The use of short-term analysis of heart rate variability to assess autonomic function in obese children and its relationship with metabolic syndrome

Background: The cardiovascular autonomic nervous system in obese children is one of the main initiators of coronary heart disease and hypertension and may have a close relationship with insulin resistance. Heart rate variability is one non-invasive method to assess the cardiovascular autonomic system. In this method, low frequency parameters reflect sympathovagal activity, high frequency parameters reflect vagal activity and the ratio of these parameters reflects sympathovagal balance. Methods: In this study, a short-term analysis of heart rate variability was conducted in 66 obese children and 40 healthy controls. Results: While high frequency parameter values are lower in the obese group compared to the controls (16.02 &#177; 12.9 nu vs. 21.45 &#177; 13.6 nu, p = 0.046), the low frequency/high frequency ratio is found significantly higher (3.79 &#177; 2.34 vs. 2.25 &#177; 0.93, p < 0.001). A significant difference was not detected for the low frequency values (p = 0.787). Insulin resistance was found in 33 (50%) patients, dyslipidemia was found in 39 (59%) and hypertension was found in 18 (27%). Metabolic syndrome was detected in 39% patients in the obese group. Conclusions: We found that vagal activity was decreased in the obese group and the autonomic nervous system balance was impaired in favor of sympathetic activity in the short-term heart rate analysis. (Cardiol J 2012; 19, 5: 501-506

Evaluation of patients receiving treatment at palliative care centers

Introduction: Palliative care centers (PC centers) provide multidisciplinary care for patients with multiple comorbid conditions. This study aimed to assess and compare patients’ diagnoses, length of hospital stays, and demographic data and coordination with home health care services.Methods: This is a descriptive, cross-sectional and retrospective study. Patients who were hospitalized in PC centers of secondary and tertiary care hospitals between 01.08.2018 and 01.08.2018 were retrospectively assessed. Patients’ demographic characteristics diagnoses of hospitalization, and length of hospital stays and centers where they received treatment were recorded. Results: Median age of 830 patients included in the study was 79 (24-102). Out of 830 patients, 48.9% were male and 51.1% were female. Mean length of hospital stay was 14 days and median length was 8.7 (0.6-112) days. The three most common comorbid diseases followed up were malignancy (21.8%), cerebrovascular disease (15.2%) and malaise-fatigue-senility (10.7%). The group with Alzheimer's disease was the oldest patient group. The group with nutritional deficiency-malnutrition was the patient group with the longest hospital stay (p=0.030). The number of patients who were hospitalized for cerebrovascular diseases was the highest in secondary care centers and the number of patients who were hospitalized for malignancy was the highest in tertiary care centers. Patients hospitalized in secondary PC center were older. The hospital stays were longer in tertiary PC center. Patients receiving treatment at a tertiary PC center had a significantly higher rate of mortality. The number of patients who were discharged was lower in the tertiary PC centers. Hospitalization to a secondary PC center through home care units was significantly higher. Conclusion: In this study, the rate and diagnoses of hospitalization and length of hospital stays were different in secondary and tertiary PC centers. Our study has made an assessment about palliative care centers at various levels of health care and can be considered as prior knowledge for other studies

A Global Perspective on PDA Management in the Extremely Premature: Shifting Trend Toward Transcatheter Closure.

Patent ductus arteriosus (PDA) is a frequently encountered defect in infants born extremely premature (≤26 weeks gestation). Historically, closure of the PDA was performed using cyclooxygenase inhibitor medications or by surgical ligations. However, the benefits of PDA closure using these therapies have never been demonstrated, albeit studies have previously not focused on the extremely premature infants. Therefore, there was a worldwide trend toward conservative management of the PDA. With improved survival of extremely premature infants, comorbidities associated with the PDA has increased, resulting in finding alternate treatments such as transcatheter patent ductus arteriosus closure (TCPC) for this population. Currently, there is a renewed interest toward selective treatment of the PDA in this high-risk cohort of small infants. This Comprehensive Review article inspects the globally changing trends in the management of the PDA in premature infants, with a special focus on the rising adoption of TCPC. Moreover, this article compiles data from several neonatal networks worldwide to help understand the problem at hand. Understanding the current management of premature infants and their outcomes is fundamentally essential if pediatric cardiologists are to offer TCPC as a viable therapeutic option for this population. This article aims to serve as a guide for pediatric cardiologists on this topic by compiling the results on landmark clinical trials on PDA management and the controversies that arise from these trials. Comparative outcomes from several countries are presented, including interpretations and opinions of the data from experts globally. This is a step toward coming to a global consensus in PDA management in premature infants

Transcatheter Removal of Embolized Port Catheters from the Hearts of Two Children

Embolization of a port catheter is a dangerous and serious complication. In this paper, we present two cases of children, aged 4.5 months and 6 years, in whom port catheters had embolized to the right ventricle one month and 1.5 years priorly, respectively; the port catheters were retrieved via snaring

Transcatheter Removal of Embolized Port Catheters from the Hearts of Two Children

Embolization of a port catheter is a dangerous and serious complication. In this paper, we present two cases of children, aged 4.5 months and 6 years, in whom port catheters had embolized to the right ventricle one month and 1.5 years priorly, respectively; the port catheters were retrieved via snaring

An Investigation of Steam Curing Pressure Effect on Pozzolan Additive Autoclaved Aerated Concrete

Autoclaved Aerated Concrete (AAC) is a porous light weight concrete obtained by adding a pore-forming material to a mixture made of finely pulverized siliceous aggregate and inorganic binder (lime and/or cement) and hardened by steam cure. In this study fly ash was used instead of siliceous aggregate and experiment samples were obtained by adding 3%, 6%, 9%, 12% silica fume to the cement. Samples were cured under 1560C and 4 bars and 1770C and 8 bars, and were investigated for compressive strength, bulk density and ultrasound pulse velocity to determine their mechanical and physical properties. Microstructure of samples was observed by using SEM and XRD techniques. Samples’ bulk density values and compressive strengths are changing between 0.6-0.7 kg/dm3 and 2.5-4.4 MPa respectively