İnfantil hemanjiomlar (İH) endotel hücrelerinin benign proliferasyonlarıdır. Çocukluk çağının en sık görülen benign tümörleridir. İH'ın çoğu kendiliğinden gerilerken, yaklaşık %10'u medikal tedavi gerektirir. İH'ın medikal tedavisinde kortikosteroidler, interferon ve vinkristin eskiden beri kullanılan ajanlardır. Son yıllarda topikal beta-blokerler teröpatik etkinliklerinin gösterilmesi ve sistemik yan etkilerin daha az görülmesi nedeniyle İH tedavisinde alternatif bir tedavi yöntemi olarak kullanılmaya başlanmıştır. Bu çalışmada, topikal beta-bloker kullanılan yüzeyel İH hastalarının epidemiyolojik özellikleri ve tedavi etkinliğinin değerlendirilmesi amaçlanmıştır. Gereç ve yöntem: Erzurum Bölge Eğitim ve Araştırma Hastanesi Çocuk Hematoloji-Onkoloji Polikliniği'ne Nisan 2015 ile Mayıs 2017 tarihleri arasında başvuran, yaşları 0-36 ay arasında olan 30 hasta çalışmaya dahil edildi. Yüzeyel hemanjiyomu olan hastalara lezyon bölgesine %0,5 timolol maleate solüsyon, sabah ve akşam ikişer damla olacak şekilde uygulandı. Bulgular: Tedavi öncesi hemanjiomların çapı ortalama 2,5±1,5 cm iken, tedavi sonrası 1,3±0,8 cm olarak belirlendi (p<0,0001). Sonuç: Lezyonda belirgin gerilemeye yol açması nedeni ile timolol kullanımı ümit vadetmektedir. Ancak daha geniş çaplı ve kontrollü-randomize çalışmalara ihtiyaç olduğu da bir gerçektir.
Objective: There are a few number of case reports and small-scale case series reporting dilated cardiomyopathy due to vitamin D-deficient rickets. The present study evaluates the clinical, biochemical, and echocardiographic features of neonates with vitamin D deficiency. Patients and methods: In this prospective single-arm observational study, echocardiographic evaluation was performed on all patients before vitamin D3 and calcium replacement. Following remission of biochemical features of vitamin D deficiency, control echocardiography was performed. Biochemical and echocardiographic characteristics of the present cohort were compared with those of 27 previously published cases with dilated cardiomyopathy due to vitamin D deficiency. Results: The study included 148 cases (95 males). In the echocardiographic evaluation, none of the patients had dilated cardiomyopathy. All of the mothers were also vitamin D deficient and treated accordingly. Comparison of patients with normocalcaemia and hypocalcaemia at presentation revealed no statistically significant difference between the ejection fraction and shortening fraction, while left ventricle end-diastolic diameter and left ventricle end-systolic diameter were higher in patients with hypocalcaemia. Previously published historical cases were older and had more severe biochemical features of vitamin D deficiency. Conclusion: To the best of our knowledge, in this first and largest cohort of neonates with vitamin D deficiency, we did not detect dilated cardiomyopathy. Early recognition and detection before developing actual rickets and preventing prolonged hypocalcaemia are critically important to alleviate cardiac complications.
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