Conclusion Results of this study showed, that hypertensive adolescents have poorer oral health than adolescents with normal BP level. This substantiates the necessity of multidisciplinary approach to management of this group of patients with participation of both pediatric physicians and dentists.

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A 14-year-old girl was admitted to our department with fatigue and arthralgia 3 weeks after an upper respiratory tract infection. Pain appeared first in the right knee followed by the left elbow 2-3 days later; at the time of presentation, pain had been ongoing for 2 weeks.The body temperature at presentation was 36.6 C, pulse rate 96 beats/min, respiratory rate 24/min and blood pressure measured from the right arm 110/60 mmHg. Cardiac auscultation revealed cardiac murmurs included a grade 4/6 pan-systolic component and a grade 2/6 early diastolic component at the apex, with radiation to the left axilla. Echocardiography revealed moderate mitral and aortic insufficiency; the left atria and ventricle were dilated. Haemoglobin level was 101 g/L, leukocyte count 8700/mm 3 (neutrophil predominance), erythrocyte sedimentation rate (ESR) 68 mm/h, C-reactive protein level 92.2 mg/L and antistreptolysin O (ASO) titre 1126 IU/L. The patient was diagnosed with acute rheumatic fever (ARF) based on the revised

In this study, we retrospectively evaluated the underlying risk factors, clinical and laboratory findings, treatment approaches, anticoagulation therapy experiences, and the complications that arose during the follow-up of patients diagnosed with infective endocarditis in our clinic between 2010-2018. Eleven patients with infective endocarditis were evaluated. The relevant features of the patients whom developed complications, given anticoagulant therapy in addition to antibiotherapy, underwent cardiac surgery, and showed a mortality course were determined. The youngest patient was 7 months old and the oldest was 14 years old (7.5 ± 4.6 years). All of the cases had congenital heart anomalies and there were no cases with rheumatic heart disease. A total of eight patients had embolic findings. Echocardiography showed vegetation in nine patients. In addition to antibiotherapy, anticoagulant treatment was applied to 2 patients. The most common microorganism in the blood culture was coagulase negative staphylococci with five cases. Five patients underwent early surgical treatment, one patient died due to multiple organ failure caused by systemic embolization, and one patient died due to sudden hemodynamic instability in the first week of follow-up. Infective endocarditis is a serious disease with life-threatening complications. In children, the main underlying risk factor is congenital heart disease unlike with adults. Once the diagnosis is made, appropriate antibiotherapy should be initiated as soon as possible to prevent septic embolism and mortality. The role of anticoagulation in the prevention of embolism and the treatment of ischemic stroke remains controversial.

Background and objectives Atrial septal defect (ASD) is a deficiency in the atrial septum leading to an abnormal communication between the right and left atria. Defects of the atrial septum are the third most common type of congenital heart disease comprising 6% of all lesions. Transcatheter closure of secundum type ASD is an alternative to surgical closure in many cases when conditions are appropriate. Studies have shown that closure of secundum type atrial septal defects with devices is a safe and successful method. In this study, we planned to share the demographic datas and postoperative follow-up results of patients with secundum atrial septal defect undergoing transcatheter closure. Methods Data of patients underwent transcatheter closure of secundum type atrial septal defect between 2004 to 2017 was investigated retrospectively. Gender, age at intervention, defect size (with transthoracic, transesophageal echocardiography), procedure duration, fluoroscopy time, periprocedural complications, residual shunt existence and long term follow-up results were collected. Results In 179 patients (41% males;%10 adults, median age, 8,1 years [1,3 to 58,6]; weight, 28 kg [11 to 90]), admitted to catheterization for ASD closure. Median ASD size was 13 mm (6 to 30); 74 (41%) patients had a large ASD (!12 mm). Suitable defects for closure were 165 of 179 patients. Three types of devices were used during procedure most used being Amplatzer Septal Occluder. Procedural success rate was 95,7%. No death was observed but periprocedural complications occurred in 3 patients (1,6%). Periprocedural complications were AV(atrioventricular) block, atrial flutter and brachial plexus paralysis. After a median follow-up of 2,8 years (range 6 months to 13,6 years; 16 patients [10%] followed >10 years), delayed major complications such as death, cardiac erosion, infective endocarditis were not experienced. Delayed minor complications were supraventricular extrasystole not required treatment and mild mitral regurgitation worsening in 2 patients (1,3%). The rate of residual shunt was 1,3% at one year follow-up and all shunts were mild. Conclusions Transcatheter ASD closure is safe in children with a minimal rate of periprocedural complications and a favorable long-term outcome, especially with no death or major complications. Residual shunt ratio is also low and insignificant. Transcatheter ASD closure can be done safely in experienced centers as an alternative treatment to surgery.Background The urgency of the problem is determined by the high infant mortality and disability associated with critical CHD (CCHD) and persistent pulmonary hypertension in newborns (PPHN). The difficulty of diagnosing critical CHD and persistent pulmonary hypertension in newborns leads to a delayed accurate diagnosis, which is the cause of late hospitalization in specialized hospitals in a difficult and often critical condition. This research paper presents a method for the early detection of newborns with PPHN and critical CHD using pulse oximetry, which differs...