scholarly journals Spontaneous closure of ventricular septal defects in newborns the first year of life

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Pihl ◽  
J Norsk ◽  
A.S Sillesen ◽  
R.O.B Voegg ◽  
H Boyd ◽  
...  
Keyword(s):  
Heart Defects ◽  
Population Based ◽  
Spontaneous Closure ◽  
First Year ◽  
Anatomical Location ◽  
Funding Source ◽  
Factors Associated ◽  
One Year ◽  
First Year Of Life

Abstract Background Ventricular septal defect (VSD) is one of the most common congenital heart defects. Some VSDs close spontaneously while persistence of the VSD may result in heart failure and, at long term, irreversible pulmonary hypertension. Consequently, identification of factors associated with spontaneous closure are important to ensure relevant clinical follow up of those at risk of a persistent VSD. Purpose We aimed to assess the rate of spontaneous closure in a population-based cohort of newborns with VSD and to identify significant predictors for spontaneous closure. Methods The study is part of a large-scale population-based study, focusing on cardiac structure and function, including newborns born from 1st April 2016 to 31st October 2018. Newborns with a VSDs at baseline were followed with echocardiography at 3, 6 and 12 months (+30 days) of age. Cox proportional hazard model was used to determine significant predictors of spontaneous closure Results Based on echocardiographies of 25.750 newborn, 850 newborns (3.3%) with a VSD were identified. The majority of newborns with VSDs were born at term (88.7%) and the mean age at inclusion was 11.7±8.1 days. VSDs were more frequent in females (57.1%, p<0.001). Of all VSDs, 787l (92.6%) were of a muscular type, 60 (7.0%) of perimembranous type and 3 (0.4%) were of subarterial type. Multiple VSDs were found in 98 (11.5%) cases and all were of a muscular type. Muscular VSDs were significantly smaller than perimembranous VSDs (1.9±0.7 mm vs. 3.7±1.8 mm, p<0.0001). During the follow up period, seven (0.8%) children underwent surgical repair: five (5 of 56) children with perimembranous VSDs and two (two of three) children with subarterial VSDs. Follow-up was complete in 89.4% of all children. After one year 82.6% (601 of 727) VSDs had closed spontaneously. The prevalence of VSD in one-year old children was thus 0.5%. The majority of VSD closed spontaneously during the first 6 months of life (57.6% (419/727)). Muscular VSDs showed significantly higher rate of spontaneous closure compared with perimembranous VSDs (86.9% (582 /670) vs. 46.2% (25/54), p=0.0001) during the first year of life. No subarterial VSDs closed spontaneously during follow-up. Muscular type (p=0.002), size (p<0.001) and presence of one VSD as opposed to multiple (p<0.0025) were associated to spontaneous closure. Sex did not significantly influence spontaneous closure rate (p=0.65). Conclusion In a population study including more than 25,000 newborns we found that the vast majority, i.e. almost 9/10 of all VSDs, closed spontaneously during the first year of life, ultimately resulting in a prevalence of VSD in one-year old children of 0.5%. The identified factors associated with spontaneous closure – anatomical location, size and presence of multiple VSDs are of use for future management of VSDs in newborns. Funding Acknowledgement Type of funding source: Other. Main funding source(s): The Danish Heart Foundation

scholarly journals The influence of gestational age at term on breastfeeding: a cohort study

2021 ◽  
Vol 55 ◽  
Author(s):  
Nathallia Seródio Michelin ◽  
Hélio Rubens de Carvalho Nunes ◽  
Maria Antonieta de Barros Leite Carvalhaes ◽  
Cristina Maria Garcia de Lima Parada
Keyword(s):  
Gestational Age ◽  
Exclusive Breastfeeding ◽  
Cox Regression ◽  
Final Analysis ◽  
Negative Influence ◽  
First Year ◽  
Baby Bottle ◽  
One Year ◽  
First Year Of Life

ABSTRACT Objective: To identify the effect of the category gestational age at term on breastfeeding in he first hour of life, the duration of exclusive breastfeeding, and practice of breastfeeding twelve months from birth. Method: Single cohort, with a one-year prospective follow-up of 541 children. A hierarchical analysis was performed, with models adjusted per Cox regression, considering critical p < 0.05. Results: During raw analysis there was a statistical difference on breastfeeding in the first hour of life (RR = 1.54; CI 95% = 1.12–2.12; p = 0.008). However, in the final analysis, there was no association between gestational age at term and breastfeeding in the first hour of life, duration of exclusive breastfeeding, and the practice of breastfeeding twelve months from birth. Secondarily, higher age and education, cesarean section, birth at private services, and the need for resuscitation were observed to have a negative influence. Duration of previous pregnancy favored breastfeeding in the first hour of life. Using baby bottle and pacifier was negative for breastfeeding in the first year of life. Conclusion: There was no association between the category gestational age at term and breastfeeding. The association of outcomes pointed out by the scientific literature have been confirmed.

scholarly journals Risk factors associated with the development of death events during the first year of follow-up after pulmonary thromboembolism

2019 ◽  
pp. 80-85
Author(s):  
S. A. Berns ◽  
E. A. Schmidt ◽  
A. G. Neeshpapa ◽  
A. A. Potapenko ◽  
K. V. Smirnov ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Anticoagulant Therapy ◽  
Severe Heart Failure ◽  
First Year ◽  
Factors Associated ◽  
Risk Of Death ◽  
One Year ◽  
The One

Purpose: to identify the factors associated with the development of death events during the year follow-up after hospitalization for pulmonary embolism (PE). Materials and methods: 93 patients with PE discharged to the outpatient stage of observation were studied. 45 (61,6%) patients were female with an average age of 66 years. The examination of patients at the stage of inclusion in the study consisted of standard methods of examination for this pathology. The diagnosis was confirmed by multislice computed tomography. Follow-up was 12 months. Statistical analysis was performed using the MedCalc Version 16.2.1. Results: during the one-year follow-up period 62 (66,7%) patients with PE were alive but 11 patients (11,8%) died, and no information was obtained about 20 patients. The causes of death were as follows: the development of recurrent PE – 4 (36,4%) patients, cancer – 3 patients (27,3%), stroke – 2 (18,1%), one patient (9,1%) died due to severe heart failure and one – myocardial infarction. A comparative analysis in the groups of alive patients (n = 62) and patients with a fatal events (n = 11) showed that the dead patients were older (78 (68; 81) vs. 65 (49; 75) years; p = 0,003), had a higher PESI score (119,0 (99,7; 137,2) vs. 88,0 (68,0; 108,0); p = 0,016) and were less compliant to prolonged anticoagulant therapy during the one year of observation (45,5% of patients (n = 5) vs. 82,3% ( = 51); p = 0,015). The ROC curve determined that a high risk of death during the one year after PE is associated with age over 70 years (p = 0,0001) and more than 95 points by PESI in the hospital period (p = 0,0001). Conclusion: The death events were developed in 11,8% of cases in patients with pulmonary embolism during the first year of follow-up. The death outcomes were significantly associated with elderly age, intermediate and high risk by PESI in the hospital period and low compliance to anticoagulant therapy extended during the year after pulmonary embolism.

scholarly journals Nasal staphylococci in children – a follow-up study

1982 ◽  
Vol 88 (3) ◽  
pp. 433-437 ◽  
Author(s):  
M. L. Burr ◽  
C. H. L. Howells
Keyword(s):  
Nasal Carriage ◽  
First Year ◽  
Carriage Rate ◽  
Follow Up Study ◽  
South Wales ◽  
Nasal Swabs ◽  
One Year ◽  
First Year Of Life ◽  
Marked Tendency

SummaryNasal carriage of Staphylococcus aureus was studied in a cohort of infants born to the residents of two towns in South Wales. The children were followed up to the age of 5 years, nasal swabs being taken annually after a more detailed survey during the first year. The carriage-rate of S. aureus reached a minimum of 10–15% at one year and then rose steadily to 41% at five years. From the age of two years about 90% of the organisms isolated were resistant to penicillin. There was a marked tendency for children to carry the same strains from year to year, but carriage during the first year of life did not predict carriage at the age of five.

scholarly journals Factors associated with breastfeeding in the first year of life in Cruzeiro do Sul, Acre

2021 ◽  
Vol 21 (1) ◽  
pp. 171-177
Author(s):  
Marcielle J Rodrigues ◽  
Lalucha Mazzucchetti ◽  
Paola Soledad Mosquera ◽  
Marly A Cardoso
Keyword(s):  
Skin Color ◽  
Regression Models ◽  
Prevalence Ratio ◽  
Bottle Feeding ◽  
First Year ◽  
Factors Associated ◽  
Robust Variance ◽  
National Estimates ◽  
First Year Of Life

Abstract Objectives: to investigate the factors associated with continued breastfeeding (BF). Methods: All the parturients at a local maternity from July 2015 to June 2016 were invited to participate in a cohort study in Cruzeiro do Sul, Acre. Data on socioeconomic, demographic, obstetric and neonatal of the babies were obtained for the interview. Multiple Poisson regression models with robust variance were used to estimate the prevalence ratio (PR) and 95% confidence intervals (95%CI). Results: among the 1551 mothers contacted, 305 lived in the rural area, leaving 1,246 eligible mothers living in urban area. For the 1-year cohort follow-up, 74 non-twin babies were assessed. Most of the mothers reported to have mixed skin color (79%), are over 21 years old (72°%o), more than 10 years of schooling (72%>) and with unpaying job (54%). The children’s age ranged from 10 to 15 months. The frequency of continued breastfeeding was 69,4%> (95%oCI=66.0-72.6). The factors negatively associated with continued breastfeeding were the use of bottle feeding (PR=1.44; CI95%> =1,33-1.56) and pacifier (PR=2.54; CI95%> =1.98-3.27), after adjusting for maternal age and socioeconomic variables. Conclusion: the frequency of continued breastfeeding in Cruzeiro do Sul was higher than the national estimates, but below the WHO recommendations for breastfeeding up to two years of age.

Epidemiology of Herpes Zoster in Children and Adolescents: A Population-Based Study

PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 512-517 ◽  
Author(s):  
H. A. Guess ◽  
D. D. Broughton ◽  
L. J. Melton ◽  
L. T. Kurland
Keyword(s):  
Herpes Zoster ◽  
Single Case ◽  
Population Based ◽  
Late Complications ◽  
Lymphocytic Leukemia ◽  
First Year ◽  
Population Based Study ◽  
Underlying Malignancy ◽  
First Year Of Life

Medical records were reviewed for all 173 cases of herpes zoster diagnosed among residents of Rochester, Minnesota, less than 20 years of age during the period 1960 through 1981. The incidence of zoster increased with age from 20 cases per 100,000 person-years in those residents less than five years of age to 63 cases per 100,000 person-years in those aged 15 to 19. Morbidity was less than has been described in adults, as only two patients required hospitalization and no postherpetic neuralgia or other late complications were diagnosed. The single case of subsequent cancer found in 1,288 person-years of follow-up was not significantly different from the number expected based on cancer incidence in the general Rochester population. The incidence of childhood zoster in patients with acute lymphocytic leukemia was 122 times higher than in children without an underlying malignancy. Chickenpox in the first year of life was found to be a risk factor for childhood zoster, with a relative risk between 2.8 and 20.9. Neither chickenpox in the second year of life nor recent vaccinations were found to be risk factors for childhood zoster.

scholarly journals Evaluation of care for at-risk newborns from the perspective of a public health policy

2011 ◽  
Vol 19 (2) ◽  
pp. 293-300 ◽  
Author(s):  
Ana Lúcia Forti Luque ◽  
Célia Mara Garcia de Lima ◽  
Maria Antonieta de Barros Leite Carvalhaes ◽  
Vera Lúcia Pamplona Tonete ◽  
Cristina Maria Garcia de Lima Parada
Keyword(s):  
Public Health ◽  
At Risk ◽  
Evaluation Study ◽  
Population Based ◽  
Public Health Care ◽  
First Year ◽  
National Guidelines ◽  
Health Care Policies ◽  
First Year Of Life

The aim was to evaluate the care for at-risk newborns under follow-up in their first year of life by the Growing Happily Program, developed in a city in inner São Paulo state. It is a population-based epidemiological health program evaluation study, which was based on the national guidelines of the Agenda of Commitments to Children and Child Mortality Reduction for data analysis. Results showed the program’s institutional vulnerability, caused by problems related to its structure and process, with implications for its outcomes. Considering the adaptation of the criteria adopted by the Program for defining at-risk newborns, as well as the proposed interventions and strategies, in consonance with the Agenda of Commitments, the need for managers to make it a priority is appointed, by effectively including it in public health care policies to be developed in cities, in order to reverse the institutional vulnerability identified.

Muenke syndrome: long-term outcome of a syndrome-specific treatment protocol

2019 ◽  
Vol 24 (4) ◽  
pp. 415-422 ◽  
Author(s):  
Bianca K. den Ottelander ◽  
Robbin de Goederen ◽  
Marie-Lise C. van Veelen ◽  
Stephanie D. C. van de Beeten ◽  
Maarten H. Lequin ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
First Year ◽  
Ventricular Size ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Skull Growth ◽  
Muenke Syndrome ◽  
First Year Of Life

OBJECTIVEThe authors evaluated the long-term outcome of their treatment protocol for Muenke syndrome, which includes a single craniofacial procedure.METHODSThis was a prospective observational cohort study of Muenke syndrome patients who underwent surgery for craniosynostosis within the first year of life. Symptoms and determinants of intracranial hypertension were evaluated by longitudinal monitoring of the presence of papilledema (fundoscopy), obstructive sleep apnea (OSA; with polysomnography), cerebellar tonsillar herniation (MRI studies), ventricular size (MRI and CT studies), and skull growth (occipital frontal head circumference [OFC]). Other evaluated factors included hearing, speech, and ophthalmological outcomes.RESULTSThe study included 38 patients; 36 patients underwent fronto-supraorbital advancement. The median age at last follow-up was 13.2 years (range 1.3–24.4 years). Three patients had papilledema, which was related to ophthalmological disorders in 2 patients. Three patients had mild OSA. Three patients had a Chiari I malformation, and tonsillar descent < 5 mm was present in 6 patients. Tonsillar position was unrelated to papilledema, ventricular size, or restricted skull growth. Ten patients had ventriculomegaly, and the OFC growth curve deflected in 3 patients. Twenty-two patients had hearing loss. Refraction anomalies were diagnosed in 14/15 patients measured at ≥ 8 years of age.CONCLUSIONSPatients with Muenke syndrome treated with a single fronto-supraorbital advancement in their first year of life rarely develop signs of intracranial hypertension, in accordance with the very low prevalence of its causative factors (OSA, hydrocephalus, and restricted skull growth). This illustrates that there is no need for a routine second craniofacial procedure. Patient follow-up should focus on visual assessment and speech and hearing outcomes.

scholarly journals Cardiovascular risk factors associated with acute myocardial infarction and stroke in the MADIABETES cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. A. Salinero-Fort ◽  
F. J. San Andrés-Rebollo ◽  
J. Cárdenas-Valladolid ◽  
M. Méndez-Bailón ◽  
R. M. Chico-Moraleja ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Hdl Cholesterol ◽  
First Year ◽  
Backward Elimination ◽  
One Year ◽  
Time Varying Covariates

AbstractWe aimed to develop two models to estimate first AMI and stroke/TIA, respectively, in type 2 diabetes mellitus patients, by applying backward elimination to the following variables: age, sex, duration of diabetes, smoking, BMI, and use of antihyperglycemic drugs, statins, and aspirin. As time-varying covariates, we analyzed blood pressure, albuminuria, lipid profile, HbA1c, retinopathy, neuropathy, and atrial fibrillation (only in stroke/TIA model). Both models were stratified by antihypertensive drugs. We evaluated 2980 patients (52.8% women; 67.3 ± 11.2 years) with 24,159 person-years of follow-up. We recorded 114 cases of AMI and 185 cases of stroke/TIA. The factors that were independently associated with first AMI were age (≥ 75 years vs. < 75 years) (p = 0.019), higher HbA1c (> 64 mmol/mol vs. < 53 mmol/mol) (p = 0.003), HDL-cholesterol (0.90–1.81 mmol/L vs. < 0.90 mmol/L) (p = 0.002), and diastolic blood pressure (65–85 mmHg vs. < 65 mmHg) (p < 0.001). The factors that were independently associated with first stroke/TIA were age (≥ 75 years vs. < 60 years) (p < 0.001), atrial fibrillation (first year after the diagnosis vs. more than one year) (p = 0.001), glomerular filtration rate (per each 15 mL/min/1.73 m2 decrease) (p < 0.001), total cholesterol (3.88–6.46 mmol/L vs. < 3.88 mmol/L) (p < 0.001), triglycerides (per each increment of 1.13 mmol/L) (p = 0.031), albuminuria (p < 0.001), neuropathy (p = 0.01), and retinopathy (p = 0.023).

scholarly journals The importance of early and late ventricular arrhythmias detection and prediction in acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Krljanac ◽  
D Trifunovic ◽  
M Asanin ◽  
L Savic ◽  
J Vratonjic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Poor Prognosis ◽  
Longitudinal Strain ◽  
Coronary Intervention ◽  
Funding Source ◽  
Clinical Center ◽  
Percutaneous Coronary ◽  
One Year

Abstract Background Malignant arrhythmias, ventricular tachycardia or ventricular fibrillation (VT/VF) in acute myocardial infarction (AIM) carry ominous prognosis including sudden cardiac death (SCD). It is not clear whether the timing of VT/VF occurrence always affects the poor prognosis of patients with AMI. Aim To investigate the prognosis of patients who undergoing primary percutaneous coronary intervention (PCI) in accordance with timing of VT/VF and to find the power predictors of their occurrence. Methods 307 consecutive patients in PREDICT-VT study (NCT03263949), 57.9±10.6 year old, 72.3% males were analysed. Of these patients, 27.7% had VT/VF from the symptoms onset, within 48 hours of AIM (early VT/VF group). 8.1% of patients had VT/VF after 48h, during one year follow up (late VT/VF group). Results The frequency of VT/VF occurrence was high between symptoms onset and the end of 2nd month and during 5th and 6th month of AIM. The parameters of conventional echocardiography were significantly impaired in late VT/VF group, as well as parameters of longitudinal strain (LS) (table). Moreover, the MACE (cardiovascular mortality, SCD, new infarction, emergency revascularisation, and hospitalized heart failure) was the highest in late VT/VF group (p=0.000). The most significant predictor of late VT/VF was systolic LS (cut off −12.72%, ROC 0.680, Sen 71%, Sp 64%, p=0.006). Conclusions Although late VT/VF occurrence after primary PCI were less frequent than early VT/VF occurrence, patients with late VT/VF had a very poor prognosis. The most power predictor of late VT/VF were systolic longitudinal strain. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Clinical Center of Serbia

Long-term effects of an intensive prevention program (IPP) after acute myocardial infarction – the IPP Follow-up and Prevention Boost Trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Wienbergen ◽  
A Fach ◽  
S Meyer ◽  
J Schmucker ◽  
R Osteresch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Prevention Program ◽  
Study Endpoint ◽  
Funding Source ◽  
Risk Factor Control ◽  
One Year

Abstract Background The effects of an intensive prevention program (IPP) for 12 months following 3-week rehabilitation after myocardial infarction (MI) have been proven by the randomized IPP trial. The present study investigates if the effects of IPP persist one year after termination of the program and if a reintervention after &gt;24 months (“prevention boost”) is effective. Methods In the IPP trial patients were recruited during hospitalization for acute MI and randomly assigned to IPP versus usual care (UC) one month after discharge (after 3-week rehabilitation). IPP was coordinated by non-physician prevention assistants and included intensive group education sessions, telephone calls, telemetric and clinical control of risk factors. Primary study endpoint was the IPP Prevention Score, a sum score evaluating six major risk factors. The score ranges from 0 to 15 points, with a score of 15 points indicating best risk factor control. In the present study the effects of IPP were investigated after 24 months – one year after termination of the program. Thereafter, patients of the IPP study arm with at least one insufficiently controlled risk factor were randomly assigned to a 2-months reintervention (“prevention boost”) vs. no reintervention. Results At long-term follow-up after 24 months, 129 patients of the IPP study arm were compared to 136 patients of the UC study arm. IPP was associated with a significantly better risk factor control compared to UC at 24 months (IPP Prevention Score 10.9±2.3 points in the IPP group vs. 9.4±2.3 points in the UC group, p&lt;0.01). However, in the IPP group a decrease of risk factor control was observed at the 24-months visit compared to the 12-months visit at the end of the prevention program (IPP Prevention Score 10.9±2.3 points at 24 months vs. 11.6±2.2 points at 12 months, p&lt;0.05, Figure 1). A 2-months reintervention (“prevention boost”) was effective to improve risk factor control during long-term course: IPP Prevention Score increased from 10.5±2.1 points to 10.7±1.9 points in the reintervention group, while it decreased from 10.5±2.1 points to 9.7±2.1 points in the group without reintervention (p&lt;0.05 between the groups, Figure 1). Conclusions IPP was associated with a better risk factor control compared to UC during 24 months; however, a deterioration of risk factors after termination of IPP suggests that even a 12-months prevention program is not long enough. The effects of a short reintervention after &gt;24 months (“prevention boost”) indicate the need for prevention concepts that are based on repetitive personal contacts during long-term course after coronary events. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Stiftung Bremer Herzen (Bremen Heart Foundation)

Sign in / Sign up

Export Citation Format

Share Document