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Öğe Adölesan obezlerde kan lipid profilinin karotis intima media kalınlığına etkisi(Dicle Üniversitesi Tıp Fakültesi, 2022) Tekin, Suat; Pirinççioğlu, Ayfer Gözü; Ünal, Edip; Akın, Alper; Türe, MehmetGiriş: Çocukluk ve adölesan dönem obezitesi erişkin dönem obezite riskini arttırmaktadır. Bu da aterosklerotik hastalık riski oluşturmaktadır. Karotis intima media kalınlığı (KIMK) ölçümleri erken, preklinik aterosklerozun tespiti için kullanılan yeni belirteçlerdendir. Son çalışmalar, ailesel hiperkolesterolemi ve ciddi obezitesi olan çocuklarda KIMK’nın artmış olduğunu göstermektedir. Amaç: Bu çalışmamızın amacı obezitesi olan adölesanlarda kan lipid profili ve KIMK arasındaki ilişkinin incelenmesi ve KIMK’nın preklinik ateroskleroz belirteci olarak kullanılabilirliğini değerlendirmektir. Yöntemler: Çalışmaya yaşları 10-20 arasında değişen ve vücut kitle indeksi (VKİ) yaşa ve cinse göre 95. persentilin üzerinde olan 108 obez hasta çalışma grubu, VKİ 85. persentilin altında olan 101 sağlıklı birey kontrol grubu olarak alındı. Çalışma grubundan en az 12 saatlik açlık sonrası kan glikozu, lipid profili (trigliserit, LDL, VLDL, HDL, total kolesterol) tespiti için kan örneği alındı. Çalışmaya alınan hastaların KIMK değerleri ekokardiyografi cihazı ile ölçüldü. Bulgular: Kontrol grubu ile kıyaslandığında çalışma grubunda KIMK ve VKİ daha yüksek tespit edildi. Gruplar kan lipid profili yönünden kıyaslandığında trigliserit, LDL ve total kolesterol düzeyleri obez grupta daha yüksek, HDL düzeyi daha düşük tespit edildi. Obez grupta kan lipid profili ile KIMK arasında istatiksel olarak anlamlı bir ilişki saptanmadı. Sonuç: Çalışmamızda adölesan obezlerde KIMK normal popülasyona göre artmış saptandı. Ancak lipid profili ile KIMK arasında herhangi bir ilişki saptanmadı. Bu nedenle obez adölesanlarda aterosklerozun erken belirlenmesi ve buna yönelik tedbirlerin alınması açısından kan lipid profili normal olsa bile KIMK ölçümünü önermekteyiz.Öğe Cardiac Evaluation of Children Presenting with Trauma(2024) Yaman, Mahmut; Türe, Mehmet; Akın, Alper; Uç, Duygu; Sürücü, Mehmet; Şen, Abdullah; Güloğlu, CahferBackground: Trauma is a critical public health issue, particularly impacting the young and caus-ing significant financial and moral losses. Approximately one-third of trauma-related hospitaliza-tions and 20-25% of trauma-related deaths are caused by serious chest injuries. We aimed to determine the prognostic value of changing pediatric global troponin levels in the emergency department after trauma. Materials and Methods: Patients who applied to the emergency department with complaints of trauma between January 1, 2015 and January 31, 2022 were evaluated. Records of pediatric patients between the ages of 0 and 18 were reviewed. The cause and severity of the trauma, electrocardiography and echocardiography results, and laboratory data (biochemical, hemogram, C-reactive protein, pro-BNP, CK-MB, troponin, etc.) of the patients were evaluated. This study is an observational and retrospective. Results: Falling from height was the most prevalent cause of injury, accounting for 43% of cases. Chest trauma was observed in 55 patients (56%). All patients with chest trauma exhibited ele-vated troponin levels. Troponin levels were found to be significantly higher in patients with chest trauma (p=0.011). Conclusions: Our findings highlighted the prognostic importance of cardiac troponins, especially in pediatric patients presenting with trauma.Öğe Çarpıntı şikayeti ile başvuran çocukların elektrokardiyografi ve 24 Saatlik holterElektrokardiyografi verilerinin incelenmesi(Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi, 2021) Türe, Mehmet; Akın, AlperGiriş: Çarpıntı; ritm bozukluğu saptanan hastaların en sık ve en önemli semptomudur. Ritm bozuklukları sadece elektrokardiyografi ile saptanamayabilir Amaç: Çalışmamızın amacı çarpıntı şikayeti ile başvuran çocukların elektrokardiyografi ve 24 saatlik Holter elektrokardiyografi monitörizasyonu sonuçlarını değerlendirip ritim bozukluklarını ve sıklığını saptamak, Holterin tanı ve tedavideki yerini vurgulamaktır. Gereç ve Yöntem: Hastanemize çarpıntı şikayeti ile başvuran 320 çocuğun yüzeyel elektrokardiyografi, 24 saatlik Holter monitörizasyonu ve ekokardiyografi verileri değerlendirildi. Bulgular: Holter monitörizasyonu ile değerlendirilen hastaların 163’ü kız (%50,9) iken, 157’si erkek (%49,1) idi. Hastaların 246’sında (%76,9) izole çarpıntı, 55’inde (%17,2) çarpıntı ve göğüs ağrısı, 18’inde (%5,6) çarpıntı ve senkop, birinde ise (%0,3) çarpıntı ve nefes darlığı şikayeti vardı. Elli hastada (%15,6) elektrokardiyografide, 182 hastada (%56,8) Holterde aritmi saptandı. Holterde en sık saptanan aritmiler; 63 hastada supraventriküler ekstrasistol (% 19,7) ve 58 hastada ventriküler ekstrasistol (%18,2) idi. Hastaların 63’ünde ciddi aritmi saptandı. İzole çarpıntı ile gelen hastalardaki ciddi aritmi oranı diğer gruplara göre istatistiksel olarak anlamlı şekilde yüksek saptandı . Sonuç: Elektrokardiyografisi normal olan çocuk hastaların Holterlerinde aritmi saptanması sadece elektrokardiyografi ile hastaların aritmilerinin atlanabileceğini göstermektedir. İzole çarpıntı ile başvuran hastalarda çarpıntı ile beraber başka şikayetleri olan hastalara göre ciddi aritmilerin daha fazla olması izole çarpıntı ile gelen hastalara aritmi açısından dahadikkatli olmamız gerektiğini gösteriyor olabilir. Ancak bunu desteklemek için daha fazla çalışmaya ihtiyaç olduğunu düşünüyoruz.Öğe Çocuk kardiyoloji polikliniğine göğüs ağrısı şikayeti ile başvuran hastaların etyolojik değerlendirilmesi(Dicle Üniversitesi Tıp Fakültesi, 2019) Çiçek, Pınar; Akın, Alper; Bilici, Meki; Türe, Mehmet; Balık, Hasan; Yılmaz, KamilAmaç: Göğüs ağrısı, çocuk kardiyoloji polikliniklerine sık başvuru semptomlarındandır. Hastaların önemli bir bölümünde iyi bir anamnez ve fizik muayene ile etyoloji aydınlatılabilir. Hayatı tehdit eden göğüs ağrısı nedenlerinin sıklığı azdır. Bu çalışmada çocuklarda göğüs ağrısı nedenleri araştırılmış ve ayırıcı tanıda göz önünde bulundurulması gereken patolojilere dikkat çekilmiştir. Yöntemler: Çalışmaya Çocuk Kardiyoloji Polikliniğine 1 Ekim 2017- 1 Aralık 2017 tarihleri arasında göğüs ağrısı şikayeti ile başvuran 134 hasta alındı. Hastaların dosya kayıtlarından ayrıntılı anamnezleri ve detaylı fizik muayane kayıtları incelendi ve etyolojiye yönelik incelemeler değerlendirildi. Bulgular: Hastaların yaşı 12,7±3,2 yıl (5-18 yaş) olup 78‘i (%58,2) erkekti. Göğüs ağrısı yakınmasının süresi ortalama 5,5 ay (1 gün-4 yıl), atakların süresi 1 saniye ile 3 saat arasında değişmekteydi. Hastaların %29’unda idiyopatik nedenli göğüs ağrısı düşünüldü. Göğüs ağrısının diğer nedenleri sırasıyla şunlardı: Kas-iskelet sistemi kaynaklı (%26), psikojenik (%12,6), sindirim sistemi patolojileri (%8,9), astım bronşiyale (%6,7), üst solunum yolu enfeksiyonu (%5,9), mitral kapak prolapsusu (%3,7), miyokardit (%2,2), ailevi akdeniz ateşi (%1,4) ve birer hastada nefrolityazis, göğüs travması, perikardit, göğüs deformitesi saptandı. Sonuç: Göğüs ağrısı adolesan dönemde daha fazla görülür. Göğüs ağrısını değerlendirirken anamnez ve fizik muayeneye önem verilmeli ve organik neden düşünülen hastalarda ileri incelemeler yapılmalıdır. Kardiyak kaynaklı göğüs ağrısı sıklığı azdır ve kardiyak patoloji düşünülen hastalarda çocuk kardiyoloji uzmanına danışılmalıdır.Öğe Common arterial trunk, interrupted aortic arch, and crossing pulmonary artery coexistence: Case report of a rare anomaly(Aves Yayıncılık, 2022) Türe, Mehmet; Öncel, Güray; Tanıdır, İbrahim Cansaran; Tüzün, BehzatTruncus arteriosus (common arterial trunk) is characterized by a single great artery that arises from the heart, and this single artery supplies the systemic, coronary, and pulmonary circulations. According to the van Praagh classification, truncus arteriosus can be divided into 4 types: type A-1, type A-2, type A-3, and type A-4. In type A-4, the aortic arch is hypoplastic or interrupted, there is a large patent ductus arteriosus (PDA), 1 and 1 or both branches of the pulmonary artery may have intrinsic stenosis, hypoplasia, or both.2 In order to prevent pulmonary vascular disease, surgeries should be performed in the first month.3 Therefore, early surgical repair is very important for the control of pulmonary hypertensive disease.Öğe Complete atrioventricular block associated with clozapine intoxication: case report(Turkish Journal of Pediatrics, 2019) Türe, Mehmet; Bilici, Meki; Akın, Alper; Demir, Fikri; Balık, Hasan; Darakçı, Savaş MertClozapine is one of the atypical anti-psychotic drugs used in the treatment of resistant schizophrenia. Although cardiac side-effects are rare, it has been reported that there may be development of myocarditis, dilated cardiomyopathy, postural orthostatic hypotension and prolonged QT duration. Complete atrioventricular (AV) block is characterized by the inability to transmit all of the atrial signal to the ventricles. Causes may be congenital, idiopathic or acquired which are associated with surgery, infection, or muscle disease. AV block is extremely serious and permanent pacemaker insertion is usually necessary for all patients. Complete AV block may develop due to clozapine intoxication through increase in vagal tonus, sinoatrial node (SN) and the inhibition of atrioventricular node signalling. The case presented here is of a 15-year old female patient who developed AV total cardiac block associated with the taking of clozapine in a suicide attempt.Öğe Cytomegalovirus myocarditis with rapid response to intravenous immunoglobulin therapy(Fatih BAŞAK, 2018) Türe, Mehmet; Balık, Hasan; Bilici, Meki; Akın, Alper; Darakci, Savaş Mert; Yanmaz, Sercan YücelMyocarditis is an inflammatory disease of the heart muscle. Most cases are caused by viral agents such as enteroviruses and adenoviruses. Cytomegalovirus is one of the more rare causes of viral myocarditis. In this article, case is reported of viral myocarditis diagnosed due to Cytomegalovirus infection and which then responded very rapidly to intravenous immunoglobulin treatment. This case report can be considered to contribute to literature as there are not enough data about intravenous immunoglobulin treatment results in Cytomegalovirus myocarditis.Öğe Does subclinical hypothyroidism affect lipid and epicardial fat tissue thickness in children?(Medcom, 2021) Ünal, Edip; Akın, Alper; Yıldırım, Ruken; Türe, Mehmet; Balık, Hasan; Taş, Funda Feryal; Pirinççioğlu, Ayfer Gözü; Haspolat, Yusuf KenanObjective: The aim of this study was to measure serum lipid levels and epicardial adipose tissue thickness in patients determined with subclinical hypothyroidism. Methods: The study included 61 paediatric patients with a diagnosis of subclinical hypothyroidism and a control group of 61 healthy children. The thyroid hormone levels, lipid parameters and epicardial adipose tissue thickness were examined in all the patients. Results: The mean epicardial adipose tissue thickness of the subclinical hypothyroidism patients was higher than that of the control group but not at a level of statistical significance (4.15±0.91 vs 4.06±0.99, p=0.598). The mean high-density lipoprotein cholesterol level of the subclinical hypothyroidism group was statistically lower than that of the control group (p=0.040). Conclusion: The results of this study showed a significant decrease in the high-density lipoprotein cholesterol levels of children with subclinical hypothyroidism. No significant increase was seen in the epicardial adipose tissue thickness of the children with subclinical hypothyroidism. This is the first study to have examined epicardial adipose tissue thickness in children with subclinical hypothyroidism.Öğe Electrocardiographic ventricular repolarization variables in children diagnosed with COVID-19(Aves, 2021) Akın, Alper; Şen, Velat; Yılmaz, Kamil; Aktar, Fesih; Türe, Mehmet; Mermutluoğlu, Çiğdem; Pirinççioğlu, Ayfer GözüCoronavirus disease 2019 (COVID-19) originated in China in 2019, and it quickly became a global pandemic within months, continues to be an important health problem. The outbreak was first encountered in our country in March 2020 and rapidly spread to thousands of people.1 Although children as well as adults can become infected; it has been reported that children are less symptomatic or develop less severe symptoms.2 However, most studies on the subject cover patients in the adult age groupÖğe Evaluation of children with acute rheumatic fever: A single-center experience(Turkish Pediatric Association, 2022) Güneş, Ahmet; Gül, Özlem; Akın, Alper; Türe, Mehmet; Balık, Hasan; Bilici, MekiObjective: The epidemiological characteristics, risk factors, complications, recurrence status, clinical and laboratory features, and treatment methods of the patients who admitted to our Pediatric Cardiology Outpatient Clinic with a pre-diagnosis of acute rheumatic fever (ARF) were evaluated. Materials and Methods: The data of 166 patients who admitted with a pre-diagnosis of ARF and were diagnosed with ARF, and the data of 51 patients who were not diagnosed with ARF, were retrospectively analyzed. Results: The patients with ARF were between the ages of 5 and 18. Most of the patients with ARF attack admitted in December (15.6%), January (13.8%), and February (13.2%). The most common complaints of the patients diagnosed with ARF were isolated joint pain and/or swelling, at 50.6%. While 91.5% of the patients were diagnosed for the first time, 8.5% had ARF recurrence. It was seen that the most common major criterion was carditis (94.6%). The severity of valve regurgitation and the rates of monoarthritis were significantly higher in patients with recurrence (P < .05). Non-compliance with prophylaxis was observed in 10 (71.4%) of 14 patients with recurrence, and in 43 (28.2%) of 152 patients without recurrence. Anti-streptolysin O was lower (P = .021) and alanine transaminase (ALT) was higher (P = .019) in the recurrence group. Conclusion: Our study showed that in patients with a pre-diagnosis of ARF, a differential diagnosis should be made with other diseases. Especially in patients with joint complaints as the only major symptom, a differential diagnosis should be made. ARF recurrence is associated with non-compliance with prophylaxis, and both the severity of valve regurgitation and monoarthritis rates are higher in patients who develop recurrence. Alanine aminotransferase is significantly higher in patients with ARF recurrence.Öğe Evaluation of QT dispersion and Tp-e interval in children with subclinical hypothyroidism(Wiley, 2018) Akın, Alper; Ünal, Edip; Yıldırım, Ruken; Türe, Mehmet; Balık, Hasan; Haspolat, Yusuf KenanBackground: Studies on adults have shown increased dispersion of QT and corrected QT (QTc), peak-to-end interval of the T wave (Tp-e), Tp-e/QT ratio, and Tp-e/QTc ratio in subclinical hypothyroidism (SH), but there have been no pediatric studies. Materials and methods: A total of 40 SH patients were compared with 40 healthy children in respect to serum thyroid-stimulating hormone (TSH), serum-free level of triiodothyronine, and free level of thyroxine (fT4). SH diagnosis was accepted as TSH above the laboratory accepted upper limit (>4.2 mU/L) and normal fT4 values. The patient and control group data were compared by calculating the QT interval, QTc, QT dispersion (QTd), QTc dispersion (QTcd), Tp-e, Tp-e/QT ratio, and Tp-e/QTc ratio on 12-lead surface electrocardiogram. Results: The mean age was 7.91 ± 3.6 years in the SH group and 8.8 ± 2.4 years in the control group. In the SH group, the minimum QT (QTmin) was determined to be statistically significantly lower (P < 0.001) and maximum QT (QTmax), QTd, QTcd, Tp-e, Tp-e/QT ratio, and Tp-e/QTc ratio were statistically significantly higher (P = 0.028, P < 0.001, P = 0.003, P < 0.001, P = 0.001, P < 0.001, respectively). A positive correlation was determined between TSH and QTmax (r: +0.331, P = 0.037). Conclusions: The current study is the first to have shown significantly increased QTd, QTcd, Tp-e, Tp-e/QT ratio, and Tp-e/QTc ratio in children diagnosed with SH. A positive correlation was determined between TSH and maximum QT values, Tp-e, Tp-e/QT ratio, and Tp-e/QTc ratio. These results suggest the need to further assess the long-term risks of prolonged QT dispersion in the setting of subclinical hypothyroidism.Öğe Factors affecting mortality in children with dilated cardiomyopathy(Turkish Journal of Pediatrics, 2019) Sabaz, Muhammed Nurullah; Akın, Alper; Bilici, Meki; Demir, Fikri; Türe, Mehmet; Balık, HasanDilated cardiomyopathy (DCMP) is a heart disease with high mortality rates that is often seen in children. Genetic and infectious reasons are primary in the etiology. The aim of this study was to investigate the etiology of DCMP and the parameters predicting mortality. A retrospective examination was made of 37 patients diagnosed with DCMP between January 2012 and October 2016. Data were recorded from the patient files of age, gender, complaints on presentation, findings of the physical examination, laboratory test results, echocardiography and electrocardiography findings at the time of diagnosis. These parameters were then compared between the surviving and non-surviving patients. The patients comprised 21 males with a mean age of 27.50±50 months. Diagnosis was made at the age of <12 months in 67.6% patients. Within mean 8 months of diagnosis, 16.2% of the patients were lost to mortality and 83.8% of the patients survived. In 83.3% of the non-surviving patients and in 29% of the surviving patients, sinus tachycardia was present at the time of diagnosis (p=0.023). Corrected QT (QTc) at the time of diagnosis was longer in the non-surviving patients (p=0.007). On ECG, the rate of ST-T wave change was higher in the non-surviving patients (80% vs. 17.8%, p=0.012). In conclusion, a significant proportion of the patients were diagnosed below the age of one year. In the non-surviving patients, as sinus tachycardia and ischaemic changes on ECG were seen more often and the QTc was longer, these findings could be considered to be predictors of mortality.Öğe Hipoksik iskemik ensefalopatide N-terminal pro brain natriüretikpeptid ve troponin I düzeylerinin önemi(Dicle Üniversitesi Tıp Fakültesi, 2021) Değer, İbrahim; Ertuğrul, Sabahattin; Yılmaz, Sibel Tanrıverdi; Türe, MehmetAmaç: Hipoksikiskemikensefalopati (HİE), perinatal dönemde hipoksiye bağlı olarak görülen ağır morbidite ve mortalite ile sonuçlanabilen klinik bir durumdur. Bu çalışmanın amacı, hipoksik iskemik ensefalopatide kardiyak biyomarkerlerden N-Terminal pro Brain Natriüretik Peptid (NTproBNP) ve Troponin I’nın rolünü değerlendirmektir. Yöntemler: Bu çalışmada, Ocak 2019 ve Mayıs 2021 tarihleri arasında Yenidoğan Yoğun Bakım Ünitesinde HİE tanısı ile takip ve tedavileri yapılmış olan hastaların Troponin I ve NTproBNP düzeyleri geriye dönük olarak incelendi. Bulgular: Bu çalışma %44,5 (45)’i kız ve %55.5(56)’sı erkek olmak üzere 101 olgudan oluştu. Normal spontan vajinal yol ile doğum oranı %57,8 (63) iken Sezaryenle doğum oranı %42,2 (46) idi. Olgularda HİE evre 1 oranı %31.7 (32), HİE evre2 oranı %31,7 (32) ve HİE evre 3 oranı%36,6 (37) olarak bulundu. Ortalama doğum ağırlığı 3139.95±499.02 g, ortalama gestasyon haftası 38.39±1.69 hafta bulundu. NTproBNP; ortalama 10099.49±12023.03 pg/mL ve Troponin I; 122.575±188.5287 ng/L bulundu. Hipoksik iskemik ensefalopatinin şiddetinin artması ile Troponin I arasında istatistiksel olarak anlamlı bir fark bulunurken, NTproBNP ile HİE’nin şiddeti arasında herhangi bir farklılık bulunmadı. Sonuç: Yenidoğan HİE’li bebeklerde NTproBNP ve Troponin I düzeylerinde artış vardır. Ayrıca, Troponin I düzeyleri ile yenidoğan hipoksik iskemik ensefalopati şiddeti arasında anlamlı ilişki olduğu bulundu.Öğe Left and right ventricular functions may be impaired in children diagnosed with subclinical hypothyroidism(Nature Research, 2020) Akın, Alper; Ünal, Edip; Yıldırım, Ruken; Türe, Mehmet; Balık, Hasan; Haspolat, Yusuf KenanSubclinical hypothyroidism (SH) may infuence both ventricular functions. The aim of this study was to evaluation the fndings of Tissue Doppler Imaging (TDI) and other echocardiography modalities in children with SH. We compared left ventricular mass index (LVMI) and TDI parameters of patients with SH and children with euthyroidism. Subclinical hypothyroidism was diagnosed when thyroid stimulating hormone level was higher than the reference value of the laboratory (>4.2 mIU/L) and free thyroxine level was in normal range. The study included a group of 35 patients with SH and a control group of 38 children with euthyroidism (mean age was 7.6± 3.5 years and 9.0 ± 2.4 years, respectively). LVMI was signifcantly higher in the patient group (p= 0.005). TDI parameters including mitral septal ejection time was lower (p= 0.003) and mitral septal myocardial performance index was higher (p= 0.009) in the patient group. Right ventricular TDI revealed that tricuspid lateral E/Ea and tricuspid septal E/Ea were higher (p= 0.015 and p= 0.024, respectively) and tricuspid septal Ea/Aa and ejection time were lower (p= 0.018 and p= 0.017, respectively) in the patient group. SH may lead to increase LVMI. Left ventricular systolic and diastolic TDI parameters (lower mitral septal ejection time, higher mitral septal myocardial performance index) as well as right ventricular systolic (lower tricuspid septal ejection time) and diastolic (higher tricuspid septal and lateral E/Ea, lower tricuspid septal Ea/ Ea) functions may be also impaired in children with subclinical hypothyroidism. TDI is a useful method used for the assessment of the efect of SH on cardiac functions.Öğe Maternal anxiety, stress, and depression: The role of food allergy(Bilimsel Tıp Yayınevi, 2022) Kan, Ahmet; Türe, Mehmet; Yılmaz, Kamil; Emre, Emre; Baş, GülnurObjective: The prevalence of food allergy in children continues to rise worldwide. Both proven and suspected food allergy in children may be associated with depression, anxiety, and stress for mothers. In this study, our primary aim was to determine the severity of depression, anxiety, and stress in mothers of food allergic children and compare them with controls. Materials and Methods: A questionnaire that included the sociodemographic features and independent risk factors and the depression, anxiety, stress scale 21 were used. Results: A total of 104 patients, and their mothers were included in the study. Most patients were diagnosed with eczema. Multiple foods or food groups were eliminated by most patients. Moderate to severe depression (p<0.001), anxiety (p<0.001), and stress (p=0.01) were significantly more common in mothers of food allergic children compared with the control group. No association was found between the maternal anxiety, depression, and stress scores and the types of food allergy, income of the family, and the number of foods eliminated from the diet. There was a positive correlation between the maternal depression score and maternal education level (p=0.029, r=0.21). Conclusion: The mother and baby should be considered as an inseparable whole and the mothers should be supported psychosocially. Psychosocial problems in the mothers of food allergic children should be detected in a timely manner by screening programs.Öğe Multisystem inflammatory syndrome in children: A single-center experience(Wiley, 2021) Türe, Mehmet; Kan, Ahmet; Akın, Alper; Yılmaz, Kamil; Şen, VelatBackground This case series aims to evaluate the presenting symptoms, laboratory data, systemic findings, and response to early treatment in patients who were followed up with the diagnosis of multisystemic inflammatory syndrome associated with novel coronavirus disease 2019 (COVID-19). Methods The presentation, laboratory findings, and responses to treatment of patients hospitalized and diagnosed with multisystemic inflammatory syndrome were evaluated retrospectively. Results A total of 32 patients were included in the study. The median age was 90 (1.5-204) months and 62.5% of the patients were male; 59.4% of the cases were non-specific disease, 31.2% typical (complete) Kawasaki, and 9.4% had phenotypic characteristics of atypical (incomplete) Kawasaki. Most of the patients were found to have low albumin and elevated C-reactive protein, sedimentation rate, and d-dimer, and all patients had elevated N-terminal pro-B-type natriuretic peptide, and procalcitonin. Lymphopenia was detected in 25 patients (78.1%) and serum ferritin levels were elevated in 25 patients (78.1%). Eleven (34.4%) patients responded well only to intravenous immunoglobulin treatment. Twenty patients (62.5%) received intravenous immunoglobulin and steroid therapy (second-line therapy). Only one patient (3.1%) received third-line therapy (intravenous immunoglobulin + steroid +anakinra + plasmapheresis). None of the patients died. Conclusions Most patients had mild clinical symptoms and responded well to intravenous immunoglobulin and / or steroid therapies as first- and second-line therapies. Only one of our patients was clinically stabilized after third-line treatment because he did not respond to intravenous immunoglobulin and steroid therapy. We think that all of our patients diagnosed with multisystem inflammatory syndrome in children recovered because we had recommended quickly medical intervention. Treatment should therefore be started immediately in patients diagnosed with multisystem inflammatory syndrome in children. If there is no response after 24 h to the initial treatment, the next treatment protocol should be started.Öğe One-year follow-up results of MIS-C patients with coronary artery involvement: A multi-center study(Springer, 2023) Baykan, Ali; Kum, Yunus Emre; Yılmazer, Murat Muhtar; Varan, Celal; Yakut, Kahraman; Sert, Ahmet; Uç, Duygu; Akın, Alper; Türe, MehmetMultisystem inflammatory syndrome (MIS-C) in children is a rare complication of SARS-CoV-2 infection. Knowing the course of the affected or unaffected coronary arteries in the patients under follow-up is important in terms of defining the long-term prognosis of the disease and determining the follow-up plan. This is a multicenter and retrospective study. The data were obtained from nine different centers. Between May 2020 and August 2022, 68 of 790 patients had coronary artery involvement. One-year echocardiographic data of 67 of 789 MIS-C patients with coronary artery involvement were analyzed. Existing pathologies of the coronary arteries were grouped as increased echogenicity, dilatation and aneurysm according to Z scores, and their changes over a 1-year period were determined. The data of all three groups are defined as frequency. SPSS Statistics version 22 was used to evaluate the data. In our study, aneurysm was observed in 16.4%, dilatation in 68.7% and increased echogenicity in 13.4% of the patients. All of the patients with involvement in the form of increased echogenicity recovered without sequelae by the end of the first month. No progression to aneurysm was observed in any of the patients with dilatation. No new-onset involvement was observed in patients with previously healthy coronary arteries during the convalescent period. In addition, from the sixth month follow-up period, there was no worsening in the amount of dilatation in any of the patients. At least 94% of the patients who completed the 12th month control period returned to normal.Öğe A paediatric case of myopericarditis post-COVID-19 mRNA vaccine(Cambridge University Press, 2022) Türe, Mehmet; Akın, Alper; Demir, Muhammed; Akay, CihanMyopericarditis is a condition, which primarily involves the pericardium, with minimal myocardial involvement. In myopericarditis, chest pain, elevated cardiac enzymes, and electrocardiographic changes occur. Although COVID-19 mRNA vaccines significantly contribute to preventing the COVID-19 disease, rarely myocarditis and/or pericarditis may develop due to these vaccines. We present a previously healthy 14-year-old male patient who developed myopericarditis after receiving the second dose of the COVID-19 mRNA vaccine.Öğe Percutaneous closure of atrial septal defects with the memopart atrial septal occluder: The Early-term results of a multicenter study(Springer, 2022) Baykan, Ali; Bilici, Meki; Narin, Nazmi; Erdem, Abdullah; Üzüm, Kazım; Akın, Alper; Pamukçu, Özge; Balık, Hasan; Türe, Mehmet; Vural, Çagdaş; Doğan, AlperAtrial septal defect (ASD) is a common congenital heart disease with left-to-right shunt that may lead to pulmonary hypertension over time. Secundum ASD closure with transcatheter technique is currently the preferred method. The aim of this study was to evaluate the clinical experience and early-term outcomes of patients treated with a MemoPart ASD occluder device between June 2013 and June 2019. Fifty-six patients (35 females) with a mean age of 9.4 +/- 6.6 years (range: 2-44 years) were included in the study. The diameters of the devices used to close the ASDs were 7-28 mm. The ratio of the device/defect diameter was 1.14:1. Atrial septal defect closure was applied successfully in all patients. The MemoPart septal occluder is a safe and effective device for ASD closure. In wide ASDs and cases with more than one deficient rim, weak rims, or wide and complicated cases, it can be used carefully with sufficient experience.Öğe Prolonged QT dispersion is associated with pediatric syncope(Türkiye Milli Pediatri Derneği, 2019) Bilici, Meki; Dedeoğlu, Zübeyde Fidancı; Demir, Fikri; Akın, Alper; Türe, Mehmet; Balık, Hasan; Tan, İlhan; Ertuğrul, SabahattinAbstract: We aimed to find out whether QT dispersion can be used as a diagnosticmarker in terms of syncope type, and recurrence risk. Fifty-two patients (28male, 53.8%) admitted to the pediatric cardiology clinic with syncope werecompared with 50 healthy controls (28 male, 56%; mean age: 13.8±2.3 years,range: 11-17 years) for QT dispersion (QTd) and other electrocardiographicfindings. Gender, age, echocardiography, blood pressure while standing andsitting, electrolyte levels, liver and kidney function tests, and QTd and QTcd(calculated with corrected QT: QTc) in electrocardiography (ECG) of patientswere all evaluated. Patients’ ages varied between 7-17 years and the meanage at first syncope was 13.9±2.4 years. Mean follow-up duration of thepatients was 10±5 months (range: 5-18 months). Mean number of syncopeattacks was 2.8±2.2. QTd (72±46 ms vs. 34±14 ms) and QTcd (77±45 msvs. 33±14 ms) values of the patients were significantly longer, compared tocontrol group (p<0.001). The age, gender, QTd, and QTcd values did notdiffer between the subtypes of syncope based on pathogenetic mechanism.Additionally, these parameters did not differ in terms of the number ofsyncope recurrence and tilt test. Patients’ complaints reduced after cardiologicevaluation and advice regarding prevention of syncope. We think that infollow-up period, education and preventive precautions that can be takenin the daily life must be emphasized, and drug treatment can be started inunresponsive cases.
