The objective of this study was to determine the impacts of preventable causes of fracture, such as vitamin D deficiency, disturbed calcium homeostasis and obesity on fracture occurrence in minor traumas. In this way, the effects of relevant parameters on fracture may be further elucidated. A prospective case-control study in children aged 2-18 years children with and without fractures was performed. Participants with a pediatric trauma score higher than 10 presenting to minor trauma were included to exclude the significant impact of severe trauma on fracture. The effects of obesity, parameters associated with vitamin D and Ca homeostasis on fracture occurrence were evaluated. Univariate and multivariate analyses were used to test for associations between fracture status and the assessed variables. The relationships between the variables and the odds of fracture occurrence were examined using logistic regression models. The sample consisted of 76 patients and 50 controls. There were no significant differences between the patients and controls in terms of age, sex, trauma type and pubertal period. The patients had a significantly higher mean BMI percentile (61.2 ± 30.7, 36.7 ± 30.7; P < 0.001). Likewise, patients were more likely than controls to have a lower mean 25(OH)D level and mean phosphorus level (respectively, 13.4 ± 7.0, 17.3 ± 7.8; P = 0.004, and 4.6 ± 0.7, 5.1 ± 0.8; P < 0.001). Moreover, fractures were substantially more frequent in children with vitamin D deficiency (<20 ng/ mL, χ 2 : 7.781, df: 1, P = 0.005). In the multivariate logistic model, BMI percentile and vitamin D levels remained significantly associated with increased odds of fracture [1.02 (1.01-1.04), P < 0.001 and 0.93 (0.89-0.98), P = 0.01]. The present study supports an association of high BMI and vitamin D deficiency with an increased odds of fracture occurrence in children. The findings may help physicians to reduce the risk factors of fracture by preventive efforts. Thus, unexpected health costs and morbidity may be minimized.

Background: Many pharmacological agents may lead to kidney damage. Preventing nephrotoxicity reduces the risk of morbidity and mortality, as well as decreasing hospitalization costs. Objectives: In this study, we investigated the comparative nephroprotective effects of silymarin, N-acetylcysteine (NAC), and thymoquinone (TQ) in animal models (rats) in which we induced nephrotoxicity using carbon tetrachloride (CCl4). Methods: This animal experimental study was conducted at the experimental animals center of Yuzuncu Yil University, Turkey, in 2015. Thirty-eight adult male Wistar rats were used in this study. We defined five experimental groups and treated them for four weeks. The first group (n = 8) was given no medicine. The second group (n = 8) was given only CCl4 (1.5 ml/kg, intraperitoneally (IP), in olive oil, twice a week). The third group (n = 6) was given TQ (10 mg/kg, IP, in dimethyl sulfoxide (DMSO), daily) and CCl4 (1.5 mL/kg). The fourth group (n = 8) was given silymarin (100 mg/kg, IP, in DMSO, daily) and CCl4 (1.5 mL/kg), while the fifth group (n = 8) was given NAC (10 mg/kg, IP, daily) and CCl4 (1.5 mL/kg). The kidneys of all the rats in every group were evaluated histologically using light microscopic methods at the end of the fourth week. A grading scheme was used to score the histological alterations related to tubular injury: absent (-), mild (+), moderate (++), severe (+++), and quite severe (++++).

Özet: Fazla kilolu ve obez çocuklarda metabolik sendrom (MS) sıklığının saptanması ve MS bulgularının karşılaştırılması. Çalışmaya Haziran-Aralık 2008 tarihleri arasında İstanbul Okmeydanı Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları polikliniğine başvuran sistemik, endokrin veya nörolojik hastalığı olmayan 102 fazla kilolu ve obez vaka alındı. Vakalar MS klinik bulguları, antropometrik ölçümler ve laboratuvar sonuçları (insülin direnci, kan şekeri, 'high density lipoptorein' (HDL) kolesterol (HDL-C), 'low density lipoprotein' (LDL) kolesterol (LDL-C), 'very low density lipoprotein' VLDL kolesterol (VLDL-C), trigliserit, C-reaktif protein (CRP), aspartat transaminaz (AST), alanin transaminaz (ALT), üre ve kreatinin düzeyleri) açısından araştırıldı, aile öyküleri sorgulandı. MS tanısını koymak için modifiye "National Cholesterol Education Program Adult Treatment Panel III" (NCEP ATP III) kriterleri kullanıldı.Vakaların ortalama yaşı 10.14±2.56 yıl (min:4 maks:15 yıl), %52.9'u (n=54) kız, %47.1'i (n=48) erkek idi. Çalışmaya alınan çocuk ve adolesanların %28.4'ü (n:29) fazla ağırlıklı ve %71.6'sı (n:73) obezdi. Obez ve fazla kilolu hastalarda hastalarda MS sıklığı sırasıyla %50,6 (n:37) ve %37,9 (n=11) idi. MS(+) olan grupta MS(-) olan gruba kıyasla aile öyküsünde MS olması (p=0,021), insülin direnci (p<0,001), açlık kan şekeri yüksekliği (p=0,008), akantozis nigrikans saptanması (p=0,021), hipertansiyon (p=0,001), bel çevresinde artış (p=0,014), CRP yüksekliği (p=0,048), trigliserit yüksekliği (p=0,008), VLDL-C yüksekliği (p=0,002) ve HDL-C düşüklüğü (p=0,047) istatistiksel olarak anlamlıydı. Fazla ağırlıklı hastaların da obez vakalar gibi MS açısından tetkik ve takibi gereklidir. Ülkemizde MS sıklığının tespiti için çok merkezli prospektif çalışmalar gerekmektedir.