Summary:Purpose: Only recently has it become known that oxidative stress and generation of reactive oxygen species are the cause and the consequence of epileptic seizures. Due to the protective role of selenium (Se) and selenoproteins against oxidative damage and the ability to promote neuronal cell survival, we compared serum selenium level and red blood cell Glutathione peroxidase activity (RBC GPx) between epileptic and healthy children.Methods: In a case control study, 53 epileptic children were compared with 57 healthy children in the same age and community of residence. Serum Se and RBC GPx activity were measured with an atomic absorption spectrophotometry and Cayman standard glutathione assay kit, respectively.Results: The mean (±standard deviation) of serum Se was 72.90 µg/L (±22.20) and 86.00 µg/L (±15.00) in patient and control groups, respectively. For RBC GPx activity the mean (±standard deviation) was 440.57 nmol/min/ml (±264.00) and 801.00 nmol/min/ml (±267.00) in patient and control groups, respectively. Statistical analysis showed a significant lower means of serum Se and RBC GPx activity in patient group compared to that of healthy control group (p < 0.001).Conclusion: Lower serum Se and RBC GPx activity in epileptic patients compared to healthy children may support the proposed crucial role of Se and GPx activity in the pathogenesis of epilepsy. However, RBC GPx activity in the case of selenium deficiency could not be a sensitive and specific indicator of Se status in serum that led us to supplant Se measurement with RBC GPx activity.

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We aimed to determine the effect of supplementation with coenzyme Q10 on conventional therapy of children with cardiac failure due to idiopathic dilated cardiomyopathy. In a prospective, randomized, double-blinded, placebo-controlled trial, we randomized 38 patients younger than 18 years with idiopathic dilated cardiomyopathy to receive either coenzyme Q10, chosen for 17 patients, or placebo, administered in the remaining 21. Echocardiographic systolic and diastolic function parameters were determined for every patient at baseline, and after 6 months of supplementation. The index score for cardiac failure in children as established in New York was used for assessing the functional class of the patients. After 6 months supplementation, 10 patients randomized to receive coenzyme Q10 showed improvements in the grading of diastolic function, this being significantly more than that achieved by those randomized to the placebo group (p value = 0.011). The mean score for the index of cardiac failure index for those receiving coenzyme Q10 was also lower than the control group (p value = 0.024).Our results, therefore, indicate that administration of coenzyme Q10 is useful in ameliorating cardiac failure in patients with idiopathic dilated cardiomyopathy through its significant effect on improving diastolic function.

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MPI might be a useful parameter for early detection of occult cardiac dysfunction in DMD patients when other simple and standard echocardiographic parameters are within the normal limits. Lack of atrial contribution in LV filling due to atrial contractile dysfunction may play a role in DMD cardiac dysfunction.

The fundamental role of pulmonary vascular resistance in the Fontan circulation is obvious. Medications decreasing this resistance may have an impact on the fate of this population. Hence, we assessed noninvasively the effect of oral sildenafil on the ventriculo-arterial coupling in patients with Fontan circulation. In a single-center, prospective case series study, 23 patients with fenestrated extracardiac total cavopulmonary connection age 12-31 years were enrolled in this study. Clinical characteristics and echocardiographic examination were performed before and after a 1 week course of sildenafil at 0.5 mg/kg every 8 h. Sildenafil had no effect on heart rate and blood pressure. However, oxygen saturation was significantly increased with sildenafil (87.6 ± 4.3 vs. 90.1 ± 3.6; P < 0.0001). The calculated noninvasive ventricular end-systolic elastance (Ees) was greater after sildenafil compared with the pre-sildenafil values (1.59 ± 0.17 vs. 1.72 ± 0.27 mm Hg/ml; P = 0.001). Moreover, significant decreases in arterial elastance (Ea) (1.62 ± 0.53 vs. 1.36 ± 0.43 mm Hg/ml; P < 0.0001), ventricular end-diastolic elastance (Eed) (0.05 ± 0.021 vs. 0.04 ± 0.013; P = 0.002), and, finally, ventriculo-arterial coupling index (0.99 ± 0.26 vs. 0.76 ± 0.15; P < 0.0001) were found after sildenafil administration. The intolerable side effects that led to stopping the sildenafil occurred only in one (4 %) patient. Sildenafil has increased ventricular systolic elastance and improved ventriculo-arterial coupling in patients palliated with Fontan circulation. Short-term sildenafil was well tolerated in most of the patients with only minor side effects.