Late diagnosis of stroke in children is the main cause of nearly 80% of children left with severe neurological damage. This points out an investigation of the National Institute of Spills in Melbourne, Australia, led by Costa Rican pediatrician Yock Adriana Corrales.

Yock Corrales made a specialization in medical emergencies in that country for a year and a half. The report, released at a medical conference, said that, on average, a diagnosis of childhood stroke is given 26 hours after it occurs, when it is too late to act without generating severe consequences that affect memory; motor or for life cause seizures in children.

“The problem is that it is more difficult to recognize a stroke in children than in adults. An adult recognize the symptoms and see your doctor, but a very young child does not know how to express their feelings because parents can not speak, and For older children who do express their ideas, often leaving parents to spend time waiting to improve and rather harm them, “said Yock.

“It’s easy to know what adults are prone to a stroke, because they are people with high cholesterol or hypertension. But children usually are small with genetic heart disease or were not expressed before, so they are apparently very healthy” he added.

Stroke

The spill is also known as attack or stroke. There are two types of stroke, the ischemic and hemorrhagic. The ischemic stroke occurs when an artery or vein in the brain is blocked and prevents blood flow to part of the brain. After a few minutes, cells begin to die from lack of oxygen and nutrients. 88% of strokes are this type.

The hemorrhagic stroke occurs when a blood vessel in the brain ruptures and bleeds. Upon bleeding within the brain, cells do not receive oxygen and nutrients. The pressure increases in the surrounding tissues and cause inflammation. 12% of strokes are this type.

These conditions are rare in children, its incidence is similar to that of a brain tumor. In Costa Rica there are eight or nine years.

The study

The first part of the research was to make a retrospective study of cases of stroke in Melbourne, Australia, for five years. 49 cases were studied. The average age of the children was 7.3 years, 57% were completely healthy children and no history of serious illness.

To give a final diagnosis, doctors delayed 26 hours. These delays were mainly due to parents of children did not realize from the beginning, the general practitioners not detected or that there was no MRI available for analysis.

For a stroke can be met on time and not leave any sickness, the child must be treated in the first six hours. During this time, it still may be given drugs to break up clots and keep blood reaching the brain normally.

If a child is late to the hospital, all doctors can do is stop a second stroke by that time because the consequences are inevitable. “Detect rapid stroke in a child has a chain of responsibility. Parents should note the symptoms quickly, but this is useless if general practitioners do not detect the signs of a stroke. This means that children are treated late and neurological damage are inevitable for many of these children, “Yock said.

The next step of research is to develop a tool to better diagnose patients and to treat them faster. This would also detect differences between stroke and other diseases with similar symptoms. “When you are finished go back to my job specialization in Children’s Hospital. There, unfortunately there is no magnetic resonance imaging that allows us to provide rapid results, but is working on that, “Yock said.

Spanish scientists have used for the first time adult cells from human heart to make stem cells from adipose tissue is becoming cardiomyocytes, according to the University of Granada (UGR). Specifically, they have managed to reprogram adult stem cells, which could have potential therapeutic implications for treating heart disease.

The use of stem cells for treatment of cardiomyopathy is one of the most used today, but work with them without first direct them to the heart tissue is fraught with many difficulties to be effective in such treatment.

Therefore, the induction of entry into the process of cardiomyocyte differentiation of these cells may be one of the best options for the treatment of such diseases.

To carry out this work, the researchers isolated adult human stem cells through liposuction. Then, patients were temporarily permeabilized and exposed to human atrial cell extract, after which the cells recovered in culture.

After 21 days in culture, the cells acquired a phenotype of cardiomyocytes, as demonstrated by morphological changes (appearance of binucleate cells that had fluted and branching fibers), detection by immunofluorescence of specific cardiac markers and the presence of related genes cardiomyocytes were analyzed by RT-PCR chain reaction of reverse transcription polymerase. The mesenchymal cells had been taken, therefore, a cardiac phenotype.

This work has been prepared by Macarena Peran, Juan A. Marchal, Elena Lopez, Manuel Jimenez-Navarro, Houria Boulaiz, Fernando Rodriguez-Serrano, Esmeralda Carrillo, Gema Sanchez-Espin, Eduardo de Teresa, David Tosh and Antonia Aranega, researchers at the University of Jaen, Universidad de Granada, Hospital Universitario Malaga and University of Bath (United Kingdom) and has been accepted for publication in the journal Cytotherapy.

The future projection of this technique would be the myocardial regeneration using a patient’s own cells, so their fat mesenchymal stem cells as the cells of heart tissue. However, scientists warn today that the investigation is in early stages and still far from a therapeutic application.

Currently, researchers are developing a new strategy to enter the cell extract in the target cell (the use of a micro-nozzle cell) that will allow them to obtain a greater number of viable differentiated cells, which are essential for utility clinic.

The next step will be to use animal models to validate the functionality of differentiated cells and finally had to perform clinical trials to assess the feasibility of the technique in humans.

The researchers last fall showed the link between vitamin D deficiency and increased risk of coronary artery disease. These new studies show that treatment of the deficiency in vitamin D supplements may help prevent or reduce a person’s risk of cardiovascular disease and a variety of chronic disorders. The researchers also determined the level of vitamin D which increases the risk reduction.

J. explains Brent Muhlestein, “replacement therapy of vitamin D is associated with reduced risk of fractures and bone diseases. But our findings show that vitamin D could have wider implications for the treatment and reduction of cardiovascular disease and other conditions chronic than we thought before.”

For the first of their studies, the researchers followed two groups of patients for a year. In the first study group involved more than 9,400 patients, mostly women, who reported initial low levels of vitamin D and had at least one follow-up examination during that period of time.

The researchers found that 47 percent of patients who increased their vitamin D levels between the two visits showed a lower risk of cardiovascular disease.

In the second study, researchers put more than 31,000 patients in three categories based on their levels of vitamin D. Patients in each category that increased levels of vitamin D to 43 nanograms per milliliter of blood or more had the lowest mortality rates, diabetes, cardiovascular disease, myocardial infarction, heart failure, hypertension, depression and kidney failure. At present, a level of 30 nanograms per milliliter is considered ‘normal’.

“It was very important to find that levels ‘normal’ were too low. Giving physicians a higher level to look provides a tool to identify patients at risk and provide better treatment,” says Heidi May, co-author study.

Muhlestein for his part said that the results of both studies will change the way they treat their patients. “Although clinical trials are coming that will be useful, I feel that there is enough information to begin treatment as this discovery,” added the researchers.

The choices here are simple, as they would begin with a blood test to determine the level of vitamin D from the patient, if detected low levels may be prescribed supplements or increased sun exposure.

According to the researchers, increased intake of vitamin D from 1,000 to 5,000 international units (IU) could be the right thing one day, depending on the health and genetic risks for the patient. Most supplements on the market provide an average of 400 IU per capsule.

Although exposure of 20 to 30 minutes in the light of the sun can provide up to 10,000 IU, Muhlestein said it was important to use sun protection factor and avoid the hottest parts of the day to avoid sunburn and ultraviolet rays associated with skin cancer.

Shingles is a painful condition that occurs by reactivation of the chickenpox virus (varicella zoster), which remains dormant in nerve fibers after rash illness.

Some people, including over 50 years and those with compromised immune systems, are at high risk for developing viral reactivation and herpes zoster.

The disorder begins with pain or itching burning somewhere in the body and causes an outbreak of blisters. Between 10 and 20 percent of cases develop in the skin around the eyes and sometimes in the same eyes.

Now a team in Taiwan found that in a group of adults with and without ophthalmic herpes, those who had had the infection were more likely to suffer a stroke the year after the treatment.

The 8 percent of 658 men and women with the infection suffered a stroke during the study, in contrast to less than 2 percent of 1974 patients without herpes.

Then, the team considered several factors that explain the high incidence of stroke, such as age and chronic diseases such as hypertension, diabetes and heart disease. The ophthalmic herpes quadrupled the risk of stroke.

The findings, published in the journal Neurology, did not prove cause ACV ophthalmic herpes in some people. But reinforcing the association between herpes and the risk of having one of these episodes.

Recently, the same researchers found that patients had been treated for any type of herpes had a slightly higher rate of stroke in a year than a control group of similar age (1.7 versus 1.3 percent).

The relationship was particularly strong among those who had ophthalmic herpes.

For them, the important thing is to do everything possible to reduce the risk of having a stroke, told Reuters Health the study’s lead author, Dr. Jau-Der Ho of the Taipei Medical University.

That said, includes not smoking, controlling blood pressure and, in diabetics, the blood sugar level.

But according to an editorial published alongside the study, the researchers stressed that more research is needed before drawing conclusions.

The main limitation of this work is to be conducted based on reviewing medical records, wrote Dr. Gustavo A. Ortiz, a neurologist at the Medical School of the University of Miami.

The team used a national database to identify 658 adults treated for herpes eye and compared each with three patients at random and without herpes the same age and gender.

Such studies can only identify relationships between two variables, such as herpes and risk of stroke, not whether a cause to another.

The study also lacked key information on patients, said Ortiz, ie as if they smoked or had atrial fibrillation, a cardiac arrhythmia that can cause a stroke.

The study compared hospitalization rates for acute respiratory infection in children with congenital heart disease without Down syndrome and Down syndrome children with and without heart disease, all under 24 months. The results showed that hospital admissions for respiratory infections, especially RSV dominate syndrome children.

“As a specific example among those with mild heart disease and have not benefited immunoprophylaxis protocols against the virus,” says Julian Lily, a pediatrician at the Hospital Niño Jesús in Madrid and author of the study.
By its physical, morphological alterations of upper and lower respiratory, immunological, pulmonary hypertension, or poor muscle tone, these children have a high predisposition to respiratory infections such as RSV bronchiolitis and pneumonia. They are more frequent and more severe than those developed for children without such chromosomal alterations.

CIVIC 21 data points to a vulnerability of these patients compared to respiratory syncytial virus: a 20% syndrome children admitted for acute respiratory infection, of which 20.7% ended in a pediatric intensive care unit, compared 11% of children without the syndrome, although with congenital heart disease.

The study highlights that children under 24 months old with Down syndrome and congenital heart disease monopolize nonsignificant increased risk of admission for respiratory infection, most often due to respiratory syncytial virus, while children who do not have this syndrome disorder heart have a risk of hospitalization for acute respiratory infection similar to those with congenital heart disease (22% and 23% respectively).
The main conclusion emphasizes lily, is the ability to modify the recommendations for antibiotic prophylaxis in infants with Down syndrome, “even though they have no significant heart disease. Regarding the seasonality of the virus, the critical months were December and January.

The increase in antidepressant therapy based supplements along with omega-3 fatty acid levels does not improve depression in patients with coronary disease, according to a study by the University of Washington published today in JAMA.

Contrary to what is apparent from published studies, a new work developed by a team at Washington University in St. Louis, indicates that the therapy increased from antidepressants (sertraline) with supplements of omega-3 fatty acids levels does not improve depression in patients with coronary heart disease.

The study, led by Robert M. Carney, of that university, and published today in The Journal of the American Medical Association, included 122 patients who received 50 milligrams daily of sertraline and who were randomized to receive 2 grams daily of omega-3 acid in the as ethyl esters or placebo capsules for ten weeks. The authors have shown no differences in the improvement according to the Beck Depression Questionnaire I and II among the different groups.

During the ten weeks they were under observation, and placebo groups did not differ omega-3 in terms of anxiety or depression. There were no significant differences in remission rates or response to therapy between the two groups.