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Öğe Clinically asymptomatic myocardial bridging in a child with familial subaortic stenosis(Cambridge Univ Press, 2014) Gokalp, Selman; Oztunc, FundaMyocardial bridging is usually seen in the setting of hypertrophic cardiomyopathy or left ventricular hypertrophy. It is rarely reported in an asymptomatic patient with an otherwise structurally normal heart. Familial subaortic stenosis is also a rare entity, and its mode of inheritance is still unknown. Here, we described the case of a 13-year-old asymptomatic girl with a positive family history of sudden cardiac death and subaortic stenosis who was diagnosed with severe myocardial bridging concomitant with familial subaortic stenosis.Öğe Diagnosis and outcome of pregnancies with prenatally diagnosed fetal dextrocardia(Taylor & Francis Ltd, 2015) Oztunc, Funda; Madazli, Riza; Yuksel, Mehmet Aytac; Gokalp, Selman; Oncul, MahmutObjective: To evaluate the incidence, associated cardiac and extracardiac malformations and clinical outcome of fetuses with dextrocardia. Method: A retrospective review of 3556 fetal echocardiograms between 2000 and 2011 revealed 39 cases of dextrocardia. Dextrocardia was defined as right-sided positioning of the fetal heart. Prenatal and postnatal records of the fetuses were reviewed. Results: The incidence was 1.1%. Of the 39 fetuses, 22 were primary dextrocardia and 17 were dextroposition. Diaphragmatic hernia was the most common cause of dextroposition with the incidence of 76%. Of the fetuses with dextroposition 35.5% had a cardiac anomaly. The survival rate of dextroposition was 31.2% and none of the survivors had an associated cardiac anomaly. Primary fetal dextrocardia was most common with situs solitus (45.4%), followed by situs ambiguous (36.3%) and then situs inversus totalis (18.1%). Structural cardiac malformations were found in 100%, 80% and 25% of fetuses with situs ambiguous, solitus and inversus, respectively. Of the dextroposition, 47.6% terminated pregnancy, 14.2% resulted in intrauterine death, 9.5% died after birth, and 28.5% survived. Conclusion: A wide spectrum of complex cardiac malformations are associated with fetal dextrocardia. Fetal echocardiography enables detection of complex cardiac anomalies so that parents can be appropriately counselled.Öğe Is Immunosuppressive and Thrombolytic Therapy Really Effective in a Patient With Intracardiac Thrombosis and Pulmonary Artery Aneurysm due to Behcet's Disease?(Turkish League Against Rheumatism, 2019) Aladag Ciftdemir, Nukhet; Gokalp, Selman; Eren, TubaBehcet's disease (BD) is a rare, multisystemic, chronic vasculitic disorder with unknown etiology. Intracardiac thrombus formation and pulmonary artery aneurysm in BD are very rare. The treatment protocol in patients with vascular involvement, particularly those with pulmonary artery aneurysm accompanied by thrombosis, have not been clearly defined. In this article, we report an exceptional case, who had been treated unsuccessfully with a combination of anti-inflammatory/immunosuppressive therapy and thrombolytic agents, to discuss the poor prognosis of pulmonary artery aneurysm accompanying intracardiac thrombosis in juvenile BD.Öğe Parvovirus Infection in a Child Presenting with Erythema Multiforme and Vasculitis after a Yellow Jacket Bee Sting(Oxford Univ Press, 2021) Can, Ceren; Yazicioglu, Mehtap; Gokalp, Selman; Ozkayin, NeseParvovirus B19 has a wide spectrum of clinical manifestations. Erythema multiforme and vasculitis are rarely reported with parvovirus B19 infections. Reactions to insect stings can range from local swelling to life-threatening systemic reactions. There have been rare reports of unusual reactions, such as vasculitis, occurring in a temporal relationship with insect stings. We report an 8-year-old patient having Parvovirus B-19-related erythema multiforme and vasculitis after a yellow jacket bee sting.Öğe Relationships between Left Heart Chamber Dilatation on Echocardiography and Left-to-Right Ventricle Shunting Quantified by Cardiac Catheterization in Children with Ventricular Septal Defects(Springer, 2014) Gokalp, Selman; Eroglu, Ayse Guler; Saltik, Levent; Koca, BulentLeft atrium and/or left ventricle dilatation on echocardiography is considered to be an indication for closure of ventricular septal defects (VSD). No study has addressed the accuracy of using dilated left heart chambers when defining significant left-to-right shunting quantified by cardiac catheterization in isolated small or moderate VSDs. In this study, the relation between dilated left heart chambers, measured by echocardiography, and left-to-right ventricle shunting, quantified by cardiac catheterization, was evaluated in patients with isolated VSD. The medical records of all patients with isolated VSD who had undergone catheterization from 1996 to 2010 were examined retrospectively. Normative data for left heart chambers adjusted for body weight (BW) and body surface area (BSA) were used. The pulmonary-to-systemic flow ratio (Qp:Qs) was calculated by an oximetry technique. A total of 115 patients (mean age 7.3 +/- A 5 years) fulfilled the inclusion criteria. There was a statistically significant difference in terms of Qp:Qs between the patient groups with normal and dilated left heart chambers, when adjusted for BW and BSA (p = 0.001 and p = 0.002, respectively). But the relationships between Qp:Qs and left heart chamber sizes on echocardiography were not strong enough to be useful for making surgical decisions, as left heart chamber dilatation was not significantly associated with Qp:Qs a parts per thousand yen 2 (p = 0.349 when adjusted for BW, p = 0.107 when adjusted for BSA). Left heart chamber dilatation was significantly associated with Qp:Qs a parts per thousand yen 1.5 only when it was adjusted for BSA (for BW p = 0.022, for BSA p = 0.006). As a result, left heart chamber dilatation measured by echocardiography does not show significant left-to-right ventricle shunting, as quantified by catheterization. We still advocate that catheter angiography should be undertaken when left heart chambers are dilated in echocardiography in order to make decisions about closing small- to moderate-sized VSD.Öğe Risk factors for persistence of coronary artery abnormalities in Turkish children with Kawasaki disease(Turkish J Pediatrics, 2015) Yilmazer, Murat Muhtar; Oner, Taliha; Gokalp, Selman; Doksoz, Onder; Guven, Baris; Vupa-Cilengiroglu, Ozgur; Mese, TimurThe aim of this study was to identify the risk factors for persistence of coronary artery abnormalities (CAAs) in Kawasaki disease and to compare the differences between complete (n=25) and incomplete (n=18) forms of the disease in relation to CAAs. The patients' demographic (age and sex), clinical (season of admission, duration of fever, form of Kawasaki disease), laboratory (complete blood count, eosinophil count, serum biochemistry, C-reactive protein level, erythrocyte sedimentation rate [ESR], urinary analysis), echocardiographic and therapeutic data were evaluated retrospectively from the medical records. The incidence of sterile pyuria was nearly twofold greater in patients with initial CAAs than in patients in which CAAs were not present (25% and 13%, respectively; p=0.33). In multivariate logistic regression analysis, ESR and pyuria were found to be associated with persistence of CAAs (p=0.035 and p=0.046, respectively). In addition, we found that duration of fever was significantly associated with persistence of CAAs (p=0.045). However, gender, age at presentation, peripheral blood eosinophilia, low albumin level, CRP, leukocytosis and anemia were not predictive for persistence of CAAs. There was no difference between the complete and incomplete form of the disease in regard to persistence of CAAs. As a result, we have determined that duration of fever, high levels of ESR and presence of sterile pyuria can be used to predict the persistence of CAAs in Kawasaki disease.
