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Background and Objectives: Anthracycline chemotherapy is a cornerstone in pediatric oncology but carries a significant risk of cardiotoxicity. The early detection of cardiac dysfunction is crucial for timely intervention. This study aims to evaluate the predictive value of combining speckle tracking echocardiography (STE) parameters with traditional cardiac biomarkers for the early detection of anthracycline-induced cardiotoxicity in pediatric oncology patients. Methods: A retrospective cohort study was conducted, involving 99 pediatric oncology patients undergoing anthracycline therapy and 50 age- and sex-matched healthy controls. Cardiac function was assessed using STE parameters—global longitudinal strain (GLS), Simpson's method of disk ejection fraction (SMOD EF), and myocardial performance index (MPI)—alongside biomarkers including cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP). Assessments were performed at baseline and at 3, 6, and 12 months post-therapy initiation. Results: A total of 28.3% of patients developed cardiotoxicity based on the LVEF decrease. Significant differences were observed between oncological patients under anthracycline treatment and healthy controls. Patients had reduced GLS (−16.1 ± 4.7% vs. −19.6 ± 5.1%, p < 0.001), a lower SMOD EF (55.7 ± 6.3% vs. 60.2 ± 6.0%, p < 0.001), and a higher MPI (0.38 ± 0.06 vs. 0.33 ± 0.05, p < 0.001). Elevated cTnI levels were found in patients compared to controls (3.1 ± 0.9 ng/mL vs. 1.3 ± 0.6 ng/mL, p < 0.001). Regression analysis showed that combining GLS, SMOD EF, MPI, and cTnI levels significantly predicted cardiotoxicity (odds ratio = 7.12, 95% CI: 3.04–12.76, p < 0.001). Conclusions: Combining STE parameters with cardiac biomarkers enhances the early detection of anthracycline-induced cardiotoxicity in pediatric oncology patients. This combined assessment may facilitate timely interventions to prevent long-term cardiac complications. [ABSTRACT FROM AUTHOR]

Background/Aim: Biomaterials are essential in modern medicine, both for patients and research. Their ability to acquire and maintain functional vascularization is currently debated. The aim of this study was to evaluate the vascularization induced by two collagen-based scaffolds (with 2D and 3D structures) and one non-collagen scaffold implanted on the chick embryo chorioallantoic membrane CAM). Materials and Methods: Classical stereomicroscopic image vascular assessment was enhanced with the IKOSA software by using two applications: the CAM assay and the Network Formation Assay, evaluating the vessel branching potential, vascular area, as well as tube length and thickness. Results: Both collagen-based scaffolds induced noninflammatory angiogenesis, but the non-collagen scaffold induced a massive inflammation followed by inflammatoryrelated angiogenesis. Vessels branching points/Region of Interest (Px^2) and Vessel branching points/Vessel total area (Px^2), increased exponentially until day 5 of the experiment certifying a sustained and continuous angiogenic process induced by 3D collagen scaffolds. Conclusion: Collagen-based scaffolds may be more suitable for neovascularization compared to non-collagen scaffolds. The present study demonstrates the potential of the CAM model in combination with AI-based software for the evaluation of vascularization in biomaterials. This approach could help to reduce and replace animal experimentation in the pre-screening of biomaterials. [ABSTRACT FROM AUTHOR]

Coarctation of the aorta is a congenital heart defect involving a narrowing of the descending aorta. Blood pressure is higher before the narrowing and lower past the narrowing, with 20 mmHg difference between upper and lower limbs, clinically expressed by absent femoral pulses. In infants, coarctation of the aorta is severe and represent a cardiological emergency, but in child, aortic coarctation is sometime under-diagnosed, patients presenting at the hospital for high blood pressure of unknown etiology, or complaining of headache, or lower limb pain in effort. We want to highlight aortic coarctation as a cause of high blood pressure in children and to drawn attention that this kind of patients, even after aortic coarctation repair may remain with hypertension that has to be treated and patients followed up. We want to share our experience with some cases of surgical correction of aortic coarctation and complications such as recoarctation in special type of gothic aortic arch and also, recoarctation after stent implanting. [ABSTRACT FROM AUTHOR]

Introduction: Most vascular anomalies are clinically easy to recognize. The age is the most prominent element to take into consideration for the diagnostic. Lesions differ by the moment of appearance: congenital hemangiomas and hemangioendotheliomas (occurred at birth); lymphatic- and venous malformations (emerged in the first week of life-unprogressive), infantile hemangiomas (emerged in the first week of life-fast evolutive) and arteriovenous malformations (appeared throughout childhood). One may diagnose up to 90% of cases based on aspect (color, depth, local temperature, presence of murmur). Doppler ultrasound and MRI may help in difficult cases. Materials and methods: We performed a prospective study of 54 cases with vascular anomalies from May 2010 to April 2013. Thirty-six girls and 18 boys treated with Propranolol - unselective beta-blocker. There were 50 vascular tumors and 4 vascular malformations. All patients underwent ECG and echocardiography before treatment. Four patients excluded based on consent withdrawal. Results: Treatment: age m=9,24 months, duration m=9,15 months and response: very good-66,66%, good-12,96%, partial-7,40%, no response-9,25% and aggravation-3,70%. As a conclusion, our results support the use of Propranolol in vascular anomalies. [ABSTRACT FROM AUTHOR]

Infantile hemangiomas (IH) are the most common benign vascular tumors in childhood, affecting 4-5 % of Caucasian infants in their first year of life. We performed a prospective study of 34 cases of IH treated with propranolol from May 2010 to December 2012. Beta blocker treatment was administered in 21 girls and 13 boys aged 2 to 14 months (mean age 5.4 months). All patients were evaluated with electrocardiography and echocardiography prior to start of treatment. Propranolol was administrated at a dose of 1mg/kg/day divided in 3 equal parts (day 1) and 2mg/kg/day divided in 3 equal parts (day 2), continuing with this dose throughout the rest of the treatment. The treatment was initiated during a 24- 48 hours hospitalization, time during which blood pressure and heart rate were measured every 6 hours. After 24 hours of hospitalization we performed an EKG and measured the blood glucose level. None of our patients developed hypotension, hypoglycemia or bronchospasm. The results are: very good-70.96%, good-16.12%, partial-6.45%, no response- 6.45%. Three patients were uncooperative and after 1 month to treatment they have not presented to control and stop the treatment. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to assess our results of the treatment in children with vascular anomalies. Methods: We retrospectively reviewed the charts of 704 patients with 843 vascular anomalies treated in the Department of Pediatric Surgery between January 1996 and June 2012. Results: Sex ratio was females/males 1.5:1, 69% were less than one year of age at the time of admission. The average time of hospital stay was 2 days. 83.5% of vascular anomalies were hemangiomas and 83,6 % of these affected the skin and subcutaneous tissue. 64% of hemangiomas were tuberous and most were located on the head and neck. 11% affected multiple sites and/or were associated with other vascular anomalies. Conclusion: This audit allows us to improve the diagnosis, methods of treatment and improving our clinic's recording. Our results stress on the necessity for implementation of educational programs among the people living in the countryside, so that they would become aware of the importance of addressing the physician for their children's health concerns. [ABSTRACT FROM AUTHOR]

Klippel-Trenaunay Syndrome (KTS) is a rare congenital malformation consisting of venous, capillary and lymphatic abnormalities, in addition to hypertrophy and overgrowth of the bony and/or soft tissue of the affected limbs. We report a unique case of KTS due to its complex association of complications (hydronephrosis, rectorrhagia and splenomegaly). [ABSTRACT FROM AUTHOR]

Aim. In COVID-19 Pandemic, a new hyperinflammatory syndrome was reported with clinical features of Kawasaki disease, named PIMS-TS. We want to present a single center experience where the patients were diagnosed with Kawasaki-like in PIMS-TS with cardiac affliction. Material and method: The study was observational and retrospective, enrolled 14 patients fulfilling the criteria of PIMS-TS with the median age of 9 (IQR, 1.6-11), 9 male (64.2 %) and 5 female (35.8 %). Results: ECG revealed tachycardia and ST-T changes in 60% of patients. In evolution, ECG modified in 20% and consisted of long QT in 7% of cases, bradycardia in 7%, 3% transitory sick sinus syndrome and 3% grade I/II degree atrio-ventricular block. Cardiac disfunction was evidenced in 4 patients (28%), with reduced ejection fraction under 50%, mitral insufficiency in 6 (42.8%), pericardial fluid in 8 (57.1%) and perivascular brightness in 8 (57.1%). The cardiac biomarkers: NT-proBNP (increased in 9), cTroponin T (increased in 7) and cTroponin I (increased in 5) confirmed heart dysfunction. During the hospitalization and under medical treatment, all the modifications recover. Evolution was good for 12 children. Conclusions: Cardiac dysfunction and myocardial injury were confirmed by elevated cardiac biomarkers. Rapid recognition allows prompt treatment for a good outcome. NT-proBNP, cTroponin T and I are of capital significance in monitoring the myocardial injury, the treatment and evolution of these patients. [ABSTRACT FROM AUTHOR]

Introduction. A congenital heart disease is a defect in the structure of the heart or great vessels that is present at birth. Signs and symptoms depend on the specific type of defect. The cause of a congenital heart defect is often unknown but remain the most common congenital malformations in newborns and infants with a major role in early and late neonatal morbidity and mortality. Material and methods. The study was carried out in the Department of Neonatology and Premature in the collaboration with the Department of Pediatric Cardiology, from the Clinical Emergency Hospital for Children Louis Țurcanu Timișoara, in a period of 3 years (2015- 2018). There were 70 patients included in the study, who presented congenital heart malformation diagnosed clinically, by ultrasound and Angio-CT. Results. The incidence of cardiac malformations in our unit was 2.11%. The most common clinical signs encountered in patients with congenital heart disease were dyspnea associated with cyanosis, systolic murmur and oxygen saturation oscillations (SaO2). Associated with pregnancy, the presence of teratogenic factors with possible implication in congenital heart malformations was also detected. There were 12 cases involved genetic syndromes, Down’s syndrome having the highest prevalence. Due to the complexity of the cardiac malformation in the studied group, 11 patients (15.71%) died. Conclusions. Congenital cardiovascular malformations are a problem of public health. In the assessment of a newborn with cardiac pathology, there should be involved obstetricians, neonatologists, anesthetists, pediatric cardiologists, pediatric cardiovascular surgeons, geneticists, with the common goal of preventing, diagnosing, monitoring and treating congenital heart abnormalities. [ABSTRACT FROM AUTHOR]

Background/aim: Biomaterials are essential in modern medicine, both for patients and research. Their ability to acquire and maintain functional vascularization is currently debated. The aim of this study was to evaluate the vascularization induced by two collagen-based scaffolds (with 2D and 3D structures) and one non-collagen scaffold implanted on the chick embryo chorioallantoic membrane (CAM)., Materials and Methods: Classical stereomicroscopic image vascular assessment was enhanced with the IKOSA software by using two applications: the CAM assay and the Network Formation Assay, evaluating the vessel branching potential, vascular area, as well as tube length and thickness., Results: Both collagen-based scaffolds induced non-inflammatory angiogenesis, but the non-collagen scaffold induced a massive inflammation followed by inflammatory-related angiogenesis. Vessels branching points/Region of Interest (Px^2) and Vessel branching points/Vessel total area (Px^2), increased exponentially until day 5 of the experiment certifying a sustained and continuous angiogenic process induced by 3D collagen scaffolds., Conclusion: Collagen-based scaffolds may be more suitable for neovascularization compared to non-collagen scaffolds. The present study demonstrates the potential of the CAM model in combination with AI-based software for the evaluation of vascularization in biomaterials. This approach could help to reduce and replace animal experimentation in the pre-screening of biomaterials., (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)