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Öğe Atopic Features and Inflammatory Markers Across Cassano-Graded Adenoid Hypertrophy(Mdpi, 2026) Kaplan, Fatih; Kurnaz Kaplan, Bilge; Gulyuz, AbdulganiHighlights What are the main findings? center dot In children with adenoid hypertrophy, disease severity was independently associated with eosinophilia rather than with IgE-mediated sensitization. center dot Family history of atopy and elevated total IgE were the strongest factors associated with clinical atopy. What is the implication of the main finding? center dot Inflammatory burden may play a more important role than classical allergic sensitization in determining adenoid hypertrophy severity. center dot Evaluation of eosinophilia may provide additional clinical information in the routine assessment of children with adenoid hypertrophy.Highlights What are the main findings? center dot In children with adenoid hypertrophy, disease severity was independently associated with eosinophilia rather than with IgE-mediated sensitization. center dot Family history of atopy and elevated total IgE were the strongest factors associated with clinical atopy. What is the implication of the main finding? center dot Inflammatory burden may play a more important role than classical allergic sensitization in determining adenoid hypertrophy severity. center dot Evaluation of eosinophilia may provide additional clinical information in the routine assessment of children with adenoid hypertrophy.Highlights What are the main findings? center dot In children with adenoid hypertrophy, disease severity was independently associated with eosinophilia rather than with IgE-mediated sensitization. center dot Family history of atopy and elevated total IgE were the strongest factors associated with clinical atopy. What is the implication of the main finding? center dot Inflammatory burden may play a more important role than classical allergic sensitization in determining adenoid hypertrophy severity. center dot Evaluation of eosinophilia may provide additional clinical information in the routine assessment of children with adenoid hypertrophy.Highlights What are the main findings? center dot In children with adenoid hypertrophy, disease severity was independently associated with eosinophilia rather than with IgE-mediated sensitization. center dot Family history of atopy and elevated total IgE were the strongest factors associated with clinical atopy. What is the implication of the main finding? center dot Inflammatory burden may play a more important role than classical allergic sensitization in determining adenoid hypertrophy severity. center dot Evaluation of eosinophilia may provide additional clinical information in the routine assessment of children with adenoid hypertrophy.Abstract Background: Evidence linking adenoid hypertrophy (AH) and atopy is conflicting. We examined whether Cassano-graded AH severity is more closely associated with inflammatory markers than with IgE-mediated sensitization. Methods: We retrospectively included children aged 3-12 years diagnosed with AH between December 2022 and December 2025. AH was graded according to the Cassano classification and dichotomized as advanced AH (Stage III-IV). Atopic features were evaluated separately as clinical atopy, IgE-mediated sensitization, elevated total IgE, and eosinophilia. Multivariable logistic regression analyses were performed to assess factors associated with clinical atopy, sensitization, and advanced AH. Results: Among 426 children, clinical atopy was present in 28.2%, sensitization in 23.0%, elevated total IgE in 16.4%, and eosinophilia in 27.7%; 39.2% had advanced AH. In multivariable analysis, clinical atopy was independently associated with family history of atopy (aOR 13.9; 95% CI 7.9-24.4), elevated total IgE (aOR 3.86; 95% CI 2.10-7. 08), and passive smoking exposure (aOR 1.73; 95% CI 1.07-2.79). Sensitization was independently associated only with family history of atopy (aOR 4.99; 95% CI 1.99-12.53). Advanced AH was independently associated only with eosinophilia (aOR 2.07; 95% CI 1.30-3.29). Conclusions: AH severity was associated with eosinophilia rather than classical IgE-mediated sensitization. Assessment of eosinophilia may aid routine severity evaluation in children with AH.Öğe Bone age advancement in non-obese children with premature adrenarche: relationship to growth acceleration and predicted adult height outcomes(Walter de Gruyter Gmbh, 2026) Ciftci, Nurdan; Gulyuz, AbdulganiObjectives: Premature adrenarche (PA) is commonly associated with bone age (BA) acceleration, but it is difficult to assess the independent contribution of adrenal androgens to skeletal maturation in studies that include obese children. This study examined BA advancement in non-obese children with PA and evaluated predicted adult height (PAH) estimates in this population. Methods: The medical records of children diagnosed with PA between April 2022 and April 2023 were reviewed retrospectively. Children who were obese, had congenital adrenal hyperplasia, central precocious puberty, genetic or syndromic disorders affecting growth, or were small for their gestational age were excluded. Anthropometric, hormonal, and radiological data were collected. BA was assessed using the Greulich-Pyle standards, and PAH was calculated using the Bayley-Pinneau method. Analyses were designed to evaluate associations rather than causal relationships. Results: Eighty-four non-obese children with PA (85.7 % female; mean age 7.41 +/- 0.67 years) were included. The mean BA-CA difference was 0.59 +/- 0.96 years. Children with a BA-CA difference of >= 1 year had significantly higher height SDS and BA (p<0.001), whereas serum DHEA-S levels did not differ across BA-CA groups. BA-CA was positively associated with height SDS and negatively associated with PAH SDS relative to current height SDS. In multivariable analyses, height SDS showed an independent association with BA advancement, whereas serum DHEA-S did not. Conclusions: In non-obese children with PA, BA advancement appears to be more closely associated with linear growth status than with circulating DHEA-S concentrations within the constraints of this study design. In most patients, predicted adult height remained within the genetic target range; however, approximately 20 % had PAH values below their mid-parental height. Longitudinal studies incorporating final adult height measurements and comprehensive hormonal profiling are required to clarify long-term growth outcomes.Öğe Clinical Implications of Post-Earthquake Environmental Exposures in Children with Allergic Diseases(Mdpi, 2026) Kaplan, Fatih; Kurnaz Kaplan, Bilge; Arikanoglu, Emrullah; Gulyuz, AbdulganiHighlights What are the main findings? Post-earthquake environmental exposures were associated with worsening disease control in children with allergic diseases. Prolonged residence in temporary housing and exposure to demolition-related dust were independently associated with clinical deterioration, particularly among children with asthma. What are the implications of the main findings? Children with chronic allergic diseases should be considered a vulnerable population in post-disaster settings. Dust-control measures, air-quality monitoring, and improved living conditions in temporary housing may help reduce post-disaster worsening of allergic diseases.Highlights What are the main findings? Post-earthquake environmental exposures were associated with worsening disease control in children with allergic diseases. Prolonged residence in temporary housing and exposure to demolition-related dust were independently associated with clinical deterioration, particularly among children with asthma. What are the implications of the main findings? Children with chronic allergic diseases should be considered a vulnerable population in post-disaster settings. Dust-control measures, air-quality monitoring, and improved living conditions in temporary housing may help reduce post-disaster worsening of allergic diseases.Abstract Background/Objectives: Environmental changes following large-scale natural disasters may influence the clinical course of chronic diseases. However, the impact of post-earthquake environmental exposures on pediatric allergic diseases remains insufficiently studied. To evaluate the association between post-earthquake environmental exposures and disease control in children with allergic diseases. Methods: This retrospective longitudinal cohort study included 528 children with previously diagnosed asthma, allergic rhinitis, or atopic dermatitis who were followed in a tertiary pediatric allergy center in Malatya, T & uuml;rkiye. Clinical assessments performed before the 6 February 2023 Kahramanmara & scedil; earthquakes (T0) were compared with follow-up evaluations conducted 6-12 months after the earthquake (T1). Environmental exposures assessed during the post-earthquake period included prolonged residence in temporary housing, demolition-related dust exposure, and elevated ambient particulate matter levels. Clinical deterioration was defined using disease-specific indicators (decline in ACT/cACT score or treatment step escalation for asthma, increase in TNSS for allergic rhinitis, and increase in SCORAD for atopic dermatitis). Multivariable logistic and linear regression models were used to evaluate associations between environmental exposures and clinical outcomes. Results: Clinical deterioration was observed in 219 children (41.5%). Prolonged residence in temporary housing for >= 6 months (aOR 2.1, 95% CI 1.2-3.9, p = 0.01) and exposure to demolition-related dust (aOR 1.9, 95% CI 1.1-3.5, p = 0.02) were independently associated with clinical deterioration. Among children with asthma, both prolonged temporary housing (adjusted beta -1.84, p = 0.002) and demolition-related dust exposure (adjusted beta -1.39, p = 0.018) were associated with worsening asthma control. Conclusions: Post-earthquake environmental exposures, particularly prolonged residence in temporary housing and demolition-related dust exposure, were associated with worsening control of pediatric allergic diseases. These findings highlight the importance of environmental health considerations in disaster response and long-term management of children with chronic allergic conditions.Öğe Is There a Relationship Between Vitamin D Deficiency and Primary Monosymptomatic Enuresis Nocturna?(Mdpi, 2025) Gulyuz, AbdulganiObjective: The aim of this study was to investigate the relationship between primary monosymptomatic enuresis nocturna (PMNE) and vitamin D deficiency in children. Patients and Methods: This retrospective case-control study included 307 PMNE patients aged 5-18 years and 254 age- and sex-matched healthy control subjects. Demographic data and biochemical parameters of the participants were obtained from hospital records. Serum 25(OH)D3 levels were measured using the chemiluminescence immunoassay method. The Mann-Whitney U test, Chi-square test, Pearson correlation and multivariate logistic regression analysis were used for statistical analyses. Results: Serum 25(OH)D3 levels were significantly lower in the PMNE group compared to the control group (p < 0.001). The rate of vitamin D deficiency was higher in the PMNE group. Vitamin D deficiency (OR: 3.164, 95% CI: 1.195-8.378, p = 0.02) and family history of enuresis (OR: 2.790, 95% CI: 1.01-5.8, p = 0.04) were found to be independent associated factors for PMNE. A significant negative correlation was found between serum vitamin D level and weekly bedwetting frequency (r = -0.377, p < 0.001). Conclusions: Serum 25(OH)D3 levels were significantly lower in the PMNE group (p < 0.001, Cohen's d = 0.89). It is recommended that vitamin D levels should be routinely evaluated in children with PMNE and the potential benefits of vitamin D supplementation should be investigated in prospective studies.Öğe Mucous Stools in Infancy as an Early Marker of the Atopic March: A Four-Year Cohort Study of Respiratory Atopy Risk(Mdpi, 2026) Kaplan, Fatih; Gulyuz, AbdulganiBackground: Mucous stools in infancy are commonly attributed to non-IgE-mediated gastrointestinal food allergies and are generally considered transient and benign. However, whether mucous stools may indicate an atopy-prone clinical phenotype and relate to later respiratory atopy remains insufficiently explored. Objective: To evaluate the long-term risk of respiratory atopy (asthma and/or allergic rhinitis) in infants presenting with mucous stools during the first year of life and to identify early clinical predictors of this risk. Methods: This retrospective cohort study included infants who presented with mucous stools within the first 12 months of life and were followed for four years. Baseline demographic, clinical, dietary, and laboratory data were extracted from standardized medical records. Mucus severity was graded using a pragmatic 0-3 clinical mucus score. The primary outcome was physician-diagnosed asthma and/or allergic rhinitis at four years. Multivariable logistic regression was used to identify independent predictors, with model discrimination assessed by the area under the receiver operating characteristic curve (AUC). Results: A total of 142 infants with complete follow-up data were analyzed. At four years, respiratory atopy was observed in 45 infants (31.7%). In multivariable analysis, family history of atopy (adjusted odds ratio [aOR] 2.68, 95% CI 1.20-5.98, p = 0.016) and wheezing at presentation (aOR 3.74, 95% CI 1.56-8.94, p = 0.003) were independent predictors of respiratory atopy. The mucus score was associated with respiratory atopy in univariable analysis but did not remain an independent predictor in multivariable modeling. The model showed good discrimination (AUC = 0.769). Conclusions: In this cohort of infants presenting with mucous stools in the first year of life, respiratory atopy was observed in nearly one-third by age 4. While mucous stool burden was associated with the outcome in univariable analyses, it did not remain an independent predictor after adjustment. Early wheezing and a family history of atopy were the strongest clinical predictors and may help identify infants who warrant closer follow-up. These findings should be interpreted as associative and hypothesis-generating in the absence of a mucous-stool-free comparison group.Öğe Recurrent Nontypeable Pneumococcal Meningitis in a Child With Bilateral Cochlear Implants(Lippincott Williams & Wilkins, 2026) Gulyuz, Abdulgani[Abstract Not Available]Öğe Relationship between serum vitamin B12 levels and primary monosymptomatic nocturnal enuresis: A prospective case-control study(Elsevier Sci Ltd, 2025) Gulyuz, AbdulganiBackground Primary monosymptomatic enuresis nocturna (PMNE) is a multifactorial disorder with possible neurological underpinnings. Micronutrient deficiencies, particularly vitamin B12, may affect urinary control mechanisms. Objective The aim of this study was to investigate the relationship between primary monosymptomatic nocturnal enuresis (PMNE) and serum vitamin B12 levels in children and to evaluate whether vitamin B12 deficiency is a potential risk factor for the development of enuresis. Materials and methods This prospective case-control study included 184 children aged 5-15 years with enuresis and 167 age- and sex-matched healthy controls. Participants' age, gender, family history of enuresis and vitamin B12 levels were recorded. Serum B12 levels were categorized as deficiency (<200 pg/mL), borderline deficiency (200-300 pg/mL) and normal (>300 pg/mL). B12 level categories were compared between groups and associated factors were evaluated using multivariate logistic regression analysis. Results In the enuresis group, the prevalence of B12 deficiency was 12.5 %, borderline deficiency 41.3 % and normal levels 46.2 %. In the control group, these rates were 9.6 %, 29.3 % and 61.1 %, respectively (p < 0.05). In multivariate analysis, B12 deficiency (OR: 2.05; 95 % CI: 1.01-4.08; p = 0.049) and family history of enuresis (OR: 8.62; 95 % CI: 4.61-16.13; p < 0.001) were significantly associated with PMNE. Conclusion The data obtained show that vitamin B12 levels are statistically significantly associated with PMNE. This finding supports the integration of vitamin B12 assessment into clinical decision-making for children with enuresis.Öğe The Diagnostic Efficacy of and Requirement for Postnatal Ultrasonography Screening for Congenital Anomalies of the Kidney and Urinary Tract(Mdpi, 2023) Gulyuz, Abdulgani; Tekin, MehmetBackground: We aimed to investigate the efficacy of postnatal ultrasonography in detecting congenital anomalies of the kidneys and urinary tract in term infants without prenatal history of congenital anomalies of the kidneys and urinary tract. Methods: In this retrospective cohort study, we reviewed the records of term infants between six weeks and three months of age who underwent urinary tract ultrasonography during routine pediatric care. Results: Congenital anomalies of the kidneys and urinary tract were detected on prenatal ultrasonography in 75 of the 2620 patients included in the study. Congenital anomalies of the kidneys and urinary tract were detected via postnatal USG in 46 (1.8%) of 2554 patients without anomalies on prenatal USG screening. The most common anomaly was hydronephrosis (69.6%). Thirty-two cases of hydronephrosis, three cases of renal agenesis, four cases of horseshoe kidney, one case of MCDK, and two cases of duplex systems which were not detected on prenatal USG were detected on postnatal USG. On the other hand, 29 (1.1%) cases with mild or moderate hydronephrosis on prenatal ultrasonography did not have hydronephrosis on postnatal ultrasonography. Conclusions: In our study, approximately one-third of the cases of hydronephrosis, unilateral renal agenesis, duplex systems, horseshoe kidney, and ectopic kidney were not detected in prenatal ultrasonography screening. Therefore, we believe that in addition to prenatal ultrasonography screening, postnatal ultrasonography screening of all children for urinary tract anomalies would be beneficial.
