Permanent resiprokan kavşak taşikardisine bağlı dilate kardiyomiyopati: Bir olgu sunumu

We present a four-year-old girl who was admitted to our hospital with the complaints of dyspnea, tachypnea, cough, excess sweating and fatigue. Electrocardiogram (ECG) in the tachycardic girl showed inverted P waves in leads 2, 3 and aVF along with a P-R interval of 0.16 sec and an R-P interval of 0.28 sec. Transthoracic echocardiography revealed an enlarged and spherical left ventricle with diminished systolic functions. Holter ECG confirmed long R-P tachycardia with a rate of 140-160 beats/minute. She was diagnosed as having permanent junctional reciprocating tachycardia-induced dilated cardiomyopathy and successfully treated with catheter ablation and flecainide.Bu olgu sunumunda hastanemize dispne, takipne, öksürük, aşırı terleme ve yorgunluk yakınması ile başvuran dört yaşında kız olgu sunduk. Taşikardik olan hastanın elektrokardiyografisinde (EKG) V2, V3 ve aVF derivasyonlarında ters P dalgaları ile birlikte 0,16 sn P-R aralığı ve 0,28 sn R-P aralığı mevcuttu. Transtorasik ekokardiyografide sistolik fonksiyonları azalmış, geniş ve sferik sol ventrikül saptandı. Holter EKG'de kalp hızı 140-160/dk olan uzun R-P intervalli taşikardi konfirme edildi. Hastaya permanent resiprokan kavşak taşikardisine bağlı dilate kardiyomiyopati tanısı kondu ve hasta kateter ablasyonu ve flekainamid tedavisi ile başarılı bir şekilde tedavi edildi

ÇINAR (Platanus orientalis L.) BİTKİSİNİN KULLANIM ALANLARI VE FARMAKOLOJİK ETKİLERİ

Çınar (Platanus orientalis L.), Platanaceae familyasında yer alan odunsu, yaprak döken ve çok yıllık bir bitkidir. Çınar Güneydoğu Avrupa'dan Türkiye ve İran da dahil olmak üzere Hindistan'a kadar uzanan geniş bir yayılışa sahiptir (Sert ve ark., 2008)

Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic

Introduction:Inter-hospital transport is an important process of pediatric emergency and pediatric intensive care; the patient is transferred to another center with the emergency medical services. Inter-hospital transport can be life-saving for pediatric patients, but the process can logistically be difficult and risky. The actions required to prevent unwanted events during transport depend mostly on the accurate and reliable data obtained. We think that research on the transport of pediatric patients is limited in our country. Our study investigated the characteristics of pediatric patients transferred to our unit by ambulance and the problems during transport.Methods:One hundred and eighty-three patients under the age of 18 who were referred to the pediatric emergency service between June 2017 and June 2019, whose data were regularly recorded, were included in our study. Data of patients who were sent to the external center for consultation via 112 were excluded. The list of the transferred patients was obtained from 112 command centers in our city and the patient records were analyzed retrospectively with the hospital information management system.Results:Fifty-nine percent of the 183 patients included in our study were male. The mean age of the patients was 62.2±39.1 months. Fourty-two percent of the patients were between 1 month and 3 years old. We found that the most frequent transports are in the spring with 42.6% and 50.9% of the transports took place between 16.00-00.00 hours. We found that the most common transported patients were pneumonia with 28.4% and respiratory distress was the most common adverse event during transport with 7.1%.Conclusion:In the transfer of pediatric patients between hospitals, every step, from the training of staff to the equipment in the ambulance, should be planned in detail. We believe that more studies are needed to examine transport protocols for children’s emergency medical services, the level of education required by the transport team, the state of the medical device used in the transport process, the patient’s pre and posttransport stability, and the safety of the patient during the transport period

Delayed time of atrial conduction in children with Familial Mediterranean Fever

Introduction: Familial Mediterranean Fever (FMF) is a disease with recurrent fever, characterized by painful, noninfectious inflammation of the serous membranes. It mostly affects Armenians, Turks, Arabs and Jews. Prolonged inflammation in FMF may lead to atrial fibrosis which can cause the deterioration of atrial conduction time and refractory periods of atrial myocardium.In the present study we aimed to assess atrial conduction time in children with FMF.Methods: The study included 36, children diagnosed with FMF(17 males/19 females, 13 (7-15) years) and 20 control(7 males/13 females, 11 (9-16) years) cases in our Pediatric Outpatient Clinic between October 2015 and October 2016. Tissue Doppler Echocardiography (TDE) measurements of intra-and interatrial electromechanical delay were done. P wave dispersion (Pdisp) was calculated from the 12-lead electrocardiogram.Results: Inter-atrial (Lateral PA– Tricuspid PA) and Intra-left (Lateral PA-Septal PA) atrial electromechanical delay were significantly longer in FMF patients (P lt;0.001,respectively). (PA: the time range between the beginning of the P wave in the surface electrocardiogram and the beginning of the tissue Doppler late diastolic wave A). Also, P-wave dispersion (Pdisp) were significantly higher in FMF patients( p= 0.002).Conclusions: This study shows that atrial electromechanical delay and Pdisp are prolonged in children with FMF. We recommend that atrial conduction time be measured for children diagnosed with FMF

The impact of childhood obesity on iron deficiency and its relationship with hepcidin, leptin, interleukin-6

WOS: 000392950600003Objective: The relationship between iron deficiency, and obesity has been shown in recent years. The reason is thought to be the anemia of chronic disease caused by chronic inflammation originating from adipose tissue. Our aim is to determine the relationship between obesity and iron deficiency, the place of hepcidin in iron homeostasis, and inflammation occurring in obesity, and also demonstrate its effect of the parametres of iron metabolism in obese children. Methods: This study was performed with 54 obese (body mass index (BMI)>95p) and 51 normal weighted (BMI: 5-95p) children aged between 5-16 years. In two groups serum iron, total iron binding capacity (TIBC), ferritin, hemoglobin, transferrin saturation index (TSI), interleukin-6 (IL-6), C-reactive protein (CRP), leptin and hepcidin were studied. Results: When compared with the control group; decreased serum iron (p=0.004), hemoglobin (Hb) (p=0.010), TSI (p=0.001), increased hepcidin (p=0.001), TDBK (p=0.041), leptin (p=0.001), CRP (p=0.001) levels were found in obese children. In 18 cases (%33.3) decreased levels of Hb were detected, while in 8 of these cases (% 14.8) the parameters were found compatible with iron deficiency anemia (IDA). Five cases (% 9.2) were accepted as anemia of chronic disease. In the obese group the number of patients with IDA was found statistically significantly higher (p=0.032). Besides higher BMI (p=0.001), however decreased hepcidin (p=0.008), and ferritin (p=0.006) levels were detected in anemia patients. Conclusion: In our study obesity was found to be associated with iron deficiency. The effect of hepcidin was shown to be the cause of iron deficiency. Every study to be performed in order to understand the relationship between inflammation, obesity and erythropoiesis will contribute to the development of nutritional, and/or pharmacological therapies with the aim to prevent the onset of iron deficiency in obese patients

The impact of childhood obesity on iron deficiency and its relationship with hepcidin, leptin, interleukin-6

Amaç: Obezitenin son yıllarda demir eksikliği ile ilişkisi gösterilmiştir. Bunun nedeni olarak adipoz doku kaynaklı oluşan kronik inflamasyonun neden olduğu düşünülmüştür. İnflamasyonla hepsidin artışı çesitli çalışmalarda gösterilmiştir. Çalışmamızda, obezite ve demir eksikliği arasındaki ilişki, obezitede hepsidin ve leptinin demir homeostazında yeri ve obezitede oluşan inflamasyonun saptanıp demir parametrelerine etkisinin gösterilmesi amaçlanmıştır.Yöntem: Elli dört obez (vücut kitle indeksi (VKİ)>95p) ve 51 normal kiloda (VKİ: 5p-95p) olan 5-16 yaş arası çocuklarda yapılan bir olgu kontrol çalışmasıdır. İki grupta demir, total demir bağlama kapasitesi (TDBK), ferritin, tam kan sayımı, transferrin saturasyon indeksi (TSİ), interlökin-6 (IL-6), C- reaktif protein (CRP), leptin ve hepsidin çalışıldı. Bulgular: Obez grup kontrol grubuyla karşılaştırıldığında, azalmış serum demir (p=0,004), hemoglobin (Hb) (p=0,010), TSİ (p=0,001) düzeyi, artmış hepsidin (p=0,001), TDBK (p=0,041), leptin (p=0,001), CRP (p=0,001) düzeyleri bulundu. Obez grubunda Hb düzeyleri 18 (%33,3) olguda düşük saptanırken, bunların 8 (%14,8)'inde demir eksikliği anemisi (DEA) ile uyumlu parametreler saptanmıştır. Beş (%9,2) olgu ise kronik hastalık anemisi kabul edilmiştir. Obez grubunda DEA saptananların sayısı istatistiksel olarak anlamlı derecede yüksek saptanmıştır (p=0,032). Hasta grubu Hb düzeyine göre karşılaştırıldığında, anemisi olan olguların VKİ'nin artmış (p=0,001), hepsidin (p=0,008) ve ferritin (p=0,006) düzeylerinin ise azalmış olduğu saptanmıştır. Sonuç: Çalışmamızda, demir eksikliği ile obezite birbiriyle ilişkili bulundu. Demir eksikliği nedeni olarak hepsidinin etkisi gösterildi. Obezite, inflamasyon ve eritropoez arasındaki ilişkiyi anlamaya yönelik olarak yapılacak her çalışma, obez hastalarda demir eksikliği ortaya çıkmasını engellemek için nütrisyonel ve/veya farmakolojik terapiler geliştirilmesine katkı sağlayacaktır.Objective: The relationship between iron deficiency, and obesity has been shown in recent years. The reason is thought to be the anemia of chronic disease caused by chronic inflammation originating from adipose tissue. Our aim is to determine the relationship between obesity and iron deficiency, the place of hepcidin in iron homeostasis, and inflammation occurring in obesity, and also demonstrate its effect of the parametres of iron metabolism in obese children. Methods: This study was performed with 54 obese (body mass index (BMI)>95p) and 51 normal weighted (BMI: 5-95p) children aged between 5-16 years. In two groups serum iron, total iron binding capacity (TIBC), ferritin, hemoglobin, transferrin saturation index (TSI), interleukin-6 (IL-6), C-reactive protein (CRP), leptin and hepcidin were studied. Results: When compared with the control group; decreased serum iron (p=0.004), hemoglobin (Hb) (p=0.010), TSI (p=0.001), increased hepcidin (p=0.001), TDBK (p=0.041), leptin (p=0.001), CRP (p=0.001) levels were found in obese children. In 18 cases (%33.3) decreased levels of Hb were detected, while in 8 of these cases (%14.8) the parameters were found compatible with iron deficiency anemia (IDA). Five cases (%9.2) were accepted as anemia of chronic disease. In the obese group the number of patients with IDA was found statistically significantly higher (p=0.032). Besides higher BMI (p=0.001), however decreased hepcidin (p=0.008), and ferritin (p=0.006) levels were detected in anemia patients.Conclusion: In our study obesity was found to be associated with iron deficiency. The effect of hepcidin was shown to be the cause of iron deficiency. Every study to be performed in order to understand the relationship between inflammation, obesity and erythropoiesis will contribute to the development of nutritional, and/or pharmacological therapies with the aim to prevent the onset of iron deficiency in obese patients

Delayed time of atrial conduction in children with Familial Mediterranean Fever

Introduction: Familial Mediterranean Fever (FMF) is a disease with recurrent fever, characterized by painful, noninfectious inflammation of the serous membranes. It mostly affects Armenians, Turks, Arabs and Jews. Prolonged inflammation in FMF may lead to atrial fibrosis which can cause the deterioration of atrial conduction time and refractory periods of atrial myocardium.In the present study we aimed to assess atrial conduction time in children with FMF.Methods: The study included 36, children diagnosed with FMF(17 males/19 females, 13 (7-15) years) and 20 control(7 males/13 females, 11 (9-16) years) cases in our Pediatric Outpatient Clinic between October 2015 and October 2016. Tissue Doppler Echocardiography (TDE) measurements of intra-and interatrial electromechanical delay were done. P wave dispersion (Pdisp) was calculated from the 12-lead electrocardiogram.Results: Inter-atrial (Lateral PA– Tricuspid PA) and Intra-left (Lateral PA-Septal PA) atrial electromechanical delay were significantly longer in FMF patients (P lt;0.001,respectively). (PA: the time range between the beginning of the P wave in the surface electrocardiogram and the beginning of the tissue Doppler late diastolic wave A). Also, P-wave dispersion (Pdisp) were significantly higher in FMF patients( p= 0.002).Conclusions: This study shows that atrial electromechanical delay and Pdisp are prolonged in children with FMF. We recommend that atrial conduction time be measured for children diagnosed with FMF

Right aortic arch with aberran left subclavian artery; accompanied with crossed pulmonary arteries: a rare association

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