Background: It is well-known that cigarette smoke contains chemical substances, including nicotin... more Background: It is well-known that cigarette smoke contains chemical substances, including nicotine and carbon monoxide, which can have harmful effects on cardiovascular function. Objectives: This study aimed to investigate and compare lipid levels and carotid artery intima-media thickness (CAIMT) among neonates born to smoking and nonsmoking mothers. Methods: This study was conducted on 40 term neonates (over 37 weeks of gestation) within the age range of 0 -30 days born to smoking mothers (study group) and 34 term neonates born to nonsmoking mothers (control group). Both groups were assessed prospectively for triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and CAIMT. Results: There was no difference in the mean age of mothers between control and study groups (29.0 ± 4.5 vs. 29.3 ± 5.7 years; P = 0.31). The CAIMT was observed as similar between the groups (0.35 ± 0.05 vs. 0.36 ± 0.05 mm in control and study groups, respectively; P = 0.665). Although HDL-C levels were significantly lower in the study group (48.5 ± 16.2 vs. 39.1 ± 17.8 mg/dL; P = 0.021), no difference was observed in LDL-C, TC, and TG levels between the two groups. Conclusions: Based on the results, there were no differences in CAIMT and lipid profile other than low HDL levels between term neonates born to smoking mothers and neonates born to nonsmoking mothers. Atherosclerosis is a disease in which numerous factors play a role in the formation beginning in the fetal period and emerging with clinical findings in advanced age; therefore, it is required to perform further studies with longer follow-up and larger sample size to confirm the present study findings.
The aim of this study was to perform a validity analysis of the Turkish version of the Catheteriz... more The aim of this study was to perform a validity analysis of the Turkish version of the Catheterization Risk Score for Pediatrics. The study sample consisted of 419 pediatric patients who underwent cardiac catheterization. Patient risk factors and outcomes were collected using the revised (r) Catheterization Risk Score for Pediatric score (21 points) and Catheterization Risk Score for Pediatric score-20 point (Nykanen score). The serious adverse events and non-serious adverse event complications that occurred during and after the procedure were recorded. The revised Catheterization Risk Score for Pediatrics and Catheterization Risk Score for Pediatrics score-20 points were administered by pediatric cardiologists. The content validity index was calculated based on expert opinions. Chi-square, correlation, and regression analyses were used. The mean age of the pediatric patients was 4.5 ± 4.8 years. Of the patients, 50.1% were male (n = 210) and 85% (n = 356) had acyanotic heart disease. The patients' Catheterization Risk Score for Pediatrics score-20 point and revised Catheterization Risk Score for Pediatrics score were 5.9 ± 2.5 (range, 3-16) and 4.0 ± 2.5 (range, 0-16), respectively. Serious adverse events developed in 10.7% (n = 45) of the patients and were found to be related with patient status/timing of catheterization, age, weight, respiratory status, and American Society of Anesthesiologist scores (P < .05). Significant positive correlations were found between the incidence of serious adverse events and total revised Catheterization Risk Score for Pediatrics score (21 points), total Catheterization Risk Score for Pediatrics score-20 point, and American Society of Anesthesiologist score (P < .01). The revised Catheterization Risk Score for Pediatrics score (21 points) and Catheterization Risk Score for Pediatrics score-20 point are valid tools for predicting preprocedural risk in the Turkish population.
Objective: Anthracyclines which are the main drug of chemotherapy protocols had cardiotoxicity as... more Objective: Anthracyclines which are the main drug of chemotherapy protocols had cardiotoxicity as the most frequent and well-known side effect. We aimed to evaluate prospectively the heart rate variability with 24-hour Holter electrocardiography (ECG) in children with cancer who treated with anthracycline drugs. The 24-hour Holter ECG monitoring was performed at the baseline, at time of 120 mg/m 2 and ≥240 mg/m 2 of cumulative anthracycline dose in patients with cancer who treated with anthracycline. The time-domain and frequency-domain measurements of heart rate variability (HRV) were obtained. The patients were classified into three groups as Group1:at baseline(n=54), Group 2:≥120mg/m 2 (n=54), Group 3:≥240mg/m 2 (n=54). The median age was 48 months (range 9-192 months). All types of cancer were 38 patients (70.4%) of acute leukemia, two patients (3.8%) of T lymphoblastic lymphoma, and 14patients (25.8%) of other childhood cancer who treated with anthracycline. However, all heart rate variability parameters were decreased after each increased cumulative anthracycline dose, especially time-domain parameters such as nSDNN index, rMSSD, pNN50, frequency parameters such as LF, HF, and Total power were significantly altered among Group1 and Group 3. LF/HF ratio was also statistically significantly increased in Group 3. According the heart rate parameters, the mean average heart rate, mean minimum heart rate and mean RR were statistically significantly prolonged from Group1 to Group 3. Heart rate variability parameters are a noninvasive technique to demonstrate cardiac autonomic neural dysfunction and early myocardial injury. The 24-hour Holter ECG may be used for detecting early cardiac dysautonomia effect during anthracycline treatment with each elevated 120mg/m 2 anthracycline of cumulative dose.
Background: It is well-known that cigarette smoke contains chemical substances, including nicotin... more Background: It is well-known that cigarette smoke contains chemical substances, including nicotine and carbon monoxide, which can have harmful effects on cardiovascular function. Objectives: This study aimed to investigate and compare lipid levels and carotid artery intima-media thickness (CAIMT) among neonates born to smoking and nonsmoking mothers. Methods: This study was conducted on 40 term neonates (over 37 weeks of gestation) within the age range of 0 -30 days born to smoking mothers (study group) and 34 term neonates born to nonsmoking mothers (control group). Both groups were assessed prospectively for triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and CAIMT. Results: There was no difference in the mean age of mothers between control and study groups (29.0 ± 4.5 vs. 29.3 ± 5.7 years; P = 0.31). The CAIMT was observed as similar between the groups (0.35 ± 0.05 vs. 0.36 ± 0.05 mm in control and study groups, respectively; P = 0.665). Although HDL-C levels were significantly lower in the study group (48.5 ± 16.2 vs. 39.1 ± 17.8 mg/dL; P = 0.021), no difference was observed in LDL-C, TC, and TG levels between the two groups. Conclusions: Based on the results, there were no differences in CAIMT and lipid profile other than low HDL levels between term neonates born to smoking mothers and neonates born to nonsmoking mothers. Atherosclerosis is a disease in which numerous factors play a role in the formation beginning in the fetal period and emerging with clinical findings in advanced age; therefore, it is required to perform further studies with longer follow-up and larger sample size to confirm the present study findings.
... Sitogenetik çalışmalarda Xp11 (IP1) ve Xq28 (IP2) de kırılma gösterilmiştir. NEMO (NF kappa B... more ... Sitogenetik çalışmalarda Xp11 (IP1) ve Xq28 (IP2) de kırılma gösterilmiştir. NEMO (NF kappa B Essential Modulator) gen mutasyonu da bu hastalarda gösterilmiştir (2). Klinik özelliklerin %95'i kızlarda görülür. ... KAYNAKLAR 1. Berlin AE, Paller AS, Chan LS. ...
Six patients with mitral valve stenosis underwent percutaneous balloon mitral valvuloplasty (PBMV... more Six patients with mitral valve stenosis underwent percutaneous balloon mitral valvuloplasty (PBMV) in our department between November 1992 and December 1997. Five patients had rheumatic mitral valve stenosis and one had congenital mitral valve stenosis and Eisenmenger's syndrome with patent ductus arteriosus (PDA). Functional status before PBMV was class IV in two patients, class III in two patients, and class II-III in two patients, as classified by the New York Heart Association (NYHA). The mean diastolic pressure gradient across the mitral valve measured during heart catheterization before and immediately after PBMV was 18.8 +/- 10.42 and 9.4 +/- 7.7 mmHg, respectively (p < 0.01). The patients were followed for a mean period of 36.6 +/- 8.5 months (range 12 to 72 months) after the procedure. During follow-up, post PBMV mean diastolic transmitral gradient measured by color Doppler echocardiography decreased from 19.3 +/- 11.16 to 7.43 +/- 7.3 mmHg (p < 0.01) and the mitral valve area increased from 1.09 +/- 0.7 to 3.1 +/- 0.9 cm2 (p < 0.002). Functional capacity showed improvement to NYHA class I in four patients, to class II-III in the patient with congenital mitral valve stenosis and Eisenmenger's syndrome with PDA and to class II in one patient with severe mitral valve calcification in whom restenosis occurred three years after PBMV. Percutaneous balloon mitral valvuloplasty PBMV can achieve very good short- and mid-term results in relieving symptomatic rheumatic mitral valve stenosis.
The aim of this study was to perform a validity analysis of the Turkish version of the Catheteriz... more The aim of this study was to perform a validity analysis of the Turkish version of the Catheterization Risk Score for Pediatrics. The study sample consisted of 419 pediatric patients who underwent cardiac catheterization. Patient risk factors and outcomes were collected using the revised (r) Catheterization Risk Score for Pediatric score (21 points) and Catheterization Risk Score for Pediatric score-20 point (Nykanen score). The serious adverse events and non-serious adverse event complications that occurred during and after the procedure were recorded. The revised Catheterization Risk Score for Pediatrics and Catheterization Risk Score for Pediatrics score-20 points were administered by pediatric cardiologists. The content validity index was calculated based on expert opinions. Chi-square, correlation, and regression analyses were used. The mean age of the pediatric patients was 4.5 ± 4.8 years. Of the patients, 50.1% were male (n = 210) and 85% (n = 356) had acyanotic heart disease. The patients' Catheterization Risk Score for Pediatrics score-20 point and revised Catheterization Risk Score for Pediatrics score were 5.9 ± 2.5 (range, 3-16) and 4.0 ± 2.5 (range, 0-16), respectively. Serious adverse events developed in 10.7% (n = 45) of the patients and were found to be related with patient status/timing of catheterization, age, weight, respiratory status, and American Society of Anesthesiologist scores (P < .05). Significant positive correlations were found between the incidence of serious adverse events and total revised Catheterization Risk Score for Pediatrics score (21 points), total Catheterization Risk Score for Pediatrics score-20 point, and American Society of Anesthesiologist score (P < .01). The revised Catheterization Risk Score for Pediatrics score (21 points) and Catheterization Risk Score for Pediatrics score-20 point are valid tools for predicting preprocedural risk in the Turkish population.
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Apr 8, 2013
ABSTRACT Mini‐AbstractRight coronary artery arising from the pulmonary artery is extremely rare, ... more ABSTRACT Mini‐AbstractRight coronary artery arising from the pulmonary artery is extremely rare, is generally present without symptoms in childhood. We present a 7‐year‐old girl with anomalous right coronary artery from the pulmonary artery (ARCAPA), that might easily missed in clinical practice. Anomalous origin of the right coronary artery was noted on echocardiography. Then, catheterization and computed tomography angiography confirmed the diagnosis. Transthoracic echocardiography is still important to detect children who deserve further investigation.
Objective: Anthracyclines which are the main drug of chemotherapy protocols had cardiotoxicity as... more Objective: Anthracyclines which are the main drug of chemotherapy protocols had cardiotoxicity as the most frequent and well-known side effect. We aimed to evaluate prospectively the heart rate variability with 24-hour Holter electrocardiography (ECG) in children with cancer who treated with anthracycline drugs. The 24-hour Holter ECG monitoring was performed at the baseline, at time of 120 mg/m 2 and ≥240 mg/m 2 of cumulative anthracycline dose in patients with cancer who treated with anthracycline. The time-domain and frequency-domain measurements of heart rate variability (HRV) were obtained. The patients were classified into three groups as Group1:at baseline(n=54), Group 2:≥120mg/m 2 (n=54), Group 3:≥240mg/m 2 (n=54). The median age was 48 months (range 9-192 months). All types of cancer were 38 patients (70.4%) of acute leukemia, two patients (3.8%) of T lymphoblastic lymphoma, and 14patients (25.8%) of other childhood cancer who treated with anthracycline. However, all heart rate variability parameters were decreased after each increased cumulative anthracycline dose, especially time-domain parameters such as nSDNN index, rMSSD, pNN50, frequency parameters such as LF, HF, and Total power were significantly altered among Group1 and Group 3. LF/HF ratio was also statistically significantly increased in Group 3. According the heart rate parameters, the mean average heart rate, mean minimum heart rate and mean RR were statistically significantly prolonged from Group1 to Group 3. Heart rate variability parameters are a noninvasive technique to demonstrate cardiac autonomic neural dysfunction and early myocardial injury. The 24-hour Holter ECG may be used for detecting early cardiac dysautonomia effect during anthracycline treatment with each elevated 120mg/m 2 anthracycline of cumulative dose.
... Sitogenetik çalışmalarda Xp11 (IP1) ve Xq28 (IP2) de kırılma gösterilmiştir. NEMO (NF kappa B... more ... Sitogenetik çalışmalarda Xp11 (IP1) ve Xq28 (IP2) de kırılma gösterilmiştir. NEMO (NF kappa B Essential Modulator) gen mutasyonu da bu hastalarda gösterilmiştir (2). Klinik özelliklerin %95'i kızlarda görülür. ... KAYNAKLAR 1. Berlin AE, Paller AS, Chan LS. ...
Six patients with mitral valve stenosis underwent percutaneous balloon mitral valvuloplasty (PBMV... more Six patients with mitral valve stenosis underwent percutaneous balloon mitral valvuloplasty (PBMV) in our department between November 1992 and December 1997. Five patients had rheumatic mitral valve stenosis and one had congenital mitral valve stenosis and Eisenmenger's syndrome with patent ductus arteriosus (PDA). Functional status before PBMV was class IV in two patients, class III in two patients, and class II-III in two patients, as classified by the New York Heart Association (NYHA). The mean diastolic pressure gradient across the mitral valve measured during heart catheterization before and immediately after PBMV was 18.8 +/- 10.42 and 9.4 +/- 7.7 mmHg, respectively (p < 0.01). The patients were followed for a mean period of 36.6 +/- 8.5 months (range 12 to 72 months) after the procedure. During follow-up, post PBMV mean diastolic transmitral gradient measured by color Doppler echocardiography decreased from 19.3 +/- 11.16 to 7.43 +/- 7.3 mmHg (p < 0.01) and the mitral valve area increased from 1.09 +/- 0.7 to 3.1 +/- 0.9 cm2 (p < 0.002). Functional capacity showed improvement to NYHA class I in four patients, to class II-III in the patient with congenital mitral valve stenosis and Eisenmenger's syndrome with PDA and to class II in one patient with severe mitral valve calcification in whom restenosis occurred three years after PBMV. Percutaneous balloon mitral valvuloplasty PBMV can achieve very good short- and mid-term results in relieving symptomatic rheumatic mitral valve stenosis.
Heterogeneity of ventricular repolarization has been assessed using the QT dispersion in Down syn... more Heterogeneity of ventricular repolarization has been assessed using the QT dispersion in Down syndrome (DS) patients with congenitally normal hearts. Novel repolarization indexes, that is, T-wave peak-end (Tp-e) interval and Tp-e/QT ratio, however, have not previously been evaluated in these patients. The aim of this study was therefore to evaluate the Tp-e interval and Tp-e/QT ratio in DS patients without congenital heart defects. Tp-e interval, Tp-e dispersion, and Tp-e/QT ratio were compared between 160 DS patients and 110 age- and sex-matched healthy controls on 12-lead surface electrocardiogram. Heart rate, Tp-e interval, Tp-e dispersion, Tp-e/QT and Tp-e/QTc ratios were significantly higher in the DS group than the control group. Myocardial repolarization indexes in DS patients with congenitally normal hearts were found to be prolonged compared with those in normal controls. Further evaluation is warranted to elucidate the relationship between prolonged repolarization indexes and arrhythmic events in these patients.
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Apr 8, 2013
ABSTRACT Mini‐AbstractRight coronary artery arising from the pulmonary artery is extremely rare, ... more ABSTRACT Mini‐AbstractRight coronary artery arising from the pulmonary artery is extremely rare, is generally present without symptoms in childhood. We present a 7‐year‐old girl with anomalous right coronary artery from the pulmonary artery (ARCAPA), that might easily missed in clinical practice. Anomalous origin of the right coronary artery was noted on echocardiography. Then, catheterization and computed tomography angiography confirmed the diagnosis. Transthoracic echocardiography is still important to detect children who deserve further investigation.
Çocukluk çağı lösemi tedavi protako/leri çoklu ve yüksek dozlarda kemoterapik ajanları kapsar. Bu... more Çocukluk çağı lösemi tedavi protako/leri çoklu ve yüksek dozlarda kemoterapik ajanları kapsar. Bunlar, kalp ve diğer birçok doku ve organ üzerinde önemli taksisite nedeni olduğundan hastalar tedavi sırasında ve sonrasında yan etkiler açısından izlenmektedir. QT dispersiyonundaki artışın kardiyak ölümler açısından artmış risk ile ilişkili olduğu gösterilmiştir. Bu çalışmada, halen kemoterapi alan ve tedavilerini tamamlamış remisyondaki lösemi/i çocuklarda olası kardiyak yan etkilerin "düzeltilmiş QT dispersiyonu (QTcD)" ku/lanılarak araştırılması amaçlanmıştır. Yöntem: Akut lenfobiastik lösemi/i 24 (%43.6)'ü kız, 31 (%56.4)'i erkek toplam 55 çocukta (ortalama yaş: 8.8 ± 4.2 yıl) QT dispersiyonları değerlendirildi. Hastaların ortalama izlem süresi 34.1 ± 21.0 (aralık 1-80) ay idi. Tüm hastaların kümülatif antrasiklin dozları (mglm 2 ) belirlendi. EKG çekimlerinin yapıldığı gün eşzamanlı olarak serum elektrolit ve protein düzeyleri, tiroid fonksiyon testleri kontrol edildi. QT ve QTc interva/leri için dispersiyon, her EKG'deki 12 derivasyanda maksimum ve minimum QT ve QTc interva/leri arasındaki farklılık olarak hesaplandı. Veriler SPSS 10.0 for Windows programıku/lanılarak analiz edildi. Bulgular: Tedavisi süren (n:21) ve tedavisi tamamlanmış olan (n:34) olgular arasında QTc, QTD, QTcD, tiroid fonksiyonları, elektrolitler, globülin düzeyi ve tiriod fonksiyon testleri ve kümülatif antrasiklin dozları açısından farklılık saptanmazken, sadece QT süresi ve albümin düzeyi açısından farklılık saptanmıştır (sırasıyla 0.31 ± 0.04'e karşı 0.34 ± 0.04, p: 0.009 ve 3. 7 ± 0.6'ya karşı 4.2 ±0.5, p:0.01). Kümülatif antrasiklin dozu :::;.250 mglm 2 (n:44) ve >250 mglm 2 olan olgularda (n: ll) ise e/ektrokardiyografik ölçum/erde farklılık saptanmazken sadece globülin seviyesi farklı bulunmuştur (2. 7 ± 0.5'e karşı 3.2 ± 0.9 p: 0.02). Hasta/arımızda ku/lanı/an kemoterapi protako/lerinin (ALL BFM 95 ve TRALL 2000) tedavi sırasında ve tedavi sonu ortalama üç yıl içinde belirgin kardiyotoksisiteye yol açmadığı görülmüş, hastaların daha uzun süreli izlemlerinin gerekli olduğu kanısına varılmıştır.
Background: It is well-known that cigarette smoke contains chemical substances, including nicotin... more Background: It is well-known that cigarette smoke contains chemical substances, including nicotine and carbon monoxide, which can have harmful effects on cardiovascular function. Objectives: This study aimed to investigate and compare lipid levels and carotid artery intima-media thickness (CAIMT) among neonates born to smoking and nonsmoking mothers. Methods: This study was conducted on 40 term neonates (over 37 weeks of gestation) within the age range of 0 -30 days born to smoking mothers (study group) and 34 term neonates born to nonsmoking mothers (control group). Both groups were assessed prospectively for triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and CAIMT. Results: There was no difference in the mean age of mothers between control and study groups (29.0 ± 4.5 vs. 29.3 ± 5.7 years; P = 0.31). The CAIMT was observed as similar between the groups (0.35 ± 0.05 vs. 0.36 ± 0.05 mm in control and study groups, respectively; P = 0.665). Although HDL-C levels were significantly lower in the study group (48.5 ± 16.2 vs. 39.1 ± 17.8 mg/dL; P = 0.021), no difference was observed in LDL-C, TC, and TG levels between the two groups. Conclusions: Based on the results, there were no differences in CAIMT and lipid profile other than low HDL levels between term neonates born to smoking mothers and neonates born to nonsmoking mothers. Atherosclerosis is a disease in which numerous factors play a role in the formation beginning in the fetal period and emerging with clinical findings in advanced age; therefore, it is required to perform further studies with longer follow-up and larger sample size to confirm the present study findings.
The aim of this study was to perform a validity analysis of the Turkish version of the Catheteriz... more The aim of this study was to perform a validity analysis of the Turkish version of the Catheterization Risk Score for Pediatrics. The study sample consisted of 419 pediatric patients who underwent cardiac catheterization. Patient risk factors and outcomes were collected using the revised (r) Catheterization Risk Score for Pediatric score (21 points) and Catheterization Risk Score for Pediatric score-20 point (Nykanen score). The serious adverse events and non-serious adverse event complications that occurred during and after the procedure were recorded. The revised Catheterization Risk Score for Pediatrics and Catheterization Risk Score for Pediatrics score-20 points were administered by pediatric cardiologists. The content validity index was calculated based on expert opinions. Chi-square, correlation, and regression analyses were used. The mean age of the pediatric patients was 4.5 ± 4.8 years. Of the patients, 50.1% were male (n = 210) and 85% (n = 356) had acyanotic heart disease. The patients' Catheterization Risk Score for Pediatrics score-20 point and revised Catheterization Risk Score for Pediatrics score were 5.9 ± 2.5 (range, 3-16) and 4.0 ± 2.5 (range, 0-16), respectively. Serious adverse events developed in 10.7% (n = 45) of the patients and were found to be related with patient status/timing of catheterization, age, weight, respiratory status, and American Society of Anesthesiologist scores (P < .05). Significant positive correlations were found between the incidence of serious adverse events and total revised Catheterization Risk Score for Pediatrics score (21 points), total Catheterization Risk Score for Pediatrics score-20 point, and American Society of Anesthesiologist score (P < .01). The revised Catheterization Risk Score for Pediatrics score (21 points) and Catheterization Risk Score for Pediatrics score-20 point are valid tools for predicting preprocedural risk in the Turkish population.
Objective: Anthracyclines which are the main drug of chemotherapy protocols had cardiotoxicity as... more Objective: Anthracyclines which are the main drug of chemotherapy protocols had cardiotoxicity as the most frequent and well-known side effect. We aimed to evaluate prospectively the heart rate variability with 24-hour Holter electrocardiography (ECG) in children with cancer who treated with anthracycline drugs. The 24-hour Holter ECG monitoring was performed at the baseline, at time of 120 mg/m 2 and ≥240 mg/m 2 of cumulative anthracycline dose in patients with cancer who treated with anthracycline. The time-domain and frequency-domain measurements of heart rate variability (HRV) were obtained. The patients were classified into three groups as Group1:at baseline(n=54), Group 2:≥120mg/m 2 (n=54), Group 3:≥240mg/m 2 (n=54). The median age was 48 months (range 9-192 months). All types of cancer were 38 patients (70.4%) of acute leukemia, two patients (3.8%) of T lymphoblastic lymphoma, and 14patients (25.8%) of other childhood cancer who treated with anthracycline. However, all heart rate variability parameters were decreased after each increased cumulative anthracycline dose, especially time-domain parameters such as nSDNN index, rMSSD, pNN50, frequency parameters such as LF, HF, and Total power were significantly altered among Group1 and Group 3. LF/HF ratio was also statistically significantly increased in Group 3. According the heart rate parameters, the mean average heart rate, mean minimum heart rate and mean RR were statistically significantly prolonged from Group1 to Group 3. Heart rate variability parameters are a noninvasive technique to demonstrate cardiac autonomic neural dysfunction and early myocardial injury. The 24-hour Holter ECG may be used for detecting early cardiac dysautonomia effect during anthracycline treatment with each elevated 120mg/m 2 anthracycline of cumulative dose.
Background: It is well-known that cigarette smoke contains chemical substances, including nicotin... more Background: It is well-known that cigarette smoke contains chemical substances, including nicotine and carbon monoxide, which can have harmful effects on cardiovascular function. Objectives: This study aimed to investigate and compare lipid levels and carotid artery intima-media thickness (CAIMT) among neonates born to smoking and nonsmoking mothers. Methods: This study was conducted on 40 term neonates (over 37 weeks of gestation) within the age range of 0 -30 days born to smoking mothers (study group) and 34 term neonates born to nonsmoking mothers (control group). Both groups were assessed prospectively for triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and CAIMT. Results: There was no difference in the mean age of mothers between control and study groups (29.0 ± 4.5 vs. 29.3 ± 5.7 years; P = 0.31). The CAIMT was observed as similar between the groups (0.35 ± 0.05 vs. 0.36 ± 0.05 mm in control and study groups, respectively; P = 0.665). Although HDL-C levels were significantly lower in the study group (48.5 ± 16.2 vs. 39.1 ± 17.8 mg/dL; P = 0.021), no difference was observed in LDL-C, TC, and TG levels between the two groups. Conclusions: Based on the results, there were no differences in CAIMT and lipid profile other than low HDL levels between term neonates born to smoking mothers and neonates born to nonsmoking mothers. Atherosclerosis is a disease in which numerous factors play a role in the formation beginning in the fetal period and emerging with clinical findings in advanced age; therefore, it is required to perform further studies with longer follow-up and larger sample size to confirm the present study findings.
... Sitogenetik çalışmalarda Xp11 (IP1) ve Xq28 (IP2) de kırılma gösterilmiştir. NEMO (NF kappa B... more ... Sitogenetik çalışmalarda Xp11 (IP1) ve Xq28 (IP2) de kırılma gösterilmiştir. NEMO (NF kappa B Essential Modulator) gen mutasyonu da bu hastalarda gösterilmiştir (2). Klinik özelliklerin %95'i kızlarda görülür. ... KAYNAKLAR 1. Berlin AE, Paller AS, Chan LS. ...
Six patients with mitral valve stenosis underwent percutaneous balloon mitral valvuloplasty (PBMV... more Six patients with mitral valve stenosis underwent percutaneous balloon mitral valvuloplasty (PBMV) in our department between November 1992 and December 1997. Five patients had rheumatic mitral valve stenosis and one had congenital mitral valve stenosis and Eisenmenger's syndrome with patent ductus arteriosus (PDA). Functional status before PBMV was class IV in two patients, class III in two patients, and class II-III in two patients, as classified by the New York Heart Association (NYHA). The mean diastolic pressure gradient across the mitral valve measured during heart catheterization before and immediately after PBMV was 18.8 +/- 10.42 and 9.4 +/- 7.7 mmHg, respectively (p < 0.01). The patients were followed for a mean period of 36.6 +/- 8.5 months (range 12 to 72 months) after the procedure. During follow-up, post PBMV mean diastolic transmitral gradient measured by color Doppler echocardiography decreased from 19.3 +/- 11.16 to 7.43 +/- 7.3 mmHg (p < 0.01) and the mitral valve area increased from 1.09 +/- 0.7 to 3.1 +/- 0.9 cm2 (p < 0.002). Functional capacity showed improvement to NYHA class I in four patients, to class II-III in the patient with congenital mitral valve stenosis and Eisenmenger's syndrome with PDA and to class II in one patient with severe mitral valve calcification in whom restenosis occurred three years after PBMV. Percutaneous balloon mitral valvuloplasty PBMV can achieve very good short- and mid-term results in relieving symptomatic rheumatic mitral valve stenosis.
The aim of this study was to perform a validity analysis of the Turkish version of the Catheteriz... more The aim of this study was to perform a validity analysis of the Turkish version of the Catheterization Risk Score for Pediatrics. The study sample consisted of 419 pediatric patients who underwent cardiac catheterization. Patient risk factors and outcomes were collected using the revised (r) Catheterization Risk Score for Pediatric score (21 points) and Catheterization Risk Score for Pediatric score-20 point (Nykanen score). The serious adverse events and non-serious adverse event complications that occurred during and after the procedure were recorded. The revised Catheterization Risk Score for Pediatrics and Catheterization Risk Score for Pediatrics score-20 points were administered by pediatric cardiologists. The content validity index was calculated based on expert opinions. Chi-square, correlation, and regression analyses were used. The mean age of the pediatric patients was 4.5 ± 4.8 years. Of the patients, 50.1% were male (n = 210) and 85% (n = 356) had acyanotic heart disease. The patients' Catheterization Risk Score for Pediatrics score-20 point and revised Catheterization Risk Score for Pediatrics score were 5.9 ± 2.5 (range, 3-16) and 4.0 ± 2.5 (range, 0-16), respectively. Serious adverse events developed in 10.7% (n = 45) of the patients and were found to be related with patient status/timing of catheterization, age, weight, respiratory status, and American Society of Anesthesiologist scores (P < .05). Significant positive correlations were found between the incidence of serious adverse events and total revised Catheterization Risk Score for Pediatrics score (21 points), total Catheterization Risk Score for Pediatrics score-20 point, and American Society of Anesthesiologist score (P < .01). The revised Catheterization Risk Score for Pediatrics score (21 points) and Catheterization Risk Score for Pediatrics score-20 point are valid tools for predicting preprocedural risk in the Turkish population.
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Apr 8, 2013
ABSTRACT Mini‐AbstractRight coronary artery arising from the pulmonary artery is extremely rare, ... more ABSTRACT Mini‐AbstractRight coronary artery arising from the pulmonary artery is extremely rare, is generally present without symptoms in childhood. We present a 7‐year‐old girl with anomalous right coronary artery from the pulmonary artery (ARCAPA), that might easily missed in clinical practice. Anomalous origin of the right coronary artery was noted on echocardiography. Then, catheterization and computed tomography angiography confirmed the diagnosis. Transthoracic echocardiography is still important to detect children who deserve further investigation.
Objective: Anthracyclines which are the main drug of chemotherapy protocols had cardiotoxicity as... more Objective: Anthracyclines which are the main drug of chemotherapy protocols had cardiotoxicity as the most frequent and well-known side effect. We aimed to evaluate prospectively the heart rate variability with 24-hour Holter electrocardiography (ECG) in children with cancer who treated with anthracycline drugs. The 24-hour Holter ECG monitoring was performed at the baseline, at time of 120 mg/m 2 and ≥240 mg/m 2 of cumulative anthracycline dose in patients with cancer who treated with anthracycline. The time-domain and frequency-domain measurements of heart rate variability (HRV) were obtained. The patients were classified into three groups as Group1:at baseline(n=54), Group 2:≥120mg/m 2 (n=54), Group 3:≥240mg/m 2 (n=54). The median age was 48 months (range 9-192 months). All types of cancer were 38 patients (70.4%) of acute leukemia, two patients (3.8%) of T lymphoblastic lymphoma, and 14patients (25.8%) of other childhood cancer who treated with anthracycline. However, all heart rate variability parameters were decreased after each increased cumulative anthracycline dose, especially time-domain parameters such as nSDNN index, rMSSD, pNN50, frequency parameters such as LF, HF, and Total power were significantly altered among Group1 and Group 3. LF/HF ratio was also statistically significantly increased in Group 3. According the heart rate parameters, the mean average heart rate, mean minimum heart rate and mean RR were statistically significantly prolonged from Group1 to Group 3. Heart rate variability parameters are a noninvasive technique to demonstrate cardiac autonomic neural dysfunction and early myocardial injury. The 24-hour Holter ECG may be used for detecting early cardiac dysautonomia effect during anthracycline treatment with each elevated 120mg/m 2 anthracycline of cumulative dose.
... Sitogenetik çalışmalarda Xp11 (IP1) ve Xq28 (IP2) de kırılma gösterilmiştir. NEMO (NF kappa B... more ... Sitogenetik çalışmalarda Xp11 (IP1) ve Xq28 (IP2) de kırılma gösterilmiştir. NEMO (NF kappa B Essential Modulator) gen mutasyonu da bu hastalarda gösterilmiştir (2). Klinik özelliklerin %95'i kızlarda görülür. ... KAYNAKLAR 1. Berlin AE, Paller AS, Chan LS. ...
Six patients with mitral valve stenosis underwent percutaneous balloon mitral valvuloplasty (PBMV... more Six patients with mitral valve stenosis underwent percutaneous balloon mitral valvuloplasty (PBMV) in our department between November 1992 and December 1997. Five patients had rheumatic mitral valve stenosis and one had congenital mitral valve stenosis and Eisenmenger's syndrome with patent ductus arteriosus (PDA). Functional status before PBMV was class IV in two patients, class III in two patients, and class II-III in two patients, as classified by the New York Heart Association (NYHA). The mean diastolic pressure gradient across the mitral valve measured during heart catheterization before and immediately after PBMV was 18.8 +/- 10.42 and 9.4 +/- 7.7 mmHg, respectively (p < 0.01). The patients were followed for a mean period of 36.6 +/- 8.5 months (range 12 to 72 months) after the procedure. During follow-up, post PBMV mean diastolic transmitral gradient measured by color Doppler echocardiography decreased from 19.3 +/- 11.16 to 7.43 +/- 7.3 mmHg (p < 0.01) and the mitral valve area increased from 1.09 +/- 0.7 to 3.1 +/- 0.9 cm2 (p < 0.002). Functional capacity showed improvement to NYHA class I in four patients, to class II-III in the patient with congenital mitral valve stenosis and Eisenmenger's syndrome with PDA and to class II in one patient with severe mitral valve calcification in whom restenosis occurred three years after PBMV. Percutaneous balloon mitral valvuloplasty PBMV can achieve very good short- and mid-term results in relieving symptomatic rheumatic mitral valve stenosis.
Heterogeneity of ventricular repolarization has been assessed using the QT dispersion in Down syn... more Heterogeneity of ventricular repolarization has been assessed using the QT dispersion in Down syndrome (DS) patients with congenitally normal hearts. Novel repolarization indexes, that is, T-wave peak-end (Tp-e) interval and Tp-e/QT ratio, however, have not previously been evaluated in these patients. The aim of this study was therefore to evaluate the Tp-e interval and Tp-e/QT ratio in DS patients without congenital heart defects. Tp-e interval, Tp-e dispersion, and Tp-e/QT ratio were compared between 160 DS patients and 110 age- and sex-matched healthy controls on 12-lead surface electrocardiogram. Heart rate, Tp-e interval, Tp-e dispersion, Tp-e/QT and Tp-e/QTc ratios were significantly higher in the DS group than the control group. Myocardial repolarization indexes in DS patients with congenitally normal hearts were found to be prolonged compared with those in normal controls. Further evaluation is warranted to elucidate the relationship between prolonged repolarization indexes and arrhythmic events in these patients.
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Apr 8, 2013
ABSTRACT Mini‐AbstractRight coronary artery arising from the pulmonary artery is extremely rare, ... more ABSTRACT Mini‐AbstractRight coronary artery arising from the pulmonary artery is extremely rare, is generally present without symptoms in childhood. We present a 7‐year‐old girl with anomalous right coronary artery from the pulmonary artery (ARCAPA), that might easily missed in clinical practice. Anomalous origin of the right coronary artery was noted on echocardiography. Then, catheterization and computed tomography angiography confirmed the diagnosis. Transthoracic echocardiography is still important to detect children who deserve further investigation.
Çocukluk çağı lösemi tedavi protako/leri çoklu ve yüksek dozlarda kemoterapik ajanları kapsar. Bu... more Çocukluk çağı lösemi tedavi protako/leri çoklu ve yüksek dozlarda kemoterapik ajanları kapsar. Bunlar, kalp ve diğer birçok doku ve organ üzerinde önemli taksisite nedeni olduğundan hastalar tedavi sırasında ve sonrasında yan etkiler açısından izlenmektedir. QT dispersiyonundaki artışın kardiyak ölümler açısından artmış risk ile ilişkili olduğu gösterilmiştir. Bu çalışmada, halen kemoterapi alan ve tedavilerini tamamlamış remisyondaki lösemi/i çocuklarda olası kardiyak yan etkilerin "düzeltilmiş QT dispersiyonu (QTcD)" ku/lanılarak araştırılması amaçlanmıştır. Yöntem: Akut lenfobiastik lösemi/i 24 (%43.6)'ü kız, 31 (%56.4)'i erkek toplam 55 çocukta (ortalama yaş: 8.8 ± 4.2 yıl) QT dispersiyonları değerlendirildi. Hastaların ortalama izlem süresi 34.1 ± 21.0 (aralık 1-80) ay idi. Tüm hastaların kümülatif antrasiklin dozları (mglm 2 ) belirlendi. EKG çekimlerinin yapıldığı gün eşzamanlı olarak serum elektrolit ve protein düzeyleri, tiroid fonksiyon testleri kontrol edildi. QT ve QTc interva/leri için dispersiyon, her EKG'deki 12 derivasyanda maksimum ve minimum QT ve QTc interva/leri arasındaki farklılık olarak hesaplandı. Veriler SPSS 10.0 for Windows programıku/lanılarak analiz edildi. Bulgular: Tedavisi süren (n:21) ve tedavisi tamamlanmış olan (n:34) olgular arasında QTc, QTD, QTcD, tiroid fonksiyonları, elektrolitler, globülin düzeyi ve tiriod fonksiyon testleri ve kümülatif antrasiklin dozları açısından farklılık saptanmazken, sadece QT süresi ve albümin düzeyi açısından farklılık saptanmıştır (sırasıyla 0.31 ± 0.04'e karşı 0.34 ± 0.04, p: 0.009 ve 3. 7 ± 0.6'ya karşı 4.2 ±0.5, p:0.01). Kümülatif antrasiklin dozu :::;.250 mglm 2 (n:44) ve >250 mglm 2 olan olgularda (n: ll) ise e/ektrokardiyografik ölçum/erde farklılık saptanmazken sadece globülin seviyesi farklı bulunmuştur (2. 7 ± 0.5'e karşı 3.2 ± 0.9 p: 0.02). Hasta/arımızda ku/lanı/an kemoterapi protako/lerinin (ALL BFM 95 ve TRALL 2000) tedavi sırasında ve tedavi sonu ortalama üç yıl içinde belirgin kardiyotoksisiteye yol açmadığı görülmüş, hastaların daha uzun süreli izlemlerinin gerekli olduğu kanısına varılmıştır.
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