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Öğe Adenosine deaminase in childhood pulmonary tuberculosis diagnostic value in serum(J tropical ped, 1999) Kuyucu, Necdet; Karakurt, Cemşit; Bilaloğlu, Eris; Karacan, Candemir; Teziç, TahsinÖğe Adenosine deaminase in childhood pulmonary tuberculosis: diagnostic value in serum(J Trop Pediatr. 1999 Aug;45(4):245-7., 1999) Kuyucu, Necdet; Karakurt, Cemşit; Bilaloğlu, E.; Teziç, TahsinThe diagnostic value of serum adenosine deaminase (ADA) activity was evaluated in childhood pulmonary tuberculosis. Serum ADA levels were measured in 20 children diagnosed with pulmonary tuberculosis (group 1) and 150 children (group 2) including 128 with tuberculosis infection (Mantoux test positive) and 22 healthy children. In group 1, the mean serum ADA activity was 74.06 +/- 18.5 U/l, which was significantly (p < 0.001) higher than that of group 2 (40.36 +/- 12.0 U/l). A serum ADA level of > or = 53.76 U/l had a sensitivity of 100 per cent, specificity of 90.7 per cent, positive predictive value of 58.8 per cent, and a negative predictive value of 100 per cent in children with tuberculosis disease. To conclude, measurement of serum ADA activity was a useful diagnostic tool in childhood pulmonary tuberculosis.Öğe Akrep sokmasına bağlı toksik miyokardit: Olgu sunumu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2007) Karakurt, Cemşit; Koçak, GülendamÖz: Akrepler tüm dünyada yaşamakla birlikte, insan sağlığı açısından tehlikeli olan türlerin yaşadığı Afrika ülkeleri, Hindistan, Mısır, Ortadoğu ve İsrail gibi bölgelerde akrep sokması önemli bir sağlık problemidir. Yapılan çalışmalarda dünyanın bazı bölgelerinde görülen akrep sokmalarında çocukların % 50'sinde miyokardit geliştiği saptanmıştır. Bu yazıda özellikle yaz aylarında ülkemizin güney ve güneydoğu bölgelerinde akrep sokmasının sık görülmesi nedeniyle son bir yıl içerisinde hastanemize başvuran akrep sokmasına bağlı iki miyokardit olgusu tartışılmıştır. Başlık (İngilizce): Toxic myocarditis after scorpion envenomation: Case report Öz (İngilizce): Altough scorpions have a worldwide distribution, scorpion sting is an acute life-threating medical emergency condition in African Countries, India, Egypt, Middle- East, Israel and tropical countries. Some studies show that 50 per cent of scorpion envenomed children were diagnosed as having myocarditis. Because the scorpion sting is an acute life threatining medical problem in summer and dry seasons in South and South- Eastern regions of our country, we want to report our two cases who administired to our hospital in last year and who experienced myocarditis and pulmonary edema after scorpion sting.Öğe Akut Pnömoni ve Bronşiyolitli Çocuklarda Elektrokardiyografik Anormallikler(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2009) Koçak, Gülendam; Tabel, Yılmaz; Karakurt, Cemşit; Demirdağ, Yeşim YılmazBu prospektif çalışmada; pnömoni ve bronşiolitli çocuklarda elektrokardiyografik değişikliklerin sıklık ve özelliklerini araştırmayı amaçladık. Hastalar ve yöntem: Çalışmaya ortalama yaşları 25.8 ay (2-168) olan 48 alt solunum yolu enfeksiyonlu çocuk (27 erkek) dahil edildi. Bulgular: Elektrokardiyografideki en yaygın değişiklikler; QTc intervalinde uzama (%89.3), QRS aksında sağa kayma (%85.4), sağ ventrikül güçlerinde artış (%70.5), taşikardi (%64.5), P voltajında artma (%54.1) ve T supresyonu (%52.1) idi. Üç hastada sağ aks deviasyonu, üç hastada p pulmonale ve 12 hastada da QTc’de uzama gözlendi. QRS aksında sağa sapma, p pulmonale ve V1R/S oranında artış pnömonili çocuklarda bronşiolitli olanlara göre daha fazla oranda saptandı. Sonuç: Elektrokardiyografik değişikliklerin çocukluk çağı alt solunum yolu infeksiyonlarında yaygın ancak tamamen geri dönüşümlü olduğunu gösterdik. Akut alt solunum yolu infeksiyonlu çocuklarda kardiyak bulguları değerlendirirken, infeksiyon düzeldikten sonraki elektrokardiyografi ile karşılaştırılması uygun olacaktır.Öğe Akut Poststreptokoksik Glomerulonefrit ve Akut Romatizmal Ateş; Eş Zamanlı Ortaya Çıkan Farklı Non-Süpüratif Poststreptokoksik Komplikasyonlar(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2007) Tabel, Yılmaz; Koçak, Gülendam; Mungan, İlke; Güngör, Serdal; Karakurt, CemşitAkut romatizmal ateş (ARA) ve poststreptokoksik akut glomerülonefrit (PSAGN), streptokok enfeksiyonlarının iki ayrı süpüratif olmayan komplikasyonudur. Farklı serotiplere bağlı geliştiklerinden dolayı ARA ve PSAGN’nin aynı hastada birlikte görülmesi oldukça seyrektir. Burada streptokoksik boğaz enfeksiyonundan sonra tipik PSAGN ve ARA bulgularını aynı anda gösteren 7 ve 10 yaşlarında iki hasta sunulmuştur.Öğe Aortic aneurysm a rare complication of ulcerative colitis(Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2007) Karakurt, Cemşit; Koçak, Gülendam; Selimoğlu, Mukadder Ayşe; Özen, MetehanUlcerative colitis is an idiopathic chronic inflammatory disorder localized in the colon and rectum. Systemic and extraintestinal complications of ulcerative colitis are arthritis, delayed growth and sexual maturation, nutritional deficiency secondary to malabsorbtion, mucocutaneous lesions, renal disease, hepatobiliar disease and ocular complications (1). Cardiac complications including myocarditis, pericarditis and increased risk of infective endocarditis may be rarely seen during the clinical course but aortic aneurysm is an extremely rare complication of ulcerative colitis.Öğe Aortic aneurysm a rare complication of ulcerative colitis(Anadolu Kardiyol Derg 2007; 7: 459-62., 2007) Karakurt, Cemşit; Selimoğlu, Ayşe; Özen, Metehan; Koçak, GülemdamA 48-year-old man who was admitted to hospital because of syncope, transient ischemic attack, palpitations and chest pain. On physical examination, he had sight deficiency on the right eye. Electrocardiography revealed T-wave inversion in leads V1 through V6. The cardiac enzymes (creatine phosphokinase-MB and Troponin-T) were normal. Laboratory analysis was normal. Echocardiogram showed an apical mass resembling thrombus in apical region of the left ventricle (Video 1, 2. See corresponding video/movie images at www.anakarder.com). The coronary angiography (CAG) of the patient showed that the patient’s left anterior descending (LAD) artery was irregular, dissected, and recanalized spontaneously following the dissection; it also revealed the presence of double lumen structure and no aneurysm any where on ventricle (Fig. 1). The other coronary arteries were normal. Brain computed tomography revealed infarction in the occipital region. It was judged by neurologists that this lesion would not hinder open heart surgery. Anticardiolipin antibodies were negative. There was no stigma of connective tissue disorder. Due to the prolonged existence of mass and continuance of the patient’s complaints despite the maximal anticoagulant treatment (keeping INR 2-3), we decided to operate the patient with the techniques of standard cardiopulmonary bypass using moderate hypothermia and cardioplegia arrest. In the operation, a mass including thrombus with diameters of 20x15 mm adjacent to the papillary muscles on the left ventricular apical region was resected. Apical region was closed with felt (Fig. 2). However, we did not perform coronary artery bypass grafting (CABG) because of the absence of significant stenosisÖğe Arterial tortuosity syndrome case report(Genet Couns, 2012) Karakurt, Cemşit; Koçak, Gülendam; Elkıran, Özlem; Coucke; PJ; Van Maldergem; L.Arterial tortuosity syndrome (ATS; OMIM 208050) is a rare autosomal recessive condition characterized by dysmorphic features, elongation, tortuosity, and aneurysm of the large and middle sized arteries. We report on a 13-year-old boy who presented with a malformed ascending aorta mimicking coarctation of aorta and a cutis laxa-like facial dysmorphia. Based on angiogram, a diagnosis of ATS was made and subsequently confirmed by a homozygous one base-pair deletion at position g.318 of SLCA10. We stress similarities (facial appearance, inguinal herniae, ..) between ATS and autosomal recessive cutis laxa, both being connective tissue disorders disorganizing the elastin network.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 Association of cardiac changes with serum adiponectin and resistin levels in obese and overweight children(J Cardiovasc Med 2013, 14:228–234., 2013) Akıncı, Ayşehan; Karakurt, Cemşit; Gürbüz, Sibel; Elkıran, Özlem; Nalbantoğlu, Özlem; Koçak, Gülemdar; Güldür, Tayfun; Yoloğlu, SaimObjectives To investigate serum adiponectin and resistin levels in childhood obesity and their relationship with cardiac changes and insulin resistance. Methods Seventy-one obese and 24 overweight children and 40 healthy children and adolescents were selected for the study. Height and weight measurements, BMI values and BMI SD score values were obtained for each individual. After blood pressure measurement, left ventricular wall thickness, left ventricular mass, stroke volume, cardiac output, systolic and diastolic functions of the left ventricle were measured using an M-mode, two dimensional colorcoded echocardiography device. Blood samples of the individuals were obtained for fasting blood sugar, total blood cholesterol, triglyceride, low-density lipoprotein (LDL) cholesterol, very low-density lipoprotein cholesterol, highdensity lipoprotein cholesterol, insulin, C-peptide, adiponectin and resistin values. Results Cholesterol and LDL values, homeostasis model assessment of insulin resistance, fasting insulin and fasting C-peptide values of the obese and overweight groups were higher (P< 0.01). Adiponectin level (P< 0.001) and resistin level (P< 0.05) of the obese and overweight groups were lower than those of the control group (P< 0.05). Echocardiographic evaluation showed diastolic dysfunction in addition to increased left ventricular wall thickness and left ventricle mass values in the obese and overweight children. We also detected a significant positive correlation among left ventricular mass, interventricular septum systolic diameter and resistin in obese children. Among the factors, resistin level was determined as an independent predictor of left ventricular mass in obese children. Conclusion In this study, even in asymptomatic obese and overweight children, cardiac structural and functional changes, such as increased left ventricular mass and diastolic dysfunction, were demonstrated. Although decreased adiponectin level was not related to cardiac changes, it was shown that decreased serum resistin levels in the obese cases lead to left ventricle hypertrophy.Öğe Brucella myocarditis in a 3 month old probable transplacental transmission(Ann Trop Paediatr, 2014) Elkıran, Özlem; Koçak, Gülendam; Karakurt, Cemşit; Kuzucu, C.A 3-month-old girl presented with myocarditis owing to brucellosis. Her mother had been diagnosed with brucellosis at 28 weeks gestation but did not receive treatment until after delivery. The infant had intrauterine retardation and had gained little weight since birth. It is considered likely that the brucellosis was transmitted transplacentally.Öğe Brucella myocarditis in a 3-month-old: probable transplacental transmission(Ann Trop Paediatr. 2010;30(3):225-8., 2010) Elkıran, Özlem; Koçak, Gülemdar; Karakurt, CemşitA 3-month-old girl presented with myocarditis owing to brucellosis. Her mother had been diagnosed with brucellosis at 28 weeks gestation but did not receive treatment until after delivery. The infant had intrauterine retardation and had gained little weight since birth. It is considered likely that the brucellosis was transmitted transplacentally.Öğe Cardiac dysrhythmias after transcatheter closure of ASD with Amplatzerdevice(Turk Journal of Pediatrics, 2011) Karakurt, Cemşit; Özkutlu, S.; Çeliker, A.; Karagöz, AlperTranscatheter closure of atrial septal defect (ASD) has been used as an alternative to open heart surgery. Although transcatheter closure of ASD with the Amplatzer septal occluder is a safe and feasible method in pediatric patients, there is little published data on arrhythmia analysis following transcatheter device closure of secundum ASD. We evaluated cardiac dysrhythmias with 24-hour ambulatory electrocardiographic (ECG) monitoring after transcatheter closure of ASD with Amplatzer device. A total of 85 consecutive patients with ASD underwent transcatheter closure of secundum ASD with Amplatzer device between October 1998 and December 2003. The study involved 65 of these patients assessed by 24-hour ambulatory ECG monitoring. Seven patients were evaluated a second time by 24-hour monitorization. During the procedure, transient complete atrioventricular (AV) block was seen in two patients. One of them returned to normal sinus rhythm in catheterization lab and the other returned to normal sinus rhythm in two hours. Transient junctional rhythm was observed in another patient during the device placement. Twenty-four hour ambulatory ECG monitoring was performed on all patients after a mean four-month period (1-12 months). Holter recordings demonstrated rare supraventricular extrasystole in two patients, rare ventricular premature beats in two patients, and intermittent sinus arrest with sinus pause lasting <1.5 seconds in one patient, for a total of five patients (7.6%). In conclusion, dysrhythmias after transcatheter device closure of secundum ASD with Amplatzer device are rare and benign. We need further long-term follow-up to evaluate late dysrhythmias after the transcatheter device closure of secundum ASD.Öğe Cardiac dysrhythmias after transcatheter closure of ASD with Amplatzerdevice(Turk J Pediatr. 2005 Oct-Dec;47(4):323-6., 2005) Çeliker, Alpay; Karakurt, CemşitTranscatheter closure of atrial septal defect (ASD) has been used as an alternative to open heart surgery. Although transcatheter closure of ASD with the Amplatzer septal occluder is a safe and feasible method in pediatric patients, there is little published data on arrhythmia analysis following transcatheter device closure of secundum ASD. We evaluated cardiac dysrhythmias with 24-hour ambulatory electrocardiographic (ECG) monitoring after transcatheter closure of ASD with Amplatzer device. A total of 85 consecutive patients with ASD underwent transcatheter closure of secundum ASD with Amplatzer device between October 1998 and December 2003. The study involved 65 of these patients assessed by 24-hour ambulatory ECG monitoring. Seven patients were evaluated a second time by 24-hour monitorization. During the procedure, transient complete atrioventricular (AV) block was seen in two patients. One of them returned to normal sinus rhythm in catheterization lab and the other returned to normal sinus rhythm in two hours. Transient junctional rhythm was observed in another patient during the device placement. Twenty-four hour ambulatory ECG monitoring was performed on all patients after a mean four-month period (1-12 months). Holter recordings demonstrated rare supraventricular extrasystole in two patients, rare ventricular premature beats in two patients, and intermittent sinus arrest with sinus pause lasting <1.5 seconds in one patient, for a total of five patients (7.6%). In conclusion, dysrhythmias after transcatheter device closure of secundum ASD with Amplatzer device are rare and benign. We need further long-term follow-up to evaluate late dysrhythmias after the transcatheter device closure of secundum ASD.Öğe Carriage of Streptococcus pyogenes in primary school children M protein types pyrogenic toxin genes and investigation of the clonal relationships between the isolates(Mikrobiyol Bul, 2015. 49(3), 301–13., 2015) Otlu, Barış; Karakurt, Cemşit; Bayındır, Yaşar; Kayabaş, Üner; Yakupoğulları, Yusuf; Gözde, Harika; Bağ, GözükaraM-protein and pyrogenic toxins are the most important virulence factors of Streptococcus pyogenes, and they play significant role in the pathophysiology of acute rheumatoid fever and scarlet fever, respectively. In this study, the pharyngeal carriage of S.pyogenes of the primary school children, clonal relationship of the strains, M-protein types, and the presence of pyrogenic toxin genes were aimed to be investigated. A total of 668 throat cultures obtained from children (age range: 6-16 years) in two primary schools in our region, were included in the study. The clonal relationships of the isolated group A streptococci (GAS) strains were investigated by DiversiLab assay (BioMérieux, France), and the clonal relatedness was confirmed by pulsed-field gel electrophoresis (PFGE) method. M-protein (emm) typing was performed by DNA sequencing as suggested by Centers for Disease Control and Prevention (CDC). The genes encoding pyrogenic toxins, speA and speC, were investigated by an in-house multiplex polymerase chain reaction (PCR) method. S.pyogenes was isolated from 134 (20.05%) of the throat samples. The GAS carriage rate of the students aged ≥10 was statistically higher than those 7-9 years age group (%22 vs %16.4, p<0.05). The M protein gene could be characterized only among 123 isolates by DNA sequencing, and 20 different emm types were detected. The most frequent emm type was emm1 (n=38, 30.9%) followed by emm12 (n=18, 14.6%), emm89 (n=10, 8.1%), emm118 (n=9, 7.3%), and emm4 (n=7, 5.7%). Pyrogenic toxin genes were found in 25 (18.6%) of the isolates, including speA in 11 isolates (8.2%) and speC in 12 isolates (8.9%) and both genes were detected in 2 isolates (1.5%). Sixty-two different Rep (Repetitive extragenic palindromic)-PCR profiles were detected in 134 S.pyogenes isolates by DiversiLab method. Thirteen different clusters were formed by a total of clonally related 36 isolates revealing a strain clustering ratio of 26.9%. Clonal relationship of all isolates in the same cluster was confirmed by PFGE method. In this study, relatively high percentage of GAS carriage was observed among primary school children in our region. The coverage rate of the 30-valent vaccine was determined to be over 90% with respect to M-protein types. Since the pyrogenic toxin-encoding genes were found in one fifth of the isolates from the studied subjects, we concluded that the carrier population may also have high risk for scarlet fever. We also concluded that, the clonal relationship ratio determined among the isolates may be a risk in school transmission of GAS.Öğe Carriage of streptococcus pyogenes in primary school children M protein types pyrogenic toxin genes and investigation of the clonal relationships between the isolates(Mikrobiyoloji Bulteni, 2015) Otlu, Barış; Karakurt, Cemşit; Bayındır, Yaşar; Kayabaş, Üner; Yakupoğulları, Yusuf; Gözükara Bağ, HarikaM-proteini ve pirojenik toksinler Streptococcus pyogenes’in en önemli virülans faktörleri olup, bu faktörler sırasıyla akut romatizmal ateş ve kızıl hastalığının patofi zyolojisinde önemli rol oynarlar. Bu çalış- mada, ilköğretim okulu çocuklarının farengeal S.pyogenes taşıyıcılık durumları, suşlar arasındaki klonal ilişki, izolatların M-protein tipleri ve pirojenik toksin gen varlığının araştırılması amaçlanmıştır. Çalışmaya, bölgemizdeki iki ilköğretim okulunda bulunan 668 çocuktan (yaş aralığı: 6-16 yıl) alınan boğaz kültürü örnekleri dahil edilmiştir. İzole edilen grup A streptokok suşları arasındaki klonal ilişki DiversiLab (BioMérieux, Fransa) yöntemiyle araştırılmış ve tespit edilen klonal ilişkiler PFGE (pulsed-fi eld gel electrophoresis) yöntemi ile doğrulanmıştır. İzolatların M-protein (emm) tiplemesi Centers for Disease Control and Prevention (CDC) tarafından önerilen DNA dizi analizi yöntemiyle gerçekleştirilmiştir. Pirojenik toksin kodlayan genlerden speA ve speC’nin varlığı in-house multipleks polimeraz zincir reaksiyonu (PCR) yöntemi ile araştırılmıştır. Çalışmada toplam 134 (%20.05) öğrencinin boğaz kültüründen S.pyogenes izole edilmiştir. 10 yaş ve üzeri öğrencilerin GAS taşıyıcılık oranı, 7-9 yaş grubu öğrencilerine göre istatistiksel olarak daha yüksek bulunmuştur (%22’ye karşı %16.4; p< 0.05). Dizi analizi ile bu izolatlardan 123’ünün M protein geni tiplendirilebilmiş ve 20 farklı emm tipi saptanmıştır. En sık tespit edilen emm tipi emm1 (n= 38, %30.9) olmuş, bunu sırasıyla emm12 (n= 18, %14.6), emm89 (n= 10, %8.1), emm118 (n= 8, %7.3) ve emm4 (n= 7, %5.7) izlemiştir. Toplam 25 (%18.6) izolatta pirojenik toksin geni bulunmuş; bunların 11’inde (%8.2) speA, 12’sinde speC (%8.9) ve ikisinde (%1.5) her iki gen birden saptanmıştır. DiversiLab yöntemi ile 134 S.pyogenes suşu içerisinde 62 farklı Rep (Repetitive extragenic palindromic)-PCR profi li belirlenmiştir. Klonal olarak ilişkili 36 izolat, 13 farklı küme içerisinde yer almıştır. Suşların kümeleşme oranı %26.9 olarak bulunmuş; aynı küme içerisinde yer alan izolatların tümü arasındaki klonal ilişki, PFGE yöntemi ile de doğrulanmıştır. Çalışmamızda, bölgemizdeki ilköğretim çocukları arasında GAS taşıyıcı- lığının yüksek olduğu ve M-protein tiplerine göre suşların 30 valanlı aşı tarafından kapsanma oranının %90’nın üzerinde olduğu tespit edilmiştir. İzolatların yaklaşık beşte birinde pirojenik toksin geni bulunması, taşıyıcılarda da kızıl hastalığı riskinin yüksek olabileceğini göstermiştir. Bununla birlikte, izolatlar arasında tespit edilen klonal ilişki oranı, okul içi GAS yayılımının risk oluşturabileceği lehine yorumlanmıştır.Öğe A case of cardiac cyst hydatid with multiple system involvement(2021) Dogan, Gulec Mert; Dogan, Sait Murat; Tasolar, Sevgi; Okut, Gokalp; Sığırcı, Ahmet; Elkıran, Özlem; Karakurt, CemşitAbstract: The larval form of the Echinococcus granulosus causes cystic echinococcosis. The liver and the lungs are the most commonly affected organs. Echinococcosis can also be present in other organs although it is rare. We reported a case with sacral bone, cardiac, lung and liver involvement. Clinical and radiological findings of this unique case were discussed. At the Thoracic Computed On the thoracic computed tomography (CT) scan of a 16-year-old female patient was seen multiple parenchymal and subpleural nodular lesions and a cystic mass in the right ventricular cavity. Echocardiographic examination of the patient also observed on CT. Most cases of cardiac cystic echinococcosis were occurred on adult patients, while only 20 cases were in children. For the 20 reported cases in children, there were 9 cases of cardiac echinococcosis involving left ventricle. Because of the possible complications in the presence of cardiac hydatid cyst, treatment should be surgery.Öğe Closure of patent ductus arteriosus in children small infants and premature babies with Amplatzer duct occluder II additional sizes multicenter study(Catheter Cardiovasc Interv, 2013) Sungur, Metin; Karakurt, Cemşit; Özbarlas, Nazan; Başpınar, OsmanObjectives: To evaluate safety and efficacy of closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder II Additional Sizes (ADO II AS) and to report early and midterm results of the device in children and very young symptomatic infants. Methods: Retrospective analysis of angiographic data of 60 children from four pediatric cardiology centers. Results: The median patient age and weight were 6.5 (0.5–168) months and 6.8 (1.19–57) kg, respectively. In the study, 26 children had a body weight of 6 kg. Of these 26 children, 9 had a body weight of 3 kg. The median narrowest diameter of PDA was 2 (1.2–4) mm. Ductal anatomy was Type A in 29, Type B in 2, Type C in 11, Type D in 1, and Type E in 16 patients, and a residual PDA after surgery in 1 patient. Closure with ADO II AS was achieved in 58 (96.6%) of 60 attempted cases. In two infants, the device was not released because of significant residual shunt. ADO II was used in one, and the other was sent to surgery. Complete closure was observed in all ADO II AS deployed children by the next day on echocardiography. Median follow-up was 12 (1–18) months. Neither death nor any major complications occurred. Conclusions: Our study shows that closure of medium and small sized PDA by using ADO II AS device is effective and safe in children. The use of the device will expand the field of application of PDA closure in small infants.Öğe Çocuk Kardiyolojisinin Hematolojik Yönleri(İnönü Üniversitesi Tıp Fakültesi, 2020) Ceylan, Emine Saliha; Karakurt, CemşitBu sunumda, Kardiyovasküler Hastalıkları olan Pediyatrik Hastalarda Dolaşım Halindeki Kanın Hücresel ve Plazma Bileşenlerindeki Klinik ve Laboratuvar Anormallikleri sunulacaktır.Öğe Combined effect of aerosolized iloprost and oxygen on assessment of pulmonary vasoreactivity in children with pulmonary hypertension(Anadolu Kardiyoloji Dergisi-The Anatolian Journal of Cardiology, 2014) Elkıran, Özlem; Karakurt, Cemşit; Koçak, GülemdarObjective: The evaluation of pulmonary vascular reactivity plays a significant role in the management of patients with pulmonary hypertension. Inhaled nitric oxide in combination with oxygen (O2) has become widely used as an agent for pulmonary vasodilator testing. However, inhaled nitric oxide is not available in many developing countries. Recently, aerosolized iloprost was suggested as an alternative to nitric oxide for this purpose. In the present study, aerosolized iloprost was used together with O2 in the pulmonary vasoreactivity test of children with severe pulmonary hypertension. Thus, the synergistic effect of both vasodilators was utilized without extending the duration of cardiac catheterization. Methods: The prospective cohort study registered a total of 16 children with severe pulmonary hypertension whose median age was 4.5 years. Hemodynamic parameters were quantified before and after the vasoreactivity test. Increased left-to-right shunt, pulmonary vascular resistance of <6 Woods units (WU)/m2 and a pulmonary-systemic resistance ratio of <0.3, as well as a decrease >10% in the pulmonary vascular resistance and pulmonary-systemic vascular resistance ratio after the vasoreactivity test were accepted as a positive response. The data were analyzed using Wilcoxon signed-rank and the Mann-Whitney U tests. Results: Eleven children gave a positive response to the vasoreactivity test, while 5 children did not respond. Pulmonary vascular resistance dropped from 9.98±1.39 WU/m2 to 5.08±1.05 WU/m2 (p=0.013) and the pulmonary-systemic vascular resistance ratio fell from 0.68±0.08 to 0.32±0.05 (p=0.003) in the children who were responsive. No side effects were observed related to iloprost administration. Conclusion: Administration of inhaled iloprost in combination with O2 for pulmonary vasoreactivity testing can be useful for correctly identifying pulmonary vasoreactivity without extending the duration of cardiac catheterization. (Anadolu Kardiyol Derg 2014; 14: 383-8) Key words: pulmonary hypertension, iloprost, children
