Extracorporeal membrane oxygenation for postcardiotomy mechanical cardiovascular support in children with congenital heart disease

Extracorporeal membrane oxygenation (ECMO) is increasingly used to support postcardiotomy cardiorespiratory failure in children with congenital heart disease. We report on survival outcomes and factors associated with survival for postcardiotomy ECMO patients.     

Catheter Ablation of Typical Atrial Flutter in Severe Pulmonary Hypertension

Atrial Flutter and Pulmonary Hypertension. Background: Radiofrequency ablation is first‐line therapy for atrial flutter (AFL). There are no studies of ablation in patients with severe pulmonary arterial hypertension (PAH). Methods: Consecutive patients with severe PAH (systolic pulmonary artery pressure >60 mmHg) and AFL referred for ablation were evaluated. Patients with complex congenital heart disease were excluded. Results: A total of 14 AFL ablation procedures were undertaken in 12 patients. A total of 75% of patients were female; mean age 49 ± 12 years. SPAP prior to ablation was 99 ± 35 mmHg. Baseline 6‐minute walk distance was 295 ± 118 m. ECG demonstrated a typical AFL pattern in only 42% of cases. Baseline AFL cycle length was longer in PAH patients compared to controls (295 ± 53 ms vs 252 ± 35 ms, P = 0.006). Cavotricuspid isthmus dependence was verified in 86% of cases. Acute success was obtained in 86% of procedures. SPAP decreased from 114 ± 44 mmHg to 82 ± 38 mmHg after ablation (P = 0.004). BNP levels were lower postablation (787 ± 832 pg/mL vs 522 ± 745 pg/mL, P = 0.02). Complications were seen in 14%. A total of 80% (8/10) of patients were free of AFL at 3 months; 75% (6/8) at 1 year. Conclusion: Ablation of AFL in severe PAH patients is feasible, with good short‐ and intermediate‐term success rates. The ECG pattern is not a reliable marker of isthmus dependence. The SPAP and BNP levels may decrease postablation. AFL may be a marker of poor outcomes in patients with PAH with a 1‐year mortality rate of 42% in this study. This rate is higher than expected in the general PAH population. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1185–1190, November 2012)     

EFFECTS OF KINESIO TAPING ON HIP ABDUCTOR MUSCLE STRENGTH AND ELECTROMYOGRAPHY ACTIVITY IN ATHLETES WITH CHRONIC ANKLE INSTABILITY: A RANDOMIZED CONTROLLED TRIAL

ObjectiveAthletes with chronic ankle instability tend to develop hip abductor muscle weakness. Kinesio taping may help this muscle perform its functions, thus preventing injury. The aim of this study was to assess the effects of Kinesio taping on hip abductor muscle strength and electromyography (EMG) activity.SubjectsA total of 34 athletes, mean age 22.08 years (standard deviation 2.71 years) participated in the study.MethodsA pre-test–post-test experimental design was used. For the experimental group, Kinesio tape, and for the control group, Micropore tape, was applied over the gluteus medius muscle. Gluteus medius muscle strength and EMG activity were noted in supine and during the single-leg squat test (SLST), respectively, before and after the intervention. Strength was measured through maximum voluntary isometric contraction (MVIC) force with a handheld dynamometer, and muscle activation measured through EMG.ResultsIn the experimental group, there was a significant increase in gluteus medius strength, by 10.27% (p = 0.00), and a significant decrease in EMG activity (p = 0.00), by 8.38%. In the control group, there was a significant increase in gluteus medius strength, by 2.89% (p = 0.01) and a not statistically significant decrease in EMG activity, by 0.80% (p = 0.15).ConclusionKinesio taping is effective in increasing hip abductor muscle strength in athletes with chronic ankle instability.LAY ABSTRACTAthletes with chronic ankle instability tend to develop hip abductor weakness, which further predisposes them to injuries in the lower limb and hinders their athletic performance. Kinesio taping may help this muscle perform its functions. The aim of this study was to determine the effects of Kinesio taping, applied over the hip abductors, on muscle strength and activation. A total of 34 athletes with chronic ankle instability were recruited to the study. Kinesio taping was found to be effective in increasing the strength of the hip abductor muscle and reducing its activation. Kinesio taping can be used by athletes with chronic ankle instability to prevent injury to the lower limb, for rehabilitation, and to enhance their athletic performance.Key words: ankle injury, hip abductors, Kinesio taping, muscle strength, electromyography

One of the most common injuries, occurring not only in sports, but also in everyday activities, is ankle sprain (1, 2). Incomplete recovery of ankle sprain is very common, and the majority of individuals after initial ankle sprains experience residual symptoms, such as repeated sprains, pain, and a sensation of “giving way” (3). This condition is called chronic ankle instability (CAI) (4). CAI is highly prevalent in high-school/ collegiate athletes, and occurs in up to 70% of athletes with initial ankle sprains (5–8). CAI is associated with reduced health-related quality of life, reduced physical activity levels, and suboptimal functional levels (9). In individuals with chronic ankle sprains the ipsilateral hip abductor muscles are weak in comparison with the uninjured side (10, 11). Beckman & Buchanan observed a significant delay in muscle activation of the gluteus medius (GM) in individuals with CAI (12).Weak hip musculature and comparatively stronger hip adductors further predispose the ankle joint to sprains, because hip joint stability and hip musculature strength are crucial for foot positioning during the heel strike phase of the gait cycle and overall proper gait mechanics (11, 13). This becomes a vicious cycle, in which CAI causes hip abductor muscle weakness and weak hip abductor muscles cause ankle injuries. Therefore, to prevent future problems in the foot and ankle complex in such individuals, this vicious cycle should be broken, either through strengthening the weak hip abductors or by reinforcing the actions of these muscles. Application of Kinesio tape (KT) (3B Scientific®tape, Burnham-on-Sea, UK) is also a method for improving muscle functions, and thus can be used to reinforce the actions of hip abductors. KT is a thin elastic tape that has stretchability up to 120–140% of its original length, and hence provides less mechanical constraint during movement. KT is considered to prevent injuries during sports and to reduce muscle spasms, swelling, and pain (14).A recent study has examined the effects of KT on hip abductor muscle strength in athletes with and without functional ankle instability (FAI) and reported an increase in muscle strength after application of KT (15). However, in that study, KT was applied over both the peroneus longus and the GM, not over the GM only. To the best of our knowledge, no study has examined the effects of KT on muscle strength and electromyography (EMG) activity of GM when KT is applied over the GM only.The aim of this study was to examine the effects of KT on muscle strength and EMG activity of GM in athletes with CAI. If KT is found to have significant effects on muscle strength and EMG activity then it can be used to improve lower limb kinematics, improve athletic performance, prevent and treat lower limb injuries. It has been hypothesized that muscle strength would increase and EMG activity of GM decrease after the application of KT over GM in athletes with CAI.     

Cystine peptides.

NHCH₃ (X = Gly 1 , Ala 2 , Aib 3 , Leu 4 and D-Ala 5 ), have been investigated by Raman and circular dichroism (CD) spectroscopy. Solid state Raman spectra are consistent with β-turn conformations in all five peptides. These peptides exhibit similar conformations of the disulfide segment in the solid state with a characteristic disulfide stretching frequency at 519 ± 3 cm^-1, indicative of a trans-gauche-gauche arrangement about the C^α—C^β—S—S—C^β—C^α bonds. The results correlate well with the solid state conformations determined by X-ray diffraction for peptides 3 and 4. CD studies in chloroform and dimethylsulfoxide establish solvent dependent conformational changes for peptides 1, 3 and 5. Disulfide chirality has been derived using the quadrant rule. CD results together with previously reported nuclear magnetic resonance (n.m.r.) data suggest a conformational coupling between the peptide backbone and the disulfide segment.     

Aneurysmal Bone Cyst of the Frontal Bone — A Case Report

A rare case of aneurysmal bone cyst of the frontal bone in a 33 years old male is presented with a brief review of the literature.     

Sonographic Evaluation of Chest Masses in Children

The sonographic appearances of 12 intrathoracic masses in children are presented. Seven out of 12 masses were malignant and presented with opaque hemithorax on chest X-ray. Different types of masses encountered were: Lymphoma, Neuroblastoma, Ewing's sarcoma, metastatic Ewing's sarcoma, Teratocarcinoma, Pseudotumor of the lung, Neuroenteric duplication cyst, Bronchogenic cyst and tubercular mediastinal lymph nodes.