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(issued by the Evelina Childrens hospital):

In view of recent public health announcements regarding the vast increase in Swine Flu cases in the UK, we have consulted the Dept. of Paediatric Cardiology for advice for parents of children and young people with Congenital Heart Disease. Dr. Shakeel Qureshi, Head of Service, has sent through the following guidelines:

* The common symptoms of swine flu are: abrupt onset of fever (greater than 38˚C) plus two or more of the following

A case of swine flu is based on these symptoms even if that person has not been swabbed to confirm flu.

  When we say “close, direct contact with a case of swine flu”, we mean being within one metre of someone with flu symptoms for at least one hour.

This would include someone with flu symptoms who

If your child is in close direct contact with someone with flu, we advise they should receive a prophylactic (meaning preventative) course of medication called Tamiflu (also called Oseltamivir) to reduce the risk of getting flu. Please call your GP to arrange this; Please print a copy of this document and hand to your GP. Please also inform us as soon as possible and we will arrange to send a letter to them regarding your child

The prophylaxis course is a taken once a day for 10 days; the dose is based on a child’s age/size and kidney function.

If your child develops flu symptoms themselves, early treatment should reduce the risk of severe disease or complications. You should contact your GP so that Tamiflu can be started immediately at treatment dosage, that is, twice daily for 5 days. It is important to understand that Tamiflu is only of benefit if given as prophylaxis after close direct contact, or as treatment in people with flu symptoms.

We ask that you maintain a close watch for flu symptoms in your child, even if they do not have known contact with flu.

If your child needs treatment with Tamiflu, do not delay in arranging this through your GP or NHS Direct, but you should also let your cardiologist know.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stem cells from umbilical cord blood may provide the raw material to repair the hearts of thousands of babies born each year with defective heart valves, according to data presented at the recent American Heart Association annual meeting.

 

Cardiologists from the University Hospital of Munich report they are about five years away from transplanting new heart valves into children with heart defects, made from the children's own cord blood.(1)

 

Congenital heart defects - or problems with the heart's structure that are present at birth - are the most common type of major birth defect. In children with heart valve abnormalities, the valves do not fully open or close and impede the flow of blood.

While surgeons can transplant new valves from donors or from artificial material, these valves won't grow as the children do, meaning these individuals will require repeated operations to provide them with new, larger valves, said Dr. Ralf Sodian, the cardiac surgeon who led the research.

 

Replacement heart valves made from the child's own cord blood stem cells would theoretically grow with the child and change shape as needed, significantly reducing the number of surgeries necessary for these patients.

 

In this study, the cord blood stem cells were seeded onto biodegradable heart valve scaffolds and grown in the laboratory. The cells formed a tissue layer around the scaffolding and further tests showed the engineered cells formed viable heart tissue. When their ability to handle blood flow and pressure were tested, the valves created from cord blood stem cells showed capabilities similar to natural heart valves.

 

Similar results from a pre-clinical study showed cord blood endothelial stem cells demonstrated excellent growth potential for tissue-engineered vascular grafts that could replace human heart defects.

 

The research presented at this meeting - as well as those pre-clinical findings - offer a compelling reason why parents with a child diagnosed intrauterinely with congenital defects should consider preserving their child's cord blood, since it may offer a treatment option in the future.

 

 

Cardiovascular disease is the leading cause of death for both men and women in the U.S. Approximately one million people die of cardiovascular disease annually despite medical intervention, with coronary artery disease claiming 50 percent of those lives. Although heart disease impacts an older population whose heart muscle, arteries and pumping function have deteriorated over time, heart ailments also strike the very young. According to the National Institutes of Health, congenital heart disease is responsible for more deaths in the first year of life than any other birth defect.

 

 

The stem cells found in a newborn's umbilical cord blood are one type of stem cell holding great promise in cardiovascular repair.

 

 

The heart demands a large volume of blood flow in order to bring nutrients and oxygen to the muscle tissue after it has been damaged. Research demonstrates that cord blood stem cells are capable of giving rise to vascular endothelial-like cells, which are believed to aid in the repair of heart tissue damage due to myocardial infarction.

 

 

Permanent loss of cardiomyocytes (heart muscle cells) and the formation of scar tissue following a heart attack result in irreversible damage to cardiac function. Human cord blood contains several different types of stem cells including hematopoietic, endothelial and mesenchymal stem cells. Although still in early stages, four in vitro studies have shown that under certain treatment conditions, cord blood mesenchymal stem cells differentiate into cardiomyocyte-like cells and were able to induce regeneration of healthy cells from damaged cardiomyocytes. This suggests that cord blood stem cells have a high potential to differentiate into cardiomyocytes and aid the regeneration of cardiomyocytes lost due to heart damage.

 

 

The ability of cord blood stem cells to become vascular endothelial-like cells, and thus, blood vessels, indicates they will likely have potential applications beyond the heart.

 

 

As a next step to the research presented at the American Heart Association meeting, the study investigators plan to begin experiments next year to test their procedure in animal models. They will implant the heart valves made from cord blood into the hearts of young lambs, observing their ability to grow and function over time.(1)

 

The growing library of research on cardiac repair suggests an infant's own cord blood could prove to be a valuable treatment option not just for treating a congenital heart defect, but perhaps later in life if the individual experiences a sudden and serious heart attack.