Pediatrics – ABC CARDIOL

IJCS

Editorial

Education and Training in Pediatric Cardiac Critical Care: An Essential Tool to Improve Outcomes

Klebia Castello Branco et al. Jorge Yussef Afiune

In an article published in the International Journal of Cardiovascular Sciences, Campos and Carvalho examine the challenges of educating and training teams in pediatric cardiac critical care in developing countries. They also highlight emerging opportunities for improvement and growth.

In recent decades, substantial advances have been made in the field of pediatric cardiology, including progress in pediatric cardiac surgery, catheter-based interventions, anesthesia, cardiac imaging and monitoring, neonatal and pediatric critical care, mechanical circulatory support, and the expansion of multidisciplinary teams. These advances have led to significant improvements in outcomes for children with congenital and acquired heart disease. However, congenital heart disease still places a significant burden on health care systems, especially in low- and middle-income countries.

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IJCS

Original Article

Childhood Obesity and Systemic Arterial Hypertension in Children and Adolescents: A Cross-Sectional Study

Rafaella Farias da Franca Almeida et al. Lívia Menezes Escorel Letícia Odete Guedes de Andrade Carvalho Camila Batista Gaudêncio … Lara Ataide Diniz Marcela Leite Marina Romero Costa Alice Barbosa Maia Berenice Lempek dos Santos Michelle Barros de Aguiar Patrícia Vidal de Negreiros Nóbrega Eugênia Moreira Fernandes Montenegro Débora Alencar de Menezes Athayde Jessica Laureano Martins

Abstract

Background:

The increase in obesity cases and the lack of screening and diagnosis of childhood hypertension highlight the need to examine these comorbidities in children.

Objectives:

To investigate the relationships between systemic arterial hypertension (SAH) and childhood obesity (CO) in pediatrics and correlate the obesity level, abdominal circumference (AC), family history, and physical activity (PA) variables.

Methods:

This cross-sectional study assessed age, sex, height, weight, body mass index (BMI), AC, family history, PA, CO, and blood pressure (BP) percentiles. The Chi-square test, Fisher’s Exact test, and Spearman’s correlation were used for data analysis, with a statistical significance level of 5%.

Results:

After applying the inclusion and exclusion criteria, 30 patients aged between 3 and 18 years (incomplete) were evaluated at three different moments. The results showed that 83.3% (n = 25) of the patients were obese and 16.70% (n = 5) had severe obesity. Among them, 20% (n = 6) were diagnosed with SAH. Data showed an independence between CO and SAH (p = 0.702) and between SAH and PA time (p = 0.748). No correlations were observed between SAH and AC (p = 0.313). The history of SAH in first-degree relatives was significantly associated with the diagnosis of SAH (p = 0.004).

Conclusion:

This study showed no correlation between CO and SAH in the evaluated sample, supporting the need for further research in the area.

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Editorial

Can D-dimer be Used as a Marker for Thromboembolic Events in Pediatric Patients With COVID-19?

Thais Rocha Salim et al. Gabriel Porto Soares

D-dimer is a protein resulting from fibrin degradation. It is released into the circulation when clot degradation occurs and is therefore used as a marker for thromboembolic events and fibrinolysis. The main role of D-dimer lies in its negative predictive value for the exclusion of thromboembolic events, when its level is below 500 ng/mL. Because D-dimer functions as an inflammatory marker, various non-thromboembolic situations can contribute to an increase in its level, such as advanced age, pregnancy, postpartum period, neoplasms, renal insufficiency, and sepsis. Age is a crucial factor when considering D-dimer a thromboembolic marker. Healthy populations over 70 years of age have shown a 50% increase in D-dimer levels without correlation with thrombotic or inflammatory events.

During the COVID-19 pandemic, several studies have demonstrated a positive correlation of elevated D-dimer levels, prolonged coagulation time, and low platelet count with mortality from COVID-19.^,,,Although D-dimers lack high specificity as a diagnostic tool, they have been widely used as predictors of severity and complications in this setting, given that D-dimer tests are rapid, simple, and low-cost.^– However, hyperinflammation caused by SARS-CoV-2 infection can lead to an increase in D-dimer unrelated to thrombosis, which implies its correlation with other tests and caution in interpreting the results.

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Education and Training in Pediatric Cardiac Critical Care: An Essential Tool to Improve Outcomes

Childhood Obesity and Systemic Arterial Hypertension in Children and Adolescents: A Cross-Sectional Study

Abstract

Background:

Objectives:

Methods:

Results:

Conclusion:

Can D-dimer be Used as a Marker for Thromboembolic Events in Pediatric Patients With COVID-19?

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