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Biomedical subjects

T Ertuğrul

Publications and source records attributed to T Ertuğrul.

5 recordsLinked to original sources
PubMed2003

Sublingual isosorbide dinitrate-stimulated tilt test for diagnosis of vasovagal syncope in children and adolescents.

Vasovagal syncope is the most likely cause of syncope in the young. Head-up tilt-table test (HUT) provides the ability to provoke vasovagal syncope under controlled laboratory settings. In adult populations, pharmacologic stimulation with intravenous/sublingual isosorbide dinitrate (ISDN) has been shown to be an alternative to isoproterenol for increasing the diagnostic yield of HUT. In this study, 40 patients aged 9-18 years with unexplained syncope and 12 healthy age-matched children were evaluated by HUT to 70 degrees for 45 minutes. If tilting alone did not induce symptoms (syncope and presyncope), 0.1 mg/kg ISDN was given while the patient lay supine. After 5 min, the table was tilted to 70 degrees for 15 min or until the symptoms occurred. The control group consisted of 12 healthy age-matched children studied in a similar manner. Six patients (15%) had a positive basal tilt test. Twenty-five patients (62.5%) lost consciousness following ISDN administration. In the control group, nobody had a syncopal episode during the basal tilt test. However, ISDN administration resulted in 1 positive response (8.3%). The sensitivity of the test was 77.5% and its specificity was 91.6%. It is concluded that sublingual nitroglycerin HUT is suitable for routine clinical practice in children and adolescents with unexplained syncope.

Administration, Sublingual↗
PubMed2001

An intrapericardial teratoma with endocrine function.

Intrapericardial teratoma was diagnosed in a nine-year-old male infant with a three-month history of labored breathing and cough. The tumor was completely resected and found to be a mature teratoma, containing pancreatic tissue and producing insulin. A few glucagon and somatostatin containing cells were also present in the periphery of the islets. Postoperative course was uneventful. This is to our knowledge, the first report of an intrapericardial teratoma with such endocrine activity.

Cough↗
PubMedDate not supplied

Transcatheter closure of the ductus arteriosus in children and young adults.

Transcatheter occlusion of persistent patent ductus arteriosus (PDA) was attempted in 32 patients (22 female and 10 male, mean age 5.12 +/- 3.98 years, range 9 months to 19.2 years) using Rashkind's occluder device (USCI). Implantation of a second occluder device was attempted in three of the patients. Device embolization to a pulmonary artery occurred in three patients, all with the 12 mm occluder device; two of these devices were retrieved by grabber catheter and the last with thoracotomy without adverse sequelae. Embolization to the right atrium occurred in another patient during a second device implantation attempt because of fluoroscopy problems; this patient required open-heart surgery with sequala of 2 (+) tricuspid insufficiency. In another patient with a significant shunt after the implantation of a 17 mm occluder device, mechanical hemolysis developed, but surgical intervention was not required. The overall complication rate was five out of 35 implantation procedures (14.3%). Besides these, sublingual nifedipine was required for two patients whose systolic blood pressure exceeded 160 mmHg just after the implantation procedure. Sixteen 12 mm and fifteen 17 mm occluder devices were successfully and uneventfully implanted in the first procedure, except for two patients in whom a 17 mm occluder device was implanted after retrieval of an embolized 12 mm occluder. Overall early and mid-term complete occlusion was achieved in 24 patients (75%). Complete occlusion of PDA in the first days after the procedure was achieved in all patients, with the narrowest ductal diameter of less-than 3 mm with the 12 mm occluder device, and less than 6 mm with the 17 mm occluder device.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Transcatheter embolization of a residual congenital coronary arteriovenous fistula with a detachable balloon; superiority of interventional cardiology?

A ten-year-old girl who presented with a continuous murmur was diagnosed with a right coronary to right ventricular fistula with colored Doppler echocardiography and selective arteriography. She underwent traditional treatment-ligation of the fistula by sternotomy. Afterwards, the systolic component of the murmur persisted and repeat arteriography showed a residual shunt through the fistula, with no change in the diameter of the right coronary artery. We describe the first case in which a residual fistula was treated with a detachable balloon embolization.

Arteriovenous Fistula↗