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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this series of one hundred and twenty-eight adults with Down's syndrome nearly half (i.e. 42.2 per cent) developed a normal EEG. This would appear to bear out the findings of Gregoziades and Pampiglione (1966) that older children with this syndrome tended to have tracings similar to the normal child. The youngest age group of fifteen to twenty-four years developed a normal tracing in 38.9 per cent of cases. The most frequent abnormality was an excess of theta, in keeping with the suggestion of Godinova and Hirai and Izawa that this was due to immaturity. Neither the presence of congenital heart disease nor diabetes nor intercurrent illness appeared to have any effect on the development of seizures. Epilepsy developed at any time during adult life but, not surprisingly, the five cases developing it had shown sharp or paroxysmal activity previously. Two had suffered from fainting attacks. In one, the diagnosis was confirmed later by a typical grand mal seizure and the other by response to anticonvulsants. Neither suffered from congenital heart disease.
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PMID:The EEG and incidence of epilepsy in Down's syndrome. 15 92

In children with congenital heart disease pulmonary vascular disease can be fatal for a variety of reasons. Even before the classical changes of advanced pulmonary vascular obstructive disease have developed, a marked increase in pulmonary vascular smooth muscle can be fatal due to pulmonary hypertensive crises. After the Fontan procedure, a modest increase in muscularity can jeopardise the outcome since there is no subpulmonary ventricle to support the pulmonary circulation. Following heart transplantation, a slight increase in muscularity can cause failure of the donor right ventricle unless that heart is already hypertrophied as in the domino procedure. In all children with pulmonary hypertension, either persistent pulmonary hypertension of the newborn or secondary to congenital heart disease the pulmonary vasculature fails to remodel normally after birth. Newborn vessels are characterized by the immaturity of the smooth muscle cells and the paucity of connective tissue. In the hypertensive lung smooth muscle differentiation and connective tissue deposition is accelerated. In children with congenital heart disease intimal changes follow. In these children the potential reversibility of disease following intracardiac repair is determined by the type of pathological change present at the time of repair. However, pulmonary hypertensive crises can occur in young children with potentially reversible disease. Operability is not synonymous with the potential reversibility of pathological lesions. Correlations between structural findings at lung biopsy and haemodynamic findings at cardiac catheterization have improved the accuracy with which the natural and unnatural history of pulmonary vascular disease can be predicted, but is still inadequate because we do not understand the functional implications of the changes.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pathophysiological and metabolic manifestations of pulmonary vascular disease in children. 139 33

In contrast to the older infant or child in whom arrhythmias are usually secondary to congenital heart disease, arrhythmias in the small, preterm infant are most commonly secondary to central nervous system immaturity or extrinsic causes. Bradycardia is the most common arrhythmia observed in this population. The staff involved in the care of these extremely fragile and usually complicated patients have to be aware of the possibility of other rhythm disturbances occurring in such patients; this will help recognition and appropriate management of the individual cases.
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PMID:Arrhythmias in the tiny, premature infant. 242 61

The behaviour of cardiopathies and the prognosis for labour was studied in 44 pregnant women with heart disease admitted to Muscatello Hospital Augusta in 1969-87. Improved cardiological and obstetric treatment together with the interdisciplinary approach adopted since 1971 eliminated maternal deaths and drastically reduced complications in pregnancies. Caesarian section was adopted in all but class I cases and was well tolerated. Puerperium passed without incident and the patients were up by the second or third day, released on day 8. There was also a distinct improvement in foetal prognosis with fewer small for date births and only one death due to foetal immaturity.
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PMID:[Cardiopathies, pregnancy and labor in our hospital practice. Clinical cases from 1969 to 1987]. 260 98

The mortality rates (MRs) of children under 5 years of age in the various population groups of the RSA were calculated as deaths/10(5) for various causes of death and groupings of causes of death as classified by the International Classification of Diseases. In 1970 the ten leading causes of death among Coloured and Black children under 5 years of age in the RSA were similar to those among children in developing countries. The rank order of causes of death (in MRs/10(5] among Coloured children was as follows: gastro-enteritis (1 733), pneumonia (725), immaturity (405), ill-defined causes of death (168), nutritional deficiencies (167), measles (126), anoxia (97), 'other bacterial diseases' (91), inflammatory diseases of the nervous system (55) and tuberculosis (48). The ten leading causes of death among White children in the RSA were characteristic of children in Western developed countries. The rank order (in MRs/10(5] was as follows: immaturity (144), anoxia (94), pneumonia (46), gastro-enteritis (41), congenital heart disease (32), other accidents (19), birth injury (19), ill-defined causes of death (12) and inflammatory diseases of the nervous system (11).
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PMID:Leading causes of death among children under 5 years of age in the various population groups of the RSA in 1970. 649 19

The endocrine phase of the stress response to cardiopulmonary bypass in children is known to be subtly different from that seen in adults. The aim of this investigation was to determine whether there are similar differences in the acute phase response. Thirteen children were studied (mean age 2.65 years). Each child had congenital heart disease and underwent corrective cardiac surgery. Blood samples taken two days prior to operation and at 6, 9, 12, 24, 48 and 120 hours after were analysed for C-reactive protein, albumin, caeruloplasmin, zinc and copper concentrations. Metal:carrier protein molar ratios were also calculated. Results demonstrate changes which, although similar to those seen in adults, differed both quantitatively and qualitatively. This is explained by the concept of immaturity leading to a generally poor capacity for protein synthesis and a relative inability to respond to altered circumstances.
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PMID:The acute phase response to cardiopulmonary bypass in children. 874 Mar 51

We report on a female preterm infant with hepatic failure and neonatal tissue siderosis of hemochromatotic type diagnosed by using both histochemistry and atomic absorption spectroscopy. The infant presented with meconium ileus, signs of rapidly progressive hepatic failure, and hyperferritinemia (7132 ng/ml). Despite surgery and intensive care the infant died 32 days after birth. Postmortem examination showed a wrinkled liver with extensive collapse of the hepatic architecture and regenerating nodules as well as hepatic and extrahepatic iron accumulation of hemochromatotic type, sparing the reticuloendothelial system. Atomic absorption spectroscopy confirmed an increase in the iron content of various organs: liver, heart, pancreas, oral salivary gland, kidney, and adrenal gland. The increase in the iron content of various organs was determined by comparing the analysis of the propositus with those of 5 gestationally age-related preterm infants who had died in the intensive care unit: 2 died of meconium aspiration syndrome, the other 3 of hyaline membrane disease, bronchopulmonary dysplasia, and immaturity, respectively. We also compared the analysis of 15 fetuses having a a condition predisposing to iron accumulation (trisomy 21, trisomy 18, cytomegalovirus, amnion infection syndrome, Rhesus- and ABO-incompatibility, congenital hemolysis, anti-phospholipid syndrome, congenital heart disease). Delta F508, the most frequent mutation seen in cystic fibrosis patients, was excluded by gene sequencing. Different noxae causing iron accumulation in the neonatal period have led to the statement that neonatal hemochromatosis may collect different etiologies, such as metabolic disorders, infections, chromosomal aberrations, and immunological disorders. In this study, we report the singular evidence of neonatal iron accumulation of hemochromatotic type in an infant presenting with meconium ileus and propose a classification of the neonatal disorders associated with iron accumulation.
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PMID:Hepatic failure with neonatal tissue siderosis of hemochromatotic type in an infant presenting with meconium ileus. Case report and differential diagnosis of the perinatal iron storage disorders. 1170 Aug 92

This paper presents a study of adolescent pregnancy in which different age groups were compared to establish which age group had the greatest incidence of risk factors. Primiparous adolescents who delivered at the Obstetric Clinic of the Medical School of the University of Sao Paulo, Brazil, between January 1975 and June 1980 were studied. During this period, 13,961 births occurred, of which 105 were to 9-15 year olds (0.7%), 137 were to 16 year olds (0.9%) and 106 were to 17 year olds (0.7%). A large majority of the adolescents in each age group were unmarried; similarly, a lack of adequate prenatal care was observed in all 3 groups. A gestational age of less than 38 weeks was encountered in 30.5% (30 cases), and 16.9% (18 cases), respectively, in the 9-15, 16, and 17 year age groups. Among pregnancy complications, there was an elevated incidence of arterial hypertension in all 3 groups, as well as an increased occurrence of eclampsia among the 9-15 year olds. Urinary infections and anemia were also evident during pregnancy. Analgesia was required in 22 cases (20.9%) of the 9-15 year old age group, in 3 cases (2.2%) of the 16 year age group, and in 2 cases (1.9%) of the 17 year age group. Fetal presentation, duration of labor, type of birth (normal, forceps, or cesarean), puerperal morbidity, birth weight, and perinatal mortality for each of the 3 groups are presented in tables. Neonatal deaths were determined to be the consequence of prematurity and its complications except in 1 case of congenital heart disease which occurred in the 17 year old group. Neonatal jaundice was the most frequent cause of morbidity in the newborns. The results of this study agree with those of similar studies appearing in the literature. The authors attribute the greater frequency of premature births among 9-16 year olds to immaturtity of uterine muscle fiber, deficient prenatal care, and the emotional tensions to which the adolescents were subjected, as well as to medical complications of pregnancy and general maternal physical immaturity. The 17 year olds presented behavior closer to that of the adult population.
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PMID:[Pregnancy in the adolescent. II. Comparative study between primigravida from 9 to 15, 16 and 17 years old]. 1226 72

We identified seventeen infants with Down syndrome without structural congenital heart disease who presented with persistent pulmonary hypertension in the newborn period. Respiratory distress with or without hypoxia was the presenting feature in these infants. Pulmonary hypertension resolved in the majority of the survivors. Two infants with refractory pulmonary hypertension benefited from patent ductus arteriosus ligation. Autopsies in two infants demonstrated structural lung immaturity. We suggest that infants with Down syndrome are at risk of developing persistent pulmonary hypertension even in the absence of structural heart disease and these infants should be followed up until resolution of the pulmonary hypertension.
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PMID:Clinical characteristics and follow up of Down syndrome infants without congenital heart disease who presented with persistent pulmonary hypertension of newborn. 1508 94

In the pediatric age group shortage of donor hearts leads to mortality rates of 30-50% on the waiting list. Because of the immaturity of the immune system of infants, ABO-incompatible heart transplantation may be an option to increase donor availability. We transplanted two infants with blood type O at the age of 7 and 5 months, respectively, with complex congenital heart disease. Intraoperative plasma exchange was performed during cardiopulmonary bypass followed by standard immunosuppression. Both recipients received a blood type A donor organ. Plasma was exchanged up to six times until anti-A antibodies were eliminated. No hyperacute rejection occurred, ventricular function is excellent and there have been no acute rejection episodes up to 4 months after transplantation. Anti-A antibody titers remained low and eventually disappeared. ABO-incompatible cardiac transplantation shows good short-term results in young infants and appears to be a safe procedure to reduce mortality on the waiting list.
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PMID:Successful ABO-incompatible heart transplantation in two infants. 1616 9


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