Two cases with isolated and complex cardiac defects together with inferior vena cava anomaly

Systemic venous anomalies are rare congenital anomalies.Although they appear in different symptoms, they areusually asymptomatic and they can be detected incidentallyduring investigation of other congenital heart anomalies.The knowledge of this kind of anomalies before cardiacangiography and open heart surgery is important toprevent time loss and unexpected complications. Echocardiographytransabdominal view is used and angiographyis performed for confirmation. We report two casesin which absent suprarenal inferior vena cava with venaazygos continuity was present. One is isolated and one ispresent with cardiac atrioventricular septal defec

Normal Values of Echocardiographic Parameters Indicating Right Ventricular Systolic Functions in 607 Healthy Children

Background: This study aimed to define the normal ranges of echocardiographic parameters that are used to evaluate right ven-tricular systolic functions. Methods: A total of 607 children within the age range of 0-18 years without any cardiac pathology or chronic disorders were in-cluded in the study. The study population was categorized into different age groups and underwent transthoracic echocardiog-raphy. In this study, tricuspid annular plane systolic excursion (TAPSE), tricuspid annular peak systolic velocity (TAPSV), and right ventricular myocardial performance index (RVMPI) values were measured. Results: There was no statistically significant difference between the mean TAPSE and TAPSV values of male and female subjects. The mean RVMPI was higher in females than in males. The study population was categorized into nine groups according to their age. The TAPSE, TAPSV, and RVMPI values were calculated for each group. Additionally, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, and +/- 2 standard deviation (SD) and +/- 3 SD values of TAPSE measurements were calculated for each age group. The study population was divided into eight groups according to their body surface area (BSA). Moreover, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of TAPSE measurements were calculated. There was a strong positive correlation between TAPSE and BSA. The TAPSE was also positively correlated with TAPSV but not with RVMPI. Conclusions: This study determined the normal values for TAPSV and RVMPI. It is important to have knowledge of the normal ranges of these parameters to recognize right ventricular dysfunction early in various cardiac disorders

Diagnostic difficulties by the unusual presentations in children and adolescents with Hashimoto thyroiditis

Complex clinical presentation with diverse timing of particular symptoms may cause diagnostic difficulties, especially in children and adolescents. This paper presents diagnostic difficulties and pitfalls in 3 children with acquired primary hypothyroidism due to Hashimoto's thyroiditis (HT) presenting with unusual manifestations. We described 3 children with acquired primary hypothyroidism due to HT. One of our patients had musculoskeletal pain and was diagnosed and treated as having connective tissue disease. Another patient presented with chest pain, dyspnea, and swelling in the abdomen. She had a massive pericardial effusion (PE). Two patients had severe growth failure. A third patient with Down syndrome had a small PE. Her complaint was dyspnea during sleep. All patients improved with thyroxin therapy. Patients with hypothyroidism due to HT who have complicated clinical manifestations were misdiagnosed and mismanaged at childhood and adolescence. Growth failure is an important sign in children and adolescents. In the presence of complicated manifestations in children and adolescents, thyroid dysfunction must be considered in differential diagnosis

Vestibular evoked myogenic potentials in patients with ankylosing spondylitis

37th National Congress of Otorhinolaryngology-Head and Neck Surgery -- OCT 28-NOV 01, 2015 -- Antalya, TURKEYOzgur, Abdulkadir/0000-0002-6155-5988; Serdaroglu Beyazal, Munevver/0000-0001-5903-5708WOS: 000382945900011PubMed: 26742904Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease with unknown etiology. Although sacroiliac joint involvement is the classic sign along with the formed immune mediators, it may result in immune-mediated inner ear disease and may cause damage to the audiovestibular system. Vestibular evoked myogenic potentials (VEMP) is a clinical reflex test used in the diagnosis of vestibular diseases and is performed by recording and evaluating the muscle potentials resulting from the stimulation of the vestibular system with different stimuli. the aim of this study is to evaluate the cervical VEMP test results in AS patients without vestibular symptoms. Thirty-three patients with AS and a control group of 30 healthy volunteers with similar demographic characteristics were evaluated in the study. VEMP wave latency, P13-N23 wave amplitude, and VEMP asymmetry ratio (VAR) values were compared between the groups. the relationship between clinical and laboratory findings of the AS patients and VEMP data were also investigated. Compared with healthy people, this study shows the response rate of patients with ankylosing spondylitis was reduced in the VEMP test, and P13-N23 wave amplitude showed a decrease in AS patients who had VEMP response (p < 0.001). There was no correlation between the clinical and laboratory findings and VEMP findings in patients with ankylosing spondylitis. the data obtained from this study suggest that AS may lead to decreased sensitivity of the vestibular system

Tissue doppler echocardiography for evaluating left ventricular functions in obese

Objective: The aim of this study was to investigate theimpact of childhood obesity on ventricular functions usingtissue Doppler echocardiography.Materials and methods: The mitral tissue Doppler signalswere recorded in the apical four-chamber view, with thesample volume placed at the lateral walls of mitral annulus.The mitral flow was examined with the sample Pulse Dopplerpositioned parallely to flow just at the orifice of the mitralleaflets. Twenty obese (mean age, 161.5±25.8 months)and 20 healthy children (mean age, 151.2±33.5 months)were included to this study.Results: Body mass index (BMI) was significantly higherin obese group (30.92±6.87). Isovolumic relaxation time(IVRT) which is one of the left ventricular (LV) diastolicfunction parameters was 66.10±7.30 ms in obese group,and 58.70±9.06 ms in the control group. IVRT was significantlyhigher in the obese group (p=0.007). In obesegroup, the mitral annulus tissue Doppler E velocity wasdecreased, flow velocity was increased and decrement inEm/Am ratio was significant. We found significant negativecorrelation between BMI and LV Em/Am ratio. Myocardialperformance index (MPI) in obese group and control groupwas 0.50±0.07 and 0.41±0.04, respectively (p<0.001).Between MPI and LV Em/Am ratio there was a significantnegative correlation while MPI showed positive correlationwith BMI. In obese group septal and LV posterior wall thicknesswas shown to be significantly increased compared tothe control group (p<0.001).Conclusion: Our findings, may be important for determinationof the relationship between obesity and cardiovascularrisk factors in children. Tissue Doppler echocardiographicimaging may be useful in revealing this relationship.Key words: obesity, doppler echocardiography, ventricular dysfunctio