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Pediatric cardiac risk assessment

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https://www.readbyqxmd.com/read/28318513/improving-risk-adjustment-for-mortality-after-pediatric-cardiac-surgery-the-uk-prais2-model
#1
Libby Rogers, Katherine L Brown, Rodney C Franklin, Gareth Ambler, David Anderson, David J Barron, Sonya Crowe, Kate English, John Stickley, Shane Tibby, Victor Tsang, Martin Utley, Thomas Witter, Christina Pagel
BACKGROUND: Partial Risk Adjustment in Surgery (PRAiS), a risk model for 30-day mortality after children's heart surgery, has been used by the UK National Congenital Heart Disease Audit to report expected risk-adjusted survival since 2013. This study aimed to improve the model by incorporating additional comorbidity and diagnostic information. METHODS: The model development dataset was all procedures performed between 2009 and 2014 in all UK and Ireland congenital cardiac centers...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28316985/prolonged-p-wave-and-qt-dispersion-in-children-with-inflammatory-bowel-disease-in-remission
#2
Helen Aghdasi Bornaun, Nuh Yılmaz, Günsel Kutluk, Reyhan Dedeoğlu, Kazım Öztarhan, Gonca Keskindemirci, Aras Tulunoğlu, Fatih Şap
Objectives. Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) with unclear underlying aetiologies. Severe cardiac arrhythmias have been emphasised in a few studies on adult IBD patients. This study aimed to investigate the alteration of the P-wave and QT interval dispersion parameters to assess the risk of atrial conduction and ventricular repolarisation abnormalities in pediatric IBD patients. Patients and Methods. Thirty-six IBD patients in remission (UC: 20, CD: 16) aged 3-18 years and 36 age- and sex-matched control patients were enrolled in the study...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28303771/epidemiology-and-outcome-of-acute-kidney-injury-in-children-a-single-center-study
#3
Werner Keenswijk, Jill Vanmassenhove, Ann Raes, Evelyn Dhont, Johan VandeWalle
BACKGROUND: Information on the epidemiology of Acute Kidney Injury (AKI) in children is scarce. We performed a single center retrospective cohort study to analyze the incidence of AKI, the male/female ratio, the underlying etiology, and age at presentation. We also aimed to assess outcome measured by mortality, duration of PICU stay, and development of Chronic Kidney Disease (CKD). METHODS: Records were searched for children presenting with or developing AKI between 1st January 2008 and 1st January 2015...
March 17, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28301910/soluble-fms-like-tyrosine-kinase-1-as-a-link-between-angiogenesis-and-endothelial-dysfunction-in-pediatric-patients-with-%C3%AE-thalassemia-intermedia
#4
Azza Abdel Gawad Tantawy, Amira Abdel Moneam Adly, Eman Abdel Rahman Ismail, Omneya Ibrahim Youssef, Mohamed ElSayed Ali
Endothelial damage has been implicated in the pathogenesis of vascular complications in β-thalassemia intermedia (β-TI). Soluble fms-like tyrosine kinase 1 (sFLT-1) is a member of the vascular endothelial growth factor receptor (VEGFR) family. Soluble fms-like tyrosine kinase 1 is an antiangiogenic protein that induces endothelial dysfunction by adhering to and inhibiting VEGF and placenta growth factor. The aim of this study was to assess the level of sFLT-1 in 35 children and adolescents with β-TI, correlating it with markers of hemolysis and iron overload as well as cardiopulmonary complications...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28292861/assessment-of-diffuse-ventricular-myocardial-fibrosis-using-native-t1-in-children-with-repaired-tetralogy-of-fallot
#5
Deane Yim, Eugenie Riesenkampff, Pablo Caro-Dominguez, Shi-Joon Yoo, Mike Seed, Lars Grosse-Wortmann
BACKGROUND: Myocardial fibrosis is linked with adverse clinical outcomes in adults after tetralogy of Fallot repair (rTOF). Native T1 times (T1) by cardiac magnetic resonance have been shown to be a surrogate marker of diffuse myocardial fibrosis. The objective was to quantify native T1 in children post-rTOF and to evaluate their relationship with surgical, imaging, and clinical factors. METHODS AND RESULTS: A retrospective cross-sectional study was performed. Midventricular native T1 were obtained in 100 children post-rTOF using a modified look-locker inversion recovery cardiac magnetic resonance sequence and compared with 35 pediatric controls...
March 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28271153/low-iron-stores-in-otherwise-healthy-children-affect-electrocardiographic-markers-of-important-cardiac-events
#6
Cem Karadeniz, Rahmi Özdemir, Mustafa Demirol, Nagehan Katipoğlu, Yılmaz Yozgat, Timur Meşe, Nurettin Ünal
Both an excess of iron and iron deficiency (ID) may lead to significant cardiac problems. Parameters that represent ventricular repolarization heterogeneity, like QT dispersion (QTd), corrected QT dispersion (QTcd), the interval between the peak and the end of the T wave (Tp-e), and Tp-e dispersion, have not been evaluated in otherwise healthy children with low iron levels before. Here we assessed the effects of low iron storage on P wave dispersion (PWd), QTd, Tp-e intervals, and Tp-e dispersion in otherwise healthy children...
March 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28258912/risk-stratification-and-pattern-of-cardiotoxicity-in-pediatric-ewing-sarcoma
#7
Emad Moussa, Manal Zamzam, Ahmed Kamel, Zeinab Salah, Iman Attia, Lina Gaber, Ranin Soliman, Sameera Ezzat
INTRODUCTION: Anthracycline chemotherapy contributes to improved outcomes in Ewing sarcoma; however, the most feared complication is cardiotoxicity. Echocardiograms were routinely used to monitor cardiac function after anthracycline treatment. Nevertheless, indices chosen to assess cardiac toxicity vary significantly among different centers, and no uniform protocol has been accepted as ideal. METHODS: This retrospective study included children with Ewing sarcoma treated at Children's Cancer Hospital Egypt over 4years...
February 28, 2017: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/28254555/epidemiology-and-outcomes-of-arterial-ischemic-stroke-in-children-the-canadian-pediatric-ischemic-stroke-registry
#8
Gabrielle A deVeber, Adam Kirton, Frances A Booth, Jerome Y Yager, Elaine C Wirrell, Ellen Wood, Michael Shevell, Ann-Marie Surmava, Patricia McCusker, M Patricia Massicotte, Daune MacGregor, E Athen MacDonald, Brandon Meaney, Simon Levin, Bernard G Lemieux, Lawrence Jardine, Peter Humphreys, Michèle David, Anthony K C Chan, David J Buckley, Bruce H Bjornson
BACKGROUND: Pediatric arterial ischemic stroke remains incompletely understood. Population-based epidemiological data inform clinical trial design but are scant in this condition. We aimed to determine age-specific epidemiological characteristics of arterial ischemic stroke in neonates (birth to 28 days) and older children (29 days to 18 years). METHODS: We conducted a 16-year, prospective, national population-based study, the Canadian Pediatric Ischemic Stroke Registry, across all 16 Canadian acute care children's hospitals...
January 26, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28245348/acute-cardiac-mri-assessment-of-radiofrequency-ablation-lesions-for-pediatric-ventricular-arrhythmia-feasibility-and-clinical-correlation
#9
Elena K Grant, Charles I Berul, Russell R Cross, Jeffrey P Moak, Karin S Hamann, Kohei Sumihara, Ileen Cronin, Kendall J O'Brien, Kanishka Ratnayaka, Michael S Hansen, Peter Kellman, Laura J Olivieri
BACKGROUND: Arrhythmia ablation with current techniques is not universally successful. Inadequate ablation lesion formation may be responsible for some arrhythmia recurrences. Peri-procedural visualization of ablation lesions may identify inadequate lesions and gaps to guide further ablation and reduce risk of arrhythmia recurrence. METHODS: This feasibility study assessed acute post-procedure ablation lesions by MRI, and correlated these findings with clinical outcomes...
February 28, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28223051/functional-status-and-quality-of-life-in-survivors-of-extracorporeal-membrane-oxygenation-after-the-norwood-operation
#10
Joshua M Friedland-Little, Karen Uzark, Sunkyung Yu, Ray Lowery, Ranjit Aiyagari, Jennifer C Hirsch-Romano
BACKGROUND: Infants who require extracorporeal membrane oxygenation (ECMO) support after a Norwood operation are at increased risk for early and late death compared with patients who do not require ECMO post-Norwood. Little is known about the effect that ECMO post-Norwood has on functional status and quality of life among long-term survivors. METHODS: We prospectively evaluated functional status and health-related quality of life in 12 surviving patients (cases) and 19 corresponding patients (controls) from a previous retrospective case-control assessment of long-term survival in patients requiring ECMO post-Norwood...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#11
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28214152/clinical-and-genetic-diagnosis-of-familial-hypertrophic-cardiomyopathy-results-in-pediatric-cardiology
#12
Bárbara Cardoso, Inês Gomes, Petra Loureiro, Conceição Trigo, Fátima Ferreira Pinto
INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is most often of autosomal dominant inheritance with incomplete penetrance and variable expression. The main purpose of family screening is to identify relatives with unrecognized HCM and to monitor those at risk for disease, in order to minimize complications and to assess risk of sudden cardiac death. The ESC and ACCF/AHA guidelines on the diagnosis and management of HCM recommend the screening of child relatives from the age of 10-12 years...
March 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28191005/significance-of-anti-hla-antibodies-on-adult-and-pediatric-heart-allograft-outcomes
#13
REVIEW
Massimo Mangiola, Marilyn Marrari, Brian Feingold, Adriana Zeevi
As methods for human leukocyte antigens (HLA) antibody detection have evolved and newer solid phase assays are much more sensitive, the last 15 years has seen a renewed focus on the importance of HLA antibodies in solid organ transplant rejection. However, there is still much controversy regarding the clinical significance of antibody level as depicted by the mean fluorescence intensity of a patient's neat serum. Emerging techniques, including those that identify antibody level and function, show promise for the detection of individuals at risk of allograft rejection, determination of the effectiveness of desensitization prior to transplant, and for monitoring treatment of rejection...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28185475/4d-flow-magnetic-resonance-imaging-role-in-pediatric-congenital-heart-disease
#14
Claire M Lawley, Kathryn M Broadhouse, Fraser M Callaghan, David S Winlaw, Gemma A Figtree, Stuart M Grieve
Imaging-based evaluation of cardiac structure and function remains paramount in the diagnosis and monitoring of congenital heart disease in childhood. Accurate measurements of intra- and extracardiac hemodynamics are required to inform decision making, allowing planned timing of interventions prior to deterioration of cardiac function. Four-dimensional flow magnetic resonance imaging is a nonionizing noninvasive technology that allows accurate and reproducible delineation of blood flow at any anatomical location within the imaging volume of interest, and also permits derivation of physiological parameters such as kinetic energy and wall shear stress...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28177675/what-factors-contribute-to-the-elevation-of-serum-free-fatty-acids-ffa-in-newborns-in-the-cardiac-surgical-setting
#15
Carin Wittnich, Michael P Belanger
Elevations in serum free fatty acids (FFA) levels during heart surgery have been reported in humans and experimental animals, causing increased arrhythmias, decreased heart function, and contributing to mortality. Factors such as heparin administration, age, cardiopulmonary bypass (CPB) and cyanosis/hypoxia have been implicated but not proven. This study was designed to clarify the contribution of these factors using an experimental pig model as follows: a) adult (n=10) versus 3-day old piglets (n=18) had FFA levels assessed before and after heparin administration; b) 3 day old piglets, the additional effect of CPB (n=8) or just severe hypoxia (PaO2 = 20-25 mmHg; n=6) exposure on FFA levels...
January 9, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28166099/pediatric-cardiopulmonary-arrest-in-the-postanesthesia-care-unit-rare-but-preventable-analysis-of-data-from-wake-up-safe-the-pediatric-anesthesia-quality-improvement-initiative
#16
Robert E Christensen, Bishr Haydar, Terri D Voepel-Lewis
BACKGROUND: Nearly 20% of anesthesia-related pediatric cardiac arrests (CAs) occur during emergence or recovery. The aims of this case series were to use the Wake Up Safe database to describe the following: (1) the nature of pediatric postanesthesia care unit (PACU) CA and subsequent outcomes and (2) factors associated with harm after pediatric PACU CA. METHODS: Pediatric CAs in the PACU were identified from the Wake Up Safe Pediatric Anesthesia Quality Improvement Initiative, a multicenter registry of adverse events in pediatric anesthesia...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28151402/mental-health-among-parents-of-children-with-critical-congenital-heart-defects-a-systematic-review
#17
REVIEW
Sarah E Woolf-King, Alexandra Anger, Emily A Arnold, Sandra J Weiss, David Teitel
BACKGROUND: Parents of children with critical congenital heart defects (PCCHDs) may be at high risk for mental health morbidity; however, the literature is not well characterized. Given that compromised parental mental health can lead to long-term cognitive, health-related, and behavioral problems in children, a systematic review of this literature could provide informed recommendations for continued research and enhance the care of families of children living with critical congenital heart defects...
February 1, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28150433/impaired-maternal-hemodynamics-in-morbidly-obese-women-a-case-control-study
#18
D Vinayagam, J Gutierrez, J Binder, E Mantovani, B Thilaganathan, A Khalil
AIM: Maternal obesity is associated with significant pregnancy complications and is a risk factor for the development of hypertensive disorders of pregnancy as well as other adverse outcomes. There are few data regarding the hemodynamic aberrations observed in maternal obesity. The aim of this study was to investigate maternal hemodynamics in morbidly obese pregnant women. METHODS: This was a prospective, case-control study of morbidly obese women (BMI >40 kg/m(2) ) and controls (BMI 20-29...
February 2, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28121970/resorbable-mesh-cranioplasty-repair-of-bilateral-cerebrospinal-fluid-leaks-following-pediatric-simultaneous-bilateral-auditory-brainstem-implant-surgery
#19
Giacomo Colletti, Marco Mandalà, Vittorio Colletti, Alberto Deganello, Fabiana Allevi, Liliana Colletti
OBJECTIVE: To present a child with cochlear nerve deficiency (CND) who received simultaneous bilateral simultaneous auditory brainstem implants (BS-ABI) and subsequently presented with bilateral cerebrospinal fluid (CSF) leaks unresponsive to standard treatments. To propose a novel rigid retrosigmoid cranioplasty for treating and preventing CSF leaks in children at high risk for this complication. PATIENT: A 3.5-year-old child with CND, vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities, coloboma, heart defect, atresia choanae, retarded growth and development, genital abnormality, and ear abnormality, Arnold Chiari malformation, previous treated tracheo-esophageal fistula underwent BS-ABI...
April 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28115007/a-home-based-exercise-program-for-children-with-congenital-heart-disease-following-interventional-cardiac-catheterization-study-protocol-for-a-randomized-controlled-trial
#20
Qing Du, Yasser Salem, Hao Howe Liu, Xuan Zhou, Sun Chen, Nan Chen, Xiaoyan Yang, Juping Liang, Kun Sun
BACKGROUND: Cardiac catheterization has opened an innovative treatment field for cardiac disease; this treatment is becoming the most popular approach for pediatric congenital heart disease (CHD) and has led to a significant growth in the number of children with cardiac catheterization. Unfortunately, based on evidence, it has been demonstrated that the majority of children with CHD are at an increased risk of "non-cardiac" problems. Effective exercise therapy could improve their functional status significantly...
January 23, 2017: Trials
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