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Helm P, Tabias D, Niessner C, Hahn S, Apitz C, Bauer U, Siaplaouras J. Fitness and Sports in Children and Adolescents with Congenital Heart Defects during the COVID-19 Pandemic. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- P. Helm
- National Register for Congenital Heart Defects, Berlin, Deutschland
| | - D. Tabias
- Division of Pediatric Cardiology, Children's Hospital, University of Ulm, Ulm, Deutschland
| | - C. Niessner
- Institute of Sports and Sports Science, Institute of Technology, Karlsruhe, Deutschland
| | - S. Hahn
- Fulda University of Applied Sciences, Fulda, Deutschland
| | - C. Apitz
- Division of Pediatric Cardiology, Children's Hospital, University of Ulm, Ulm, Deutschland
| | - U. Bauer
- National Register for Congenital Heart Defects, Berlin, Deutschland
| | - J. Siaplaouras
- Division of Pediatric Cardiology, Children's Hospital, University of Ulm, Ulm, Deutschland
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Siaplaouras J, Niessner C, Helm P, Bauer U, Abdul-Khaliq H, Apitz C. Physical Activity and Sports Participation of Children with Congenital Heart Disease: A Nationwide Survey. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bauer UMM, Helm P, Siaplaouras J, Niessner C, Sticker E, Flemming M, Apitz C. P2576Sports in children and adolescents with congenital heart defects. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Age-appropriate physical activity is an important basis for healthy physical and mental development for children and adolescents with congenital heart defects (CHD)
Purpose
The main goal of this study was to learn more about the physical activity of young and adolescent CHD-patients to understand patient's needs physical activity and to improve the medical advice regarding physical activity and sports by taking the CHD-severity into account.
Methods
An online-questionnaire was developed. CHD patients registered in the German National Register for Congenital Heart Defects were invited by email/post to join the study. In total, 1,718 patients took part. 1,262 patients have finished the questionnaire and are included in the statistical analysis (average age: 11.6±3.1 years; 588 women). CHD severity: 411 patients with simple CHD, 423 with moderate CHD, 364 with complex CHD and 64 with unclassified CHD. The study participants were asked to answer questions regarding physical activity and (school) sports to evaluate their activity level and their individual needs regarding sports.
Results
We identified 831 (65.9%) patients who reported they were exercising sports for at least three days or more for 60 minutes or longer per week (simple CHD: 68.9%; moderate CHD: 64.5%; complex CHD: 63.5%; other CHD: 68.8%). Over all 47 patients (3.7%) stated that they had no regular school sports and 12 patients (1%) reported to have less than one regular sports lessen per week. Out of the 1,215 patients who reported to have regular school sports (simple CHD: 97.3%; moderate CHD: 98.1%; complex CHD: 94.5%; other CHD: 87.5%), the patients stated about how hard they usually work in a regular sports lesson as follows: “without sweating and without shortness of breath” (188 patients, 15.5%; simple CHD: 15.4%; moderate CHD: 17.1%; complex CHD: 14.8%; other CHD: 7.1%), “a little bit sweaty and a bit short of breath” (825 patients, 67.9%; simple CHD: 68.8%; moderate CHD: 65.3%; complex CHD: 68.9%; other CHD: 75%), “a lot of sweat and a lot of shortness of breath” (202 patients, 16.6%; simple CHD: 15.8%; moderate CHD: 17.6%; complex CHD: 16.3%; other CHD: 17.9%).
Conclusions
Overall, young and adolescent patients with CHD appear to be exercising sports regularly and are well integrated into school sports. Although there are slight differences between the individual degrees of CHD severity. These differences can be interpreted as minor fluctuations.
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Affiliation(s)
- U M M Bauer
- National Register for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research), Berlin, Germany
| | - P Helm
- National Register for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research), Berlin, Germany
| | - J Siaplaouras
- University of Ulm, Sektion Pädiatrische Kardiologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Ulm, Germany
| | - C Niessner
- Karlsruher Institut für Technologie (KIT), Institute for Sport and Sport Science (IfSS), Karlsruhe, Germany
| | - E Sticker
- Department Psychologie, Humanwissenschaftliche Fakultät, Universität zu Köln, Köln, Germany
| | - M Flemming
- Coaching Competence Cooperation Rhein-Neckar, Schwetzingen, Germany
| | - C Apitz
- University of Ulm, Sektion Pädiatrische Kardiologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Ulm, Germany
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Zöller D, Siaplaouras J, Apitz A, Latus H, Schranz D, Apitz C. Supervised Exercise Training in Children and Adolescents with Moderate Pulmonary Arterial Hypertension. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1556004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
UNLABELLED We report on a female preterm infant of 29 wk gestational age, who developed acquired lobar emphysema after prolonged artificial ventilation secondary to respiratory disease syndrome and bronchopulmonary dysplasia. The infant underwent atypical segmentectomy at the age of 12 mo because of life-threatening hypoxaemia with pulmonary hypertension and failure of conservative treatment. CONCLUSION Lung volume reduction surgery (LVRS) dramatically improved the respiratory function and resulted in adequate weight gain and psychomotor development. In selected cases LVRS can be an option for lobar emphysema in premature infants with severe bronchopulmonary dysplasia.
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Affiliation(s)
- J Siaplaouras
- Department of Paediatrics, University of Giessen, Germany.
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Abstract
BACKGROUND Intussusception is the most common cause of abdominal emergency in early childhood. The majority of cases are ileocolic type of intussusception. Only few reports concerning small bowel intussusception have been reported. PATIENTS AND METHOD We retrospectively reviewed the clinical records and imaging findings of all patients with the diagnosis of intussusception (comparing small bowel intussusception with ileocolic type of intussusception), which were documented by ultrasound in the period April 1997 to January 2001. The routine ultrasound scans included an evaluation of the entire abdomen using sector and linear transducers of high frequency (5 - 7.5 MHz) and power doppler ultrasound. RESULTS A total of 22 patients with small bowel intussusception (9 female, 13 male) and 29 patients diagnosed to suffer from ileocolic intussusception (10 female, 19 male) were identified and treated. Children with small bowel intussusception were significant older in comparison to children with ileocolic type of intussusception (median age 50 vs. 11 months). In our series the presenting symptoms of patients with small bowel intussusception consisted of abdominal pain (86 %) and vomiting (36 %). The initial clinical symptoms of patients with ileocolic intussusception were abdominal pain (100 %), vomiting (72 %) and/or rectal fresh blood (35 %). Small bowel intussusception was an incidental finding in 3 asymptomatic patients (14 %). Hydrostatic reduction was attempted in 14 % of children with small bowel intussusception (vs. 93 % of children with ileocolic intussusception), one patient needed operative treatment (vs. 21 %). Outcome in all patients was favorable. CONCLUSION The high percentage of patients with small bowel intussusception observed may relate to increased use of abdominal ultrasound in children presenting with abdominal pain and improvements in resolution and quality of the images. Small bowel intussusceptions in our series were in the majority of cases short-segmented, self-limited and without a lead point. In comparison to patients with ileocolic intussusception the presenting symptoms of small bowel intussusception are less acute.
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Affiliation(s)
- J Siaplaouras
- Zentrum für Kinderheilkunde und Jugendmedizin der Justus-Liebig-Universität Giessen, Abteilung Allg. Pädatrie und Neonatologie
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Abstract
Acute rejection of the donor heart is a major cause of mortality in infant heart transplant recipients. The early diagnosis of acute cardiac rejection (ACR) is crucial. Non-invasive methods have shown poor sensitivity in detecting rejection when compared to endomyocardial biopsies (EMB). We assessed troponin I as a new marker to diagnose cardiac rejection. Serum cardiac troponin I (cTNI) levels were retrospectively analysed in 25 heart transplant patients (ages, 2 wk to 13 yr; mean age, 3 months) presenting 36 acute rejections. In early post-operative rejection and initially elevated cTNI levels, rejection was associated with a second increase of serum cTNI concentrations in 21% of the patients (p = 0.15). If cTNI levels were in normal range before ACR an elevation was monitored in 59% of the rejection periods (p < 0.05). In 25% of the cases (n = 9) cTNI levels remained in normal range during the rejection episode (<0.6 ng/mL), in 22% (n = 8) cTNI levels did not exceed pathological values from 0.6 to 1.5 ng/mL and in 53% (n = 19) the measured levels went beyond 1.5 ng/mL. Maximum concentrations of cTNI were measured mostly 12 d from the moment rejection was suspected (day 1) in patients (median day 3). However, cTNI levels were elevated for 2-43 d after ACR was diagnosed (median 10 d). Twenty per cent of the patients with grade 3 rejection (ISHLT) and 75% of the patients with grade 4 rejection had a corresponding elevated cTNI level (p = 0.013). No false-positive elevations of cTNI were documented. The present data demonstrate that cTNI is a not a sensitive but a specific marker of ACR in children.
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Affiliation(s)
- J Siaplaouras
- Kinderklinik der Justus-Liebig-Universität Giessen, Kinderherzzentrum, Giessen, Germany
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Siaplaouras J, Thul J, Will JC, Bauer J, Kreuder J, Valeske K, Akintürk H, Schranz D. [Cardiac troponin I after heart surgery corrective operation in infancy and childhood]. Z Kardiol 2001; 90:408-13. [PMID: 11486575 DOI: 10.1007/s003920170150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Perioperative myocardial damage is an important determinant for postoperative cardiac function and recovery. Cardiac troponin I (cTNI) is a specific marker for myocardial damage. The aim of our study was to evaluate pre- and postoperative cTNI levels, the pattern of elevation in the first four postoperative days and the prognostic value after pediatric cardiac operation. METHODS Cardiac troponin I levels were measured in 115 children mean age 36 +/- 45 months (range 4 days to 189 months) undergoing elective operation of a congenital heart defect. Routine measurements were made preoperatively, immediately after cardiopulmonary bypass and serially 8, 18, 42, 90, 138 hours thereafter. Data from 13 patients undergoing surgery without cardiopulmonary bypass served as controls. Postoperative cTNI levels were correlated with intra- and postoperative parameters (such as duration of aortic crossclamping, cardiopulmonary bypass time and need for postoperative inotropic support). RESULTS All preoperative cTNI levels were in the normal range. Postoperatively, the highest median cTNI levels were found in patients after repair of tetralogy of Fallot (TOF), atrioventricular septal defect (AVSD) and implantation of a homo- or xenograft. Postoperative cTNI levels correlated significantly with duration of cardiopulmonary bypass and aortic crossclamping, operative approach (ventriculotomy versus atriotomy) and inotropic support (p < 0.0001). Peak cTNI levels were found immediately after surgery in 77.4% of our patients, 8 hours postoperative in 13.9% and at 18 hours after the surgery in 5.2% of the patients. In three children cTNI continued to increase; a secondary increase was found in one patient. Two of these children died, two had a prolonged postoperative recovery. CONCLUSION The postoperative level of cardiac troponin I could be used as a marker of perioperative myocardial injury caused by ischemia and operative trauma. Peak levels usually could be obtained immediately after surgery, but a further increase of cTNI during the following 18 hours may occur and is not necessarily related to impaired recovery. However still increasing cTNI levels after 18 hours postoperatively and a secondary increase as well may be used as indicators of poor outcome.
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Affiliation(s)
- J Siaplaouras
- Zentrum für Kinderheilkunde der Justus-Liebig-Universität Giessen Feulgenstrasse 12 35385 Giessen, Germany
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Illies G, Siaplaouras J, Lanksch W, Gutensohn K, Heim M, Fuchs N, Salama A. Epilepsy Is Not a Contraindication for Autologous Blood Donation. Transfus Med Hemother 2000. [DOI: 10.1159/000025241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Jürgensen I, Bachmann G, Siaplaouras J, Cassens J. [Clinical value of conventional radiology and MRI in assessing osteochondrosis dissecans stability]. Unfallchirurg 1996; 99:758-63. [PMID: 9005564 DOI: 10.1007/s001130050052] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A prospective study was performed on 72 patients with osteochondritis dissecans (OD) of the knee and ankle to compare plane radiography, MRI and arthroscopy before therapeutic procedures. Special interest was placed on the assessment of fragment stability with radiological methods for staging related therapy. OD was localized in 46 cases on the femoral condyle and in 26 cases on the talus. Radiological methods were performed simultaneously and shortly before definite arthroscopical therapy. Using conventional radiography, OD of the condyles was staged according to the classification of Rodegerdts and Gleissner and OD of the talus suggested by Berndt and Harty. MRI staging was performed by morphology of the interface of the OD. Arthroscopical staging based on the classification of Guhl. There was an excellent correlation between the stages in MRI and arthroscopy, showing correct prediction of stable and unstable fragments in 92%. In contrast, fragment stability could not be efficiently assessed by conventional radiology because fragments could be stably fixed in cases of bony separation. MRI is indicated before performance of staging-related therapy of OD to select patients with stable fragments for conservative therapy and those with unstable OD for surgical therapy.
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Affiliation(s)
- I Jürgensen
- Orthopädische Klinik und Poliklinik, Justus-Liebig-Universität Giessen
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Bachmann G, Jürgensen I, Siaplaouras J. [The staging of osteochondritis dissecans in the knee and ankle joints with MR tomography. A comparison with conventional radiology and arthroscopy]. ROFO-FORTSCHR RONTG 1995; 163:38-44. [PMID: 7626751 DOI: 10.1055/s-2007-1015941] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE A prospective study was performed on 50 patients suffering from osteochondritis dissecans of the knee and ankle to define criteria for stability and fixation of osteochondral lesions. METHODS Morphological parameters in MRI (size, fragmentation, cartilage, interface) and conventional radiology (separation, fragmentation) were registered and compared with arthroscopic staging. MRI staging based on different types of interfaces was demonstrated on T1- and T2-weighted images. RESULTS MRI could correctly predict a Grade 1 lesion in 50%, a Grade 2 lesion in 90%, a Grade 3 lesion in 0%, and a Grade 4 lesion in 79%. Stable lesions were differentiated from unstable lesions in 90%. Radiographic findings corresponded with arthroscopic staging in only 56% of the cases because fibrotic connection may guarantee stability in cases of bony separation. CONCLUSION MRI should be performed before therapy to select those patients who do not need surgical therapy or arthroscopy.
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Affiliation(s)
- G Bachmann
- Abteilung Diagnostische Radiologie, Justus-Liebig-Universität, Giessen
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