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Enhoş A, Doğuş Kus H, Yozgat CY, Cakır E, Yazan H, Erol AB, Erenberk U, Yozgat Y. Short-term azithromycin use is associated with QTc interval prolongation in children with cystic fibrosis. Arch Pediatr 2024:S0929-693X(24)00060-5. [PMID: 38637249 DOI: 10.1016/j.arcped.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/07/2024] [Accepted: 02/17/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Azithromycin is used for children with cystic fibrosis (CF) for its immunomodulatory and anti-inflammatory action. This study investigated the short-term alterations in QTc interval associated with azithromycin prophylaxis in pediatric patients with CF. METHODS This study included 121 patients with mild CF, of whom 76 received azithromycin (patient group) and 45 did not receive azithromycin (control group). The patient and control groups were categorized according to age as under 12 years of age and over 12 years of age. The first presentation measured all the patient and control groups at basic QTc time intervals. The QTc intervals of all patients were then remeasured systemically at 1, 3, and 6 months. Age categories and QTc intervals that were calculated at each month in the patient and control groups were compared statistically. RESULTS A statistically significant difference was detected in the patient group between the initial QTc interval time and the electrocardiogram (ECG) findings in the first and third months after prophylaxis treatment (p < 0.001; p = 0.01). However, no statistically significant difference was detected in the sixth month (p > 0.05) in all groups. Almost all of the children's QTc intervals were within normal range and within the safety zone (under 0.44 s). No statistically significant difference was detected in the control group between the initial ECG and the QTc intervals measured at 1, 3, and 6 months. CONCLUSION Short-term use of azithromycin prophylaxis in pediatric patients with mild CF slightly increased the QTc interval in the first and third months of follow-up. Nevertheless, all QTc interval changes fell within the safety zone. Notably, 1 month of follow-up treatment should be performed to check for any alteration in the QTc interval. If increased QTc interval duration is not detected in the first month, azithromycin prophylaxis can be safely prescribed.
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Affiliation(s)
- Asım Enhoş
- Department of Cardiology, Istanbul Medipol University, Istanbul, Turkey.
| | - Hazar Doğuş Kus
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Erkan Cakır
- Department of Pediatric Pulmonology, Istinye University Hospital, Liv Vadi Hospital, Istanbul, Turkey
| | - Hakan Yazan
- Department of Pediatric Pulmonology, Istanbul Medipol University, Istanbul, Turkey
| | - Ahmet Berk Erol
- Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ufuk Erenberk
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
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Temur HO, Alkan A, Yozgat CY, Cakir E, Yazan H, Yabul FC, Cesme DH, Yozgat Y. MRI evaluation of right heart functions in children with mild cystic fibrosis. Cardiol Young 2023; 33:1828-1833. [PMID: 36226672 DOI: 10.1017/s1047951122003249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study aimed to assess the ventricular anatomy, function of the right ventricle, and the haemodynamic findings of pulmonary artery in children with cystic fibrosis using cardiac MRI. PATIENTS This prospective study consisted of 32 children with mild cystic fibrosis and 30 age-matched healthy control participants. METHODS Cardiac MRI was used to assess right ventricular volumes, anatomy, and function and to assessment of haemodynamic findings of pulmonary artery in the control and study groups. Haemodynamic findings of pulmonary arteries were determined using pulmonary arteries peak velocity (cm/s), and pulmonary arteries time-to-peak velocity (ms) and pulmonary artery systolic pressure. All data of children with mild cystic fibrosis were compared with those of 30 age-matched healthy control group participants. RESULTS Our patients and their age-matched controls were aged from 6 to 17 years and from 7 to 15 years, respectively. We found that ejection fraction (%), cardiac output (L/ml), cardiac output (L/ml/m2), and systolic volume (ml/m2) were significantly lower in children with cystic fibrosis (p < 0.01). Right ventricular anterior wall thickness (mm) was significantly higher in children with cystic fibrosis (p = 0.01). No significant difference was observed between the haemodynamic parameters of pulmonary artery in the patient group. CONCLUSION In our study, cardiac MRI was used to investigate whether the right ventricle was affected functionally and anatomically in children with mild cystic fibrosis. We detected a significant decrease in right ventricular systolic functions and notable alterations in the right ventricular geometry of children with mild cystic fibrosis. These alterations usually manifest themselves as hypertrophy of the right ventricle. Our study's results demonstrate no relationship between the development of pulmonary hypertension in mild cystic fibrosis children.
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Affiliation(s)
- Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Alpay Alkan
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Erkan Cakir
- Department of Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey
| | - Hakan Yazan
- Department of Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey
| | - Fatma Celik Yabul
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Dilek Hacer Cesme
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
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Yilmaz Ciftdogan D, Ekemen Keles Y, Karbuz A, Cetin BS, Elmas Bozdemir S, Kepenekli Kadayifci E, Metin Akcan O, Ozer A, Erat T, Sutcu M, Buyukcam A, Belet N, Erdeniz EH, Dalgic Karabulut N, Hancerli Torun S, Oncel S, Orbak Z, Turel O, Gayretli Aydin ZG, Kilic O, Yahsi A, Kara Aksay A, Ergenc Z, Petmezci MT, Oflaz MB, Sarikaya R, Otar Yener G, Ozen S, Gul D, Arslan G, Kara SS, Demirkol D, Yazici Ozkaya P, Yozgat Y, Varan C, Kara M, Arga G, Yakut N, Kilic AO, Cakici O, Kucuk M, Kaba O, Karaoglu Asrak H, Bursal Duramaz B, Dalkiran T, Berna Anil A, Turgut M, Karapinar B, Somer A, Elmali F, Dinleyici EC, Ciftci E, Kara A. Multisystem inflammatory syndrome in children associated with COVID-19 in 101 cases from Turkey (Turk-MISC study). J Paediatr Child Health 2022; 58:1069-1078. [PMID: 35199895 PMCID: PMC9115147 DOI: 10.1111/jpc.15913] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/19/2021] [Accepted: 02/06/2022] [Indexed: 12/11/2022]
Abstract
AIM Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey. METHODS The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients' medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis. RESULTS The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6-9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112-228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30-84) and procalcitonin levels (86/89, median 5 μg/L; IQR 0.58-20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died. CONCLUSION The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management.
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Affiliation(s)
- Dilek Yilmaz Ciftdogan
- Department of Pediatric Infectious Diseases, Faculty of MedicineIzmir Katip Celebi UniversityIzmirTurkey,Department of Pediatric Infectious Diseases, Faculty of Medicine, Izmir Tepecik Training and Research HospitalUniversity of Health SciencesIzmirTurkey
| | - Yildiz Ekemen Keles
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Izmir Tepecik Training and Research HospitalUniversity of Health SciencesIzmirTurkey
| | - Adem Karbuz
- Department of Pediatric Infectious DiseasesIstanbul Professor Doctor Cemil Tascioglu City HospitalIstanbulTurkey
| | - Benhur Sirvan Cetin
- Department of Pediatric Infectious Diseases, Faculty of MedicineErciyes UniversityKayseriTurkey
| | - Sefika Elmas Bozdemir
- Department of Pediatric Infectious DiseasesBursa Dortcelik Children's HospitalBursaTurkey
| | - Eda Kepenekli Kadayifci
- Department of Pediatric Infectious Diseases, Faculty of MedicinePendik Training and Research Hospital, Marmara UniversityIstanbulTurkey
| | - Ozge Metin Akcan
- Department of Pediatric Infectious Diseases, Faculty of MedicineNecmettin Erbakan University, Meram HospitalKonyaTurkey
| | - Arife Ozer
- Division of Pediatric Infectious Diseases, Van Training and Research HospitalUniversity of Health SciencesVanTurkey
| | - Tugba Erat
- Division of Pediatric Infectious DiseasesSanliurfa Training and Research HospitalSanliurfaTurkey
| | - Murat Sutcu
- Department of Pediatric Infectious Diseases, Faculty of MedicineIstinye University HospitalIstanbulTurkey
| | - Ayse Buyukcam
- Division of Pediatric Infectious DiseasesGaziantep CG Obstetrics and Children's HospitalGaziantepTurkey
| | - Nursen Belet
- Department of Pediatric Infectious Diseases, Faculty of MedicineDokuz Eylul University HospitalİzmirTurkey
| | - Emine Hafize Erdeniz
- Department of Pediatric Infectious DiseasesOndokuz Mayis University HospitalSamsunTurkey
| | - Nazan Dalgic Karabulut
- Division of Pediatric Infectious DiseasesHealth Sciences University Sisli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Selda Hancerli Torun
- Department of Pediatric Infectious Diseases, Faculty of MedicineIstanbul University HospitalIstanbulTurkey
| | - Selim Oncel
- Department of Pediatric Infectious Diseases, Faculty of MedicineKocaeli University HospitalKocaeliTurkey
| | - Zerrin Orbak
- Department of Pediatrics, Faculty of Dentistry and MedicineAtatürk UniversityErzurumTurkey
| | - Ozden Turel
- Department of Pediatric Infectious Diseases, Faculty of MedicineBezmialem Vakif University HospitalIstanbulTurkey
| | - Zeynep Gokce Gayretli Aydin
- Department of Pediatric Infectious Diseases, Faculty of MedicineKaradeniz Teknik University HospitalTrabzonTurkey
| | - Omer Kilic
- Department of Pediatric Infectious Diseases, Faculty of MedicineOsmangazi University HospitalEskisehirTurkey
| | - Aysun Yahsi
- Division of Pediatric Infectious Diseases, Samsun Training and Research HospitalUniversity of Health SciencesSamsunTurkey
| | - Ahu Kara Aksay
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Izmir Tepecik Training and Research HospitalUniversity of Health SciencesIzmirTurkey
| | - Zeynep Ergenc
- Department of Pediatric Infectious Diseases, Faculty of MedicinePendik Training and Research Hospital, Marmara UniversityIstanbulTurkey
| | - Mey Talip Petmezci
- Department of Intensive CareIstanbul Professor Doctor Cemil Tascioglu City HospitalIstanbulTurkey
| | - Mehmet Burhan Oflaz
- Department of Pediatric Cardiology, Faculty of MedicineNecmettin Erbakan University, Meram HospitalKonyaTurkey
| | - Remzi Sarikaya
- Division of Cardiology, Van Training and Research HospitalUniversity of Health SciencesVanTurkey
| | - Gülcin Otar Yener
- Division of Pediatric RomatologySanliurfa Training and Research HospitalSanliurfaTurkey
| | - Seval Ozen
- Department of Pediatric Infectious Diseases, Faculty of MedicineAdiyaman UniversityAdiyamanTurkey
| | - Doruk Gul
- Department of Pediatrics, Faculty of MedicineIstinye University HospitalIstanbulTurkey
| | - Gazi Arslan
- Department of Pediatric Intensive Care, Faculty of MedicineDokuz Eylul University HospitalİzmirTurkey
| | - Soner Sertan Kara
- Department of Pediatric Infectious Diseases, Faculty of MedicineAydin Adnan Menderes UniversityAydinTurkey
| | - Demet Demirkol
- Department of Pediatric Intensive Care, Faculty of MedicineIstanbul University HospitalIstanbulTurkey
| | - Pinar Yazici Ozkaya
- Department of Pediatric Intensive Care, Faculty of MedicineEge University HospitalIzmirTurkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Faculty of MedicineBezmialem Vakif University HospitalIstanbulTurkey
| | - Celal Varan
- Department of Pediatric Cardiology, Faculty of MedicineAdiyaman UniversityAdiyamanTurkey
| | - Manolya Kara
- Division of Pediatric Infectious DiseasesNecip Fazil City HospitalKahramanmarasTurkey
| | - Gul Arga
- Department of Pediatric Infectious Diseases, Faculty of MedicineAnkara University HospitalAnkaraTurkey
| | - Nurhayat Yakut
- Department of Pediatric Infectious Diseases, Faculty of MedicinePendik Training and Research Hospital, Marmara UniversityIstanbulTurkey
| | - Ahmet Osman Kilic
- Department of Pediatrics, Faculty of MedicineNecmettin Erbakan University, Meram HospitalKonyaTurkey
| | - Ozlem Cakici
- Department of Pediatric Infectious Diseases, Faculty of MedicineKocaeli University HospitalKocaeliTurkey
| | - Mehmet Kucuk
- Division of Pediatric Cardiolgy, Samsun Training and Research HospitalUniversity of Health SciencesSamsunTurkey
| | - Ozge Kaba
- Department of Pediatric Infectious Diseases, Faculty of MedicineIstanbul University HospitalIstanbulTurkey
| | - Hatice Karaoglu Asrak
- Department of Pediatric Infectious Diseases, Faculty of MedicineDokuz Eylul University HospitalİzmirTurkey
| | - Burcu Bursal Duramaz
- Department of Pediatric Infectious Diseases, Faculty of MedicineBezmialem Vakif University HospitalIstanbulTurkey
| | - Tahir Dalkiran
- Division of Pediatric Intensive CareNecip Fazil City HospitalKahramanmarasTurkey
| | - Ayse Berna Anil
- Department of Pediatric Intensive Care, Faculty of MedicineIzmir Katip Celebi UniversityIzmirTurkey
| | - Mehmet Turgut
- Department of Pediatric Infectious Diseases, Faculty of MedicineAdiyaman UniversityAdiyamanTurkey
| | - Bulent Karapinar
- Department of Pediatric Intensive Care, Faculty of MedicineEge University HospitalIzmirTurkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, Faculty of MedicineIstanbul University HospitalIstanbulTurkey
| | - Ferhan Elmali
- Department of BiostatisticsIzmir Katip Celebi UniversityIzmirTurkey
| | - Ener Cagri Dinleyici
- Department of Pediatrics, Faculty of MedicineEskisehir Osmangazi UniversityEskisehirTurkey
| | - Ergin Ciftci
- Department of Pediatric Infectious Diseases, Faculty of MedicineAnkara University HospitalAnkaraTurkey
| | - Ates Kara
- Department of Pediatric Infectious Diseases, Faculty of MedicineHacettepe University HospitalAnkaraTurkey
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Sari G, Oteyaka E, Kuguoglu OE, Basunlu MT, Karakurt Y, Yozgat Y, Demirel G, Ugurlucan M, Tastekin A, Turkoglu H. Congenital tricuspid insufficiency due to rupture of chordae tendinea secondary to intrauterine obliteration of ductus arteriosus. Cardiol Young 2022; 33:1-4. [PMID: 35545882 DOI: 10.1017/s1047951122001482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Congenital rupture of tricuspid chordae tendinea leading to severe tricuspid insufficiency is an extremely rare pathology associated with signs and symptoms of congestive heart failure presenting at birth. If the diagnosis and treatment of this pathology are not made early in life fetal demise may become inevitable.We herein present a neonate with central cyanosis and congestive heart failure due to rupture of an anterior leaflet chordae resulting in severe insufficiency of the tricuspid valve who was treated with appropriate surgery.
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Affiliation(s)
- Gizem Sari
- Istanbul Medipol University Faculty of Medicine, Department of Pediatric Cardiology, Turkey
| | - Emre Oteyaka
- Istanbul Medipol University Faculty of Medicine, Department of Cardiovascular Surgery, Turkey
| | - Okan Eren Kuguoglu
- Istanbul Medipol University Faculty of Medicine, Department of Cardiovascular Surgery, Turkey
| | - Mehmet Turan Basunlu
- Istanbul Medipol University Faculty of Medicine, Department of Pediatric Cardiology, Turkey
| | - Yakup Karakurt
- Istanbul Medipol University Faculty of Medicine, Department of Neonatology, Turkey
| | - Yilmaz Yozgat
- Istanbul Medipol University Faculty of Medicine, Department of Pediatric Cardiology, Turkey
| | - Gamze Demirel
- Istanbul Medipol University Faculty of Medicine, Department of Neonatology, Turkey
| | - Murat Ugurlucan
- Istanbul Medipol University Faculty of Medicine, Department of Cardiovascular Surgery, Turkey
| | - Ayhan Tastekin
- Istanbul Medipol University Faculty of Medicine, Department of Neonatology, Turkey
| | - Halil Turkoglu
- Istanbul Medipol University Faculty of Medicine, Department of Cardiovascular Surgery, Turkey
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Aliyeva N, Yozgat Y, Bakhshaliyev N, Afshord TZ, Yozgat CY, Kilicoglu AG. Evaluation of executive functions in children with rheumatic heart diseases. Pediatr Int 2022; 64:e15035. [PMID: 34674348 DOI: 10.1111/ped.15035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/30/2021] [Accepted: 10/13/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acute rheumatic fever (ARF) is a multisystemic inflammatory disease in children and young adults. The most notable complications of ARF are rheumatic heart disease (RHD) and Sydenham's chorea (SC). There have been many reports about executive dysfunctions with children who have SC. "Executive function" is an umbrella term that is used to describe higher level cognitive functions. The aim of this study is to determine the executive functions of children with RHD. We evaluated executive functions in healthy children with the same sociodemographic characteristics as children with RHD. METHODS Our study was designed as a cross-sectional randomized study, including children with RHD aged between 12 and 18, and healthy controls. The difference between the patient and control group participants in terms of age, gender, education level, education level of the parents, family income level, and executive functions were investigated. Executive functions composed of Digit Sequence Test, Verbal Fluency Test, Trail-Making Test, Stroop Test, Wisconsin Card Sorting Test. RESULTS In our study, a total of 30 children with RHD were followed up at the pediatric cardiology outpatient clinic of Bezmialem Vakif University Hospital composed the patient group. The control group was made up of 30 healthy children of the same sex and age group as the patient group. The mean age of the case group was 14.73 ± 1.84 years. The Digit Span Test, Verbal Fluency Test, Trail-Making Test, Wisconsin Card Sorting Test, and Stroop Test produced no statistically significant differences between the RHD patients and the controls. CONCLUSIONS No statistically significant difference was found between the RHD patients and control patients in any executive function test. It was suggested that executive dysfunction might not develop in RHD patients before developing SC.
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Affiliation(s)
- Nigar Aliyeva
- Department of Child and Adolescent Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
| | | | - Telli Zadehgan Afshord
- Department of Child and Adolescent Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Ali Guven Kilicoglu
- Department of Child and Adolescent Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
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Yurtsever I, Yesilbas O, Yozgat CY, Tekin E, Yozgat Y. New variation of scimitar syndrome with tracheal bronchus, upper lobe agenesis, and ventricular septal defect in a child. Pediatr Int 2022; 64:e15029. [PMID: 35437892 DOI: 10.1111/ped.15029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/28/2021] [Accepted: 09/30/2021] [Indexed: 01/05/2023]
Affiliation(s)
- Ismail Yurtsever
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Osman Yesilbas
- Department of Pediatric Intensive Care Medicine, Faculty of Medicine, Karadeniz Technical University, Istanbul, Turkey
| | | | - Eser Tekin
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
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Yozgat Y, Kus HD, Kahraman FU, Yuksel M, Firat CK, Toprak A, Yozgat CY, Yakut K, Sahin SS, Iscan A, Temur HO, Ergor SN, Erenberk U, Saritas T. Evaluation of cardiac arrhythmias by electrocardiographic markers in pediatric patients who have tuberous sclerosis without cardiac rhabdomyoma. Arch Pediatr 2021; 28:204-208. [PMID: 33715930 DOI: 10.1016/j.arcped.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 12/11/2020] [Accepted: 02/13/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Tuberous sclerosis (TS) is an autosomal dominant and hereditary disorder. Cardiac rhabdomyoma and arrhythmias are the most deleterious risk factors linked to TS. Although arrhythmias in pediatric patients with TS who have cardiac rhabdomyoma have been frequently reported, arrhythmia in patients who have TS without rhabdomyoma is rarely reported in the literature. The study aimed to assess the susceptibility of pediatric patients who have TS without cardiac rhabdomyoma to cardiac arrhythmia using electrocardiographic (ECG) markers. METHODS This prospective study included 10 patients who had TS without cardiac rhabdomyoma. The control group was made up of 30 healthy children of the same age and sex as the patient group. P wave, P wave dispersion, QT dispersion, QTc dispersion, TP-e interval, and TP-e interval dispersion were calculated on 12-lead surface ECGs for each patient in both groups and compared. RESULTS P wave, P wave dispersion, QT dispersion, and QTc dispersion were found to be significantly higher in the patient group (P<0.001). Furthermore, patients had a greater Tp-e interval and Tp-e interval dispersion than healthy children (P<0.001). CONCLUSION Pediatric patients with TS without cardiac rhabdomyoma might be prone to atrial and ventricular arrhythmias according to their prolonged ECG markers. Our findings suggest that patients with TS without cardiac rhabdomyoma need close monitoring for atrial and ventricular arrhythmias.
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Affiliation(s)
- Y Yozgat
- Department of pediatric cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | - H D Kus
- Department of pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - F U Kahraman
- Department of pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - M Yuksel
- Department of pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - C K Firat
- Department of pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - A Toprak
- Department of biostatistics, Bezmialem Vakif University, Istanbul, Turkey
| | - C Y Yozgat
- Faculty of medicine, Bezmialem Vakif University, Istanbul, Turkey.
| | - K Yakut
- Department of pediatric cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | - S S Sahin
- Department of pediatric neurology, Bezmialem Vakif University, Istanbul, Turkey
| | - A Iscan
- Department of pediatric neurology, Bezmialem Vakif University, Istanbul, Turkey
| | - H O Temur
- Department of radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - S N Ergor
- Department of neonatology, Bezmialem Vakif University, Istanbul, Turkey
| | - U Erenberk
- Department of pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - T Saritas
- Department of pediatric cardiology, Istanbul Medipol University, Istanbul, Turkey
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8
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Guliyeva A, Cakir E, Yazan H, AlShadfan L, Sharifov R, Temur HO, Karaarslan U, Yozgat CY, Erenberk U, Yakut K, Yozgat Y. Assessment of Right Heart Functions in Children with Mild Cystic Fibrosis. Klin Padiatr 2021; 233:231-236. [PMID: 33601431 DOI: 10.1055/a-1341-1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) is a multisystemic disease that prevalently involves the lungs. Hypoxemia occurs due to the existing of progressive damage to the pulmonary parenchyma and pulmonary vessels. The condition may cause systolic and diastolic dysfunction to the right ventricle due to the effects of high pulmonary artery systolic pressure (PASP). The study aimed to determine echocardiographic alterations in PASP, right ventricle (RV) anatomy, and functions in mild CF children. MATERIALS AND METHODS RV anatomy, systolic, and diastolic functions were evaluated with conventional echocardiographic measurements. Estimated PASP was used measured with new echocardiographic modalities, including pulmonary artery acceleration time (PAAT), right ventricular ejection time (RVET), and their ratio (PAAT/RVET). The obtained echocardiographic data were statistically compared between the patient group and the control group. RESULTS The study consisted of 30 pediatric patients with mild CF and 30 healthy children with similar demographics. In patient group, conventional parameters disclosed differences in RV anatomy, both systolic and diastolic functions of RV compared with the healthy group. We did not compare the patient group with published standard data because of the wide range variability. However, new echocardiographic parameters showed notable increase in pulmonary artery pressure compared with values of control group and published standard data (p<0.001). CONCLUSION Elevated PASP, RV failure, and Cor pulmonale usually begin early in children with mild CF. In addition to routine echocardiographic measurements to evaluate RV, we recommend the use of new echocardiographic modalities for routine examinations and in the follow up of children with mild CF.
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Affiliation(s)
- Aynur Guliyeva
- Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Erkan Cakir
- Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey
| | - Hakan Yazan
- Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey
| | - Lina AlShadfan
- Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey
| | | | | | - Utku Karaarslan
- Pediatric Intensive Care Unit, Dr Behcet Uz Child Disease and Surgery Training and Research Hospital, Izmir, Turkey
| | | | - Ufuk Erenberk
- Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Kahraman Yakut
- Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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Ergor SN, Kutuk MS, Duman N, Yozgat CY, Temur HO, Ugurlucan M, Yozgat Y. Co-occurrence of interrupted aortic arch and Apert syndrome: A case report. Pediatr Neonatol 2021; 62:125-126. [PMID: 33077402 DOI: 10.1016/j.pedneo.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/29/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
- Serap Nur Ergor
- Department of Neonatology, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Serdar Kutuk
- Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey
| | - Nilgun Duman
- Department of Medical Genetics, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Murat Ugurlucan
- Department of Cardiovascular Surgery, Istanbul Medipol University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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10
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Yozgat CY, Yesilbas O, Uzuner S, Saritas B, Ergor SN, Otcu Temur H, Yozgat Y. Recurrent Elevation of Troponin Levels in Acute Myocarditis: Is it a Sign of Ventricular Tachycardia? Indian J Pediatr 2020; 87:1076-1077. [PMID: 32617745 DOI: 10.1007/s12098-020-03272-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 03/12/2020] [Indexed: 11/25/2022]
Affiliation(s)
| | - Osman Yesilbas
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Selcuk Uzuner
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Betul Saritas
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Serap Nur Ergor
- Department of Neonatology, Bezmialem Vakif University, Istanbul, Turkey
| | - Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey.
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11
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Yozgat CY, Yesilbas O, Iscan A, Yurtsever I, Temur HO, Bayramova N, Ergun G, Tekin N, Yozgat Y. Development of Antiarrhythmic Therapy-Resistant Ventricular Tachycardia, Ventricular Fibrillation, and Premature Ventricular Contractions in a 15-Year-Old Patient. J Pediatr Intensive Care 2020; 11:72-76. [DOI: 10.1055/s-0040-1715851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022] Open
Abstract
AbstractSudden cardiac arrest (SCA) is the sudden cessation of regular cardiac activity so that the victim becomes unresponsive, with no signs of circulation and no normal breathing. Asystole, ventricular tachycardia (VT), ventricular fibrillation (VF), and pulseless electrical activity are the underlying rhythm disturbances in the pediatric age group. If appropriate interventions (cardiopulmonary resuscitation-CPR and/or defibrillation or cardioversion) are not performed rapidly, this condition progresses to sudden death. There have not been many reported cases of the approach and treatment of cardiac arrhythmias after SCA. Herein, we would like to report a case of a 15-year-old female patient with dilated cardiomyopathy (DCM) who was admitted to our clinic a year ago, and while her left ventricular systolic functions were improved, SCA suddenly occurred. Since the SCA event occurred in another city, intravenous treatment of amiodarone was done immediately and was switch to continuous infusion dose of amiodarone until the patient arrived at our institution's pediatric intensive care unit (PICU) 3 hours later. During the patient's 20-day PICU hospitalization, she developed pulseless VT and VF from time to time. The patient's pulseless VT and VF attacks were brought under control by the use of a defibrillator and added antiarrhythmic drugs (amiodarone, flecainide, esmolol, and propafenone). Intriguingly, therapy-resistance bigeminy with premature ventricular contractions (PVCs) continued despite all these treatments. The patient did not have adequate blood pressure measured by invasive arterial blood pressure monitoring while having bigeminy PVCs. The intermittent bigeminy PVCs ameliorated rapidly after intermittent boluses of lidocaine. In the end, multiple antiarrhythmic therapies and intermittent bolus lidocaine doses were enough to bring her cardiac arrhythmias after SCA under control. This case illustrates that malign PVC's should be taken very seriously, since they may predispose to the development of VT or VF. Also, this case highlights the importance of close vigilance of arterial pressure tracings of patients with bigeminy PVCs which develop after SCA and should not be accepted as normal.
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Affiliation(s)
| | - Osman Yesilbas
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Akin Iscan
- Department of Pediatric Neurology, Bezmialem Vakif University, Istanbul, Turkey
| | - Ismail Yurtsever
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Nigar Bayramova
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Gokce Ergun
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Nur Tekin
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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12
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Yesilbas O, Yozgat CY, Akinci N, Sonmez S, Tekin E, Talebazadeh F, Jafarov U, Temur HO, Yozgat Y. Acute Myocarditis and Eculizumab Caused Severe Cholestasis in a 17-Month-Old Child Who Has Hemolytic Uremic Syndrome Associated with Shiga Toxin-Producing Escherichia coli. J Pediatr Intensive Care 2020; 10:216-220. [PMID: 34395040 DOI: 10.1055/s-0040-1713111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/02/2020] [Indexed: 10/23/2022] Open
Abstract
Cardiovascular involvement is uncommon in pediatric patients with hemolytic uremic syndrome associated with Shiga toxin-producing Escherichia coli (STEC-HUS). In this case report we presented a case of 17-month-old toddler who had a sporadic type of STEC-HUS complicated by acute myocarditis. The patient was successfully treated by a single dose of eculizumab after six doses of therapeutic plasma exchange (TPE) were inefficient to prevent the cardiac complication. Hepatotoxicity was observed after a single dose of eculizumab. Hepatic and cholestatic enzyme levels slowly returned to normal within 6 months. To the best of our knowledge, this is the first case of myocarditis/cardiomyopathy treated with eculizumab in STEC-HUS. This case illustrates the need for vigilance regarding myocardial involvement and eculizumab-induced hepatotoxicity in STEC-HUS.
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Affiliation(s)
- Osman Yesilbas
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Nurver Akinci
- Department of Pediatric Nephrology, Bezmialem Vakif University, Istanbul, Turkey
| | - Sirin Sonmez
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Eser Tekin
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Faraz Talebazadeh
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Uzeyir Jafarov
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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13
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Yozgat Y, Temur HO, Coban S, Oner T, Karaarslan U, Yozgat CY, Karadeniz C, Ergor SN, Erenberk U. Short-term efficacy of ORS formulation and propranolol regimen in children with POTS. Arch Pediatr 2020; 27:328-332. [PMID: 32651146 DOI: 10.1016/j.arcped.2020.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/09/2020] [Accepted: 06/01/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND To evaluate the short-term effectiveness of reduced-osmolarity oral rehydration salt formulation (ORS) and propranolol in children diagnosed with postural orthostatic tachycardia syndrome (POTS) in head-up tilt testing (HUTT). METHODS Children were admitted with symptoms of orthostatic intolerance (OI) occurring in a standing position and disappearing in the supine position. Patients with heart rate increments of ≥40bpm and symptoms of OI constituted the pediatric POTS group in HUTT. A total of 70 pediatric patients with POTS were included in the study. POTS patients were divided into two groups based on whether they were prescribed reduced-osmolarity ORS and propranolol or not. The study group comprised patients on a regimen of reduced-osmolarity ORS and propranolol (n=34), while the control group comprised patients who were not prescribed any medication (n=36). The frequency of symptoms and standardized symptom scores were analyzed before and after 3 months of treatment in both groups. RESULTS The post-treatment frequency of syncopal attacks was significantly reduced in both groups (P<0.01 for both groups), but the post-treatment standardized symptom scores were significantly reduced in the pediatric study group compared with the control group (P<0.01). CONCLUSION The frequency of syncopal attacks was significantly reduced and the symptom scores for OI were improved in the study group. The improvement in OI symptom scores was better in the treatment group than in the control group. The control group symptoms persisted and caused extreme difficulty in their daily activities. In view of its clinical efficacy, we strongly advocate the use of combined treatment of reduced-osmolarity ORS and low-dose propranolol in pediatric patients with POTS.
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Affiliation(s)
- Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Senay Coban
- Department of Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
| | - Taliha Oner
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Utku Karaarslan
- Department of Pediatrics, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | | | - Cem Karadeniz
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Serap Nur Ergor
- Department of Neonatology, Bezmialem Vakif University, Istanbul, Turkey
| | - Ufuk Erenberk
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
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14
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Yozgat CY, Uzuner S, Ay Y, Temur HO, Bursal Duramaz B, Turel O, Calim M, Buyukpinarbasili N, Yozgat Y. Lifesaving Treatment of Aortic Valve Staphylococcus aureus Endocarditis: Daptomycin and Early Surgical Therapy. J Pediatr Intensive Care 2020; 10:298-302. [PMID: 34745704 DOI: 10.1055/s-0040-1713614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/13/2020] [Indexed: 10/23/2022] Open
Abstract
Infective endocarditis (IE) is an uncommon infection in children. The recommended treatment for native valve endocarditis secondary to methicillin-susceptible Staphylococcus aureus infection is antistaphylococcal penicillins such as nafcillin or oxacillin. If the initial therapy fails in IE, it can lead to catastrophic results. Nowadays, daptomycin is the best alternative antimicrobial agent to treat children with severe infections, when standard antimicrobial therapy does not yield a result. Herein, in this article, we described a case of a 16-year-old boy who had aortic valve S. aureus endocarditis with septic embolization and stroke. The patient was successfully treated only with daptomycin as well as surgical therapy in the early phase of the infection.
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Affiliation(s)
| | - Selcuk Uzuner
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Yasin Ay
- Department of Cardiovascular Surgery, Bezmialem Vakif University, Istanbul, Turkey
| | - Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Burcu Bursal Duramaz
- Department of Pediatric Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
| | - Ozden Turel
- Department of Pediatric Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
| | - Muhittin Calim
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University, Istanbul, Turkey
| | - Nur Buyukpinarbasili
- Department of Pathology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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15
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Yozgat CY, Uzuner S, Bursal Duramaz B, Yozgat Y, Erenberk U, Iscan A, Turel O. Dermatological manifestation of pediatrics multisystem inflammatory syndrome associated with COVID-19 in a 3-year-old girl. Dermatol Ther 2020; 33:e13770. [PMID: 32500647 PMCID: PMC7300549 DOI: 10.1111/dth.13770] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 01/08/2023]
Affiliation(s)
| | - Selcuk Uzuner
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Burcu Bursal Duramaz
- Department of Pediatric Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Ufuk Erenberk
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Akin Iscan
- Department of Pediatric Neurology, Bezmialem Vakif University, Istanbul, Turkey
| | - Ozden Turel
- Department of Pediatric Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
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16
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Otcu Temur H, Yozgat CY, Tanyeri Bayraktar B, Tahaoglu I, Yozgat Y. Isolated origin of one-branch pulmonary artery from aorta mimics transient tachypnea of the newborn. Pediatr Int 2020; 62:870-871. [PMID: 32627305 DOI: 10.1111/ped.14207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/26/2020] [Accepted: 02/20/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | | | | | - Irmak Tahaoglu
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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17
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Temur HO, Yozgat CY, Uzuner S, Ugurlucan M, Yazan H, Cakir E, Yozgat Y. Balanced Double Aortic Arch Causing Persistent Respiratory Symptoms Mimicking Asthma in an Infant. J Pediatr Intensive Care 2020; 10:162-166. [PMID: 33884220 DOI: 10.1055/s-0040-1712959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/30/2020] [Indexed: 10/24/2022] Open
Abstract
Double aortic arch (DAA) is a common form of complete vascular ring. The condition leads to airway obstruction and compression of the esophagus. A balanced type of DAA is an extremely rare anomaly. The anatomical aberration cannot be easily distinguished by transthoracic echocardiography when an infant has chronic respiratory distress. Herein we presented a case of an 11-month-old infant who had chronic respiratory distress and a balanced type of DAA.
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Affiliation(s)
- Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Selcuk Uzuner
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Murat Ugurlucan
- Department of Cardiovascular Surgery, Istanbul Medipol University, Istanbul, Turkey
| | - Hakan Yazan
- Department of Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey
| | - Erkan Cakir
- Department of Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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18
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Bursal Duramaz B, Yozgat CY, Yozgat Y, Turel O. Appearance of skin rash in pediatric patients with COVID-19: Three case presentations. Dermatol Ther 2020; 33:e13594. [PMID: 32412681 PMCID: PMC7261998 DOI: 10.1111/dth.13594] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Burcu Bursal Duramaz
- Department of Pediatric Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Ozden Turel
- Department of Pediatric Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
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19
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Yozgat CY, Uzuner S, Temur HO, Ergor SN, Guliyeva A, Tahaoglu I, Coban S, Yozgat Y. Development of Myocardial Infarction in a 12-Year-Old Female after the Use of Inhaled Salbutamol. J Pediatr Intensive Care 2020; 9:295-298. [PMID: 33133748 DOI: 10.1055/s-0040-1709151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 03/01/2020] [Indexed: 10/24/2022] Open
Abstract
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) accounts for 0.023% of all cases reported in pediatric patients. According to literature, only a handful of ALCAPA patients are able to reach adulthood. Clinical manifestations of ALCAPA range from fatigue during exercise to sudden death in adulthood. Herein, we described a 12-year-old symptomatic patient with ALCAPA who had severe chest pain after using salbutamol treatment for presumed asthma. ALCAPA is one of the curable versions of myocardial ischemia and infarction in childhood. Due to clinical findings in conjunction with electrocardiogram and echocardiography, a computed tomography scan with coronary angiography was performed and the diagnosis of ALCAPA was confirmed. We presented this case because ALCAPA-related myocardial ischemia and infarction in children are rare with only sporadic cases reported. This case illustrated the need for close monitoring and surgery as the best treatment for ALCAPA associated with myocardial infarction.
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Affiliation(s)
| | - Selcuk Uzuner
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Serap Nur Ergor
- Department of Neonatology, Bezmialem Vakif University, Istanbul, Turkey
| | - Aynur Guliyeva
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Irmak Tahaoglu
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Senay Coban
- Department of Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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20
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Yesilbas O, Yozgat CY, Akinci N, Talebazadeh F, Jafarov U, Guney AZ, Temur HO, Yozgat Y. Sudden Cardiac Arrest and Malignant Ventricular Tachycardia in an 8-Year-Old Pediatric Patient Who Has Hemolytic Uremic Syndrome Associated with Shiga Toxin-Producing Escherichia coli. J Pediatr Intensive Care 2020; 9:290-294. [PMID: 33133747 DOI: 10.1055/s-0040-1708553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/16/2020] [Indexed: 10/24/2022] Open
Abstract
Gastrointestinal, neurological, pancreatic, hepatic, and cardiac dysfunction are extrarenal manifestations of hemolytic uremic syndrome associated with Shiga toxin-producing Escherichia coli (STEC-HUS). The most frequent cause of death for STEC-HUS is related to the central nervous system and cardiovascular system. Cardiac-origin deaths are predominantly related to thrombotic microangiopathy-induced ischemia and the immediate development of circulatory collapse. STEC-HUS cardiac related deaths in children are rare with only sporadic cases reported. In our literature search, we did not come across any pediatric case report about STEC-HUS causing sudden cardiac arrest and malignant ventricular tachycardia (VT). Herein, we report the case of an 8-year-old female child with a typical clinical manifestation of STEC-HUS. On the seventh day of pediatric intensive care unit admission, the patient had a sudden cardiac arrest, requiring resuscitation for 10 minutes. The patient had return of spontaneous circulation with severe monomorphic pulsed malignant VT. Intravenous treatment with lidocaine, amiodarone and magnesium sulfate were promptly initiated, and we administered multiple synchronized cardioversions, but VT persisted. Furthermore, we were not able to ameliorate her refractory circulation insufficiency by advanced cardiopulmonary resuscitation. Thus, inevitably, the patient lost her life. This case illustrates the need for aggressive management and the dilemma that pediatric critical care specialists, cardiologists, and nephrologists have to face when dealing with STEC-HUS that is worsened by a sudden cardiac arrest accompanied with VT.
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Affiliation(s)
- Osman Yesilbas
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Nurver Akinci
- Department of Pediatric Nephrology, Bezmialem Vakif University, Istanbul, Turkey
| | - Faraz Talebazadeh
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Uzeyir Jafarov
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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21
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Yesilbas O, Kus HD, Şik G, Citak A, Temur B, Yozgat CY, Temur HO, Cakir E, Yozgat Y. Double Aortic Arch Mimics the Clinical Characteristics of Severe Reactive Airway Disease in a Pediatric Patient. J Pediatr Intensive Care 2020; 9:141-144. [PMID: 32351771 DOI: 10.1055/s-0039-1700952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 11/23/2019] [Indexed: 10/25/2022] Open
Abstract
Reactive airway disease is a prevalent condition that can be detected in the early infancy period. The condition might also deteriorate into asthma in some cases. If infants do not respond to the treatment of persistent wheeze and coughing, other rare causes should be investigated. The complete form of vascular ring is an extremely uncommon congenital cardiovascular abnormality. Double aortic arch constitutes the most significant portion of the complete vascular ring anomalies. Clinical manifestations of the anomaly are mainly respiratory due to the tracheal compression and mimicking the conditions of asthma. There have not been many reports about the clinical presentations of double aortic arch being remarkably similar to the same clinical manifestations of asthma in the literature. As far as we can be sure, there have not been any reported cases about severe reactive airway disease that caused a patient to have a life-threatening condition in the pediatric intensive care unit. Herein, we present a 5-month-old girl who had double aortic arch. Her anatomical aberration was diagnosed by three-dimensional computed tomography angiography of thorax, and the anomaly mimicked the clinical characteristics of life-threatening severe reactive airway disease.
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Affiliation(s)
- Osman Yesilbas
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Hazar Dogus Kus
- Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Güntülü Şik
- Department of Pediatric Critical Care Medicine, Mehmet Ali Aydınlar University, Faculty of Medicine, Atakent Acıbadem Hospital, Istanbul, Turkey
| | - Agop Citak
- Department of Pediatric Critical Care Medicine, Mehmet Ali Aydınlar University, Faculty of Medicine, Atakent Acıbadem Hospital, Istanbul, Turkey
| | - Bahar Temur
- Department of Cardiovascular Surgery, Mehmet Ali Aydınlar University, Faculty of Medicine, Atakent Acıbadem Hospital, Istanbul, Turkey
| | | | - Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Erkan Cakir
- Department of Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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22
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Yozgat Y, Uzuner S, Yesilbas O, Ogur M, Yakut K, Yozgat CY, Temur HO, Ay Y. Pulmonary Edema in the Acute Stage of Rheumatic Fever Treated with Double-Valve Replacement in a Pediatric Patient. J Pediatr Intensive Care 2019; 9:77-80. [PMID: 31984164 DOI: 10.1055/s-0039-3399580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022] Open
Abstract
Cardiogenic pulmonary edema (CPE) is a rare clinical condition of acute rheumatic fever (ARF) in the early stage. Generally, CPE can be convalesced by steroid and anticongestive treatment. Herein, we describe a case of a 14-year-old boy with ARF presenting with bilateral pulmonary edema secondary to acute mitral and aortic insufficiency. In this case, the pulmonary edema of ARF was successfully managed by combined surgical replacements of both valves.
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Affiliation(s)
- Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Selcuk Uzuner
- Department of Pediatric Critical Care, Bezmialem Vakif University, Istanbul, Turkey
| | - Osman Yesilbas
- Department of Pediatric Critical Care, Bezmialem Vakif University, Istanbul, Turkey
| | - Mustafa Ogur
- Department of Pediatric Critical Care, Bezmialem Vakif University, Istanbul, Turkey
| | - Kahraman Yakut
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Hafize Otcu Temur
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Yasin Ay
- Department of Cardiovascular Surgery, Bezmialem Vakif University, Istanbul, Turkey
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Yozgat Y, Uzuner S, Demir AD, Ogur M, Yozgat CY, Turel O. A 13-Year-Old Boy Who Has Kawasaki Disease Shock Syndrome Presents with Parotitis. J Pediatr Intensive Care 2019; 9:60-63. [PMID: 31984160 DOI: 10.1055/s-0039-1697978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/30/2019] [Indexed: 10/25/2022] Open
Abstract
We report a 13-year-old boy who (initially) had symptoms of toxic shock-like syndrome and mumps. Then, the patient was hospitalized in the pediatric intensive care unit (PICU) because of his ongoing hemodynamic instability (low blood pressure of 70/30 mm Hg and capillary refill time of > 4 seconds). During his stay in the PICU, the patient was treated with fluid resuscitation and vasoactive infusion and at the same time was diagnosed with Kawasaki disease shock syndrome (KDSS), when giant right coronary artery aneurysms were detected on echocardiographic examination. This case illustrates the risk of KDSS in patient who carries both parotitis and toxic shock-like syndrome. The clinicians should be cautious about detecting any types of coronary artery aneurysms in such patients. This is the first case of KDSS associated with parotitis reported in the literature.
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Affiliation(s)
- Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Selcuk Uzuner
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Aysegul Dogan Demir
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Mustafa Ogur
- Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Ozden Turel
- Department of Pediatric Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
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Ugurlucan M, Oztas DM, Bahseliyev S, Aliyev B, Yozgat Y, Tireli E, Alpagut U. Glenn Procedure in a Baby with Single Pulmonary Artery and Single Lung. Heart Views 2019; 19:106-108. [PMID: 31007860 PMCID: PMC6448474 DOI: 10.4103/heartviews.heartviews_19_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Glenn followed by Fontan are still the main two procedures for the treatment of patients with single ventricle. Some patients may be challenging due to unfavorable cardiopulmonary anatomy. In this report, we present Glenn shunt procedure in a patient with single pulmonary artery and congenitally agenetic lung.
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Affiliation(s)
- Murat Ugurlucan
- Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Didem Melis Oztas
- Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Shiraslan Bahseliyev
- Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Bahruz Aliyev
- Department of Pediatric Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Bezmialem University Hospital, Istanbul, Turkey
| | - Emin Tireli
- Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Ufuk Alpagut
- Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
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Mutlu K, Karadas U, Yozgat Y, Meşe T, Demirol M, Coban S, Karadeniz C, Özdemir R, Orbatu D, Karaarslan U, Tavli V. Echocardiographic evaluation of cardiac functions in newborns of mildly preeclamptic pregnant women within postnatal 24-48 hours. J OBSTET GYNAECOL 2017. [PMID: 28631496 DOI: 10.1080/01443615.2017.1322564] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study is to detect preeclampsia-related cardiac dysfunction within 24-48 hours of delivery in newborns born from preeclamptic mothers. Forty newborns from mildly preeclamptic mothers formed the study group and the control group was formed by 40 healthy newborns. Cardiac function for the groups were evaluated using conventional echocardiography and myocardial performance index (MPI) within the first 24-48 hours of their lifetime and the results of both groups were compared. A significant difference between the groups was observed especially in the PW Doppler MPI measurements (the left ventricle MPI 0.37 ± 0.09 and 0.26 ± 0.11, p < .001; the right ventricle MPI 0.29 ± 0.08 and 0.26 ± 0.07, p < .035) for the control group and the study group. Elongation in the left and right ventricle MPI was detected to be more significant in terms of comparing systolic and diastolic functions to determine preeclampsia-related cardiac injury in newborns from preeclamptic mothers within the first 24-48 hours of their lifetime. Impact statement Today, the methods which may detect cardiac injury earlier than conventional echocardiographic methods are used for evaluating cardiac functions. Among them, myocardial performance index (MPI) measurement with PW Doppler is the most common ones. While studies are available in the literature evaluating foetal cardiac functions with MPI in foetuses of preeclamptic women, studies evaluating cardiac functions with MPI index within the first 24-48 hours in postnatal period are not available. This is the first study to detect cardiac injury by measuring cardiac functions of the newborns of preeclamptic babies using conventional echocardiography (EF, SF, mitral and tricuspid E/A) and myocardial performance index within the first 24-48 hours of life and compare these values with those of a control group composed of healthy newborns with similar demographic characteristics. According to the results of the study, elongation in right and left ventricle MPI was detected to be more significant compared to systolic and diastolic functions for determining preeclampsia-related cardiac injury in newborns of preeclamptic mothers within 24-48 hours of delivery. Ventricle functions of the newborns of preeclamptic mothers should also be evaluated with MPI measurement besides conventional echocardiographic measurements.
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Affiliation(s)
- Kadir Mutlu
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
| | - Ulas Karadas
- b MH Aegean Maternity , Teaching and Training Hospital , İzmir , Turkey
| | - Yilmaz Yozgat
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
| | - Timur Meşe
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
| | - Mustafa Demirol
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
| | - Senay Coban
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
| | - Cem Karadeniz
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
| | - Rahmi Özdemir
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
| | - Dilek Orbatu
- b MH Aegean Maternity , Teaching and Training Hospital , İzmir , Turkey
| | - Utku Karaarslan
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
| | - Vedide Tavli
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
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Ozdemir R, Isguder R, Kucuk M, Karadeniz C, Ceylan G, Katipoglu N, Yilmazer MM, Yozgat Y, Mese T, Agin H. A Valuable Tool in Predicting Poor Outcome due to Sepsis in Pediatric Intensive Care Unit: Tp-e/QT Ratio. J Trop Pediatr 2016; 62:377-84. [PMID: 27085180 DOI: 10.1093/tropej/fmw021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess the feasibility of 12-lead electrocardiographic (ECG) measures such as P wave dispersion (PWd), QT interval, QT dispersion (QTd), Tp-e interval, Tp-e/QT and Tp-e/QTc ratio in predicting poor outcome in patients diagnosed with sepsis in pediatric intensive care unit (PICU). METHODS Ninety-three patients diagnosed with sepsis, severe sepsis or septic shock and 103 age- and sex-matched healthy children were enrolled into the study. PWd, QT interval, QTd, Tp-e interval and Tp-e/QT, Tp-e/QTc ratios were obtained from a 12-lead electrocardiogram. RESULTS PWd, QTd, Tp-e interval and Tp-e/QT, Tp-e/QTc ratios were significantly higher in septic patients compared with the controls. During the study period, 41 patients had died. In multivariate logistic regression analyses, only Tp-e/QT ratio was found to be an independent predictor of mortality. CONCLUSION The ECG measurements can predict the poor outcome in patients with sepsis. The Tp-e/QT ratio may be a valuable tool in predicting mortality for patients with sepsis in the PICU.
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Affiliation(s)
- Rahmi Ozdemir
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Rana Isguder
- Department of Pediatric Intensive Care Unit, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Mehmet Kucuk
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Cem Karadeniz
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Gokhan Ceylan
- Department of Pediatric Intensive Care Unit, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Nagehan Katipoglu
- Department of Pediatric Intensive Care Unit, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Murat Muhtar Yilmazer
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Timur Mese
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Hasan Agin
- Department of Pediatric Intensive Care Unit, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey
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27
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Yozgat Y, Avci ME, Kilic A, Ozdemir R, Demirol M, Karaarslan U, Mese T, Unal N. Can abnormal ductus venosus peak velocity index for veins in normal fetuses predict failure of functional closure of the foramen ovale in the postnatal period? Med Ultrason 2015; 17:295-299. [PMID: 26343076 DOI: 10.11152/mu.2013.2066.173.yyk] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To investigate whether ductus venosus (DV) wave velocities and/or DV peak velocity index for veins (DV-PVIV) can predict failure of functional closure of the foramen ovale in the postnatal period. MATERIAL AND METHODS Fetal echocardiography was performed in 455 healthy women with uneventful pregnancies between the 20-24th gestational weeks. DV blood flow and DV-PVIV data were collected prospectively. Echocardiography was repeated in healthy subjects on the 30th postnatal day. Four hundred patients met the study criteria. Newborns with clearly visible foraminal flaps, interatrial septal defects smaller than 5 mm and right-to-left shunting through the defect were accepted as patent foramen ovale (PFO) (n=91). Newborns without PFO (n=309) comprised the control group. RESULTS A statistically significant difference was detected between the groups with and without PFO in terms of mean DV-PVIV values, DV-D and DV-a wave velocities (p<0.05 for all). ROC analysis showed that increased DV-PVIV values were related to and predictive of PFO (AUC=0.75; p<0.001) and that a threshold value of 0.62, had a sensitivity of 86.8% (95% CI 78.1-93.0%) and a specificity of 51.7% (95% CI 46.1-57.5%). CONCLUSION DV-PVIV values above 0.62 at the time of fetal echocardiographic examination can predict failure of functional closure of the foramen ovale in the postnatal period.
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Affiliation(s)
- Yilmaz Yozgat
- Department of Pediatric Cardiology, Dr.Behcet Uz Children's Hospital, İzmir, Turkey
| | - Muhittin Eftal Avci
- Department of Perinatology, Tepecik Training and Research Hospital, İzmir, Turkey.
| | - Ayhan Kilic
- Department of Pediatric Cardiology, Gulhane Medical Academy, Ankara, Turkey
| | - Rahmi Ozdemir
- Department of Pediatric Cardiology, Dr.Behcet Uz Children's Hospital, İzmir, Turkey
| | - Mustafa Demirol
- Department of Pediatric Cardiology, Dr.Behcet Uz Children's Hospital, İzmir, Turkey
| | - Utku Karaarslan
- Department of Pediatric Cardiology, Dr.Behcet Uz Children's Hospital, İzmir, Turkey
| | - Timur Mese
- Department of Pediatric Cardiology, Dr.Behcet Uz Children's Hospital, İzmir, Turkey
| | - Nurettin Unal
- Department of Pediatric Cardiology, Dr.Behcet Uz Children's Hospital, İzmir, Turkey
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Affiliation(s)
- Y Yozgat
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
| | - M E Avci
- b Department of Perinatology , Aegean Training and Research Hospital , İzmir , Turkey
| | - M Karacelik
- c Department of Cardiovascular Surgery , Dr .Behcet Uz Children's Hospital , İzmir , Turkey
| | - A L Avci
- d Department of Anesthesiology , Gaziemir State Hospital , İzmir , Turkey
| | - R Ozdemir
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
| | - T Mese
- a Department of Pediatric Cardiology , Dr. Behcet Uz Children's Hospital , İzmir , Turkey
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Doksoz O, Oner T, Guven B, Karaarslan U, Ozdemir R, Yozgat Y, Mese T, Tavli V, Okur FF, Alayunt EA. Mid-term assessment of cardiac autonomic functions in children with transposition of the great arteries after arterial switch operation. ACTA ACUST UNITED AC 2014; 14:735-40. [DOI: 10.5152/akd.2014.5124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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30
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Yozgat Y, Kilic A, Karadeniz C, Ozdemir R, Doksoz O, Gulfidan G, Mese T. Sphingomonas paucimobilis bacteraemia and shock in a patient with rheumatic carditis. Indian J Med Microbiol 2014; 32:451-4. [PMID: 25297038 DOI: 10.4103/0255-0857.142253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Acute rheumatic fever (ARF) carditis is treated with steroids, which can cause changes in the cellular immune response, especially decreased CD3 (+) T cells. Nosocomial infections due to steroid use for treatment of ARF carditis or secondary to the changes in the cellular immune response have not been reported in the literature. Sphingomonas paucimobilis is a Gram-negative bacillus causing community- and hospital-acquired infections. It has been reported as causing bacteraemia/sepsis, pneumonia or peritonitis in patients with malignancies, immunosuppression or diabetes. We present a case with S. paucimobilis bacteraemia/sepsis and shock after administration of steroids for treatment of ARF carditis. We suggest early identification of the causative agent and appropriate adjustments of the treatment plan to avoid shock and possible mortality. This is the first reported case of S. paucimobilis bacteraemia/sepsis in the setting of steroid use for ARF carditis.
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Affiliation(s)
- Y Yozgat
- Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, İzmir, Turkey
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31
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Yozgat Y, Kilic A, Ozdemir R, Karadeniz C, Kucuk M, Karaarslan U, Mese T, Unal N. Modified myocardial performance index is not affected in fetuses with an isolated echogenic focus in the left ventricle. J Matern Fetal Neonatal Med 2014; 28:333-7. [PMID: 24749803 DOI: 10.3109/14767058.2014.916679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES We prospectively investigated the efficacy of modified myocardial performance index (mod-MPI) in the assessment of cardiac functions in fetuses with and without an isolated hyperechogenic focus (IHF) in the left ventricle and compared with conventional fetal echocardiography. METHODS The study group consisted of 50 fetuses with only an IHF in the left ventricle, without any other cardiac or extracardiac anomalies; 50 fetuses without IHF served as controls. All fetal echocardiographic studies were performed between 20th and 24th weeks of gestation. Left ventricular functions were evaluated with both conventional echocardiographic methods (peak velocity of the aortic valve, mitral E/A ratio, fractional shortening) and mod-MPI. RESULTS There was no statistically significant difference between the groups in terms of maternal age, BMI or gestational age at the time of examination (p > 0.05 for all). No statistically significant differences were found between the findings of conventional echocardiographic measurements and left ventricular mod-MPI between the study and control groups (p > 0.05 for all). CONCLUSION Fetal left ventricular mod-MPI is not affected by the presence of an IHF in the fetal left ventricle between 20th and 24th gestational weeks and thus it does not need to be assessed in this situation.
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Affiliation(s)
- Yilmaz Yozgat
- Department of Pediatric Cardiology, Dr Behcet Uz Children's Hospital , Izmir , Turkey and
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Yozgat Y, Karadeniz C, Ozdemır R, Kucuk M, Doksoz O, Karacelik M, Mese T, Sarıosmanoglu O, Unal N. PP-240 Pericardial Effusion and Compression of the Right Ventricle due to Massive Thymic Hyperplasia in a Two-Month-Old Female Patient. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yozgat Y, Karadeniz C, Ozdemır R, Doksoz O, Kucuk M, Mese T, Unal N. PP-243 Can Left Coronary Artery Ectasia and the Thrombus Formation Detected on Echocardiographic Examination be an Overdiagnosis? Case Report. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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34
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Yozgat Y, Karadeniz C, Ozdemır R, Kucuk M, Doksoz O, Mese T, Unal N. PP-242 A Rare Cause of Cyanosis in Childhood: Suprasystemic Right Ventricular due to Severe Pulmonary Stenosis: Case Report. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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35
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Doksöz Ö, Meşe T, Küçük M, Karaarslan U, Özdemir R, Yozgat Y, Yılmazer M. OP-036 Assessment of Microvolt T-wave Alternans in Repaired Tetralogy of Fallot Patients with 24-hour Holter Electrocardiography. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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36
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Karadeniz C, Ozdemir R, Kurtulmus S, Doksoz O, Yozgat Y, Mese T. Diclofenac-induced intrauterine ductal closure. Fetal Diagn Ther 2013; 34:133-4. [PMID: 23752059 DOI: 10.1159/000350979] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 03/19/2013] [Indexed: 11/19/2022]
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Hacihamdioğlu B, Okutan V, Yozgat Y, Yildirim D, Kocaoğlu M, Lenk MK, Ozcan O. Abdominal obesity is an independent risk factor for increased carotid intima- media thickness in obese children. Turk J Pediatr 2011; 53:48-54. [PMID: 21534339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We aimed in this study to investigate carotid intima-media thickness (IMT) in obese children and evaluate the relationship of IMT to various cardiovascular risk factors. One-hundred four obese children (9.3 +/- 2.5 years) and 30 healthy age-matched control subjects were enrolled in the study. All children were assessed for fasting levels of glucose, insulin, lipid profile, skinfold thickness (SFT), waist circumference (WC), and blood pressure (BP). Insulin resistance was estimated by the homeostasis model assessment (HOMA) index. Carotid IMT measurements and non-alcoholic fatty liver disease (NAFLD) were diagnosed with ultrasonographic findings. IMT was significantly higher in obese children compared to controls (0.49 +/- 0.05 vs. 0.40 +/- 0.02 mm, p < 0.001). Significant positive correlations were found between increased carotid IMT and body fat percentage (BFP), body mass index (BMI), age, height, systolic BP, WC, SFT, triglyceride and insulin levels, and insulin resistance index. In a linear logistic regression analysis, the only parameter affecting the increase in carotid IMT was WC (beta: 0.589, p < 0.001). Furthermore, IMT was increased significantly in obese children with NAFLD when compared to obese children without NAFLD (0.54 +/- 0.04 vs. 0.48 +/- 0.05 mm, p < 0.001). Children with abdominal obesity are at increased risk for atherosclerosis, and WC can be used to determine the atherosclerosis risk in obese children.
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Affiliation(s)
- Bülent Hacihamdioğlu
- Department of Pediatrics, Gülhane Military Medical Academy and Medical Faculty, Ankara, Turkey
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Saritas T, Tascilar E, Abaci A, Yozgat Y, Dogan M, Dundaroz R, Hasimi A, Yesilkaya E, Lenk MK, Kilic A. Importance of plasma N-terminal pro B-type natriuretic peptide, epicardial adipose tissue, and carotid intima-media thicknesses in asymptomatic obese children. Pediatr Cardiol 2010; 31:792-9. [PMID: 20419296 DOI: 10.1007/s00246-010-9705-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Accepted: 04/01/2010] [Indexed: 12/19/2022]
Abstract
This study aimed to analyze the variations of N-terminal pro B-type natriuretic peptide, epicardial adipose tissue thickness, and carotid intima-media thickness in childhood obesity. The study participants consisted of 50 obese children in the study group and 20 nonobese children referred for evaluation of murmurs who proved to have an innocent murmur and were used as control subjects. All the subjects underwent transthoracic echocardiographic examination for determination of left ventricular systolic function and mass index, myocardial tissue rates, and myocardial performance index. Epicardial adipose tissue thickness and carotid intima-media thickness also were measured during echocardiography. Serum N-terminal pro B-type natriuretic peptide levels were measured at the time of evaluation. The left ventricle mass index was 40.21 + or - 10.42 g/m(2) in the obese group and 34.44 + or - 4.51 g/m(2) in the control group (p > 0.05). The serum N-terminal pro B-type natriuretic peptide level was 109.25 + or - 48.53 pg/ml in the study group and 51.96 + or - 22.36 pg/ml and in the control group (p = 0.001). The epicardial adipose tissue thickness was 5.57 + or - 1.45 mm in the study group and 2.98 + or - 0.41 mm in the control group (p = 0.001), and the respective carotid intima-media thicknesses were 0.079 + or - 0.019 cm and 0.049 + or - 0.012 cm (p = 0.001). The left ventricular systolic and diastolic functions showed no statistically significant correlations with N-terminal pro B-type natriuretic peptide levels, carotid intima-media thickness, or epicardial adipose tissue thickness values. The results show that measurement of serum N-terminal pro B-type natriuretic peptide level, carotid intima-media thickness, and epicardial adipose tissue thickness in asymptomatic obese children is not needed.
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Affiliation(s)
- Turkay Saritas
- Department of Pediatric Cardiology, Gulhane Military Medical Academy, Ankara, Turkey.
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Tascilar E, Yokusoglu M, Dundaroz R, Baysan O, Ozturk S, Yozgat Y, Kilic A. Cardiac autonomic imbalance in children with allergic rhinitis. TOHOKU J EXP MED 2010; 219:187-91. [PMID: 19851046 DOI: 10.1620/tjem.219.187] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The involvement of autonomic imbalance has been reported in the pathogenesis of hypersensitivity reactions. Allergic diseases are more frequent in children and some of predisposing factors may be changed according to the increasing age, but the involvement of autonomic imbalance has not been investigated in pediatric population. In this cross-sectional, case-control study, we evaluated the autonomic system by measuring heart rate variability (HRV) in pediatric patients with allergic rhinitis. Thirty-five pediatric patients with allergic rhinitis and 36 healthy children (mean age 11 +/- 2.7, and 12 +/- 3 years, respectively) were enrolled in the study. Age and gender were not different between the groups. The diagnosis of allergic rhinitis was based on the history, symptoms, and skin prick tests. Participants with acute infection, nasal polyposis, bronchial asthma, and any other medical problems, assessed by history, physical examination and routine laboratory tests, were excluded. Twenty-four hour ambulatory electrocardiographic recordings were obtained, and the time domain and frequency domain indices of HRV were analyzed. We found significant increase in calculated HRV variables in children with allergic rhinitis compared to controls, which reflect parasympathetic tones, such as number of R-R intervals exceeding 50 ms, root mean square of successive differences between normal sinus R-R intervals, the percentage of difference between adjacent normal R-R intervals, and high frequency. These results indicate that HRV is increased, which implies sympathetic withdrawal and parasympathetic predominance. We propose that autonomic imbalance may be involved in the pathophysiology of allergic rhinitis in pediatric patients.
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Affiliation(s)
- Emre Tascilar
- Department of Pediatrics, Gulhane Military Medical School, Ankara, Turkey
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Abstract
An 18-month-old boy presented with abdominal pain and distension. On physical examination there was a 10 x 7-cm mass in the right upper abdominal quadrant. His alpha-fetoprotein level was 175,000 IU/mL. Abdominal magnetic resonance findings revealed hepatomegaly with multiple tumor masses involving nearly all the segments of the liver (PRETEXT IV). The tumor extended through the inferior vena cava and filled 2/3 of the right atrium. Echocardiography revealed normal cardiac function. Histopathologic findings after liver biopsy were consistent with hepatoblastoma. After 6 courses of chemotherapy including cisplatin and doxorubicin (PLADO, SIOPEL protocol), the cardiac tumor regressed completely. The patient's primary tumor was then fully resected; no cardiac surgery was performed. After surgery the AFP level was 4 IU/mL and echocardiography revealed normal cardiac function with no residual tumor. The patient has been in remission for 31 months postdiagnosis.
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Affiliation(s)
- Vural Kesik
- Department of Pediatric Oncology, Gulhane Military Medical Academy, School of Medicine, Etlik, Ankara, Turkey.
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Okutan V, Kürekçi AE, Sarici SU, Atay AA, Yozgat Y, Azik F, Lenk MK, Ozcan O. Neutrophil hypersegmentation in children receiving angiotensin converting enzyme inhibitors. Turk J Pediatr 2008; 50:438-442. [PMID: 19102047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Captopril and enalapril are the most commonly used angiotensin converting enzyme inhibitors in several cardiac diseases in children. On the other hand, the intrinsic renin-angiotensin system in the bone marrow might affect the growth of hematopoietic colonies and cellular production, proliferation and differentiation in physiological and pathological states. Starting with the hypothesis that inhibition of the renin-angiotensin system may have some effects on the hematopoietic system, including morphological changes within the granulocytes, we thus aimed to investigate prospectively whether the use of angiotensin converting enzyme inhibitors has any effect on the morphology, and especially segmentation, of neutrophils in peripheral blood. A total of 40 children with various heart diseases receiving either of two angiotensin converting enzyme inhibitors (captopril or enalapril) aged between 2 to 16 years were enrolled, and 40 healthy age- and sex-matched children were enrolled as controls. Complete blood count, peripheral blood smear, liver and renal function tests, and measurement of serum alkaline phosphatase, ferritin, vitamin B12 and folate levels were performed in all cases. Peripheral blood smears were viewed by two pediatric hematologists in a blinded manner. Neutrophil hypersegmentation was described as presence of five or more neutrophils with five well-separated lobes or at least one neutrophil with six or more lobes among 100 segmented neutrophils. The number of patients with neutrophil hypersegmentation in the study group was significantly higher than in the control group, and the mean lobe count in the study group was significantly higher than in the control group. Neutrophil hypersegmentation, as detected in patients using angiotensin converting enzyme inhibitors in the present study, has not been reported previously. Further studies aiming to explain the pathophysiological mechanism(s) underlying neutrophil hypersegmentation in patients receiving angiotensin converting enzyme inhibitors are needed.
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Affiliation(s)
- Vedat Okutan
- Department of Pediatrics, Gülhane Military Medical Academy, Ankara, Turkey
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Aydin HI, Yozgat Y, Demirkaya E, Olgun A, Okutan V, Lenk MK, Ozcan O. Correlation between vascular endothelial growth factor and leptin in children with cyanotic congenital heart disease. Turk J Pediatr 2007; 49:360-364. [PMID: 18246735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The objective in this study was to determine whether there was any relation between leptin and vascular endothelial growth factor (VEGF) in children with cyanotic and acyanotic heart anomalies. The study group consisted of 18 children with cyanotic congenital heart disease (CHD) and 20 age-adjusted children with acyanotic CHD as controls. Serum VEGF and leptin levels were determined by enzyme-linked immunosorbent assay (ELISA). The mean VEGF level was 149.25+/-42.93 pg/ml (range 80.66-217.00) in the cyanotic group and 88.18+/-20.94 pg/ml (range 48.44-112.71) in the acyanotic group (p<0.001). The mean leptin level was 7.55+/-1.46 ng/ml (range 4.08-10.25) in the cyanotic group and 6.89+/-1.43 ng/ml (range 2.67-8.57) in the acyanotic group (p=0.168). There was a significant positive correlation (r=0.723, p<0.001) between VEGF and leptin levels in the cyanotic group while there was no correlation (r=0.235, p=0.348) in the acyanotic group. Arterial oxygen saturation (SaO2) was negatively correlated (r=-0.625, p<0.001) with VEGF, but not correlated with leptin (r=-0.207, p=0.211) in the cyanotic group. There was no correlation between VEGF, leptin and SaO2 in the acyanotic group. We conclude that it is likely that both VEGF and leptin have a role in the pathogenesis of angiogenesis in cyanotic CHD.
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Süleymanoğlu S, Okutan V, Yozgat Y, Lenk MK. Determination of normal echocardiographic values for right ventricular volume in children with two-dimensional transthoracic echocardiography. Turk J Pediatr 2007; 49:141-7. [PMID: 17907512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Assessment of right ventricular volume and functions is needed during the decision-making process in a number of cardiological disease states. We aimed to study these variables with conventional transthoracic two-dimensional echocardiography in 213 healthy cases, aged 15 days-15 years. Left ventricular systolic and diastolic volumes were measured from the apical five-chamber view and the right ventricular systolic and diastolic diameters, areas and volumes were measured from the subcostal coronal view, using the Simpson equation. Results were analyzed statistically to derive their relationship with age, height, body weight and body surface area. We conclude that right ventricular volumes measured with two-dimensional echocardiography in the subcostal coronal view using the Simpson equation are in accordance with data derived with other more complex methods reported in the literature; average values derived with this method in larger patient groups can be used as nomograms.
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Affiliation(s)
- Selami Süleymanoğlu
- Cardiology Unit, Department of Pediatrics, Gülhane Military Medical Academy, Ankara, Turkey
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