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Tanidir C.,Bakirkoy State and Research Hospital for Mental Health and Neurological Disorders | Tanidir I.C.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Bahali K.,Bakirkoy State and Research Hospital for Mental Health and Neurological Disorders | Gunes H.,Bakirkoy State and Research Hospital for Mental Health and Neurological Disorders | And 3 more authors.
Klinik Psikofarmakoloji Bulteni | Year: 2016

Objective: In this study, we aimed to explore the effects of atomoxetine on thyroid functions in children and adolescents with attention deficit hyperactivity disorder. Methods: A retrospective chart review was done to evaluate the thyroid function tests of patients diagnosed with attention deficit hyperactivity disorder and treated with only atomoxetine. The thyroid function tests of 38 subjects, from both before atomoxetine was started and during an effective dose of atomoxetine treatment, were found from the patient charts and compared statistically. Results: There were no statistically significant differences between the baselines levels of thyroidstimulating hormone (TSH), free T4, and free T3 values and those during an effective dose of atomoxetine treatment. In one subject, four weeks after atomoxetine was started and titrated to the effective dose, an insignificant increase in TSH was observed, which decreased to the normal range after the discontinuation of the atomoxetine treatment. Conclusion: Therapeutic doses of atomoxetine do not seem to change thyroid functions in children and adolescents with attention deficit hyperactivity disorder. © 2016, Cukurova Univ Tip Fakultesi Psikiyatri Anabilim Dali. All rights reserved.


Akinci G.,Dr Behcet Uz Childrens Hospital | Topaloglu H.,Hacettepe University | Akinci B.,Dokuz Eylül University | Onay H.,Ege University | And 7 more authors.
European Journal of Medical Genetics | Year: 2016

Congenital generalized lipodystrophy type 4 is an extremely rare autosomal recessive disorder. We report our clinical experience on two unrelated Turkish patients with congenital generalized lipodystrophy type 4. A 13-year-old girl (patient-1) presented with generalized lipodystrophy and myopathy. Further tests revealed ventricular and supraventricular arrhythmias, gastrointestinal dysmotility, atlantoaxial instability, lumbosacral scoliosis, and metabolic abnormalities associated with insulin resistance. A 16-year-old girl (patient-2) with congenital generalized lipodystrophy type 4 was previously reported. Here, we report on her long term clinical follow-up. She received several course of anti-arrhythmic treatments for catecholaminergic polymorphic ventricular tachycardia and rapid atrial fibrillation. An implantable cardioverter defibrillator was also placed. A homozygous PTRF mutation, c.259C > T (p.Gln87*), was identified in patient-1. Congenital generalized lipodystrophy type 4 was caused by homozygous PTRF c.481-482insGTGA (p.Lys161Serfs*41) mutation in patient-2. Our data indicate that patients with congenital generalized lipodystrophy type 4 should be meticulously evaluated for cardiac, neuromuscular, gastrointestinal and skeletal diseases, as well as metabolic abnormalities associated with insulin resistance. © 2016 Elsevier Masson SAS.


PubMed | Center for Human Nutrition, Hacettepe University, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Ege University and 2 more.
Type: Journal Article | Journal: European journal of medical genetics | Year: 2016

Congenital generalized lipodystrophy type 4 is an extremely rare autosomal recessive disorder. We report our clinical experience on two unrelated Turkish patients with congenital generalized lipodystrophy type 4. A 13-year-old girl (patient-1) presented with generalized lipodystrophy and myopathy. Further tests revealed ventricular and supraventricular arrhythmias, gastrointestinal dysmotility, atlantoaxial instability, lumbosacral scoliosis, and metabolic abnormalities associated with insulin resistance. A 16-year-old girl (patient-2) with congenital generalized lipodystrophy type 4 was previously reported. Here, we report on her long term clinical follow-up. She received several course of anti-arrhythmic treatments for catecholaminergic polymorphic ventricular tachycardia and rapid atrial fibrillation. An implantable cardioverter defibrillator was also placed. A homozygous PTRF mutation, c.259C>T (p.Gln87*), was identified in patient-1. Congenital generalized lipodystrophy type 4 was caused by homozygous PTRF c.481-482insGTGA (p.Lys161Serfs*41) mutation in patient-2. Our data indicate that patients with congenital generalized lipodystrophy type 4 should be meticulously evaluated for cardiac, neuromuscular, gastrointestinal and skeletal diseases, as well as metabolic abnormalities associated with insulin resistance.


Tanidir I.C.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Ergul Y.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Ozturk E.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Dalgic F.,Istanbul University | And 4 more authors.
PACE - Pacing and Clinical Electrophysiology | Year: 2016

Background: Cryoablation is increasingly utilized in children because of its safety profile. Recently, larger catheter tips have been more widely used to improve long-term success rates. The aim of this study was to assess the safety and efficacy of 8-mm-tip catheters for cryoablation of right-sided accessory pathways (APs) in children. Methods: Electrophysiological procedures were performed using the EnSite™ system (St. Jude Medical Inc., St. Paul, MN, USA). Results: Between July 2010 and July 2014, 54 patients (mean age: 13.1 ± 3.7 years) underwent cryoablation using an 8-mm-tip catheter. In 18 of 54 (33%) patients where an 8-mm-tip catheter was the first-choice catheter, the success rate was 18 of 18 (100%). There was a history of previous failed attempts or recurrence with radiofrequency ablation and/or 6-mm-tip cryoablation in 36 of 54 (67%) patients. The success rate in these patients was 24 of 36 (67%). No fluoroscopy was used in 34 of 54 procedures. The recurrence rate was six of 42 (14%) during a mean follow-up period of 32 ± 15 months. In one patient, transient atrioventricular block occurred. Conclusions: Cryoablation with an 8-mm-tip catheter for right-sided APs in children who weigh over 40 kg appears to be safe and acutely effective in cases where conventional ablation methods fail and also as a first choice for ablation procedure. However, the recurrence rate still seems to be high. © 2016 Wiley Periodicals, Inc.


Odemis E.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital
Diagnostic and Interventional Radiology | Year: 2012

We present the case of a five-year-old boy with a caroticoazygous fistula, which is an extremely rare congenital vascular malformation. The patient also had patent ductus arteriosus, a common cause of continuous murmur. The murmur continued despite successful coil embolization of the ductus. Repeated catheter-angiography revealed a large caroticoazygous fistula. The fistula was successfully embolized using the Amplatzer® Vascular Plug 1. Transcatheter occlusion of caroticoazygous fistula was performed easily, safely, and efficiently with a vascular plug. © Turkish Society of Radiology 2012.


Ergul Y.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Tanidir I.C.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Ozyilmaz I.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Akdeniz C.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Tuzcu V.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital
Pediatrics International | Year: 2015

Background: Syncope is a frequent complaint in children and adolescents and may be a significant sign of serious pathology. Although patient history, family history, and physical examination are sufficient to reach a diagnosis in most cases of syncope, the cause of syncope still cannot be determined after initial investigation in one-third to half of all patients. The aim of this study was to evaluate the diagnostic yield of implantable loop recorder (ILR) in children with unexplained syncope. Methods: A retrospective review was carried out of clinical data, indications, findings, and a final management strategy in patients who underwent ILR implantation. Results: A total of 12 patients with a mean age of 9.4 ± 4.5 years underwent ILR (Reveal Plus; Medtronic) implantation. ILR implantation indication was syncope in all of the patients. Family history, routine cardiac assessment, including resting 12-lead electrocardiogram, transthoracic echocardiography, 24 h Holter recording, and event recorder findings, were normal with the exception of one patient with (previously corrected) tetralogy of Fallot. After an average of 20 months (range, 1-36 months), six patients developed symptoms. ILR memory showed torsades de pointes-ventricular fibrillation (n = 3), catecholaminergic polymorphic ventricular tachycardia (n = 1), asystole and ventricular tachycardia (n = 1), and normal sinus rhythm (n = 1). At the time of writing six patients were still in follow up with no symptoms after an average of 25.2 months. Conclusion: Implantable loop recorder plays an important role in the diagnosis of life-threatening arrhythmias in which syncope is otherwise unexplained. ILR implantation should be remembered in children whose symptoms are strongly correlated with rhythm disturbances. © 2014 Japan Pediatric Society.


Odemis E.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Ozyilmaz I.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Guzeltas A.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | Erek E.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital | And 2 more authors.
Artificial Organs | Year: 2013

Pulmonary atresia with intact ventricular septum (PAIVS) is characterized by a broad spectrum of heterogeneous morphologies. Perforation of the atretic valve, balloon dilatation, and stenting of the patent ductus arteriosus are the percutaneous techniques that are used with increasing frequency in our clinic as well. They have some advantages over surgery, including short hospital stay and short intensive care unit stay. The main goal of the primary interventional approach is to avoid surgery. However, a group of patients with PAIVS still need surgery due to poor right ventricular growth. Therefore, the final achievement of the initial percutaneous treatment strategies is still debatable. In this article, we present the early- and mid-term results of the percutaneous approach utilized at our clinic in order to investigate the final effects of interventional therapy according to initial morphology. Between May 2010 and May 2012, 15 neonates diagnosed with PAIVS underwent transcatheter intervention. Detailed echocardiographic examination focused on right ventricle size, and tricuspid valve morphology and coronary sinusoids were performed in all the patients before the intervention. Nine of the patients were boys and six were girls. The mean age was 11.40±12.87 days and mean weight was 3.34±0.46kg. Only one procedure-related mortality occurred. The mean follow-up period was 10.05±3.42 months (1-26 months). The mean duration of intensive care was 7.19±5.14 days. The mean follow-up time was 10.05±3.42 months. After this period, survival rate was 66% (10/15). Two of the patients achieved biventricular physiology after pulmonary valve perforation. Two patients still have univentricular physiology. Six patients have been followed as a one and half ventricle repair candidate. Five out of 15 patients had stent patency during 6 months of follow-up, while restenosis developed in one patient (1/5, 20%), who had undergone the Glenn operation at 5 months of age. Transcatheter management for PAIVS is a feasible, safe, and effective primary palliative treatment in newborns. Shunt surgery may be considered in cases where cyanosis occurs despite transcatheter intervention. Right ventricular size determines the type of intervention. The early outcomes can be comparable with surgical palliation. However, a group of PAIVS, particularly with severe right ventricular hypoplasia, needs surgery even after a successful primary percutaneous intervention. © 2013, The Authors. Artificial Organs © 2013, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.


PubMed | Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital
Type: Case Reports | Journal: Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir | Year: 2014

Pulmonary valve atresia with intact ventricular septum, which is a rare congenital heart defect, can be treated either surgically or via transcatheter. Nowadays, in many centers, transcatheter treatment options have become the standard of care for pulmonary atresia, with an intact ventricular septum, for eligible patients. More commonly, radiofrequency wires are used for the perforation of the atretic valve, and subsequently, balloon dilatation is performed. There are limited options for radiofrequency resistant atretic valves. Here, we present the case of 5 day-old male with a radiofrequency resistant atretic pulmonary valve, where perforation was successfully achieved using a Conquest Pro 12 coronary guidewire.


PubMed | Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital
Type: Journal Article | Journal: Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir | Year: 2014

The radiation dose from interventional cardiac catheterization is particularly relevant when treating children because of their greater radiosensitivity compared to adults. The transcatheter closure of patent ductus arteriosus (PDA), as well as other more complex pediatric interventions, have raised concerns regarding radiation exposure, particularly relevant when treating children. The purpose of this study is to show how to perform the transcatheter closure of PDA in children while giving less ionized radiation and to prove that the amount of radiation and contrast material can be reduced.Following appropriate device selection based on PDA morphology and diameter, transthorasic echocardiography images and control aortography findings were analyzed. The following devices were used during the procedure: Gianturco coils (10/63), an Amplatzer Duct Occluder (ADO, 31/63), Flipper coils (19/63), and an Amplatzer vascular plug (3/63).The scopy time, radiation dose, and contrast were 12 6.4 mins, 28.1 14.7 cmGy/cm/kg, and 4.2 2.3 cc/kg, respectively. In the control aortography shortly after the procedure, residual shunt was detected at various levels in 39.7% of patients, and 9.5% demonstrated residual shunt in real-time echocardiography. In the control aortography, the exposure to radiation was 13.3% of the total, and the amount of infused contrast was 27.2% of the total.Patients may be exposed to less radiation and contrast material if an echocardiographic evaluation, instead of a final control aortography injection, is performed after the transcatheter closure of PDA.

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