A Study of Evaluation and Management of Rare Congenital Breast Diseases.

Introduction: Polymastia and polythelia may be asymptomatic or cause pain, restriction of arm movement, milk discharge, cosmetic problems or anxiety. Cosmesis is the main indication for surgical excision of accessory breasts in axilla. In addition it also confirms the diagnosis and allays the patient's fear of harbouring a malignancy.

Laying open (deroofing) and curettage under local anesthesia for pilonidal disease: An outpatient procedure.

Aim: To test the efficacy of lay open (deroofing, not excision) with curettage under local anesthesia (LOCULA) for pilonidal sinus as an outpatient procedure.

Methods: LOCULA procedure was done for all types of pilonidal disease. The primary outcome measure was cure rate.

Waist circumference to height ratio and left ventricular mass in children and adolescents.

Objectives: Waist circumference to height ratio, a measure of central obesity, is a better predictor of cardiovascular risk than body mass index in the paediatric population. Increased left ventricular mass secondary to obesity and hypertension increases the risk for death and cardiovascular disease in adults. Similar data on left ventricular mass are lacking among young patients with central obesity, as defined by waist circumference/height.

Waist circumference to height ratio in children and adolescents.

Background: Waist circumference (WC) to height ratio (WC/HT) is used as a measure of central obesity. However, the optimum ratio that will separate populations with high from low cardiovascular risk remains controversial. This investigation evaluates an optimum WC/HT value to define central obesity in children.

Left ventricular mass in children and adolescents with elevated body mass index and normal waist circumference.

Children and adolescents with elevated body mass index (BMI) who have normal waist circumference (NWC) have a cardiometabolic risk profile similar to normal children. However, there is a lack of adequate information regarding their left ventricular mass (LVM). The present study was undertaken to evaluate LVM in children with elevated BMI with NWC.

Left ventricular mass by echocardiographic measures in children and adolescents.

Background: Recent evidence in adults suggests that left ventricular mass measured as left ventricular mass/height predicts cardiovascular morbidity and mortality better than the two widely used indices, left ventricular mass/body surface area and left ventricular mass/height Standards of left ventricular mass/height have not been reported in children, for whom, owing to lack of significant cardiovascular morbidity and mortality, body mass index has traditionally been used as a potential cardiovascular risk factor.

Methods: In this retrospective study, 692 clinically normal children aged 1 day to 18 years underwent detailed echocardiographic assessment to assess whether any of the left ventricular mass indices--left ventricular mass/height, left ventricular mass/body surface area, and left ventricular mass/height--are associated with obesity as measured by body mass index. Correlations, t-tests, and linear regressions were used for statistical testing.

Abdominal obesity, waist circumference, body mass index, and echocardiographic measures in children and adolescents.

Background: Waist circumference (WC) may predict cardiovascular risk better than body mass index (BMI) in adults. The relationships between WC and echocardiographic measurements known to predict adult cardiovascular risk have not yet been explored in children.

Objective: This investigation sought to investigate whether WC predicts echocardiographic measures of cardiac structure and function and whether WC is a better predictor of these outcomes than BMI.

Prevention of necrotizing enterocolitis in preterm infants: a 20-year experience.

Objective: Diet, indomethacin, and early use of dexamethasone have been implicated as possible causes of necrotizing enterocolitis and intestinal perforation. Because we seldom prescribe indomethacin or early dexamethasone therapy and we follow a special dietary regimen that provides late-onset, slow, continuous drip enteral feeding, we reviewed our 20 years of experience for the incidence of necrotizing enterocolitis and bowel perforation.

Methods: We reviewed data on all 1239 very low birth weight infants (501-1500 g) admitted to our level III unit over a period of 20 years (1986-2005), for morphologic parameters, necrotizing enterocolitis, bowel perforation, use of the late-onset, slow, continuous drip protocol, and indomethacin therapy.

Effect of regular exercise after third decade on Doppler-derived left ventricular filling.

The present study prospectively evaluated filling properties of the left ventricle by pulsed tissue Doppler echocardiography in subjects >35 years old who exercised regularly. Data from 30 subjects (>35 years) who exercised regularly (group I) were compared with 30 age-matched subjects who did not exercise regularly (group II) and with data from 30 younger (22 to 35 years) subjects (group III). Except for the lower heart rate in group I, there were no significant differences between groups I and III; however, subjects in groups I and III, compared with group II, had significantly higher average early (E) waves (14.

Comparison of myocardial function in children with body mass indexes >/=25 versus those <25 kg/m2.

Diastolic functions of the heart, measured by pulsed tissue Doppler echocardiography from 25 overweight and obese children, were compared with 91 children of normal weight who were 10 to 18 years old and had normal 2-dimensional echocardiographic examinations. Overweight and obese subjects, as compared with the control group, had a significant decrease in the peak early diastolic E wave at the ventricular septum (12.8 +/- 2.

Prenatal cocaine/polydrug exposure and infant performance on an executive functioning task.

Executive functioning in cocaine/polydrug (marijuana, alcohol, tobacco) exposed infants was assessed in a single session, occurring between 9.5 and 12.5 months of age.

Autonomic alterations in cocaine-exposed infants.

Background: Heart rate variability (HRV) reflects autonomic control of the heart. After intrauterine cocaine exposure, asymptomatic newborn infants within 72 hours of life have decreased HRV. It is unknown whether these alterations are transient (acute effect) or persist in older infants and possibly reflect a teratogenic effect of cocaine.

Heart rate variability by triangular index in infants exposed prenatally to cocaine.

Background: In adults, heart rate variability triangular index (HRVi) is a highly reproducible measure of heart rate variability (HRV), which makes it more suitable for use in longitudinal studies. Although normative data have been published for newborns, studies in infants with pathological conditions are lacking.

Methods: From 1997 to 2000, within the first 4 days of life, we prospectively evaluated HRVi in cocaine-exposed asymptomatic newborns (N = 97) by Holter monitoring.

Diastolic alterations in infants exposed to intrauterine cocaine: a follow-up study by color kinesis.

Background: During the first 48 hours of life, newborn infants exposed to cocaine in utero have left ventricular diastolic segmental abnormalities. It is unknown whether these abnormalities are transient because of short-term effects or persist in older infants, possibly reflecting a teratogenic effect of cocaine.

Methods: This study prospectively evaluated global and segmental systolic and diastolic cardiac parameters by color kinesis.

Parental involvement in pediatric cardiology outpatient visits.

There is a lack of information regarding parental involvement in subspecialty care of their offspring. We evaluated trends in 3,118 parental visits, accompanied by their children to a pediatric cardiology office during a 5-year period. Offspring accompanied both parents 29%, mothers alone 64%, and fathers alone 5% of the total visits.

Diastolic filling abnormalities by color kinesis in newborns exposed to intrauterine cocaine.

Because cocaine crosses the placenta, we prospectively evaluated global and segmental systolic and diastolic cardiac function by color kinesis in clinically asymptomatic newborns who were exposed to cocaine in utero (group 1, n = 82). Their data were compared with normal controls (group 3, n = 87) and newborns exposed to drugs other than cocaine (group 2, n = 108). During left ventricular filling, newborns exposed to cocaine, compared with groups 2 and 3, had significantly (P <.

Quantification of regional left ventricular wall motion in newborns by color kinesis.

Background: Normal values for regional left ventricular wall motion, although documented in adults, have not been reported in healthy newborns.

Methods: This study prospectively evaluated global and segmental systolic and diastolic cardiac function by color kinesis in clinically asymptomatic healthy newborns.

Results: Eighty-eight asymptomatic infants who were less than 48 hours old were studied.

Heart rate variability in healthy newborn infants.

In adults and older children, heart rate variability (HRV) is frequently used to study autonomic function noninvasively. Normal values of HRV in newborn infants, however, are not widely available. This problem may be partially attributed to the lack of standardization of different methods.