Intravascular Ultrasound for Assessment of Residual Coarctation of the Aorta after Balloon Angioplasty in Infants.

Intravascular ultrasound (IVUS) has been introduced as an accurate and minimally invasive diagnostic technique for the assessment of vascular anatomy and its abnormalities. We believe that IVUS can be used for clarifying the reasons for failure of balloon angiography in infantile coarctation of the aorta (CoA), because post-balloon angioplasty tearing, intimal flap, thrombosis and pseudoaneurysm of the aorta can be evaluated by IVUS with greater sensitivity and specificity. We aimed to assess the outcome of balloon angioplasty of CoA using angiography as the gold standard and IVUS as a new method in infants, comparing the two techniques for the evaluation of the diameter and area of CoA segment pre- and post-procedure. This cross-sectional study was performed on 18 infants hospitalized with a final diagnosis of CoA. All the infants underwent angiography and were also assessed by IVUS to measure the preoperative and postoperative diameter of the narrow segment in the two anterior-posterior and lateral views. In assessment by IVUS, the mean diameter of the coarctation site increased from 2.10 ± 0.30 mm to 4.50 ± 0.94 mm (P < 0.001). Similarly, the average minimum area of the coarctation level increased from 5.26 ± 1.50 mm2 to 13.77 ± 3.48 mm2 after angioplasty (P < 0.001). Comparing these findings, angiography and IVUS showed a high level of agreement. In the assessment of a dissection flap, there was a high level of agreement between angioplasty and IVUS before the procedure, but IVUS had higher accuracy after the procedure. Our study showed that IVUS was more reliable than angiography in the assessment of residual coarctation. IVUS yielded high sensitivity (58.3%) and specificity (100%) for discriminating the presence and absence of residual coarctation as well as the need for repeating the procedure. The assessment of coarctation before and after angioplasty procedures in children is possible using the IVUS method, with high accuracy. IVUS can offer greater accuracy than angiography in the evaluation of the coarctation area, detecting tears, dissection and flaps, and assessment of residual coarctation.

Coronavirus and Its effect on the respiratory system: Is there any association between pneumonia and immune cells.

BACKGROUND: With a new mutation, coronavirus has now become an important pandemic that gripped the entire world. Coronavirus infection often begins in the nasopharynx and destroys the olfactory epithelium. Despite many studies, little progress has been made in the treatment of coronavirus. This study aimed to further investigate the pathogenicity of coronavirus to reduce its infection by examining the virus function in the body and its stages of infection. MATERIAL AND METHODS: With the aim of investigating the coronavirus and its effect on the human respiratory system from 1992 to 2020, this study examined the coronavirus and its different aspects and tried to answer whether there is an association between pneumonia and immune cells. This study was conducted in April 2020 and to obtain the related papers on the characteristics of the virus, Nature, ISC Pubmed, Medline WHO, NCBI, and PsycINFO databases were used. Out of 284 papers, 53 were used in this study. RESULT: Studies have shown that avoiding infected areas and strengthening the immune system inhibit the virus to bind the mucosal layers. Given the important role of acquired immunity and lymphocytes against coronavirus, it is necessary to pay attention to boost the immune system in adults and the elderly. Antioxidants help reduce the oxidative stress and inflammation in the immune system thus help it regenerate better. The results showed that children are susceptible to the virus though have lower mortality and clinical manifestations than adults. CONCLUSION: The vaccine should receive further attention and in the long run, antiviral drugs and broad-spectrum vaccines are produced for infectious diseases.

Single Dose Corticosteroid Therapy After Surgical Repair of Fallot's Tetralogy; A Randomized Controlled Clinical Trial.

BACKGROUND: Inflammatory reaction can produce several complications after cardiac surgery. Many attempts have been made to reduce these complications; perioperative corticosteroid therapy is one of the simplest methods. OBJECTIVES: We conducted a randomized study to evaluate the efficacy of single dose methylprednisolone, prescribed after surgery, for reducing the complications. Repair of Tetralogy of Fallot was chosen as a homogenous large group for the study. PATIENTS AND METHODS: One hundred children who underwent total repair of Tetralogy of Fallot were enrolled in this study. After the surgery, all patients were transferred to pediatric ICU and were randomized (in a double-blind fashion) in 2 groups (A and B); a single dose of methylprednisolone (30 mg/kg of body weight) was injected to participants of group "A" just at the time of ICU entrance. Group "B" received no drug. Then, clinical outcomes and laboratory data were compared between the two groups. RESULTS: The only significant differences were lower incidence of bacteremia and higher incidence of hyperglycemia in the group who were used methylprednisolone. CONCLUSIONS: Using a single postsurgical dose of methylprednisolone does not significantly alter the clinical outcome after repairing Tetralogy of Fallot.