Do quantitative levels of cardiac troponin I implicate on severity of disease in children, adolescences, and young adults with acute myocarditis and myopericarditis?

OBJECTIVES: When cardiac muscle damage occurs, cardiac troponins are released to blood and their detection is used as a marker in clinical setting. The prognostic value of the quantitative levels of blood troponin I in cases of myocarditis and myopericarditis is unclear. The aim of this study was to analyse whether troponin quantitative blood levels can be correlated with the course of hospitalisation and prognosis. METHODS: Retrospective data was collected from all consecutive patients aged ≤30 hospitalised with a diagnosis of acute myocarditis or acute myopericarditis in our health Care Campus between the years 2010-2016. RESULTS: Ninety-three patients with myocarditis and myopericarditis were identified. Higher peak troponin levels correlated with longer hospitalisation times in the cardiac or paediatric wards (p = 0.03, Pearson correlation: r -0.23), and median troponin level at admission correlated with longer overall hospitalisation (p = 0.026, Pearson correlation: r = 0.23). Patients admitted to ICU, received oral cardiac supportive therapy or that were discharged with cardiac drugs had higher median troponin compared to patients who were not but this was not statistically significant. A small group of patients that needed intravenous cardiac support had significantly lower median peak troponin levels (n = 4, 0.375ng/ml, p = 0.048). Only two patients needed extracorporeal membrane oxygenation support, and one died. The small number of patients precludes statistical analysis. CONCLUSION: Higher troponin levels correlated significantly with longer hospitalisation, lower troponin values correlated with intravenous cardiac support, while other variables related to the severity of disease could not be significantly related to higher troponin levels.

Rapid response of a cardiac rhabdomyoma causing severe right ventricular outflow obstruction to Sirolimus in an infant with negative genetics for Tuberous sclerosis.

Mammalian target of rapamycin inhibitors was found recently to be an effective treatment for manifestations of Tuberous sclerosis complex, including cardiac rhabdomyomas. Most cases with Cardiac rhabdomyoma treated with mammalian target of rapamycin inhibitors to date were diagnosed with Tuberous sclerosis. We report a case of cardiac rhabdomyoma and severe right ventricular outflow obstruction in a baby with negative genetics for Tuberous sclerosis that responded rapidly to Sirolimus.

[Non-traumatic unintentional injuries and risk factors for hospitalization in children presenting to a pediatric emergency department].

OBJECTIVE: Unintentional injuries are a major cause of morbidity and mortality in children. The authors present the results of a study in which data was collected regarding unintentional injuries presented to the Pediatrics Emergency Department (PED) at Ha'Emek Medical Center. The present study represents the first collection and analysis of such data gathered from the Pediatric Emergency Department in Northern Israel. METHODS: This was a prospective study in which data was collected regarding children who presented with non-traumatic unintentional injuries to the Pediatric Emergency Department (PED) between the years 2000 and 2002. The injuries presented included poisoning, aspiration and swallowing of foreign bodies, smoke inhalation and near drowning. Data collected included the type of injury, location and time of the accident, and data regarding the child and his family. The authors examined the association between variables in order to identify the risk factors for hospitalization. RESULTS: Of 412 children, 59% were males and 41% were females. Seventy-three percent of all accidents happened in the child's home or yard, and 36.5% occurred during the summer. Poisoning was the most common unintentional injury (61% of cases) and house cleaning material was the most common source of poisoning. The probability of hospitalization was higher for the following situations: aspiration of foreign bodies, injuries that occurred during the summer, children of Arab ethnicity and patients presenting to the hospital at night. IN CONCLUSION: This study presents initial data regarding these types of injuries from the Jezreel Valley. These data may help establish and target prevention programs.

Incidence and clinical manifestations of breast milk-acquired Cytomegalovirus infection in low birth weight infants.

OBJECTIVES: To determine the incidence and clinical manifestations of human breast milk (HMB)-associated acquired cytomegalovirus (CMV) infection in small premature infants. STUDY DESIGN: A prospective study of premature infants born at or prior to 32 weeks gestation, and or infants weighing 1500 g or less at birth. The babies were divided into two groups: Group 1 included babies of CMV seropositive mothers who received HBM throughout the study period. Group 2 included babies of seronegative mothers or babies that did not receive HBM at all. Urine sample were obtained once weekly from birth until the age of 8 weeks or until discharge and were tested for the presence of CMV-DNA by PCR. RESULTS: Four of 70 infants from group 1 (5.7%, 95% CI, 0 to 11%) acquired CMV infection between the ages of 3 and 7 weeks as compared to none of 26 babies in group 2. Only one infected baby had severe CMV disease with complete recovery. CONCLUSION: The relative incidence of HBM-associated CMV infection and the severity of HBM-associated CMV disease in premature infants are low.