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SummaryTo investigate vitamin D status in children with community-acquired pneumonia (CAP) and explore the association between vitamin D deficiency and the immune response in CAP children, 77 children with CAP were retrospectively analyzed. The baseline characteristics of patients were obtained from medical records. Based on the blood samples collected during diagnosis of CAP, the routine blood examination results and proportions of lymphocyte subsets were assessed. There were 71.4% (55/77) of patients with vitamin D deficiency among CAP children. The serum 25(OH)D level significantly decreased with age. Patients with vitamin D deficiency had a significantly higher neutrophil percentage, but significantly lower lymphocyte percentage and count as well as proportion of CD19 positive lymphocytes (CD191). Spearman's rho test further confirmed these positive correlations and negative correlations. Moreover, significant associations of vitamin D deficiency with age and the above immune markers were also confirmed by univariate logistic regression analysis. However, only age entered the backward stepwise regression model in multivariate analysis. Vitamin D status in CAP children was negatively associated with age. Age-related vitamin D deficiency may affect the immune response in children with CAP.

Subcutaneous implantable cardioverter defibrillator (S-ICD) is an accepted alternative to conventional transvenous devices. Their efficacy in arrhythmia management is comparable to ICDs. However, those devices also have limitations such as lack of anti-tachycardia pacing capability or higher occurrence of device oversensing associated with inappropriate shocks. Air entrapment inside one or more of subcutaneous pockets has been reported as one of uncommon causes of device malfunction. It is important to recognize the wandering or drifting baseline signals during device interrogation for timely diagnosis and appropriate treatment.

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Infective endocarditis (IE) can lead to significant morbidity and mortality without appropriate treatment. Modified Duke Criteria are accepted by many professional societies to establish the diagnosis of IE, and cardiac imaging is one of the major diagnostic criteria. Transesophageal echocardiography is an algorithmic escalation to diagnose IE when transthoracic echo does not appreciate a positive finding. In patients with contraindications to transesophageal echocardiography, cardiac magnetic resonance imaging, cardiac computed tomography (CT), cardiac CT angiography, and fluorodeoxyglucose positron emission tomography with CT or CT angiography may be alternative diagnostic tools. However, these imaging modalities have their own limitations such as local unavailability, the presence of non–magnetic resonance imaging compatible implants, or impaired renal function. Intracardiac echocardiography could be a considerable alternative under those circumstances.