SUMMARYIn the 27 years from 1952 to 1979 (before the introduction of advanced cardiac surgery) all children in Central Bohemia (population 1 2 million) who died before the age of 15 were examined at necropsy. Period death rates at various ages were calculated in those with congenital heart disease. Nearly all the deaths (848, 89-6%) occurred in the first year. Forty three (44% of survivors) died in the second year and 17 (31% of survivors) died between the second and fifth years. Over half (20) of the survivors died between the fifth and tenth years. Nearly half (44-2%) of those born with congenital heart disease who died before the age of 15 died in the first four weeks. About a third (2911%) died in the first week and period death rates were 9-7 %, 7-6%, and 5-7 % for the second, third, and fourth weeks respectively. In neonates death rates were highest in those with hypoplastic left heart syndrome (89-2%), coarctation of the aorta (66-7%), truncus arteriosus (61-8%), double outlet right ventricle (57 1%), and pulmonary atresia (56-3%).A necrospy was performed on all children who died in Central Bohemia (population 1-2 million) before the age of 15 in a 27 year period from 1952 to 1979. We reviewed the data on children with congenital heart disease, which were collected before the introduction of advanced cardiac surgery. The distribution of the congenital heart malformations found in the dead children has been reported elsewhere.'In the present study we examine the distribution of the age at death in children who died before the age of 15 and in whom various congenital heart defects were found at necropsy.
SUMMARY402 subjects with diabetes mellitus have been vaccinated of the total of 34,000 vaccinees immunized during the study period of 9 and half months. Altogether 229 diabetic patients (56.97%) have been vaccinated against tick-borne encephalitis (TBE) and 74 (18.4%) against viral hepatitis (41 types A+B, 30 type A, 3 type B). The average age in four most commonly administered vaccines (FSME IMMUN 0.5 ML, Twinrix Adult, Typhim Vi, and Havrix 1440) was 65, 52, 56, and 54 years, respectively. Live attenuated vaccines have been given to 6 patients with diabetes (1.49%) -5 travellers to endemic countries received the yellow fever vaccine Stamaril (1 female, 4 male) and one male patient varicella vaccine Varilrix. Among the least common vaccines in diabetic patients were those against invasive pneumococcal and meningococcal infections. Not a single unexpected side effect has been observed following the vaccination procedure in any diabetic patient.Based on the results of this retrospective study we can conclude that vaccination in diabetic patients is free of any risk -provided that there are no other contraindications, e.g. allergy to vaccine components or severe acute febrile illness. In the case of unstable glycaemia and significantly impaired immune system due to diabetes mellitus, vaccination with live attenuated vaccines should be carefully considered and measured against the risks of exposure to each and every specific infectious agent.There is no reason to be afraid of vaccination in diabetic patients provided that general contraindications are respected. On the contrary, this risk group can benefit from vaccination more remarkably since it may have some life-saving potential.
Thorax, 29, 446-450. Atresia of right pulmonary veins and anomalous left pulmonary venous drainage into portal circulation. An anomaly of pulmonary venous drainage in a male newborn infant is described whereby the left pulmonary veins entered the portal vein and the right pulmonary veins were atretic. A correct diagnosis was made by detecting high-oxygen saturation in the hepatic veins, right-to-left shunt at atrial level, and increased pulmonary artery wedge pressure in comparison with the left atrial pressure, and was confirmed by angiography.Atresia of one pulmonary vein or of the common pulmonary vein is an extremely rare condition. Postmortem findings in two cases of pulmonary venous atresia were described by Benesova (1955). Pulmonary veins converged to form a trunk which terminated as a capillary network in the posterior mediastinum, obviously representing a collateral route. Lucas et al. (1962) reported three similar cases of pulmonary venous atresia diagnosed at necropsy.
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