Taner Yavuz

Intestinal parasitic infection in children in post-disaster situations years after earthquake

Backround : Two earthquakes in the north‐west region of Turkey destroyed 80% of the houses and schools in Düzce in 1999. This study was conducted to determine the parasitic infection rate associated with the post‐earthquake unhealty living conditions and related epidemiological risk factors.

Changing patterns of hepatitis A and E sero-prevalences in children after the 1999 earthquakes in Duzce, Turkey

Aim:  Hepatitis A and E are enteric viral diseases that are characteristically found in developing countries. Sero‐epidemiological data about both infections showed higher prevalence rates soon after the 1999 earthquakes in Duzce, Turkey. The aim of the present study was to evaluate the data 4 years after the earthquakes.

The relationship between iron status and thyroid hormones in adolescents living in an iodine deficient area.

BACKGROUND Iron may be only one of many nutritional factors that influence thyroid hormone metabolism in iodine-deficient areas. OBJECTIVE To evaluate the effect of iron status on thyroid hormone profile in adolescents living in a mild iodine-deficient area in Turkey. SUBJECTS Three hundred and thirty school-aged children with mean age 14 years were examined. METHODS Free triiodothyronine, free tetraiodothyronine and thyrotropin levels were analyzed by chemiluminescent enzyme immunoassay. Hemoglobin and mean corpuscular volume were measured with a Hemocounter. Iron and total iron binding capacity concentration were determined by colorimetric photometric methods. Ferritin level was determined by immunoturbidimetry. RESULTS Thyroid hormone levels of the children with anemia were not significantly different compared to children without anemia. No significant correlation was found between thyroid hormones and iron status. CONCLUSION The thyroid hormone profile was not significantly affected in this area. This survey showed no correlation between iron status and thyroid hormone levels.

Investigation of cardiomyopathy in children with cirrhotic and noncirrhotic portal hypertension.

Background: Cirrhotic cardiomyopathy (CCMP) is a functional disorder characterized by electrophysiological disturbances, and diastolic and/or systolic dysfunction in patients with liver disease. This disorder is a well-defined entity in adults, but pediatric data are limited. The aim of the study was to determine the incidence, features, and risk factors of CCMP in children with portal hypertension (PHT). Methods: This study included 50 children with cirrhotic PHT (40/50) and noncirrhotic PHT (10/50). Fifty healthy children were also selected for the control group. Electrocardiography and echocardiography were used to evaluate cardiac functions. Corrected QT (QTc) ≥ 0.45 was accepted as prolonged on electrocardiography. The study group was divided into 3 groups: cirrhotic, noncirrhotic, and control. Then, the CCMP group was created according to the diagnostic criteria. Latent CCMP was diagnosed in the presence of prolonged-QTc along with a minor criterion (tachycardia). Manifest CCMP was diagnosed in the presence of at least 2 major criteria (prolonged-QTc along with abnormal echocardiographic findings). Moreover, in this study, the risk factors for CCMP were investigated. Results: The CCMP group included 10 cases (20%). Nine of these cases had latent CCMP (18%), and the remaining one (2%) had manifest CCMP. All of the cases with CCMP had cirrhosis and ascites. None of the patients with CCMP had severe cardiac symptoms, but they were already using some cardioprotective drugs such as propanolol and spironolactone. As risk factors for CCMP, pediatric end-stage liver disease scores, Child-Pugh scores, and ascites grades were found to be significant for the determination of CCMP. The most important risk factor was ascites severity (P = 0.001, odds ratio 9.4). Conclusions: Approximately 20% of children with PHT have CCMP. A detailed cardiac examination should be carried out periodically in children with cirrhotic PHT, especially in the presence of ascites and high Child-Pugh score.

A unique case of right-sided Poland syndrome with true dextrocardia and total situs inversus

Poland syndrome has been reported to be associated with true dextrocardia, but not with true situs inversus. In this report, we describe the first patient with total situs inversus in medical literature and try to highlight the syndromes probable etiology and pathogenetic mechanisms in utero.

The effects of surgical repair on P-wave dispersion in children with secundum atrial septal defect

IntroductionAtrial septal defect (ASD) is one of the most common congenital heart diseases in children. P-wave dispersion has been reported to be associated with non-homogeneous propagation of sinus impulses. The heterogeneity of atrial conduction time may predispose the atria to arrhythmias. The aim of this study was to determine the impact of surgical repair on P-wave indices in children with isolated secundum ASD.MethodsChildren with isolated secundum ASD undergoing surgical repair (n=50; mean age, 7.0±3.0 years) and healthy controls (n=51; mean age, 7.6±2.7 years) were compared. Maximum P-wave duration (Pmax), shortest duration (Pmin) and P-wave dispersion (Pd) were measured using 12-lead surface electrocardiography.ResultsMean Pmax was found to be significantly higher in children with ASD compared with controls (95.2±10.8 vs 84.1±9.2 msec; P<0.001), and Pd before surgery was significantly higher compared with controls (47.4±12.0 vs 38.8±9.7 msec; P<0.001). Both P-wave indices were significantly decreased within the first year after surgical closure — the values decreased to those comparable to healthy controls (Pmax, 86.2±9.7 msec; Pd, 39.8±10.7 msec; P>0.05).ConclusionSurgical closure of ASD in children decreases Pmax and P-wave conduction time. We speculate that earlier closure of the defect may play an important role in avoiding permanent changes in the atrial myocardium and atrial fibrillation in adulthood.

Pyrrolidine dithiocarbamate attenuates the development of monocrotaline-induced pulmonary arterial hypertension

We aimed to demonstrate the potential protective effects of pyrrolidine dithiocarbamate (PDTC) on monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). Adult male rats were randomly assigned to 4 groups: control group, MCT-treated rats only, MCT-injected rats treated with PDTC, and PDTC-treated rats only. Blood and tissue samples were collected after the sacrifice. Levels of malondialdehyde (MDA) were measured by using the thiobarbituric acid method. Total antioxidant status (TAS) was determined using a commercially available ImAnOx kit. A histopathological evaluation was accomplished by scoring the degree of severity. Endothelial damage of the main pulmonary artery was evaluated by immunohistochemical labeling of endothelial cells using anti-rat endothelial cell antigen 1 (RECA-1) antibody. MCT-induced right ventricular hypertrophy (RVH) was reduced significantly in the MCT+PDTC-treated group. MDA levels were significantly lowered in the MCT+PDTC-treated group. TAS was significantly higher in the MCT+PDTC-treated group when compared with the rats with PAH. Histopathological examination demonstrated that PDTC treatment reduced the development of inflammation, hemorrhage and congestion, and collagen deposition. In conclusion, PDTC attenuated PAH and protected pulmonary endothelium in rats administered MCT. These findings suggest that PDTC treatment may provide a new effective therapeutic approach in the treatment of PAH.

Cord blood lipoprotein profile after magnesium sulphate treatment in pre-eclamptic patients

Aim: To determine lipoprotein metabolism alterations in magnesium‐exposed neonates of women with pre‐eclampsia. Methods: The study group comprised seven singleton neonates of women with pre‐eclampsia at term and treated with magnesium sulphate. Controls were 26 neonates of uncomplicated pregnancies of term delivery. Total serum magnesium concentrations were analysed by the photometric colour method. Total serum cholesterol, triglycerides and high‐density lipoprotein cholesterol (HDL‐C) levels were determined by enzymatic colour methods, while apoprotein (apo) A‐I and apo B values were measured by immunoturbidimetry. Low‐density lipoprotein cholesterol (LDL‐C) levels were calculated by Friedewalds formula. Very‐low‐density lipoprotein cholesterol levels, total cholesterol/ HDL‐C, apo B/apo A‐I, LDL‐C/apo B, LDL‐C/HDL‐C, and HDL‐C/apo A‐I ratios were determined by calculation. Results: Magnesium levels of magnesium‐exposed neonates were found to be 1.6 times higher than those of controls. Magnesium‐exposed neonates had lower serum apo A‐I levels, and they had higher apo B/apo A‐I and HDL‐C/apo A‐I ratios when compared to controls.

Obez Çocuklardaki Hipertansiyon ve İnsülin Direncinin Kardiyak İşlev Bozukluğuna Etkisinin Ekokardiyografi İle Değerlendirilmesi

Objective: The purpose of this research was aimed to evaluate the cardiac functions of obese children by echocardiography and in addition to find out the affects of insulin resistance and/ or hypertension on cardiac functions. Material and Method: The Obese group included 52 children in this study (32 boys and 20 girls) with ages ranged between 4-19 years old (mean 11.6±3.7 years) and BMI ≥ 95 percentiles. Children with appropriate for age (4-19 years, mean 11.0±4.1 years), sex (25 boys and 19 girls), and with normal BMI were selected as control group. Serum fasting glucose, thyroid functions, lipid profile, insulin and cortisole levels were measured in the obese group. The patients were also divided into 4 subgroups according to existing of hypertension and/or insulin resistance, and they were also compared between each other. Echocardiographic measurements of both groups were made by using M-mode, 2-D and PW Doppler techniques and MPI values of the left and the right ventricles were calculated. The student’s t test was used to compare the main groups, and Analysis of variance (ANOVA) was used for comparisons of the different groups. Sidak test as a posthoc test was used for comparisons of the subgroups. Probability values of p <0.05 in all tests were considered significant.

Unique variant of Adams–Oliver syndrome with dilated cardiomyopathy and heart block

Reported herein is the case of a 2‐year‐old boy with Adams–Oliver syndrome who presented with dilated cardiomyopathy and complete atrioventricular block. The patient had aplasia cutis congenita with partial aplasia of the skull bones, and terminal transverse limb malformations characteristic of the disease. Although congenital cardiac malformations may be associated with the syndrome, dilated cardiomyopathy has not been previously reported to be associated with the syndrome.