Left ventricular non-compaction in children and adolescents: Clinical features, treatment and follow-up

Background: Left ventricular non-compaction (LVNC) is a specific cardiomyopathy that occurs following a disruption of endomyocardial morphogenesis. This study presents clinical findings, diagnostic features, treatment and follow-up of pediatric patients diagnosed with LVNC. Methods: Patients with LVNC who were followed from January 2006 to March 2010 were included in this study. Diagnosis was made with the use of characteristic findings of magnetic resonance imaging and echocardiography. Holter electrocardiography and metabolic screening tests were also performed in all patients. Results: A total of 24 patients were studied (18 male, six female). Patient age at diagnosis was 50 ± 60 months (eight days to 15 years). Average follow-up period was 22 ± 12 months (four months to four years). Findings at diagnosis were as follows: eight (33%) patients had heart failure, five (20%) had rhythm abnormalities, five (20%) had cardiomegaly, two had murmurs, two had cyanosis, and two presented with fatigue. Ten (41%) patients had been followed previously with other diagnoses. In 21 (87.5%) patients, electrocardiographic abnormalities were noted, especially left ventricular hypertrophy and ST-T changes. Patients had an average ejection fraction of 46% (18-73%) and three of them had additional congenital heart disease (patent ductus arteriosus, aortopulmonary window and complex cyanotic heart disease). Scanning for metabolic diseases revealed fatty acid oxidation disorder in one patient, and mitochondrial disease in another. During follow-up, a permanent pacemaker was implanted in a patient with severe bradycardia and ventricular dysfunction, and three patients died. Conclusion: LVNC can be diagnosed at any age from newborn to adolescent and has a variable clinical course. Closer study of patients with cardiomegaly and heart failure can reduce delays in diagnosis of LVNC. (Cardiol J 2011; 18, 2: 176-184

Mean field multilayer stackelberg differential games in multi-agent systems

In this paper, we study linear-quadratic hierarchical mean field Stackelberg differential games with decentralized adapted open-loop information structure. In this game model, there are three levels of decision making, with a leader at the top level, sub-leaders at the intermediate level, and a large population of followers at lowest level. Accordingly, the leader cannot influence the followers' actions directly, but instead sub-leaders link up followers to the global leader as an intermediate layer. The leader plays a Stackelberg game with the sub-leaders, and the sub-leaders play a Stackelberg game of the mean field type with the followers. The followers are (weakly) coupled through a mean field term, which only affects the followers' individual costs. One of the contributions of this work is to consider the infinite population limit of the finite-follower multi-layer game model. We establish the existence of Stackelberg equilibrium in the limiting case, which is expected to be an approximate Stackelberg equilibrium by the law of large numbers when the population of followers is finite, but sufficiently large. We show the effectiveness of the proposed method through a numerical example.TÜBİTA

A case of Hennekam syndrome presenting with massive pericardial effusion

Hennekam syndrome is an autosomal recessive disease characterized by intestinal lymphangiectasia accompanied by severe lymphedema of the limbs, genitalia, and face, and learning difficulties. A 38-month-old boy was admitted with breathing difficulty. He had facial abnormalities and preputial hyperplasia consistent with Hennekam syndrome. Lymphangiography showed lymphedema in the left eye and right foot. Teleradiography showed cardiomegaly and echocardiography showed massive pericardial effusion. He first underwent pericardiocentesis for the removal of pericardial effusion, but pericardial tube drainage was required upon recurrence of effusion. On the fifth day, the drain was removed because of significant decrease in the drainage

Association of MDR1 (C3435T) polymorphism and resistance to carbamazepine in epileptic patients from turkey

Background and Aims: We investigated the prevalence of this multidrug resistance 1 gene (MDR1) polymorphism in drug-responsive versus drug-resistant epilepsy patients treated with carbamazepine (CBZ), which is a substrate of this protein. Methods: We genotyped the C3435T variant of MDR1 in 97 patients treated with CBZ monotherapy who had been on stable doses for more than 1 month. Our control group included 174 healthy individuals. Plasma CBZ concentrations were also measured using fluorescence polarization immunoassay. Results: We could not demonstrate any statistically significant relationship with the genotypes among drug-resistant patients (n = 44). The frequency of the homozygous mutant (TT) genotype was 15% in drug-responsive patients, 11.3% in drug-resistant patients and 25.8% in the control group. We also did not observe any significant correlation between the presence of a specific allele and CBZ plasma level/dose index. Conclusion: Our study did not support any significant association between the MDR1 (C3435T) polymorphism and resistance to CBZ in epilepsy patients from Turkey. Copyright (C) 2007 S. Karger AG, Basel

Evaluation of non-valvular aortic stenosis cases

Aim: We aimed to determine the morphological and clinical features of non-valvular aortic stenosis cases, who have attended our Pediatric Cardiology Clinic for thelast three years. Material an

Evaluation of the Nutritional Status of Male Adolescents

Objectives: The aim of this study was to evaluate the nutritional status of adolescent male students in rural and urban areas of Edirne, Turkey

Evaluation of Cardiac Autonomic Dysfunction in Patients With Duchenne-type Muscular Dystrophy

Objective: The aim of this study was to investigate the presence of cardiac autonomic dysfunction by time-domain heart rate variability analysis in patients with Duchenne Muscular Dystrophy (DMD)

Dietary Intakes of Adolescents Living in Edirne, Turkey

Objective: To assess the dietary intakes of the adolescents in the area of Edirne, Turkey