Hemolysis After Administration of High-Dose Immunoglobulin in a Patient with Myocarditis

ABSTRACT The use of high-dose intravenous immunoglobulin (IVIG) has greatly increased in the last years. With broader use of immunoglobulin, the numbers of reported side effects are also growing. IVIG have also been used in the treatment of myocarditis and dilated cardiomyopathy. Here we reported a child with presumed acute myocarditis who has developed severe hemolytic anemia following high-dose IVIG administration. As our knowledge, this is the first case report with myocarditis or dilated cardiomyopathy who developed hemolytic anemia following high-dose IVIG administration

Evaluation of cardiac functions of infants of diabetic mothers using tissue Doppler echocardiography

Amaç: Diyabetik anne bebeklerinde geçici kalp hipertrofi olmaktadır. Olgu kontrol çalışması ile bu durumun kalp işlevlerine olan etkisi doku Doppler tekniği kullanılarak araştırılmıştır. Gereç ve Yöntemler: Bu çalışmada, 45 zamanında doğmuş diyabetik anne bebeği ve 50 sağlıklı zamanında doğmuş yenidoğanın, sağ ve sol ventrikül sistolik ve diyastolik işlevleri doku Doppler ekokardiyografi ile incelenmiştir. Bulgular: Diyabetik anne bebeklerinden 16sında (%36) septum kalın saptandı. Diyabetik anne bebeklerinde hem sol hem de sağ ventrikül mi- yokard velositeleri kontrol grubuna göre düşük saptandı. Bizim çalışma- mızda, sol ventrikülde kontrol grubundan farklı olarak yalnızca diyabetik anne bebeği grubunda Em/Am oranı birin altında bulunmuştur. Ayrıca diyabetik anne bebeği (grup 1, 2) ve kontrol grubunda septum ve sağ ventrikülde bakılan Em/Am oranı birin altında bulundu. Hesaplanan Tei indeksi interventriküler septumu kalın olan diyabetik anne bebeklerinde kontrol grubundan daha yüksek bulundu. Çıkarımlar: Diyabetik anne bebeklerinde interventriküler septal kalınlaş- ma her iki ventrikül diyastolik işlevlerini bozmaktadır. Bu durum doku Doppler ekokardiyografi ile gösterilebilir. Bu sonuçlar diyastolik işlevle- rin diyabetik anne bebeği grubunda her iki ventrikülde ve sağlıklı bebek- lerde sadece sağ ventrikülde bozulduğunu göstermektedir. Bu durumun yenidoğan döneminde var olan fizyolojik akciğer hipertansiyon sonucu gelişen sağ ventrikül işlev bozukluğu ile açıklanabileceği düşünülmüştür. Doku Doppleri ile saptadığımız subklinik sağ ve sol ventrikül diyastolik işlev bozuklukları, özellikle septumu kalın diyabetik anne bebeklerinin yakın olarak izlenmesi gerektiğini göstermektedir. (Türk Ped Arş 2014; 49: 25-9)Aim: Transient cardiac hypertrophy occurs in infants of diabetic mothers. The effect of this state on cardiac functions was investigated with a case- control study using tissue Doppler technique. Material and Methods: In this study, right and left ventricle systolic and diastolic functions of 45 term babies of diabetic mothers and 50 healthy term newborns were examined using tissue Doppler echocardiography. Results: The septum was found to be thick in 16 (36%) of the babies of diabetic mothers. Both the left and right ventricle myocardial velocities were found to be lower in the babies of diabetic mothers compared to the control group. In our study, the Em/Am ratio was found to be below one only in the babies of diabetic mothers in the left ventricle in contrast to the control group. In addition, the Em/Am ratio in the septum and right ventricle was found to be below one both in the babies of diabe- tic mothers (group 1, 2) and control group. The calculated Tei index was found to be higher in the babies of diabetic mothers who had a thicker interventricular septum compared to the control group. Conclusion: Interventricular septal thickening in babies of diabetic mot- hers disrupt the diastolic function of both ventricles. This can be de- monstrated by tissue Doppler echocardiography. These results show that diastolic function is disrupted in both ventricles in babies of diabetic mothers and only in the right ventricle in healthy babies. It was thought that this could be explained by right ventricular dysfunction arising from physiological pulmonary hypertension in the neonatal period. Subclini- cal right and left ventricular diastolic dysfunctions which we found by tissue Doppler indicate that babies of diabetic mothers especially with a thick septum should be closely monitored. (Türk Ped Arş 2014; 49: 25-9

Successful pacemaker implantation for sinus node dysfunction in a patient with duschenne muscular dystrophy

Duschenne müsküler distrofisi (DMD) müsküler distrofiler içerisinde en sık görülen ve en ciddi seyreden formudur. Distrofin proteinindeki mutasyon sonucu iskelet ve kalp kasında dejenerasyon ve bunun yerini alan yağ dokusu ve fibrosiz ile karakterize kalıtsal bir hastalıktır. Kardiyak tutulumun %90 olduğu bu hastalıkta kalp yetersizliğine ek olarak ritim problemleri de olabilmektedir. Bu olguda DMD ile takip edilen ve senkop şikayeti olan bir hastaya elektrokardiyogramda (EKG) sinüs duraklamaları olması nedeniyle kalıcı pacemaker implantasyonu yapıldı. DMD’nin aritmik komplikasyonlarını bu vaka takdiminde kısaca tartışmaya çalıştık.Duschenne muscular dystrophy (DMD) is the most frequent and severe form of the muscular dystrophies. The syndrome is hereditary disease which is characterized with degeneration in the sceletal and cardiac muscle cells as a cause of mutation in the dystrophin pro- tein. Cardiac involvement is about 90% and in addition to heart failure, rhythm disorders may also develop. In this case report, patient with a diagnosis of DMD presented with syncope and sinus pause in the electrocardiogram was referred to the cardiology and pacemaker implantation was performed. We briefly discuss arrhythmic ccomplications of DMD in this case presentation

Evaluation of waste in seismic metamaterial applications

Within the scope of this study, a simulation study was carried out in order to prove the usability of waste in seismic metamaterial studies. In the study, a square array field application was preferred, and a 3-layer cylindrical pile design was used. In addition, direct contact of waste with soil and direct air is prevented. Within the scope of the study, polypropylene, which is frequently contained in medical products, concrete as a containment layer, and lime materials to prevent leakage of hazardous waste were used as materials. In addition, a design has been made within the soil structure as the ground structure. As a result of the study, it was determined that transmission losses occur in low frequency regions such as 3-10 Hz values due to obtaining partial band gaps. In addition, when looking at the propagation of the vibration waves in the field plane depending on the time, it is seen that the waves are significantly reduced, and the results are promising

Ellis-van creveld syndrome (chondroectodermal dysplasia) a case report: Association of common atrium and persistent left superior vena cava

Ellis-van Creveld (EvC) sendromu, otosomal resesif olarak kalıtılan nadir bir kondral ve ektodermal hastalıktır. Kondro ve ektodermal displazi, polidaktili ve konjenital kalp defektleri bu sendromun karakteristik bulgularıdır. Tek atrium ve endokardiyal yastık defektlerinin bu sendromda en sık rastlanan konjenital kalp defektleri olduğu bildirilmektedir. EvC sendromunun nadir görülmesi nedeni ile ekokardiyografik ve anjiyokardiyografik incelemede, tek atrium ve persistan sol süperior vena kava gibi doğumsal kalp anomalilerinin yanı sıra EvC sendromunun diğer klasik bulguları saptanan dört yaşındaki kız hasta sunulmuştur.The Ellis-van Creveld (EvC) syndrome (EvC) is a rare chondral and ectodermal dysplasia inherited autosomal recessively. The EvC syndrome is characterized by chondrodysplasia and ectodermal dysplasia, polydactyly, and congenital cardiac defects. It is reported that common atrium and endocardial cushion defects are the most common congenital cardiac defects in patients with the EvC syndrome. Here, a four-year-old girl with the diagnostic features of EvC syndrome and a common atrium with persistent left superior vena cava demonstrated by echocardiographic and angiocardiographic investigations is described because of the rarity of this syndrome