Semra Atalay

Ankara Children's Hematology Oncology Training and Research Hospital, Engüri, Ankara, Turkey

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Publications (90)168.17 Total impact

  • Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology 08/2013; 33(6):627. · 0.43 Impact Factor
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    ABSTRACT: Rheumatic fever and Rheumatic heart disease continue to be an important public health problem in the developing countries. Doppler echocardiography is now widely used for early detection and recurrences of clinical evident carditis (CC) and silent (subclinical) carditis (SC). The aim of the study is to determine the frequency of silent carditis and to compare clinical and echocardiographic features of the patients with silent and clinical carditis. 156 consecutive patients, diagnosed with acute rheumatic fever were included into study. The patients without clinical evidence but with echocardiographic findings of carditis were diagnosed as SC. Acute rheumatic fever was diagnosed in 156 patients and 103 (66%) of them had carditis. The ratio of SC was 28.2% among these 103 patients. Seventy-four of the patients with carditis were followed up more than one year and 20 of those had SC. Valvular regurgitation disappeared completely in 18.5% and improved in 45.5% of the patients with CC. The recovery and improvement rates in SC group were 15% and 30%, respectively. We suggest that Doppler echocardiography should be performed in all patients with suspected acute rheumatic fever for early detection of SC. Echocardiographic examination should be taken as a diagnostic criterion in order not to miss the diagnosis of SC.
    Pediatrics International 06/2013; · 0.88 Impact Factor
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    ABSTRACT: BACKGROUND: There is increasing evidence of clustering of certain cardiac amomalies in some families. The frequency and echocardiographic features of such anomalies among the relatives of the patients with bicuspid aortic valve (BAV) or other left-sided cardiovascular anomalies (LSCAs) were evaluated. METHODS: The patients, evaluated with BAV or any other LSCA and their relatives were enrolled into the study. They underwent an echocardiographic examination. The probands were assessed in three groups: BAV, BAV+coarctation of aorta (CoA), and other LSCAs. Their relatives were also grouped and evaluated accordingly. The echocardiographic measurements were standardized by Z-scores. RESULTS: Eighty-six probands and 261 relatives were evaluated. The numbers of the patients in BAV, BAV+CoA, and other LSCAs group were 52, 14, and 20 respectively. Any LSCA was determined in 17 (6.5%) of the relatives. Thirteen (5%) had aortic dilatation and the remainder (1.5%) had BAV. Accordingly, BAV incidence among relatives of the patients with BAV was found 1.9%. A second individual with a LSCA was observed in 12.8% of 86 families investigated. The frequencies of aortic stenosis (AS), aortic regurgitation (AR), AS+AR, and aortic dilatation in the patients with BAV were found 37.9%, 53%, 25.8% and 48.5% respectively. In contrast to previous reports, no enlargement was observed in the pulmonary arteries of BAV patients. CONCLUSIONS: BAV and other LSCAs are of clinical significance. Because the clustering of LSCAs in some families is observed, we recommend echocardiographic screening of those relatives. If not possible, at least it should be achieved for BAV.
    Pediatrics International 05/2013; · 0.88 Impact Factor
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    ABSTRACT: Abstract Objective: The objective of this study was to find out the percentage of preterm infants that needed treatment for patent ductus arteriosus, when treatment decision was based on clinical signs and symptoms, besides echocardiographic findings. Methods: Daily echocardiographic evaluation was conducted in 39 preterms ≤29(6/7) weeks' gestation. Patients with ductus arteriosus were closely followed up for clinical symptoms of patent ductus arteriosus for treatment decision until ductus arteriosus was closed either spontaneously or by treatment. Results: Patent ductus arteriosus was found in 25 (64%) infants. Mean gestational age and birth weight of the patients with patent ductus arteriosus were 27.8±1.2 and 998±221 g, respectively. Patent ductus arteriosus closed spontaneously or had minimal ductal shunting before any signs and symptoms attributable to patent ductus arteriosus were observed in 16 (41%) infants. Mean ductus size/birth weight ratio and mean left atrial/aortic root ratio were significantly higher in 9 (23%) symptomatic patients (2.06±0.75 mm vs 1.32±0.75 mm, p=0.012 and 1.31±0.52 mm vs 1.19±0.2, p=0.043 respectively). Patent ductus arteriosus closure was observed after the first dose of ibuprofen in 6/9 patients. Conclusion: Correlation of clinical signs with echocardiographic findings for decision of patent ductus arteriosus treatment can be appropriate to prevent unnecessary medical treatment.
    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 05/2013; · 1.36 Impact Factor
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    ABSTRACT: Hereditary hearing loss is characterized by a high degree of genetic heterogeneity. Here we present OTOGL mutations, a homozygous one base pair deletion (c.1430 delT) causing a frameshift (p.Val477Glufs(∗)25) in a large consanguineous family and two compound heterozygous mutations, c.547C>T (p.Arg183(∗)) and c.5238+5G>A, in a nonconsanguineous family with moderate nonsyndromic sensorineural hearing loss. OTOGL maps to the DFNB84 locus at 12q21.31 and encodes otogelin-like, which has structural similarities to the epithelial-secreted mucin protein family. We demonstrate that Otogl is expressed in the inner ear of vertebrates with a transcription level that is high in embryonic, lower in neonatal, and much lower in adult stages. Otogelin-like is localized to the acellular membranes of the cochlea and the vestibular system and to a variety of inner ear cells located underneath these membranes. Knocking down of otogl with morpholinos in zebrafish leads to sensorineural hearing loss and anatomical changes in the inner ear, supporting that otogelin-like is essential for normal inner ear function. We propose that OTOGL mutations affect the production and/or function of acellular structures of the inner ear, which ultimately leads to sensorineural hearing loss.
    The American Journal of Human Genetics 11/2012; 91(5):872-82. · 11.20 Impact Factor
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    ABSTRACT: High cumulative doses of anthracyclines (300-500 mg/m(2)) used in the treatment of children with cancer may result in cardiotoxicity, a major long-term adverse effect that limits clinical usefulness of this class of chemotherapeutic agents. We assessed anthracycline-induced cardiotoxicity by measuring Pro-BNP levels and echocardiographic (ECHO) findings and investigated potential protective effect of selenium (Se) supplementation in a group of pediatric cancer patients. Plasma level of Pro-BNP was measured, and ECHO was performed in 67 patients (45 boys, 22 girls; ages 2-18 years; median age 12 years) after they completed anthracycline-containing chemotherapy. Serum Se level was measured in 37 patients. Eleven patients had high Pro-BNP levels and/or cardiac failure with Pro-BNP levels of 10-8,022 pg/mL (median 226.3 pg/mL; laboratory normal level is less than 120 pg/mL). Serum Se levels were low (20-129 mcg/L, median 62 mcg/L) in ten of these eleven patients. Eight of 10 patients with low Se and high Pro-BNP levels were supplemented with Se 100 mcg/day for a period of 4-33 months (median 6 months) which resulted in improvement in Pro-BNP and/or ECHO findings. These results suggest that Se supplementation may have a role in protection against anthracycline-induced cardiac toxicity.
    Journal of Oncology 01/2012; 2012:651630.
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    Pediatrics International 10/2011; 53(5):761-3. · 0.88 Impact Factor
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    ABSTRACT: Arterial tortuosity syndrome (ATS) is a rare hereditary, autosomal recessive, connective tissue disorder. Herein, we describe a five-year-old boy. He had hyperextensible skin, atypical facial features and inguinal hernia. We present his vascular imaging studies of kinking and tortuosity of the aorta and bilateral multiple peripheral pulmonary artery stenoses determined by conventional and magnetic resonance angiographic (MRA) examination. ATS must be considered in patients with connective tissue condition associated with diffuse arterial changes and involvement of the skin, joints and other organs. Vascular imaging studies, especially MRA, are useful in the screening of these vascular abnormalities.
    The Turkish journal of pediatrics 01/2011; 53(1):104-7. · 0.56 Impact Factor
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    ABSTRACT: Neurocardiogenic syncope (NS) is a common clinical problem during childhood. In order to characterize the autonomic profile in syncopal children, we evaluated heart rate variability (HRV) of 27 patients, ages 8-17 years, in an asymptomatic period. HRV was calculated over a 24-hour (h) period for the time-domain indices and frequency-domain indices. The obtained results were compared to values in 27 healthy children, ages 10-17 years. Patients with syncope did not have significantly different HRV values in comparison to healthy children. After behavior modification and education, HRV assessment was repeated six months later in the symptomatic group under follow-up, and we found no significantly different values. We conclude that there was no significant difference in baseline autonomic values between children with NS and the healthy control group. After behavior modification and education, none of the patients with NS under follow-up experienced syncope or presyncope during the follow-up period. The major complaint had disappeared but did not reflect the HRV values. There was no significant difference in baseline HRV values of the patients in follow-up. We conclude that patients are predisposed to faint by a triggering autonomic stress, without having constant autonomic instability.
    The Turkish journal of pediatrics 01/2011; 53(1):59-66. · 0.56 Impact Factor
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    Pediatrics International 06/2010; 52(3):501-2. · 0.88 Impact Factor
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    ABSTRACT: The identification of the different subtypes of amiodarone-induced thyrotoxicosis (AIT) may provide a rational basis for the choice of the appropriate medical treatment. The aim of this study was to evaluate differential diagnosis and treatment regimens of AIT in children and adolescent. We reported 3 patients: A 6.7 years old boy with type I AIT; a 17.9 years old girl with type II AIT and a 14.6 years old girl with mixed type AIT. AIT is not an uncommon complication in countries with low iodine intake. AIT can be asymptomatic and can occur at any time in patients receiving amiodarone therapy. It is also very important to distinguish the type of AIT when planning therapy. Steroid therapy should be started when findings indicate type II or mixed-type AIT. Beta blockers may prevent heart thyrotoxicosis and recurrence of primary arrhythmia if amiodarone is discontinued.
    Journal of pediatric endocrinology & metabolism: JPEM 04/2010; 23(4):363-8. · 0.75 Impact Factor
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    ABSTRACT: Noonan syndrome (NS; MIM #163950) is an autosomal dominant syndrome characterized by hypertelorism, downward slanting of the palpebral fissures, ptosis, low-set posteriorly angulated ears, short stature, and congenital heart disease, most commonly pulmonary valve stenosis, hypertrophic cardiomyopathy (HCM), and atrial septal defects (ASDs). We report a 6-day-old girl who had an unusual combination of supravalvular pulmonary stenosis (PS), obstructive HCM, secundum ASD, and abnormal mitral chordae. Diagnosis was based on characteristic dysmorphic features and presence of HCM. Subsequent cardiac catheterization confirmed the presence of hemodynamically significant PS, and surgical correction was planned. Supravalvular PS is an unusual cardiac phenotype in NS and its association with HCM and ASD has not been reported previously. A detailed echocardiographic examination is mandatory in NS patients for accurate diagnosis of cardiac phenotype and for further treatment plans.
    Congenital Heart Disease 03/2010; 5(2):178-81. · 1.01 Impact Factor
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    ABSTRACT: The peritoneal equilibration test (PET) is recommended in paediatric peritoneal dialysis (PD) patients to assist prescription management. Despite contradictory reports, high transporter status is associated with reduced survival rate in adults. Since cardiac disease is one of the main causes of mortality in paediatric PD patients, we aimed to evaluate whether transport features have any effect on biochemical data and cardiac function in this group. One hundred and ten PD patients (13 +/- 5 years, PD vintage: 31 +/- 27 months) were enrolled into the study. Four-hour dialysate/plasma creatinine ratio was used for differentiating PET groups. Thirty-eight patients were high transporters, 29 were high-average transporters and 43 were low-average/low transporters. Echocardiography was performed in all subjects. Age, PD vintage, dialysate glucose concentration, ultrafiltration volume, urine volume and blood pressure levels were similar in all PET groups. No biochemical or echocardiographic data (ejection fraction, fractional shortening, left ventricular mass index, myocardial performance index, power Doppler E/tissue Doppler E ratio reflecting diastolic function) were different among PET groups except lower albumin (P = 0.025) levels in high transporters and higher high-sensitivity C-reactive protein (P = 0.026) levels in high and high-average transporters compared to other transport groups. Cardiac structural and functional abnormalities are highly prevalent among paediatric PD patients. Transport rates did not have a significant effect on biochemical parameters or cardiac structural/functional parameters. It might be suggested that being a high transporter does not provide a disadvantage in terms of atherogenic tendency and cardiac disease in paediatric PD patients. Oligoanuria, anaemia and hypertension were independent predictors of cardiac disease.
    Nephrology Dialysis Transplantation 02/2010; 25(7):2296-303. · 3.37 Impact Factor
  • International Journal of Cardiology - INT J CARDIOL. 01/2010; 140.
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    ABSTRACT: We hypothesized that decreased sympathetic/parasympathetic balance as a result of the absence of auditory stimuli on the autonomic nervous system might be an explanation for our previous finding of lower mean heart rate in congenitally deaf children. To test our hypothesis, we obtained heart rate variability (HRV) data of 23 children with congenital sensorineural deafness from 24-hour Holter ECG recordings and compared them to data of 18 healthy children. HRV was measured by calculating time-domain and frequency-domain indexes from 24-hour recordings and from 6 hours of recordings obtained while subjects were sleeping. We additionally compared the HRV values obtained from children with and without GJB2 gene mutations. We did not find any significant difference in HRV parameters between deaf children and healthy children. There were also no significant differences in HRV parameters between deaf children with and without GJB2 mutations. We conclude that cardiac autonomic dysfunction does not seem to be present in patients with congenital sensorineural deafness.
    The Turkish journal of pediatrics 01/2010; 52(2):173-8. · 0.56 Impact Factor
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    ABSTRACT: Kawasaki disease (KD) is the leading cause of acquired heart disease in childhood in the developed countries. The objective of this study is to describe the clinical and epidemiological characteristics of children with KD in Turkey. The medical records of 24 patients treated for KD between January 1994 and June 2009 at Ankara University Medical School, Turkey were reviewed. The male-to-female ratio was 1.4 : 1. The median age at diagnosis was 2 years (range: 6.5 months to 11 years). Conjunctivitis and changes in the lips and oral cavity were seen in 21/24 (87.5%), cervical lymphadenopathy 17/24 (70.8%), polymorphous rash 16/24 (66.7%) and peripheral changes in 12/24 (50%). Coronary artery abnormality (CAA) was observed in 8/24 (33.3%) cases. CAA was seen in both the complete and incomplete groups with similar frequency (31.3% vs. 37.5%, respectively). KD must be kept in mind in the differential diagnosis of infants with prolonged fever.
    Journal of Tropical Pediatrics 12/2009; 56(4):260-2. · 1.01 Impact Factor
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    ABSTRACT: To evaluate left and right ventricular myocardial performance using pulsed-tissue Doppler imaging (TDI) and its relation to BNP levels in patients with beta-thalassaemia major (beta-TM). We enrolled 36 thalassaemic patients (21 male, 15 female; mean age: 14.2 +/- 4.1 years) with normal left ventricular systolic and diastolic functions with conventional echocardiography and 30 healthy control subjects (18 male, 12 female, and 12.5 +/- 4.2 years). Myocardial performance indexes (MPI) of left ventricular (LV) lateral wall, interventricular septum (IVS) and right ventricular (RV) lateral wall were calculated with TDI. Plasma BNP levels were measured in all patients. MPIs and other echocardiographic parameters of patients with beta-TM were compared with control group. All the patients' plasma BNP levels were within normal limits. There were no differences between conventional echocardiographic parameters of patients and control group. MPI of LV, IVS, and RV of patients were significantly higher than control group (P = 0.01, and P < 0.01, and P < 0.001, respectively). Our study confirms that MPI obtained by TDI seems to be an early sensitive parameter of cardiac dysfunction in beta-TM. We concluded that MPI obtained by TDI may be an adjunctive parameter to conventional echocardiography for detecting early myocardial damage.
    The international journal of cardiovascular imaging 12/2008; 25(4):379-86. · 2.15 Impact Factor
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    ABSTRACT: Cardiovascular abnormalities are observed in most children with end-stage renal disease (ESRD). The aim of this study was evaluation of left-ventricular (LV) myocardial performance using tissue-Doppler imaging (TDI) in patients with ESRD. Twenty-five patients with ESRD and 25 healthy gender- and age-matched control subjects were assessed with conventional M-mode echocardiography, pulsed-wave Doppler (PWD), and TDI. Myocardial Performance Index (MPI) and LV mass index (LVMI) were calculated. MPI and conventional echo-Doppler indices were compared in the ESRD and control groups. Significant differences were present in the mean systolic and diastolic blood pressure (BP) between children with ESRD and healthy children (p = 0.007 and p < 0.001, respectively). The mean LVMI was significantly greater in the patient group (p < 0.001). The tissue-Doppler MPI of patients was significantly higher than that in healthy children (p < 0.001). LVMI was significantly correlated with systolic and diastolic BP. MPI obtained by TDI was significantly correlated with LVMI. Our study confirms that LV dysfunction is present in patients with ESRD and hypertension is an important risk factor.
    Pediatric Nephrology 06/2008; 23(5):779-85. · 2.94 Impact Factor
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    ABSTRACT: Fungal peritonitis is a rare but serious complication in children on peritoneal dialysis. Clinical presentation of fungal peritonitis is similar to bacterial peritonitis and Candida spp. are the most common agent. Fungal peritonitis has been usually associated with high morbidity, mortality and its treatment is difficult. In this report, we present an infant with Acremonium spp. peritonitis. A 7-month-old boy with Down syndrome, congenital heart disease, pulmonary hypertension and congestive heart failure required peritoneal dialysis for his persistent pulmonary oedema and symptomatic hyponatremia. Acremonium spp. peritonitis developed while he was on extended spectrum antibiotics and fluconazole. The patient was successfully treated with peritoneal dialysis catheter removal and liposomal amphotericin B. The case was presented to draw attention to a rare cause of peritonitis -Acremonium spp. - in a paediatric patient.
    Mycoses 05/2008; 51(5):455-7. · 1.28 Impact Factor
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    ABSTRACT: Pulmonary venous abnormalities are generally diagnosed by echocardiography and often confirmed by cardiac catheterization. Although angiography has been the gold standard for evaluation it carries certain inherent risks, especially in small and sick infants. In this study we retrospectively assessed the utility of magnetic resonance angiography (MRA) and computed tomography angiography (CTA) in the evaluation of pulmonary venous abnormalities in pediatric patients. The results were compared with operative findings. We reviewed nine patients with total APVC and four with partial APVC. Twelve patients were infant (age range: 1 day to 8 months) and the other was 16 years old. MRA and/or CTA clearly visualized the anomalous drainage of pulmonary veins in all patients. Cardiac catheterization was performed five patients with one total anomalous pulmonary venous connection and four with partial anomalous pulmonary venous connection. Ten patients were operated on. Diagnoses of patients were confirmed by operative findings. In Conclusions, MR and CT angiography allow detailed and comprehensive evaluation of the APVC and are good diagnostic modalities for use in the preoperative assessment of the anomaly in pediatric patients.
    The International Journal of Cardiovascular Imaging 03/2008; 24(2):229-35. · 2.65 Impact Factor

Publication Stats

366 Citations
168.17 Total Impact Points

Institutions

  • 2011
    • Ankara Children's Hematology Oncology Training and Research Hospital
      Engüri, Ankara, Turkey
  • 1993–2011
    • Ankara University
      • • Department of Pediatric Cardiology
      • • Department of Pediatric Intensive Care
      • • Department of Pediatrics
      Ankara, Ankara, Turkey
  • 2010
    • Gazi University
      • Department of Pediatric Nephrology
      Ankara, Ankara, Turkey
  • 1990
    • Hacettepe University
      • Department of Cardiology
      Ankara, Ankara, Turkey