Prediction of the hypertension risk in teenagers

Background: Creation of a hypertension risk stratification model and development of an algorithm to detect hypertension in teenagers. Methods: The study group consisted of 690 middle and high school students, aged 15–17 years, from the metropolitan area of Warsaw, Poland. Information concerning family history and presence of risk factors for cardiovascular disease was gathered. Three-time blood pressure measurements were taken during at least two separate visits, which were at least a week apart, using the auscultatory method, according to standard procedures. Anthropometric measurements included: body weight, height, arm, hip and abdominal circumference, skin-fold thickness measured on the rear surface of an arm, below the inferior angle of the scapula and at the belly. Following indexes were determined: body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR), hip to height ratio. Results: A logistic regression model, describing the risk of hypertension in adolescents aged 15–17 was invented. π ̂(x)=e^(g ̂(x))/(1+e^(g ̂(x)) ) where: g ̂(x) = –0.097 × height + 0.085 × weight + 7.764 × WHR + 1.312 × hypertens_1(=yes). Hypertens_1 means presence of hypertension among members of the closest family.The formula was created, allowing the pre-selection of adolescents at risk of hypertension during screening. Next an algorithm for the detection of hypertension for practical use was proposed. Conclusions: Body weight, WHR and incidence of hypertension in the family are the strongest predictors of hypertension in teenagers. Proposed screening algorithm can be a useful tool for selecting teenagers at risk of hypertension and in need of specialized diagnostics and care

Zapalenie mięśnia sercowego u dzieci i młodzieży — przegląd piśmiennictwa

Zapalenie mięśnia sercowego (ZMS) według Światowej Organizacji Zdrowia definiuje się jako chorobę zapalną obejmującą kardiomiocyty, tkankę śródmiąższową, naczynia, a czasem również osierdzie. W poniższym opracowaniu przeanalizowano piśmiennictwo z ostatnich 5 lat dotyczące epidemiologii, badań diagnostycznych, leczenia i rokowania w ZMS u dzieci i młodzieży. W tym celu dokonano przeglądu medycznej bazy danych Pubmed, używając słów/zwrotów kluczowych: „dzieci” (ang. ‘children’), „zapalenie mięśnia sercowego” (ang. ‘myocarditis’) — strategia ta pozwoliła uzyskać łącznie 117 artykułów. Spośród nich wyodrębniono prace, w których badana grupa obejmowała co najmniej 5 dzieci, a w opisie zawarto dane dotyczące objawów klinicznych, odchyleń w badaniach laboratoryjnych oraz badaniach obrazowych, identyfikacji czynników etiologicznych, zastosowanego leczenia oraz czasu hospitalizacji i liczby zgonów. Do analizy końcowej włączono 17 artykułów; zestawienie obejmuje łącznie 1891 dzieci, u których rozpoznano ZMS. Z analizy wynika, że ZMS jest chorobą rzadką. Obserwuje się dwa szczyty zachorowań: w wieku noworodkowym i wczesnoniemowlęcym oraz w okresie dojrzewania, przy czym wiek poniżej 2. rż. jest niekorzystnym czynnikiem rokowniczym. W raportowanych przypadkach najczęstszymi objawami podmiotowymi były: osłabienie, ból w klatce piersiowej, kołatania serca. Wśród objawów przedmiotowych dominowały: tachypnoe, tachykardia, hipotensja, hepatomegalia. Wywiad, wynik badania przedmiotowego oraz wyniki badań dodatkowych (stężenia troponin, elektrokardiogram, echokardiogram) przybliżają do rozpoznania, natomiast „złotym standardem” do ustalenia diagnozy jest badanie rezonansu magnetycznego serca. W analizowanej grupie 65–90% dzieci wymagało leczenia na oddziale intensywnej terapii, u 168 dzieci zastosowano ciągłe pozaustrojowe natlenianie krwi, a 35 dzieciom wszczepiono tak zwane sztuczne komory. U 38 pacjentów wykonano przeszczepienie serca. Śmiertelność w ZMS jest wysoka (w przeanalizowanym piśmiennictwie wyniosła 25–35%). U około 25% dzieci dysfunkcja mięśnia sercowego pozostała trwała. Ze względu na nieprzewidywalny przebieg choroby pacjent w ostrym okresie choroby powinien być hospitalizowany, a po wypisaniu ze szpitala podlegać dalszej kontroli kardiologicznej

Children and adolescents with pulmonary arterial hypertension : baseline and follow-up data from the polish registry of pulmonary hypertension (BNP-PL)

We present the results from the pediatric arm of the Polish Registry of Pulmonary Hypertension. We prospectively enrolled all pulmonary arterial hypertension (PAH) patients, between the ages of 3 months and 18 years, who had been under the care of each PAH center in Poland between 1 March 2018 and 30 September 2018. The mean prevalence of PAH was 11.6 per million, and the estimated incidence rate was 2.4 per million/year, but it was geographically heterogeneous. Among 80 enrolled children (females, n = 40; 50%), 54 (67.5%) had PAH associated with congenital heart disease (CHD-PAH), 25 (31.25%) had idiopathic PAH (IPAH), and 1 (1.25%) had portopulmonary PAH. At the time of enrolment, 31% of the patients had significant impairment of physical capacity (WHO-FC III). The most frequent comorbidities included shortage of growth (n = 20; 25%), mental retardation (n = 32; 40%), hypothyroidism (n = 19; 23.8%) and Down syndrome (n = 24; 30%). The majority of children were treated with PAH-specific medications, but only half of them with double combination therapy, which improved after changing the reimbursement policy. The underrepresentation of PAH classes other than IPAH and CHD-PAH, and the geographically heterogeneous distribution of PAH prevalence, indicate the need for building awareness of PAH among pediatricians, while a frequent coexistence of PAH with other comorbidities calls for a multidisciplinary approach to the management of PAH children

Assessment of left ventricular diastolic function in children after successful repair of aortic coarctation

The purpose of the study was an assessment of left ventricular diastolic function in children after the successful repair of aortic coarctation (CoA). The prospective study concerned 32 pediatric patients after the CoA surgery. Tissue Doppler imaging parameters including strain and strain rate and the conventional echocardiographic indexes were analyzed in patients and healthy controls. Analysis of mitral annulus velocities, E–E′ ratio, strain, and strain rate of left ventricular mid-cavity segments and conventional indexes of mitral inflow showed the worsening of left ventricular diastolic mechanics in the study group compared to healthy controls. The E/E′ ratio was significantly higher in the study group compared to the control group (8.30 ± 3.24 vs. 6.95 ± 1.36; p < 0.05). The early diastolic strain rate to late diastolic strain rate ratio as well as early to late diastolic strain ratio of the left ventricular mid-cavity segments were significantly lower in the study group compared to healthy controls (1.81 ± 0.63 vs. 3.74 ± 1.53; p < 0.001 and 1.20 ± 0.49 vs. 3.41 ± 1.26; p < 0.001). No differences of the pulmonary venous flow parameters between those two groups were observed. The left ventricular diastolic mechanics in hypertensive patients after CoA repair did not differ from normotensive subjects. Hypertensive and normotensive children after surgical repair of CoA are found to have worsening of the left ventricular diastolic mechanics suggesting the impairment of the active myocardial relaxation

EuReCa ONE—27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

AbstractIntroductionThe aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.MethodsThis was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.ResultsData on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.ConclusionThe results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe.EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Impacts of the Tropical Pacific/Indian Oceans on the Seasonal Cycle of the West African Monsoon

The current consensus is that drought has developed in the Sahel during the second half of the twentieth century as a result of remote effects of oceanic anomalies amplified by local land–atmosphere interactions. This paper focuses on the impacts of oceanic anomalies upon West African climate and specifically aims to identify those from SST anomalies in the Pacific/Indian Oceans during spring and summer seasons, when they were significant. Idealized sensitivity experiments are performed with four atmospheric general circulation models (AGCMs). The prescribed SST patterns used in the AGCMs are based on the leading mode of covariability between SST anomalies over the Pacific/Indian Oceans and summer rainfall over West Africa. The results show that such oceanic anomalies in the Pacific/Indian Ocean lead to a northward shift of an anomalous dry belt from the Gulf of Guinea to the Sahel as the season advances. In the Sahel, the magnitude of rainfall anomalies is comparable to that obtained by other authors using SST anomalies confined to the proximity of the Atlantic Ocean. The mechanism connecting the Pacific/Indian SST anomalies with West African rainfall has a strong seasonal cycle. In spring (May and June), anomalous subsidence develops over both the Maritime Continent and the equatorial Atlantic in response to the enhanced equatorial heating. Precipitation increases over continental West Africa in association with stronger zonal convergence of moisture. In addition, precipitation decreases over the Gulf of Guinea. During the monsoon peak (July and August), the SST anomalies move westward over the equatorial Pacific and the two regions where subsidence occurred earlier in the seasons merge over West Africa. The monsoon weakens and rainfall decreases over the Sahel, especially in August.Peer reviewe

Search for heavy resonances decaying to two Higgs bosons in final states containing four b quarks

A search is presented for narrow heavy resonances X decaying into pairs of Higgs bosons (H) in proton-proton collisions collected by the CMS experiment at the LHC at root s = 8 TeV. The data correspond to an integrated luminosity of 19.7 fb(-1). The search considers HH resonances with masses between 1 and 3 TeV, having final states of two b quark pairs. Each Higgs boson is produced with large momentum, and the hadronization products of the pair of b quarks can usually be reconstructed as single large jets. The background from multijet and t (t) over bar events is significantly reduced by applying requirements related to the flavor of the jet, its mass, and its substructure. The signal would be identified as a peak on top of the dijet invariant mass spectrum of the remaining background events. No evidence is observed for such a signal. Upper limits obtained at 95 confidence level for the product of the production cross section and branching fraction sigma(gg -> X) B(X -> HH -> b (b) over barb (b) over bar) range from 10 to 1.5 fb for the mass of X from 1.15 to 2.0 TeV, significantly extending previous searches. For a warped extra dimension theory with amass scale Lambda(R) = 1 TeV, the data exclude radion scalar masses between 1.15 and 1.55 TeV