[Left ventricular mass in children in relation to body surface area]. / Masa miesnia lewej komory serca a powierzchnia ciala u dzieci.

BACKGROUND: In spite of growing interest in the problem of left ventricular hypertrophy in children there is relatively little published data on normal values of the left ventricular mass (LVM) among data on normal values in the developmental age. AIM: To determine the normal values of LVM in infants and children in relation to body surface area (BSA), age (in months) and gender. MATERIAL AND METHODS: This study was carried out on 773 children (403 girls and 370 boys, aged from 2 weeks to 18 yrs). They were referred for echocardiographic investigations from paediatric and neonatal hospital departments, from outpatients clinics and primary schools. In all patients cardiovascular disease was excluded. LVM (in grams) was calculated in relation to BSA, age in months and sex. All echocardiographic studies were carried out by the same investigator, according to the American Society of Echocardiography (ASE) convention, modification 2D using, Philips HD14000 Ultrasonograph. The LVM values were calculated at the end of diastole from: left ventricle dimension (LVDd), interventricular septum thickness (IVSd) and thickness of the posterior wall of the left ventricle (LVPWd). Data were analysed in relation to the body surface area (in 17 consecutive intervals from 0.2 m(2) to 1.8 m(2)) and to age (in months) for all children and for girls and boys separately. LVM values were calculated as a mean +/- SD and extreme values 5 or 95 percentile. The results were accepted as normal when they did not exceed 2SD or 5(th) or 9(th) percentile. Statistic analysis was performed with the use of rank correlation Spearman test and Mann-Whitney U.test. RESULTS: The left heart ventricular mass was determined on the base of data from healty children aged 2 weeks to 18 years. A significant correlation of LVM with BSA and with age was found. There were no significant gender dependent differences in LVM values. Abnormal values exceeding the 95(th) percentile were present in 25 (3.2 %) examined children. CONCLUSIONS: 1. LVM values obtained in this study can be used as reference values. 2. No gender differences were found in LVM. 3. BSA is a good reference parameter in calculating LVM in children aged 2 weeks-18 years. Both BSA and age give high correlation with left ventricular hypertrophy, in children with left muscular ventricular mass exceeding 95 percentile or + 2SD, long term care in department of cardiology is recommended.

[The influence of delivery and perinatal risk factors on the concentration of cystatine C in umbilical cord blood]. / Wplyw porodu i czynników ryzyka okoloporodowego na stezenie cystatyny C we krwi pepowinowej.

UNLABELLED: Cystatin C--a low molecular protein, recognized as a sensitive marker of glomerular filtration rate and inhibitor of the lisosomal proteolitic enzymes in the organism. It is produced continuously and released to biological fluids. The concentration of cystatin C in the cord blood is higher and more diverse than in the peripheral blood with children and adults. THE AIM OF THIS STUDY: To determinate the range of the concentrations cystatin C in the umbilical cord blood and to research the influence of delivery and perinatal risk factors on concentration of cystatin C in cord blood. MATERIAL AND METHODS: The study included 444 newborns born by spontaneous deliveries and cesarean sections. In both subgroups, term neonates, preterm and some amount of newborns with additional perinatal risk factors (hipotrofia, infection, asphyxia) were found. Clinical evaluation, blood tests and USG examination were performed. Blood cord samples were analyzed entirely in the neonates with normal USG image of urinary tract was normal. RESULTS: The mean cystatine C concentration in umbilical cord blood were 1.65 +/- 0.44 mg/l. There were not differences in the mean cystatin C concentration between term and preterm newborns without additional risk factors. The most important factor influencing cystatin C concentration appeared to be the kind of delivery In neonates born by spontaneous delivery mean cystatin C concentration was significantly higher (1.82 mg/l) than in neonates born by cesarean sections (1.48 mg/l). Mean cystatin C concentration was strongly correlated with a lactic acid concentration and a length of delivery. CONCLUSIONS: Statistically higher concentrations of cystatine C were found in neonates born by spontaneous delivery. Laktacidemia is probably one of the factors responsible for elevation of cystatin C concentration in the cord blood. Higher cystatine C level can be recognized as a mechanism protecting the neonate from local or/and systemic proteolytic activity.

[Intentional self-poisonings among children and youth hospitalized in pediatric clinic]. / Celowe zatrucia u dzieci i mlodziezy w materiale kliniki ogólnopediatrycznej.

UNLABELLED: The aim of the study was to identify the most important factors that can favour suicide attempts among children and to establish the age of highest risk, and note the extent of the phenomenon on the base of admissions to hospital within five years. MATERIAL AND METHODS: The research covered 42 patients of Paediatric clinic at the age of 12-17 years. Clinical intervention and observation, psychological evaluation and psychiatric examination were carried out. RESULTS: Fifty percent of the patients came of an incomplete (single-parent) families. Thirty one percents of patients' families were affected by alcoholism, nearly half of poisoned children were 14-15 years of age. There was a significant prevalence of girls in the group (88%). Seventeen percents of them had a history of multiple suicidal attempts. Children hospitalized by reason of intentional self-poisoning constituted, according to a year of observation, 0.45-1.34% (mean 0,81%) of all patients of the Paediatric Clinic. CONCLUSIONS: Female sex and age of 15-16 years is a time of highest risk. Alcoholism is a frequent problem in families of children attempting suicide. Children with disturbed personality, behaviour and emotionality are particularly at risk of repeating an suicidal attempt and require longer psychological and psychiatrical care.

[Limulus amebocyte lysate test use in clinical diagnostic in children with infectious diseases--preliminary report]. / Ocena przydatnosci testu zelizatu lizatu amebocyta Limulus polyphaemus w diagnostyce klinicznej u zakazonych dzieci--doniesienie wstepne.

OBJECTIVE: The aim of this preliminary study was (1) to evaluate the usefulness of the Limulus amebocyte lysate (LAL) test as a diagnostic tool in pediatric clinic, and (2) to examine the serum ET levels in hospitalized patients. MATERIAL AND METHODS: Bacterial blood endotoxin (ET) was measured in 50 children with infections of different etiology and localization. A Limulus amebocyte lysate (LAL) test was used. CONCLUSIONS: The usefulness of LAL test in routine diagnostic procedures in hospitalized children with infections was not proven so far. However, the LAL test appeared useful in the urinary tract infection (UTI) cases in which significant elevation of serum ET levels were demonstrated. Moreover, it was confirmed that LAL test can be performed as well in serum: the mean values of serum ET levels in our patients were comparable with published ET plasma values in adults.

[The influence of Sudden Infant Death Syndrome (SIDS) risk factors on health, growth and development in the first year of life. A preliminary report]. / Wplyw zachowan zdrowotnych i praktyk pielegnacyjnych uwazanych za czynniki ryzyka zespolu naglej smierci niemowlat (Sudden Infant Death Syndrome -- SIDS) na rozwój i zachorowalnosc dzieci w pierwszym roku zycia. Obserwacje wstepne.

AIM: To establish the occurrence of SIDS risk factors (including 'removable' ones) and the incidence of the ecg long QT interval (accepted as a risk factor) and their influence upon infants development and morbidity. MATERIAL AND METHODS: A group of 98 infants from normal birth at term to the end of first year of life was observed. The data sources were as follows: 1) a questionnaire filled by mothers before discharge front maternity ward, 2) records of four consecutive medical examinations (including ecg records) performed on 3rd day and 3rd, 6th and 12th month of life. Chi-Square test and Fisher test were used. RESULTS: The most often identified risk factors were: prone sleeping position of infant (60.2%), environmental and maternal tobacco smoking (40.8%) and bed sharing practices (32.6%). A significant but transient signs of delay in psychomotor development (in motor zone) as well as more frequent respiratory tract infections in infants sleeping prone were noted. There were no deaths in the observed group neither cases of long QT interval. CONCLUSIONS: 1) the most frequently occurring SIDS risk factors are: environmental tobacco smoking, infant prone sleeping and bed sharing, 2) these inappropriate nursing practices and improper habits of adult family members known as a 'removable' SIDS risk factors have a bad effect on infant health and development, 3) identification of SIDS risk factors in an infant does not predict crib death.

[The evaluation of natural anticoagulants in systemic lupus erythematosus in children]. / Ocena naturalnych inhibitorów ukladu krzepniecia w toczniu rumieniowatym ukladowym u dzieci.

Thromboembolic complications in adults with systemic lupus erythematosus (SLE) are described in literature. We intended to investigate the activity of natural anticoagulants, such as C protein. S protein and antithrombin III (AT III) in children with SLE to obtain data concerning activity of the disease and thrombotic complications. The study population consisted of 36 children with SLE and of 51 healthy children serving as a control group. The results showed a significant decrease of S protein activity, with particularly low levels in the group of patients with the presence of anticardiolipin antibodies (aCL), and decrease of C protein activity in patients with higher activity of the disease. They appear to prove the involvement of these inhibitors in inflammation and, on the other hand, the activation of intravascular coagulation, a risk factor of thrombosis.