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Pediatric Echocardiography

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https://www.readbyqxmd.com/read/28225219/educational-intervention-for-improving-the-appropriateness-of-transthoracic-echocardiograms-ordered-by-pediatric-cardiologists
#1
Ritu Sachdeva, Pamela S Douglas, Michael S Kelleman, Courtney E McCracken, Leo Lopez, Kenan W D Stern, Benjamin W Eidem, Oscar J Benavidez, Rory B Weiner, Elizabeth Welch, Robert M Campbell, Wyman W Lai
OBJECTIVE: The objective of this study was to evaluate effectiveness of educational intervention (EI) in the Pediatric Appropriate Use of Echocardiography (PAUSE) study to improve appropriateness of transthoracic echocardiograms (TTEs) ordered in pediatric cardiology clinics. DESIGN: Data were prospectively collected after the publication of the Appropriate Use Criteria (AUC) document during 2 phases: the pre-EI phase (1/1/15 to 4/30/15) and the post-EI phase (7/1/15 to 10/30/15)...
February 22, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28214110/pediatric-echocardiographic-nomograms-what-has-been-done-and-what-still-needs-to-be-done
#2
REVIEW
Massimiliano Cantinotti, Shelby Kutty, Eliana Franchi, Marco Paterni, Marco Scalese, Giorgio Iervasi, Martin Koestenberger
Nomograms are essential tools for quantification in pediatric echocardiography. In the last few years, multiple sources highlight that nomograms employed for decades presented significant numerical and methodological limitations. As a result, widely different ranges of normality were generated, thus creating confusion in estimation of several cardiac diseases. New nomograms have recently been generated, overcoming some of the gaps of previous research: wider sample sizes (including neonates/infants), solid statistical/methodological plan, and availability of new data (chamber dimensions, many functional parameters)...
January 19, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28183324/identification-of-taz-mutations-in-pediatric-patients-with-cardiomyopathy-by-targeted-next-generation-sequencing-in-a-chinese-cohort
#3
Jian Wang, Ying Guo, Meirong Huang, Zhen Zhang, Junxue Zhu, Tingliang Liu, Lin Shi, Fen Li, Huimin Huang, Lijun Fu
BACKGROUND: Barth syndrome (BTHS) is a rare X-linked recessive disease characterized by cardiomyopathy, neutropenia, skeletal myopathy and growth delay. Early diagnosis and appropriate treatment may improve the prognosis of this disease. The purpose of this study is to determine the role of targeted next-generation sequencing (NGS) in the early diagnosis of BTHS in children with cardiomyopathy. METHODS: During the period between 2012 and 2015, a gene panel-based NGS approach was used to search for potentially disease-causing genetic variants in all patients referred to our institution with a clinical diagnosis of primary cardiomyopathy...
February 10, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28177138/application-of-pediatric-appropriate-use-criteria-for-initial-outpatient-evaluation-of-syncope
#4
Heather M Phelps, Michael S Kelleman, Courtney E McCracken, Oscar J Benavidez, Robert M Campbell, Pamela S Douglas, Benjamin W Eidem, Wyman W Lai, Leo Lopez, Kenan W D Stern, Elizabeth Welch, Ritu Sachdeva
BACKGROUND: Syncope is a common reason for outpatient transthoracic echocardiography (TTE). We studied the applicability of pediatric appropriate use criteria (AUC) on initial outpatient evaluation of children (≤18 years) with syncope. METHODS: Data were obtained before (Phase I, April-September 2014) and after (Phase II, January-April 2015) the release of the AUC document from six participating pediatric cardiology centers. Site investigators determined the indication for TTE and assigned appropriateness rating based on the AUC document: Appropriate (A), May Be Appropriate (M), Rarely Appropriate (R), or "unclassifiable" (U) if it did not fit any scenario in the AUC document...
February 8, 2017: Echocardiography
https://www.readbyqxmd.com/read/28164029/trends-in-pediatric-echocardiography-and-the-yield-for-congenital-heart-disease-in-a-major-cardiac-referral-hospital-in-cameroon
#5
Clovis Nkoke, Eric Balti, Alain Menanga, Anastase Dzudie, Alain Lekoubou, Samuel Kingue, Andre Pascal Kengne
BACKGROUND: Congenital heart disease (CHD) is a common condition in children in Sub-Saharan Africa (SSA), where it is associated with poor outcomes. Diagnosis of CHD in SSA depends essentially on echocardiography, which is available only in few urban referral centers. Our aim was to assess time changes in the pattern of referral for pediatric echocardiography and the subsequent diagnosis of structural CHD in a major SSA city. METHODS: All pediatric echocardiography performed between 2004 and 2013 at the echocardiography laboratory of the Yaounde General Hospital were reviewed...
January 2017: Translational pediatrics
https://www.readbyqxmd.com/read/28163426/a-pediatric-echocardiographic-z-score-nomogram-for-a-developing-country-indian-pediatric-echocardiography-study-the-z-score
#6
Rajendra Kumar Gokhroo, Avinash Anantharaj, Devendra Bisht, Kamal Kishor, Nishad Plakkal, Rajeswari Aghoram, Nivedita Mondal, Shashi K Pandey, Ramsagar Roy
BACKGROUND: Almost all presently available pediatric echocardiography Z-score nomograms are based on Western data. They may not be a suitable reference standard for assessing the sizes of cardiac structures of children from developing countries. OBJECTIVE: This study's objective was to collect normative data of 21 commonly measured cardiovascular structures using M-mode and two-dimensional echocardiography in Indian children aged between 4 and 15 years and to derive Z-score nomograms for each...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28153478/perfusion-index-and-pulse-oximetry-screening-for-congenital-heart-defects
#7
Federico Schena, Irene Picciolli, Massimo Agosti, Antonio Alberto Zuppa, Gianvincenzo Zuccotti, Luciana Parola, Giulia Pomero, Giorgio Stival, Markus Markart, Silvia Graziani, Luigi Gagliardi, Cristina Bellan, Simona La Placa, Giuseppe Limoli, Gabriella Calzetti, Andrea Guala, Enza Bonello, Fabio Mosca
OBJECTIVE: To evaluate the efficacy of combined pulse oximetry (POX) and perfusion index (PI) neonatal screening for severe congenital heart defects (sCHD) and assess different impacts of screening in tertiary and nontertiary hospitals. STUDY DESIGN: A multicenter, prospective study in 10 tertiary and 6 nontertiary maternity hospitals. A total of 42 169 asymptomatic newborns from among 50 244 neonates were screened; exclusion criteria were antenatal sCHD diagnosis, postnatal clinically suspected sCHD, and neonatal intensive care unit admission...
January 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28150025/initial-field-test-of-a-cloud-based-cardiac-auscultation-system-to-determine-murmur-etiology-in-rural-china
#8
Lee Pyles, Pouya Hemmati, J Pan, Xiaoju Yu, Ke Liu, Jing Wang, Andreas Tsakistos, Bistra Zheleva, Weiguang Shao, Quan Ni
A system for collection, distribution, and long distant, asynchronous interpretation of cardiac auscultation has been developed and field-tested in rural China. We initiated a proof-of-concept test as a critical component of design of a system to allow rural physicians with little experience in evaluation of congenital heart disease (CHD) to obtain assistance in diagnosis and management of children with significant heart disease. The project tested the hypothesis that acceptable screening of heart murmurs could be accomplished using a digital stethoscope and internet cloud transmittal to deliver phonocardiograms to an experienced observer...
February 2, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28148335/a-pediatric-cardiology-fellowship-boot-camp-improves-trainee-confidence
#9
Catherine K Allan, Paul Tannous, Elizabeth DeWitt, Michael Farias, Laura Mansfield, Christina Ronai, David Schidlow, Stephen P Sanders, James E Lock, Jane W Newburger, David W Brown
: Introduction New paediatric cardiology trainees are required to rapidly assimilate knowledge and gain clinical skills to which they have limited or no exposure during residency. The Pediatric Cardiology Fellowship Boot Camp (PCBC) at Boston Children's Hospital was designed to provide incoming fellows with an intensive exposure to congenital cardiac pathology and a broad overview of major areas of paediatric cardiology practice. METHODS: The PCBC curriculum was designed by core faculty in cardiac pathology, echocardiography, electrophysiology, interventional cardiology, exercise physiology, and cardiac intensive care...
December 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/28141792/preventing-permeability-transition-pore-opening-increases-mitochondrial-maturation-myocyte-differentiation-and-cardiac-function-in-the-neonatal-mouse-heart
#10
Jayson V Lingan, Ryan E Alanzalon, George A Porter
BACKGROUND: In embryonic myocytes, closure of the mitochondrial permeability transition pore (PTP) drives mitochondrial maturation and cardiac myocyte differentiation. Since neonatal cardiac myocytes remain relatively immature, we hypothesized that inducing PTP closure at this age, by inhibiting the PTP regulator, cyclophilin D (CyPD), genetically or with Cyclosporin A (CsA) and NIM811, would increase cardiac function by increasing mitochondrial maturation and myocyte differentiation...
January 31, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28138106/teratogenicity-of-antiepileptic-drugs
#11
Betül Tekin Güveli, Rasim Özgür Rosti, Alper Güzeltaş, Elif Bahar Tuna, Dilek Ataklı, Serra Sencer, Ensar Yekeler, Hülya Kayserili, Ahmet Dirican, Nerses Bebek, Betül Baykan, Ayşen Gökyiğit, Candan Gürses
Objective: Antiepileptic drugs (AED) have chronic teratogenic effects, the most common of which are congenital heart disease, cleft lip/palate, urogenital and neural tube defects. The aim of our study is to examine teratogenic effects of AED and the correlation between these malformations and AED in single or multiple pregnancies. Methods: This is a retrospective study of malformations in children born to mothers currently followed up by our outpatient clinics who used or discontinued AED during their pregnancy...
February 28, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28129792/intramuscular-injection-of-human-umbilical-cord-derived-mesenchymal-stem-cells-improves-cardiac-function-in-dilated-cardiomyopathy-rats
#12
Chenggang Mao, Xu Hou, Benzhen Wang, Jingwei Chi, Yanjie Jiang, Caining Zhang, Zipu Li
BACKGROUND: Stem cells provide a promising candidate for the treatment of the fatal pediatric dilated cardiomyopathy (DCM). This study aimed to investigate the effects of intramuscular injection of human umbilical cord-derived mesenchymal stem cells (hUCMSCs) on the cardiac function of a DCM rat model. METHODS: A DCM model was established by intraperitoneal injections of doxorubicin in Sprague-Dawley rats. hUCMSCs at different concentrations or cultured medium were injected via limb skeletal muscles, with blank medium injected as the control...
January 28, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28126563/cardiac-dysfunction-at-echocardiogram-and-ferritin-as-early-markers-of-severity-in-pediatric-sepsis
#13
Cristian T Tonial, Pedro Celiny R Garcia, Louise Cardoso Schweitzer, Caroline A D Costa, Francisco Bruno, Humberto H Fiori, Paulo R Einloft, Ricardo Branco Garcia, Jefferson Pedro Piva
OBJECTIVE: The aim of this study was to verify the association of echocardiogram, ferritin, C-reactive protein, and leukocyte count with unfavorable outcomes in pediatric sepsis. METHODS: A prospective cohort study was carried out from March to December 2014, with pediatric critical care patients aged between 28 days and 18 years. Inclusion criteria were diagnosis of sepsis, need for mechanical ventilation for more than 48h, and vasoactive drugs. Serum levels of C-reactive protein, ferritin, and leukocyte count were collected on the first day (D0), 24h (D1), and 72h (D3) after recruitment...
January 23, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28099426/fetal-origins-of-adult-cardiac-disease-a-novel-approach-to-prevent-fetal-growth-restriction-induced-cardiac-dysfunction-using-insulin-like-growth-factor
#14
Tarek Alsaied, Khaled Omar, Jeanne F James, Robert B Hinton, Timothy M Crombleholme, Mounira Habli
BACKGROUND: Fetal growth restriction is a risk factor for adult cardiovascular disease. Intra-placental gene transfer of human insulin-like growth factor-1 corrects birth weight in our mouse model of fetal growth restriction. This study addresses long term effects of fetal growth restriction on cardiac function and the potential preventive effect of insulin-like growth factor-1. STUDY DESIGN: Laparotomy was performed on pregnant C57BL/6J mice at embryonic day 18 and pups were divided into 3 groups: Sham operated; fetal growth restriction (induced by mesenteric uterine artery ligation); treatment (intra-placental injection of insulin-like growth factor-1 after uterine artery ligation)...
January 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28099422/relationship-between-perfusion-index-and-patent-ductus-arteriosus-in-preterm-infants
#15
Enrique Gomez-Pomar, Majd Makhoul, Philip M Westgate, Katrina T Ibonia, Abhijit Patwardhan, Peter J Giannone, Henrietta Bada, Elie G Abu Jawdeh
BACKGROUND: Perfusion index (PI) is a noninvasive measure of perfusion. ΔPI (difference between pre and post-ductal PI) may identify hemodynamically significant PDA. However, studies are limited to brief and intermittent ΔPI sampling. Our objective is to assess the value of continuous high resolution ΔPI monitoring in the diagnosis of PDA. METHODS: Continuous ΔPI monitoring in preterm infants was prospectively performed using two high resolution pulse oximeters...
January 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28097194/the-mystery-of-the-z-score
#16
REVIEW
Alexander E Curtis, Tanya A Smith, Bulat A Ziganshin, John A Elefteriades
Reliable methods for measuring the thoracic aorta are critical for determining treatment strategies in aneurysmal disease. Z-scores are a pragmatic alternative to raw diameter sizes commonly used in adult medicine. They are particularly valuable in the pediatric population, who undergo rapid changes in physical development. The advantage of the Z-score is its inclusion of body surface area (BSA) in determining whether an aorta is within normal size limits. Therefore, Z-scores allow us to determine whether true pathology exists, which can be challenging in growing children...
August 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28094679/a-retrospective-analysis-of-a-pediatric-tele-echocardiography-service-to-treat-triage-and-reduce-trans-pacific-transport
#17
Christopher A Rouse, Brandon T Woods, C Becket Mahnke
Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28092064/critical-congenital-heart-disease-newborn-screening-implementation-lessons-learned
#18
Monica R McClain, John S Hokanson, Regina Grazel, Kim Naarden Van Braun, Lorraine F Garg, Michelle R Morris, Kathleen Moline, Keri Urquhart, Amy Nance, Harper Randall, Marci K Sontag
Introduction The purpose of this article is to present the collective experiences of six federally-funded critical congenital heart disease (CCHD) newborn screening implementation projects to assist federal and state policy makers and public health to implement CCHD screening. Methods A qualitative assessment and summary from six demonstration project grantees and other state representatives involved in the implementation of CCHD screening programs are presented in the following areas: legislation, provider and family education, screening algorithms and interpretation, data collection and quality improvement, telemedicine, home and rural births, and neonatal intensive care unit populations...
January 16, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28070903/myocardial-deformation-in-pediatric-patients-with-mucopolysaccharidoses-a-two-dimensional-speckle-tracking-echocardiography-study
#19
Francesco Borgia, Enrica Pezzullo, Vincenzo Schiano Lomoriello, Regina Sorrentino, Francesco Lo Iudice, Sara Cocozza, Roberto Della Casa, Giancarlo Parenti, Pietro Strisciuglio, Bruno Trimarco, Maurizio Galderisi
BACKGROUND: Mucopolysaccharidoses (MPS) are inherited lysosomal storage disorders caused by deficiency of required glycosaminoglycans breakdown enzymes, inducing cardiac involvement. Little is known about myocardial deformation involvement in MPS. Our aim was to assess biventricular structure and function in asymptomatic children with MPS using standard echo Doppler and 2D speckle tracking (STE). METHODS: Fifteen MPS children (one type I, six type II, three type III A, one III B, three IV A, one VI), asymptomatic for cardiac symptoms, and 15 age and sex-matched healthy controls underwent echo Doppler and STE...
January 10, 2017: Echocardiography
https://www.readbyqxmd.com/read/28043739/canadian-cardiovascular-society-canadian-pediatric-cardiology-association-position-statement-on-pulse-oximetry-screening-in-newborns-to-enhance-detection-of-critical-congenital-heart-disease
#20
Kenny K Wong, Anne Fournier, Deborah S Fruitman, Lisa Graves, Derek G Human, Michael Narvey, Jennifer L Russell
Congenital heart disease is the most common congenital malformation and approximately 3 in 1000 newborns have critical congenital heart disease (CCHD). Timely diagnosis affects morbidity, mortality, and disability, and newborn pulse oximetry screening has been studied to enhance detection of CCHD. In this position statement we present an evaluation of the literature for pulse oximetry screening. Current detection strategies including prenatal ultrasound examination and newborn physical examination are limited by low diagnostic sensitivity...
February 2017: Canadian Journal of Cardiology
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