Normal electrocardiogram values of healthy children.

AIM: Electrocardiography is an important diagnostic tool in the evaluation of cardiac diseases. Normal electrocardiograms are age-dependent and may also vary due to several factors. Many studies have been performed to establish the normal values for the childhood period. The aim of this study was to determine the normal electrocardiograms values for healthy Turkish children in Aydin. MATERIAL AND METHODS: All children underwent physical examination by a pediatrician and the electrocardiograms were analyzed by the same pediatrician. In the event of improper or insufficient data, the analyses were repeated. Children with a suspicious electrocardiograms or physical examination were recalled and examined by same pediatric cardiologist in outpatient clinic. RESULTS: In this study, electrocardiogram records were collected randomly from 1163 children with a sampling rate of 500 Hz. Of the children, 562 were female (47.4%) and 601 were male (52.6%). The total population was divided into ten age groups. Significant differences in normal limits were determined compared with previously published studies. CONCLUSION: The observed differences in various electrocardiograms parameters could be related to biologic variability and to some technical details such as precordial electrode placement and visual checking of the records in addition to race.

AMAÇ: Elektrokardiyografi kardiyak hastaliklarin degerlendirilmesinde önemli bir tani aracidir. Normal elektrokardiyogram yasa bagimlidir ve çesitli etmenlerle degismektedir. Çocukluk dönemi normal degerlerini belirlemek için bir çok çalisma yapilmistir. Bu çalismanin amaci Aydin ilinde saglikli Türk çocuklarinda normal elektrokardiyogram degerlerini belirlemektir. GEREÇ VE YÖNTEMLER: Çalismada tüm çocuklarin fizik bakisi çocuk doktoru tarafindan yapildiktan sonra ayni kisi tarafindan elektrokardiyogramlari çekilerek degerlendirilmistir. Uygun olmayan verilerin olmasi durumunda analiz tekrar edilmistir. Fizik bakida ya da elektrokardiyogramda süphe olmasi durumunda hastaneye çagrilarak çocuk kardiyologu tarafindan ayrintili inceleme yapilmistir. BULGULAR: Çalismada 500 Hz örneklem hiziyla toplam 1 163 olgudan elektrokardiyogram örnekleri alinmistir. Olgularin 562'si kiz (%47,4%) iken 601'i erkekti (%-52,6). Tüm çalisma popülasyonu toplam 10 yas grubuna ayrildi. Tüm gruplardan elde edilen normal degerlerde daha önce yayinlanmis normal degerlere göre anlamli farkliliklar görüldü. ÇIKARIMLAR: Elektrokardiyogram degiskenlerinde gözlenen farkliliklar biyolojik degiskenlik ve irksal özelliklere ek olarak prekordiyal elektrot yerlestirme, kayitlarin görsel kontrolü gibi bazi teknik detaylarla iliskili olabilir.

Involuntary movement in infants during vitamin B12 treatment.

Megaloblastic anemia is rare in infants and is generally due to vitamin B12 (cobalamin) deficiency in the mother. Neurologic symptoms of vitamin B12 deficiency include irritability, failure to thrive, hypotonia, and developmental regression/delay. Herein we present 2 infants with vitamin B12 that developed movement disorder 5 d after initiation of vitamin B12 treatment. Symptoms included tremor and myoclonus, involving in particular the face, tongue, and hands. Clinical findings in infants associated with vitamin B12 deficiency vary, and temporary involuntary movement can be observed during vitamin B12 therapy.

Cardiac auscultatory skills of academic family physicians: strength of association with an academic pediatric cardiologist.

Aim. Heart murmur is common in children, and it is one of the main reasons for referral among children in primary care. The aim of this study is to evaluate agreement and consistency of normal, innocent, and pathologic murmur decision between academic family physicians and academic pediatric cardiologist. Methods. Seven hundred fifteen primary school children were examined by family physicians and paediatric cardiologist. Auscultatory examination was performed. Intensity, frequency, duration, quality, location, and radiation of the murmur were described if present. Agreement of normal, innocent, and pathologic murmur classification decision between family physician and paediatric cardiologist was analyzed by using kappa statistic. Results. Normal, innocent and pathologic murmurs were reported for 419, 228, and 54 children in family physicians' reports, respectively. Paediatric cardiologist agreed on 383 (91.4%) children as normal, 191 (83.7%) children having innocent murmur, and 19 (35.2%) children having pathologic murmur among family physician's reports. There was good consistency between family physicians and paediatric cardiologist (κ value = 0.679, 95% CI 0.630-0.727, P < .001). They agreed on the majority of normal and innocent murmur decisions. However family physicians reported pathologic murmur more frequently. Conclusion. Cardiac auscultatory skills of academic family physicians may be concordant with paediatric cardiologist.

Nontraumatic myositis ossificans with an unusual location: case report.

Myositis ossificans is a pathologic entity rarely met, but still it must be kept in mind in differential diagnosis of a tender soft tissue swelling. The authors present an 8-year old boy with nontraumatic myositis ossificans circumscripta in the left paravertebral muscle. In diagnostic workup, ultrasonography and computed tomography (CT)-scan showed a well marginated, regular, ossified mass in the paravertebral muscle, but we were not able to exclude malignancy on the clinical grounds. The mass was excised totally, and the histopathologic examination found myositis ossificans. The authors suggest that surgical intervention may be an option for diagnosis and treatment in unusual cases when diagnosis is not certain.