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The 2-lead Holter ECG also showed a paroxysmal second-degree atrioventricular block, with a maximal R-R interval of 1.5 s, and several episodes of sinus bradycardia (Fig. Holter electrocardiography can be helpful in preterm infants to detect and define paroxysmal atrioventricular block. The heart rate abnormalities gradually improved, and a 2-lead Holter ECG obtained at 3 months of age showed sinus arrest, a maximal R-R interval of 1.9 s, and sinus bradycardic events (maximal R-R interval, 1.0 s) without paroxysmal atrioventricular block (PAVB). [Extracted from the article]

The article presents a case study of a neonate with a rare condition of neonatal complicated right ventricular diverticulum (RVD) with effective contraction. It is reported that the baby, prenatally diagnosed with double chamber right ventricle and pulmonary valve stenosis, exhibited cyanosis at birth. It is further reported that echocardiography revealed an abnormal muscle bundle dividing the right ventricle, diagnosed as RVD.

The article presents case study of patient was a 14-day-old female neonate with no specific abnormalities, who had growth restriction during her fetal period. It mentions diagnosis with neonatal cerebral sinovenous thrombosis (CSVT) because of its lower risk of bleeding compared with unfractionated heparin.

The article presents a case study of a 23-year-old woman with no significant medical history was diagnosed with Wolff–Parkinson–White (WPW) syndrome during pregnancy and her fetus was diagnosed with tetralogy of Fallot (TOF). Topics include the electrocardiogram has showed right axis deviation and short PR interval with a narrow QRS complex, the transthoracic echocardiogram has showed a ventricular septal defect, and the medications were not required during the neonatal period.

Aim: We aimed to validate the incidence of, risk factors for, and postoperative outcomes of acute kidney injury (AKI) according to the modified Kidney Disease Improving Global Outcomes (m‐KDIGO) criteria and compare this criteria with both the paediatric Risk, Injury, Failure, Loss, End‐stage disease (pRIFLE) and Acute Kidney Injury Network (AKIN) criteria in infants after cardiac surgery. Methods: We retrospectively enrolled 145 consecutive infants who underwent open‐heart surgery at Kagoshima University Hospital. Results: Acute kidney injury was present in 55 (37.9%), 111 (75.9%), and 95 (65.5%) patients according to the m‐KDIGO, pRIFLE, and AKIN criteria, respectively. Among these, 71.9% of patients pRIFLE Risk patients and 60.5% of AKIN 1 patients were categorized in the 'no‐AKI' group according to the m‐KDIGO criteria. Low body weight (m‐KDIGO odds ratio [OR], 0.73; P = 0.015; pRIFLE OR, 0.66; P = 0.001; AKIN OR 0.69, P = 0.002) and prolonged cross‐clamp time (m‐KDIGO OR, 1.02;

The article describes the case of a previously healthy, 11-year-old girl who presented with primary or lone atrial fibrillation (AF) with cardiac troponin T elevation. Topics covered include the results of the physical examination indicated and electrophysiological (EP) study which led to the diagnosis of unsuspected, orthodromic atrioventricular reciprocating tachycardia (AVRT), patient outcome following milrinone and dexmedetomidine therapy, and complications in the diagnosis of lone AF.

ABSTRACT Chromosomal abnormalities involving 19p13.3 have rarely been described in the published literature. Here, we report on a girl with a pure terminal duplication of 6.1 Mb on 19p13.3, caused by an unbalanced translocation der(19)t(10;19)(qter;p13.3)dn. Her phenotype included severe psychomotor developmental delay, skeletal malformations, and a distinctive facial appearance, similar to that of a patient previously reported by Lybaek et al. [Lybaek et al. (2009); Eur J Hum Genet 17:904-910]. These results suggest that a duplication of >3 Mb at the terminus of 19p13.3 might represent a distinct chromosomal syndrome. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The article discusses case study of 5-year-old girl with no past medical history had dyspnea and fatigue during exercise. It mentions She developed a cough and was presented to a pediatric department. A chest radiograph showed a rightward deviation of the trachea and mediastinum with volume loss over the right lung but she underwent no further medical examination.

Background: A diagnosis of Kawasaki disease (KD) is established using six principal symptoms. Because the principal symptoms are deeply connected with KD, it is thus important to investigate the usefulness of the principal symptoms for evaluating the disease severity of KD. Methods: Patients with definite KD or suspicion of KD were retrospectively examined. Blood test data and the incidence of patients who failed to respond to the initial i.v. immunoglobulin treatment (non-responders) were compared between patients with six principal symptoms, including fever of ≤4 days, before treatment of KD (six-symptom patients), and those with five or fewer symptoms (five-symptom patients). Results: The study group of 207 patients who were treated with immunoglobulin consisted of 121 six-symptom patients and 86 five-symptom patients. The six-symptom patients were older and had higher neutrophil proportion and total bilirubin, and lower serum sodium at diagnosis than the five-symptom patients. Although the treatments did not differ between the groups, the six-symptom patients had a higher incidence of non-responders than the five-symptom patients (17% vs 5%; P= 0.008). Logistic regression analysis showed that six-symptom status was related to the risk of being a non-responder (odds ratio [OR], 5.3; 95% confidence interval [95%CI]: 1.6-17.4). This association was still significant after adjustment for the effect of age, neutrophil proportion, and total bilirubin and sodium (OR, 4.4; 95%CI: 1.4-17.3). Conclusions: The number of principal symptoms before treatment is a useful guide to KD disease severity. Six-symptom patients have a higher risk of being a non-responder than five-symptom patients. [ABSTRACT FROM AUTHOR]

Background: Electrocardiographic and molecular studies have clarified an association between sudden infant death syndrome (SIDS) and long QT syndrome (LQTS), and few data are available for the QT interval in infancy from birth to 1 year of age. Appropriate time of electrocardiographic screening is not clarified. Medical examinations during infancy are mandatory in Japan. Methods and Results: The study population included 1,058 infants. Electrocardiograms were collected with information of infants at birth and at examination. The QT intervals of three consecutive beats were measured in lead V5. Statistical analysis revealed that the following formula was appropriate to minimize the effect of heart rate for infants: corrected QT interval; QTc = QT interval/RR interval 0.43. Subjects were divided into four groups as follows: 0–2, 3–6, 6–11, and 12–52 weeks of age. Tukey''s multiple comparison showed that the QTc intervals were longest (p < 0:0001) in subjects who were 6–11 weeks of age. Conclusions: The QTc interval showed the highest peak at 6-11 weeks of age in infancy. The peak period of occurrence of SIDS is at approximately 2 months of age. An appropriate time of electrocardiographic screening for QT prolongation will be one month of age, and follow-up studies are needed. [Copyright &y& Elsevier]

Despite the effectiveness of the Hib vaccine, multiple amplification of the capb locus contributes to vaccine failure. However, there has been no report on the effect of Hib locus amplification in Japan. We examined 24 Hib strains from Japanese children with invasive diseases due to Hib. Although all strains showed the same capb sequence, Southern blot analysis showed that four strains (16.7%) harbored multiple copies (more than two) of the capb locus. Careful analysis of the locus in circulating Hib strains is necessary now that the Hib vaccine has been introduced into Japan. [ABSTRACT FROM AUTHOR]

Kawasaki syndrome (KS) is an acute febrile vasculitis of childhood. Coronary artery abnormalities (CAA) are a significant problem in KS patients. High dose intravenous immunoglobulin (IVIG) is effective for reducing the occurrence of CAA. Clinical and histopathological findings suggest that vascular endothelial growth factor (VEGF) is involved in CAA. In circulating blood, newly activated platelets are the major source of VEGF, which is released in large amounts in vascular inflammation. The present study analysed 80 KS patients (69 IVIG responders and 11 IVIG non-responders) and evaluated the role of platelet VEGF in KS vasculitis. Serum VEGF and platelet VEGF levels were significantly higher in KS patients than controls ( P < 0·001). Platelet VEGF reflected the reactivity of IVIG treatment and was decreased in responders ( P < 0·001), but remained increased in non-responders ( P = 0·01). Platelet VEGF levels, but not serum VEGF levels, before IVIG were significantly correlated with the maximum CAA z-score ( r = 0·524, P = 0·02). Our findings demonstrate that platelet VEGF may reflect the severity of vasculitis related to the pathological development of CAA in KS. Platelet VEGF may be an important feature of KS pathophysiology. [ABSTRACT FROM AUTHOR]

The article presents a case study of an infant girl diagnosed with Interrupted aortic arch underwent the Norwood procedure with the RV-PA conduit (8 mm GORETEX) at 3 months of age. It mentions that She had left hemiplegia after surgery; computed tomography confirmed cerebral infarction in the right middle cerebral artery region.

A case study of a 36-year-old woman who reported of uterine contractions at 33 weeks of her first pregnancy is presented. It is noted that she had no history of arrhythmia, cardiovascular or endocrine disease, and no family history of arrhythmia or sudden death. The article discusses that ritodrine can cause maternal tachycardia and disturb the normal response of heart in physiologic status. It is notes that her child had a normal heart with no abnormalities.

The article presents a case study of an 11-year-old boy with nephrotic syndrome. The patient was given steroid and had complete remission but suffered a relapse at the age of five. Steroids did not improve his symptoms and was diagnosed with steroid-resistant nephrotic syndrome where his condition stabilized with cyclosporine. The patient suffered from repeated relapses and refractory nephrotic syndrome complicated by isolated thrombus in the right ventricle diagnosis was formed.

The article presents a case study of an 8-month-old boy who had high fever and lymphadenopathy which was treated with antibiotics but later developed into autoimmune neturopenia that led to the development of Kawasaki syndrome after being treated with granulocyte colony-stimulating factor (G-CSF). He was diagnosed with neutropenia due to the presence of anti-neutrophil antibody that was used for his lymphadenopathy. Plasma exchange (PE) therapy decreased dilation of his left coronary artery.