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Başpınar O, Kervancıoğlu M, Kılınç M, Şahin DA, Temel MT. Evaluation of the reduction of radiation dose received by pediatric patients in new-generation biplane angiocardiography: Randomized controlled study. Heliyon 2024; 10:e28138. [PMID: 38590841 PMCID: PMC10999867 DOI: 10.1016/j.heliyon.2024.e28138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/23/2024] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
Objective We aimed to evaluate the safety and efficacy of radiation dose reduction with a new-generation biplane angiocardiography system in patients undergoing transcatheter isolated patent ductus arteriosus (PDA) closure. Materials and methods Fifty pediatric patients who underwent transcatheter PDA closure were randomly divided into two groups as normal radiation dose and low dose. Patients who required additional procedures other than PDA closure were excluded. PDA closure was performed according to the angiographic measurement of the defect. After the procedure, age, weight, sex, PDA measurements, and radiation measurements such as dose-area product (DAP, Gy.cm2) and air kerma (AK, mGy) were compared between the groups. Results There was no statistically significant difference between the groups in age, sex, weight, PDA diameter, PDA type, device used, and device diameter (p > 0.05). While there was no statistically significant difference between the groups in terms of cine recording, number of recorded images, and fluoroscopy time (p > 0.05), there was a statistically significant difference between the total DAP, cine and fluoroscopy DAP, total AK, frontal and lateral tube AK, and DAP/kg (mGy.m2/kg) measurements (p < 0.05). Conclusion Transcatheter PDA closure with a low radiation dose is as effective as that with a normal radiation dose. The radiation dose received by the patient during the procedure was significantly reduced. With the vision provided by this study, it seems possible to work with a low radiation dose in other groups of patients.
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Affiliation(s)
- Osman Başpınar
- Gaziantep University, Faculty of Medicine, Department of Pediatric Cardiology, Turkey
| | - Mehmet Kervancıoğlu
- Gaziantep University, Faculty of Medicine, Department of Pediatric Cardiology, Turkey
| | - Metin Kılınç
- Gaziantep University, Faculty of Medicine, Department of Pediatric Cardiology, Turkey
| | - Derya Aydın Şahin
- Gaziantep University, Faculty of Medicine, Department of Pediatric Cardiology, Turkey
| | - Münevver Tuğba Temel
- Gaziantep University, Faculty of Medicine, Department of Pediatric Cardiology, Turkey
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Baykan A, Kum YE, Yılmazer MM, Varan C, Yakut K, Sert A, Öztunç F, Öncül M, Uç D, Başpınar O, Pamukçu Ö, Murat M, Tanıdır İC, Alkan G, Murt NU, Akın A, Karakurt C, Şahin DA, Doğan A, Duman D, Öztürk E, Coşkun Yİ, Türe M, Temel MT, Elkıran Ö. One-Year Follow-Up Results of MIS-C Patients with Coronary Artery Involvement: A Multi-center Study. Pediatr Cardiol 2024; 45:282-291. [PMID: 38159144 DOI: 10.1007/s00246-023-03364-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/26/2023] [Indexed: 01/03/2024]
Abstract
Multisystem inflammatory syndrome (MIS-C) in children is a rare complication of SARS-CoV-2 infection. Knowing the course of the affected or unaffected coronary arteries in the patients under follow-up is important in terms of defining the long-term prognosis of the disease and determining the follow-up plan. This is a multicenter and retrospective study. The data were obtained from nine different centers. Between May 2020 and August 2022, 68 of 790 patients had coronary artery involvement. One-year echocardiographic data of 67 of 789 MIS-C patients with coronary artery involvement were analyzed. Existing pathologies of the coronary arteries were grouped as increased echogenicity, dilatation and aneurysm according to Z scores, and their changes over a 1-year period were determined. The data of all three groups are defined as frequency. SPSS Statistics version 22 was used to evaluate the data. In our study, aneurysm was observed in 16.4%, dilatation in 68.7% and increased echogenicity in 13.4% of the patients. All of the patients with involvement in the form of increased echogenicity recovered without sequelae by the end of the first month. No progression to aneurysm was observed in any of the patients with dilatation. No new-onset involvement was observed in patients with previously healthy coronary arteries during the convalescent period. In addition, from the sixth month follow-up period, there was no worsening in the amount of dilatation in any of the patients. At least 94% of the patients who completed the 12th month control period returned to normal.
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Affiliation(s)
- Ali Baykan
- Department of Pediatric Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Yunus Emre Kum
- Department of Pediatric Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
| | - Murat Muhtar Yılmazer
- Department of Pediatric Cardiology, Dr. Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - Celal Varan
- Department of Pediatric Cardiology, Adıyaman Training and Research Hospital, Adıyaman, Turkey
| | - Kahraman Yakut
- Department of Pediatric Cardiology, Istanbul Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Ahmet Sert
- Department of Pediatric Cardiology, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Funda Öztunç
- Department of Pediatric Cardiology, Faculty of Medicine, Istanbul University Cerrahpaşa, Istanbul, Turkey
| | - Mehmet Öncül
- Department of Pediatric Cardiology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Duygu Uç
- Department of Pediatric Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Osman Başpınar
- Department of Pediatric Cardiology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Özge Pamukçu
- Department of Pediatric Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Murat
- Department of Pediatric Cardiology, Dr. Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - İbrahim Cansaran Tanıdır
- Department of Pediatric Cardiology, Istanbul Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Gülsüm Alkan
- Department of Pediatric Infectious Disease, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Nujin Uluğ Murt
- Department of Pediatric Cardiology, Faculty of Medicine, Istanbul University Cerrahpaşa, Istanbul, Turkey
| | - Alper Akın
- Department of Pediatric Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Cemşit Karakurt
- Department of Pediatric Cardiology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Derya Aydın Şahin
- Department of Pediatric Cardiology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Alper Doğan
- Department of Pediatric Cardiology, Batman Training and Research Hospital, Batman, Turkey
| | - Derya Duman
- Department of Pediatric Cardiology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Erkut Öztürk
- Department of Pediatric Cardiology, Istanbul Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Yusuf İskender Coşkun
- Department of Pediatric Cardiology, Faculty of Medicine, Istanbul University Cerrahpaşa, Istanbul, Turkey
| | - Mehmet Türe
- Department of Pediatric Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Münevver Tuğba Temel
- Department of Pediatric Cardiology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Özlem Elkıran
- Department of Pediatric Cardiology, Faculty of Medicine, İnönü University, Malatya, Turkey
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Abstract
Cutis laxa tip1b is a rare autosomal recessive disorder caused by FBLN 4 mutation and primarily characterized by vascular anomalies. Herein, we present five patients who are the members of the same family. The primary cardiac findings of these patients were giant aortic aneurysms. One 2.5-year-old patient with a massive aneurysm of the ascending aorta died as a result of compression to the heart chambers, trachea, and bronchi. The bentall procedure was performed in three of our patients who are under follow-up. One patient is still under clinical follow-up without surgery. After the diagnosis of the first patient, a genetic study was performed in which FBLN 4 mutations were investigated. Four new patients were detected during genetic screening of the family. Other 29 family members were screened bur were negative in physical examinations and echocardiography. Pedigree is important for early diagnosis of genetic diseases in asymptomatic individuals.
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Affiliation(s)
- Ayşe Sülü
- Division of Pediatric Cardiology, Department of Pediatrics, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Osman Başpınar
- Division of Pediatric Cardiology, Department of Pediatrics, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Derya Aydın Şahin
- Department of Pediatric Cardiology, Süleymaniye Maternity Training and Research Hospital, İstanbul, Turkey
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Abstract
OBJECTIVES Celiac disease (CD) is a chronic immune-mediated enteropathy caused by the ingestion of gluten in genetically predisposed individuals. In some reports, sensorineural hearing loss (SNHL) has been identified as an extraintestinal symptom of CD. We aimed to further investigate the possible association between CD and SNHL by examining a greater number of pediatric CD patients. METHODS The study was carried out from March to September 2014 and included 110 pediatric patients with biopsy-confirmed CD (220 ears) and 41 age- and sex-matched controls (82 ears); participants were evaluated by tympanometry and pure tone audiometry (frequency, 250-8000Hz frequency). RESULTS Audiometric bone conduction thresholds were significantly different between the CD patients and the controls (p<0.05), but there were no significant differences in pure tone averages for air conduction (p>0.05). When the results for CD patients were analyzed according to duration of disease (≤36 months and >36 months), a significant difference in bone conduction thresholds (p<0.05) was noted, with significant increments at the later stages of disease. However, this difference was not sufficient to define clinical hearing loss, as the pure tone average thresholds remained below 20dB. CONCLUSION These results indicate that subclinical hearing loss may be present in children with CD, which could presage more serious hearing impairments at older ages and later stages of the disease. Hearing screenings should be recommended for children with CD in order to prevent the potentially unfavorable effects of hearing loss on the emotional, behavioral, cognitive, and sensorimotor development of these patients.
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Affiliation(s)
- Yasin Şahin
- Gaziantep University, Faculty of Medicine, Department of Pediatric Gastroenterology-Hepatology and Nutrition, Gaziantep, Turkey.
| | - Cengiz Durucu
- Gaziantep University, Faculty of Medicine, Department of Otorhinolaryngology, Head and Neck Surgery, Gaziantep, Turkey.
| | - Derya Aydın Şahin
- Gaziantep University, Faculty of Medicine, Department of Pediatric Cardiology, Gaziantep, Turkey.
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