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    Clinical and echocardiographic evaluation in children with cardiomyopathy
    (1996) Elevli M.; Kilinc M.; Gunbey S.; Devecioglu C.; Tas M.A.
    Thirty cases diagnosed cardiomyopathy by echocardiography were evaluated with clinical and laboratory findings. The patients were aged between 2.5 months and 13 years. There was history of consanguinity in of 26 cases with myocarditis and cardiomyopathy. The left ventricular apical thrombus was in two patients with myocarditis and cardiomyopathy. Dyspne, cough, cyanosis weakness and fever were the most often encountered clinical symptoms of patients with idiopathic and dilated myocarditis and cardiomyopathy. The left ventricular apical thrombus was observed in two patients with myocarditis dilated cardiomyopathy. The mean left atrial dimension was 127.04 23.88 % of the predicted normal mean value in patients with myocarditis and dilated cardiomyopathy. In patients with myocarditis and dilated cardiomyopathy left ventricular end-diastolic and right ventricular end-diastolic dimensions were considerably in excess of expected normal upper limits in children with the same body weight (119.58 18.67 % and 136.85 25.89 % respectively. The ejection fraction and fractional shortening were significantly lower than the normal value in all the patients with myocarditis and dilated cardiomyopathy (ejection fraction: 34.21 8.34 %, fractional shortening: 15.99 4.99 % respectively). In cases with hypertrophic cardiomyopathy the mean fractional shortening values were 75.5 22.45 % and 48.92 4.21 %. M-mode and two-dimensional echocardiographic study are valuable diagnostic methods in the diagnosis of myocarditis and dilated and hypertropathy. Color Doppler echocardiographic study is also available by the measurement of flow velocities an the determination of valvular insufficiencies.
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    Öğe
    Clinical and laboratory presentation of typhoid fever
    (2001) Yaramis A.; Yildirim I.; Katar S.; Özbek M.N.; Yalçin I.; Tas M.A.; Hosoglu S.
    A total of 314 children with clinical and/or laboratory diagnosis of typhoid fever admitted to the Dicle University Hospital pediatric infectious diseases ward were reviewed for demographic data such as age, sex, clinical features, and results of laboratory tests. There were 187 male and 127 female patients, with a mean age of 9.6 years ranging from 6 months to 16 years. Eleven of all the children were less than one year of age, while 23 were under the age of five years. Predominant symptoms were fever, abdominal pain, vomiting, and headache. Hepatomegaly was almost twice as frequently observed as splenomegaly. Common clinical signs of typhoid fever in adults such as relative bradycardia and spots were seldom documented. A febrile convulsion was the presenting symptom in nine of the patients, all of whom were under the age of five years. Intestinal perforation was present in five of the patients. Antibiotic susceptibility tests in 67 cases revealed resistance rates of 17% for ampicillin, 5% for trimethoprim-sulfamethoxazole, 4% for ceftriaxone, and 6% for sulbactam-ampicillin. No resistance was detected against the quinolones and chloramphenicol. Elevated serum alanine and aspartate aminotransferase (50 > /U/L) levels were observed in 32% of our patients. At presentation, 38% of all patients were anemic (Hb <12 g/dl), 10% were thrombocytopenic (<105/mm3). Except the two bacteriologically confirmed typhoid fever patients died during the period of observation, all patients survived from their severe illness completely.