Fluoxetine removal by anodic oxidation using different anode materials and graphite cathode.

Fluoxetine (FLX) is a selective serotonin reuptake inhibitor (SSRI) medication commonly used to treat mental health disorders, but it can be harmful to the environment if not properly disposed of due to incomplete metabolism. In this study, electrochemical anodic oxidation with mixed metal oxide anodes was studied as a method to remove FLX from water and wastewater. Iridium dioxide-coated titanium (Ti/IrO2) and ruthenium dioxide-coated Ti (Ti/RuO2) electrodes were found to be more effective than platinum-coated Ti (Ti/Pt) electrodes, with removal efficiencies of 91.5% and 93.9%, respectively. Optimal conditions for FLX removal were determined to be an applied current of 150 mA, initial pH of 5, and oxidation time of 120 min. The rate of FLX degradation (kFLX) for the Ti/Pt, Ti/IrO2, and Ti/RuO2 electrodes were determined to be 0.0081 min-1 (R2:0,8161), 0.0163 min-1 (R2:0,9823), and 0.0168 (R2:0,9901) min-1 for 25 mg/L initial FLX concentration, respectively. The kFLX values varied based on the initial FLX concentration and decreased as the initial FLX concentration increased. The specific energy consumption (SEC) after 120 min of operation was 51.0 kWh/m3 for the Ti/Pt electrode, 39.6 kWh/m3 for the Ti/IrO2 electrode, and 48.6 kWh/m3 for the Ti/RuO2 electrode under optimised conditions. Overall, electrochemical anodic oxidation is an effective method for removing FLX from water and wastewater, with Ti/IrO2 and Ti/RuO2 electrodes providing superior performance compared to Ti/Pt electrodes.

Spatio-temporal distribution of microplastic pollution in surface sediments along the coastal areas of Istanbul, Turkey.

Microplastics (MPs) have become prevalent in various environmental compartments, including air, water, and soil, attracting attention as significant pollutant parameters. This study investigated the prevalence of MP pollution in surface sediments along Istanbul's Marmara Sea, encompassing the megacity and the Bosphorus. A comprehensive sampling approach was employed, covering 43 stations across four seasons and depths ranging from 5 to 70 m. The objective was to assess the impact of terrestrial, social, and industrial activities on MPs. The average concentrations varied per season, with fall, winter, spring, and summer values recorded as 2000 ± 4100, 1600 ± 3900, 4300 ± 12,000, and 9500 ± 20,300 particles/kg-DW. The study identified river stations in the Golden Horn and sea discharge locations as hotspots for high concentrations. Notably, the dominant shape shifted from fibers in fall, winter, and spring to fragments during summer, coinciding with mucilage occurrences. The study identified 11 different polymers, with polyethylene (44 %) and polypropylene (31 %) being the most common.

Chemical oxygen demand and tannin/lignin removal from paper mill wastewater by electrocoagulation combined with peroxide and hypochlorite treatments.

The present investigation sought to assess the practicality of utilizing a combined pre-treatment approach comprising electrocoagulation, peroxide, and hypochlorite treatments for the removal of chemical oxygen demand (COD) and tannin/lignin from paper mill wastewater. The study aimed to optimize the operating parameters with a view to maximizing the removal efficiencies while minimizing energy consumption. A pair of iron electrodes were used as anode and cathode in the study, and the main operating parameters were determined as initial pH, applied current, treatment time and oxidant dosage/COD ratio. Response surface methodology (RSM) was used to evaluate the effect of these parameters on COD and tannin/lignin removals. The primary findings of the investigation indicated that the integration of electrocoagulation with peroxide and hypochlorite treatments exhibited efficacy in removing COD, tannin/lignin, colour, phenol, and turbidity from paper mill wastewater. The optimized conditions resulted in COD removal efficiencies of 48.13 ± 2.2% and 29.53 ± 1.4% for EC with H2O2 and Ca(OCl)2, respectively. Tannin/lignin removal efficiencies were 92.59 ± 3.6% and 94.09 ± 1.8% for EC-H2O2 and EC-Ca(OCl)2, respectively. The specific energy consumption (SEC) values showed that EC-Ca(OCl)2 required 7 times more energy than EC-H2O2 for removing 1 kg COD. The principal deduction drawn from the study was that EC-H2O2 pre-treatment demonstrated superior COD removal efficiency and lower energy consumption, while EC-Ca(OCl)2 pre-treatment exhibited greater efficiency in removing toxic and recalcitrant pollutants. In future studies, it would be useful to conduct research to increase COD removal efficiency in addition to tannin/lignin removal in EC-Ca(OCl)2 process.

Treatment of wastewater from the washing process of a municipal solid waste collection container by electrochemical treatment using different anode materials: a statistical optimization.

An underground municipal solid waste (MSW) container should be washed periodically to prevent/reduce odor and leachate production. In this study, the treatment process of wastewater derived from the washing process of an MSW container was investigated using the electrochemical (EC) treatment process with different anode materials (Fe, TiO2, and graphite). Response surface methodology (RSM) was used to evaluate the effect of process parameters such as initial pH, applied current, and reaction time on chemical oxygen demand (COD), Tannin/Lignin, and color removals. According to the results obtained from the RSM models, all process parameters were significant. The optimum process parameters in terms of COD removal were derived from the models for each anode material. Under the optimized conditions, the COD removals were determined to be 93.25%, 75.95%, and 98.46% for Fe-Fe, TiO2-Fe, and graphite-Fe electrode pairs, respectively. The color and Tannin/Lignin removals were determined as 98.12% and 77.78% for the Fe-Fe, 92.76% and 98.45% for the TiO2-Fe and 94.50% and 79.56% for the graphite-Fe electrode pair, respectively. The specific energy consumption (SEC) values were found as 46.95, 300.02, and 32.95 kWh/m3 for each electrode combination given above, respectively. In terms of both removal efficiencies and SEC, the most effective anode material was determined as graphite, followed by iron.

Effects of hydrogen peroxide and calcium hypochlorite on chemical oxygen demand solubilization and disintegration of waste activated sludge by electro-chemical pretreatment.

ABSTRACTThe combination of electrochemical (EC) pretreatment with hydrogen peroxide (HP) and calcium hypochlorite (CHC) was investigated in this study for their effect on soluble chemical oxygen demand (CODs) and disintegration degree (DD) of waste activated sludge (WAS). For this aim, response surface methodology (RSM) and Box-Behnken design (BBD) were applied the determination of the optimum operational conditions. Operational conditions were varied between 0.2 and 2.0 mmol/g SS for HP and CHC dosages, 1-5 A for the applied current, 2-10 for the initial pH, and 15-45 min for the treatment time. Obtained results for each treatment were accurate and significant with correlation coefficients (R2) of 0.8639% and 0.9189% for EC combined with HP pretreatment and EC combined with CHC pretreatment, respectively. According to the obtained results, CODs increased in comparison to the raw sludge (168 mg/L) noting that CODs for EC - CHC (1155 ± 21 mg/L) was higher than EC - HP (811.5 ± 15 mg/L) at optimized conditions (for EC-HP pretreatment: HP dosage: 0.34 mmol/g TSS, Applied current:5 A, Initial pH:10, Time: 45 min, For EC-CHC pretreatment: CHC dosage: 0.23 mmol/g TSS, Applied current:4.83 A, Initial pH:10, Time: 40 min). Besides, the DD in terms of COD, total nitrogen (TN) and total organic carbon (TOC) (DDCOD, DDTN and DDTOC) registered increased values after the application of the EC treatment with both oxidants. The highest DDCOD, DDTN and DDTOC values were obtained with EC-CHC pretreatment for 11.34%, 20.34% and 9.18% respectively compared to EC-HP pretreatment (DDCOD: 7.37%, DDTN: 15.18% and DDTOC: 6.94%).

Highlighting the cathodic contribution of an electrooxidation post-treatment study on decolorization of textile wastewater effluent pre-treated with a lab-scale moving bed-membrane bioreactor.

This study is carried out to investigate the effect of the cathodic contribution in the performance of electro-oxidation process for decolorization of the textile wastewater effluent pre-treated with a lab-scale moving bed-membrane bioreactor. For this purpose, titanium dioxide (TiO2) was used as anode electrode and four different cathodic electrode materials: Graphite, TiO2, TiO2-coated Platine, and TiO2-coated ruthenium dioxide (RuO2) (namely RuO2) were tested and compared for their color removal efficiencies. Besides, the optimization parameters that affect color removal in correspondence to the electrode materials, such as applied current, electrolysis time, and pH were studied. In this context, the optimum parameters for each electrode material were selected, and the color removal percentages were found as 92.95%, 91.58%, 91.40%, and 89.17% for TiO2/Graphite, TiO2/Platine, TiO2/TiO2, and TiO2/RuO2, respectively. Finally, the operational cost for each of the tested cathodic electrode materials was calculated in each of the studied optimization parameters making it easier and practical for the selection and evaluation of the electrode materials by the readers. The correlation coefficients (R2) were 81.2%, 87.1%, 86.7%, and 88.6% respectively as a result of the optimization study using the nonlinear regression modeling.

Decolorization of textile wastewater by electrooxidation process using different anode materials: Statistical optimization.

The presence of reactive dyes in textile wastewater is a serious environmental concern due to their associated mutagenic and carcinogenic effects. The present study aims to analyze the effect of different anodic materials on the decolorization of a real textile wastewater effluent. For this purpose, four different anodic materials-TiO2 -coated platine, TiO2 -coated ruthenium dioxide (RuO2 ) (viz., RuO2 ), titanium dioxide (TiO2 ), and graphite-were connected, respectively, to titanium dioxide (TiO2 ) used as a cathode electrode. Color and cost optimization studies were performed using the response surface methodology and the Box-Behnken experimental design (BBD). According to ANOVA results, the R2 values for Pt/TiO2 , RuO2 /TiO2 , TiO2 /TiO2 , and graphite/TiO2 electrode pairs were found to be 97.4%, 93.8%, 92.44%, and 92.2%, respectively, indicating a good compatibility as it is close to one. The results show that color removal efficiencies at the optimal conditions were 86.3%, 90.8%, 91.5%, and 93.6% for Pt/TiO2 , graphite/TiO2 , TiO2 /TiO2 , and RuO2 /TiO2 , respectively. Furthermore, energy consumption cost at the optimum conditions was also evaluated, and the results were as follows: Pt/TiO2 (0.95 €/m3 ), graphite/TiO2 (0.74 €/m3 ), TiO2 /TiO2 (0.31 €/m3 ), and RuO2 /TiO2 (0.26 €/m3 ). Consequently, this research paper shows that all of the tested anodic materials give satisfactory color removal efficiencies higher than 86%. When energy consumption and color removal are considered together, the use of TiO2 /TiO2 and RuO2 /TiO2 pairs would be preferred. PRACTITIONER POINTS: Anodic contribution was investigated for decolorization of textile wastewater by electrooxidation process. Graphite, TiO2 -coated Pt, TiO2 -coated RuO2 , and TiO2 were used as anode materials. Highest color removal with lowest energy consumption was achieved with TiO2 -coated RuO2 anode material (93.6%).

Preliminary study testing the effects of tea and coffee on sludge characteristics and N-butyryl-l-homoserine lactone in an MBR system.

Membrane bioreactors (MBRs) are rapidly developing systems widely used for the treatment of municipal and industrial wastewater prior to their discharge into the environment. Membrane fouling is the most important challenge in MBRs, because it negatively affects membrane performance, resulting in low permeate flux, higher transmembrane pressure and frequent membrane cleaning/replacement. In this study, the effect of tea and coffee on sludge characteristics, membrane fouling and the bacterial signalling molecule N-butyryl-l-homoserine lactone (C4-HSL) in a membrane bioreactor system were investigated. For this purpose, four different continuously operated membrane bioreactors, treating synthetic domestic wastewater and dairy wastewater were operated in parallel under the same conditions. The results indicated that the soluble microbial products (SMP) and the extracellular polymeric substances (EPS) in the reactors showed similar trends for both synthetic domestic and dairy wastewater, where protein levels were higher than carbohydrate levels. Other parameters such as floc size, zeta potential, hydrophobicity, sludge volume index and capillary suction time were also analysed prior to and after the addition of coffee and tea. Analysis of the wastewater samples by GC-MS revealed that coffee and tea significantly enhance the extraction efficiency of C4-HSL. The results obtained in this study can serve as a good basis for further research.

Performance evaluation of conventional membrane bioreactor and moving bed membrane bioreactor for synthetic textile wastewater treatment.

In this study, conventional membrane bioreactor (MBR) and moving bed-membrane bioreactor (MB-MBR) processes were compared in synthetic textile wastewater treatment. For this purpose, the bioreactors were operated as a conventional MBR, an MB-MBR with a biocarrier filling ratio of 20 % and an MB-MBR with a biocarrier filling ratio of 10 %, respectively. In the conventional MBR operation, 93.1 % chemical oxygen demand (COD) and 87.1 % color (Reactive Red 390) removal efficiencies were obtained. In both MB-MBR operations, almost equal COD and color removal efficiencies were found as 98.5 % and 89.5 %, respectively. Moreover, offline physical and chemical membrane cleaning processes were applied every other day and every 15 days throughout the conventional MBR operation, respectively, while no physical or chemical membrane cleaning was required during both MB-MBR operations. Furthermore, lower polysaccharide concentrations of extracellular polymeric substances (EPS) and floc sizes of sludge and higher zeta potential of sludge were determined in MB-MBR. Considering the obtained results, it may be stated that the MB-MBR process is an attractive treatment technology for reducing membrane fouling propensity for treatment of textile wastewater.

Binary Dispersive Liquid-Liquid Microextraction Strategy for Accurate and Precise Determination of Micropollutants in Lake, Well and Wastewater Matrices.

In this study, a binary mixture in dispersive liquid-liquid microextraction was used for the preconcentration and determination of selected pesticides, pharmaceutical and hormone by GC-MS. A Box-Behnken experimental design was used to optimize the amounts of binary mixture, dispersive solvent and salt. The optimum parameters obtained were dichloromethane/1,2-dichloroethane binary mixture (200 µL), ethanol (2.0 mL) and potassium nitrate (1.0 g). Analytical performance of each analyte was determined under the optimum conditions and the lowest and highest detection limits calculated were 0.43 and 5.9 ng/mL. Low relative standard deviations were obtained even in the lowest concentrations in linear calibration plots, signifying high precision for the sample preparation procedure and instrumental measurement. Accuracy of the developed method and applicability to real samples was tested on well, lake, hospital and municipal wastewater. The percent recoveries acquired at different spiked concentrations were satisfactory (89%-108%), validating the accuracy of the method for the quantification of the analytes in the selected matrices.

Wastewater treatment from the biodiesel production using waste cooking oil by electrocoagulation: a multivariate approach.

This study mainly focuses on the process of electrocoagulation (EC) for the wastewater treatment from biodiesel production using waste cooking oil. The effects of current density, initial pH and electrolysis time on the EC process using aluminum (Al) and iron (Fe) electrodes were investigated for removal of chemical oxygen demand (COD). The COD removal efficiencies were found to be 62.7% and 63.4% at optimum conditions for Al (current density: 43 mA/cm2, pH: 5, time: 21 min) and Fe (current density: 47 mA/cm2, pH: 7.7, time: 30 min) electrodes, respectively. At these optimum conditions, the removal efficiencies of oil & grease, total phosphorus (TP), orthophosphate (PO4-P) and total suspended solids (TSS) were determined respectively to be above 89.9%, 98.9%, 99.5%, 86.7% for Al electrodes and 90.8%, 98.5%, 97.6%, 89.6% for Fe electrodes. Total operating costs were also found to be 6.43 €/m3 and 7.01 €/m3 for Al and Fe electrodes, respectively. The results indicate that the EC process using both types of electrodes seems to ensure an efficient treatment of biodiesel wastewater in terms of oil & grease and TP.

Performance and activated sludge characteristics at short solid retention time in a submerged MBR: effects of C/N ratio of wastewater.

This study investigated the effect of carbon to nitrogen (C/N) ratio of influent wastewater on performance and activated sludge properties at a sludge retention time of 5 d in a submerged membrane bioreactor. The chemical oxygen demand and ammonia-Nitrogen (NH3-N) removal efficiencies were found to be over 96.3% and 86.9% in the sMBRs having different C/N ratios. It was found that total extracellular polymeric substances and total soluble microbial products increased with an increase in C/N ratio. It was also observed that critical flux, relative hydrophobicity and zeta potential values decreased, and capillary suction time, particle size and viscosity of sludge increased as the C/N ratio increased.

Sphingosine-1-phosphate lyase mutations cause primary adrenal insufficiency and steroid-resistant nephrotic syndrome.

Primary adrenal insufficiency is life threatening and can present alone or in combination with other comorbidities. Here, we have described a primary adrenal insufficiency syndrome and steroid-resistant nephrotic syndrome caused by loss-of-function mutations in sphingosine-1-phosphate lyase (SGPL1). SGPL1 executes the final decisive step of the sphingolipid breakdown pathway, mediating the irreversible cleavage of the lipid-signaling molecule sphingosine-1-phosphate (S1P). Mutations in other upstream components of the pathway lead to harmful accumulation of lysosomal sphingolipid species, which are associated with a series of conditions known as the sphingolipidoses. In this work, we have identified 4 different homozygous mutations, c.665G>A (p.R222Q), c.1633_1635delTTC (p.F545del), c.261+1G>A (p.S65Rfs*6), and c.7dupA (p.S3Kfs*11), in 5 families with the condition. In total, 8 patients were investigated, some of whom also manifested other features, including ichthyosis, primary hypothyroidism, neurological symptoms, and cryptorchidism. Sgpl1-/- mice recapitulated the main characteristics of the human disease with abnormal adrenal and renal morphology. Sgpl1-/- mice displayed disrupted adrenocortical zonation and defective expression of steroidogenic enzymes as well as renal histology in keeping with a glomerular phenotype. In summary, we have identified SGPL1 mutations in humans that perhaps represent a distinct multisystemic disorder of sphingolipid metabolism.

Oculoauriculofrontonasal Dysplasia Syndrome With Additional Clinical Features.

Oculo-auriculo-vertebral spectrum and frontonasal dysplasia are two well-known examples of dysmorphology syndromes. Oculoauriculofrontonasal syndrome (OAFNS) is a clinical entity involving the characteristics of both OAVS and FND and is thought to be a result of the abnormal development of structures in the first and the second branchial arches, including the abnormal morphogenesis of maxillary processes. Herein we report a case of OAFNS with cliteral hypertrophy, premaxillary teeth, and inguinal hernia, features not previously reported in the literature.

Association of wider neck circumference and asthma in obese children.

BACKGROUND: Obesity is a well-established risk factor for asthma. Previous studies have reported that central obesity is associated with asthma. OBJECTIVE: To investigate the association between fat distribution, which is determined by anthropometric measures, including neck circumference (NC), and asthma in school-aged children. METHODS: Children diagnosed as having asthma were enrolled along with controls who were admitted to our outpatient department with allergic symptoms, such as rhinitis, urticaria and atopic dermatitis. Anthropometric measures, including height, weight, NC, waist circumference, and hip circumference, were obtained. Skin prick tests, blood eosinophil counts, and serum total IgE level measurements were performed. RESULTS: A total of 196 children (92 male [46.9%]) were included. Asthma was present in 102 patients (52.1%). Ninety-one of the patients (46.4%) were overweight, and 45 patients (22.9%) were obese. The NC of children with asthma was significantly higher than that of children in the control group. Grades defined according to NC percentiles were also significantly different between groups. In children with asthma, the prevalence of children with an NC higher than the 90th percentile (grade 6) was more frequent when compared with controls. The median NC of obese-overweight children with asthma was significantly higher compared with obese-overweight controls without asthma. Results of multivariable logistic regression analysis revealed that the presence of an NC in the greater than 90th percentile was associated with asthma in obese-overweight children. CONCLUSION: This study found that NC, which is a simple anthropometric measure, is associated with asthma in obese children.

A Rare Reason of Hyperinsulinism: Munchausen Syndrome by Proxy.

Hyperinsulinism, one of the most important causes of hypoglycaemia, can be congenital or acquired. Rarely, drug toxicity can be a reason for hyperinsulinism. In the context of Munchausen syndrome by proxy (MSP), toxicity usually occurs in children due to drug administration by a parent or caregiver. A 7-year-old girl was referred to our department due to a hyperglycaemic period and hypoglycaemic episodes. On admission, gliclazide was initiated due to her hyperglycaemia, which we attributed to maturity onset diabetes of the young. However, during follow-up, hypoglycaemic levels were detected. Despite cessation of gliclazide, hypoglycaemic seizures occurred. Even with the medications administered, hypoglycaemia could not be prevented. During follow-up, the mother's affect, characterized by anxiety and interest in her daughter's medical care, appeared discordant with the situation. Due to our suspicion of MSP, we discovered toxic levels of gliclazide in the blood and urine samples which had been sent to the toxicology laboratory to search for hypoglycaemic agents. The patient was isolated, and all medications were stopped. After isolation, her hypoglycaemia disappeared, and she became hyperglycaemic (250 mg/dl). Physicians should consider the possibility of MSP in hyperinsulinaemic patients with discordant laboratory results and clinical symptoms, even if the child's parents display great concern.

The Growth Characteristics of Patients with Noonan Syndrome: Results of Three Years of Growth Hormone Treatment: A Nationwide Multicenter Study.

OBJECTIVE: Noonan syndrome (NS) is a multisystem disorder, and short stature is its most striking manifestation. Optimal growth hormone (GH) treatment for NS is still controversial. In this study, using a nationwide registration system, we aimed to evaluate the growth characteristics and the clinical features of NS patients in Turkey and their growth response to GH treatment. METHODS: Children and adolescents with a diagnosis of NS were included inthe study. Laboratory assessment including standard GH stimulation test results were evaluated. Height increment of patients with or without GH treatment were analyzed after three years of therapy. RESULTS: A total of 124 NS patients from different centers were entered in the web-based system. Short stature and typical face appearance were the most frequently encountered diagnostic features of our patients. Of the 84 patients who were followed long-term, 47 hadreceived recombinant human GH (rhGH). In this group of 47 patients, height standard deviation score (HSDS) increased from -3.62±1.14 to -2.85±0.96 after three years of therapy, indicating significant differences from the patients who did not receive GH treatment. PTPN11 gene was analyzed in 61 patients, and 64% of these patients were found to have a mutation. HSDS at admission was similar in patients with or without PTPN11 gene mutation. CONCLUSION: A diagnosis of NS should be kept in mind in all patients with short stature showing systemic clinical findings. GH therapy is effective for improvement of short stature especially in the first two years of treatment. Further studies are needed for optimisation of GH therapy and evaluation of final height data in NS patients.

The Etiology and Clinical Features of Non-CAH Gonadotropin-Independent Precocious Puberty: A Multicenter Study.

AIM: The causes of gonadotropin-independent precocious puberty are diverse, and often have overlapping clinical and biochemical features. With the exception of congenital adrenal hyperplasia (CAH), disorders that cause gonadotropin-independent precocious puberty (GIPP) are uncommon. The literature is devoid of any large-scale studies on the etiologic distribution of GIPP. The aim of this study was to determine the frequency of each etiology in a cohort of patients with GIPP (excluding those with CAH), and to evaluate the clinical and laboratory features of these patients. MATERIALS AND METHODS: This multicenter, nationwide web-based study collected data on patients who presented with non-CAH GIPP in Turkey. RESULTS: Data were collected for 129 patients (102 girls and 27 boys) from 29 centers. Based on the data collected, the estimated prevalence of non-CAH GIPP in the studied population was 14 in 1 000 000 children. Functional ovarian cyst was the most common etiology, accounting for 37% of all cases, followed by McCune-Albright syndrome (MAS) (26%). Among the patients with MAS, 11.7% had fibrous dysplasia, 32.3% had café-au-lait spots, and 52.9% had both. Human chorionic gonadotrophin-secreting tumors included choriocarcinoma of the liver, hepatoblastoma, and germ cell tumors of the sellar-suprasellar region and mediastinum. Patients with adrenocortical tumors presented at an earlier age than those with other etiologies. Ovarian tumors included mature cystic teratoma, dysgerminoma, juvenile granulosa tumor, and steroid cell tumor. Despite overlapping features, it was possible to identify some unique clinical and laboratory features associated with each etiology. CONCLUSION: This largest cohort of patients with non-CAH GIPP to date yielded an estimation of the frequency of non-CAH GIPP in the general pediatric population and showed that girls were affected at a rate 4-fold greater than that of boys owing to functional ovarian cysts and MAS, which were the two most common etiologies. The data collected also provided some unique characteristics associated with each etiology.

Anthropometric findings from birth to adulthood and their relation with karyotpye distribution in Turkish girls with Turner syndrome.

To evaluate the anthropometric features of girls with Turner syndrome (TS) at birth and presentation and the effect of karyotype on these parameters. Data were collected from 842 patients with TS from 35 different centers, who were followed-up between 1984 and 2014 and whose diagnosis age ranged from birth to 18 years. Of the 842 patients, 122 girls who received growth hormone, estrogen or oxandrolone were excluded, and 720 girls were included in the study. In this cohort, the frequency of small for gestational age (SGA) birth was 33%. The frequency of SGA birth was 4.2% (2/48) in preterm and 36% (174/483) in term neonates (P < 0.001). The mean birth length was 1.3 cm shorter and mean birth weight was 0.36 kg lower than that of the normal population. The mean age at diagnosis was 10.1 ± 4.4 years. Mean height, weight and body mass index standard deviation scores at presentation were -3.1 ± 1.7, -1.4 ± 1.5, and 0.4 ± 1.7, respectively. Patients with isochromosome Xq were significantly heavier than those with other karyotype groups (P = 0.007). Age at presentation was negatively correlated and mid-parental height was positively correlated with height at presentation. Mid-parental height and age at presentation were the only parameters that were associated with height of children with TS. The frequency of SGA birth was found higher in preterm than term neonates but the mechanism could not be clarified. We found no effect of karyotype on height of girls with TS, whereas weight was greater in 46,X,i(Xq) and 45,X/46,X,i(Xq) karyotype groups.