Çocukluk çağında obezite hem dünyada hem de ülkemizde giderek daha sık görülmektedir. Bu nedenle obez çocuk ve adolesanların birinci basamak sağlık kurumlarında değerlendirilmesi ve yönetimi önem kazanmaktadır. Bu derlemede çocuk ve adolesan obezitesine yaklaşımda bir birinci basamak merkezinde obez çocuk ve adolesanın değerlendirilmesinde gerekli klinik ortam, obezite yönetiminde gerekli araç ve gereçler, etkinliği kanıtlanmış etkili yöntemler özetlenmektedir.

Giriş ve Amaç Kanser vücudun herhangi bir bölümünde meydana gelebilen, hücrelerin kontrolsüz bir şekilde çoğalması ve yayılmasıyla oluşan bir hastalıktır.

Background: Age-related differences in Multiple Myeloma (MM) are studied in clinical and genomic context, however, transcriptome changes have not yet been determined. The aim of this study is to identify the genes that are expressed differently in young and old patient groups and to examine the relationship of these genes with biological pathways and the drugs that can be used. Methods: The MMRF CoMMpass cohort RNA-Seq data (n=634) was used to analyze differentially expressed genes between young and old patients. GO term and KEGG gene-set enrichment analysis were conducted using R packages. Drug-gene interactions were detected using DGIdb. Results: Globally, 523 genes (366 upregulated, 157 downregulated) were differentially expressed (p < 0.05) in young patients. Totally 220 GO terms, mostly related to immune regulation pathways were enriched. “Cytokine-cytokine receptor interaction” gene-set was enriched in KEGG GSEA. Among the highest expression difference, genes involved in immune regulation (FCGR1A, FCER1G, TLR2), known proto-oncogenic genes (BCL2, FGR) and genes under investigation for association with various cancers (RGL4, MT-RNR1, ETS2, ENPP3, FUT7, NTNG2, PRAM1) were identified. Drugs associated with the pathways affected by these genes were identified. Conclusions: Further investigation of differentially expressed genes in young patients may shed light on new treatment options.

Background/Aim: Multiple studies have investigated the effects of drugs that alter ACE2 expression, such as renin-angiotensin system inhibitors, non-steroidal anti-inflammatory drugs, and thiazolidinediones, on the clinical course of coronavirus disease-2019 (COVID-19). But a consensus has not yet been reached, and it has been stated that they do not have any effect. There are publications in which metformin is associated with low mortality and insulin with high mortality. Data from different parts of the world are important given that the rate of spread of COVID-19 may be related to the expression status of ACE2 or TMPRSS2 receptors or some other unknown genetic factors. This study aims to examine the effects of medications used chronically in the last 6 months before contracting COVID-19 on the clinical course of COVID-19 in a sample of Istanbul, Turkey. Methods: In this retrospective cohort study, which included 525 patients diagnosed with COVID-19 between March and November 2020 from four family health centers in Istanbul, the records of the patients were retrospectively analyzed. In addition to demographic information, all medications chronically used by the patients in the last 6 months before the diagnosis of COVID-19 were noted. The effects of demographic data and medications on the three main endpoints of the study, which were hospitalization, intensive care unit (ICU) admission, and mortality, were analyzed using logistic regression models. Results: Of the 525 COVID-19 patients included in the study, 109 (20.8%) were hospitalized, 18 (3.4%) were treated in ICU, and 11 (2.1%) patients died. Increasing age is associated with hospitalization, ICU admission and mortality. Also, the presence of COVID-19 thoracic computed tomography (CT) findings and polypharmacy was associated with increased hospitalization. Living alone and the presence of COVID-19 thoracic CT findings was associated with increased ICU admission. When adjusted for age and comorbidity, logistic regression models revealed that medications for diabetes mellitus (DM) increased the probability of hospitalization (OR: 3.9, 95% CI 1.2-13.0), and calcium channel blockers (CCBs) increased the probability of ICU admission (OR: 15.8, 95% CI 2.1–120.2) and mortality (OR: 295.1, 95% CI 4.6–18946.6). Conclusion: Previous use of DM medications and CCBs may negatively affect the clinical course of COVID-19. '+st+' Semenzato L, Botton J, Drouin J, Baricault B, Vabre C, Cuenot F, et al. Antihypertensive drugs and COVID-19 risk: a cohort study of 2 million hypertensive patients. Hypertension. 2021 Mar 3;77(3):833-42. doi: 10.1161/HYPERTENSIONAHA.120.16314. Epub 2021 11 January. PMID: 33423528; PMCID: PMC7884243. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.120.16314 Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. 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Amaç: Bortezomib, multipl miyelom tedavisinde yaygın olarak kullanılan önemli bir proteazom inhibitörüdür; ancak kazanılmış direnç, ilacın uzun dönem klinik etkinliğini sınırlandırmaktadır. MikroRNA’lar apoptoz, stres yanıtı, hücresel adaptasyon ve ilaç direnci süreçlerinde rol oynayan önemli post-transkripsiyonel düzenleyicilerdir. Bu çalışmada, multipl miyelom hücre modellerinde bortezomib direnci ile ilişkili olabilecek seçilmiş mikroRNA’ların ekspresyon profillerinin araştırılması amaçlandı. Yöntem: Bortezomib dirençli U266 ve RPMI-8226 multipl miyelom hücreleri, artan konsantrasyonlarda bortezomibe sürekli maruz bırakılarak oluşturuldu. Dirençli ve kontrol hücrelerinde miR-25, miR-30c, miR-34a, miR-34c, miR-200b, miR-200c, miR-326, miR-429, miR-449a, miR-449b, miR-499a, miR-582 ve miR-708 ekspresyon düzeyleri kantitatif gerçek zamanlı PCR yöntemi ile analiz edildi. Endojen kontrol olarak U6 snRNA kullanıldı ve relatif ekspresyon düzeyleri 2⁻ΔΔCt yöntemi ile hesaplandı. Bulgular: Bortezomib dirençli U266 ve RPMI-8226 hücrelerinde hem ortak hem de hücre hattına özgü mikroRNA ekspresyon değişiklikleri gözlendi. miR-34a, miR-34c, miR-326, miR-429, miR-449a ve miR-449b her iki dirençli hücre hattında da anlamlı olarak yüksek eksprese edildi. miR-25, miR-200c ve miR-708 ekspresyonları yalnızca dirençli RPMI-8226 hücrelerinde arttı. Buna karşılık, miR-200b, miR-499a ve miR-582 iki dirençli model arasında zıt ekspresyon paternleri sergilerken, miR-30c ekspresyonunda değişiklik saptanmadı. Sonuç: Multipl miyelomda kazanılmış bortezomib direnci, hem ortak hem de hücre hattına özgü mikroRNA değişiklikleri ile ilişkilidir. miR-34, miR-326 ve miR-449 aile üyelerinin her iki dirençli hücre hattında tutarlı şekilde artmış olması, bu mikroRNA’ların proteazom inhibisyonuna karşı gelişen adaptif yanıtlarda rol oynayabileceğini düşündürmektedir. Diğer mikroRNA’larda gözlenen farklı ekspresyon paternleri ise direnç mekanizmalarının heterojen yapısına işaret etmektedir. Bu mikroRNA’ların bortezomib direncindeki fonksiyonel rollerinin aydınlatılması için ileri çalışmalara ihtiyaç vardır.