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Öğe Assessment of P-wave dispersion in children with atrial septal aneurysm(CAMBRIDGE UNIV PRESS, 2014) Arslan, Derya; Cimen, Derya; Guvenc, Osman; Oran, Bulent; Yilmaz, Fatma HilalBackground: This was a prospective controlled study to determine the P-wave duration and P-wave dispersion in patients with atrial septal aneurysm. Methods: A total of 41 children with atrial septal aneurysm, including 21 boys and 20 girls (mean age 11.85 +/- 3.8 years), and 32 controls, including 17 boys and 15 girls (mean age 12.3 +/- 2.9 years), were included. P-wave dispersion was calculated from the 12-lead electrocardiogram. Cardiac functions, morphology of the aneurysm, and left atrial diameter were measured using conventional echocardiography. The diagnosis of atrial septal aneurysm was made when the base of the aneurysms with an excursion ratio >= 25% was found on echocardiography. Results: There was no significant difference between the patient and control groups in demographic, clinical findings, and M-mode echocardiographic parameters. The P-wave dispersion in patients with atrial septal aneurysm was significantly longer compared with the control group (64.4 +/- 13.4 ms; p < 0.0001). Similarly, the the maximum duration of the P wave in the patient group was significantly longer compared with the control group (106.1 +/- 13.3 ms; p < 0.001). The P-wave duration and dispersion were not correlated with age, gender, systolic and diastolic blood pressure, or m-mode echocardiographic parameters. Conclusions: This study shows that P-wave dispersion is delayed in atrial septal aneurysm patients. Prolonged P-wave dispersion was determined to indicate electrical disturbance, and therefore it has an increased electrocardiographic risk of atrial arrhythmia in children with atrial septal aneurysm.Öğe Case Presentation: Approach To Acute Rheumatic Fever Patient With Hepatotoxicity Due To Acetylsalicylic Acid(GALENOS YAYINCILIK, 2017) Guvenc, Osman; Cimen, Derya; Aslan, Eyup; Emiroglu, Haldun; Arslan, Derya; Oran, BulentTreatment with acetylsalicylic acid is the first choice for arthritis and mild carditis of acute rheumatic fever which is a common disease in our country. There may be many adverse reactions during treatment. 10 year-old male patient diagnosed as acute rheumatic fever had hepatotoxicity due to acetylsalicylic acid therapy. This clinic manifestation has the possibility that can be seen always in pediatric cardiology practice. This case is presented due to limited literature on the treatment of patients with hepatotoxicity.Öğe Co-occurrence of Carpenter syndrome and double outlet right ventricle(TURKISH SOC CARDIOLOGY, 2017) Guvenc, Osman; Cimen, Derya; Arslan, Derya; Guler, IbrahimCarpenter syndrome (acrocephalopolysyndactyly type 2, OMIM 201000) is a rarely seen autosomal recessive disorder. In addition to abnormalities such as acrocephaly, craniosynostosis, facial asymmetry, polydactyly and syndactyly, obesity, hypogonadism, mental retardation, and corneal opacity, it may frequently be accompanied by congenital heart diseases such as ventricular septal defect, patent ductus arteriosus and pulmonary stenosis. Double outlet right ventricle is a defect in which both major arter-ies originate in the morphological right ventricle. To the best of our knowledge, this is the first report in the literature of double outlet right ventricle disease in combination with Carpenter syndrome.Öğe Double inlet left ventricle-ventriculoarterial discordance without surgical treatment(WILEY, 2016) Guvenc, Osman; Saygi, Murat; Sengul, Fatma S.; Ayyildiz, Pelin; Guzeltas, AlperUniventricular heart is a rare congenital defect that consists, in nearly 80% of cases, of double inlet left ventricle, to which both atrioventricular valves connect. A 31-year-old male patient was diagnosed with single ventricle at the age of 9. He had not received any surgical intervention and was not on any medication. Functional capacity was assessed as New York Heart Association class III. Both atrioventricular valves were found to open into the morphological left ventricle, which was located on the right; the hypoplasic right ventricle was on the left side of the left ventricle, the posteriorly located aorta emerged from the right ventricle, and the anteriorly located pulmonary artery emerged from the left ventricle. There was significant subvalvular and valvular stenosis in the pulmonary valve site. The disease is complex and it is very rare that untreated patients reach adulthood.Öğe Heparin-Induced Thrombocytopenia Association with Impaired Liver Function Tests(DERMAN MEDICAL PUBL, 2016) Arslan, Derya; Guvenc, Osman; Cimen, Derya; Oran, BulentHeparin-induced thrombocytopenia is an intensely procoagulant disorder and carries significant morbidity and mortality. However, the elevations in serum aminotransferases are characteristically asymptomatic and reversible with treatment termination. The serious liver injury due to heparins has not been reported but liver function should be monitored closely since potential severe liver damage with hepatocyte necrosis can occur. In this case report, we present a one-year-old male patient who developed a left lower extremity arterial thrombosis following an pulmonary artery banding procedure. Our case was taking unfractionated heparin for anticoagulation. On the third day of heparin therapy, routine blood analysis revealed deranged hepatic function tests and thrombocytopenia. Unfractionated heparin treatment was discontinued and he was treated with therapeutic doses of low-molecular-weight heparin for arterial thrombosis. His platelet count and liver function tests had normalised 2 weeks later.Öğe Huge ascending aortic aneurysm in a 7-year-old patient with Marfan syndrome(VIA MEDICA, 2014) Saygi, Murat; Ozyilmaz, Isa; Guvenc, Osman; Guzeltas, Alper; Odemis, Ender[Abstract not Available]Öğe Hypertrophic cardiomyopathy with Jeune syndrome: The first reported case(TURKISH SOC CARDIOLOGY, 2016) Guvenc, Osman; Uygun, Saime Sundus; Cimen, Derya; Aslan, Eyup; Annagur, AliJeune syndrome (Asphyxiating thoracic dysplasia) is a rare dystrophy of the skeleton, inherited as an autosomal recessive condition. Patients develop a narrowed thorax, rhizomelic dwarfism, and hepatic, renal, and pancreatic abnormalities. High rates of pulmonary hypoplasia and pulmonary hypertension have been reported. Some patients die in early stages of life due to respiratory failure. The case of a patient referred with a history of severe asphyxiating birth, who had been diagnosed with Jeune syndrome and later hypertrophic cardiomyopathy (HCM) upon echocardiographic examination is described in the present report. This rare disease is discussed with respect to the current literature, as the present is the first reported case to be accompanied by HCM.Öğe Myocardial Ventricular Noncompaction: Recent Literature Due to its Rarity in Childhood(GALENOS YAYINCILIK, 2015) Guvenc, Osman; Cimen, Derya; Arslan, Derya; Sivri, Mesut; Koplay, Mustafa; Oran, BulentMyocardial noncompaction is a rare form of congenital cardiomyopathy. The disorder represents an arrest of normal embryogenesis of myocardium in utero. It is characterized by deep trabecular structures anatomically and deep intratrabecular recesses. Congestive heart failure, thromboembolism and cardiac arrhythmias are main clinical findings. On the other hand patients may be asymptomatic. We describe a case of myocardial noncompaction presenting with decreased exercise capacity in our clinic. We would like to remind this rare disorder and search recent literatures.Öğe Normal M mode values in healthy Turkish children(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2014) Oran, Bulent; Bodur, Abdurrahman Said; Arslan, Derya; Cimen, Derya; Guvenc, OsmanAim: Evaluation of cardiac structures requires a large study group for accurate data on normal values. The aim of the study was to obtain normal M mode echocardiographic values in a substantial sample of healthy term neonates and children to develop centile charts. Materials and methods: Data were obtained over 2 years from a single center in Turkey, from 1200 healthy infants and children aged 1 day to 17 years. Using echocardiographic investigation, measurements were obtained of the following: left ventricular dimension at end diastole and end systole; thickness of interventricular septum and posterior wall of the left ventricle; aortic and pulmonary root diameter; and left atrial dimension. The influence of systematic errors as statistical noise in this large sample was decreased using third-degree polynomial curves. Results: Measurements are presented graphically as curved lines of centiles with respect to body weight for healthy term neonates and children. The values showed a good correlation with body weight and allowed the construction of percentile curves (5%, 25%, 50%, 75%, and 95%). Higher values were observed in boys during adolescence. Conclusion: The presented charts and tables make it possible to judge the echocardiographic measurements of a particular patient as normal or abnormal.Öğe Platelet Distribution Width and Mean Platelet Volume in Children With Pulmonary Arterial Hypertension Secondary to Congenital Heart Disease With Left-to-Right Shunt: New Indices of Severity?(SPRINGER, 2013) Arslan, Derya; Cimen, Derya; Guvenc, Osman; Kaya, Fatma; Sert, Ahmet; Oran, BulentThe majority of patients with congenital heart disease (CHD), particularly those with relevant systemic-to-pulmonary shunts, if left untreated, will experience the development of pulmonary arterial hypertension (PAH). Previous studies have shown that platelet activation occurs in patients with PAH. In response, this study aimed to investigate the platelet indices, including platelet distribution width (PDW) and mean platelet volume (MPV), in patients with PAH. The study was conducted in the pediatrics cardiology unit of Selcuk University Medical Faculty between July 2010 and January 2012. The patients' clinical and laboratory data were obtained retrospectively from hospital recordings. The study enrolled 57 children with CHD (all with left-to-right shunting). The patients who had undergone diagnostic cardiac catheterization were analyzed according to the presence or absence of PAH. Group 1 had CHD with PAH, and group 2 had CHD without PAH. Compared with the group 2 patients, a significant decrease in PDW (p < 0.0001) was noted in the group 1 patients (with PAH). Likewise, a significant difference was found in the MPV of group 1 (p < 0.0001). Statistically, groups 1 and 2 did not differ in terms of platelet count (p = 0.3). Patients who had pulmonary hypertension secondary to CHD with left-to-right shunting exhibited a lower PDW and MPV.Öğe Prolonged QT Dispersion in the Infants of Diabetic Mothers(SPRINGER, 2014) Arslan, Derya; Guvenc, Osman; Cimen, Derya; Ulu, Havva; Oran, BulentMyocardial hypertrophy and cardiac dysfunction frequently occur in newborns of diabetic mothers. The authors hypothesized that wall hypertrophy or disproportionate left ventricular wall thickness in newborns of diabetic mothers may affect both QT and QTc dispersion. This study aimed to assess whether left ventricular hypertrophy affects the QT variables of infants born to diabetic mothers. This prospective cross-sectional study was conducted with 47 consecutively selected neonates of gestational diabetic mothers and 30 healthy neonates born to healthy mothers. All the subjects were evaluated during the neonatal period. Electrocardiography with echocardiography was performed for the patients and the control subjects. The newborns of the diabetic mothers were classified according to septal thickness as group 1 (16 newborns with septal hypertrophy) or group 2 (31 newborns without septal hypertrophy). The study group consisted of three cohorts: groups 1, 2, and 3 (control group). Both QT and QTc dispersion were computed from a randomly selected beat as well as from an average beat derived from 12 beats included in a 10-s electrocardiography. A total of 16 infants (34 %) had a septal thickness of 6 mm or greater. The left ventricular end-systolic diameter in group 1 was smaller (p = 0.0029) than in groups 2 and 3 (p = 0.003). The interventricular septal thickness at end diastole (IVSTd) and the left ventricular posterior wall thickness at end diastole in group 1 were higher than in of groups 2 and 3. The QT and QTc dispersion intervals were longer in group 1 than in groups 2 and 3 (p < 0.001), and a highly significant positive correlation was detected between IVSTd and QT dispersion (r = 0.514, p = 0.042). Elevated QT and QTc dispersions may be risk factors for the development of arrhythmias in newborns of diabetic mothers. These patients may critically need systematic cardiac screening.Öğe Sitting Buddha position: Sacral agenesis case(MEDICAL INVESTIGATIONS SOC, 2016) Guvenc, Osman; Guler, Ibrahim; Annagur, AliSacral agenesis syndrome (Caudal regression syndrome) is a neural tube defect that is characterized by absence of the vertebral segment that constitutes the sacrum. It is very rarely seen and generally develops sporadically. Its etiology is influenced by maternal diabetes, genetic factors, teratogenic agents and vascular hypo-perfusion. It is important to make a diagnosis in the prenatal period. This paper presents a newborn diagnosed with sacral agenesis as a case and discusses this disease in the light of the latest literature information.Öğe An Unusual Presentation of Acute Rheumatic Fever(MODESTUM LTD, 2015) Arslan, Derya; Guvenc, Osman; Cimen, Derya; Oran, BulentAcute rheumatic fever (ARF) is a multisystem disease caused by an immunological response to group A streptococcus infection. Its sequel rheumatic heart disease continue to cause a large burden of morbidity and mortality in developing countries. Early detection of ARF is paramount to the prevention of rheumatic heart disease. We report a case of ARF with presenting epistaxis. The variety of clinical manifestations, which may be the presenting signs and symptoms of ARF, are not included in the updated-revised Jones criteria. Therefore, a careful examination and awareness of the disease can play an important role in identifying ARF.Öğe The usefulness of plasma asymmetric dimethylarginine (ADMA) levels and tissue doppler echocardiography for heart function in term infants born to mothers with gestational diabetes mellitus(TAYLOR & FRANCIS LTD, 2013) Arslan, Derya; Oran, Bulent; Vatansev, Husamettin; Cimen, Derya; Guvenc, OsmanObjective: The aim of this study was to examine whether asymmetric dimethylarginine (ADMA) concentrations are associated with ventricular function in the infants of mothers with gestational diabetes. Method: Twenty-five term newborns of mothers with gestational diabetes and term newborns as the control group (n=25) with normal general health status were evaluated at two time points, on the 3rd postnatal day, at the 3th months. Echocardiographic evaluations of all participants were performed and ADMA level was measured. Results: In the first analysis, 10 patients (40%) had a septal thickness of 6mm or more, indicating septal hypertrophy. In the first and second analysis, interventricular septum end-diastolic thickness (IVSTd) and the left ventricular posterior wall end-diastolic thickness (LVPWTd) in the patient group were higher than the control group. ADMA level measurement was not significantly different between the groups the first and second analysis. There was no difference in ADMA levels of the group with septal thickness >= 6mm and the group with <6 mm. Conclusion: Newborn cardiac wall thickness was increased in pregnancies complicated by Gestational diabetes mellitus (GDM), and the increase was independent of glycemic control. Diastolic newborn cardiac function was impaired in GDM, and this effect was independent of septal thickness. We found no association between ADMA levels and cardiac systolic, diastolic functions or septum thickness in the GDM newborn.
