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    Evaluation of epicardial adipose tissue in children with type 1 diabetes
    (Springernature, 2024) Trabzon, Guel; Gungor, Sukru; Gullu, Seyma Demiray; Caliskan, Osman Firat; Gullu, Ufuk Utku
    Introduction Epicardial adipose tissue (EAT), the visceral fat surrounding the heart between the myocardium and visceral pericardium, intersects with Type 1 diabetes (T1D). This review aims to elucidate the intricate association between EAT and childhood T1D.Materials and methods In this retrospective study, two pediatric groups were involved children with type 1 diabetes, and healthy children. Epicardial fat thickness was measured appropriately, and the study documented HbA1c levels and time to diabetes diagnosis for comprehensive analysis.Results Encompassing 51 children with T1D and 69 healthy controls, revealed that children with type 1 diabetes had a mean HbA1c level of 9.4 +/- 0.2, and a mean insulin dose of 0.94 units/kg/day. Epicardial adipose tissue (EAT) values were significantly higher in the Type 1 DM group. It has been shown that epicardial fat thickness may have a specific and sensitive value in type 1 diabetics.Discussion The increased presence of epicardial fat tissue in children with type 1 diabetes is highlighted, prompting the consideration of various mechanisms. However, the complexity of this relationship underscores the need for further studies to provide a more comprehensive understanding of the underlying factors. Ongoing research in this area is crucial for advancing our knowledge and potential therapeutic interventions.Impacts Cardiac complications are one of the most important causes of morbidity and mortality in people with type 1 diabetes. Being able to detect cardiological complications of diabetes at an early stage contributes to morbidity. We found that epicardial fat tissue thickness was thicker in children with type 1 diabetes than in healthy children. Epicardial fat tissue thickness may be associated with poor control in children with type 1 diabetes and maybe a guide in terms of cardiac risks.
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    N95 mask usage in children with type 1 diabetes mellitus: Does it affect clinical outcomes?
    (Elsevier Science Inc, 2025) Trabzon, Gul; Gullu, Seyma Demiray; Gungor, Sukru; Caliskan, Osman Firat; Oguzman, Hamdi; Ozcan, Oguzhan; Gullu, Ufuk Utku
    Background: The global COVID-19 pandemic has necessitated the widespread use of N95 masks, yet their impact on children with chronic conditions like type 1 diabetes (T1DM) remains underexplored. Objective: This study investigates the effects of N95 mask usage on clinical outcomes in children with T1DM. Methods: This study enrolled 34 children aged 10-18 with T1DM. Study participants' systemic symptoms and physiological parameters were assessed before and after wearing N95 masks for one hour. Blood glucose levels and capillary blood gas analyses were performed, and any symptoms reported were documented. Results: Nearly half of the participants (47 %) experienced symptoms such as difficulty breathing (41.2 %), ear pain (26.5 %), and runny nose (20.6 %). Despite these symptoms, no significant changes were observed in laboratory values or vital signs, including blood glucose levels, pH, pCO2, HCO3, base excess, lactate, blood pressure, respiratory rate, pulse rate, and oxygen saturation. Conclusions: The findings suggest that N95 masks may cause discomfort but do not adversely affect physiological parameters in children with T1DM. The study highlights the importance of balancing mask-related discomfort with the protective benefits of mask usage in this population. To confirm these findings, more extensive studies with extended mask use durations are needed. Practice implications: Nurses are crucial in educating children and their families about proper mask usage, addressing potential discomfort, and implementing strategies to improve adherence. These may include ensuring an appropriate mask fit and advising on brief, safe breaks when needed. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
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    Prognostic value of cardiac biomarkers and Phoenix criteria in pediatric sepsis: a retrospective cohort study
    (Bmc, 2025) Ipek, Sevcan; Gullu, Ufuk Utku; Gungor, Sukru; Gullu, Seyma Demiray
    BackgroundThis study investigated the effects of cardiac biomarkers at admission on the prognosis and timing of vasoactive drug administration in children with sepsis according to the 2005 SIRS criteria. Additionally, the Phoenix sepsis criteria have been applied to patients and examined in detail.MethodsThe study was conducted as a single-center retrospective study between March 2019 and 2022. Laboratory parameters and echocardiographic measurements at admission were evaluated. The primary outcomes are mortality and vasoactive drug use. Receiver operating characteristic (ROC) analysis was used to determine the time to initiate vasoactive drugs.ResultsIn this study 162 (45.1% females) children with sepsis were included. The total mortality was 26.4%. Among the 162 patients, 28.6% were not classified as having sepsis according to the Phoenix 4 criteria and 24.2% according to the Phoenix 8 criteria. Among the non-surviving patients, 9.3% were not classified as sepsis according to the Phoenix 4 criteria (p = 0.001) and 7% according to the Phoenix 8 criteria (p = 0.002). ROC analysis revealed that a pro-BNP value of >= 1835 ng/L predicted the initiation of vasoactive therapy with 73.1% sensitivity and 90.9% specificity (p = 0.002).ConclusionsLaboratory parameters such as pro-BNP obtained in the early stages of the disease could serve as good guides for in determining the timing of initiation of vasoactive drug therapy. Furthermore, the fact that children who died did not meet the Phoenix sepsis criteria raises concerns about the ability of these criteria to detect sepsis at an early stage.