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https://www.readbyqxmd.com/read/28523341/cost-of-unnecessary-testing-in-the-evaluation-of-pediatric-syncope
#1
Connor Redd, Cameron Thomas, Martha Willis, Michelle Amos, Jeffrey Anderson
Syncope is a common and a typically benign clinical problem in children and adolescents. The majority of tests ordered in otherwise healthy pediatric patients presenting with syncope have low diagnostic yield. This study quantifies testing and corresponding patient charges in a group of pediatric patients presenting for outpatient evaluation for syncope. Patients seen between 3/2011 and 4/2013 in the multi-disciplinary Syncope Clinic at Cincinnati Children's Hospital Medical Center were enrolled in a registry which was reviewed for patient information...
May 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28510296/pharmacokinetics-and-safety-of-single-dose-inhaled-loxapine-in-children-and-adolescents
#2
Sally Selim, Robert Riesenberg, James Cassella, Jeevan Kunta, Edward Hellriegel, Mark A Smith, Alexander A Vinks, Laura Rabinovich-Guilatt
This multisite open-label study sought to characterize the pharmacokinetics and safety of a single dose of inhaled loxapine in children and adolescents. Loxapine powder for oral inhalation was administered via a single-use handheld drug device to children and adolescents (aged 10-17 years) with any condition warranting chronic antipsychotic use. Patients were dosed according to body weight and cohort (<50 kg [n = 15], 2.5 or 5 mg; ≥50 kg [n = 15], 5 or 10 mg); the first 6 patients (cohort 1) enrolled in each weight group received the lower dose...
May 16, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28509783/the-evaluation-of-adolescent-chest-pain-a-screening-ecg-or-psc-17
#3
Patricia E Acra, María T Pérez
PURPOSE OF REVIEW: The present review offers an update on entities presenting as chest pain in the adolescent population. It discusses recently proposed tools and shared mental models used in primary and urgent care settings to evaluate chest pain, and their focus on identifying life-threatening processes. We consider whether the current practice may be improved by accounting for the increasingly recognized non-life-threatening causes of adolescent chest pain. RECENT FINDINGS: The present experiences and behaviors of adolescents have added new causes of chest pain to the work-up of this disquieting chief complaint...
May 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28508456/age-and-sex-based-reference-ranges-for-non-invasive-ventricular-repolarisation-parameters
#4
Annabella Braschi, Maurizio G Abrignani, Vincenzo C Francavilla, Vincenzo Abrignani, Giuseppe Francavilla
BACKGROUND: Some electrocardiographic parameters are able to assess indirectly ventricular repolarisation homogeneity. It is consequently essential to discriminate between normal and abnormal values in clinical decision-making. Considering there is still not a consensus about normal cut-off values, the aim of this study was to document reference intervals in all age groups of a healthy population, providing for age- and sex-percentile tables, which can be used easily and quickly in clinical practice...
May 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28506854/long-term-safety-and-efficacy-of-solifenacin-in-children-and-adolescents-with-overactive-bladder
#5
Donald Newgreen, Brigitte Bosman, Adriana Hollestein-Havelaar, Ellen Dahler, Robin Besuyen, Robert Snijder, Will Sawyer, Søren Rittig, Stéphane Bolduc
PURPOSE: To evaluate long-term safety and efficacy of once-daily oral solifenacin suspension in children (aged 5-<12 years) and adolescents (aged 12-<18 years) with overactive bladder. MATERIALS AND METHODS: 40-week, open-label extension of a 12-week double-blind, placebo-controlled trial. OUTCOME MEASURES: incidence and severity of adverse events (primary endpoint), laboratory variables, vital signs, 12-lead electrocardiogram, post-void residual volume, change from baseline to end of treatment in: mean number of micturitions and incontinence episodes/24 hours, number of incontinence-free days/7 days, number of grade 3 or 4 urgency episodes/24 hours (adolescents only)...
May 12, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28500423/physiological-self-regulation-buffers-the-relationship-between-impulsivity-and-externalizing-behaviors-among-nonclinical-adolescents
#6
Michelle A Kuhn, Joshua J Ahles, Jaclyn T Aldrich, Madeline D Wielgus, Amy H Mezulis
Trait impulsivity is a risk factor for rule breaking and aggressive (externalizing) behaviors among nonclinical youth. Buffers of trait-based risk are of practical interest to preventing externalizing behaviors. One such buffer may be the capacity and efforts of a child to self-regulate their physiology. Youth who possess baseline physiological self-regulatory capacities are more likely to maintain adaptive engagement with their environment and may be less prone to impulsively rule break or be aggressive. Similarly, youth who are able to use self-regulatory skills to calm their physiology in times of stress may be less likely to externalize distress...
May 12, 2017: Journal of Youth and Adolescence
https://www.readbyqxmd.com/read/28420263/an-unusual-cause-of-frequent-sudden-transient-unexplained-falls-and-new-onset-status-epilepticus-case-report-and-mini-review
#7
Dinesh Singh, Alford Dyer, Sherry Gu, Patrick McCarville, Annie Hess, Olugbenga Akingbola, Jane El-Dahr, Stephen Nelson
We report a 14-year old adolescent Caucasian female, who presented with frequent, sudden, transient, and unexplained falls leading to multiple serious injuries to her head and extremities requiring several visits to the emergency department. She was evaluated numerous times and imaging studies, echocardiogram, electrocardiogram, and electroencephalogram studies were all normal. She eventually presented to outside emergency department with dystonic posturing and status epilepticus and was transferred to our pediatric intensive care unit for further management...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28402139/long-term-open-label-safety-study-of-edivoxetine-monotherapy-in-children-and-adolescents-with-attention-deficit-hyperactivity-disorder
#8
Emel Serap Monkul Nery, Mark Bangs, Peng Liu, Jonna Ahl, David Perahia
OBJECTIVE: The purpose of this study was to assess the long-term safety and tolerability of edivoxetine, a selective norepinephrine reuptake inhibitor, which was being developed as monotherapy in pediatric attention-deficit/hyperactivity disorder (ADHD). METHODS: This was an open-label study of edivoxetine once daily dosing (0.1-0.3 mg/kg) as treatment for ADHD in children (6-11 years) and adolescents (12-17 years) to assess safety for up to 5 years. The safety assessments included the incidence of adverse events, vital signs, electrocardiograms, laboratory tests, percentile changes in weight, height, and body mass index, and Tanner staging...
April 12, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28367598/early-repolarization-in-normal-adolescents-is-common
#9
Humera Ahmed, Richard J Czosek, David S Spar, Timothy K Knilans, Jeffrey B Anderson
In adults with structurally normal hearts, the early repolarization pattern (ERP) on electrocardiogram (ECG) may be associated with an increased risk of sudden cardiac death. The prevalence and significance of the ERP in children is unknown. This study examines the prevalence of the ERP, the population in which it is found, and whether there exists any correlation with increased LV mass or family history of significant cardiac events. This was a secondary review of data obtained from healthy adolescents undergoing a limited ECG and transthoracic echocardiogram (TTE) as part of a cardiac screening study...
April 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28356306/effect-of-age-and-sex-on-the-qtc-interval-in-children-and-adolescents-with-type-1-and-2-long-qt-syndrome
#10
Arja S Vink, Sally-Ann B Clur, Ronald B Geskus, Andreas C Blank, Charlotte C A De Kezel, Masao Yoshinaga, Nynke Hofman, Arthur A M Wilde, Nico A Blom
BACKGROUND: In congenital long-QT syndrome, age, sex, and genotype have been associated with cardiac events, but their effect on the trend in QTc interval has never been established. We, therefore, aimed to assess the effect of age and sex on the QTc interval in children and adolescents with type 1 (LQT1) and type 2 (LQT2) long-QT syndrome. METHODS AND RESULTS: QTc intervals of 12-lead resting electrocardiograms were determined, and trends over time were analyzed using a linear mixed-effects model...
April 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28324986/electrocardiographic-waveforms-fitness-check-device-technique-for-sudden-cardiac-death-risk-screening
#11
O J Escalona, M Mendoza
A novel cardiac health device technique development for reliable, non-invasive and cost-effective heart screening in preventive cardiovascular healthcare is presented. In particular, identification of apparently healthy individuals involved in sports activities (particularly in the young, age <; 35 years) who may be at-risk of sudden-cardiac-death (SCD) is mainly focused here. Nevertheless, the same device technique may be prospectively extended for detecting cardiovascular abnormalities in children and adolescents with type1-diabetes, and also in detecting patients with Brugada syndrome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28318658/temporary-removal-sudden-death-in-athletes
#12
Domenico Corrado, Alessandro Zorzi
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
March 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28301398/a-pilot-study-cardiac-parameters-in-children-receiving-new-generation-antidepressants
#13
Mai Uchida, Andrea E Spencer, Tara Kenworthy, James Chan, Maura Fitzgerald, Ana Maria Rosales, Elana Kagan, Alexandra Saunders, Joseph Biederman
OBJECTIVE: Because of concerns about potential associations between high doses of citalopram and QTc prolongation in adults, this study examined whether such associations are operant in children. We hypothesized that therapeutic doses of nontricyclic antidepressant medications (non-TCAs) prescribed to children would be cardiovascularly safe. STUDY DESIGN: The sample consisted of 49 psychiatrically referred children and adolescents 6 to 17 years old of both sexes treated with a non-TCA (citalopram, escitalopram, fluoxetine, paroxetine, sertraline, bupropion, duloxetine, venlafaxine, mirtazapine)...
June 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28289530/consumption-of-energy-beverage-is-associated-with-attenuation-of-arterial-endothelial-flow-mediated-dilatation
#14
John P Higgins, Benjamin Yang, Nikki E Herrin, Santi Yarlagadda, George T Le, Brandon L Ortiz, Asif Ali, Stephen C Infanger
AIM: To investigate whether consumption of an energy drink will acutely impair endothelial function in young healthy adults. METHODS: Energy drinks are being consumed more and more worldwide, and have been associated with some deaths in adolescents and young adults, especially when consumed while exercising. After fasting and not smoking for at least 8 h prior, eleven medical students (9 males) received an electrocardiogram, blood pressure and pulse check, and underwent baseline testing (BL) of endothelial function using the technique of endothelium-dependent flow mediated dilatation (FMD) with high-resolution ultrasound (according to recommended guidelines of the University of Wisconsin Atherosclerosis Imaging Research Program Core Laboratory)...
February 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28287681/the-preparticipation-physical-evaluation
#15
Patrick J Lehman, Rebecca L Carl
With rising rates of sports participation among children and adolescents, pediatricians are increasingly being called upon to perform preparticipation physical evaluations (PPEs) for young athletes. The purpose of this review article is to discuss the general structure of a comprehensive PPE and how the PPE differs from a typical health maintenance visit. The PPE focuses attention on screening for cardiac conditions that predispose athletes to sudden cardiac death with exercise. This review also addresses the debate over whether electrocardiogram screening should be a routine required part of the PPE...
March 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28227258/electrocardiographic-waveforms-fitness-check-device-technique-for-sudden-cardiac-death-risk-screening
#16
O J Escalona, M Mendoza, O J Escalona, M Mendoza, O J Escalona, M Mendoza
A novel cardiac health device technique development for reliable, non-invasive and cost-effective heart screening in preventive cardiovascular healthcare is presented. In particular, identification of apparently healthy individuals involved in sports activities (particularly in the young, age <; 35 years) who may be at-risk of sudden-cardiac-death (SCD) is mainly focused here. Nevertheless, the same device technique may be prospectively extended for detecting cardiovascular abnormalities in children and adolescents with type1-diabetes, and also in detecting patients with Brugada syndrome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28161875/pseudo-real-time-low-pass-filter-in-ecg-self-adjustable-to-the-frequency-spectra-of-the-waves
#17
Ivaylo Christov, Tatyana Neycheva, Ramun Schmid, Todor Stoyanov, Roger Abächerli
The electrocardiogram (ECG) acquisition is often accompanied by high-frequency electromyographic (EMG) noise. The noise is difficult to be filtered, due to considerable overlapping of its frequency spectrum to the frequency spectrum of the ECG. Today, filters must conform to the new guidelines (2007) for low-pass filtering in ECG with cutoffs of 150 Hz for adolescents and adults, and to 250 Hz for children. We are suggesting a pseudo-real-time low-pass filter, self-adjustable to the frequency spectra of the ECG waves...
February 4, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28143993/transcatheter-closure-of-patent-ductus-arteriosus-in-adolescents-and-adults-a-case-series
#18
Sukman Tulus Putra, Mulyadi M Djer, Nikmah S Idris, Sudigdo Sastroasmoro
During 11 years period from January 2005 to December 2015 there were 18 adolescent and adult patients  who underwent transcatheter closure of PDA using PDA Amplatzer Duct Occluder (ADO). There were 9 cases with age of 14 to 18 years and 9 cases with age of more than 18 years where the oldest case was 46 years old. Two cases were male and 16 cases were female. Prior to procedures, clinical assessment, ECG, chest x-ray and transthoracic echocardiography (TTE) were performed to confirm the diagnosis of PDA. The procedures of device implantation was performed under conscious sedation in adults and using general anesthesia in adolescents...
October 2016: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/28138202/treating-an-adolescent-with-long-qt-syndrome-for-bipolar-disorder-a-case-presentation
#19
Özlem Önen, Ayşe Kutlu, Handan Özek Erkuran
OBJECTIVES: Long QT syndrome (LQTS) is described as the development of sudden syncope attacks or death as a result of ventricular tachycardia (VT) episodes that might be observed as elongated QT interval in electrocardiography (ECG). Implantable Cardioverter Defibrillator (ICD) is recommended as first-line treatment for the condition in guidelines. We aimed to present an adolescent recently diagnosed with Bipolar Disorder (BD) who had LQTS that was treated with ICD, discussing her follow up and treatment along with relevant literature...
January 26, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28101660/pocketecg-a-new-noninvasive-method-for-continuous-and-real-time-ecg-monitoring-initial-results-in-children-and-adolescents
#20
Katarzyna Bieganowska, Agnieszka Kaszuba, Maciej Bieganowski, Krzysztof Kaczmarek
Long-term ECG is widely used in diagnosis and assessment of many cardiac symptoms which may be caused by dangerous arrhythmias that sometimes can be difficult to document. The PocketECG system is a new technological solution for a long-term, noninvasive, continuous and real-time ECG monitoring that provides automatic diagnosis of dysrhythmias. ECG data transmission occurs over a mobile network. The goal of this study was to assess the reliability of long-term ECG recordings acquired with the PocketECG system...
March 2017: Pediatric Cardiology
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