Acquired left ventricular submitral aneurysms in the course of Takayasu arteritis in a child.

A 9-year-old black African boy was hospitalized for heart failure revealing a severe left ventricular dysfunction associated with dilated cardiomyopathy, two submitral aneurysms, occlusion of the circumflex artery and a giant coronary artery aneurysm on the proximal left anterior descending artery. The boy was coinfected with human immunodeficiency virus and Mycobacterium tuberculosis. Though rare, association of Takayasu arteritis and submitral aneurysm leads to rethinking the pathogenesis of submitral aneurysm and suggests that some of them may be acquired. In our case, a common inflammatory process, possibly triggered by tuberculosis or HIV, may underlie Takayasu and submitral aneurysms.

Exercise training and cardiovascular risk factors in type 1 diabetic adolescent girls.

Sixteen postmenarcheal Type 1 diabetic adolescent girls were randomized into training (involving aerobic and strength exercises) and nontraining groups. Body composition (skinfold thickness), aerobic fitness (PWC170), plasma lipids, serum apolipoproteins, lipoprotein(a), leptin, and adiponectin were assessed before and after the 6-month period. After the 6-month period, fat mass and leptin increased significantly in the nontraining group but not in the training group. Conversely, in the latter group, fat-free mass increased (P < .01). Moreover, PWC170 improved and apolipoproteinB:apolipoproteinA-1 ratio decreased with physical training (P < .05). Thus, physical training reduces cardiovascular risks and the increase of insulin resistance risk factors in diabetic adolescent girls.

Normal physical working capacity in prepubertal children with type 1 diabetes compared with healthy controls.

BACKGROUND: Exercise testing has become a valuable help for the physician to examine the influence of recommended exercise training on physical fitness. However, the question as to how diabetic prepubertal children differ from their non-diabetic peers in their performance capacity has only partial and sometimes conflicting answers in the literature. AIM AND METHODS: The aim of the current study was thus to evaluate aerobic fitness during an incremental submaximal test (measure of the Physical Working Capacity 170 (PWC170)) in 17 well-controlled prepubertal insulin-dependent diabetic boys aged 8.5-13 y. Eighteen healthy prepubertal boys matched for age, body size and physical activity served as controls. Part of the method was to check capillary blood glucose level in the diabetic patients and in nine of the healthy subjects throughout the exercise. RESULTS: From this experiment it appeared that the level of physical fitness was similar in diabetic and healthy boys (PWC170 2.28+/-0.09 vs 2.37+/-0.13 W x kg(-1)). While glucose homeostasis was well maintained in the healthy group, diabetic children showed a marked fall in blood glucose during the exercise. In addition, the PWC170 level correlated significantly with the estimate of energy expenditure attributed to vigorous activities in the diabetic boys. CONCLUSION: By studying the responses to incremental exercise there is growing evidence that normal physical fitness is preserved in diabetic prepubertal boys given appropriate involvement in physical activity.