Background: To study the effect of levetiracetam in treating Sydenham chorea. Methods: We retrospectively collected the data of 140 patients diagnosed with Sydenham chorea in the pediatric neurology and pediatric cardiology outpatient clinics of Van Training and Research Hospital between January 2010 and December 2018. Results: There were 140 patients, 102 (70%) of whom were girls, with mean age of onset 11.8 AE 2.7 years. Symptomatic treatment was initiated in all patients at the time of diagnosis; this medication was changed during follow up in 15 patients. The most frequently prescribed drugs were haloperidol and sodium (Na) valproate, and the most frequently discontinued one was haloperidol, due to side effects. The second-choice drug was most often levetiracetam. Clinical response often began within the first 2 weeks, with Na valproate (P = 0.002), within 4 weeks with carbamazepine (P = 0.037) but 1-6 months with haloperidol (P = 0.018) and levetiracetam (P = 0.008). Time to full remission was similar with Na valproate, carbamazepine, haloperidol, and levetiracetam (P = 0.276). Our study indicated that levetiracetam was as effective as the other commonly used drugs in the symptomatic treatment of Sydenham chorea. Conclusion: Levetiracetam might be an option in the treatment of Sydenham chorea because of its acceptable effect and safety profile. This observation needs further support with evidence obtained through controlled and blinded trials.

Obesity is a metabolic disorder defined as excessive accumulation of body fat, which is made up of genetic, environmental, and hormonal factors and has various social, psychological, and medical complications. Childhood obesity is a major indicator of adult obesity. The aim of this study is to evaluate the cardiac functions via electrocardiography (ECG), echocardiography (ECHO), and treadmill test in childhood obesity. A patient group consisting of 30 obese children and a control group consisting of 30 non-obese children were included in the study. The age range was between 8 and 17 years. Anthropometric measurements, physical examination, ECG, ECHO, and treadmill test were done in all patients. P-wave dispersion (PD) was found to be statistically significantly high in obese patients. In ECHO analysis, we found that end-diastolic diameter, end-systolic diameter, left ventricle posterior wall thickness, and interventricular septum were significantly greater in obese children. In treadmill test, exercise capacity was found to be significantly lower and the hemodynamic response to exercise was found to be defective in obese children. Various cardiac structural and functional changes occur in childhood obesity and this condition includes important cardiovascular risks. PD, left ventricle end-systolic and end-diastolic diameter, left ventricle posterior wall thickness, interventricular septum thickness, exercise capacity, and hemodynamic and ECG measurements during exercise testing are useful tests to determine cardiac dysfunctions and potential arrhythmias even in early stages of childhood obesity. Early recognition and taking precautions for obesity during childhood is very important to intercept complications that will occur in adulthood.

Bruselloz tüm dünyada en sık görülen zoonotik hastalıktır. Bu çalışmada brusellozun yüksek endemisite gösterdiği Van ilinde bruselloz farkındalığını araştırmak amaçlanmıştır. Gereç ve Yöntemler: Bu anket çalışması Temmuz 2014-Mart 2015 tarihleri arasında Van ili şehir merkezinde yapıldı. Bulgular: Çalışmamıza 987 kişi dahil edildi; 555 (%56.2)'i kadın, 432 (%44.8)'si erkekti. Katılımcıların yaş ortalaması 26.8 ± 8.3 yaş idi. Katılımcıların 830 (%84.1)'u daha önce bruselloz hastalığını duyduğunu ifade etti. Katılımcıların öğrenim düzeyleri ile bruselloz bulaşı hakkındaki sorulara verdikleri doğru cevap oranları incelendiğinde, brusellozun çiğ sütten yapılmış peynir yemekle bulaştığını bilme oranı ortaokul ve daha az öğrenim almış olanlarda daha yüksekken, diğer tüm sorulara doğru cevap verme oranları lise ve daha üstü öğrenim almış olanlarda daha yüksek bulundu. Katılımcıların çiğ sütten yapılmış peynir ile bruselloz bulaşını bilme oranı %78.7 idi, ancak diğer bulaş yolları hakkında bilgi düzeyi düşük bulundu. Katılımcıların 296 (%30)'sı geçmişte hayvancılıkla uğraşmıştı, 155 (%15.7)'i halen uğraşmaktaydı. Hayvancılık işlemleri sırasında bulaş için riskli durumlar, brusellozun hayvanlardaki belirtileri ve korunma için yapılacak işlemler konusunda bilgi düzeyi çok düşük bulundu. Sonuç: Çalışmamızın sonuçları Van ilinde bruselloz hakkında bilgi seviyesinin düşük olduğunu; hem toplum sağlığını korumak hem de hayvancılık sektöründe gelir kayıplarının önüne geçmek için bruselloz hakkında toplumun bilgi seviyesini artırmaya yönelik girişimlere ihtiyaç olduğunu ortaya koymuştur.

Pulmonary arterial hypertension (PAH) is an important cause of morbidity and mortality. Congenital heart disease associated PAH (APAH-CHD) and idiopathic PAH are classified in Group 1 PAH. There are limited studies about pediatric patients with PAH. The aim of our study is to evaluate the clinical, diagnostic and treatment characteristics of pediatric PAH. 53 consecutive patients with PAH in a 7 years' study period were retrospectively analyzed. Clinical, echocardiographic and cardiac catheterization findings and targeted treatment modalities were noted. Thirty (56.6%) patients were male and mean age at diagnosis was 5.2±4.30 years. All patients were classified as group 1 consisting of APAH-CHD and idiopathic PAH. Patients with Eisenmenger syndrome w ere the largest group. Ventricular septal defect was the most CHD associated with PAH overall. Atrial septal defect, patent ductus arteriosus, atrioventricular septal defect, aortopulmonary window, double inlet left ventricle, double outlet right ventricle, d-transposition of great arteries and truncus arteriosus were other congenital heart malformat ions were detected. Targeted therapy were given to 34 patients (%64.1%), of them, 22 were under monotherapy, while 12 were under combined therapy. Bosentan was the most chosen drug in all. NYHA FC, exercise capacity with 6MWT improved well by targeted therapy. Life quality and survey are improved with the targeted therapies in pediatric patients with PAH. Single drug or combination therapies including bosentan, tadalafil and inhaled iloprost are effective, safe and well tolerated with rare and minor side effects in pediatric patients with group 1 PAH.

Background. Galectin-3 is a biomarker which takes a role in both acute and chronic inflammation as well as fibrosis and oxidative stress. Increased levels of it are associated with cardiovascular diseases. This study was performed to investigate the levels of galectin-3 in acute rheumatic fever (ARF). Methods. 30 patients with ARF and 26 healthy children were included. Galectin-3 levels of the patients were compared with the controls, as well as within the patients before and after the treatment. Results. The patients had significantly lower galectin-3 levels on admission than the control (p=0.02), but its levels were not significantly different between these groups at the end of treatment (p=0.714). The mean galectin-3 levels of the patients were increased after the treatment (p < 0.001). Severity of carditis and galectin-3 levels were negatively correlated (r=-539, p=0.02). Conclusions. Children with ARF have significantly reduced levels of galectin-3 and there is a negative correlation between the severity of the carditis and galectin-3 levels. Studies with larger sample sizes may give more accurate data about the role of galectin-3 in ARF.

No abstract

Congenital cardiac ventricular diverticulum is an extremely rare condition that usually occurs as a part of Pentalogy of Cantrell and frequently associated with sternal, pericardial, diaphragmatic, and thoracoabdominal wall defects. The prognosis of the patient depends on the complexity of abnormalities. Herein, we report biventricular diverticula as a part of incomplete Cantrell’s syndrome in a 1-day-old newborn.

Bruselloz tüm dünyada en sık görülen zoonotik hastalıktır. Bu çalışmada brusellozun yüksek endemisite gösterdiği Van ilinde bruselloz farkındalığını araştırmak amaçlanmıştır.