This study provides reference values for diaphragmatic excursion and thickness in healthy infants and children. Percentile curves for right diaphragmatic excursion plotted against body weight were plotted.

The GGAGAA combined genotype and the GGA haplotype of IL-17A rs2275913, IL-17F rs763780 and rs2397084 can be considered risk factors for the development of SLE in Egyptian children. IL-17A rs2275913, IL-17F rs763780 and rs2397084 are not related to the LN development, SLE disease activity or overall survival.

Background: Coronavirus disease 2019(COVID-19) is responsible for significant lung disease in adults. Despite mild manifestations in most children, multisystem inflammatory syndrome (MIS-C) associated with COVID-19 is well-described in older children with cardiac manifestations. However, MIS-C-related cardiac manifestations are not as well-described in younger children. Methods: The study is a retrospective analysis of MIS-C patients under age 5 years admitted between May to November 2020 to a single-center. Included cases fulfilled the case definition of MIS-C according to RCPCH criteria with cardiac laboratory, ECG, or echocardiographic evidence of cardiac disease. Collected Data included patients’ demographics, laboratory results, echocardiographic findings, management, and outcomes. Results: Out of 16 MIS-C cases under 5 years, 10 (62.5%) had cardiac manifestations with a median age of 12 months, 9 (90%) were previously healthy. Cardiac manifestations included coronary arterial aneurysms or ectasia in 5 (50%) cases, 2 (20%) with isolated myopericarditis, coronary aneurysm with myocarditis in 2 (20%), and SVT in 1(10%). Intravenous immunoglobulins were given in all cases with coronary aneurysms or myocarditis. The median duration of hospitalization was 7(6-14) days; 2 (20%) cases with cardiac disease were mechanically ventilated and mortality in MIS-C cases below 5years was 12.5%. Normalization of systolic function occurred in half of the affected cases within one week and reached 100% by 30days of follow-up. Conclusion: MIS-C associated with SARS-CoV-2 has a high possibility of serious associated cardiac manifestations in children under the age of 5years with mortality and/or long-term morbidities such as coronary aneurysms even in previously healthy pediatric patients.

Clinical asthma phenotypes have an impact on myocardial function especially those presented with shortness of breath. Thus, measurement of MPI by TDI can detect subclinical changes in the cardiac performance in asthmatic children.

Background: Patent ductus arteriosus stenting in duct-dependent pulmonary circulation is a challenging procedure. Percutaneous carotid artery access for ductal stenting has proven to be feasible; however, comparison with femoral artery access in terms of procedure details and complications either immediate or late is scarce. Therefore, we evaluated carotid artery access in comparison with femoral artery for stenting of patent ductus arteriosus. Methods: Forty neonates were reviewed, 20 were stented via carotid artery access, and 20 via the traditional femoral artery access. Comparison variables were neonatal demographics at the procedure, angiographic ductal anatomy, procedure details, and immediate complications. Follow-up Doppler ultrasound on access site was performed to document late complications. Results: Median age of included cases was 10.5 (3–28) days with complex ductal anatomy more frequently accessed via carotid artery than femoral. Immediate access-related complications were significantly higher with femoral than carotid artery access; 9 (45%) versus 3 (15%) respectively, p = 0.038. With carotid access, we had only one case with small pseudoaneurysm and acute hemiparesis 3 days after the procedure. Delayed local complications were more common with femoral access (15%) than carotid access (5%), mild stenosis in one case, and severe in another with femoral access; while with transcarotid arterial access, only one case had mild narrowing. Conclusion: Percutaneous carotid artery access in neonates is a more convenient approach for patent ductus arteriosus stenting especially with complex ductal anatomy. Moreover, local complications are limited and vascular patency is better preserved, in comparison with trans-femoral arterial access. However, the potential for neurological adverse events should not be overlooked.