was no difference between right or left involvement.

[Childhood and adolescent acute maxillary sinusitis]. / Cocukluk çagi ve adölesansda akut maksiller sinüsit.

In the first part of this study, a correlation between the throat and nasopharyngeal cultures and the etiological agents of sinusitis given in the literature is investigated. No correlation has been found. In the second part, 80 patients is divided randomly into three groups, 23 patients (28.8%) has been given serum physiologic therapy, 34 patients (42.4%) amoxicillin + antihistaminic + nose drops therapy and 23 patients (28.8%) amoxicillin + antihistaminic + nose drops therapy. Statistically significant clavulanate difference has been found in the cure rate between the antibiotic related regimens and serum physiologic therapies (p less than 0.05), but no significance has been found between amoxicillin and amoxicillin clavulanate regimens (p greater than 0.05).

[Acute maxillary sinusitis treated with spiramycin]. / Akut maksiller sinusit tedavisinde spiramisin.

25 girls (54.3%) and 21 boys (45.7%) total 46 patients with clinically and radiologically proven acute maxillary sinusitis have been treated with spiramycin. The dosage of the drug was 50 mg/kg/daily and the duration of the therapy was 10 days. Total cure has been achieved in 34 patients (73.9%) and no side effects of the drug has been detected.

Epidemiological aspects of childhood poisonings in Ankara: a 10-year survey.

In the 10-year period 1975-1984, 1188 children were admitted to the Children's Hospital of Hacettepe University in Ankara with a diagnosis of poisoning. Retrospective analysis of their medical records showed that the incidence of poisoning with medicinal drugs was 64.0%, while pesticides accounted for 17.8% and plants for 6.7% of total cases. The majority (69.9%) of cases were due to accidental poisoning, 70.6% of which occurred in children under 5 years of age; 15.1% of the poisonings were diagnosed as therapeutic mishaps of which 68.3% involved children under 5 years of age. Analgesics (186 cases), barbiturates (176 cases) and tranquilizers (37 cases) were the most common drugs encountered, however, the two drugs most frequently overused were aspirin (146 cases) and Optalidon (175 cases). Overall mortality was 4.9% (58 cases). Fifty per cent of fatalities were due to accidental poisoning while 41.4% (24 cases) were due to therapeutic mishaps. This study is presented as a background to the need for the development of a Poison Information Service for Ankara.

Self poisoning in children: a ten year survey.

All children, 17 years of age or less, admitted to the Children's Hospital of Hacettepe University Medical Center in Ankara during the period of 1975 to 1984 with a diagnosis of poisoning were studied. Of the 1188 cases reviewed, mode of poisoning was deliberate self-poisoning in a total of 152 cases (12.8%). Drugs accounted for 95.4%, insecticides for 3.9% and carbon monoxide for only 0.7% of the overall suicide attempts or gestures. Analgesics and tranquilizers were the most common agents encountered, however the major drug used for self-poisoning was a barbiturate containing analgesic, Optalidon. The incidence of self-poisoning was 79.0% in the age group 13-17 of the overall poison admissions and in all of the age groups self-poisoning showed a significant (p less than 0.001) sex difference with definite prevalence of girls.

[Tuberculous meningitis in childhood]. / Cocukluk çaginda menenjit tüberküloz.

Tuberculous meningitis is a very important disease in childhood with poor prognosis, high mortality and severe complications. Important points of tuberculous meningitis in childhood were discussed retrospectively in the light of the results of 68 patients.