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    Communication skills of residents to families with Down syndrome babies
    (Soc Argentina Pediatria, 2016) Dogan, Derya G.; Kutluturk, Yesim; Kivilcim, Meltem; Canaloglu, Sinem K.
    Background. Generally, pediatricians are the first health caregivers to deliver initial diagnosis of Down syndrome (DS) to the families. However, most of the parents are not satisfied with the contents and how they receive information when their child is born with DS. Pediatric residents should target educational interventions to help parents to overcome with these issues and to provide accurate information. The objective is to assess comfort levels and training requirements of pediatric residents to communicate with parents of babies born with Down syndrome. Methods. Diagnostic Situations Inventory (DSI) is a rating scale which included ten questions to assess discomfort level. A survey was sent via mobile, websites and all the social media which were available to all pediatrics residents in the country. Socio-demographic factors including information about training requirement were collected as well. Results. From the 326 participants, total mean discomfort level was 30.22 in DSI out of 50 which was the highest score. Discomfort level was significantly increased in female participants (p=0.033). Being female (p=0.014), having less residency level (p=0.028), examining less number of patients with Down syndrome (p=0.025) and having higher discomfort levels (p=0.001) were found to be related with increased training requirement. From the residents, 84% declared the need for additional training. Conclusions. This study showed that pediatric residents had a high level of discomfort when communicating with parentes of newborn with Down Syndrome. Female residentes had a discomfort level significantly higher than male residentes.
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    The effect of modification of inhaler spacer’s visual user guideline on the correct use of the inhaler spacer
    (2018) Topal, Erdem; Demirtas, Mehmet Semih; Kutluturk, Yesim; Kutluturk, Kazim; Turker, Kenan; Sayan, Yekbun Gamze; Alatas, Cem
    Aim: To determine the effect of modification of visual user guideline of inhaler spacer device on the skill of correct usage. Material and Method: The medical faculty intern students at İnönü University were enrolled in the study. The participants were interviewed face-to-face and requested to fill out questionnaires for modified and non-modified visual user guideline. Result: A total of 172 students were included in the study; 104 (60.5%) of the students were male. The study group included 90 students who were evaluated with the modified visual user guidelines; the other group included 82 students who were evaluated with the non-modified visual user guidelines. 76 (84%) out of 90 participants in the group who was given modified visual user guideline performed the inhaler spacer device technique correctly. In contrast, only 12 (15%) of 82 participants in the group who was given non-modified visual user guideline carried out the inhaler spacer device technique correctly (p=0.001). The most common mistakes made in non-modified visual user guideline group were; taking 5-6 deep and slow breaths; 28 (34.1%), shaking MDI and removing cap; 45 (54.9%), and placing mouthpiece between teeth and lips or placing facemask; 57 (69.5%), respectively. Having compared the both groups for the steps of inhaler spacer device use, the modified visual user guideline group fulfilled all the steps more correctly. Conclusion: The visual user guideline of the inhaler devices in our country are insufficient. We are of the opinion that especially visual improvements on user guideline will increase the correct usage of the device by parents.
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    The relationship between serum FGF-23 concentration and insulin resistance, prediabetes and dyslipidemia in obese children and adolescents
    (Walter De Gruyter Gmbh, 2019) Kutluturk, Yesim; Akinci, Aysehan; Ozerol, Ibrahim Halil; Yologlu, Saim
    Background: Obesity is known to cause metabolic disturbances including insulin resistance, dyslipidemia and alters bone mineralization. The effects of obesity on fibroblast growth factor 23 (FGF-23), which is important in bone mineralization, have not yet been clarified. Our aim was to investigate the association between FGF-23 concentration and obesity-associated dysmetabolism. Methods: Subjects comprised 46 obese children and adolescents. The same number of age-matched, healthy controls were recruited. Markers of bone mineralization and glucose metabolism were measured. Thyroid function and insulin resistance were investigated in both groups. In obese subjects; an oral glucose tolerance test (OGTT) was performed and hemoglobin A(1c) and lipid fractions were measured. Bone mineral density and hepatic steatosis were investigated. Results: Serum FGF-23, alpha-klotho and 1,25(OH)(2)D-3 concentrations were significantly lower while fasting insulin, fasting glucose, C-peptide and alkaline phosphatase (ALP) concentrations and homeostasis model assessment of insulin resistance (HOMA-IR) were significantly higher in the obese group compared to controls. A significant negative correlation was observed between free tri-iodothyronine (fT3) and both FGF-23 and alpha-klotho in the obese group. Significant negative correlation was found between FGF-23 and C-peptide and a positive correlation was found between FGF-23 and high density lipoprotein-cholesterol (HDL-c) in the obese subjects with impaired glucose tolerance (IGT). Significant negative correlations were found between FGF-23 and both fasting insulin levels and C-peptide levels in the obese subjects with hepatic steatosis. Conclusions: In our study, insulin resistance-associated hyperinsulinism and/or lower 1,25(OH)(2)D-3 levels, both present in obese children and adolescents, may lead to decreased serum FGF-23 concentrations in obese subjects.