Coskun Dorak

Tepecik Training and Research Hospital, Ismir, İzmir, Turkey

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Publications (3)2.48 Total impact

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    ABSTRACT: Hypoxic-ischemic cerebral injury due to perinatal asphyxia is an important cause of neonatal mortality and morbidity. To predict who will survive or die due to this disorder still remains obscure. The aim of this study is to evaluate the predictive value of myocardial involvement in the assessment of mortality for the neonates with hypoxic-ischemic encephalopathy (HIE). The study included 34 term newborns fulfilling the diagnostic criteria for HIE and staged according to Sarnat and Sarnat classification. To assess the myocardial involvement, electrocardiogram (ECG) and echocardiogram (Echo) were performed in the first 24-48 h of life. In addition, serum Troponin I and creatine kinase-myocardial band (CK-MB) were measured at delivery and postnatal day 3. Of the 34 cases, 19 (55.9%) were stage in 1, 9 were in (26.4%) stage 2 and 6 (17.6%) were in stage 3 HIE. Nine (26.4%) patients died of the disease. Thirteen patients (38.2%) showed ECG findings related to perinatal asphyxia. Only one patient had mild Echo changes. Higher Troponin I level was a significant predictor of mortality, whereas CK-MB did not show any significant predicting value. Troponin I test showed 33% sensitivity and 80% specificity in predicting mortality. In addition, the sensitivity and specificity of ECG as a predictor of mortality were 77 and 76%, respectively. This study highlights the significance of monitoring cardiac functions in newborns with HIE. ECG changes and serum Troponin I level at 72 h after birth are likely to have significant predictive value in the assessment of mortality in HIE. Further studies will provide additional data for the long-term prognostic value of cardiac functions in this disorder.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 04/2009; 22(3):239-42. · 1.36 Impact Factor
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    ABSTRACT: Large pericardial effusions and cardiac tamponade are rare in childhood. The aim of this study was to evaluate the aetiological factors and clinical findings of large pericardial effusion and cardiac tamponade in children. We reviewed retrospectively the records of 10 (6 male, 4 female) patients (mean age: 8.05 +/- 4.4 y) with the diagnosis of large pericardial effusion and cardiac tamponade requiring pericardiocentesis and pericardial drainage between 2002 and 2004. After extensive diagnostic investigation we detected that three patients had tuberculosis, one patient had uraemic pericarditis; one patient had bacterial pericarditis; one patient had post-pericardiotomy syndrome; two patients had malignancy and two patients had no identifiable aetiology. Echocardiography-guided percutaneous pericardial puncture and pigtail catheter placement is safe and effective for initial treatment of patients with large pericardial effusion and cardiac tamponade and in most cases, initial assessment with clinical, serologic, and radiologic investigation and careful follow-up can reveal the aetiology. Although tuberculosis is rare in industrialized countries, in developing countries it remains one of the most important causes of large pericardial effusion and should be investigated and excluded in each patient.
    Acta cardiologica 05/2007; 62(2):129-33. · 0.56 Impact Factor
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    ABSTRACT: Left ventricular filling patterns were assessed by Doppler echocardiography in 63 beta-thalassemia major patients, aged for to 21 years, with no clinical evidence of congestive heart failure and 63 age- and sex-matched normal controls. The patients with beta-thalassemia major were divided into three age groups, namely four to nine years (6.8 +/- 1.5 years), 10-15 years (12.1 +/- 1.6 years) and older than 15 years (17.3 +/- 1.7 years). They were compared with age- and sex-matched normal controls in respects of Doppler diastolic indices. The ratio between the early and late (atrial) peaks of flow velocity was higher and peak flow velocity in late diastole was significantly lower in patients with beta-thalassemia major as compared to controls in all three age groups (p < .001). As compared with the controls, peak early diastolic flow velocity was also significantly higher in the thalassemics aged 10 to 15 years (92 +/- 16 vs 80 +/- 12 cm/s, P < .01) and in those older than 15 years (95 +/- 16 vs 79 +/- 13 cm/s, p < .001). Restrictive left ventricular diastolic abnormalities were detected in a total of 34 (54%) patients with beta-thalassemia major, whereas left ventricular systolic abnormalities were identified only eight (13%) of them. None of the patients without left ventricular diastolic abnormalities showed left ventricular systolic abnormalities. There was not any significant correlation between the hematologic parameters, such as mean serum ferritin, maximum serum ferritin and the number of blood units transfused, and left ventricular Doppler diastolic indices (p > .05). From the data presented here, we therefore conclude that left ventricular diastolic abnormalities develop in patients with beta-thalassemia major in the early phase of the disease and before the appearance of systolic abnormalities, when clinical symptoms of congestive heart failure are absent.
    The Turkish journal of pediatrics 01/1998; 40(2):201-9. · 0.56 Impact Factor