ABSTRACT
Objective To retrospectively analyze the etiology and prognosis of the children and adolescents with situational syncope in a single center.Methods There were 4 274 cases of children and adolescents [aged from 2 to 18 years old,the average age being (10.82 ± 3.13)years old],male 2 208 cases,female 2 066 cases with ortho-static intolerance syndromes,such as unexplained syncope or symptoms of presyncope,etc,who were treated at Children's Syncope Outpatient Department or Inpatient Department in the Second Xiangya Hospital,Central South University from January 2000 to November 2017.All subjects underwent detailed history investigation,careful physical examinations, routine 12-lead electrocardiogram,Holter electrocardiogram(ECG),chest X-ray,echocardiography,electroencephalo-gram(EEG)and head computerized tomography(CT)or magnetic resonance imaging(MRI),blood biochemical exami-nation (including fasting glucose,myocardial enzymes)and organic diseases in the heart,brain,blood vessels were ex-cluded,but the cause of syncope was still not clear.The head-up tilt table test (HUTT)was performed after the pa-tients or/and the families wrote the informed consent agreement.Results A total of 177 (4.14%)patients with situa-tional syncope were diagnosed among 4 274 cases.Etiology included the abdominal musecle exercise (35.59%,63/177 cases),urination (24.29%,43/177 cases),bathing (9.60%,17/177 cases),defecation (7.34%,13/177 cases), singing (5. 08%,9/177 cases),rides (4.52%,8/177 cases),blood-injection-injury phobia (3.95%,7/177 ca-ses),swallowing (3.39%,6/177 cases),and hair-grooming (2. 82%,5/177 cases),syncope during acupuncture treatment (2. 26%,4/177 cases),and cough (1.13%,2/177 cases). The common positions were upright position (84.18%,149/177 cases),squatting to standing position (8.47%,15/177 cases),sitting position (5.08%,9/177 cases),and squatting position (2.26%,4/177 cases).HUTT positive rate was 69.49%(123/177 cases),common type of hemodynamic were the vasodepressive type of vasovagal syncope (45.20%,80/177 cases),mixed type of vaso-vagal syncope (19.77%,35/177 cases),postural orthostatic tachycardia syndrome (3.39%,6/177 cases)and the cardiac suppressive type of vasovagal syncope (1.13%,2/177 cases).In 35 cases of situational syncope,the number of children and adolescents with syncope was significantly reduced by health education and upstanding training.By the first follow-up review,the cases were reduced from (2.69 ± 1.81)times to (0.59 ± 0.96)times after healthy edu-cation of 2-16 weeks [(4.97 ± 3.16)weeks].By the second follow-up review,3 out of 8 cases did not faint,3 cases fainted 1 time,1 case fainted 2 times,and 1 case fainted 4 times.The outcomes of the first reexamination of HUTT in 16 cases were negative,and other 3 cases were negative by twice visit.Conclusions The etiology of children and adoles-cents are flag-raising(abdominal muscle exercise),urination,bathing,defecation,singing,riding,blood-injection-injury phobia,swallowing,hair -grooming,syncope during acupuncture treatment and coughing. Healthy education is good for situational syncope.
ABSTRACT
Aim To investigate the possible roles of age, bodyheight, mass and body mass index(BMI) in Lumbar1-4 bone mineralcontent (L1-4BMC), L1-4 areal bone mineral density(L1-44BMD) and L1-4volumetric bone mineral apparent density(L1-4BMAD) of Chinese adoles-cents with early ankylosing spondylitis (AS). Methods Thirty-one maleChinese adolescent outpatients with early AS were included. Age (y),total body mass (kg), height(cn) and body mass index (BMI, kg/m2)of subjects were obtained. L1-44BMC(g) and L1-4 BMD(g/cm2) were e-valuated by using DEXA, and L1-4 BMAD(L1-44BMC/Area3/2, g/cm3)was subsequently calculated. Correlation and multiple regression analyseswere performed. Results Multiple regression revealed that height ( P =0.000) and BMI(P=0.009) were significantly positively related toL1-44BMC (R=0.759, Radj2=0.545, P=0.000 ＜0.01), and heightplayed the pivotal roles in significant correlation with L144BMC(R =0. 676 Radj2 = 0. 439, P = 0. 000) . Body mass significantly positivelycorrelated with both L-44BMD ( R = 0. 657, Radj2 = 0. 412, P = 0. 000)and L1-4BMAD (R=0.551, Radj2=0.280, P=0.001) .Therefore,height as well as BMI significantly positively correlated with L144BMC andmass was definitely associated with both L1-4BMD and L1-4BMAD in ado-lescents with early AS in this study. Conclusion Height and mass couldhave significantly positive effects on axial bone mass and densities ofadolescents with early AS.