ABSTRACT
The VACTERL association, co-occurrence of vertebral, anorectal, cardiac, tracheoesophageal, genitourinary, and limb malformations, is a rare congenital anomaly. Several cardiac anomalies have been reported as a part of the VACTERL association, particularly ventricular and atrial septal defects. Pulmonary artery sling is a rare congenital abnormality in which the left pulmonary artery arises from the right pulmonary artery. This anomaly is not frequently observed in the VACTERL association and has been rarely reported. A 20-month-old girl was admitted to our hospital due to pneumonia in the right lung, which had pulmonary artery sling as a part of the VACTERL association. Barium meal X-ray showed pressure effects on the esophagus, and computed tomography angiography revealed pulmonary artery sling. Pneumonia management was done. However, the parents of our patient refused to give consent for the surgical correction of this vascular anomaly. Three months after discharge from the hospital, the patient was visited, at which time the parents again refused surgery and treatment for their daughter despite our recommendations
ABSTRACT
Atherosclerosis is the most common cause of myocardial infarction and ischemic stroke. Various risk factors have been identified for atherosclerosis. Recently, bacterial and viral organisms, which are involved in chronic inflammatory processes, have been also implicated in atherosclerosis development. Individuals with a prior history of periodontal diseases and/or tooth loss are considered to be at a higher risk for peripheral arterial disease, compared to those without periodontal diseases or tooth loss. Evidence suggests that periodontitis contributes to the overall burden of infection and inflammation and may lead to cardiovascular events and stroke in susceptible patients. In this article, we aimed to review the available data on the relationship between periodontal diseases and cardiovascular diseases, especially coronary artery disease. At least sixty papers were reviewed during 2014-15. Of these, 44 were included in our study
ABSTRACT
Background: The late postoperative course for children with transposition of the great arteries [TGA] with an intact ventricular septum [IVS] is very important because the coronary arteries may be at risk of damage during arterial switch operation [ASO]. We sought to investigate left ventricular function in patients with TGA/IVS by echocardiography
Methods: From March 2011 to December 2012, totally 20 infants [12 males and 8 females] with TGA/IVS were evaluated via 2-dimensional speckle-tracking echocardiography [2D STE] more than 6 months after they underwent ASO. A control group of age-matched infants and children was also studied. Left ventricular longitudinal strain [S], strain rate [SR], time to peak systolic longitudinal strain [TPS], and time to peak systolic longitudinal strain rate [TPSR] were measured and compared between the 2 groups
Results: Mean +/- SD of age at the time of study in the patients with TGA/IVS was 15 +/- 5 months, and also age at the time of ASO was 12 +/- 3 days. Weight was 3.13 +/- 0.07 kg at birth and 8.83 +/- 1.57 kg at the time of ASO. Global strain [S], Time to peak strain rate [TPSR], and Time to peak strain [TPS] were not significantly different between the 2 groups, whereas global strain rate [SR] was significantly different [p value < 0.001]. In the 3-chamber view, the values of S in the lateral, septal, inferior, and anteroseptal walls were significantly different between the 2 groups [p value < 0.001], and SR in the posterior wall was significantly different between the 2 groups [p value < 0.001]. There were no positive correlations between S and SR in terms of the variables of heart rate, total cardiopulmonary bypass time, and aortic cross-clamp time. There were no statistically significant differences between the 2 groups regarding S, SR, TPS, and TPSR in the anteroseptal and posterior walls in the 3-chamber view and in the lateral and septal walls in the 4-chamber view
Conclusion: We showed that between 6 and 18 months after a successful ASO, the parameters of S, SR, and global TPS were normal in our patients with TGA/IVS. However, LV myocardial TPSR did not normalize in this time period
ABSTRACT
Acute renal failure [ARF] is a clinical syndrome in which a sudden deterioration in renal function results in the inability of the kidneys to maintain fluid and electrolyte homeostasis. A classification system has been proposed to standardize the definition of acute kidney injury in adults. These criteria of risk, injury, failure, loss and end-stage renal disease were given the acronym of RIFLE. Our goal was to study the mean platelet volume [MPV] as a prognostic predictor of ARF in children. Mean platelet volume [MPV] is a machine-calculated measurement of the average size of platelets in blood and typically included in blood tests as part of CBC [Complete Blood Count]. Since the average platelet size is larger when the body is producing increased numbers of platelets, MPV can be used to make inferences about platelet production in bone marrow or platelet destruction problems. The records of 200 patients with ARF were investigated prospectively. Complete blood count including MPV, erythrocyte sedimentation rate, serum C-reactive protein and electrolytes of patients were measured and compared. MPV values were low in loss [p=0.0012] and failure [p<0.005]. The sensitivity and specificity of MPV for the diagnosis of loss and failure were higher than those of the other inflammation markers. MPV<8.2 fL was significantly associated with poor prognosis in renal functions. MPV is a fast and reliable measurement with considerable predictive value for prediction of prognosis in acute renal failure
ABSTRACT
The kidney regulates sodium balance and is the principal site of sodium excretion. Sodium is unique among electrolytes because water balance, not sodium balance, usually determines its concentration. Although water balance is usually regulated by osmolality, volume depletion stimulates thirst, renal protection of water and ADH secretion. Volume reduction has priority over osmolality; volume depletion stimulates ADH secretion, even if a patient has hyponatremia. The aim of this study was to consider scar nephropathy in children with UTI and hyponatremia and compare it with children without hyponatremia. 200 children with pyelonephritis were included in this case-control study as case and control groups, respectively. Subjects were selected from children referred to the pediatric clinic of our hospital in Arak, Iran. Case group included children with hyponatremia and UTI [with VUR] and control group included children with UTI [With VUR] and normal serum sodium. Data was analyzed using SPSS ver.18 Among 200 [100%] children in both groups, 5 children [5%] had normal sodium and reflux nephropathy and 23 children had hyponatremia and reflux nephropathy. Hyponatremia in children with reflux nephropathy was significantly more common than children without reflux nephropathy. The observed correlation between reflux-related injury and hyponatremia necessitates evaluation of electrolytes in children with pyelonephritis
ABSTRACT
Neonatal Marfan syndrome is a rare and severe phenotype of this disease. A poor prognosis is anticipated due to the high probability of congestive heart failure, and mitral and tricuspid regurgitations with suboptimal response to medical therapy and difficulties in surgical management at an early age. We present two consecutive patients with this disease who are the first reported cases from Iran to the best of our knowledge. Unfortunately both of them died shortly after diagnosis. Neonatal Marfan syndrome is reported from Iran and has a poor prognosis like the patients reported from elsewhere