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Pediatric Arterial hypertension

Liu Yang, Lili Yang, Yuanyuan Zhang, Bo Xi
Background: Subclinical target organ damage (TOD) has been common in hypertensive children, but there is limited data in the Chinese pediatric population. This study aimed to investigate the prevalence of subclinical TOD in the Chinese hypertensive children and adolescents. Methods: A cross-sectional study was performed in children and adolescents from four schools in Jinan, China between September 2012 and September 2014. The hypertensive status was confirmed based on elevated blood pressure across three different occasions...
2018: Frontiers in Pediatrics
G F Yan, X D Cai, C B Zhou, X Y Hong, Y Wang, C M Zhang, Z H Yang, Y C Zhang, Y Cui, Y Q Cui, Y B Cheng, S Y Qian, P F Zhang, Y P Jin, X D Zhu, H Gao, Z P Li, X L Lu, H J Miao, Q Y Zhang, Y M Li, W G Yang, C Y Liu, B Li, Y Li, Z J Bo, J P Chu, X Wang, G P Lu
Objective: To survey the conduction and evaluate the effectiveness of extracorporeal membrane oxygenation (ECMO) therapy in pediatric intensive care unit (PICU) in China mainland. Methods: In a questionnaire-based survey, we retrospectively reviewed the application of ECMO in children's hospital and general hospital in China mainland to summarize and analyze the categories of diseases and prognosis of children treated with ECMO therapy. Results: By December 31, 2017, a total of 23 hospitals using ECMO, including 22 tertiary referral hospitals and 1 secondary hospital, among which 16 were children's hospitals and 7 were general hospitals...
December 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Laura Roli, Agnese Veronesi, Maria C De Santis, Enrica Baraldi
BACKGROUND: Sparse metanephrines reference intervals in pediatric populations are available and different study designs and technologies/ assays used in these studies lead to hardly transferable data from a laboratory to another. The objective of the study was to update pediatric reference intervals of total fractionated metanephrines in spot urine samples, using a commercial extraction kit run on a specific high pressure liquid chromatograph coupled with an electrochemical detector. METHODS: 452 spot pediatric urinary samples previously submitted to urinalysis were consecutively included in the study with the exclusion of children's samples with diagnosis or clinical suspicion of paraganglioma/pheochromocytoma, kidney diseases and arterial hypertension...
December 3, 2018: Minerva Pediatrica
Nour C Bacha, Marilyne Levy, Coralie L Guerin, Bernard Le Bonniec, Annie Harroche, Isabelle Szezepanski, Jean M Renard, Pascale Gaussem, Dominique Israel-Biet, Chantal M Boulanger, David M Smadja
BACKGROUND: Pulmonary arterial hypertension (PAH) results from pulmonary vascular disease and may eventually lead to right heart failure and death. Vasodilator therapy has greatly improved PAH prognosis. Circulating microvesicles are considered as surrogate markers of endothelial and hematopoietic cell activation. AIM: Thus, our purpose was to determine if MVs are upregulated in pediatric PAH such as reported in adult patients, and to analyze the impact of vasodilator therapies on MV count and function...
November 28, 2018: Pediatric Pulmonology
Qingyang Cui, Jun Lu, Chong Zhang, Shun Tan
RATIONALE: Paraganglioma is a catecholamine-producing neuroendocrine tumor. Management of paraganglioma including its diagnosis is difficult, because it has no characteristic symptoms and many diseases can manifest as headache and high blood pressure. Herein, we report a rare case of paraganglioma of the abdomen with headache and initial normal blood pressure. PATIENT CONCERNS: A 9-year-old Chinese girl was hospitalized because of intermittent headache persisting for more than 9 months and recurrent headache for 15 days, accompanied by weight loss, impaired heat tolerance, and otherwise normal blood pressure...
November 2018: Medicine (Baltimore)
Martin Koestenberger, Alexander Avian, Massimiliano Cantinotti, Georg Hansmann
The tricuspid annular plane systolic excursion (TAPSE) has evolved into one of the major echocardiographic indicators of systolic right ventricular (RV) longitudinal function in pediatric pulmonary hypertension (PH). Current RV function research in children with PH focusses on multi-parametric approaches that include TAPSE. The RV ejection efficiency (RVEe) is one of the new variables that reflects the relationship of TAPSE divided by the indexed pulmonary vascular resistance (PVRi) measured by cardiac catheterization...
January 1, 2019: International Journal of Cardiology
Hirofumi Sawada, Yoshihide Mitani, Tomotaka Nakayama, Hiroyuki Fukushima, Shigetoyo Kogaki, Takehiro Igarashi, Fukiko Ichida, Yasuo Ono, Toshio Nakanishi, Shozaburo Doi, Shiro Ishikawa, Masaki Matsushima, Osamu Yamada, Tsutomu Saji
RATIONALE: To detect pulmonary arterial hypertension (PAH) at any early stages is a promising approach to optimize the outcome. OBJECTIVES: To investigate the impact of school electrocardiography(ECG)-based screening on detecting idiopathic or heritable (I/H)-PAH in general pediatric population. METHODS: A nationwide survey of I/H-PAH patients newly diagnosed at 3 months-18years of age in Japan during 2005-12. MEASUREMENTS AND MAIN RESULTS: Eighty-seven eligible patients (age range: 1-16 years) were recruited...
November 14, 2018: American Journal of Respiratory and Critical Care Medicine
Mohamad Ezzeldin, Eslam W Youssef, Ali Sultan-Qurraie, Eugene Lin, Osama O Zaidat
The anterior cerebral artery (ACA) is a unique artery with many important variations with substantial clinical significance. Tortuous intracranial arteries usually occur in basilar, communicating, anterior, posterior cerebral arteries and in the white matter arterioles. This could happen for many reasons including but not limited to ageing, hypertension, patients with Moyamoya disease, congenital malformation, or increased flow associated with elastin degradation. While dolichoectasia of the ACA has been described even in children, to our knowledge, a serpiginous ACA without ectasia has not been reported, especially in the pediatric population...
October 2018: Interventional Neurology
Mohamed N El-Gamasy, Walid Ahmed El-Shehaby
INTRODUCTION: Acute nephritic syndrome (ANS) is the most common cause of hypertensive heart failure in pediatric population. There are few publications on myocardial evaluation using electrocardiographic and echocardiographic data in pediatric patients with ANS. This study aimed to evaluate myocardial function by electrocardiography and 2-dimensional echocardiography in Egyptian pediatric patients with ANS. MATERIALS AND METHODS: Sixty children with ANS were included and subjected to clinical, laboratory, electrocardiography for corrected QT interval, and 2-dimensional echocardiographic study on admission, and repeated at 6 and 12 weeks to measure left ventricular ejection fraction, left atrium-aorta ratio, and the ratio of peak early filling (E wave) to late diastolic filling (A wave) velocities (E/A ratio)...
October 2018: Iranian Journal of Kidney Diseases
Abderrahim Marouane, Elisabeth A M Cornelissen, Anneliese Nusmeier, Charlotte M H H T Bootsma-Robroeks
OBJECTIVE: Blood pressure (BP) monitoring in children immediately after kidney transplantation is ideally performed with an arterial line. Accurate measurement of BP is necessary for optimal management. However, during the first days postoperative, the arterial line is removed and BP measurement is switched to a non-invasive device. The aim of this study was to determine the accuracy and reliability of the automated oscillometric device compared to invasive arterial BP (IBP) monitoring in patients after renal transplantation in pediatric intensive care unit (PICU)...
October 25, 2018: Pediatric Transplantation
Michael S Bohnen, Lijiang Ma, Na Zhu, Hongjian Qi, Conor McClenaghan, Claudia Gonzaga-Jauregui, Frederick E Dewey, John D Overton, Jeffrey G Reid, Alan R Shuldiner, Aris Baras, Kevin J Sampson, Marta Bleda, Charaka Hadinnapola, Matthias Haimel, Harm J Bogaard, Colin Church, Gerry Coghlan, Paul A Corris, Mélanie Eyries, J Simon R Gibbs, Barbara Girerd, Arjan C Houweling, Marc Humbert, Christophe Guignabert, David G Kiely, Allan Lawrie, Rob V MacKenzie Ross, Jennifer M Martin, David Montani, Andrew J Peacock, Joanna Pepke-Zaba, Florent Soubrier, Jay Suntharalingam, Mark Toshner, Carmen M Treacy, Richard C Trembath, Anton Vonk Noordegraaf, John Wharton, Martin R Wilkins, Stephen J Wort, Katherine Yates, Stefan Gräf, Nicholas W Morrell, Usha Krishnan, Erika B Rosenzweig, Yufeng Shen, Colin G Nichols, Robert S Kass, Wendy K Chung
BACKGROUND: In pulmonary arterial hypertension (PAH), pathological changes in pulmonary arterioles progressively raise pulmonary artery pressure and increase pulmonary vascular resistance, leading to right heart failure and high mortality rates. Recently, the first potassium channelopathy in PAH, because of mutations in KCNK3, was identified as a genetic cause and pharmacological target. METHODS: Exome sequencing was performed to identify novel genes in a cohort of 99 pediatric and 134 adult-onset group I PAH patients...
October 2018: Circulation. Genomic and precision medicine
Yuri Sonoda, Kenichiro Yamamura, Kanako Ishii, Kazuhiro Ohkubo, Kenji Ihara, Yasunari Sakai, Shouichi Ohga
Prostaglandin I2 (PGI2) causes hyperthyroidism, a critical complication in patients with pulmonary arterial hypertension (PAH). However, it remains unknown whether PGI2 may have unfavorable effects on thyroid functions in children with congenital portosystemic venous shunt syndrome (CPSVS). We present a boy with CPSVS who developed PAH at 7 years of age. During the PGI2 therapy, he experienced thyrotoxicosis at 17 years of age. The literature review showed that the past 12 patients with PAH (median 11 years of age) developed hyperthyroidism during 1 to 11 years of PGI2 treatments...
October 16, 2018: Journal of Clinical Research in Pediatric Endocrinology
T Ueno, S Hiwatashi, R Saka, H Yamanaka, Y Takama, Y Tazuke, K Bessho, S Kogaki, T Yonekura, H Okuyama
Pediatric living donor liver transplantation (LDLT) in patients with advanced portopulmonary hypertension (PoPH) is associated with poor prognoses. Recently, novel oral medications, including endothelin receptor antagonists (ERAs), phosphodiesterase 5 (PDE5) inhibitors, and oral prostacyclin (PGI2) have been used to treat PoPH. Pediatric patients with PoPH who underwent LDLT from 2006 to 2016 were enrolled. Oral pulmonary hypertension (PH) medication was administered to control pulmonary arterial pressure (PAP)...
March 15, 2018: Transplantation Proceedings
Ammar Al-Mashhadi, Michael Häggman, Göran Läckgren, Sam Ladjevardi, Tryggve Nevéus, Arne Stenberg, A Erik G Persson, Mattias Carlström
BACKGROUND: As much as 20% of all cases of hypertension are associated with kidney malfunctions. We have previously demonstrated in animals and in pediatric patients that hydronephrosis causes hypertension, which was attenuated by surgical relief of the ureteropelvic junction (UPJ) obstruction. This retrospective cohort study aimed to investigate: (1) the proposed link between hydronephrosis, due to UPJ obstruction, and elevated arterial pressure in adults; and (2) if elevated blood pressure in patients with hydronephrosis might be another indication for surgery...
October 8, 2018: Upsala Journal of Medical Sciences
Shinichi Takatsuki, Shun Yanai, Satoshi Ikehara, Tomotaka Nakayama, Horoyuki Matsuura
Syncope is more common in children with idiopathic pulmonary arterial hypertension (PAH) than in adults with PAH. Although syncope is associated with a poor prognosis in adult PAH, the clinical effects of syncopal events on disease severity and outcome in children have not been carefully investigated. This study assessed the prevalence of syncope in pediatric PAH and examined its clinical, hemodynamic, and prognostic importance. This retrospective study assessed clinical data, including syncope status, from 78 children (37 girls) with idiopathic and heritable PAH (median age at diagnosis, 11 years)...
October 5, 2018: Pediatric Cardiology
Eve Grillo Carvalho, Henrique Guarino Colli Peluso, Lorena Luana Batista, Cissa Santos Moreira, Juliana Suzano Moraes Protti, Maria Cristina Bento Soares, Aline de Freitas Suassuna Autran, Amanda Rocha Soares Almeida, Denise Cristina Rodrigues, Lívia Verônica Grillo Romano Bernardes, Luciana Pimenta de Paula
INTRODUCTION: The posterior reversible encephalopathy (PRES) syndrome encompasses a set of clinical-radiological findings associated with severe systemic arterial hypertension. This case report proposes to discuss the identification, diagnosis, and management of PRES in the pediatric population. CASE PRESENTATION: Female patient, 10 years old, admitted to the emergency room with complaint of oliguria and generalized edema. At the initial physical exam, the only alteration present was anasarca...
September 21, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Hanno H Leuchte, Henrik Ten Freyhaus, Henning Gall, Michael Halank, Marius M Hoeper, Harald Kaemmerer, Christian Kähler, Gabriela Riemekasten, Silvia Ulrich, Martin Schwaiblmair, Ralf Ewert
In the summer of 2016, delegates from the German Respiratory Society, the German Society of Cardiology and the German Society of Pediatric Cardiology met in Cologne, Germany, to define consensus-based practice recommendations for the management of patients with pulmonary arterial hypertension (PAH). These recommendations were built on the 2015 European Pulmonary Hypertension guidelines and included new evidence, where available, and were last updated in the spring of 2018. This article focusses on the proposed risk stratification and assessment of disease progression in patients with pulmonary arterial hypertension (PAH), covering 3 parts: In part 1, methods and markers that are recommended to assess severity and progression of PAH are discussed and commented...
September 13, 2018: International Journal of Cardiology
Rohit S Loomba, Seth B Gray, Saul Flores
INTRODUCTION: Ketamine is a drug often used for procedural sedation or as adjunct agent for general sedation in children with congenital heart disease. In the clinical realm, there is often confusion regarding the effects of ketamine on hemodynamics, particularly pulmonary vascular resistance and systemic vascular resistance. We performed a meta-analysis of studies investigating the effects of ketamine on hemodynamics. METHODS: A systematic review was conducted to identify studies characterizing the hemodynamic effects of ketamine in children with congenital heart disease...
September 27, 2018: Congenital Heart Disease
Piers Blackett, Minu George, Don P Wilson
Pediatric lipid screening and management with the aim of reducing and preventing adult disease is an internationally accepted concept, and guidelines have been published in several countries. However, implementation by the practicing pediatric community in the United States has been less than expected and delays have been attributed to uncertainty among providers. Reduced screening rates have also been reported for conditions contributing to arterial wall pathology such as obesity, hypertension, and prediabetes despite accumulating evidence that detection and intervention can lead to risk reversal...
August 29, 2018: Journal of Clinical Lipidology
Li Jiang, Wei Sun, Kai Zhang, Bin Zhou, Xiangqing Kong
Sildenafil is a pulmonary artery hypertension (PH)-targeted drug that finds an increased indiscriminate use in children with PH secondary to congenital heart disease (CHD).We performed a meta-analysis to evaluate the effects of sildenafil on pediatric patients with PH secondary to CHD during perioperative period.PubMed, EMBASE, the Cochrane Library, and the Google Scholar were searched up to May 2016 for randomized controlled trials (RCTs) assessing the perioperative treatment of sildenafil in pediatric patients with PH secondary to CHD...
September 25, 2018: International Heart Journal
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