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    Adherence to Growth Hormone Therapy: Results of a Multicenter Study
    (Amer Assoc Clinical Endocrinologists, 2014) Aydın, Banu Küçükemre; Aycan, Zehra; Sıklar, Zeynep; Berberoğlu, Merih; Öcal, Gönül; Çetinkaya, Semra; Darendeliler, Feyza
    Objective: To evaluate the adherence to growth hormone (GH) therapy and identify the influencing factors and outcomes in children. Methods: A total of 217 GH-naive patients in 6 pediatric endocrinology clinics were enrolled in the study. Structured questionnaires were filled out and patients were evaluated at the initiation and 3rd, 6th, and 12th months of therapy. Patients were categorized into 4 adherence segments based on percentage of doses omitted at each evaluation period, classified as excellent if 0%, good if 5%, fair if 5 to 10%, and poor if > 10%. Results: There was a decrement in adherence to GH therapy during the study period (P = .006). Patients who showed excellent and good adherence to therapy had better growth velocity and growth velocity standard deviation scores (SDSs) (P = .014 and P = .015, respectively). A negative correlation between growth velocity SDS and number of missed injections was also observed (r = -.412; P = .007). A positive correlation between delta insulin-like growth factor-1 (IGF-1) SDS and growth velocity was demonstrated (r = .239; P = .042). IGF-1 levels were significantly higher in patients who showed excellent and good adherence to therapy (P = .01). Adherence was better in boys than in girls (P = .035), but adherence rates were not associated with age, cause of GH treatment, socioeconomic status, person who administered the injections, type of injection device, or GH product. Conclusion: Poor adherence to GH therapy was common in our group of patients and was one of the factors underlying suboptimal growth during therapy. Before considering other problems that can affect growth, clinicians should confirm good adherence to therapy.
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    Öğe
    Hyperthyroidism in early childhood, diagnosis and follow-up: Two case reports
    (2011) Uçkun Kitapçı, Ayşin; Çetinkaya, Semra
    Hyperthyroidism occurring in approximately 1:5000 in childhood is most commonly seen in the 11-15 year age group. It is extremely rare in pre-school ages and Graves' disease is its most common cause. Because hyperthyroidism may seriously affect growth and development in this age group, it is very important to diagnose and start treatment as soon as possible. The clinical studies and data are relatively limited due to the low prevalence of the disease in all over the world as well as in Turkey. Here we report two preschool-age cases with Graves' hyperthyroidism to bring the subject to general pediatricians' attention and discuss the management of those children. Copyright © 2011 by Türkiye Klinikleri.