Associations between cardiorespiratory fitness, fatness, hemodynamic characteristics, and sedentary behaviour in primary school-aged children.

BACKGROUND: Low cardiorespiratory fitness (CRF) is associated with the development of cardiovascular diseases during childhood, adolescence and older ages. The purpose of the study was to investigate associations between fatness, hemodynamic characteristics and secondary time with CRF in primary school-aged children. METHODS: Height, weight, body mass index (BMI), blood pressure (BP), heart rate (HR), CRF (20 m shuttle-run) and sedentary time were measured for 105 children (categorized as normal, overweight, obese). The independent sample t-test checked for differences and one-way ANOVA-Post Hoc Test and stepwise linear regression analysis assessed the 20 m shuttle-run performance predictors. RESULTS: There was a statistically significant difference in CRF between boys and girls. There was a statistically significant difference between (p < 0.05) CRF for Normal weight (M = 47.58 ± 3.26 kg m-2) and Obese (M = 44.78 ± 3.23 kg m-2). CRF correlated with age, BMI and sedentary time (r > 0.3; p < 0.05). BMI is the best independent predictor of CRF. CONCLUSIONS: Children with normal BMI tend to present better CRF performance than obese and overweight children. Sedentary behaviour is associated with lower CRF in primary school-aged children.

Bronchoscopical Repair of Tracheal Laceration Using Conventional Instrumentation: A Novel Technique.

Postintubation tracheobronchial laceration is a rare complication of endotracheal intubation. It requires early serial treatment in cases of pneumomediastinum with difficulty in ventilation to prevent mediastinitis and stricture. The surgical access to the posterior tracheal wall depends on the site of the laceration. A right posterolateral thoracotomy is performed for lacerations of the middle-distal trachea and a transcervical approach for the upper third. Either of them is associated with specific postoperative morbidities. We describe a novel technique of exclusively intraluminal repair of postintubation tracheobronchial laceration using conventional endoscopic instrumentation through a 14.1-mm rigid bronchoscope.

Successful treatment of postoperative massive pulmonary embolism with paradoxal arterial embolism through extracorporeal life support and thrombolysis.

Pulmonary embolism is a common clinical entity related to high mortality. About 200,000 to 300,000 patients die every year due to pulmonary embolism. The purpose of this article is to describe a case of a patient who on the second postoperative day after undergoing thromboembolectomy of the left femoral artery, manifested a massive pulmonary embolism. Due to cardiorespiratory collapse a combined treatment via extracorporeal life support (ECLS) and parallel catheter thrombolysis was decided and performed. By cardiorespiratory improvement and final stabilization the patient was successfully weaned from ECLS and the system was successfully removed. After a reasonable postoperative time the patient was dismissed in good overall condition.

Hamman's syndrome (spontaneous pneumomediastinum presenting as subcutaneous emphysema): A rare case of the emergency department and review of the literature.

Pneumomediastinum is a rare clinical entity that concerns the clinicians in the emergency department. We present a case of a patient with spontaneous pneumomediastinum (Hamman's syndrome) that presented to our hospital's emergency department with cervical subcutaneous emphysema. A conservative treatment with observation was performed. The patient after 24 hours of observation was discharged with a suggested follow-up.

The value of adenosine test in the diagnosis of sick sinus syndrome: susceptibility of sinus and atrioventricular node to adenosine in patients with sick sinus syndrome and unexplained syncope.

AIMS: Patients (pts) with sick sinus syndrome (SSS) and unexplained syncope show increased susceptibility of sinus and atrioventricular node (AVN) to intravenous adenosine, respectively. Our aim is to assess the diagnostic value of adenosine test in pts with SSS, as well as to evaluate the response of AVN to adenosine either in pts with unexplained syncope or in pts with syncope and known SSS. METHODS AND RESULTS: The effect of adenosine administration on the sinus and AVN was studied in a population consisted of 19 pts with clinical SSS (group SSS), 7 pts with syncope of unknown origin (group SUO), and 12 control subjects (group C). We calculated the maximum corrected sinus node recovery time (CSNRT), after overdrive pacing of the atrium at cycle lengths of 600, 500, and 400 ms and compared this value with the longest sinus pause, following adenosine administration corrected to the basic cycle length (ADSNRT). The longest R-R interval during atrioventricular block in response to adenosine injection (ADAVB) was also measured. Adenosine was given in a bolus dose of 0.15 mgr/kg through a femoral or large antecubital vein. There was a significant difference in the mean values of CSNRT among the three groups: group SSS (651 +/- 228 ms) > group SUO (284 +/- 100 ms) = group C (291 +/- 117 ms), F(2.35) = 19.078, P = 0.000. A significant difference was also found with ADSNRT: group SSS (5437 +/- 6863 ms) > group SUO (122 +/- 120 ms) = group C (801 +/- 1897 ms), F(2.35) = 4.513, P = 0.018. Using 525 ms as a cutoff value indicating sinus node dysfunction, CSNRT had a sensitivity of 74% and specificity of 100% for diagnosis of SSS while ADSNRT had 94% and 84%, respectively. Higher values of ADAVB in pts with SSS (10659 +/- 5872) and SUO (10026 +/- 7092) in comparison with controls (3615 +/- 5002) were measured, F(2.35) = 5.697, P = 0.007. No difference in the degree of ADAVB was found between the pts with SUO (10026 +/- 7092 ms) and syncope in the presence of SSS (12058 +/- 6787 ms), F(1.15) = 0.356, P = 0.56. CONCLUSION: Adenosine test appears to be at least comparable with CSNRT in making the diagnosis of SSS and may be considered as an alternative non-invasive test for confirmation of suspected SSS. No difference in the susceptibility of AVN to adenosine between the pts with syncope in the presence of SSS and those with unexplained syncope was found, suggesting that adenosine test cannot be used to diagnose atrioventricular block as the cause of syncope.

Brugada type electrocardiographic changes induced by concomitant use of lithium and propafenone in patient with Wolff-Parkinson-White syndrome.

We report a case of ST elevation in right precordial leads compatible with type 1 Brugada syndrome following administration of propafenone in a patient with Wolff-Parkinson-White syndrome who was receiving lithium at concentrations within therapeutic levels. The mechanism of the electrocardiogram changes was considered to be caused by the two drugs synergistic sodium channel blocking effects.