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Öğe 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, TamerBackground: 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.Öğe Clinical analysis and follow-up results of children with vasovagal syncope(2013) Elmacı, Ahmet Midhat; Akın, Fatih; Karaarslan, SevimAmaç: Senkop özellikle çocukluk ve adolesan yaş grubunda daha sık olmakla birlikte her yaş grubunda görülebilen klinik bir problemdir. Bu çalışmada, vazovagal senkoplu hastalarda semptomların devamı ve medikal tedavi verilen hastalarda tedavinin etkinliği araştırıldı. Ayrıca tilt testi sonuçlarının pozitif ve negatif olması ile devam eden senkop şikâyetleri arasındaki ilişki incelendi. Yöntemler: Vazovagal senkop tanısıyla 6 ay veya daha uzun süredir takip edilen 49 hasta telefon ile irtibat kurularak hastanemize çağrıldı. Hastaların takip süreleri, senkop ve presenkop sıklığı, ilaç kullanım öyküleri kaydedildi ve tüm hastalara tekrar tilt testi uygulandı. Elde edilen bulgular istatistiksel olarak değerlendirildi. Bulgular: Hastaların 27si kız (%55), 22si erkek (%45), ortalama yaş 14,97,9 yıl, ortalama takip süresi 15,68,9 aydır. Kız ve erkekler arasında tilt testi sonucunun pozitif veya negatif olması açısından anlamlı bir fark yoktu (p0,05). İkinci tilt testinde pozitiflik oranı ilk teste göre anlamlı olarak düşük bulunmuştur (p0,05). İlk tilt testi negatif olup şikâyeti devam eden hastalarda tekrarlanan tilt testinin pozitif olma oranı %40 idi. İlk tilt testi negatif olup senkop şikayeti bulunmayan hastalarda, ikinci tilt testinin negatif bulunma ihtimali, senkop şikayeti devam eden hastalardan anlamlı olarak daha yüksek saptandı (p0,05). Senkop geçirenlerde tilt testi pozitifliği, presenkoplulardan anlamlı olarak fazlaydı (p0,05). Sonuç: İlk tilt testi sonucu negatif olsa da şikâyeti devam eden pediatrik hastalarda ayırıcı tanı açısından tilt testinin tekrarını önermekteyiz.Öğe 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, SevimThis 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.Öğe 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, TamerObjectives: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.Öğe 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, HuseyinRhabdomyomas, 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.Öğe 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, TamerBackground: 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.Öğe 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, ZehraBackground: 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.Öğe 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, ZehraBackground: 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.Öğe Evaluation of Serum Ischemia Modified Albumin Levels in Acute Rheumatic Fever Before and After Therapy(All India Inst Medical Sciences, 2014) Toker, Aysun; Karatas, Zehra; Altin, Hakan; Karaarslan, Sevim; Cicekler, Humeyra; Alp, HayrullahTo investigate ischemia modified albumin (IMA) levels in children with acute rheumatic fever (ARF) before and after therapy and compare them with those of controls. Twenty seven patients with ARF and 18 healthy, age and sex matched children were included in the study. The diagnosis of ARF was established according to the modified Jones criteria. Follow-up studies were made when acute phase reactants [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)] levels returned normal. IMA levels were measured using the rapid and colorimetric method with the albumin cobalt binding test. IMA levels were significantly higher in ARF group (p < 0.001) compared with controls at the time on admission. IMA (absorbance units) was measured as 0.41 +/- 0.10 in the control group, 0.55 (0.44-1.13) in the study group before treatment and 0.48 +/- 0.12 in the study group after treatment. After treatment, statistically important decrements were determined in the levels of ESR (p < 0.001), CRP (p < 0.001) and IMA (p < 0.01). There was no significant difference for IMA levels between after treatment and control group. IMA levels at the time on admission correlated positively with ESR (r = 0.605, p < 0.01) and CRP (r = 0.543, p < 0.01). The present study shows that increased serum IMA levels in patients with ARF at the time of diagnosis is a sign of increased inflammation. Thus, serum IMA levels may be used as a follow-up marker like CRP and ESR for evaluating the efficacy of treatment in ARF.Öğe Hennekam sendromunda başarı ile uygulanan perikardiyektomi(2013) Karataş, Zehra; Karaarslan, Sevim; Alp, Hayrullah; Sarıgül, Ali; Baysal, TamerHennekam 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.Öğe Is myocardial performance index useful in differential diagnosis of moderate and severe hypoxic-ischaemic encephalopathy? A serial Doppler echocardiographic evaluation(Cambridge Univ Press, 2012) Karaarslan, Sevim; Alp, Hayrullah; Baysal, Tamer; Cimen, Derya; Ors, Rahmi; Oran, BulentIntroduction: The aim of this study was to investigate the importance of myocardial performance index as an additive criterion to Sarnat criteria in differential diagnosis of newborn babies with moderate and severe hypoxic-ischaemic encephalopathy. Methods: Our study group included 50 healthy term newborn babies and 20 newborn babies with hypoxic ischaemic encephalopathy. The 20 newborn babies with hypoxic-ischaemic encephalopathy were scored using Sarnat grades. Left and right ventricular functions were determined on the first day and thereafter in the 1, 3-4, 6-7, and 11-12 months of life by M-Mode and pulsed Doppler. Results: Myocardial performance indexes of the left ventricle were significantly higher in the severe hypoxic ischaemic encephalopathy group than in the control group during the first, second, and third analyses (p = 0.01, p = 0.02, p = 0.02, respectively) and only during the first analysis (p = 0.01) in the moderate hypoxic-ischaemic encephalopathy group. In addition, the myocardial performance indexes of the right ventricle were significantly higher during the first, second, and third analyses in both severe and moderate hypoxic-ischaemic encephalopathy groups than in the control group (p = 0.01, all). Hypoxia-induced alterations last longer in the right ventricle than in the left ventricle in the moderate group, as during the second and third analyses myocardial performance index continues to be higher than the control group. Conclusion: Myocardial performance indexes for the left and right ventricles were significantly higher in both severe and moderate hypoxic-ischaemic encephalopathy groups than in the control group during the first analysis, and myocardial performance index greater than or equal to 0.5 can be used in order to distinguish moderate and severe hypoxic-ischaemic encephalopathy babies according to Sarnat grades as a discriminative additive criterion.Öğe Is myocardial performance index useful in differential diagnosis of moderate and severe hypoxic-ischaemic encephalopathy? A serial Doppler echocardiographic evaluation (vol 22, pg 335, 2012)(Cambridge Univ Press, 2012) Karaarslan, Sevim; Alp, Hayrullah; Baysal, Tamer; Cimen, Derya; Ors, Rahmi; Oran, Bulent[Abstract Not Availabe]Öğe Normal values of left and right ventricular function measured by M-mode, pulsed doppler and Doppler tissue imaging in healthy term neonates during a 1-year period(Elsevier Ireland Ltd, 2012) Alp, Hayrullah; Karaarslan, Sevim; Baysal, Tamer; Cimen, Derya; Ors, Rahmi; Oran, BulentBackground: The measurements of left and right ventricular functions change after birth due to the influence of several hemodynamic changes upon the immature myocardium. Aim: The aim of this study was to investigate the changes in left (LV) and right ventricular (RV) functions of healthy term newborns using conventional and Doppler echocardiography during a 1-year period. Subjects and methods: Fifty healthy term newborns were examined prospectively on the first day, 3-4, 6-7, 9-10 and 11-12 months of their lives by M-mode, pulsed Doppler (PD) and Doppler tissue imaging techniques (DTI). PD velocities were obtained from mitral and tricuspid valves while DTI velocities were obtained from the lateral annuluses of atrioventricular valves. Results: EF and FS did not change significantly by time. Early (E) flow velocity and early myocardial (Em) velocity were higher than late (A) flow velocity and atrial systolic (Am) velocity for LV, while A and Am velocities were higher than E and Em velocities for RV, respectively during the study period. E. A, Em, Am, Sm velocities and Em/Am ratios increased while E/Em ratios decreased significantly by time (P<0.05) for both ventricle. However, E/A ratios of LV and RV did not change significantly by time. Myocardial performance index (MPI), obtained by PD for RV and by DTI for LV, decreased significantly by time (P<0.05) and these DTI values were higher than PD values during the study period. Conclusions: Due to hemodynamic and maturation change of myocardium PD and DTI velocity changes took place during the first year of life which reflects differences in ventricular adaptation. (C) 2012 Elsevier Ireland Ltd. All rights reserved.Öğe Prediction of the development of pulmonary arterial hypertension with Tei Index in congenital heart diseases with left-to-right shunt(Turkish Soc Cardiology, 2019) Yucel, Mehmet; Alp, Hayrullah; Yorulmaz, Alaaddin; Karaarslan, Sevim; Baysal, TamerObjective: The aim of this study was to determine the usefulness of the Tei Index, an echocardiographic parameter, in the early determination of pulmonary artery pressure (PAP) in congenital heart disease (CHD) with a left-to-right shunt. Methods: Right and left ventricular functions were evaluated using Tei Index values determined with tissue Doppler echocardiography. Cardiac catheterization was performed in all cases. The presence of pulmonary arterial hypertension (PAH) was defined as a mean PAP of >= 25 mm Hg and a pulmonary vascular resistance index of >3 WU/m(2). Patients with a pulmonary/systemic blood flow ratio of >= 2 were considered candidates for surgery. Results: The Tei Index values measured from the left ventricular posterior wall and the right ventricular anterior wall were found to be significantly higher in the patients with PAH (0.68 +/- 0.18, 0.67 +/- 0.16, respectively) compared with the patients without PAH (0.56 +/- 0.16, p=0.027; 0.51 +/- 0.12 p=0.001). A significant correlation was detected between the Tei Index value measured from the left ventricular posterior wall and the mean PAP (correlation coefficient: 0.491). Conclusion: The right ventricular Tei Index values in children with CHD and a left-to-right shunt can be used as a parameter to follow up on the potential development of PAH, to make a diagnosis in the early period, and to make a timely decision about surgery.Öğe Pulmonary Artery Sling: Two Different Clinical Entities(Galenos Yayincilik, 2014) Alp, Hayrullah; Alpinar, Abdullah; Pekcan, Sevgi; Baysal, Tamer; Karaarslan, SevimPulmonary artery sling is an anomalous origin of the left pulmonary artery from the right pulmonary artery. The most common clinical presentations are respiratory symptoms. On the other hand, some patients may be asymptomatic. This report demonstrated two different clinic entities including symptomatic and asymptomatic disease courses.Öğe QT and P-wave dispersions in rheumatic heart disease: Prospective long-term follow up(Wiley-Blackwell, 2014) Alp, Hayrullah; Baysal, Tamer; Altin, Hakan; Karatas, Zehra; Karaarslan, SevimBackgroundSimple electrocardiogram (ECG) markers have been used to evaluate conduction times. Acute rheumatic fever (ARF) is an autoimmune disease that affects these conduction times. The aim of this prospective long-term follow-up study was to evaluate QT, QTc and P-wave dispersions in children with ARF and chronic rheumatic heart disease (CRHD). MethodsSixty-four patients with ARF, 33 patients with CRHD and 41 healthy, age- and sex-matched control subjects were included in the study. The ARF patients were divided into two subgroups: carditis and arthritis. Echocardiographic and ECG measurements at the onset of diagnosis and final evaluation were included. ResultsQT, QTc and P-wave dispersions were significantly greater in both the ARF carditis and CRHD groups than the ARF arthritis and control subjects during the initial and final analysis (for all, P < 0.001). There was no significant statistical difference in QT, QTc and P-wave dispersion between the initial and final analysis in each groups. Severity of mitral regurgitation and left atrial enlargement were found to be positively correlated with P-wave dispersion (r = 0.438, P < 0.001; r = 0.127, P < 0.001, respectively). QT, QTc and P-wave dispersion greater than 52, 60 and 57 ms, respectively, had higher sensitivity and specificity for predicting ARF carditis. ConclusionThese ECG measurements can be used in the diagnosis of ARF carditis as minor criteria with modified Jones criteria. In contrast, this increase in the dispersions is permanent in patients with ARF carditis.Öğe Serum ischemia-modified albumin level and its association with cardiovascular risk factors in obese children and adolescents(Walter De Gruyter Gmbh, 2012) Baysal, Tamer; Alp, Hayrullah; Koc, Nesibe; Atabek, Mehmet Emre; Eklioglu, Beray Selver; Karaarslan, SevimBackground: Serum ischemia modified albumin (IMA) levels have been previously studied and found to correlate with some anthropometric and laboratory measurements in adult obesity. IMA had not been studied in obese children and adolescents. Objective: The aim of the study is to analyze serum IMA levels and to evaluate their correlation with cardiovascular risk factors in obese children and adolescents with and without metabolic syndrome (MS). Subjects and methods: Sixty-one obese children/adolescents and 33 healthy children were included in the study. The obese group was divided into four subgroups, including MS (n=25), non-MS (n=36), liver steatosis (n=19) and non-liver steatosis (n=42) groups. Blood was collected to analyze biochemical parameters and IMA. Epicardial adipose tissue thickness was measured with echocardiography, and liver steotosis was determined with ultrasonography for each subject. Results: Body mass index (BMI), waist circumferences (WC), left ventricular mass (LVM) and epicardial adipose tissue (EAT) thickness were significantly higher in obese subjects. Serum IMA levels were significantly higher in the metabolic syndrome (MS) and hepatosteotosis groups. Additionally, LVM and EAT thickness were found to be correlated with serum IMA levels in these groups. Conclusions: Our study suggests that serum IMA levels may be used to predict cardiovascular risk in obese children with MS and hepatosteotosis. This may be related to the duration of obesity in childhood ending in adulthood.Öğe Serum ischemia-modified albumin level and its association with cardiovascular risk factors in obese children and adolescents(Walter De Gruyter Gmbh, 2012) Baysal, Tamer; Alp, Hayrullah; Koc, Nesibe; Atabek, Mehmet Emre; Eklioglu, Beray Selver; Karaarslan, SevimBackground: Serum ischemia modified albumin (IMA) levels have been previously studied and found to correlate with some anthropometric and laboratory measurements in adult obesity. IMA had not been studied in obese children and adolescents. Objective: The aim of the study is to analyze serum IMA levels and to evaluate their correlation with cardiovascular risk factors in obese children and adolescents with and without metabolic syndrome (MS). Subjects and methods: Sixty-one obese children/adolescents and 33 healthy children were included in the study. The obese group was divided into four subgroups, including MS (n=25), non-MS (n=36), liver steatosis (n=19) and non-liver steatosis (n=42) groups. Blood was collected to analyze biochemical parameters and IMA. Epicardial adipose tissue thickness was measured with echocardiography, and liver steotosis was determined with ultrasonography for each subject. Results: Body mass index (BMI), waist circumferences (WC), left ventricular mass (LVM) and epicardial adipose tissue (EAT) thickness were significantly higher in obese subjects. Serum IMA levels were significantly higher in the metabolic syndrome (MS) and hepatosteotosis groups. Additionally, LVM and EAT thickness were found to be correlated with serum IMA levels in these groups. Conclusions: Our study suggests that serum IMA levels may be used to predict cardiovascular risk in obese children with MS and hepatosteotosis. This may be related to the duration of obesity in childhood ending in adulthood.Öğe Successful pericardiectomy in Hennekam syndrome(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Karatas, Zehra; Karaarslan, Sevim; Alp, Hayrullah; Sarigul, Ali; Baysal, TamerHennekam syndrome is an autosomal recessive disorder, characterized by lymphangiectasia in internal organs with lymphedema. Pleural or pericardial effusions may present with lymphedema on extremities in the course of the disease. Although a poor long-chain fatty diet is given for treatment, its success rate is low. In this article, we report the results of a successful pericardiectomy performed on a 21-month-old boy who was diagnosed with Hennekam syndrome.Öğe Supraventricular tachycardia due to blunt chest trauma in an adolescent(2014) Alp, Hayrullah; Baysal, Tamer; Karaarslan, SevimKünt göğüs travması ve bununla ilişkili komplikasyonlar çocukluk çağında görülen kardiyak arrestin nadir nedenleridir. Ayrıca, bu olgular da giderek artan sayıda bildirilmektedir. Kurbanlar sıklıkla ventriküler fibrilasyon veya taşikardi ile teşhis edilmektedir. Bununla birlikte kardiyak ileti bozuklukları da bildirilmektedir. Bu yazıda, futbol topu ile künt göğüs travmasına bağlı supraventriküler taşikardi gelişen sağlıklı bir adolösan olgu sunuldu. Bu olgular içerisinde göğüs travmasına bağlı atrial aritmi olması nedeniyle literatürdeki ilk bildiridir.