Between 1976 and 1986, the authors treated 33 children with Schönlein-Henoch purpura (S-H purpura), with physiological urinary finding on admission. Twenty-three of them received prednisone already at the beginning of hospitalization, 10 were not given any prednisone at all. In patients with prednisone, nephropathy occurred only once (4.3%), in those without prednisone it occurred 5 times (50%), the incidence being thus significantly higher. Prednisone was administered in doses ranging between 1.0 and 2.5 mg/kg body mass/day, on an average for 21 days (first 10 days in the same dose, later in reduced doses). Since there is a general lack of data on the positive effect of steroids upon the prevention of nephropathies in S-H purpura, the authors recommend more thorough studies in the initial stage of the disease (before the development of nephropathies).
The aim of this study was to obtain information about parameters of heart rate variability (HRV) in three frequency bands (high frequency - HF, low frequency - LF and very low frequency - VLF), the sensitivity of cardiovascular tests, and subjective feelings depending on autonomic nervous system balance in a group of young patients with diabetes mellitus type 1 (IDDM). Sixty-four subjects were examined: 32 patients with diabetes with a mean age of 16.1 +/- 0.7 years and a mean duration of IDDM of 6.3 +/- 0.8 years, and 32 healthy controls matched for age, sex and BMI. Shorter R-R intervals and abnormal values reflecting HRV were found in the diabetic group. In particular, parameters of total power, and HF and LF bands were reduced. The ratio VLF/HF power revealed predominance of sympathetic tone in the diabetic subjects. Although relative power VLF was increased in the supine position, the reactive rise of the VLF band activity in orthostasis was lower in the IDDM group. Using cardiovascular tests (deep breathing, Valsalva, orthostasis), significant differences in reactions were found only in the deep breathing test. Evaluation of sympathetic:parasympathetic:indifferent subjective feelings by questionnaire did not reveal any differences between the diabetic and healthy groups.
In 38 patients with orthostatic proteinuria (O.P.) and in 31 children of the control group (C) roentgenograms of excretory urography have been compared, made in the standing erect and in the lying down posture. In children with O.P. significantly more frequent and more expressive ptosis of the kidneys during orthostasis was found than in the controls. In children with O.P. disturbed urine outflow was found in 36.8%, while in children of the control group only in 3.2%. On the basis of the results obtained relations between haemodynamic changes in ptosis of the kidneys, disturbed urine outflow and the origin of O.P. are analysed.
In 27 children (14 juvenile hypertonics and 13 healthy control children, with the mean age 14.7 +/- 0.4 y. or 15.2 +/- 0.5 y., respectively, P greater than 0.05) the changes of heart rate (HR), its variability (HRV) during deep inspiration and subsequent expiration, Valsalva's maneuver, doubled breathing frequency and the deepening of breathing were studied. The resting supine mean HR was significantly higher (P less than 0.001) in hypertonics than in controls. Deep inspiration was in both groups accompanied with the HR increase. However, the percentage increase in hypertonics was significantly lower than in normals (P less than 0.02). With subsequent expiration, the HR fell in both groups. There was no significant difference between the percentage decreases in both groups (P greater than 0.05). During the Valsalva's maneuver, in the first phase the tachycardic response occurred, which was in hypertonics significantly less pronounced. After the recovery of breathing a bradycardic reaction occurred which was equal in both groups (P greater than 0.05). Both, in juvenile hypertonics and in controls the doubled frequency of breathing increased the mean HR and decreased the HRV. During the deepened breathing there was an increase in mean HR in both groups, and only in the controls there was an increase in HRV. Heart rate variability in hypertonics was lower than in the controls under all the conditions.
The primary aim of the study was to compare heart rate variability (HRV) in children and adolescents with diabetes mellitus type 1 (DM 1) regularly engaged in sports (trained -T) and those not engaged in physical activities (non-trained -NT). The study evaluated the effect of a short-term stay in a reconditioning summer camp on HRV, and assessed the importance of physical exercise in young diabetics. The patients included twenty diabetics with DM 1 (mean age 15.5 years -range 8-27) with an average duration of DM 1 of 6.0 (0.5 -15) years examined by system VariaPulse TF3 on the second and the last day (9 ,h day) of their stay in camp. The mean value of glycosylated hemoglobin (HbA lc ) of the trained subgroup was significantly lower (8.8 ± 0.7 %) in comparison to the NT subgroup (11.6 ± 0.9%). Trained diabetics had significantly longer RR intervals (slower heart rate), higher values of MSSD, spectral total power and powers in three studied frequency bands (very low -VLF, low-LF, high-HF) of the HRV. In active orthostasis, trained subjects had higher reactive changes of spectral powers in the VLF and HF band. Trained subjects had a significantly lower occurence of abnormal values of individual measures of HRV (T = 14 ± 6%, NT = 54 ± 9 %). In the whole group (T+NT) at the end of the stay, as compared with starting values, there were significantly longer RR intervals and higher values of HRV parameters. The increase of the whole spectral power was mainly due to an increased power in HF -parasympathetic band. The results indicate the importance of physical activity and sports in the maintenance and improvement of physiological regulation of cardiac activity in diabetic children and adolescents.
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