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    Altered kynurenine pathway metabolite levels in toddlers and preschool children with autism spectrum disorder
    (Taylor & Francis Ltd, 2022) Bilgic, Ayhan; Abusoglu, Sedat; Sadic celikkol, Cagla; Oflaz, Mehmet Burhan; Akca, Omer Faruk; Sivrikaya, Abdullah; Baysal, Tamer
    Aim There are increasing reports about the potential role of kynurenine pathway metabolites in autism spectrum disorder (ASD). Early childhood is a very crucial period of time for the etiopathogenesis of ASD and previous studies reported an age-dependent alteration in kynurenine metabolism. However, no study specifically examined kynurenine metabolites in very young children with ASD. This study aimed to investigate kynurenine pathway metabolite levels, kynurenine pathway enzyme activities and neuroprotective index (kynurenic acid/3-hydroxykynurenine ratio) in toddlers and preschool children with ASD. Materials and Methods A total of 68 children with ASD and 44 healthy controls aged between 18 and 60 months were included in this study. Serum levels of kynurenine pathway metabolites were determined by liquid chromatography-mass spectrometry/mass spectrometry system. Results Serum 3-hydroxykynurenine and kynurenic acid concentrations were significantly higher in the ASD group than in the control group, whereas serum 3-hydroxyanthranilic acid concentrations were significantly lower. Conclusions These findings showed that the kynurenine pathway may play a role in the etiopathogenesis of ASD in early childhood.
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    Assessment of cardiovascular functions in children with attention-deficit/hyperactivity disorder who are new users of methylphenidate
    (Kuwait Medical Assoc, 2020) Sargin, Fatma; Oflaz, Mehmet Burhan; Yar, Ahmet; Baysal, Tamer
    Objectives: It was aimed to evaluate cardiovascular functions via blood pressure and electrocardiogram (ECG) of patients with attention deficit and hyperactivity disorder (ADHD) who were treated with methylphenidate. Design: This is a descriptive and prospective study. Settings: Necmettin Erbakan University Meram Faculty of Medicine and Konya Training and Research Hospital, Turkey Subjects: Thirty-five patients with ADHD who were selected to be treated with methylphenidate were evaluated using ECG, heart rate (beats/minute), systolic blood pressure (mmHg) and diastolic blood pressure (mmHg) recorded before treatment, and after 1st month and 3rd month of treatment. Interventions: Heart rate, rhythm, QRS axis, P-R interval, P dispersion, QT dispersion, QTc interval and QTc dispersion were measured on ECG. Main outcome measures: ECG changes of patients with ADHD who were treated with methylphenidate Results: There were no statistically significant differences in the heart rate, systolic blood pressure, diastolic blood pressure, P-R interval, P dispersion, QT dispersion and QTc dispersion between the measurements performed at baseline and at one and three months of treatment. Statistically significantly increased QRS axes were observed at baseline, and at one and three months of treatment, although this increase was not clinically significant. None of the patients had adverse cardiovascular events. Conclusion: In conclusion, methylphenidate which is used commonly in the treatment of ADHD does not alter the heart rate, blood pressure and ECG recordings at one and three months of treatment compared to the baseline.
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    Association Between Nonalcoholic Fatty Liver Disease and Cardiovascular Risk in Obese Children and Adolescents
    (Elsevier Science Inc, 2013) Alp, Hayrullah; Karaarslan, Sevim; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Altin, Hakan; Baysal, Tamer
    Background: The recent rise in the prevalence of obesity likely explains nonalcoholic fatty liver disease (NAFLD) epidemic worldwide. We evaluated cardiac functions, cardiovascular risk, and associated parameters with grades of NAFLD in obese children. Methods: Four hundred obese children were enrolled in the study. Obese children with NAFLD were classified in 2 subgroups according to ultrasonographic visualizing. Ninety-three obese children with NAFLD (mean age 11.73 +/- 2.72 years in group 2 and 12.69 +/- 2.61 years in group 3) were compared with 307 age- and sex-matched non-NAFLD obese children and 150 control subjects. Laboratory parameters were measured during the fasting state. Pulsed and tissue Doppler echocardiography were performed. Intima-media (IMT) and epicardial adipose tissue (EAT) thicknesses were measured. Results: NAFLD groups had a significantly higher body mass index (29.15 +/- 3.42 and 30.46 +/- 4.60; P < 0.001), total adipose tissue mass (37.95 +/- 4.46% and 46.57 +/- 6.45%; P < 0.001), higher insulin, alanine aminotransferase, and aspartate aminotransferase levels. Increased end-systolic thickness of the interventricular septum (P < 0.001), larger left ventricular mass (P < 0.003) and index (P < 0.003) were found in NAFLD groups. Children with NAFLD had higher Tei index values. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Waist and hip circumference, total cholesterol level, total adipose tissue mass, and interventricular septum were statistically different in NAFLD groups. Conclusions: Children with NAFLD had mildly altered left and right ventricular functions and all obese children had increased IMT and EAT thickness. Also, grade of liver steatosis was positively correlated with total adipose tissue mass and interventricular septum systolic thickness.
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    Breastfeeding does not protect against the development of carditis in children with acute rheumatic fever
    (Cambridge Univ Press, 2022) Gurbuz, Funda; Sahiner, Nejla Canbulat; Unal, Emin; Gurbuz, Ahmet Seyfeddin; Baysal, Tamer
    Introduction: Acute rheumatic fever is an autoimmune disease that develops due to streptococcal infection. The positive effect of breastfeeding on the development of the child's immune system is well documented. In this study, we aimed to investigate the effect of breast milk intake period on the development of carditis. Materials and methods: Patients (n: 182) who were diagnosed with acute rheumatic fever between 2010 and 2019 were enrolled in the study. The patients were divided into groups according to carditis development. The demographic, socio-economic, and breastfeeding data were compared between groups. Results: The mean age of the patients was 10.5 +/- 3.4, and 43.4 % (n: 79) of them were female. Independent predictors of the development of carditis in the first acute rheumatic fever episode were the number of children at home (OR: 1.773, CI 95%: 1.105, 2.845; p: 0.018) and breast milk intake less than 6 months (OR: 0.404, CI 95%: 0.174, 0.934; p: 0.034). Independent predictors of the development of carditis in any of the acute rheumatic fever episodes were the number of children at home (OR: 1.858, CI 95%: 1.100, 3.137; p: 0.021) and female gender (OR: 3.504, CI 95%: 1.227, 10.008; p: 0.019). The only independently predictor of the development of chorea during acute rheumatic fever was female gender (OR: 3.801, CI 95%: 1.463, 9.874; p: 0.006). Conclusion: Although the occurrence of carditis is less common during the first acute rheumatic fever attack in patients with breast milk intake less than six months, this advantage is lost in recurrent attacks. This study showed that breast milk does not have a negative effect on acute rheumatic fever carditis.
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    Claudin-5, occludin, zonulin and tricellulin levels of children with attention-deficit/hyperactivity disorder
    (Elsevier Espana Slu, 2024) Ferahkaya, Hursit; Akca, Omer Faruk; Baysal, Tamer; Kilinc, Ibrahim
    Background and objectives: Accumulating studies have pointed out that gut-blood and blood -brain barrier dysfunctions due to the alterations in permeability may play a role in the patho-physiology of neurodevelopmental disorders. Tight junctions are crucial components of these barriers and some peptides including claudin-5, occludin, zonulin and tricellulin are important components of these structures. This study aimed to investigate the relationship between these molecules and attention deficit hyperactivity disorder (ADHD) in children and adolescents.Methods: A total of 57 children with ADHD and 60 controls aged between 6 and 12 years were included in the study. The severity of ADHD symptoms was assessed through a parent-rated questionnaire, and Conner's Continuous Performance Test was administered to the study group. Serum levels of biochemical variables were measured using enzyme-linked immunosorbent assay kits. Biochemical parameter levels and scale scores were compared using Mann-Whitney U or Student's t tests. In addition, a multivariate analysis of covariance (MANCOVA) and a one-way analysis of covariance (ANCOVA) was performed on the outcome variables. Finally, a hierarchical regression model was conducted on the study group.Results: Serum claudin-5 and tricellulin levels were significantly lower in the ADHD group compared to the control group. The difference between the groups in terms of serum claudin-5 and tricellulin levels remained significant after controlling for confounding factors such as age, gender and autistic characteristics. There was no significant difference between the groups in terms of serum zonulin and occludin levels.Conclusion: These results reveal that claudin-5 and tricellulin levels vary in patients with ADHD. Alterations in these peptides may affect the brain by leading to a dysregulation in intestinal or blood-brain barrier permeability. The causal relationship between these peptides and ADHD requires further investigation.(c) 2023 Sociedad Espanola de Psiquiatna y Salud Mental. Published by Elsevier Espana, S.L.U. All rights reserved.
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    Comparison of left and right ventricular pulsed and tissue Doppler myocardial performance index values using Z-score in newborns with hypoxic-ischemic encephalopathy
    (Turkish Soc Cardiology, 2011) Alp, Hayrullah; Karaaslan, Sevim; Baysal, Tamer; Oran, Bulent; Ors, Rahmi
    Objective: The aim of the study is determination of myocardial performance index (MPI/Tei index) using pulsed (PD) and tissue Doppler (TD) techniques to show cardiac response in newborns with hypoxic-ischemic encephalopathy (HIE) and healthy newborns and eventually evaluation of the differences between these two techniques. Methods: The study is a prospective observational study. Twenty term newborns diagnosed as perinatal asphyxia during postnatal 24 hours due to the defined criteria and fifty healthy term neonates as control group were included the study. Hypoxic group was divided into two groups with Sarnat stages, Sarnat Stage 1 and 2-3. MP's (Tei indexes) were calculated with PD and TO echocardiographic techniques in all groups after the 24 hours of birth and one year later. The statistical differences between same techniques were calculated with Kruskal-Wallis test and Z score was used to compare the superiority of two techniques. Results: The MPI values calculated by PD (0.41 +/- 0.04, 0.51 +/- 0.02) and TD (0.59 +/- 0.04, 0.51 +/- 0.02) during the first day of life in Sarnat Stage 2-3 in both ventricles were significantly higher than the control group (p<0.01, p<0.02, p<0.03). While the Z score, calculated for MPI measured by PD and TD methods, were found similar in both ventricles in Sarnat Stage 1 and control groups, it was significantly different in other groups of Sarnat stages. Conclusion: The degree of cardiac response in neonates with HIE is associated with the severity of hypoxia. MPI values are not different from the controls in newborns received mild hypoxia while they are higher in the patients who were received moderate or severe hypoxia. Any advantage could not be found between two techniques according to the measurement values, but higher variability in the value of MPI, measured by TO method, calculated from moderate and severe hypoxia group was detected. (Anadolu Kardiyol Derg 2011; 11: 719-25)
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    Dispersion Durations of P-wave and QT Interval in Children With Congenital Heart Disease and Pulmonary Arterial Hypertension
    (Springer, 2013) Sap, Fatih; Karatas, Zehra; Altin, Hakan; Alp, Hayrullah; Oran, Bulent; Baysal, Tamer; Karaarslan, Sevim
    This study aimed to investigate homogeneity disorders of ventricular repolarization and atrial conduction via QT dispersion and P-wave dispersion in children with congenital heart disease (CHD) and pulmonary arterial hypertension (PAH). Three groups of 20 each were generated and involved in this study. The first group included 20 children with both CHD and PAH. The second group consisted of 20 children with CHD but no PAH, and the third group was composed of 20 age- and sex-matched healthy children. Electrocardiographic records were used to determine P-wave, QT, and corrected QT (QTc) dispersions. The pulmonary hypertension group compared with the group having no pulmonary hypertension and the control group showed a significantly longer P-wave dispersion duration (39.10 +/- A 9.54 vs. 26.30 +/- A 4.99 ms, p < 0.001; and 24.80 +/- A 6.94 ms, p < 0.001, respectively) and QT dispersion duration (52.80 +/- A 15.11 vs. 37.60 +/- A 6.00 ms, p < 0.001; and 35.00 +/- A 7.77 ms, p < 0.001, respectively). In addition, the durations of maximum QTc and QTc dispersion were significantly longer in pulmonary hypertension group than in the other two groups. The risk of atrial and ventricular arrhythmia was found to be increased in the patients with both CHD and PAH. Physicians should pay close attention to possible atrial and ventricular arrhythmias during the treatment and follow-up evaluation of these patients.
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    Doğumsal Kalp Hastalıkları ve Anne-Baba Akrabalığı Arasındaki İlişki
    (2015) Ertoy Karagöl, Hacer İlbilge; Karagöl, Cüneyt; Baysal, Tamer
    Amaç: Çocuk kardiyoloji kliniğinde doğumsal kalp hastalığı (DKH) tanısı alan hastaların anne-baba akrabalığı açısından değerlendirmesi. Gereç ve Yöntemler: Ocak 2008-Ocak 2009 tarihleri arasında hastanemiz çocuk kardiyoloji polikliniğine ilk kez mü- racaat eden 3295 çocuk olgunun dosyası geriye dönük olarak incelendi. Ekokardiyografi ile DKH tanısı alan 651 olgu çalışmaya dâhil edildi. Kontrol grubu olarak aynı tarihler arasında başvuran ve DKH saptanmayan ve akrabalık bilgisine ulaşılabilen 2430 olgu alındı. Bulgular: Çalışma grubundaki 651 olgunun 127sinde (%19.5) anne-baba akrabalığı vardı. En sık olarak 3.dereceden akrabalık 87 hasta da (%68.5), ikinci sıklıkta 5. dereceden akrabalık 33 hastada (%25.9), 4. dereceden akrabalık ise 7 hastada (%5.5) tespit edildi. Kontrol grubunda akrabalık oranları çalışma grubuna benzer şekilde %20.8 olarak bulundu ve çoğunluğu 3. derece akrabalıktı. Her 2 grup arasında ve DKH alt tipleri değerlendirildiğinde anne baba akrabalığı açısından istatistiksel olarak anlamlı fark bulunmadı (p0.072). Sonuç: Çoğunun sebebi hala aydınlatılamamış olan ve çevresel ve genetik faktörlerin etkileşimi sonucu ortaya çıktığı düşünülen DKHda, nedene yönelik olarak akrabalık konusunda daha fazla çalışmaya ihtiyaç olduğu düşünülmektedir. Anahtar Sözcükler: Akrabalık, Çocuk, Doğumsal kalp hastalıkları
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    The effect of hypertension and obesity on left ventricular geometry and cardiac functions in children and adolescents
    (Lippincott Williams & Wilkins, 2014) Alp, Hayrullah; Karaarslan, Sevim; Eklioglu, Beray S.; Atabek, Mehmet E.; Baysal, Tamer
    Objectives:Obesity and hypertension are associated with structural and functional cardiac change in children and adults. The aim of the study is to evaluate the effect of hypertension and obesity on left ventricular geometric patterns and cardiac functions assessed by conventional and Doppler echocardiography.Methods:Four hundred and thirty obese children, aged 6-17 years and 150 age and sex-matched healthy controls, were included in the study. Left ventricular geometry was classified as concentric hypertrophy, eccentric hypertrophy, concentric remodeling and normal geometry.Results:Concentric hypertrophy group had the worst subclinical systolic and diastolic cardiac functions among all left ventricular geometric patterns. BMI and total adipose tissue mass are the predictors of abnormal ventricular geometry. Apart from the increase in carotid intima-media and epicardial adipose tissue thicknesses in different left ventricular geometry patterns, they are not predictable for abnormal geometry.Conclusion:The variety of alterations in cardiac function and morphology that has been observed in obese adults, appears to start earlier in life. Obesity and hypertension were clearly associated with the left ventricular geometry. Also, subclinical systolic and load-depended diastolic dysfunctions can be detected in obese hypertensive children with concentric hypertrophy.
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    Electrocardiographic ST elevation (mosque sign) without myocardial ischemia in an infant with tuberous sclerosis
    (Georg Thieme Verlag Kg, 2014) Alp, Hayrullah; Baysal, Tamer; Karaarslan, Sevim; Alpmar, Abdullah; Caksen, Huseyin
    Rhabdomyomas, the most common primary cardiac tumors seen in infants and children, are often associated with tuberous sclerosis. However, these cardiac rhabdomyomas may cause hemodynamic disturbances and arrhythmias. In the present case, we demonstrated an infant with electrocardiographic ST elevation suggesting myocardial ischemia associated with multiple cardiac rhabdomyomas.
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    Ellis-van creveld sendromu (Kondroektodermal displazi) bir olgunun sunumu: Tek atrium ve persistan sol süperior vena kava birlikteliği
    (2013) Alp, Hayrullah; Şap, Fatih; Altın, Hakan; Karataş, Zehra; Baysal, Tamer; Karaaslan, Sevim
    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.
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    Evaluation of Appetite-Regulating Hormones in Young Children with Autism Spectrum Disorder
    (Springer/Plenum Publishers, 2021) Sadic, Cagla Celikkol; Bilgic, Ayhan; Kilinc, Ibrahim; Oflaz, Mehmet Burhan; Baysal, Tamer
    This study aimed to investigate the role of leptin, ghrelin, neuropeptide Y, and nesfatin-1 in young children with autism spectrum disorder (ASD). A total of 44 children with ASD and 44 healthy controls aged 18-60 months were included. Plasma levels of hormones were measured using commercial enzyme-linked immunosorbent assay kits. Plasma leptin and ghrelin levels were significantly higher in the ASD group than in the control group. However, no significant difference for plasma neuropeptide Y and nesfatin-1 levels was detected between the groups. No relation was found between the severity of ASD symptoms, severity of eating problems, and plasma levels of hormones. Leptin and ghrelin may play a potential role in the pathogenesis of ASD.
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    Evaluation of cardiac functions in term small for gestational age newborns with mild growth retardation: A serial conventional and tissue Doppler imaging echocardiographic study
    (Elsevier Ireland Ltd, 2012) Altin, Hakan; Karaarslan, Sevim; Karatas, Zehra; Alp, Hayrullah; Sap, Fatih; Baysal, Tamer
    Background: The aim of this study is to evaluate the cardiac functions of term small for gestational age (SGA) babies with mild growth retardation by echocardiography during the postnatal period. Methods and results: Thirty term SGA (2271 +/- 207 g/38-41 weeks (mean 39.5 weeks)) and 30 term AGA (3298 +/- 338 g/38-41 weeks (mean 39 weeks)) newborns as the control group, with normal general health status and with no nutritional problems were evaluated at three time points, on the 3rd postnatal day, at the 3rd and the 6th months. In the initial analysis, heart rate, left ventricular end diastolic diameter index (LVEdDI), cardiac index (CI), all E/A, Em/Am and E/Em ratios, pulsed wave Doppler myocardial performance index (MPI), and tissue Doppler imaging MPI values were higher in SGA babies than the control group. In the last analysis, only heart rate, LVEdDI and CI values were different between SGA and control groups. Conclusions: Systolic and diastolic cardiac dysfunctions were determined in SGA babies with mild growth retardation during the first 6 months of postnatal period. Any disease that affects the hemodynamic stability of these patients during postnatal period may lead to early progressive deterioration in cardiac functions. Furthermore, many of the cardiac functions of these babies have been improved about the 6th month period, and high levels of heart rate and LVEdDI may be suggested as an indicator of cardiac remodeling. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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    Evaluation of Electrocardiographic Markers for the Risk of Cardiac Arrhythmia in Children with Obesity
    (Galenos Publ House, 2023) Dagli, Hatice Yilmaz; Sap, Fatih; Oflaz, Mehmet Burhan; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Baysal, Tamer
    Aim: This study was conducted to examine the electrocardiographic markers used in the risk assessment of cardiac arrhythmia in children with obesity.Materials and Methods: In this prospective study, 60 children aged 3-17 years with exogenous obesity and 60 age and sex-matched healthy controls were included. Demographic data, assessment of atrial and ventricular arrhythmia risk markers in electrocardiography, and standard echocardiography measurements were performed. Values of p<0.05 were considered significant.Results: The mean ages of the study and control groups were 11.51 +/- 3.48 years and 10.74 +/- 3.72 years, respectively. Both groups had 30 males and 30 females. The study group had significantly higher average mean body mass index (BMI) compared to the control group. In electrocardiographic examinations, P-wave dispersion, QT dispersion (QTd), corrected QTd (QTcd), Tpeak-Tend (Tp-e), Tp-e/QT, and Tp-e/QTc values were significantly higher in the obese group compared to the control group. In echocardiographic examinations, the dimensions of the heart chambers and vascular structure and wall thicknesses were found to be significantly higher in those children with obesity.Conclusion: The electrocardiographic risk markers used to predict cardiac arrhythmias were found to be increased in those children with obesity. This may suggest that increased body weight and adiposity may have unfavorable effects on the cardiac conduction system.
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    Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents
    (Walter De Gruyter Gmbh, 2014) Alp, Hayrullah; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Karaarslan, Sevim; Baysal, Tamer; Altin, Hakan; Karatas, Zehra
    Background: Childhood obesity is a cardiovascular risk factor. Objective: Epicardial adipose tissue (EAT) thickness, carotid intima-media thickness (IMT) and cardiac functions of obese children and their correlations were evaluated. Subjects: Five hundred obese children and 150 age-and sex-matched healthy controls. Methods: Anthropometric, laboratory data and echocardiographic measurements of IMT, EAT and cardiac functions were determined. Results: Increased M-mode echocardiographic measurements, E/e' ratios, Tei index values and decreased E/A and e'/a' ratios (where E and A are early and late mitral/tricuspid diastolic velocities, respectively, and e' and a' are peak early diastolic and peak atrial systolic myocardial velocities, respectively), were determined in the obese group. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Carotid artery IMT, EAT thickness and left ventricular mass (LVM) were found to be strongly associated with Tei index values. Conclusion: Obesity is a major risk factor for cardiovascular diseases. In our study, we showed that obese children have early subclinical systolic and diastolic dysfunctions. Also, these cardiac impairments are correlated with the increase in IMT, EAT thickness and LVM.
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    Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents
    (Walter De Gruyter Gmbh, 2014) Alp, Hayrullah; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Karaarslan, Sevim; Baysal, Tamer; Altin, Hakan; Karatas, Zehra
    Background: Childhood obesity is a cardiovascular risk factor. Objective: Epicardial adipose tissue (EAT) thickness, carotid intima-media thickness (IMT) and cardiac functions of obese children and their correlations were evaluated. Subjects: Five hundred obese children and 150 age-and sex-matched healthy controls. Methods: Anthropometric, laboratory data and echocardiographic measurements of IMT, EAT and cardiac functions were determined. Results: Increased M-mode echocardiographic measurements, E/e' ratios, Tei index values and decreased E/A and e'/a' ratios (where E and A are early and late mitral/tricuspid diastolic velocities, respectively, and e' and a' are peak early diastolic and peak atrial systolic myocardial velocities, respectively), were determined in the obese group. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Carotid artery IMT, EAT thickness and left ventricular mass (LVM) were found to be strongly associated with Tei index values. Conclusion: Obesity is a major risk factor for cardiovascular diseases. In our study, we showed that obese children have early subclinical systolic and diastolic dysfunctions. Also, these cardiac impairments are correlated with the increase in IMT, EAT thickness and LVM.
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    First Evaluation of P Dispersion and Tp-e Parameters in Electrocardiograms of Children with Diabetic Ketoacidosis
    (Galenos Yayincilik, 2022) Egil, Oguz; Sap, Fatih; Eklioglu, Beray Selver; Oflaz, Mehmet Burhan; Atabek, Mehmet Emre; Baysal, Tamer
    Objective: Diabetic ketoacidosis (DKA) is an important complication of type 1 diabetes mellitus. We aimed to evaluate the effect of metabolic disorders of DKA on electrocardiography (ECG) parameters in children. Methods: This study was performed between December 2018 and March 2020 and included 39 children with DKA and 40 healthy children. Three ECGs (one before and two after treatment) were obtained from the patient group. P-wave dispersion (Pd), QT dispersion (QTd), QTc dispersion (QTcd), Tp-e intervals, and the ratios of Tp-e/QT and Tp-e/QTc were measured electrocardiographically. ECG parameters from children with DKA and healthy controls were compared statistically. Results: The mean age of the patient group was 10.50 +/- 4.12 years. There was no significant difference in terms of age, gender, weight, height and body mass index between patients and controls. In the patient group, a statistically significant increase was found in Pd, QTd and QTcd in the initial ECG compared to the second and third ECGs. Also, when the first and third ECGs were compared, a significant increase in Tp-e and Tp-e/QT was evident in the first ECG. There was a significant difference in the values of Pd, QTd, QTcd, Tp-e and Tp-e/QT in the first ECGs, obtained before DKA treatment, and those values obtained from the control group. Conclusion: This is the first article evaluating Pd and Tp-e parameters in children with DKA. Cardiac arrhythmia risk markers were increased in children with DKA compared to controls. Therefore, clinicians should be aware of the possibility of developing new arrhythmias during DKA treatment.
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    Hennekam sendromunda başarı ile uygulanan perikardiyektomi
    (2013) Karataş, Zehra; Karaarslan, Sevim; Alp, Hayrullah; Sarıgül, Ali; Baysal, Tamer
    Hennekam sendromu, lenfödem ile birlikte iç organlarda lenfanjiyektazinin görüldüğü otozomal resesif geçişli bir hastalıktır. Hastalığın seyri sırasında ekstremitelerdeki lenfödeme eşlik eden plevral veya perikardiyal efüzyonlar görülebilmektedir. Tedavide uzun zincirli yağdan fakir diyet uygulansa da, başarı oranı düşüktür. Bu yazıda, Hennekam sendromu tanısı konulan 21 aylık erkek olguda başarı ile uygulanan perikardiyektominin sonucu sunuldu.
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    Increased ischaemia-modified albumin is associated with inflammation in acute rheumatic fever
    (Cambridge Univ Press, 2014) Karatas, Zehra; Baysal, Tamer; Sap, Fatih; Alp, Hayrullah; Mehmetoglu, Idris
    Introduction: Ischaemia-modified albumin, a novel biochemical marker for tissue ischaemia, was found to be associated with oxidative stress. The purpose of this study was to assess the role of ischaemia-modified albumin in the diagnosis of acute rheumatic fever and also to evaluate the ischaemia-modified albumin levels in children with heart valve disease. Methods: The study groups, aged 5-18 years, consisted of 128 individuals - 40 with acute rheumatic fever, 35 with congenital heart valve disease, 33 with chronic rheumatic heart disease, and 20 healthy control subjects. Results: The ischaemia-modified albumin, erythrocyte sedimentation rate, and C-reactive protein levels of the acute rheumatic fever group were significantly higher than those in the chronic rheumatic heart disease, congenital heart valve disease, and control groups, separately (p < 0.001). The ischaemia-modified albumin levels in both carditis and isolated arthritis subgroups of children with acute rheumatic fever were significantly higher than in the control group (p < 0.001, p < 0.01, respectively). However, there was no statistically significant difference between the chorea subgroup and control subjects. In addition, significant correlations were observed between ischaemia-modified albumin and acute phase reactants of patients with acute rheumatic fever (p < 0.001 for both erythrocyte sedimentation rate and C-reactive protein). The ischaemia-modified albumin levels of chronic rheumatic heart disease, congenital heart valve disease, and control subjects were similar. Conclusions: The increased level of ischaemia-modified albumin in children with acute rheumatic fever seems to be associated with inflammation. However, further studies are needed to provide stronger evidence.
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    Investigation of the effect of epicardial adipose tissue thickness on cardiac conduction system in children with type 1 diabetes mellitus
    (Walter De Gruyter Gmbh, 2020) Guney, Ahmet Yasin; Sap, Fatih; Eklioglu, Beray Selver; Oflaz, Mehmet Burhan; Atabek, Mehmet Emre; Baysal, Tamer
    Objectives: Investigation of the association between epicardial adipose tissue thickness (EATT) and P-wave dispersion (Pd), QT dispersion (QTd), corrected QT dispersion (QTcd) and Tp-e interval in children with Type 1 Diabetes Mellitus (T1DM) was aimed. Methods: Forty-one children with T1DM and 41 age- and gender-matched healthy children were included in the study. Demographical characteristics of all cases were examined. In echocardiography; in addition to conventional echocardiographic measurements, end-systolic EATT was measured from right ventricular free wall. In electrocardiogram; Pd, QTd, QTcd and Tp-e interval durations, as well as Tp-e/QT and Tp-e/QTc ratios were calculated. Correlation values between EATT and electrocardiographic parameters were also noted. Results: Mean age of the patient group was determined to be 12.43 +/- 3.04 years and that of the control group was determined to be 12.08 +/- 2.56 years. There was no significant difference between the groups in regard to age, gender, body weight, height and body mass index. In the patient group; EATT, Pd, QTd, QTcd and Tp-e interval were determined to be significantly higher compared to the control group. In the patient group, no significant correlation was determined between EATT and Pd, QTd, QTcd and Tp-e. However, when both patient and control groups were evaluated together, a statistically significant positive correlation was determined between EATT and Pd, QTd, QTcd and Tp-e. Conclusions: In children with T1DM, an increase in epicardial adipose tissue thickness and in risk of cardiac arrhythmias has been demonstrated. To reveal the possible unfavorable effects of EATT on cardiac conduction system in T1DM patients needs further studies.