The influence of maternal COVID-19 on cardiac functions: From fetal life to infancy.

OBJECTIVE: To evaluate both short and mid-term effects of maternal COVID-19 on cardiac functions of fetuses and children. METHODS: The present case-control study was conducted on 36 pregnant women who had COVID-19 infection in the second trimester of pregnancy and 30 pregnant women as healthy controls. Fetal, neonatal, and infant cardiac functions were compared between the groups. Assessment of fetal cardiac functions were performed in the last trimester of the pregnancy at least 6 weeks after the recovery of infection. The first postnatal echo was performed within the first 2 weeks and the follow-up (second) echo was performed in the 6-8 weeks of life. RESULTS: The demographic data were similar between groups. Interventricular septum and left ventricular posterior wall end-diastolic dimensions were significantly higher in the study group in both fetal, neonatal, and infant periods. Impaired diastolic functions of right and left ventricles were detected and myocardial performance indexes with tissue doppler imaging of both lateral walls and septum were significantly higher than controls at all periods. CONCLUSION: Maternal COVID-19 seems to have a global impact on the cardiac functions of babies in the short and mid-term periods after maternal recovery.

A rare combination: a single common pulmonary vein with polysplenia syndrome.

A single common pulmonary vein is a rare anomaly, mostly occurring with asplenia. We wanted to report our case because it co-exists with polysplenia and ciliary dyskinesia.A baby girl about 2 months old with respiratory arrest was admitted to the emergency room of our hospital. She responded to pulmonary resuscitation. We ascertained from her medical history that she had been hospitalised twice because of recurrent lung infections. After the initial check and treatment, we applied imaging modalities to detect underlying problems of recurrent lung infection. Echocardiographic evaluation was suboptimal because of the widespread pulmonary infiltration. Still, we noticed a single common pulmonary vein without obstruction at the junction of the left atrium. Subsequently, a chest CT scan with contrast was performed. It revealed a single common pulmonary vein entering the left atrium with a single orifice, atrial septal defect, two lobes in both lungs, hepatic veins draining directly into the right atrium, and polysplenia. When the flow of a single common pulmonary vein goes directly to the right atrium through the defect, it may cause right heart dilatation as it did in our case. Therefore, patients may need to undergo surgery at an earlier age.

Tetralogy of Fallot with double aortic arch and aortopulmonary window: a very rare trifecta.

Tetralogy of Fallot with an aortopulmonary window and double aortic arch is very rare. This complex coexistence may be over a wide clinical spectrum. Herein, we present an asymptomatic 8-day-old infant who was diagnosed as having tetralogy of Fallot, double aortic arch, and an aortopulmonary window using transthoracic echocardiography while being examined for microcephaly.

Impact of tea leaves types on antioxidant properties and bioaccessibility of kombucha.

Five different tea varieties (white, green, oolong, black and pu-erh) were infused, drained and used for kombucha production. Antioxidant capacity, total phenolic content and bioaccessibility values were determined. Extractable, hydrolysable and bioaccessible fractions were used for antioxidant capacity and total phenolic content (TPC) and expressed as µmole TEAC/mL and mg GAE/100 mL, respectively. Antioxidant capacity and TPC were determined by Folin Ciocalteu's, ABTS and CUPRAC methods. In vitro digestion enzymatic extraction was used to determine bioaccessible fractions. It has found that kombucha fermentation with the tea extracts caused to elevate antioxidant capacity, TPC, and bioaccessibility. The green tea kombucha had the highest antioxidant capacity (4153.23 µmole TEAC/mL) and bioaccessibility (50.18%). Therefore, it can be suggested as a good supplement with high nutritional value in kombucha production. In general, TPC content increased significantly. The extractable fractions and bioaccessibility values of the kombucha tea varieties increased due to the fermentation, while the hydrolysable fractions decreased. Antioxidant capacity in the extractable fractions of the green tea kombucha samples was measured to increase by ABTS and CUPRAC methods. Bioaccessibility values of pu-erh tea by ABTS and white tea by CUPRAC were found to increase by the kombucha production.

In vitro evaluation of the bioaccessibility of antioxidative properties in commercially baby foods.

Fruit-vegetable based products are essential for infants as they widely used the first complementary solid foods. This study aimed to investigate the physicochemical properties, the antioxidant capacities, total phenolic content, and bioaccessibility of 24 different commercially fruit-vegetable based complementary foods. To determination of bioaccessibility, samples were processed by an in vitro digestive enzymatic extraction that mimics the conditions in the gastrointestinal tract. Total polyphenol content was analyzed using Folin-Ciocalteu assay, and antioxidant capacities were assessed by CUPRAC and ABTS methods. The total phenol content of the samples ranges from 892.21 to 1729.13 mg GAE mg/100 g. While the antioxidant capacity of the samples averages 256.26 µmol TE mg/100 g according to the ABTS method, they were found 2417.79 µmol TE mg/100 g for CUPRAC method. Also, the bioaccessibility of total phenol content determined 62.72-98.48% of all samples. As a result, antioxidant properties and bioaccessibility of the samples were changed according to the sample content and chemical composition. The use of fruit or fruit juice in the preparation of commercial baby food has improved antioxidant capacity and bioaccessibility, thus increasing the beneficial health effect and nutraceutical properties of the baby meal.

Use of coffee silverskin to improve the functional properties of cookies.

The purpose of this study was to determine the suitability of coffee silverskin (CSS) supplementation to enhance phenolic content and antioxidant capacity of cookies. Cookie samples were prepared with partial replacement of wheat flour by CSS (2.5, 5.0, and 7.5%). Spread ratios were found lower in all cookies with CSS than in control. Cookies became darker with increasing levels of CSS. This is due to the fact that CSS has a dark color like cocoa. CSS supplementation had improved functional quality of cookies by increasing phenolic contents, antioxidant capacities, and in vitro bioaccessibilities of them. According to the sensory evaluation, all samples with CSS received 6 and above scores (6: like slightly, 7: like moderately) for all attributes from the panelists. The results demonstrated that CSS supplementation have a good potential for developing functional and acceptable cookies and similar bakery products.

Comparative analysis of the effectiveness of coarctation surgery between neonates and infants.

OBJECTIVE: This study aimed to compare the effectiveness of resection and extended end-to-end anastomosis between neonate and infant patients with coarctation. METHODS: This study was designed retrospectively and included 41 neonate (<30 days) and infant (30 days to 1 year) patients who were operated on using the resection and extended end-to-end anastomosis technique for aortic coarctation. Preoperative aortic annulus diameters and Z scores, all aortic arch diameters and Z scores, the presence of hypoplastic aortic segment, and the presence of prematurity were reviewed in both groups. Subsequently, we investigated whether these parameters were statistically related to the residual gradient in the operation area, whether there was a need for early re-intervention, and what was the incidence of mortality in the early postoperative period. In addition, the aortic arch Z scores of the patients at 6 months postoperatively were examined. RESULTS: While the mean age (p<0.001), body weight (p<0.001), and proximal arch Z score (p=0.029) were found to be significantly lower in the neonate group than in the infant group, the total length of the intensive care unit stay (p=0.013) and the total length of hospital stay (p=0.017) were found to be significantly higher. In addition, significant enlargement was detected in the proximal arch, distal arch, and isthmus segments in both patient groups. CONCLUSION: The resection and extended end-to-end anastomosis is an equally effective technique that can provide a marked decrease in gradient in the coarctation area and a significant enlargement of the aortic arch segments in the early period after coarctation repair in both neonate and infant patients.

Comparative Analysis of Modified BT Shunt and Central Shunt in Pediatric Patients.

INTRODUCTION: Cyanotic congenital heart diseases constitute 40-45% of all congenital heart diseases. In patients who are not suitable for primary repair, modified BT (MBT) shunt and central shunt (CS) procedures are still frequently used. METHODS: This study included 62 pediatric patients who underwent MBT shunt or CS via median sternotomy. Patients' demographic, echocardiographic, operative, and postoperative data were collected retrospectively. The patients were classified as single ventricle and bi-ventricle according to their cardiac anatomy, and the presence of prematurity and heterotaxy was noted. Procedure details of the patients who underwent endovascular intervention prior to the surgery were investigated, and operation data were accessed from the surgery notes. Data regarding postoperative follow-ups were obtained and comparatively analyzed. RESULTS: Of the total 62 patients, 32 (51.6%) were newborns and 16 (25.8%) had a body weight < 3 kg. MBT shunt was applied to 48 patients (77.4%), while CS was applied to 14 patients (22.6%). There was no significant difference between the two surgical procedures in terms of requirement for urgent shunt or cardiopulmonary bypass, additional simultaneous surgical intervention, need for high postoperative inotropes, and in-hospital mortality (P>0.05). The rate of congestive heart failure in patients with in-hospital mortality was determined as 66.7% and it was significantly higher than in patients without heart failure (P<0.001). CONCLUSION: MBT shunt and CS are still frequently used in cyanotic patients. The use of small-diameter shunts, particularly when centrally located, can prevent the onset of congestive heart failure and lower mortality.

Effects of oleaster flour supplementation in total phenolic contents, antioxidant capacities and their bioaccessibilities of cookies.

In presented study total phenolic contents, antioxidant capacities and their bioaccessibilities from cookies supplemented with oleaster flour were investigated. Oleaster flours (OFs) were produced using two different methods (peeled oleaster flour: POF and unpeeled oleaster flour: UPOF) from two different genotypes. OFs were used to replace wheat flour in the cookie formulation (control) at the levels of 5, 10, 15, 20 and 25% (w/w). According to the results, enrichment of OFs clearly increased total phenolic contents, antioxidant capacities and bioaccessibilities of cookies. The highest bioaccessible antioxidant capacities (ABTS, CUPRAC, and FRAP) of the samples were obtained from cookie samples enriched with 25% UPOF-1. In conclusion, the increases in phenolic contents, antioxidant capacities, and bioaccessibilities from cookies supplemented with OFs suggest the potential enhancement of beneficial health effect of cookie due to increased content of bioactive compounds present in oleaster flour.

A Retrospective Survey Comparing Suture Techniques Regarding the Risk of Permanent Epicardial Pacemaker Implantation After Ventricular Septal Defect Closure.

OBJECTIVE: The aim of this study is to compare the continuous and combined suturing techniques in regards to the needing epicardial pacing at the time of weaning from cardiopulmonary bypass (EP-CPB) and to evaluate permanent epicardial pacemaker (PEP) implantation in patients who had undergone surgical ventricular septal defect (VSD) closure. METHODS: This single-centre retrospective survey includes 365 patients who had consecutively undergone VSD closure between January 2006 and October 2015. RESULTS: The median age and weight of the patients were 15 months (range 27 days - 56.9 years) and 10 kg (range 3.5 - 100 kg), respectively. Continuous and combined suturing techniques were utilised in 302 (82.7%) and 63 (17.3%) patients, respectively. While 25 (6.8%) patients required EP-CPB, PEP was implanted in eight (2.2%) patients. Comparison of the continuous and combined suturing techniques regarding the need for EP-CPB (72% vs. 28%, P=0.231) and PEP implantation (87.5% vs. 12.5%, P=1.0) were not statistically significant. The rate of PEP implantation in patients with perimembraneous VSD without extension and perimembraneous VSD with inlet extension did not reveal significant difference between the suture techniques (P=1.0 and P=0.16, respectively). In both univariate and multivariate analyses, large VSD (P=0.001; OR 8.63; P=0.011) and perimembraneous VSD with inlet extension (P<0.001; OR 9.02; P=0.005) had a significant influence on PEP implantation. CONCLUSION: Both suturing techniques were comparable regarding the need for EP-CPB or PEP implantation. Caution should be exercised when closing a large perimembraneous VSD with inlet extension.

A rare cause of fatal cardiac arrhythmia: Inhalation of butane gas.

Pamuk U, Gürsu HA, Emeksiz S, Özdemir-Sahan Y, Çetin I. A rare cause of fatal cardiac arrhythmia: Inhalation of butane gas. Turk J Pediatr 2018; 60: 755-756. Butane gas, especially available in lighters, is commonly misused among adolescents and its side effects are rarely observed but serious. A 14-yearold male was brought to our emergency department. The electrocardiographic (ECG) examination showed biphasic T waves in leads V4-V6, and long QTc at 481ms. Echocardiographic study showed left ventricular systolic dysfunction. Troponin I level was found to be high at 9.1 ng/ml. Taking into consideration the patient`s history, clinical and laboratory findings, ventricular fibrillation and myocardial injury resulting from butane gas inhalation was diagnosed.

Phenolics, antioxidant capacity and bioaccessibility of chicory varieties (Cichorium spp.) grown in Turkey.

In this study, the changes in phenolics, anthocyanin, antioxidant capacity, and bioaccessibility of chicory varieties (Cichorium spp.) in Turkey were investigated. A total of 19 phenolic standards were screened in the chicory varieties studied and the most abundant compounds in the samples, extracted with methanol, were phenolic acids, syringic (2.54mg/kg) and trans-ferulic acid (1.85mg/kg), whilst (+)-catechin was the major flavanol. The highest flavanol content using either methanol or ethanol was determined in the green chicory samples (0.62mg/kg). The red chicory variety had higher anthocyanin (12.80mg/kg), and contained more phenolics, extractable (8855.50mg GAE/100g) and hydrolysable (7005.51mg GAE/100g), than the other varieties. Also, the antioxidant capacities in this variety, as measured using the CUPRAC assay (570.54 and 425.14µmol Trolox/g dw, respectively), had a wider range of difference than was found in the other assays used. Total phenolics were more bioaccessible from the white chicory variety (61.48%). However, the bioaccessibility of antioxidants was higher in the green chicory variety.

Antimicrobial effect of PEG-PLA on food-spoilage microorganisms.

Polyethylene glycol (PEG) and polyethylene glycol-polylactic acid (PEG-PLA) have an organic structure and no negative effect on human health. The present study compares the antimicrobial effectiveness of PEG and PEG-PLA on microbial growth. The following pathogens and fungi were examined: seven bacteria strains and 10 fungi (four yeasts and six molds). PEG, a non-modified polymer, exhibited no inhibition effect on all test microorganisms. However, the antimicrobial effect increased with the concentration of PEG-PLA. Bacteria showed more sensitivity to PEG-PLA compared with the other microorganisms used in this study. Enterobacter ATCC 19434 was found to be the most resistant bacteria. Molds and yeasts were more resistant than bacteria against PEG-PLA. MIC and MFC could not be determined on the tested fungi owing to the level of concentrations used, with the exception of the yeast Candida albicans and the molds Penicillium expansum and Aspergillus parasiticus.

A rare complication of chronic granulomatous disease in a child: constrictive aspergillus pericarditis.

A 3-year-old girl with the diagnosis of chronic granulomatous disease (CGD) was hospitalized for bronchopneumonia and congestive heart failure. Her medical history included methylprednisolone medication for autoimmune gastric outlet obstruction. Computed tomography revealed pneumonic infiltrations and pericardial thickening. A pulsed-wave Doppler recording revealed E/A >1. During a pericardiectomy, multiple islands of thick, firm-walled, fibrinous exudate-containing, small abscess formations were observed. Histopathological evaluation of pericardial tissue revealed granulomatous inflammation. Aspergillus fumigatus was cultured from the abscess. In conclusion, development of constrictive aspergillus pericarditis should be considered in patients with CGD because immediate initiation of antifungal management with aggressive surgical treatment is life-saving.

Necrotizing Liver Granuloma/Abscess and Constrictive Aspergillosis Pericarditis with Central Nervous System Involvement: Different Remarkable Phenotypes in Different Chronic Granulomatous Disease Genotypes.

Chronic granulomatous disease (CGD) is a primary immune deficiency causing predisposition to infections with specific microorganisms, Aspergillus species and Staphylococcus aureus being the most common ones. A 16-year-old boy with a mutation in CYBB gene coding gp91phox protein (X-linked disease) developed a liver abscess due to Staphylococcus aureus. In addition to medical therapy, surgical treatment was necessary for the management of the disease. A 30-month-old girl with an autosomal recessive form of chronic granulomatous disease (CYBA gene mutation affecting p22phox protein) had invasive aspergillosis causing pericarditis, pulmonary abscess, and central nervous system involvement. The devastating course of disease regardless of the mutation emphasizes the importance of early diagnosis and intervention of hematopoietic stem cell transplantation as soon as possible in children with CGD.

A retrospective survey comparing suture techniques regarding the risk of permanent epicardial pacemaker implantation after ventricular septal defect closure

Abstract Objective: The aim of this study is to compare the continuous and combined suturing techniques in regards to the needing epicardial pacing at the time of weaning from cardiopulmonary bypass (EP-CPB) and to evaluate permanent epicardial pacemaker (PEP) implantation in patients who had undergone surgical ventricular septal defect (VSD) closure. Methods: This single-centre retrospective survey includes 365 patients who had consecutively undergone VSD closure between January 2006 and October 2015. Results: The median age and weight of the patients were 15 months (range 27 days - 56.9 years) and 10 kg (range 3.5 - 100 kg), respectively. Continuous and combined suturing techniques were utilised in 302 (82.7%) and 63 (17.3%) patients, respectively. While 25 (6.8%) patients required EP-CPB, PEP was implanted in eight (2.2%) patients. Comparison of the continuous and combined suturing techniques regarding the need for EP-CPB (72% vs. 28%, P=0.231) and PEP implantation (87.5% vs. 12.5%, P=1.0) were not statistically significant. The rate of PEP implantation in patients with perimembraneous VSD without extension and perimembraneous VSD with inlet extension did not reveal significant difference between the suture techniques (P=1.0 and P=0.16, respectively). In both univariate and multivariate analyses, large VSD (P=0.001; OR 8.63; P=0.011) and perimembraneous VSD with inlet extension (P<0.001; OR 9.02; P=0.005) had a significant influence on PEP implantation. Conclusion: Both suturing techniques were comparable regarding the need for EP-CPB or PEP implantation. Caution should be exercised when closing a large perimembraneous VSD with inlet extension.