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https://www.readbyqxmd.com/read/28932358/estimating-pressure-gradients-by-auscultation-how-technology-echocardiography-can-help-improve-clinical-skills
#1
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/28902082/contrast-enhanced-3-dimensional-fluid-attenuated-inversion-recovery-sequences-have-greater-sensitivity-for-detection-of-leptomeningeal-metastases-in-pediatric-brain-tumors-compared-with-conventional-spoiled-gradient-echo-sequences
#2
Michael J Utz, Mandeep S Tamber, Gary E Mason, Ian F Pollack, Ashok Panigrahy, Giulio Zuccoli
Postcontrast 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequences have reduced vascular and flow-related artifacts and high sensitivity to low gadolinium concentrations. We compared the performance of postcontrast spoiled gradient echo images to 3D-FLAIR in the detection of leptomeningeal metastases in 47 pediatric patients with brain tumors. We found 10 cases with more leptomeningeal signal abnormalities on 3D-FLAIR. Overall there were significantly more lesions on 3D-FLAIR than spoiled gradient echo sequences...
September 8, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28888565/the-use-of-echocardiography-for-pediatric-patients-presenting-with-syncope
#3
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/28884203/left-ventricular-dilation-when-pediatric-meet-adult-guidelines
#4
Jill Harmon, Kacy Sisco, Marc Dutro, Clifford L Cua
Measuring and grading left ventricular (LV) size is essential for diagnostic, treatment, and prognostic purposes. Guidelines for quantifying LV size exist for pediatric and adult patients via M-mode measurements, but no data exist determining how well they agree with one another. The goal of this study was to determine the agreement between pediatric echocardiographic readers (PER), pediatric guidelines, and adult guidelines in assessing LV dilation. A retrospective review of all noncongenital echocardiograms from 9/2002 to 11/2015 that had a left ventricular end-diastolic diameter (LVEDD) >5...
September 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28865558/impact-of-accreditation-on-quality-in-echocardiograms-a-quantitative-approach
#5
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
https://www.readbyqxmd.com/read/28864465/automated-left-heart-chambers-volumetric-assessment-using-three-dimensional-echocardiography-in-chinese-adolescents
#6
Xiu-Xia Luo, Fang Fang, Hung-Kwan So, Chao Liu, Man-Ching Yam, Alex Pui-Wai Lee
BACKGROUND: Several studies have reported the accuracy and reproducibility of HeartModel for automated determination of three-dimensional echocardiography (3DE)-derived left heart volumes and left ventricular (LV) ejection fraction (LVEF) in adult patients. However, it remains unclear whether this automated adaptive analytics algorithm, derived from a 'training' population, can encompass adequate echo images in Chinese adolescents. OBJECTIVES: The aim of our study was to explore the accuracy of HeartModel in adolescents compared with expert manual three-dimensional (3D) echocardiography...
September 1, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28859033/longitudinal-analysis-of-echocardiographic-abnormalities-in-children-with-sickle-cell-disease
#7
Jamie K Harrington, Usha Krishnan, Zhezhen Jin, Christopher Mardy, Serge Kobsa, Margaret T Lee
BACKGROUND: Cardiac abnormalities have been described in echocardiograms of children with sickle cell disease (SCD). However, longitudinal studies investigating progression of echocardiographic abnormalities across the pediatric age spectrum in SCD are lacking. METHODS: A retrospective longitudinal analysis of 829 echocardiograms from pediatric patients with SCD at steady-state was performed. Left heart parameters included left ventricular end-systolic, end-diastolic diameters, fractional shortening, and mass...
August 30, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28821935/age-related-t2-relaxation-times-at-3-tesla-as-a-biomarker-of-infratentorial-brain-maturation
#8
Eva Bültmann, Loukia M Spineli, Friederike Göhner, Hans Hartmann, Heinrich Lanfermann
PURPOSE: The purpose of this study was to examine age-related, infratentorial changes in T2 relaxation times during infancy and childhood using routine MRI data at 3 Tesla. METHODS: One hundred patients (0-199 months) without signal abnormalities on conventional MRI were retrospectively selected from our pool of pediatric MRI examinations. T2 maps based on our routinely acquired triple-echo turbo spin-echo (TSE) sequence were created. Based on their clinical symptoms, the children were divided into 43 controls and 57 diseased children with different clinical diseases...
August 18, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28801303/health-care-providers-knowledge-of-hpv-vaccination-barriers-and-strategies-in-a-state-with-low-hpv-vaccine-receipt-mixed-methods-study
#9
Echo L Warner, Qian Ding, Lisa Pappas, Julia Bodson, Brynn Fowler, Ryan Mooney, Anne C Kirchhoff, Deanna Kepka
BACKGROUND: Human papillomavirus (HPV) vaccination is below national goals in the United States. Health care providers are at the forefront of improving vaccination in the United States, given their close interactions with patients and parents. OBJECTIVE: The objective of this study was to assess the associations between demographic and practice characteristics of the health care providers with the knowledge of HPV vaccination and HPV vaccine guidelines. Furthermore, our aim was to contextualize the providers' perceptions of barriers to HPV vaccination and strategies for improving vaccination in a state with low HPV vaccine receipt...
August 11, 2017: JMIR Cancer
https://www.readbyqxmd.com/read/28801085/measuring-in-vivo-cerebral-maturation-using-age-related-t2-relaxation-times-at-3t
#10
Eva Bültmann, Loukia M Spineli, Hans Hartmann, Heinrich Lanfermann
OBJECTIVE: To examine age-related changes in T2 relaxation times during infancy and childhood in order to assess T2 values obtained from routine MRI as a biomarker. METHODS: From our pool of clinical pediatric MRI examinations at 3T all patients with normal conventional MRI scans were retrospectively selected. Depending on their clinical findings the identified 99 patients (0-199months) were divided into 43 healthy controls and 56 diseased children with various clinical abnormalities (developmental delay, epilepsy, prematurity, and deafness)...
August 8, 2017: Brain & Development
https://www.readbyqxmd.com/read/28800832/knowledge-of-appropriate-outpatient-pediatric-echocardiogram-ordering-in-primary-care-physicians-and-trainees
#11
Sean M Lang, Joshua A Daily, Micheal R FitzGerald, Xinyu Tang, Thomas H Best, James M Robbins, R Thomas Collins
Appropriate Use Criteria (AUC) for the initial use of outpatient pediatric echocardiography were established to aid all clinicians in the evaluation of children with possible heart disease, and limit low diagnostic yield studies. We sought to (1) assess PCPs' and trainees' awareness of the AUC document; (2) compare their knowledge of appropriate echocardiogram ordering with that of pediatric cardiologists; and (3) identify additional medical and nonmedical factors affecting PCP echocardiogram ordering. An online survey with clinical scenarios derived from the AUC guidelines was distributed to PCPs and trainees in Arkansas, and pediatric cardiologists from Arkansas Children's Hospital and Cincinnati Children's Hospital Medical Center...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28796432/7t-mri-visualization-of-cortical-lesions-in-adolescents-and-young-adults-with-pediatric-onset-multiple-sclerosis
#12
Ritobrato Datta, Varun Sethi, Sophia Ly, Amy T Waldman, Sona Narula, Blake E Dewey, Pascal Sati, Daniel Reich, Brenda Banwell
BACKGROUND: Cortical pathology in multiple sclerosis (MS) has been associated with prolonged and progressive disease. 7T magnetic resonance imaging (MRI) provides enhanced visualization of cortical lesions (CLs). Hence, we conducted a pilot study to explore whether CLs occur early in MS, as evidenced by pediatric-onset patients. METHODS: A total of 8 pediatric-onset MS patients were imaged using 7T MRI. CLs were annotated on T1-weighted magnetization-prepared rapid acquisition of gradient echoes images as leukocortical (LC), intracortical, or subpial...
September 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28776136/comparison-of-echocardiographic-diagnostic-criteria-of-left-ventricular-noncompaction-in-a-pediatric-population
#13
Anna Joong, Denise A Hayes, Brett R Anderson, Warren A Zuckerman, Sheila J Carroll, Wyman W Lai
BACKGROUND: There is controversy regarding the best echocardiographic diagnostic criteria for left ventricular noncompaction (LVNC). We assessed the diagnostic utility and reproducibility of the previously proposed echocardiographic diagnostic criteria in a pediatric population using a segmental approach. METHODS: Echocardiograms were matched for patients with and without a clinical diagnosis of LVNC. Blinded reviews of echocardiograms measured (1) depths of intertrabecular recesses (X/Y), (2) noncompaction-to-compaction ratio (NC/C), and (3) number of trabeculations, using a segmental approach...
August 3, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28736822/congenital-heart-disease-and-cardiac-procedural-outcomes-in-patients-with-trisomy-21-and-turner-syndrome
#14
Raysa Morales-Demori
Congenital heart disease (CHD) is present in approximately 50% of patients with trisomy 21 (T21) and Turner syndrome (TS). According to the American Academy of Pediatrics, every patient with these genetic disorders should have a postnatal echocardiogram. T21 is usually associated with atrioventricular (30%-60%), atrial (16%-21%), or ventricular septal defects (14%-27%). TS is usually associated with left-sided heart disease. However, the spectrum of CHD in these genetic disorders is wider than those mentioned lesions...
July 24, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28708228/clinical-and-subclinical-cardiac-late-effects-in-pediatric-hodgkin-s-lymphoma-survivors
#15
Carlo Materazzo, Maura Massimino, Elisabetta Schiavello, Marta Podda, Lorenza Gandola, Graziella Cefalo, Serena Catania, Cristina Meazza, Ivan Moschetti, Monica Terenziani
PURPOSE: Cardiac late effects are responsible for a significant burden of mortality and morbidity among pediatric Hodgkin's lymphoma (HL) survivors (HLS). The aim of our study was to assess clinical and subclinical cardiac sequelae in a cohort of childhood HLS treated in the 1980s with doxorubicin, bleomycin, vinblastine, and dacarbazine (the ABVD regimen) and limited-field radiotherapy (RT). METHODS: We retrospectively examined a series of HLS treated from 1979 to 1989...
July 8, 2017: Tumori
https://www.readbyqxmd.com/read/28704916/three-dimensional-echocardiography-in-adult-congenital-heart-disease
#16
REVIEW
Hyun Suk Yang
Congenital heart disease (CHD) is now more common in adults than in children due to improvements in fetal echo, neonatal and pediatric care, and surgical techniques leading to dramatically increased survivability into adulthood. Adult patients with CHD, regardless of prior cardiac surgery, experience further cardiac problems or therapeutic challenges; therefore, a non-invasive, easily accessible echocardiographic examination is an essential follow-up tool. Among echocardiographic modalities, three-dimensional (3D) echocardiography provides better delineation of spatial relationships in complex cardiac geometries and more accurate volumetric information without geometric assumptions...
July 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28693787/secretin-enhanced-magnetic-resonance-cholangiopancreatography-for-assessing-pancreatic-secretory-function-in-children
#17
Andrew T Trout, Daniel B Wallihan, Suraj Serai, Maisam Abu-El-Haija
OBJECTIVE: To assess the accuracy and interrater reproducibility of measurements of pancreatic secretory function by magnetic resonance cholangiopancreatography in response to secretin administration and to describe our experience using the technique to noninvasively assess pancreatic secretory function in a pediatric population. STUDY DESIGN: In the accuracy study, phantoms with varying fluid volume (47-206 mL) were imaged using the clinical quantification sequence...
September 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28693511/cardiac-findings-in-children-with-juvenile-dermatomyositis-at-disease-presentation
#18
Serdar Cantez, Gil J Gross, Ian MacLusky, Brian M Feldman
BACKGROUND: Juvenile Dermatomyositis (JDM) is a pediatric vasculopathy characterized primarily by skin and muscle involvement. Cardiac findings have been reported in children with JDM but have rarely been investigated in detail. METHODS: We aimed to describe the relevant clinical and laboratory cardiac findings of a cohort of patients with JDM, followed at one centre, at disease diagnosis. RESULTS: We performed a retrospective review of 105 patients with JDM, followed from 1991 to 2007...
July 11, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28680572/pulmonary-arterial-hypertension-in-the-usa-an-epidemiological-study-in-a-large-insured-pediatric-population
#19
Lin Li, Susan Jick, Stefanie Breitenstein, Gemzel Hernandez, Alexander Michel, David Vizcaya
Pulmonary arterial hypertension (PAH) is rare in children and few data are available in a pediatric general population. This study aims to calculate the annual incidence and prevalence of PAH and to describe these children in a large US population of patients aged under 18 years. Using the US MarketScan claims database we identified 695 children with PAH in 2010-2013. We calculated annual incidence rates and prevalence overall, by age and PAH type (idiopathic and non-idiopathic) using Byar's method. We also described characteristics, co-morbidities, treatment patterns, and diagnostic procedures for these children...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28670826/current-practices-are-variable-in-the-evaluation-and-management-of-patients-with-anomalous-aortic-origin-of-a-coronary-artery-results-of-a-survey
#20
Hitesh Agrawal, Carlos M Mery, Patrick E Day, S Kristen Sexson Tejtel, E Dean McKenzie, Charles D Fraser, Athar M Qureshi, Silvana Molossi
BACKGROUND: Anomalous aortic origin of a coronary artery (AAOCA) is the second leading cause of sudden cardiac death in young athletes in the USA. Long-term outcome data for these patients are lacking to date. There is insufficient knowledge on the best approach to these patients and they are managed in a nonuniform manner. METHODS: An online survey of 15 questions regarding management of AAOCA was sent out to 198 cardiac healthcare providers. The goal was to define gaps in knowledge to justify a dedicated scientific forum for discussion of AAOCA...
July 2, 2017: Congenital Heart Disease
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