[Is infection with group A streptococcus the only reason for rheumatic fever?--a case report of rheumatic fever coexisting with Coxsackie B1 virus infection]. / Czy zakazenie paciorkowcem grupy A jest wylaczna infekcyjna przyczyna goraczki reumatycznej?--opis przebiegu goraczki reumatycznej u 11-letniego chlopca ze wspólistniejaca infekcja wirusem Coxackie B1.

The course of rheumatic fever in 11 years old boy is described. The significance of cellular immunity in rheumatic fever pathogenesis and the importance of virus infection coexistence is emphasized in discussion.

Association of lipid metabolism with subclinical diabetic cardiomyopathy in children and adolescents with type 1 diabetes.

UNLABELLED: Nowadays, it is known that atherosclerosis is not a disease affecting elderly people but that it starts as early as in childhood. Children with diabetes mellitus are particularly prone to early development of atherosclerosis. It seems advisable to evaluate the behaviour of lipoprotein (a), apolipoprotein B (atherogenic factors), and apolipoprotein A-I in this group of patients as possible causal or preventive factors of the developing diabetic cardiomyopathy. The purpose of this study was to evaluate the effect of the intensification of lipid metabolism disorders on systolic-diastolic parameters of heart ventricles in children and adolescents with insulin-dependent diabetes mellitus. The study was performed on 19 children and adolescents (11 boys and 8 girls) at the age of 8.4-18.5 (x = 14.2) who have had insulin-dependent diabetes mellitus for 1.5 to 14 years (x = 7.9 years). Control group consisted of 17 healthy children. All patients were subjected to full echocardiographic examination which measured the systolic-diastolic activity of both heart ventricles, and to examinations determining the presence of complications (including the subclinical ones). Additionally, patients had their lipid metabolism parameters defined, i.e.: Lp(a), apo A-I, apo B, triglycerides, cholesterol and its LDL and HDL fractions. CONCLUSIONS: 1. Children and adolescents with type 1 diabetes mellitus have higher concentration of Lp(a) and apolipoprotein B irrespective of the degree of diabetes control, which makes them prone to premature development of atherosclerosis. 2. Lipid metabolism disorders do not have direct influence on the development of diabetic cardiomyopathy in young patients with type 1 diabetes mellitus.

Elevated concentrations of homocysteine in children and adolescents with arterial hypertension accompanying Type 1 diabetes.

BACKGROUND: Ischemic heart disease is the primary cause of morbidity and mortality among diabetics, especially those who became ill at a young age. In evaluating the risk of the development of atherosclerotic changes, especially when occurring prematurely, increasing attention is being paid to new, unconventional risk factors. One of many such new factors, and one whose role in the development of atherosclerotic changes currently seems to be beyond dispute, is homocysteine. The purpose of this article is to evaluate the concentration of homocysteine in children and youth with Type 1 diabetes, and to attempt to determine the dependence between homocysteine and the degree of metabolic control, the duration of the illness, the age at onset, the insulin dose, the appearance of complications, and a family history of ischemic heart disease. MATERIAL AND METHODS: Our research involved 103 children and youth (average age 13.3 years) with Type 1 diabetes, with an average duration of illness of 5.3 years. The control group consisted of 44 healthy, non-obese children. The concentration of homocysteine was measured using the AXIS homocystein EIA immunoenzymatic method with a set of reagents from the Bio Rad company. RESULTS: The average homocysteine concentration in the experimental group was 5.6 micromol/L, which did not constitute a significant difference from the control group's 6.1 micromol/l. No statistically significant differences were discovered in the concentration of homocysteine depending on the degree of metabolic control, age at onset, method of insulinotherapy, or family history. A significant increase in the concentration of homocysteine was found in children who had been ill for a long time (more than 10 years): 6.1 micromol/L, as against 5.1 micromol/l in children who had been ill for a shorter period of time, and a significantly higher concentration of Hcy in children with diabetic complications (6.1 vs 5.3 micromol/L) and in children with arterial hypertension. CONCLUSIONS: The significant increase in the concentration of homocysteine in children with Type 1 diabetes and arterial hypertension indicates that this group is particularly exposed to early atherosclerotic changes, independently of metabolic control and the parameters of lipid metabolism, and requires the implementation of treatment aimed at reducing the blood concentration of homocysteine.