Lower respiratory tract infections are an important reason for mortality and morbidity in children with congenital heart disease. This study aimed to evaluate 50 children who had congenital heart disease and were hospitalized with lower respiratory tract infection in the Ege University Faculty of Medicine Pediatrics Hospital. Materials and Methods: Fifty pediatric patients were taken into the study. Their clinical symptoms, acute phase reactants, chest X-rays, bacterial culture of transtracheal aspirate, respiratory virus panel (with multiplex polimerase chain reaction) from nasopharyngeal swab were examined. The groups were evaluated in terms of age, gender, enviromental smoke exposure, living with school-aged siblings, Respiratory Syncytial virus (RSV) prophylaxis, hospitalization time, causative pathogen, additional risk factors. Results: Of the 50 cases, 12 (24%) were cyanotic, 38 (76%) were acyanotic. There were 26 boys and 24 girls. The most common diagnosis in the acyanotic group was hemodynamically significant VSD (isolated or with other diagnoses) with 20 cases. The average age of the cyanotic group was 23.88±28.81, and the acyanotic group was 12.25±15.45 months old. Hospitalizations most frequently occured in winter. The most frequent viral agent was RSV, which was not seen in the cyanotic group. All of the RSV infected patients were under 12 months old. In 16.7% of cyanotic and 52.6% of acyanotic patients there were extra risk factors such as immune deficiency, Down syndrome, prematurity, Di George syndrome, cerebral palsy, postoperative early period. Three cases lost their lives due to severe respiratory failure. There was no statistically significant difference between the two groups when compared for demografic variables, risk factors, causative pathogens, hospitalization times. Conclusion: Lower respiratory tract infections and especifically RSV pneumonia are important causes of mortality and morbidity in patients diagnosed with congenital heart disease. To prevent risk factors, more studies must be done.

Introduction: In this study, we aimed to detect the cytokine that is involved in the early stage of chronic kidney disease and associated with cardiovascular disease. Methods: We included 50 patients who were diagnosed with predialytic chronic kidney disease and 30 healthy pediatric patients in Ege University Medical Faculty Pediatric Clinic, İzmir/Turkey. Interleukin-8 (IL-8), interleukin-10 (IL-10), interleukin-13 (IL-13), and transforming grow factor-β1 (TGF-β1) levels (pg/mL) were measured by ELISA. Carotid-femoral pulse wave velocity (PWV), augmentation index (Aix), carotid intima media thickness (cIMT), and left ventricular mass index (LVMI) were evaluated as markers of cardiovascular disease. The presence of a cardiovascular disease marker was defined as an abnormality in any of the parameters (cIMT, PWV, Aix, and left ventricular mass index (SVKI)). The patient group was divided into two groups as with and without cardiovascular disease. Results: Mean Aix and PWV values were higher in CKD patients than controls (Aix: CKD 32.8±11.11%, healthy subjects: 6.74±6.58%, PWV CKD: 7.31±4.34m/s, healthy subjects: 3.42±3.01m/s, respectively; p=0.02, p=0.03). The serum IL-8 levels of CKD were significantly higher than of healthy subjects 568.48±487.35pg/mL, 33.67±47.47pg/mL, respectively (p<0.001). There was no statistically significant difference between IL-8, IL-10, IL-13, TGF-1, in CKD patients with and without cardiovascular disease (p> 0.05). Discussion: IL-8 is the sole cytokine that increases in pediatric patients with chronic kidney disease among other cytokines (IL-10, IL-13 and TGF-β1). However, we did not show that IL-8 is related to the presence of cardiovascular disease.

Cardiomyopathy is a major factor contributing to mortality and morbidity in patients with Duchenne and Becker muscular dystrophies (DMD/ BMD), and is therefore among the increasingly important findings. These X-linked recessive disorders involve the deficiency or absence of dystrophin in the skeletal muscle as well as the myocardium. This defect brings about changes in the cardiac muscle in three phases: an initial hypertrophic stage, followed by an arrhythmogenic stage, and finally end-stage dilated cardiomyopathy due to increased loss of myocytes. While cardiac involvement can be observed in carriers of BMD and DMD, the incidence of dilated cardiomyopathy is reported to be higher in BMD patients than DMD patients. The only curative treatment option for medically refractory dystrophinopathic end-stage heart failure is heart transplantation. In this report, we present two patients, 14 and 15 years of age, who presented with dilated cardiomyopathy and were diagnosed with muscular dystrophy. One of the patients remains under follow-up with a left ventricular assist device as a bridge-to-transplantation, while the other underwent successful orthotopic heart transplantation.

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