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Öğe Assesment of normal ECG percentiles and cardiac rhythm problems through 12-lead ECG screening in school-age children(2022) Yılmaz, Ercan; Elkıran, Özlem; İnce, Damla; Yılmaz, Zeynep Yamancan; Yoloğlu, Saim; Karakurt, CemşitAim: Electrocardiography (ECG) is an important non-invasive examination tool used for the diagnosis of cardiovascular diseases and rhythm problems for nearly hundred years. Although, many studies have been conducted showing the significant effect of age and gender on electrocardiographic traces, the data on normal reference values of pediatric ECG and the relationship between abnormal ECG recordings and heart disease are insufficient in the current literature. The aim of this study was to evaluate the standard percentile values of ECG measurement and the prevalence of cardiac disorders in school children aged 6-18 in our region. Materials and Methods: 2154 students who were randomly selected from eight elementary, secondary and high schools in Malatya city center were included in the study and informed consent form was taken from their families. Using MAC 2000 (GE Healthcare, Milwaukee, USA) device capable of taking digital ECG record, ECG records with standard 12 derivations were taken for all participating children. ECG records of all children were examined by the same pediatric cardiologists. Using 24 hour Holter ECG and echocardiography, advanced evaluation was performed for the children with problems detected in ECG records. Results: Pathology was detected in the ECG of 110 out of a total of 2154 children whose ECG records were examined. Average age of 2044 children without detected conduction and rhythm disorder was 11.4±2.8 and 56.8% (n=1149) were female. These eleven parameters were compared to the other studies in literature. Mean QTc interval was detected below 440 milliseconds in all age groups (6-9, 9-13, 13-18). Mean heart rate per minute was found higher in all age groups in our study compared to other studies. Thus mean QTc interval was found lower than the other studies although QT distance was similar. Conclusion: Data of this study is important for the detection of normal ECG percentiles and the prevalence of rhythm problems in children and would guide other future studies on this subject.Öğe Does childhood chorea mean sydenham chorea everytime?(2022) Özgör, Bilge; İnce, Damla; Güngör, Serdal; Karakurt, CemşitAim: We were retrospectively our experience in Sydenham Chorea and reexamined 39 patients with choreiform movement disorder who were admitted to pediatric neurology and cardiology outpatient clinics between 2010 and 2017. Materials and Methods: We reviewed these case symptoms, diagnosis period, differential diagnosis and shortening the duration of symptoms with chorea treatment. Results: Two of 39 patients who diagnosed Sydenham Chorea, were finally diagnosed Systemic Lupus Erythematosus. Symptoms duration time is shorter with neurodol or valproaic treatments. Conclusion: Although Sydenham Chorea’s is the most common movement disorders, the practitioners should aware of the differential diagnosis. The relapse of Acute Rheumatic Fever with chorea can be prevented by administering antibiotic prophylaxis.Öğe An Extremely Rare Cause of Wolff-Parkinson-White Syndrome: Rhabdomyoma in Association With Tuberous Sclerosis(Erciyes Medical Journal, 2019) Elkıran, Özlem; Karakurt, Cemşit; İnce, DamlaÖz: Rhabdomyomas are the most common primary cardiac tumors in infants and children. They are usually associated with tuberous sclerosis (TS). As the tumors tend to regress spontaneously, surgical intervention is not usually performed unless they become obstructive or cause incessant arrhythmias. We report an extremely rare case of rhabdomyoma serving as a substrate for Wolff-Parkinson-White (WPW) syndrome and intractable supraventricular tachycardia accompanied by TS. Our case is particularly interesting because it was diagnosed prenatally. The signs of WPW syndrome disappeared from the electrocardiogram with the regression of the tumor.Öğe Kawasaki disease: evaluation of 15 cases(2017) İnce, Damla; Elkıran, Özlem; Karakurt, Cemşit; Tabel, YılmazAmaç: Kawasaki hastalığı genellikle 5 yaşın altında görülen, etyolojisi bilinmeyen orta küçük çaplı damarları etkileyen bir vaskülittir. Hastalığın en önemli morbidite ve mortalite nedeni koroner arter tutulumudur. Bu çalışmanın amacı 2011-2016 yılları arasında kliniğimizde takip edilmiş olan Kawasaki olgularının klinik ve labaratuvar özelliklerinin değerlendirilmesidir. Gereç ve Yöntem: Ocak 2011-Mayıs 2016 tarihleri arasında Kawasaki hastalığı nedeniyle kliniğimizde takip ve tedavisi yapılan 15 hastanın verileri geriye dönük olarak incelendi. Hastaların tanısı Amerikan Kalp Akademisinin Kawasaki hastalığı tanı kriterlerine göre konuldu. Bulgular: Çalışmamıza 15 tane hasta dahil edildi. Kawasaki hastalığının kriterlerinden ateş tüm olgularda görülen tek semptomdu. Bu hastaların içerisinde koroner arter tutulumu olan 1 hastamız vardı. Takiplerinde hastaların tümünde klinik ve labaratuvar bulgular normale döndü, ek bir komplikasyon olmadı. Sonuç: Kawasaki hastalığı hastalığı genellikle 5 yaşın altında görülen, orta küçük çaplı damarları etkileyen bir vaskülittir. Tedavi edilmeyen hastaların % 25'inde koroner arter tutulumu bildirilmekle beraber hastalığın erken tanısı ve intravenöz immunoglobulin kullanımı ile bu oran % 5'e inmektedir. Tedaviye rağmen genetik yatkınlık nedeniyle dünyanın farklı bölgelerinde koroner arter tutulumu sıklığı farklı oranlarda bildirilmektedir. Ülkemizde Kawasaki hastalığının gerçek sıklığı bilinmemekle beraber bu çalışmada bölgemizde Kawasaki hastalığına bağlı koroner arter tutulumunun ülkemizden yapılan diğer yayınlara göre daha az olduğu saptanmıştır.Öğe Kawasaki disease: evaluation of 15 cases(Turgut Özal Tıp Merkezi Dergisi, 2017) İnce, Damla; Elkıran, Özlem; Karakurt, Cemşit; Tabel, YılmazAbstract Objective: Kawasaki disease is characterized with acute systemic self–limited vasculitis, commonly affects middle and small size arteries, occurs predominantly in children under 5 years old age. Most common causes of morbidity and mortality in Kawasaki disease are coronary artery complications. Aim of this retrospective study is to evaluate clinical and laboratory results of 15 Kawasaki patients who were followed-up in 2011-2016 years. Materials and Methods: In this study the clinical and laboratory data of 15 Kawasaki disease patients, who were followed-up in January 2011- May 2016, were evaluated retrospectively. Diagnosis of Kawasaki disease was done according to the American Heart Association criteria. Results: Fever was most common clinical symptom and was seen in all patients. We observed coronary artery aneurysm only in one patient. During follow-up clinical and laboratory findings were improved and we did not determine any other complications. Conclusion: Kawasaki disease is characterized with acute systemic self – limited vasculitis, commonly affects middle and small size arteries, occurs predominantly in children under 5 years old age. Although coronary artery aneurysms was seen in 25% of untreated Kawasaki patients, the frequency of coronary artery aneurysm was decreased to 5% by using IVIG treatment. Despite the IVIG treatment, coronary aneurysms may be seen in different ratios in the gorups of Kawasaki patients due to genetic predisposition. Although we don’t have any information about the incidence of Kawasaki disease in our country, coronary artery aneurysms were seen lower in our patients than in other publications from our country. Keywords: Kawasaki Disease; Coronary Aneurysm; Vasculitis; Treatment.Öğe Kawasaki disease: evaluation of 15 cases(Journal of Turgut Ozal Medical Center, 2016) İnce, Damla; Elkıran, Özlem; Karakurt, Cemşit; Tabel, YılmazKawasaki disease is characterized with acute systemic self–limited vasculitis, commonly affects middle and small size arteries, occurs predominantly in children under 5 years old age. Most common causes of morbidity and mortality in Kawasaki disease are coronary artery complications. Aim of this retrospective study is to evaluate clinical and laboratory results of 15 Kawasaki patients who were followed-up in 2011-2016 years. Materials and Methods: In this study the clinical and laboratory data of 15 Kawasaki disease patients, who were followed-up in January 2011- May 2016, were evaluated retrospectively. Diagnosis of Kawasaki disease was done according to the American Heart Association criteria. Results: Fever was most common clinical symptom and was seen in all patients. We observed coronary artery aneurysm only in one patient. During follow-up clinical and laboratory findings were improved and we did not determine any other complications. Conclusion: Kawasaki disease is characterized with acute systemic self – limited vasculitis, commonly affects middle and small size arteries, occurs predominantly in children under 5 years old age. Although coronary artery aneurysms was seen in 25% of untreated Kawasaki patients, the frequency of coronary artery aneurysm was decreased to 5% by using IVIG treatment. Despite the IVIG treatment, coronary aneurysms may be seen in different ratios in the gorups of Kawasaki patients due to genetic predisposition. Although we don’t have any information about the incidence of Kawasaki disease in our country, coronary artery aneurysms were seen lower in our patients than in other publications from our country.Öğe Kawasaki Hastalığı: 15 Olgunun Değerlendirilmesi(2017) İnce, Damla; Elkıran, Özlem; Karakurt, Cemşit; Tabel, YılmazÖz: Amaç: Kawasaki hastalığı genellikle 5 yaşın altında görülen, etyolojisi bilinmeyen orta küçük çaplı damarları etkileyen bir vaskülittir. Hastalığın en önemli morbidite ve mortalite nedeni koroner arter tutulumudur. Bu çalışmanın amacı 2011-2016 yılları arasında kliniğimizde takip edilmiş olan Kawasaki olgularının klinik ve labaratuvar özelliklerinin değerlendirilmesidir. Gereç ve Yöntem: Ocak 2011-Mayıs 2016 tarihleri arasında Kawasaki hastalığı nedeniyle kliniğimizde takip ve tedavisi yapılan 15 hastanın verileri geriye dönük olarak incelendi. Hastaların tanısı Amerikan Kalp Akademisinin Kawasaki hastalığı tanı kriterlerine göre konuldu. Bulgular: Çalışmamıza 15 tane hasta dahil edildi. Kawasaki hastalığının kriterlerinden ateş tüm olgularda görülen tek semptomdu. Bu hastaların içerisinde koroner arter tutulumu olan 1 hastamız vardı. Takiplerinde hastaların tümünde klinik ve labaratuvar bulgular normale döndü, ek bir komplikasyon olmadı. Sonuç: Kawasaki hastalığı hastalığı genellikle 5 yaşın altında görülen, orta küçük çaplı damarları etkileyen bir vaskülittir. Tedavi edilmeyen hastaların % 25’inde koroner arter tutulumu bildirilmekle beraber hastalığın erken tanısı ve intravenöz immunoglobulin kullanımı ile bu oran % 5’e inmektedir. Tedaviye rağmen genetik yatkınlık nedeniyle dünyanın farklı bölgelerinde koroner arter tutulumu sıklığı farklı oranlarda bildirilmektedir. Ülkemizde Kawasaki hastalığının gerçek sıklığı bilinmemekle beraber bu çalışmada bölgemizde Kawasaki hastalığına bağlı koroner arter tutulumunun ülkemizden yapılan diğer yayınlara göre daha az olduğu saptanmıştır.Öğe Myocarditis in childhood report of 67 patients(2022) Kılınç, Fatma; Karakurt, Cemşit; Elkıran, Özlem; İnce, DamlaAim: The aim of this study is to evaluate the clinical findings, sociodemographic characteristics and follow -up of the myocarditis cases and to investigate factors affecting the mortality. Materials and Methods: Patients who diagnosed myocarditis from January 2009 to December 2017 were included in this study. Sex, date of admission, age at the time of admission, presence of previous infection, physical examination findings, serum cardiac biomarkers, whole blood count, C reactive protein and viral serology results, electrocardiographic findings, telecardiography and echocardiographical findings and the medical records about complications and mortality during follow-up were analysed. Statistical analyzes performed with IBM SPSS 22.0. Pearson chi-square and continuity corrected chi-square tests were used. Numerical data were summarized with median, minimum and maximum values. Univariate Kaplan - Meier and Cox regression analyzes were used in comparisons. The significance level was accepted as 0.05 in all tests. Results: From January 2007 to December 2017, 67 patients with myocarditis were retrospectively analyzed. 31 (46.2%) patients were recovered. 21 patients (31.3%) developed dilate cardiomyopathy. Six patients were died in acute phase. 7 of 21 patients with dilate cardiomyopathy were died at follow-up period. Nine patients were referred to a cardiovascular surgery center for VAD, ECMO or cardiac transplantation. Among them seven patients were died under ECMO. 2 patients were implanted VAD. Conclusion: Myocarditis is an inflammatory disease of the myocardium. Diagnosis of myocarditis may be difficult to subtle clinical findings. The clinical picture may be varying from a mild subclinical period to congestive heart failure. The prognosis varies from recovery to complicated chronic disease and death. In our study, increased cardiothoracic index and pulmonary congestion findings in telecardography, increased serum myoglobin level and decreased echocardiographic shortening fraction were factors associated with increased mortality. The using the cardiac support devices in patients with myocarditis may decrease mortality.Öğe Pericardial cyst: A very rare anomaly in children(2019) İnce, Damla; Elkıran, Özlem; Karakurt, Cemşit; Görmeli, Ayşe Cemile; Çetiner, NilüferPericardial cyst: A very rare anomaly in children
