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https://www.readbyqxmd.com/read/29049043/challenges-of-healthcare-administration-optimizing-quality-and-value-at-an-affordable-cost-in-pediatric-cardiology
#1
Mitchell I Cohen, Patricio A Frias
PURPOSE OF REVIEW: The purpose of this review is to explore the paradigm shift in healthcare delivery that will need to take place over the next few years away from an emphasis on supply-driven health care to better quality transparent-driven health care whose focus is on the consumer's best interest. RECENT FINDINGS: The current healthcare system is fragmented and costs continue to rise. The best way to contain costs is to improve quality to the consumer, the patient...
October 18, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29042698/evaluating-low-kv-dual-source-ct-angiography-by-high-pitch-spiral-acquisition-and-iterative-reconstruction-in-pediatric-congenital-heart-disease-patients
#2
Yohei Marukawa, Shuhei Sato, Takashi Tanaka, Akihiro Tada, Yuichiro Kanie, Susumu Kanazawa
We retrospectively evaluated the qualities of pediatric cardiovascular dual-source computed tomography (DSCT) images reconstructed by sinogram-affirmed iterative reconstruction (SAFIRE) and filtered back projection (FBP). We analyzed the cases of 287 congenital heart disease (CHD) patients < 5 years old, referred to our department in August 2013-March 2015. We divided them into two groups according to tube voltage (70 kVp, n=147; 80 kVp, n=140). All images were acquired by a CARE kV system and reconstructed by FBP and SAFIRE...
October 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/29034445/dental-prevention-and-disease-awareness-in-children-with-congenital-heart-disease
#3
Steffen Koerdt, Julia Hartz, Stefan Hollatz, Gesche Frohwitter, Marco R Kesting, Peter Ewert, Renate Oberhoffer, Herbert Deppe
OBJECTIVES: The importance of excellent oral health is known to be crucial in children with congenital heart diseases (CHD). Data about dental health and disease awareness is limited. This study aims to assess preventive measures taken to improve dental health in children with CHD and to gain insight into disease awareness and knowledge about the importance of oral health in children with CHD and to propose measures that could be taken. MATERIAL AND METHODS: Parents of 150 children with CHD were asked to complete a questionnaire containing specific questions about the preventive measures taken by the parents and dental and medical practitioners and their knowledge about underlying disease and the importance of oral health...
October 16, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29028762/intermittent-versus-continuous-and-intermittent-medications-for-pain-and-sedation-after-pediatric-cardiothoracic-surgery-a-randomized-controlled-trial
#4
Jamie S Penk, Cheryl A Lefaiver, Colleen M Brady, Christine M Steffensen, Kimberly Wittmayer
OBJECTIVES: Compare continuous infusions of morphine and midazolam in addition to intermittent doses with an intermittent only strategy for pain and sedation after pediatric cardiac surgery. DESIGN: Randomized controlled trial. SETTING: Advocate Children's Hospital, Oak Lawn, IL. PATIENTS: Sixty patients 3 months to 4 years old with early extubation after pediatric cardiac surgery. INTERVENTIONS: Patients received a continuous infusion of morphine and midazolam or placebo for 24 hours...
October 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28984030/epigenetics-for-the-pediatric-cardiologist
#5
Andrew D Spearman
A genetic basis of congenital heart disease (CHD) has been known for decades. In addition to the sequence of the genome, the contribution of epigenetics to pediatric cardiology is increasingly recognized. Multiple epigenetic mechanisms, including DNA methylation, histone modification, and RNA-based regulation, are known mediators of cardiovascular disease, including both development and progression of CHD and its sequelae. Basic understanding of the concepts of epigenetics will be essential to all pediatric cardiologists in order to understand mechanisms of pathophysiology, pharmacotherapeutic concepts, and to understand the role of epigenetics in precision medicine...
October 5, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28980341/do-not-forget-the-parents-parents-concerns-during-transition-to-adult-care-for-adolescents-with-congenital-heart-disease
#6
E L Bratt, Å Burström, K Hanseus, A Rydberg, M Berghammer
BACKGROUND: Growing up with congenital heart disease (CHD) often means transfer to adult care and lifelong medical follow-up. An optimal transition process usually involves a multipart collaboration between the patient, their parents and other family members, and the healthcare providers. Taking an active role while knowing when it is time to step aside can be difficult for all the concerned parties, even the healthcare professionals. The aim of the present study therefore, was to explore parents' expectations and needs during their adolescent's transition to adult care...
October 5, 2017: Child: Care, Health and Development
https://www.readbyqxmd.com/read/28977197/collaborative-quality-improvement-in-the-congenital-heart-defects-development-of-the-assist-consortium-and-a-preliminary-surgical-outcomes-report
#7
Fabio Carmona, Paulo Henrique Manso, Mariana Nicoletti Ferreira, Nana Miura Ikari, Marcelo Biscegli Jatene, Luciana Amato, Aida Luiza Turquetto, Luiz Fernando Caneo
OBJECTIVE: ASSIST is the first Brazilian initiative in building a collaborative quality improvement program in pediatric cardiology and congenital heart disease. The purposes of this manuscript are: (a) to describe the development of the ASSIST project, including the historical, philosophical, organizational, and infrastructural components that will facilitate collaborative quality improvement in congenital heart disease care; (b) to report past and ongoing challenges faced; and (c) to report the first preliminary data analysis...
July 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28974851/accidental-heart-murmurs
#8
REVIEW
Edin Begic, Zijo Begic
INTRODUCTION: Accidental murmurs occur in anatomically and physiologically normal heart. Accidental (innocent) murmurs have their own clearly defined clinical characteristics (asymptomatic, they require minimal follow-up care). AIM: To point out the significance of auscultation of the heart in the differentiation of heart murmurs and show clinical characteristics of accidental heart murmurs. MATERIAL AND METHODS: Article presents review of literature which deals with the issue of accidental heart murmurs in the pediatric cardiology...
August 2017: Medical Archives
https://www.readbyqxmd.com/read/28971577/development-of-quality-metrics-for-ambulatory-pediatric-cardiology-transposition-of-the-great-arteries-after-arterial-switch-operation
#9
Carissa M Baker-Smith, Karina Carlson, Jose Ettedgui, Takeshi Tsuda, K Anitha Jayakumar, Matthew Park, Nikola Tede, Karen Uzark, Craig Fleishman, David Connuck, Maggie Likes, Daniel J Penny
OBJECTIVE: To develop quality metrics (QMs) for the ambulatory care of patients with transposition of the great arteries following arterial switch operation (TGA/ASO). DESIGN: Under the auspices of the American College of Cardiology Adult Congenital and Pediatric Cardiology (ACPC) Steering committee, the TGA/ASO team generated candidate QMs related to TGA/ASO ambulatory care. Candidate QMs were submitted to the ACPC Steering Committee and were reviewed for validity and feasibility using individual expert panel member scoring according to the RAND-UCLA methodology...
October 2, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28967605/-22q11-2%C3%A2-microdeletion-syndrome-analysis-of-the-care-pathway-before-the-genetic-diagnosis
#10
T Ingrao, L Lambert, M Valduga, G Bosser, E Albuisson, B Leheup
BACKGROUND: 22q11.2 deletion syndrome (22q11.2DS) is a very broad phenotypic spectrum disorder. It can affect many organs or systems. 22q11.2DS is the most common microdeletion syndrome in humans, with a prevalence ranging from one in every 2000 to one in 4000 newborns. It seems to be more prevalent than reported and under-recognized or undiagnosed because of its inherent clinical variability and heterogeneity. In France, 15,000 patients may be affected by this disease, more than half without knowing it...
September 26, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28956269/the-journey-of-an-indian-pediatric-cardiologist-dr-k-c-chaudhuri-lifetime-achievement-award-oration-at-aiims-new-delhi-september-2017
#11
P Syamasundar Rao
The life journey of an Indian pediatric cardiologist, who bestowed considerable attention to the development of new knowledge and train/teach physicians around the world while providing care of patients with heart disease over a 45-y period, is reviewed. This appraisal focuses particular attention on the scientific contributions to the literature. These include spontaneous closure of physiologically advantageous ventricular septal defects, various issues related to a congenital heart defect namely, tricuspid atresia and transcatheter and, interventional pediatric cardiac procedures...
September 27, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28955719/impact-of-a-pediatric-cardiology-clinical-program-on-congenital-heart-disease-outcomes-in-guyana
#12
Debra Isaac, Vikhashni Nagesh, Alexandra Bell, Rodrigo Soto, Marisa Seepersaud, Kimberley Myers, Saif Zahir
Background: Children with congenital heart disease (CHD) in Guyana have not historically been managed with timely intervention, increasing the likelihood of serious, irreversible complications. In 2014, a pediatric cardiology clinical program (Guyana Paediatric Cardiology Steering Committee [GPCSC]) and partnership with International Children's Heart Foundation (BabyHeart) was developed to improve CHD care. Objectives: To describe the characteristics of CHD in Guyanese children and to determine the impact of GPCSC on CHD outcomes...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28948941/vitamin-d-and-cardiovascular-risk-in-children
#13
REVIEW
Wen-Rui Xu, Hong-Fang Jin, Jun-Bao Du
OBJECTIVE: Vitamin D is a group of fat-soluble molecules that are structurally similar to steroids. Emerging data have led to the hypothesis that Vitamin D plays a role in the regulation of many physiological processes beyond calcium and phosphorus homeostasis. With this review, we aimed to summarize the changes in Vitamin D levels in children with cardiovascular diseases based on the literature. In addition, we also reviewed the potential mechanisms underlying cardiovascular diseases associated with Vitamin D deficiency or insufficiency...
September 22, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28932358/estimating-pressure-gradients-by-auscultation-how-technology-echocardiography-can-help-improve-clinical-skills
#14
Rohini L Kadle, Colin K L Phoon
AIM: To extend our previously-published experience in estimating pressure gradients (PG) via physical examination in a large patient cohort. METHODS: From January 1, 1997 through December 31, 2009, an attending pediatric cardiologist compared clinical examination (EXAM) with Doppler-echo (ECHO), in 1193 patients with pulmonic stenosis (PS, including tetralogy of Fallot), aortic stenosis (AS), and ventricular septal defect (VSD). EXAM PG estimates were based primarily on a murmur's pitch, grade, and length...
August 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28928605/change-of-guard-introducing-the-new-editor-of-the-annals-of-pediatric-cardiology-dr-ks-iyer
#15
EDITORIAL
Raman Krishna Kumar
No abstract text is available yet for this article.
September 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28912187/pediatric-cardiomyopathies
#16
REVIEW
Teresa M Lee, Daphne T Hsu, Paul Kantor, Jeffrey A Towbin, Stephanie M Ware, Steven D Colan, Wendy K Chung, John L Jefferies, Joseph W Rossano, Chesney D Castleberry, Linda J Addonizio, Ashwin K Lal, Jacqueline M Lamour, Erin M Miller, Philip T Thrush, Jason D Czachor, Hiedy Razoky, Ashley Hill, Steven E Lipshultz
Pediatric cardiomyopathies are rare diseases with an annual incidence of 1.1 to 1.5 per 100 000. Dilated and hypertrophic cardiomyopathies are the most common; restrictive, noncompaction, and mixed cardiomyopathies occur infrequently; and arrhythmogenic right ventricular cardiomyopathy is rare. Pediatric cardiomyopathies can result from coronary artery abnormalities, tachyarrhythmias, exposure to infection or toxins, or secondary to other underlying disorders. Increasingly, the importance of genetic mutations in the pathogenesis of isolated or syndromic pediatric cardiomyopathies is becoming apparent...
September 15, 2017: Circulation Research
https://www.readbyqxmd.com/read/28888565/the-use-of-echocardiography-for-pediatric-patients-presenting-with-syncope
#17
Jonathan H Pelletier, Sarah Blanchard, Reid C Chamberlain, Christoph P Hornik, Michael J Campbell, Kevin D Hill
OBJECTIVES: To assess the frequency, yield, and cost of echocardiograms meeting "rarely appropriate" criteria. STUDY DESIGN: Retrospective, single-center study of pediatric patients presenting with syncope. Patients were categorized according to the appropriate use criteria and based upon location of care (emergency department only, primary care setting only, or referred to a pediatric cardiologist). Multivariable regression was used to determine factors associated with performance of a "rarely appropriate" echocardiogram...
September 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28880457/development-of-quality-metrics-for-ambulatory-care-in-pediatric-patients-with-tetralogy-of-fallot
#18
Juan Villafane, Thomas C Edwards, Karim A Diab, Gary M Satou, Elizabeth Saarel, Wyman W Lai, Gerald A Serwer, Peter P Karpawich, Russell Cross, Russell Schiff, Devyani Chowdhury, Thomas J Hougen
OBJECTIVE: The objective of this study was to develop quality metrics (QMs) relating to the ambulatory care of children after complete repair of tetralogy of Fallot (TOF). DESIGN: A workgroup team (WT) of pediatric cardiologists with expertise in all aspects of ambulatory cardiac management was formed at the request of the American College of Cardiology (ACC) and the Adult Congenital and Pediatric Cardiology Council (ACPC), to review published guidelines and consensus data relating to the ambulatory care of repaired TOF patients under the age of 18 years...
September 7, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28871660/clinical-echocardiographic-and-therapeutic-aspects-of-congenital-heart-diseases-of-children-at-douala-general-hospital-a-cross-sectional-study-in-sub-saharan-africa
#19
Félicité Kamdem, Danielle Kedy Koum, Ba Hamadou, Mélanie Yemdji, Henry Luma, Marie Solange Doualla, Diomède Noukeu, Esther Barla, Christophe Akazong, Anastase Dzudie, Henry Ngote, Yves Monkam, Sidiki Mouliom, Samuel Kingue
INTRODUCTION: Cardiovascular diseases in pediatric pathologies have emerged in the recent years in sub-Saharan Africa (SSA), with congenital heart diseases (CHDs) being the most frequent. Unfortunately, their diagnosis is usually delayed, thereby increasing childhood morbidity and mortality. OBJECTIVES: Describe the clinical, echocardiographic, and therapeutic aspects of CHDs of children at Douala General Hospital. METHODS: We carried out a cross-sectional descriptive study over a 10-year period, from January 2006 to December 2015...
September 4, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28865558/impact-of-accreditation-on-quality-in-echocardiograms-a-quantitative-approach
#20
Sarina K Behera, Shea N Smith, Theresa A Tacy
BACKGROUND: Accreditation through the Intersocietal Accreditation Commission (IAC) is believed but not proven to increase quality in imaging. The goal of this study was to use quality metrics to evaluate the impact of accreditation on quality in pediatric echocardiography. METHODS: This is a retrospective study comparing quality metrics in 236 pediatric transthoracic echocardiograms in patients with congenital heart disease from (1) California Pacific Medical Center (CPMC), a community hospital, before and after IAC accreditation, and (2) the IAC-accredited Lucile Packard Children's Hospital (LPCH), an academic children's referral center, during equivalent eras...
September 2017: Journal of the American Society of Echocardiography
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