Abstract-Carotid-femoral pulse wave velocity is an established method for characterizing aortic stiffness, an individual predictor of cardiovascular mortality in adults. Normal pulse wave velocity values for the pediatric population derived from a large data collection have yet to be available. The aim of this study was to create a reference database and to characterize the factors determining pulse wave velocity in children and teenagers. Carotid-femoral pulse wave velocity was measured by applanation tonometry. Reference tables from pulse wave velocities obtained in 1008 healthy subjects (aged between 6 and 20 years; 495 males) were generated using a maximum-likelihood curve-fitting technique for calculating SD scores in accordance with the skewed distribution of the raw data. Effects of sex, age, height, weight, blood pressure, and heart rate on pulse wave velocity were assessed. Sex-specific reference tables and curves for age and height are presented. Pulse wave velocity correlated positively (PϽ0.001) with age, height, weight, and blood pressure while correlating negatively with heart rate. After multiple regression analysis, age, height, and blood pressure remained major predictors of pulse wave velocity. This study, involving Ͼ1000 children, is the first to provide reference values for pulse wave velocity in children and teenagers, thereby constituting a suitable tool for longitudinal clinical studies assessing subgroups of children who are at long-term risk of cardiovascular disease. (Hypertension. 2010;56: 217-224.)Key Words: adolescence Ⅲ blood pressure Ⅲ children Ⅲ vessels Ⅲ pulse wave velocity C ardiovascular disease is the leading cause of death in Western societies. 1 Although there is ample evidence that arteriosclerosis begins in childhood, 2-4 hard end points, such as stroke and ischemic heart disease, are rare or virtually lacking in the pediatric population. There is, thus, an increasing need to establish validated noninvasive tools to forecast early arterial disease and to be able to characterize elevated cardiovascular risk in youngsters. 5 It has been widely recognized that aortic pulse wave velocity (PWV) is a sensitive marker of arterial stiffness and, consequently, of cardiovascular outcome. 6 -9 However, large multicenter clinical studies aimed at generating normal PWV values and assessing the influence of anthropometric factors on PWV in healthy children and teenagers are still lacking.In our previous investigations, we showed that, in specific patient populations with growth retardation, the use of agematched controls failed to reflect the true impact of cardiovascular disease on PWV. Rather, controls matched for both age and height or normalized PWV data such as PWV Z score or PWV/height should be used in such instances. 10 -12 The aim of the present study was to create a reference database and to characterize the factors determining PWV in children and teenagers. To achieve this, the distribution mode of PWV was evaluated in a large group of healthy children and adolescents usin...

Background: The severity of Coronavirus Disease 2019 (COVID-19) is a multifactorial condition. An increasing body of evidence argues for a direct implication of vitamin D deficiency, low serum calcium on poor outcomes in COVID-19 patients. This study was designed to investigate the relationship between these two factors and COVID-19 in-hospital mortality. Materials: This is a prospective study, including 120 severe cases of COVID-19, admitted at the department of Reanimation-Anesthesia. Vitamin D was assessed by an immuno-fluoroassay method. Total serum calcium by a colorimetric method, then, corrected for serum albumin levels. The association with in-hospital mortality was assessed using the Kaplan-Meier survival curve, proportional Cox regression analyses and the receiver operating characteristic curve. Results: Hypovitaminosis D and hypocalcemia were very common, occurring in 75% and 35.8% of patients. When analyzing survival, both were significantly associated with in-hospital mortality in a dose-effect manner (p Log-Rank ¼ 0.009 and 0.001 respectively). A cutoff value of 39 nmol/l for vitamin D and 2.05 mmol/l for corrected calcemia could predict poor prognosis with a sensitivity of 76% and 84%, and a specificity of 69% and 60% respectively. Hazard ratios were (HR ¼ 6.9, 95% CI [2.0-24.1], p ¼ 0.002 and HR ¼ 6.2, 95% CI [2.1-18.3], p ¼ 0.001) respectively. Conclusion: This study demonstrates the high frequency of hypocalcemia and hypovitaminosis D in severe COVID-19 patients and provides further evidence of their potential link to poor shortterm prognosis. It is, therefore, possible that the correction of hypocalcemia, as well as supplementation with vitamin D, may improve the vital prognosis.

Coronavirus Disease 2019 is a very fast-spreading infectious disease. Severe forms are marked by a high mortality rate. The objective of this study is to identify routine biomarkers that can serve as early predictors of the disease progression. This is a prospective, single-center, cohort study involving 330 SARS-CoV-2 infected patients who were admitted at the University Hospital of Blida, Algeria in the period between the 27th of March and 22nd of April 2020. The ROC curve was used to evaluate the predictive performance of biomarkers, assessed at admission, in the early warning of progression toward severity. Multivariate logistic regression was used to quantify the independent risk for each marker. After an average follow-up period of 13.9 ± 3.5 days, 143 patients (43.3%) were classified as severe cases. Six biological abnormalities were identified as potential risk markers independently related to the severity: elevated urea nitrogen (>8.0 mmol/L, OR ¼ 9.3 [2.7-31.7], p < .00001), elevated CRP (>42mg/L, OR ¼ 7.5 [2.4-23.3], p ¼ .001), decreased natremia (<133. 6 mmol/L, OR ¼ 6.0 [2.0-17.4], p ¼ .001), decreased albumin (<33.5 g/L, OR ¼ 5.2 [1.7-16.6], p ¼ .003), elevated LDH (>367 IU/L, OR ¼ 4.9 [1.7-14.2], p ¼ .003) and elevated neutrophil to lymphocyte ratio (>7.99, OR ¼ 4.2, [1.4-12.2], p ¼ .009). These easy-to-measure, time-saving and very low-cost parameters have been shown to be effective in the early prediction of the COVID-19 severity. Their use at the early admission stage can improve the risk stratification and management of medical care resources in order to reduce the mortality rate.

No abstract

No abstract

No abstract

No abstract

No abstract