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24 International Congress on Pediatrics 24th International Congress on Pediatrics & 10th Congress on Pediatrics Nursing Oct 11- 15, 2012 Children’s Medical Center Tehran- Iran Organizer: Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IR Iran Growth & Development Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Children’s Medical Center, Pediatrics Center of Excellence, Tehran, IR Iran President Dr. Ali Rabbani Tehran University of Medical Sciences Department of Pediatrics Growth & Development Research Center Tehran University of Medical Sciences Pediatrics Center of Excellence, Children’s Medical Center Tehran University of Medical Sciences Scientific Director: Gholam-Reza Walizadeh, MD Executive Director: Nima Rezaei, MD, PhD Coordinator of Scientific Program: Mahmoud Reza Ashrafi, MD In colaboration with: • TUMS International Relations Office • TUMS Public Relations Office • Iranian Pediatric Endocrinology Association • Iranian Pediatric Neurology Association • Students' Scientific Research Center, Tehran University of Medical Sciences Organization Committee: • Ashrafi, Mahmoud-Reza; MD • Haghi- Ashtini, Mohammad Taghi; MD • Pasalar, Parvin, PhD • Rezaei, Nima, MD, PhD • Shajari, Hamideh; MD • Setodeh, Aria • Shakiba, Marjan • Tootoonchi, Parichehr, MD • Ziaee, Vahid; MD Executive Committee: 1- Ekrami, Sh 7- Karimi, H. 2- Rabiei, F. 8- Kianmehr, Sh. 3- Rahimi, S. 9- Mirzaei, B. 4- Rostami, Y 10- Nekorazm, A 5- Seifkhani, A. 11- Yaghmaei, B; MD 6- Karimi, R.; MD 1 Cardiology & Pulmonology Screening of children for the Marfan They include gastrointestinal symptoms (abdominal pain, syndrome nausea, vomiting, and poor appetite), failure to thrive, easy fatigability, and recurrent or chronic cough with wheezing. • Older children: Older children may present with exercise Keyhan Sayadpour Zanjani, Babak Mahshidfar intolerance, anorexia, wheezing, dyspnea, edema, Tehran University of Medical Sciences palpitations, chest pain, or syncope. Physical examination: Physical findings vary depending on Background: The Marfan syndrome is a multisystemic the reduction of cardiac output, and degree of volume disease involving cardiac valves, aorta, eyes, overload with signs of pulmonary and/or systemic venous musculoskletal system, etc. The incidence is one in 5-10 congestion. Findings are suggestive of the underlying thousand people which is not low. Cardiovascular etiology for heart failure as demonstrated by the following involvement can predict mortality as complications like examples: High blood pressure limited to upper extremities aortic aneurysm and dissection are potentially fetal. Drug and/or feeble pulses in lower extremities are suggestive of therapy (betha blockers, angiotensin-converting enzyme aortic coarctation. The presence of a systolic murmur may inhibitors, etc.) can prevent fatal complications but it be seen in patients with outflow obstruction in hypertropic should be started in early life. Therefore, the importance of cardiomyopathy or aortic stenosis, congenital heart defects early diagnosis of this syndrome can not be ignored. with left to right shunting (eg, ventricular septal defects), or Methods: We incorporated screening of the Marfan mitral regurgitation. Precordial examination may reveal a syndrome in the general screening of school children by the “thrill” in patients with shunt lesions, whereas those with a help of the Health, Treatment and Medical Education long-standing cardiomyopathy may have a “heave” with a Ministry. Suspected children are referred to a pediatric laterally displaced point of maximal impulse. The diagnosis cardiologist for cardiac and skleteal examinations and if the of heart failure in children is based on a combination of diagnosis is likely, to an ophthalmologist for furthur characteristic signs and physical findings of impaired examinations. If the diagnosis of Marfan syndrome is cardiac output, respiratory distress, and poor growth established, proper treatment and prevention of .Laboratory studies and imaging studies generally are used complications are issued. Our objective of introducing this to confirm the diagnosis of heart failure when there is project is attracting the attention of pediatricians. They can clinical uncertainty, assess the severity of failure, and detect many patients and increase the efficacy of this determine the underlying cause. In a child with congenital project. We will discuss the features of this syndrome in heart disease, an echocardiogram is useful to elucidate the children and the way pediatricians can help us in this following: cardiac anatomy, arterial and venous project. connections, presence and amount of shunting, presence Keywords: Marfan Syndrome, aortic Disease, screening and amount of valvular stenosis and regurgitation, atrial and ventricular sizes, diastolic function, estimation of right Heart failure among infants and children: ventricular and pulmonary artery pressures. Keywords: heart failure, child, diagnosis Etiology and diagnosis Contrast induced nephropathy (CIN) after Bahram Mohebbi Tehran University of Medical Sciences administration of IODIXANOL (VISIPAQUE) during cardiac catheterization The presentation of pediatric heart failure is diverse in children with congenital heart disease because of the numerous underlying cardiac etiologies and varying clinical settings. Heart failure is a clinical condition Saeed Abtahi, Elham Mohamadi rana that results from impairment of the ventricle to fill with or Islamic azad university, Mashhad branch eject blood. Heart failure is caused by ventricular pump dysfunction, or by overload of volume (preload) or pressure Background: Contrast induced nephropathy ( CIN ) is a (afterload). Heart failure has been categorized either to common complication of percutaneous coronary describe its natural history after exposure to a risk factor for intervention (PCI). The aim of this study was determination heart failure or to describe the severity of symptoms on a of the incidence of CIN after administration of Iodixanol given day. Symptoms and physical findings in children during cardiac catheterization in children with congenital with heart failure reflect the patient’s inability to heart disease. adequately increase cardiac output (eg, exercise intolerance Methods: All children age < 18 years that referred for and easy fatigue) and/or pulmonary or systemic fluid cardiac catheterization were enrolled in this study. History overload (eg, shortness of breath at rest or with effort due and physical examination were taken before catheterization to pulmonary interstitial edema or hepatomegaly). History: and 5 ml of serum sample was drawn for measuring of Symptoms of heart failure vary with the age of the patient serum urea and creatinine. A total volume of iodixanol ( as follows: concentration 320mg/ml ) was 4-10 ml/kg . Serum sample • Infants: The most common symptoms are tachypnea and for urea and creatinine was taken again 72 hours after diaphoresis during feedings, easy fatigability, irritability, catheterization, rising more than 25% compared to baseline decreased volume of feedings, and poor weight gain. serum creatinine was considered as CIN. • Young children: In young children, the symptoms may be Findings: 58 children enrolled at the study, 28 boys( mistaken for common childhood illnesses such as 44.8%) and 32 girls( 55.2% ) with mean age of 64+/- 53.5 gastroenteritis, reflux, asthma or even behavioral issues. months. CIN ( increased of serum creatinine > 25% of Proceeding of the 24th International Congress of Pediatrics – Oct 2012 2 Cardiology & Pulmonology baseline ) was occurred in 17.2% of patients( 13.8% in cyanotic and 3.4% in acyanotic patients). Risk of CIN was Parvin Akbari-Asbagh, Milad Taghavi not changed statistically related with age, sex, weight and Department of Pediatrics, Valasr Hopital, Tehran dose of contrast media. University of Medical Sciences and Health Services Conclusion: Iodixanol seems to be safe in cardiac catheterization of children. Although the risk of CIN was Background: Many studies have been performed regarding not statistically related with age, sex, weight and dose of the relationship between maternal diabetes and visipaque, there was significant relationship between risk of malformations in fetuses. It seems that cardiovascular CIN in cyanotic congenital heart disease. malformations are the most common anomalies in infants Keywords: children catheterization Iodixanol, CIN of diabetic mothers. Concerning the high prevalence of diabetes mellitus in Iran further studies in this field seem to Evaluation of left ventricular function by be necessary. The objective of this study was to focus on Doppler echocardiography and N- terminal the relationship between different types of diabetes mellitus in pregnant women and various cardiovascular Pro B-type Natriuretic peptide in children malformations occurring in their infants. Other aspects such with chronic kidney as the effects of diabetes duration and control methods are also studied in this research. Roya Isa Tafreshi1, Nakysa Hooman2, Hasan Otukesh2, Methods: This is a retrospective cohort study in which 70 Azar Nikavar, Ebrahim Khamse2, Sudabe Hoseini neonates admitted to Valiasr hospital between the years 1Department of Pediatric Cardiology, 2Department of 1387 to 1389 are chosen and devided into two groups: one Pediatric Nephrology. 1, 2 Aliasgar Children’s Hospital, group consists of infants of diabetic mothers and the other Tehran University of Medical Sciences and Health group consists of infants
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