How do different types of physical activity affect echocardiography findings and heart rate variability in children?

This study aims to investigate how different types of regular physical activity affect cardiac functions in school children. This is a cross-sectional review of 15 children who are not engaged with any regular physical activity (controls) and 60 athletes who swim (n=15), play basketball (n=15), play volleyball (n=15), and play tennis (n=15) regularly. The children who are not engaged with any sports, the children who swim, and the children who play basketball, volleyball and tennis are statistically similar with respect to age, sex, height, weight and body mass index (p>0.05 for all). When compared to the controls and other athletes, the swimmer children have significantly higher left ventricle diastolic mass, higher left ventricle posterior wall systolic thickness, lower mitral A wave, higher mitral annular plane systolic excursion and higher mitral E/A ratio (p=0.006, p=0.035, p=0.030, p=0.025 and p=0.043 respectively). The swimmer children have significantly lower interventricular septum E and A waves and significantly longer left ventricle IVRT than the controls and other athletes (p=0.001, p=0.040 and p=0.004 respectively). When compared with the controls and other athletes, the swimmer children have significantly lower p-wave dispersion and QT dispersion values (p=0.038 and p=0.035 respectively). The swimmer children have significantly higher total power and SDNN values than the controls and other athletes (p=0.046 and p=0.026 respectively). Swimming might contribute to the growth of cardiac muscles and help to improve the cardiac conduction system and enhance parasympathetic innervation of the heart in children. [Med-Science 2022; 11(4.000): 0-0

A review of pediatric pulmonary hypertension with new guidelines

This study aims to review pediatric pulmonary hypertension (PH) by comparing the guidelines of the European Society of Cardiology (ESC)/European Respiratory Society (ERS), the American Heart Association (AHA)/American Thoracic Society (ATS), and the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). All three sets of guidelines define PH as having a mean pulmonary artery pressure of >= 25 mmHg and accept the validity of the World Health Organization (WHO) classification system. Every child with a high index of suspicion for PH should undergo an initial work-up of chest X-rays, electrocardiography, and echocardiography. The AHA/ATS guidelines emphasize the necessity of cardiac catheterization and hemodynamic studies. As mentioned in the AHA/ATS guidelines, the symptoms and tests that can detect PH include right ventricle failure, WHO functional class, syncope, echocardiography findings, hemodynamic data, brain natriuretic peptide (BNP)/N-terminal pro-BNP, the 6-min walk test, and cardiopulmonary exercise tests. The EPPVDN guidelines refer to positive acute vasoreactivity test results and growth as risk factors. All three guidelines highlight the importance of treating and following affected children in specialized centers and recommend calcium channel blockers as a first-line treatment in children (aged > 12 months) who have a positive acute vasoreactivity test. Children with PH have distinct clinical features. In order to overcome the controversies related to the optimal management of pediatric PH, well-designed clinical studies should be carried out on a large cohort of affected children

Would Anti-Hypertensive Treatment be a Risk Factor for National Health Budget of Turkey in 2023?

This study aims to predict the prevalence of hypertension and the cost of anti-hypertensive treatment in future by analyzing the adults diagnosed with hypertension and the drugs prescribed for their treatment in Turkey during a period of five years. This study reviews data related to the patients diagnosed with hypertension amongst the individuals registered within the Medula database of the Turkish Social Insurance Institution from 2009 to 2013. A significant and gradual increase was specified in the prevalence of hypertension during the study period. The number of female patients was significantly higher than the number of male patients over the passing years. The number of anti-hypertensive drug boxes consumed was significantly increased during the study period. Surprisingly, the number of anti-hypertensive boxes annually consumed by the hypertensive patients remained statistically similar between 2009 and 2013. A significant increase was noted in the prescription of angiotensin II receptor blockers, beta blockers, and angiotensin converting enzyme inhibitors during the study period. The cost of anti-hypertensive treatment was found to decrease by 36.7% during the study period. The economical measures currently adopted for drug pricing are successful but health policies developed for the prevention of hypertension are inadequate. [Med-Science 2015; 4(4.000): 2813-24

Evaluation of dysmorphic children according to echocardiographic findings: A single center experience

Background: Abnormal echocardiographic findings are more common in dysmorphic children. In our study, dysmorphic child development and echocardiographic findings were presented according to prenatal, natal and postnatal periods. Aim of the study: The aim of this study is to evaluate the frequency and distribution of cardiac anomalies in dysmorphic children. The other aim is to investigate the prenatal, natal and postnatal characteristics of dysmorphic childs according to echocardiography findings. Design and setting: This study was carried out jointly by the Medical Genetics and Pediatric Cardiology Departments. The files and the genetic reports of the patients were examined and the hospital registry system scanned, retrospectively. The patients were followed up by the medical geneticist from 2012 to 2017. Their systemic physical examination was performed and recorded. Methods: This is a retrospective study which contains 468 children (244 males and 224 females) who were referred to the department of medical genetics due to dysmorphic features. Results: Abnormal echocardiography findings were detected in 157 dysmorphic children (33.4%). Atrial septal defect, patent foramen ovale and ventricular septal defect were the most commonly detected echocardiography findings in dysmorphic children. The number of male children in the abnormal echocardiography group was significantly higher than in the normal echocardiography group. The incidences of consanguineous marriage, polyhydramnios, intrauterine growth retardation (IUGR) and preterm delivery in the abnormal echocardiography group were significantly higher than in the normal echocardiography group. Chromosomal aneuploidy rate in the abnormal echocardiography group was significantly higher than in the normal echocardiography group (37.6% vs 1.0%; p = 0.001). Conclusion: According to our study findings, abnormal echocardiography findings were significantly associated with neonatal sex, consanguineous marriage, polyhydramnios, IUGR, preterm delivery and chromosomal aneuploidies in dysmorphic children. Keywords: Dysmorphic child, Echocardiography, Cardiac anomal

Prevalence of microscopic colitis in patients with chronic diarrhea

Microscopic colitis affects nearly 10% of the patients with chronic diarrhea which is defined as an increase in the number of daily defecation or the amount of stool lasting more than 4 weeks. The present study aims to analyze the Prevalence of Microscopic Colitis in patients who have admitted to a tertiary health center due to chronic diarrhea with unidentified etiology. This is a retrospective review of 54 patients (31 men and 23 women) with chronic diarrhea who were admitted to the gastroenterology department of the study center between July 2009 and July 2010. Data related with the patient age, patient gender, laboratory findings and histopathological alterations were obtained from hospital files. The men and women included in this study were statistically similar with respect to their mean age (36.4 ±11.1 years vs 43.1 ±18.0 years, p=0.125). The male and female patients with cheronic diarrhea had statistically similar incidences of duodenitis (8/31 vs 11/23, 25.8% vs 47.8%, p=0.097). These men and women had also statistically similar incidences of terminal ileitis (10/31 vs 8/23, 32.3% vs 34.8%, p=0.847) respectively. The male and female patients with chronic diarrhea had statistically similar incidences of non-specific colitis (19/31 vs 12/23, 61.3% vs 52.2%, p=0.499). However, non-specific colitis was significantly more frequent in patients with normal duodenum biopsy than patients with duodenitis (24/35, 68.6% vs 7/19, 36.8%; p=0.008). Microscopic colitis should be considered in differential diagnosis of middle aged and elderly women with chronic diarrhea. Although there is no general consensus about the localization and number of intestinal biopsies, a large number of biopsies should be collected, even from the colon mucosa with normal macroscopic appearance in these patients. [Med-Science 2018; 7(4.000): 841-4

Congenital muscular dystrophy a case study with a mutation in the POMT1 gene

Background: The congenital muscular dystrophies (CMD) are a group of heterogeneous diseases, manifested with a wide variety of clinical findings. Dystroglycanopathy is regarded as a subgroup among the CMD group of diseases. POMT1 mutations that cause alpha-dystroglycan hypoglycolization are reported to cause CMD diseases with autosomal recessive inheritance pattern. Case Presentation: A 14-year-old girl patient was referred with classical symptoms for CMDs. Whole exome sequencing (WES) analysis revealed a mutation in the POMT1 gene after the differential diagnosis of the patient. A homozygous mutation detected in the patient diagnosed muscular dystrophy-dystroglycanopathy (congenital with mental retardation), type B, 1 (OMIM 613155). Conclusion: Different mutations in the POMT1 gene have been found to cause three different types of diseases (CMDs). The differential diagnosis for these diseases clinically remains difficult, as a result, detailed clinical evaluation of patients becomes mandatory. Also, a multidisciplinary and collaborative approach involving complete clinical information and anamnesis is essential for the interpretation of genetic test results for such complex disorders. [JBCGenetics 2019; 2(2.000): 143-146

Persistent left superior vena cava: Experience of a tertiary health-care center

WOS: 000298589000046PubMed: 21810152Background: The aim of this study was to assess the prevalence of persistent left superior vena cava (PLSVC) in patients with all types of congenital heart defects and to determine the congenital heart anomalies accompanying PLSVC. Methods: The present study is based on a retrospective review of 1205 children who consecutively underwent cardiac catheterization from 2000 to 2007. In order to determine the existence of PLSVC, all the subjects routinely underwent superior vena cava (SVC) injection during angiography at the catheter laboratory of the study center. Results: The prevalence of PLSVC was computed to be 6.1% for the present study population. Transthoracic echocardiography was able to detect PLSVC in 32 children (2.6%) whereas angiography diagnosed PLSVC in 74 children (6.1%). The mean age of the patients with PLSVC was 40.09 +/- 50.21 months. A communication between the right and left SVC was determined in 27% of the children who were diagnosed with PLSVC after angiography was performed (20 out of 74). A statistically significant association was present between PLSVC and other congenital cardiac anomalies, including ventricular septal defect (n = 42, 56.8%), atrial septal defect (n = 31, 41.9%), pulmonary stenosis (n = 19, 25.7%), atrioventricular septal defect (n = 10, 13.5%), patent ductus arteriosus (n = 6, 8.1%) and cor triatriatum (n = 3, 4.1%). Conclusion: Transthoracic echocardiography usually visualizes dilated coronary sinus in association with PLSVC. However, SVC injection should be performed in patients undergoing angiography so that morbidity and mortality related with persistent left superior vena cava can be avoided during cardiovascular surgery

Behavioral Correlates of Television Viewing in Young Adolescents in Turkey

We evaluated the behavioral effects of television (TV) viewing in 860 young adolescents as reported by parents (n=581) on Child Behavior Checklist (CBCL). The mean duration of TV viewing was 2.32 +/- 1.77 hours/day according to parents and 2.08 +/- 1.41 hours/day according to self report (r=0.37, P < 0.0001). The linear regression analysis revealed a statistically significant relation between socioeconomic status (P=0.019) and aggressive behavior score of CBCL (P=0.016) and parent reported TV viewing hours. Self reported TV viewing for more than 2 hours was significantly associated with social problem score (OR 1.17; 95% CI: 1.016-1.349; P=0.030) and having a TV in bedroom (OR:1.706; 95% CI: 1.065-2.731, P=0.026)