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Öğe Association of MTHFR A1298C polymorphism with conotruncal heart disease(Cambridge Univ Press, 2015) Kocakap, Beyza D. Sayin; Sanli, Cihat; Cabuk, Feryal; Koc, Murat; Kutsal, AliCongenital heart diseases are common congenital anomalies with 1% prevalence worldwide and are associated with significant childhood morbidity and mortality. Among a wide range of aetiologically heterogeneous conditions, conotruncal anomalies account for approximately one-third of all congenital heart defects. The aetiology of conotruncal heart diseases is complex, with both environmental and genetic causes. Hyperhomocysteinaemia, which is often accompanied by the defects of folic acid metabolism, is known to cause conotruncal heart anomalies. In this study, we have evaluated three polymorphisms in the following two hyperhomocysteinaemia-related genes: methylenetetrahydrofolate reductase (MTHFR C677T and A1298C) and nicotinamide N-methyl transferase (NNMT rs694539) in 79 children with conotruncal heart disease and 99 children without conotruncal heart disease. Genotype distribution of the MTHFR A1298C polymorphism showed a statistically significant difference between the two groups. In the case group, AC and CC genotypes were higher than the control group (p<0.05). We have found that MTHFR A1298C polymorphism is associated with conotruncal heart disease; C allele (p=0.028), AC (OR[95% CI]=2.48[1.24-4.95], p=0.010), CC (OR[95% CI]=3.01[1.16-7.83], p=0.023), and AC+CC (OR[95% CI]=2.60[1.36-4.99], p=0.004) genotypes are more frequent in the patient group. Genotype distributions of the MTHFR C677T and NNMT rs694539 polymorphisms were similar in the two groups when evaluated separately and also according to the dominant genetic model (p > 0.05). Our results suggest that MTHFR 1298C allele is a risk factor for conotruncal heart disease.Öğe Cardiac Troponin T in Children With Acute Rheumatic Carditis(Springer, 2011) Ozdemir, Osman; Oguz, Deniz; Atmaca, Emel; Sanli, Cihat; Yildirim, Ayse; Olgunturk, RanaThe existence of cardiac damage in active rheumatic carditis patients is unknown, especially in those without pericarditis. The aim of this study was to determine cardiac myocyte damage using cardiac troponin T (cTnT) measurements in active rheumatic carditis. The levels of creatine kinase MB isoenzyme (CK-MB), cTnT, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), cardiothoracic ratio (CTR), and fractional shortening (FS) were compared using Mann-Whitney U test between 28 patients with active rheumatic carditis and 32 controls (healthy children). Association of cTnT levels with ESR, CRP, and CTR was evaluated with Spearman correlation analysis. ESR, CRP, cTnT levels, and CTR were statistically higher in the patients than in the controls. There were no differences between the groups for CK-MB levels and FS. No relationships were found between cTnT levels and ESR, CRP, and CTR in the patient group. The results of the study suggest that when cTnT levels are within non-pathological range, there is no serious cardiac damage; however, statistically significant increases in cTnT levels may indicate minor damages in patients with active carditis due to acute rheumatic fever.Öğe Clinicopathologic challenge: Linear brown macules on the chest and arm(Wiley-Blackwell, 2008) Erkek, Emel; Bozdogan, Onder; Sanli, Cihat; Ozoguz, PinarWhat is your diagnosis?Öğe Cystatin C as biomarker of contrast-induced nephropathy in pediatric cardiac angiography(Tubitak Scientific & Technical Research Council Turkey, 2014) Ozdemir, Osman; Oguz, Ayse Deniz; Eren, Abdulkadir; Sanli, Cihat; Soylemezoglu, Husnu Oguz; Cayci, Ayse BanuBackground/aim: The purpose of this study is to find the frequency of contrast-induced nephropathy (CIN) and to show the risk factors in the development of CIN and the diagnostic utility of serum cystatin C (CysC) and serum and urine neutrophil gelatinase-associated lipocalin (NGAL) during childhood following cardiac angiography. Materials and methods: In this prospective study, we studied 46 children with congenital heart disease. The levels of serum creatinine, serum CysC, and serum NGAL were measured at 4, 24, and 48 h, while levels of urine NGAL and urine creatinine were measured at 4 to 8 and 48 h following cardiac angiography. Results: According to serum creatinine levels, with a cutoff value of 4.1 mL/kg for development of CIN, sensitivity, specificity, area under the receiver-operating characteristic curve, and positive likelihood ratio were calculated as 69%, 70%, 0.67, and 2.29, respectively. The levels of serum CysC and serum creatinine significantly increased at 4, 24, and 48 h after the application of the contrast agent. Conclusion: The results of this study show that according to the definition of CIN, the incidence of CIN is significantly increased in pediatric patients with congenital heart disease. Moreover, the results support that serum CysC levels may allow the detection of CIN after cardiac angiography, like serum creatinine in present study.Öğe Elevated Homocysteine and Asymmetric Dimethyl Arginine Levels in Pulmonary Hypertension Associated With Congenital Heart Disease(Springer, 2012) Sanli, Cihat; Oguz, Deniz; Olgunturk, Rana; Tunaoglu, Fatma Sedef; Kula, Serdar; Pasaoglu, Hatice; Cevik, AyhanPulmonary arterial hypertension (PAH) is a major cause of morbidity and mortality among patients with congenital heart disease (CHD). This study was designed to determine biomarker levels in patients with PAH associated with CHD (PAH-CHD) and CHD patients without PAH and to investigate the relationship of these potential biomarkers with hemodynamic findings. In this prospective single-center study, patients with CHD were analyzed according to the presence or absence of PAH and compared with healthy control subjects. Cardiac catheterization and echocardiographs were performed. Plasma homocysteine, asymmetric dimethyl arginine (ADMA), and nitric oxide (NO) levels were determined by enzyme-linked immunosorbent assay. Homocysteine and ADMA levels were higher in the PAH-CHD group (n = 30) than among CHD patients with left-to-right shunting but no PAH (n = 20; P < 0.001) and healthy control subjects (n = 20; P < 0.001). There was no difference in NO levels. Cyanotic PAH-CHD patients had significantly higher homocysteine than acyanotic patients in the same group. No correlation was shown between echocardiographic/hemodynamic parameters and homocysteine, ADMA, and NO levels. Homocysteine and ADMA levels are increased in patients with PAH-CHD. These parameters have the potential to be used as biomarkers in the diagnosis and follow-up evaluation of patients with PAH-CHD. However, large, multicentered prospective studies are required to facilitate routine use of these biologic markers in the clinical setting.Öğe Eruptive Vellus Hair Cysts: Report of a Pediatric Case With Partial Response to Calcipotriene Therapy(Quadrant Healthcom Inc, 2009) Erkek, Emel; Kurtipek, Guelcan Saylam; Duman, Deniz; Sanli, Cihat; Erdogan, SibelEruptive vellus hair cysts (EVHCs) are characterized by asymptomatic, follicular, comedonelike papules usually located on the anterior chest and abdomen. We present a pediatric case of EVHC associated with attention deficit hyperactivity disorder that partially responded to calcipotriene cream within 2 months. Our aim is to refamiliarize clinicians with a common albeit frequently unrecognized disorder of vellus hair follicles. Cutis. 2009;84:295-298.Öğe Evaluation of Epicardial AdiposeTissue Thickness in Children Detected Subclinical Hypothyroidism(Karger, 2016) Asik, Gaye; Ergur, Ayca Torel; Sanli, Cihat…Öğe Evaluation of pulmonary vascular resistance and vasoreactivity testing with oxygen in children with congenital heart disease and pulmonary arterial hypertension(Turkish Soc Cardiology, 2014) Cevik, Ayhan; Kula, Serdar; Olgunturk, Rana; Tunaoglu, Sedef; Oguz, Deniz; Saylan, Berna; Sanli, Cihat…Öğe Evaluation of the functional capacity, respiratory functions and musculoskeletal systems of the children with chest pain for non-cardiac reasons(Turkish J Pediatrics, 2017) Daskapan, Arzu; Sanli, Cihat; Aydogan-Arslan, Saniye; Ciledag-Ozdemir, Filiz; Korkem, Duygu; Kara, UgurcanChronic chest pain in healthy children and adolescents generally arises from non-cardiac factors. The purpose of our study was to compare the evaluation results of effort test, respiratory function and musculoskeletal system in children and adolescents with chest pain for non-cardiac reasons with healthy children and adolescents. Physical activity level was determined by the International Physical Activity Questionnaire. The respiratory function test was performed using a spirometer. The posture analysis was performed to determine the upper body deformities. The effort test was performed on a treadmill. The two groups were similar in terms of the physical activity levels, respiratory function and effort test results (p>0.05). The rate of the rounded shoulder, kyphosis was significantly higher in the patient group with chest pain (p<0.005). Consequently, the musculoskeletal system findings including the pectoralis minor shortness, rounded shoulder, and thoracic kyphosis could have a role in non-cardiac chest pain.Öğe Health risk behaviors of students in an Anatolian university(Amer Acad Pediatrics, 2008) Hizel Bulbul, Selda Fatma; Sanli, Cihat; Fidan, Serdar; Agar, Ayca; Ceyhun, Gulsen[Abstract No tAvailable]Öğe Heart Rate Variability in Neonates with Hypoxic Ischemic Encephalopathy(All India Inst Medical Sciences, 2012) Aliefendioglu, Didem; Dogru, Tolga; Albayrak, Meryem; DibekMisirlioglu, Emine; Sanli, CihatObjective To evaluate the changes in heart rate variability (HRV) in newborns with hypoxic-ischemic encephalopathy (HIE). Methods Twenty-two newborns (14 boys, 8 girls) with moderate or severe HIE and 24 term neonates with similar gestational and postnatal age for control were included in this study. Normalized low and high frequency components of HRV and their ratio were evaluated for 24-h in newborns with HIE and control subjects. Results The newborns with hypoxic-ischemic encephalopathy had significantly lower normalized low frequency (LFn) and low frequency (LF) / high frequency (HF) values and higher normalized high frequency (HFn) values when compared with the control babies. In addition, when the cases with severe HIE are compared with those of moderate HIE, decreased LFn, LF/HF values and also increased HFn values were present in the severe cases. Conclusions HIE is associated with reduced sympathetic nervous system activity, and increased parasympathetic nervous system activity and these activities also correlate with the severity of the disease.Öğe Maternal Blood Group Is a Possible Predictor for Developing Congenital Heart Disease in Turkish Children with Down's Syndrome(Georg Thieme Verlag Kg, 2024) Kandur, Yasar; Kocakap, Derya Beyza Sayin; Alpcan, Aysegul; Sanli, Cihat; Sayan, Cemile Dayangan; Koyuncu, Omer LutfiWe aimed to evaluate the clinical characteristics and the risk factors for the anomalies of Down's syndrome (DS) patients and reviewed the relation of blood groups of the patients and the mothers with these anomalies. Pediatric patients who were diagnosed with trisomy 21 between 2010 and 2022 were enrolled in this study. The medical records of the DS patients and their parents were retrospectively reviewed. A total of 48 patients applied to our clinic. 24 (50%) patients were diagnosed with congenital heart disease. 21 (43.75%) patients had hypothyroidism. The distribution of individual congenital heart defects (CHDs) was as follows: ventricular septal defect in eight (33.3%) patients, one of which also had patent ductus arteriosus (PDA); atrioventricular septal defects in seven (29.1%) patients; atrial septal defects in four (16.6%) patients, one of which also had patent ducus arteriosus; and PDA in five (20.8%) patients. One (4.2%) patient had tetralogy of Fallot. The incidence of CHD in patients with maternal blood group A was significantly higher than those without CHD, with a prevalence of 63.6 and 21.1%, respectively ( p = 0.020). Binary logistic regression analysis showed that maternal blood group A was a risk factor for CHDs (odds ratio = 6.563; 95% confidence interval: 1.259-34.204; p = 0.025). Although we found that the rate of advanced father age was high in hypothyroidism type, the regression analysis showed that it was not a risk factor. We found that maternal blood group A increased the likelihood of being born with CHDs in DS.Öğe MOTHERS' KNOWLEDGE, ATTITUDES, AND BEHAVIOUR CONCERNING CHILDHOOD CANCER IN A RURAL ANATOLIAN PROVINCE(Gazi Univ, Fac Med, 2009) Hizel, Selda; Toprak, Sule; Albayrak, Meryem; Sanli, Cihat; Kocak, UlkerPurpose: Cancer is a physical disease but it has mental and social components. It is usually perceived as an illness that suggests death involving feelings of guilt, panic, hostility, aggression, anxiety, loneliness, and helplessness. It was reported that 50% of the parents of cancer patients had psychiatric disorders and that 73% of these were depressive disorders. The main reason for the anxiety is the close association of the illness with death and a lack of knowledge about childhood cancers. The aim of this study was to evaluate the knowledge and attitudes and anxiety level of mothers regarding childhood cancers. Materials and Methods: This cross-sectional study examined 300 mothers of children who presented to Kirikkale University, Medical School, Pediatrics Department and two health centers in central Kirikkale. Questionnaires consisting of 38 questions were completed by a research assistant by face-to-face interviews after permission was obtained from the mothers. The mothers' knowledge was regarded as good if 8-10 of the 10 knowledge questions about cancer were answered correctly, while 4-7 indicated moderate knowledge and 0-3 poor knowledge. Results: At least one cancer patient in their close community was known to 40.3% of the mothers. Information on cancer was mostly obtained from healthcare centers (20.7%), the media (35.3%), friends and relatives (10.7%), or both the media and friends and relatives (33.3%). The most widely known childhood cancers were leukemia and lymphoma. The rate of cancer screening among the participants was 7.3% (n=22). There was no significant correlation between having a family member with cancer and undergoing screening for cancer (p>0.05). The three main reasons for cancer were stated as smoking, food, and alcohol. The rate of smoking among the mothers was 57% and smoking was more common among mothers with less knowledge although this difference was not statistically significant. Twenty-three percent of the participants thought that cancer could not be treated. Mostly mothers stated that they would feel great sorrow and would experience great anxiety if they had a child with cancer. Only 22.7% of the mothers had sufficient knowledge about cancer. Anxiety on a subject exists when the level of information is inadequate. However, we found no correlation between the anxiety levels and the level of information about cancer among the mothers. Moreover, 71.7% of the mothers stated that they would not tell their child if he or she were diagnosed with cancer, while 7.7% said that they would not know what to do in that situation. Conclusion: The level of kowledge about cancer among the public is inadequate and thisresults in subjective value judgments, which directly influence anxiety levels. Therefore, parents need to be informed more extensively about the prevention and treatment of cancer to decrease their anxiety.Öğe Persistent left superior vena cava: Experience of a tertiary health-care center(Wiley-Blackwell, 2011) Kula, Serdar; Cevik, Ayhan; Sanli, Cihat; Pektas, Ayhan; Tunaoglu, Fatma Sedef; Oguz, Ayse Deniz; Olgunturk, RanaBackground: The aim of this study was to assess the prevalence of persistent left superior vena cava (PLSVC) in patients with all types of congenital heart defects and to determine the congenital heart anomalies accompanying PLSVC. Methods: The present study is based on a retrospective review of 1205 children who consecutively underwent cardiac catheterization from 2000 to 2007. In order to determine the existence of PLSVC, all the subjects routinely underwent superior vena cava (SVC) injection during angiography at the catheter laboratory of the study center. Results: The prevalence of PLSVC was computed to be 6.1% for the present study population. Transthoracic echocardiography was able to detect PLSVC in 32 children (2.6%) whereas angiography diagnosed PLSVC in 74 children (6.1%). The mean age of the patients with PLSVC was 40.09 +/- 50.21 months. A communication between the right and left SVC was determined in 27% of the children who were diagnosed with PLSVC after angiography was performed (20 out of 74). A statistically significant association was present between PLSVC and other congenital cardiac anomalies, including ventricular septal defect (n = 42, 56.8%), atrial septal defect (n = 31, 41.9%), pulmonary stenosis (n = 19, 25.7%), atrioventricular septal defect (n = 10, 13.5%), patent ductus arteriosus (n = 6, 8.1%) and cor triatriatum (n = 3, 4.1%). Conclusion: Transthoracic echocardiography usually visualizes dilated coronary sinus in association with PLSVC. However, SVC injection should be performed in patients undergoing angiography so that morbidity and mortality related with persistent left superior vena cava can be avoided during cardiovascular surgery.Öğe PERTUSSIS; STILL A CLINICAL DIAGNOSIS(Gazi Univ, Fac Med, 2006) Kocak, Ulker; Sanli, Cihat; Albayrak, Meryem; Bulduk, Reyhan Erol; Saygi, SemraPertussis is an acute, contagious respiratory infection characterized by paroxysmal coughing episodes. The most important and severe complication in infants is respiratory failure due to pneumonia. We report the case of a 3-month-old infant without any immunization who presented with cough, whooping and cyanosis, and developed pneumonia on the second day and a leukemoid reaction on the sixth day of admission. The relation between pneumonia and mortality, especially in infants, and the prognostic impact of a leukemoid reaction are emphasized.Öğe Remembering the Importance of an Old Friend: History Taking in Preoperative Evaluation of Healthy Children: A Single Center Experience(Gazi Univ, Fac Med, 2016) Toprak, Sule; Kocak, Ulker; Misirlioglu, Emine Dibek; Sanli, Cihat; Albayrak, Meryem; Basar, HulyaObjective: To investigate the consequences of routine laboratory tests that lead to surgical delay or high cost in patients with a normal medical history and physical examination who undergo minor surgical interventions. Patients and Method: Files of 1,322 patients aged between 0-16 years that had undergone elective surgical intervention within six years were reviewed. Results: Of the 1,322 patients, 1,246 (94.3%) had normal physical examination and laboratory findings. Seventy-six children who had abnormalities in laboratory findings and physical examination were referred to pediatrics. Of the 76 pediatric referees, 42 (55.3%) were reevaluated and were diagnosed with upper respiratory tract infection (n=23; 30.2%), iron deficiency anemia (n=5; 6.5%), innocent murmur (n=4; 5.3%), thalassemia minor (n=2; 2.6%), lower respiratory tract infection (n=2; 2.6%), urinary tract infection (n=1; 1.3%), mumps (n=1; 1.3%), acute gastroenteritis (n=1; 1.3%), minimal aortic and tricuspid valve insufficiency (n=1; 1.3%), minimal aortic stenosis (n=1; 1.3%), atrial septal defect (n=1; 1.3%). Surgical interventions were delayed until the recovery of the infectious diseases. In 25 of the patients, repeated tests showed normal ranges after the second test; however nine (n=9) of the patients showed increased or decreased numbers of white blood cell counts and whose medical history and physical examination revealed signs and symptoms related to infection. Conclusion: Routine laboratory tests contribute little to preoperative evaluation of children with normal history and physical examination undergoing low grade surgery.Öğe The Frequency of Hepatitis B, Hepatitis C and Hepatitis G Virus in Patients with Beta-Thalassemia Major Who Receive Frequent Blood Transfusion(Galenos Yayincilik, 2005) Sanli, Cihat; Albayrak, Meryem; Nakipoglu, Fikret; Gumruk, FatmaThe purpose of this study is to investigate the frequency of hepatitis B (HBV), hepatitis C (HCV) and hepatitis G (HGV) virus, the demographical characteristics and clinical information of patients with beta-thalassemia major who receive frequent blood transfusion. Seventy patients with beta-thalassemia major [36 (51.5%) male, 34 (48.5%) female] are included in our study. The age of the patients was between two and 24 years. Age, gender and clinical information (time of first transfusion, number of transfusions and hepatitis B vaccination) of the patients are recorded. HBsAg, anti-HBs, anti-HBc IgG, HBV-DNA, anti-HCV, HCV-RNA and HGV-RNA tested in all patients. Three (4.3%) patients tested HGV-RNA positive. HBsAg in 1 (1.4%) patient, anti-HBs in 66 (94.3%) patients, anti-HBc IgG in 23 (% 32.9) patients, anti-HCV in14 (20%) patients and in 5 (7.1%) HCV-RNA tested positive. There was no relationship between HGV-RNA positivity and factors such as age, gender, number of transfusion, time of first transfusion, serum ferritin or serum ALT levels. While average serum ALT levels of two patients with both HGV-RNA and HCV-RNA positive was higher than the other patients. In 4.3% of the patients who received frequent blood transfusion the HGV-RNA was detected. While HGV infection can co-exist with HBV and HCV infections, however, when it exists alone, pronounced increase in transaminase levels had not occured.Öğe Topotecan treatment and its toxic effects on hematologic parameters and trace elements(Humana Press Inc, 2008) Hizel, Selda Buelbuel; Sanli, Cihat; Muluk, Nuray Bayar; Albayrak, Meryem; Ozyazici, Ahmet; Apan, AlpaslanThe aim of this study was to investigate the effects of topotecan, a topoisomerase I-inhibiting anticancer agent, on hematologic parameters and serum levels of trace elements. The study was conducted on three groups consisting of 16 and 18 rabbits in the study groups and 15 rabbits in the control group. Rabbits in group I (n=16) received high-dose topotecan intravenously (i.v.; 0.5 mg/kg once daily), while rabbits in group II (n=18) received low-dose topotecan i.v. (0.25 mg/kg once daily) for 3 days. The 15 rabbits comprising the control group did not receive topotecan. Serum samples were collected from each rabbit on the first day, before the treatment, and on the 15th day of treatment. Erithrocytes, hemoglobin, white blood cell count, thrombocyte count, and trace elements such as selenium, copper, lead, zinc, and cobalt were analyzed. Hemoglobin levels and erythrocyte counts were lower in both study groups than in the control group. However, thrombocyte and leukocyte counts were similar in all three groups (p > 0.005). Serum trace element levels (copper, lead, zinc, and cobalt) did not differ significantly between groups. However, serum selenium levels were significantly lower in both study groups than the control group (p < 0.001). The results revealed that topotecan treatment causes a decrease in erythrocyte counts and hemoglobin levels due to bone marrow suppression, and these effects must be taken into account during treatment. In addition, selenium supplementation might be helpful in cancer patients receiving topotecan to increase the effect of the chemotherapeutic agent.Öğe TRADITIONAL CHILD CARE PROCEDURES IN AN ANATOLIAN CITY(Gazi Univ, Fac Med, 2009) Aliefendioglu, Didem; Hizel, Selda; Misirlioglu, Emine Dibek; Sanli, Cihat; Albayrak, Meryem; Oktay, AylaPurpase Traditional procedures as old as humanity are current issues in today's modern medicine. Social and cultural characteristics influencing child care behavior and some procedures could be detrimental to the baby. The aim of this study was to determine traditional child care procedures in the central Anatolian city of Kirikkale, a city established after extensive migration. Method: Randomly chosen mothers were asked to fill in a questionnaire. The sociodemographic characteristics and traditional practices of the mothers were assessed. The results were compared by using the chi-square test. The relationships between the traditional procedures used by the mothers and the age at marriage and educational status were analyzed with logistic regression models. Results: A total of 974 mothers aged 18-60 years were interviewed. Of these, 201 (43%) were less than 30 years old. The average age at marriage was 17 or younger for 29% of the group and the age at first pregnancy was 17 or younger in 16%. Forty-eight percent of all were using at least one traditional procedure. Swaddling was the most commonly used method (27.2%). These practices were seen at higher rates in women with education of less than eight years' duration, among those who had married at 17 years of age or younger, and among those for whom more than 10 years had passed since their last pregnancy (p<0.05). Conclusion: Traditional procedures for baby care are still in use today. However, procedures that may be harmful to the baby are used less often by younger and better educated mothers. This result indicates that educating mothers is crucial and that the social fabric has changed somewhat over the years.Öğe Transposition of the great arteries in a newborn whose mother was treated with carbamazepine during pregnancy(Turkish Soc Cardiology, 2007) Misirlioglu, Emine Dibek; Aliefendioglu, Didem; Dogru, M. Tolga; Sanli, Cihat; Oktay, Ayla…