Publications by authors named "Sekarski N"

Introduction: One-third of women experience childbirth as traumatic and some develop symptoms of childbirth-related posttraumatic stress symptoms (CB-PTSD symptoms). Whether CB-PTSD symptoms negatively impact on physiological and psychological stress responses in mothers and their offspring and whether they are associated with mother-infant synchrony is not clear. This study aimed to investigate stress responses of (1) mothers with CB-PTSS, (2) of their infant, and (3) the physiological mother-child-synchrony at six months postpartum.

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  • Kawasaki disease, a rare inflammatory condition primarily affecting children under five, showed an 88% increase in incidence during the COVID-19 pandemic in Switzerland compared to the pre-pandemic period.
  • The study analyzed data from 90 children, noting that 30% had been exposed to SARS-CoV-2, but other aspects like demographics and treatment remained similar.
  • This research is the first extended European investigation into Kawasaki disease trends relating to the pandemic, highlighting significant shifts in its occurrence rates.
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Fontan surgery is vital for infants born with a single-ventricle heart. This intervention establishes a new blood flow circuit bypassing the single ventricle, thereby the separating pulmonary and systemic circulation to preserve single ventricular function. However, it carries risks of hepatic complications, collectively termed Fontan-associated liver disease (FALD), characterized by progressive hepatic congestion and fibrosis potentially leading to an equivalent of cirrhosis.

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  • The study investigated the effects of postoperative necrotizing enterocolitis (NEC) on neurodevelopmental outcomes in children who underwent cardiac surgery in their infancy.
  • A total of 101 neonates with congenital heart disease (CHD) were examined, revealing that NEC resulted in longer stays in the intensive care unit and hospital compared to those without NEC.
  • The findings indicated that children with NEC had significantly lower cognitive and motor scores on a developmental assessment tool at one year old, underscoring the negative impact of NEC on neurodevelopment.
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  • Sodium-glucose cotransporter type 2 inhibitors, specifically dapagliflozin and empagliflozin, have changed the game for treating adults with type 2 diabetes, heart failure, and chronic kidney disease, but their use in children is less established.* -
  • A systematic review of clinical data involving 415 children showed that these medications were used in various conditions, including type 2 diabetes, kidney diseases, and other metabolic disorders, highlighting the potential for efficacy and safety.* -
  • In two randomized trials focused on type 2 diabetes in adolescents, results indicated a notable reduction in glycosylated hemoglobin (HbA1c) levels, suggesting that dapagliflozin and empag
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Introduction: Turner syndrome association with multi-organ system comorbidities highlights the need for effective implementation of follow-up guidelines. We aimed to assess the adequacy of care with international guidelines published in 2007 and 2017 and to describe the phenotype of patients.

Methods: In this multicenter retrospective descriptive cohort study, we collected growth and pubertal parameters, associated comorbidities, treatment, and karyotype in patients diagnosed at age <18 years between 1993 and 2022.

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  • Calmodulinopathy is caused by mutations in CALM genes and leads to serious arrhythmias, particularly in young people; the ICalmR aims to connect clinical symptoms with molecular causes.
  • The ICalmR has gathered data from 140 patients, showing a notable presence of CALM-LQTS and CALM-CPVT, and has observed a decrease in the frequency of serious cardiac events compared to past data.
  • The condition presents a wide range of symptoms, from severe arrhythmias to no symptoms at all; while therapy options are limited and based on current practices, management often involves medication and devices like defibrillators.
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Introduction: The aim of this national prospective surveillance study was to compare the clinical presentation, laboratory findings, treatment, and coronary artery outcome in patients with incomplete and complete Kawasaki disease (KD).

Methods: Between March 2013 and February 2019, children with a diagnosis of complete and incomplete KD were reported by the Swiss Paediatric Surveillance Unit and prospectively enrolled. Clinical data, laboratory values, treatment, and echocardiographic features were collected at diagnosis and 1 year of follow-up.

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Introduction: Hyperglycemia is associated with a higher cardiovascular risk, as evidenced by increased carotid-intima media thickness (CIMT) in youth with diabetes. We conducted a systematic review and meta-analysis to assess the effect of pharmacological or non-pharmacological interventions on CIMT in children and adolescents with prediabetes or diabetes.

Methods: We conducted systematic searches of MEDLINE, EMBASE, and CENTRAL, together with supplementary searches in trial registers and other sources for studies completed up to September 2019.

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Unlabelled: Diuretics are frequently prescribed drugs and help managing several pathological conditions, including acute and chronic kidney disease, nephrotic syndrome, congestive heart failure, ascites, systemic and pulmonary hypertension. Diuretic classes include among others osmotic diuretics and carboanhydrase inhibitors, loop diuretics, thiazides, and potassium-sparing diuretics. In this educational article, we aim at reviewing indications, mechanisms of action, and side effects, as well as basic pharmacokinetics considerations and data on diuretics in children, supporting practicing clinicians in choosing (and understanding the background of) the best-suited diuretic regimen for the individual patient.

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Background: Hyperglycaemic disorders of pregnancy are associated with offspring cardiovascular alterations.

Methods: MySweetHeart cohort study aimed to assess the effect of maternal gestational diabetes (GDM) on offsprings' cardiovascular health. Newborns underwent clinical and echocardiographic examinations between 2016 and 2020.

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  • MYBPC3 is the most commonly mutated gene linked to hypertrophic cardiomyopathy (HCM) and has multiple loss-of-function variants that show minimal impact on reproductive fitness across different regions.
  • One notable variant, NM_000256.3:c.3330+2T > G, was initially found in severe HCM cases among Amish newborns but is also seen in adult HCM patients and has now been reported in Swiss families.
  • The presence of this variant in various populations suggests a larger pool of asymptomatic carriers, indicating that those with severe early-onset symptoms might not represent the full scope of the variant's effect on health.
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Introduction: Congenital heart disease (CHD) is the most frequent birth defect. As survival has significantly improved, attention has turned to neurodevelopmental outcomes of children undergoing heart surgery in early infancy. Since multiple risk factors contribute to neurodevelopmental alterations, a nationwide registry collecting data on medical characteristics, interventions, clinical course and neurodevelopment until school-age is needed to improve the quality of management, identify risk- and protective factors affecting neurodevelopment, and facilitate multicentre trials.

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Background: The long-term outcome of adults with repaired total anomalous pulmonary venous connection (TAPVC) is poorly documented. Therefore, the present study aims to provide current clinical data on adult survivors with repaired TAPVC focusing on arrhythmia.

Methods: Clinical and imaging data (prevalence and type of arrhythmias, symptoms, surgical and medical treatment, echocardiographic and cardiac magnetic resonance haemodynamic parameters) were retrospectively collected from 8 European centres and compared between patients with and without arrhythmias.

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Background: Surgical repair of tetralogy of Fallot is usually performed between 3 and 6 months of age with pulmonary valve-sparing repair promoted for the best long-term result. Through a humanitarian program from developing countries, late complete surgical repair of tetralogy of Fallot has been performed at our institution for many years.

Methods: Retrospective analysis of pre- and perioperative data, as well as 30-days outcome of patients older than one year with a confirmed diagnosis of tetralogy of Fallot who had a complete surgical repair between 2005 and 2018 at our institution.

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Objective: Hyperglycaemia during pregnancy is associated with cardiometabolic risks for the mother and the offspring. Mothers with gestational diabetes mellitus (GDM) have signs of subclinical atherosclerosis, including increased carotid intima-media thickness (CIMT). We assessed whether GDM is associated with increased CIMT in the offspring at birth.

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Aim Of The Study: Kawasaki disease is a febrile illness which can lead to significant coronary artery lesions. Its incidence varies among countries and is highest in Japan (330.2 children under 5 years old/100,000 per year).

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Objectives: To determine the association between plasma hemoglobin (HB) at three time-points (birth, postnatal days 0-3 and 0-10) and spontaneous closure of the ductus arteriosus (sDAC).

Study Design: A retrospective case-control study of preterm infants born (2013-2016) between 24 and 29 weeks of gestational age (GA) was conducted in a level three perinatal center in Switzerland. We collected hemoglobin at birth, between days 0-3 and 0-10 in two distinct groups: (i) patients treated for a PDA and (ii) patients with spontaneous closure of the ductus arteriosus (sDAC).

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  • * Data were analyzed from the Swiss Neuropediatric Stroke Registry, focusing on children with cardiac disease who experienced AIS after procedures from 2000 to 2015, revealing that a substantial number experienced AIS shortly after cardiac interventions.
  • * Key risk factors identified for postprocedural AIS included hypotension, the presence of prosthetic cardiac materials, right-to-left shunts, arrhythmias, low cardiac output, and infections, indicating that many of these risks are potentially modifiable.
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Introduction: Emergency caesarean section (ECS) qualifies as a psychological trauma, which may result in postnatal post-traumatic stress disorder (PTSD). Maternal PTSD may not only have a significant negative impact on mother-infant interactions, but also on long-term infant development. The partner's mental health may also affect infant development.

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Aims: Calmodulinopathies are rare life-threatening arrhythmia syndromes which affect mostly young individuals and are, caused by mutations in any of the three genes (CALM 1-3) that encode identical calmodulin proteins. We established the International Calmodulinopathy Registry (ICalmR) to understand the natural history, clinical features, and response to therapy of patients with a CALM-mediated arrhythmia syndrome.

Methods And Results: A dedicated Case Report File was created to collect demographic, clinical, and genetic information.

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Kawasaki disease is an acute vasculitis with a particular involvement of the coronary arteries. Coronary artery aneurysms develop in 20% of untreated children. It has been shown that early treatment with intravenous immunoglobulins and aspirin decreases this risk to 5%, but the medium to long term prognosis of children with Kawasaki disease is still unclear.

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Introduction: Carotid intima-media thickness (CIMT) is a surrogate marker of atherosclerosis that is measured in adults and children to better understand the natural history of cardiovascular disease (CVD). In adults, CIMT is predictive of myocardial infarction and stroke. In children and adolescents, CIMT is used to assess vascular changes in the presence of CVD risk factors (obesity, hypertension, smoking, etc) or clinical conditions associated with a high risk for premature CVD.

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