RESUMEN
A child who had undergone subclavian vein catheterization in the neonatal period was hospitalized in a grave condition at the age of 1 year 7 months with echocardiographic signs of right ventricular thrombus. Further examination revealed low level of protein C and mutations in methylenetetrahydrofolate reductase and plasminogen activator inhibitor-1 genes. Basing on this observation, the authors recommend purposeful search for genetic thrombophilia in children with history of prolonged catheterization of veins and prophylactic anticoagulation therapy in case of positive result. article describes a case of intracardiac thrombosis in a child 1 year 7 month having a reduction of protein C and mutations in the genes of methylenetetrahydrofolate reductase and plasminogen activator inhibitor 1. e suffered a subclavian vein catheterization in the neonatal period. The patient was hospitalized in serious condition. According to the results of echocardiography revealed a thrombus in the right ventricle. This case shows that the intracardiac thrombi in children are the result of exposure to many of prothrombotic factors. With this in mind, the authors recommend a survey of genetic thrombophilia children having long vein catheterization and use of anticoagulation therapy as a prophylactic measure.
Asunto(s)
Cardiopatías/etiología , Trombofilia/complicaciones , Trombosis/etiología , Ecocardiografía , Femenino , Cardiopatías/patología , Ventrículos Cardíacos/patología , Humanos , Lactante , Metilenotetrahidrofolato Reductasa (NADPH2) , Mutación , Inhibidor 1 de Activador Plasminogénico/genética , Terapia Trombolítica , Trombofilia/genética , Trombosis/tratamiento farmacológico , Trombosis/patologíaRESUMEN
BACKGROUND: The article is devoted to the study of clinical and laboratory characteristics of the current of hemorrhagic vasculitis in children in the Republic of Buryatia. PATIENTS AND METHODS: The study included 27 patients aged 7.6 +/- 4.02 years, who conducted clinical and laboratory tests, immunological study of antiphospholipids of antibodies, genetic testing for thrombophilia markers of candidate genes. RESULTS: The results showed that hemorrhagic vasculitis often affects children of Buryat nationality. In 96% of cases there are mixed clinical forms of the disease. 63% of children of hemorrhagic vasculitis preceded by various factors, a higher percentage of infectious diseases. The first clinical symptom in 63% of patients is a typical purpura hemorrhagic rash. Results of clinical laboratory blood tests revealed no significant deviations. Circulation of lupus anticoagulant was detected in 37% of subjects. The alphaCL IgM detected in 3 children, alphabeta2-GP-I IgA--in 4, alphabeta2-GP-I IgM--in 1 patient. Carriers of thrombophilia polymorphisms were in 95% of children. Noted that homozygous variants of genes polymorphisms of methylenetetrahydrofolatered reductase and plasminogen activator inhibitor-1 correlate with the presence of urinary symptoms and recurrence of the rash. CONCLUSION: The study shows the risk of recurrent flow of hemorrhagic vasculitis and nefritis of Henoch-Schonlein in children with thrombophilia gene polymorphism.
Asunto(s)
Vasculitis por IgA , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Inhibidor 1 de Activador Plasminogénico/genética , Trombofilia , Niño , Preescolar , Exantema/fisiopatología , Femenino , Predisposición Genética a la Enfermedad/epidemiología , Humanos , Vasculitis por IgA/complicaciones , Vasculitis por IgA/epidemiología , Vasculitis por IgA/genética , Vasculitis por IgA/inmunología , Vasculitis por IgA/fisiopatología , Masculino , Monitorización Inmunológica , Polimorfismo Genético , Recurrencia , Federación de Rusia/epidemiología , Trombofilia/complicaciones , Trombofilia/epidemiología , Trombofilia/genética , Trombofilia/inmunología , Trombofilia/fisiopatología , Sistema Urinario/fisiopatologíaRESUMEN
Aim. To determine limits of interval QT in children and adolescents aged 0-17 years and to detect possible ethnic differences of its changes. Material and Method. Twelve lead ECGs were recorded in 1531 subjects without overt cardiovascular pathology (47.2% females, 52.8 males, 57.3% of Slavic and 42.7% of Buryat i.e. mongoloid ethnicity). Results. Corrected QT interval (QTc) exceeded 440, 460 and 480 ms in 2.3, 1.05, and 0.26% of children. Prolongation of QTc was found in 0.46% and 0.11% of Slavic and Buryat children, respectively (p=ns). Starting from the age of 8 years girls had longer QTc than boys (454.1+/-15.2 and 438.3+/-8.4 ms, respectively, p<0.05). QTc less than 350 ms was registered in 12 children (0.78%). Eight of these children with mean QTc 329.1+/-32.3 ms had family history of syncope or sudden death. Variability of absolute QT values was 8+/-14.3 ms (maximally up to 40 ms). Conclusions. QT interval is prolonged when QTc duration exceeds 440 ms in children younger than 8 years and in male adolescents or 460 ms in girls aged 8 years or older and in children during first year of life. QT interval is shortened when QTc is less than 350 ms (1st degree of shortening). In children with QTc below 330 ms (2nd degree of shortening) short QT syndrome should be excluded. Normal variability of absolute QT value during sinus arrhythm on ECG at rest does not exceed 40 ms.
Asunto(s)
Electrocardiografía , Síncope , Adolescente , Niño , Cardiopatías , Humanos , Síndrome de QT Prolongado , DescansoRESUMEN
Effectiveness of different regimes of a course exposure to impulse low-intensity electromagnetic field (Infita unit) was studied in 69 adolescents with essential hypertension. A ten-day course of single 9 min procedures with 30 Hz field produced better antihypertensive effects than the regime used in the adults. This treatment provided improvement in bioelectric activity of the brain, mental state, central hemodynamics.