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Öğe 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, TamerAim 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.Öğe 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, TamerObjectives: 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.Öğe Bradycardia With Ribavirin Therapy in Crimean-Congo Hemorrhagic Fever(Lippincott Williams & Wilkins, 2015) Oflaz, Mehmet Burhan; Kucukdurmaz, Zekeriya[Abstract Not Availabe]Öğe 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, TamerThis 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.Öğe 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, TamerAim: 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.Öğe Evaluation of Neutrophil Gelatinase-Associated Lipocalin in Children with Sydenham's Chorea Accompanying Valvular Regurgitation(Georg Thieme Verlag Kg, 2018) Oflaz, Mehmet Burhan; Deveci, Koksal; Guven, Ahmet Sami; Alaygut, Demet EglenogluBackground Acute rheumatic fever (ARF) is a nonsuppurative complications of GroupA ss hemolytic streptococcal (GABHS) infection due to a delayed immune response. Sydenham's chorea (SC) is an important neurological manifestation of ARF, and heart involvement is seen in a large proportion of patients with SC. The immune systemhas a crucial role in initiating and spreading inflammation, which causes tissue damage in ARF. Aim The purpose of this study was to investigate urine neutrophil gelatinaseassociated lipocalin (NGAL) as a biomarker for kidney injury in children with rheumatic chorea accompanying valvular involvement. Materials and Methods Twenty- eight consecutive children with SC accompanying evidence of valvular involvement, and 30 nonrheumatic, age- and sex- matched healthy children were included in the study. Cardiac evaluations were performed, and urinary NGAL, micro- total protein and creatinine levels were measured in all participants. Results Age, gender, weight, and height were similar in the patients and controls. Twenty- three patients had isolated mitral regurgitation, and five patients had mitral and aortic regurgitation. While there was no statistically significant difference between the urine creatinine and micro- total protein levels in patients and controls, the patient group demonstrated a significantly higher mean urine NGAL level (18.01 =/- 7.9 vs. 3.22 =/- 1.4, p 1/4 0.002) and mean urine NGAL/creatinine ratio (2.80 +/- 1.9 vs. 0.33 +/- 0.1, p = 0.008). However, there were no correlations between severity of chorea and urinary NGAL or urinary NGAL/creatinine ratio, there were significant positive correlations between severity of valvular regurgitation and urinary NGAL (r = 0.751, p < 0.001) and urinary NGAL/creatinine ratio (r = 0.694, p < 0.001). Conclusion The present study revealed that urinary NGAL level and urinary NGAL/creatinine ratio were higher in patients with SC accompanying valvular involvement. The results obtained from this study suggest that ARF may cause subclinical renal injury in patients with intense and prolonged cellular immune response leading to chorea and carditis.Öğe Evaluation of Platelet Activity Markers in Prognostic Value of Children with Crimean-Congo Hemorrhagic Fever(Georg Thieme Verlag Kg, 2020) Guven, Ahmet Sami; Duksal, Fatma; Akcan, Ozge Metin; Aygunes, Utku; Oflaz, Mehmet BurhanObjective The aim of this study is to investigate the prognostic value of platelet (PLT) activity markers in children with Crimean-Congo hemorrhagic fever (CCHF) and compare results with healthy controls. Materials and Methods A total of 135 patients with CCHF and 100 healthy children were included in this retrospective study. Mean age was 12.4 +/- 3.3 years in CCHF group, and 92 patients were male. We measured PLT count, mean platelet volume (MPV), platelet distribution width (PDW), and mean platelet mass (MPM) as PLT activity markers. Results A statistically significant decrease in MPM and PLT, and significantly higher levels of PDW and activated partial thromboplastin time (aPTT) and no significant difference in MPV were observed in patients with CCHF compared with controls. Although there were no significant differences between the severe and nonsevere CCHF groups in term of MPV and PDW, the MPM value was significantly decreased in severe patients ( p < 0.001). Furthermore, MPM values were inversely correlated with aPTT ( r = -0.617, p = 0.015), and positively correlated with PLT ( r = 0.703, p < 0.001) which are considered likely to be indicators of disease severity. Multivariate logistic regression analysis revealed MPM as an independent risk factor for severe disease. Conclusion Our study demonstrated that MPM values were decreased in severe cases compared with nonsevere in children with CCHF. The MPM as an indicator of PLT activation at the time of diagnosis in children with CCHF can be used as a prognostic index for disease severity.Öğe 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, TamerObjective: 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.Öğe Incidence of congenital heart disease with consanguinity: 10 years of experience in a single-center(Bayrakol Medical Publisher, 2023) Yilmaz, Hueseyin; Oflaz, Mehmet BurhanAim: Congenital heart diseases (CHD) are inborn structural and functional anomalies of the heart and its great vessels. It is considered to have a multifactorial origin. This study aims to determine the frequency and types of CHD between siblings in Central Anatolia and investigate consanguineous marriages' contribution to this undesirable incidence. Material and Methods: The study included 1916 children admitted to the pediatric cardiology outpatient clinic between 2009-2019. Congenital heart diseases were grouped as uncomplex CHD, complex CHD, heart muscle diseases and other heart conditions. Results: There were 113 consanguineous parents. No relation was found between the types of consanguineous marriages and CHD incidence. Atrial septal defect (ASD) was the most common heart condition among consanguineous marriages seen in 73 patients. Parents with congenital heart diseases had ASD or Ventricular septal defect( VSD) type septal lesions. There was no relationship between the parents' consanguinity and the presence of CHD in any sibling (p=0.169). In 300 siblings, CHD was present in both patients. The older sibling having CHD increases the risk for the younger one (p<0.05). Of the patients, 827 had noncomplex cardiac lesions, 13 had complex cardiac lesions, and 136 had other cardiac pathological echocardiographic (ECHO) findings. Discussion: Families who have a child with pre-existing CHD should be informed about the possibility of CHD recurrence before pregnancy, and these cases should be examined using fetal ECHO in the prenatal period. Those under risk should be followed up and treated in appropriate centers in terms of CHD.Öğe 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, TamerObjectives: 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.Öğe 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, TamerObjectives: 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.Öğe Is the heart of premature babies born as a result of IVF pregnancy different?(Bayrakol Medical Publisher, 2022) Yilmaz, Fatma Hilal; Oflaz, Mehmet Burhan; Altunhan, Hueseyin; Emiroglu, Nuriye; uenal, Emin; Gueltekin, Nazli DilayAim: This prospective study aims to reveal whether preterm births with ART-induced pregnancies are at greater risk of structural and functional cardiac pathologies compared to the control group of preterm births from spontaneous pregnancy.Material and Methods: Between October 2017 and January 2020, 25 premature babies born by means of assisted reproductive techniques (AC) and 25 babies born from spontaneous pregnancy (SC) were included in the study. All babies recruited for the study were born at or below 34 weeks of gestational age. The groups were evaluated in terms of anatomical, m-mode and tissue Doppler systolic and diastolic functions using transthoracic echocardiography (ECHO). Results: The groups were found to be similar in terms of anatomical, m-mode and tissue doppler systolic and diastolic functions by transthoracic ECHO (p=0.156).Discussion: Early diagnosis of possible cardiac diseases is vital for pre-and post-natal management and ultimately for the survival of the infant. Studies should be focused on understanding and eliminating the pathophysiologies increasing the risk of CHD during ever-increasing ART practices.Öğe Is there a relationship between causative microorganisms and hearing loss in neonatal sepsis?(Wiley, 2021) Yilmaz, Fatma Hilal; Emiroglu, Nuriye; Oflaz, Mehmet Burhan; Yucel, Mehmet; Kececi, Ramazan; Arbag, Hamdi; Altunhan, HuseyinBackground The aim of the present study was to determine the possible relationship between cultured microorganisms and hearing loss in infants admitted to the neonatal intensive care unit (NICU) who could not pass a standard hearing test. Method The medical records of infants treated at the NICU were retrospectively evaluated. The patients were first divided into two groups, and group 1 was divided into two subgroups: Group 1 included patients with hearing loss accompanied by proven sepsis caused by either gram-negative (group 1A) or gram-positive (group 1B) bacteria, and group 2 included patients with clinical sepsis. The groups were compared with potential risk factors related to hearing loss. Results Between January 2014 and January 2019, the cases of 3,800 infants admitted to the NICU were reviewed. Of 3,548 living babies, the Auditory Brainstem Response (ABR) test showed that 35 infants (0.98%) were diagnosed with hearing loss. In 12 infants with hearing loss, microbial growth in the blood cultures was detected, whereas in the remaining 23, the blood cultures were negative. Of the cases with microbial growth, five were gram negative and seven were gram positive. In the comparison of groups 1A, 1B, and 2, there were statistically significant differences in terms of risk factors such as low birth weight (p = .048), neonatal hospitalization time (p = .001), free oxygen support (p = .001), intraventricular bleeding (p = .001), loop diuretic use (p = .001), and blood transfusion (p = .048). Conclusion The relationship between hearing loss and microorganisms causing sepsis could not be determined in this research.Öğe Management of Patent Ductus Arteriosus in Preterm Patients Who Were Given Surfactant(Bayrakol Medical Publisher, 2020) Yilmaz, Fatma Hilal; Emiroglu, Nuriye; Oflaz, Mehmet Burhan; Gultekin, Nazli Dilay; Yucel, Mehmet; Kececi, Ramazan; Altunhan, HuseyinAim: Respiratory distress syndrome (RDS) and perinatal asphyxia are known to be risk factors in hemodynamically significant Patent Ductus Arteriosus (hsPDA). In this study, we aimed to reveal scientific data in respiratory distressed preterm infants in the light of the current literature and to discuss the management of PDA in babies born at 33d weeks of gestation and up to 33d weeks which we have treated and followed in our unit. Materials and Methods: The medical records of premature infants treated at Necmettin Erbakan University Neonatal Intensive Care Unit (NICU) between January 2016 and January 2019 were retrospectively evaluated. Results: Between January 2016 and January 2019, 476 patients born prior to 33d gestational weeks were admitted to our unit.. PDA was detected in 149 of these patients because of RDS due to the surfactants. In 112 (75.1%) of these patients, the PDA closed spontaneously within the first week of life. Thirty-seven (24.8%) patients developed hs-PDA. The incidence of premature retinopathy (ROP), bronchopulmonary dysplasia (BPD), and late neonatal sepsis morbidity was significantly elevated during the hospitalization (p=0.05, p=0.01, p=0.06). Invasive mechanical ventilation, non-invasive mechanical ventilation, and free oxygen requirement times were found to be longer (p= 0.0001, p= 0.004, p= 0.014). Complete enteral nutrition and discharge times were longer in the treated group (p= 0.03, p= 0.002). We identified the presence of Small for Gestational Age (SGA) (r = 0.30 p = 0.04) and low birth weight (r = 0.99 p = 0.02) in logistic regression analysis of the factors affecting the PDA as meaningful results. Discussion: The presence of hs-PDA in infants with RDS is directly proportional to the birth week and weight, the presence of SGA reduces the frequency of hs-PDAs, the presence of hs-PDA is associated with ROP, BPD, and late sepsis. The presence of hs-PDA has been found to be correlated with prolonged respiratory support and delayed discharge.Öğe Mosaic trisomy 14 and aorta-pulmonary window association: A case report(Turkish Soc Cardiology, 2019) Yilmaz, Fatma Hilal; Oflaz, Mehmet Burhan; Tarakci, Nuriye; Baysal, Tamer; Altunhan, HuseyinTrisomy 14 mosaicism is a rare chromosomal abnormality with distinct and recognizable clinical features. Congenital heart anomalies can accompany in this syndrome. To the best of our knowledge, this is the first case of mosaic trisomy 14 with an aortopulmonary window to be described in the literature.Öğe A Turkish Family with Loeys-dietz Syndrome and a Report of a Homozygous Patient with SMAD3 Pathogenic Variation(Galenos Yayincilik, 2022) Altindas, Betul Okur; Zamani, Ayse Gul; Oflaz, Mehmet Burhan; Gunes, Muhammed; Yildirim, Mahmut SelmanLoeys-Dietz syndrome (LDS) is a rare autosomal dominant connective tissue disorder with multisystemic involvement caused by pathogenic genetic variations in the transforming growth factor-beta pathway. Here, we report a homozygous case with LDS. A newborn male patient who had congenital diaphragmatic hernia, aortic dilatation and talipes equinovarus was referred to our medical genetics polyclinic. After clinical evaluation, next generation sequencing analysis showed a homozygous c.859C>T pathogenic missense variation [R287W (p.Arg287Trp)] in the SMAD3 gene. It was confirmed that the parents harbor the variant heterozygously. Due to the autosomal dominant inheritance pattern, rarely seen biallelic individuals are expected to have severe clinical conditions. Since there was only one previous report of an individual harboring a homozygous SMAD3 variant in the literature; this case was presented to further enhance our understanding of LDS.
