Heart Rate Variability in Children and Adolescents with Cerebral Palsy-A Systematic Literature Review.

Cardiac autonomic dysfunction has been reported in patients with cerebral palsy (CP). The aim of this study was to assess the existing literature on heart rate variability (HRV) in pediatric patients with CP and a special attention was paid to the compliance of the studies with the current HRV assessment and interpretation guidelines. A systematic review was performed in PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases searched for English language publications from 1996 to 2019 using Medical Subject Headings (MeSH) terms "heart rate variability" and "cerebral palsy" in conjunction with additional inclusion criteria: studies limited to humans in the age range of 0-18 years and empirical investigations. Out of 47 studies, 12 were included in the review. Pediatric patients with CP presented a significantly higher resting heart rate and reduced HRV, different autonomic responses to movement stimuli compared to children with normal development, but also reduced HRV parameters in the children dependent on adult assistance for mobility compared to those generally independent. None of the included studies contained the necessary details concerning RR intervals acquisition and HRV measurements as recommended by the guidelines. Authors of HRV studies should follow the methodological guidelines and recommendations on HRV measurement, because such an approach may allow a direct comparison of their results.

Signs and symptoms, evaluation, and management of genitourinary tract consequences of premature ovarian insufficiency.

Premature ovarian insufficiency (POI) occurs in 1% of women under 40 years old. Hypoestrogenism associated with this condition may result in vaginal atrophy and urine incontinence, called genitourinary syndrome. The symptoms include: vaginal dryness, irritation, dyspareunia, and dysuria. There is relative lack of studies on the occurrence and treatment of genitourinary problems in women with POI. Prevalence rates vary from 17 to 54% depending on cause, duration of oestrogen depletion, and the treatment used. Patients with POI gain lower scores in tests measuring vaginal health or sexual function in comparison to healthy peers. Hormonal treatment in premature ovarian insufficiency is recommended until the natural age of menopause. The vaginal route of oestrogen administration is supposed to be the criterion standard in treating genitourinary symptoms. Androgen supplementation is not routinely recommended.

Premature ovarian insufficiency - hormone replacement therapy and management of long-term consequences.

Premature ovarian insufficiency (POI) correlates with increased risk of cardiovascular diseases, osteoporosis, genitourinary syndrome, and other symptoms of prolonged oestrogen deprivation. Properly selected therapy improves the quality of women's lives and reduces the risk of mortality. There is a wide spectrum of available oestrogen and progestogen formulations restoring proper levels of serum sex steroid hormones. The treatment should be implemented at recognition of the POI and continued to at least the age of natural menopause. Transdermal oestradiol and oral or vaginal progesterone administration provide the most physiological sex steroid replacement therapy. Patients' views and individual preference according the route, dose, and regimen of hormonal treatment have to be taken into consideration in order to achieve high compliance rates. Women with POI should be managed by a multidisciplinary team, such as a gynaecologist, endocrinologist, dietitian, and psychologist.

[Serological and molecular methods in diagnostics of primary acute hepatitis caused with human herpesvirus type 6 - a case report].

INTRODUCTION: HHV-6 has been identified as the etiologic agent of exanthema subitum in infants and acute febrile illness in young children, although primary HHV-6 infection in immunocompetent adolescents and adults is very rare. We report the case of acute hepatitis in an 18-year-old man without any immunological dysfunctions. MATERIAL AND METHODS: Full virological examination of sera samples was performed. Specimens were tested for the presence of specific anti-EBV and anti-HHV-6 antibodies and also for the presence of DNA of other herpesviruses, using qPCR assays. RESULTS: Obtained results demonstrated the presence of HHV-6 DNA in all examined sera samples and IgM-class antibodies against HHV-6 in the second specimen. No other etiologic agents were found that are known to induce hepatitis. Hence, patient was diagnosed as having acute hepatitis triggered by HHV-6. CONCLUSIONS: We found that qPCR is a very useful tool for the detection of different herpesvirus infections, especially with low-copy viraemia in clinical specimens.

The occurrence of herpes simplex viruses 1 and 2 in skin and mucosal lesions in patients with suspicion of genital herpes.

INTRODUCTION: Infection with herpes simplex viruses 1 and 2 (HSV 1 and 2 or Human herpesvirus HHV) are one of the most common infections in human. Real time PCR is a sensitive and specific method for diagnostics of HHV infections. The aim of the study was to investigate the occurrence of HHV 1 and HHV 2 DNA in patient with clinical symptoms suggesting HHV infection. METHODS: We used real time PCR to investigate swabs from genital and perianal lesions from 74 patients of the Department of Dermatology and Venereology Medical University Warsaw and of gynecological outpatient clinics in Warsaw 40 women and 34 men. RESULTS: The results were positive for HHV 2 in 25 cases (34%), for HHV 1 in 19 cases (26%) and for both viruses in 20 cases (27%). 10 samples were negative for both viruses. CONCLUSIONS: The results confirm that the main cause of symptomatic genital herpes is HHV 2, however the percentage of HHV 1 and specially of mixed HHV 1/HHV 2 infections was unexpectedly high.

[Comparison of three multiplex real-time PCR assays for the detection of herpes simplex viruses type 1 and type 2 DNA].

INTRODUCTION: Herpes simplex viruses type 1 and type 2 (HSV-1 and HSV-2) cause widespread infection worldwide with different course and intensity. Although the disease caused by this viruses mainly concern healthy children and adults, the HSV infections are much more dangerous for people with immunodeficiencies. The aim of this work was to compare the diagnostic value of two qPCR methods for detection HSV-1/2 DNA, based on TaqMan* and HybProbes chemistry with commercial HSV-1/2 Qual Kit. METHODS: DNA from 51 clinical samples was tested for presence of HSV-1/2 sequences on LightCycler 2.0 thermocycler, using two ,,in-house" developed multiplex real-time PCR assays and commercial test using SCORPIONSTM primers. RESULTS: The results showed high specificity and sensitivity of all molecular biology tests used. Statistically, there was no significant difference in the sensitivity of real-time PCR assays when using TaqMan* and HybProbes' chemistry and when using the commercial SCORPIONSTM based method (P>0.05). CONCLUSIONS: Obtained results show that all tested methods are highly specific and can possibly be used to simultaneously detect and differentiate HSV-1/2 DNA in clinical samples. The high detection rate and short duration of qPCR assayas has great importance for immunocompromised patients where quick application of effective and safe treatment is necessary. It is also important in the event of amorphous form of the infection and the occurrence of nonspecific and generalized symptoms.

[Novel multiplex real-time PCR assay for detection and differentiation of herpes simplex virus type 1 and 2 DNA]. / Wykorzystanie nowej techniki multiplex real-time PCR do wykrywania i róznicowania DNA wirusów opryszczki typu 1 i 2.

INTRODUCTION: Herpes simplex viruses type 1 and 2 are the cause of world spread multiple infections with different course and severity. The aim of this work was to design and to optimize multiplex real-time PCR assay for simultaneous detection of HSV-1 and HSV-2. The second aim of the project was to check if the designed method is laboratory useful analyzing different clinical specimens. MATERIALS AND METHODS: In this experiment primers and probes were designed to specific viral sequences: for HSV-1 to the gene of viral DNA polymerase; for HSV-2 to the UL5 sequence. For performing qPCR assay TaqMan chemistry was used. Reference strains HSV-I McIntyre and HSV-2 MS were used as a positive control. To test laboratory utility of the designed method 58 different clinical specimens were analyzed. RESULTS: Developed multiplex real-time PCR gave positive result only in the samples containing genetic material of HSV-1/2. Of the 58 clinical samples tested, 27 proved to be positive for HSV-1 and 17 for HSV-2. The 7 samples showed the presence of both types of DNA herpes simplex virus, and 7 others were found for both HSV-1 and HSV-2 negative. CONCLUSIONS: Obtained results show that the designed method is highly specific and can possibly be used to simultaneously detect and differentiate HHV-1/2. Both high specificity and very short time of analysis have great importance in diagnosing immunocompromised patients, which ought to be diagnosed quickly and effectively in order to provide appropriate treatment.