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Objective: The epidemiological characteristics, risk factors, complications, recurrence status, clinical and laboratory features, and treatment methods of the patients who admitted to our Pediatric Cardiology Outpatient Clinic with a pre-diagnosis of acute rheumatic fever (ARF) were evaluated. Materials and Methods: The data of 166 patients who admitted with a pre-diagnosis of ARF and were diagnosed with ARF, and the data of 51 patients who were not diagnosed with ARF, were retrospectively analyzed. Results: The patients with ARF were between the ages of 5 and 18. Most of the patients with ARF attack admitted in December (15.6%), January (13.8%), and February (13.2%). The most common complaints of the patients diagnosed with ARF were isolated joint pain and/or swelling, at 50.6%. While 91.5% of the patients were diagnosed for the first time, 8.5% had ARF recurrence. It was seen that the most common major criterion was carditis (94.6%). The severity of valve regurgitation and the rates of monoarthritis were significantly higher in patients with recurrence (P < .05). Non-compliance with prophylaxis was observed in 10 (71.4%) of 14 patients with recurrence, and in 43 (28.2%) of 152 patients without recurrence. Anti-streptolysin O was lower (P = .021) and alanine transaminase (ALT) was higher (P = .019) in the recurrence group. Conclusion: Our study showed that in patients with a pre-diagnosis of ARF, a differential diagnosis should be made with other diseases. Especially in patients with joint complaints as the only major symptom, a differential diagnosis should be made. ARF recurrence is associated with non-compliance with prophylaxis, and both the severity of valve regurgitation and monoarthritis rates are higher in patients who develop recurrence. Alanine aminotransferase is significantly higher in patients with ARF recurrence.

CityGML, kent modellerinin depolanması ve transfer edilmesi için tasarlanmış, açık bir veri modeli ve veri formatıdır. CityGML, 3B CBS uygulamalarında en çok kullanılan veri modeli ve veri formatıdır. TKGM tarafından gerçekleştirilen 3B Kent Modelleri ve 3B Kadastro Projesi kapsamında da CityGML veri modeli ve formatı kullanılmaktadır. Bu proje kapsamında, CityGML veri modeli, veri modelinde tanımlı olmayan 3B kadastro çalışmalarında gerekli verilerin tutulması için genişletilmelidir. Bu bağlamda TKGM, örnek “TKGM CityGML” adlı bir veri modeli tasarlayarak, geliştiriciler için kullanılmak üzere bu veri modeline uygun olarak hazırlanmış örnek bir dosya oluşturmuştur. Bu çalışmada TKGM CityGML veri modeli ve örnek CityGML dosyası incelenmiştir. Böylece TKGM CityGML veri modeline göre gerçekleştirilecek 3B CBS projelerinde veri modeli ve veri formatından dolayı oluşabilecek sorunlar irdelenmiştir. Bu veri modelinin, veri tekrarına sebep olduğu, içerisindeki verilerin ayrıştırılmasının zor olduğu görülmüştür. Özellikle web uygulamaları için TKGM CityGML veri modeli ve formatının uygun olmadığı görülmüş, bu çalışma kapsamında tespit edilen sorunları gideren yeni bir veri modeli ve formatı önerilmiştir CityGML is designed as an open data model and XML-based format for the storage and exchange of 3DCMs. CityGML is the most used data model and data format for 3D GIS applications. It is also used by nationwide 3D cadastre project called 3D City Models and 3D Cadastre Project by General Directorate of Land Registry and Cadastre. In the context of this project, CityGML data model should be extended to store city objects that are not defined in the existing CityGML data model. For this purpose, General Directorate of Land Registry and Cadastre designed a new data model called “TKGM CityGML” and prepared a sample CityGML file for TKGM CityGML data model to be used by developers. In this work, TKGM data model and sample CityGML file has been investigated. The problems that may arise in the 3D applications that use TKGM CityGML data model have been determined. This work indicates that this data model causes data duplication, and this data format is not easy to parse, just like the data model itself. Particularly, this data model and format was not suitable for web applications and in this study a new data model and format have been suggested to eliminate aforementioned problems.

Objective: The aim of this study was to measure serum lipid levels and epicardial adipose tissue thickness in patients determined with subclinical hypothyroidism. Methods: The study included 61 paediatric patients with a diagnosis of subclinical hypothyroidism and a control group of 61 healthy children. The thyroid hormone levels, lipid parameters and epicardial adipose tissue thickness were examined in all the patients. Results: The mean epicardial adipose tissue thickness of the subclinical hypothyroidism patients was higher than that of the control group but not at a level of statistical significance (4.15±0.91 vs 4.06±0.99, p=0.598). The mean high-density lipoprotein cholesterol level of the subclinical hypothyroidism group was statistically lower than that of the control group (p=0.040). Conclusion: The results of this study showed a significant decrease in the high-density lipoprotein cholesterol levels of children with subclinical hypothyroidism. No significant increase was seen in the epicardial adipose tissue thickness of the children with subclinical hypothyroidism. This is the first study to have examined epicardial adipose tissue thickness in children with subclinical hypothyroidism.

Amaç: Çocuk kardiyoloji polikliniğimize kardiyak üfürüm nedeni ile gönderilen hastaların kardiyak üfürüm ve ekokardiyografi bulgularının değerlendirilmesi amaçlanmıştır. Materyal ve Metod: Hastaların üfürümleri masum ve patolojik olmak üzere ikiye ayrıldı. Hastalara elektrokardiyografik ve ekokardiyografik değerlendirme yapıldı. Bulgular: Çalışmamıza üfürüm ile başvuran 219 hasta alındı. Hastaların yaş ortalaması 21,61 ± 34,3 ay. Masum üfürümü olan 138 hastada şu an için tedavi gerektirmeyen patent foramen ovale (40 hasta), küçük sekundum atriyal septal defekt (1 hasta) saptandı. Patolojik üfürüm olduğu düşünülen hastaların %96,2’sinde kardiyak patoloji saptanırken, masum üfürüm saptanan hastaların ise hiçbirinde tedavi gereken kardiyak patoloji saptanmadı (p

Giriş: Çarpıntı; ritm bozukluğu saptanan hastaların en sık ve en önemli semptomudur. Ritm bozuklukları sadece elektrokardiyografi ile saptanamayabilir Amaç: Çalışmamızın amacı çarpıntı şikayeti ile başvuran çocukların elektrokardiyografi ve 24 saatlik Holter elektrokardiyografi monitörizasyonu sonuçlarını değerlendirip ritim bozukluklarını ve sıklığını saptamak, Holterin tanı ve tedavideki yerini vurgulamaktır. Gereç ve Yöntem: Hastanemize çarpıntı şikayeti ile başvuran 320 çocuğun yüzeyel elektrokardiyografi, 24 saatlik Holter monitörizasyonu ve ekokardiyografi verileri değerlendirildi. Bulgular: Holter monitörizasyonu ile değerlendirilen hastaların 163’ü kız (%50,9) iken, 157’si erkek (%49,1) idi. Hastaların 246’sında (%76,9) izole çarpıntı, 55’inde (%17,2) çarpıntı ve göğüs ağrısı, 18’inde (%5,6) çarpıntı ve senkop, birinde ise (%0,3) çarpıntı ve nefes darlığı şikayeti vardı. Elli hastada (%15,6) elektrokardiyografide, 182 hastada (%56,8) Holterde aritmi saptandı. Holterde en sık saptanan aritmiler; 63 hastada supraventriküler ekstrasistol (% 19,7) ve 58 hastada ventriküler ekstrasistol (%18,2) idi. Hastaların 63’ünde ciddi aritmi saptandı. İzole çarpıntı ile gelen hastalardaki ciddi aritmi oranı diğer gruplara göre istatistiksel olarak anlamlı şekilde yüksek saptandı . Sonuç: Elektrokardiyografisi normal olan çocuk hastaların Holterlerinde aritmi saptanması sadece elektrokardiyografi ile hastaların aritmilerinin atlanabileceğini göstermektedir. İzole çarpıntı ile başvuran hastalarda çarpıntı ile beraber başka şikayetleri olan hastalara göre ciddi aritmilerin daha fazla olması izole çarpıntı ile gelen hastalara aritmi açısından dahadikkatli olmamız gerektiğini gösteriyor olabilir. Ancak bunu desteklemek için daha fazla çalışmaya ihtiyaç olduğunu düşünüyoruz. Objective:Palpitations are the most common and most important symptoms of patients with rhythm disturbances. Rhythm disturbances may not be detected by electrocardiography.The aim of our study is to evaluate the results of electrocardiography and 24-hour holter electrocardiography monitoring in children presenting with the complaint of palpitations, to determine the rhythm disturbances and their frequency, and to emphasize the role of holter in diagnosis and treatment. Material and Methods: Electrocardiography, 24-hour holter monitoring and echocardiography data of 320 children admitted to our hospital with the complaint of palpitations were evaluated. Results: One hundred-sixty three of the patients were female (50.9%). Isolated palpitations in 246 (76.9%) patients, palpitations and chest pain in 55 (17.2%), palpitations and syncope in 18 (5.6%), one patient had (0.3%) palpitations and shortness of breath. The most common arrhythmias were supraventricular extrasystole in 63 patients (19.7%) and ventricular extrasystole in 58 patients (18.2%) in holter. Severe arrhythmia was detected in 63 of the patients. The rate of severe arrhythmia in patients presenting with isolated palpitations was found to be statistically significantly higher than the other groups. Conclusion: Detection of arrhythmias in the holters of pediatric patients with normal electrocardiography shows that the arrhythmias of the patients can be overlooked only with electrocardiography. The higher rate of serious arrhythmias in patients presenting with isolated palpitations compared to patients with other complaints may indicate that we should be more careful in terms of arrhythmia in patients presenting with isolated palpitations.

Coronavirus disease 2019 (COVID-19) originated in China in 2019, and it quickly became a global pandemic within months, continues to be an important health problem. The outbreak was first encountered in our country in March 2020 and rapidly spread to thousands of people.1 Although children as well as adults can become infected; it has been reported that children are less symptomatic or develop less severe symptoms.2 However, most studies on the subject cover patients in the adult age group

Subklinik hipotiroidi (SH), serum tiroid uyarıcı hormon (TSH) düzeyinin normalden yüksek olmasıyla birlikte serum serbest tiroksin (fT4) düzeyinin normal referans aralığında olmasıdır.

PMID: 26690601 Akın A, Bilici M, Demir F, Gözü-Pirinççioğlu A, Yavuz C. Cardiac thrombus developing after an accidental high-voltage electric shock in a child. Turk J Pediatr 2015; 57: 180-182. Electric shock is a condition that may affect various organ systems and potentially cause death. Cardiac findings vary from asymptomatic mild injury to fatal myocardial involvement. Herein we present a five-year-old boy with a cardiac thrombus developing after an accidental electrical shock. Cardiac arrhythmias and evidence of ischemia have been reported after electric shock; we were, however, unable to identify an earlier case report of intracardiac thrombosis related to electric shock. Findings such as elevated cardiac enzymes and systolic dysfunction, which indicate myocardial damage following electric shock, were present in our patient. We think that the cardiac thrombus might have resulted from the myocardial damage and the slowed intracardiac blood flow related to systolic dysfunction. As the thrombus was thought to have been formed through known mechanisms, it was treated traditionally. However, further data regarding the etiology and management of such thrombi is needed.

Çocukluk çağı göğüs ağrısı nedenlerinin önemli bir bölümü idyopatik ya da kas iskelet sistemi kaynaklıdır. Kalp ve çevresinin malign tümörleri de göğüs ağrısı nedeni olabilmekle beraber malignitelerde klinik genellikle hızlı başlangıçlı ve birden fazla sistemik semptomu içerir. Göğüs ağrısının diğer bulgulardan önce tek semptom olarak ortaya çıkması olağan bir durum değildir. Biz burada ilk semptomun göğüs ağrısı olduğu ve daha sonra fibrosarkom ve lenfoma tanısı alan iki çocuk hasta sunuyoruz. Bu iki hasta nedeniyle göğüs ağrısı şikayetiyle başvuran çocuklarda etyolojide kalp ve çevresinin malign tümörlerinin de ayırıcı tanıda yer alması gerektiğini belirtmek istiyoruz. The majority of chest pain in children is idiopathic or associated with locomotor system pathologies. Albeit cardiac and other thoracic malign tumors may cause chest pain, malignancies usually show rapid clinical onset and are presented with multiple systemic symptoms. It is not a usual finding for chest pain being the sole initial symptom. Herein, we report two children who were presented with chest pain as an initial symptom and diagnosed with fibrosarcoma and lymphoma afterwards. Therefore, we want to emphasize that cardiac and pericardial malignant tumors should be remembered in differential diagnosis of chest pain in children.