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Pediatric cardiac risk assessment

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https://www.readbyqxmd.com/read/29024698/pediatric-clif-sofa-score-is-the-best-predictor-of-28-day-mortality-in-children-with-decompensated-chronic-liver-disease
#1
Rishi Bolia, Anshu Srivastava, Surender Kumar Yachha, Ujjal Poddar
BACKGROUND AND AIMS: Early identification of children with decompensated chronic liver disease (DCLD) at risk of short-term mortality helps improve outcome. We evaluated the predictors of outcome and role of Child Pugh [CP], Pediatric End- stage Liver Disease [PELD] and pediatric chronic liver failure sequential organ failure assessment [pCLIF-SOFA] score in prognosticating 28 days mortality in DCLD children. METHODS: DCLD children were prospectively evaluated with a clinico-laboratory proforma and followed till 28 days to determine outcome...
October 9, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28968807/chymase-is-a-predictive-biomarker-of-dengue-hemorrhagic-fever-in-pediatric-and-adult-patients
#2
Hasitha Tissera, Abhay P S Rathore, Wei Yee Leong, Brian L Pike, Tyler E Warkentien, Farouk S Farouk, Ayesa Syenina, Eng Eong Ooi, Duane J Gubler, Annelies Wilder-Smith, Ashley L St John
Background: Most dengue patients experience mild disease, dengue fever (DF), while few develop life-threatening severe disease, or dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). No laboratory tests predict DHF/DSS. We evaluated whether serum chymase can predict DHF/DSS in adult and pediatric patients and the influence of pre-existing conditions (PECs) on chymase levels. Methods: Serum chymase levels were measured in patients presenting with undifferentiated fever to hospitals in Colombo District, Sri Lanka...
August 25, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28922191/acr-spr-str-practice-parameter-for-the-performance-of-cardiac-positron-emission-tomography-computed-tomography-pet-ct-imaging
#3
Rathan M Subramaniam, Warren R Janowitz, Geoffrey B Johnson, Martin A Lodge, Marguerite T Parisi, Mark R Ferguson, Jeffrey C Hellinger, Gregory W Gladish, Narainder K Gupta
This clinical practice parameter has been developed collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Thoracic Radiology (STR). This document is intended to act as a guide for physicians performing and interpreting positron emission tomography-computed tomography (PET/CT) of cardiac diseases in adults and children. The primary value of cardiac PET/CT imaging include evaluation of perfusion, function, viability, inflammation, anatomy, and risk stratification for cardiac-related events such as myocardial infarction and death...
September 15, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28894592/changes-in-delta-adc-reflect-intracranial-pressure-changes-in-craniosynostosis
#4
Yuko Takahashi, Masaaki Hori, Kazuaki Shimoji, Masakazu Miyajima, Osamu Akiyama, Hajime Arai, Shigeki Aoki
BACKGROUND: In patients with craniosynostosis, intracranial pressure (ICP) has been reported to increase even in the absence of overt symptoms. The early and non-invasive detection of intracranial hypertension is important for reducing the risk of abnormal brain development in pediatric patients. PURPOSE: To assess whether the apparent diffusion coefficient (ADC) of white matter during the cardiac cycle (ΔADC) would change after surgery to relieve ICP in children with craniosynostosis...
September 2017: Acta Radiologica Open
https://www.readbyqxmd.com/read/28874164/radiation-free-cmr-diagnostic-heart-catheterization-in-children
#5
Kanishka Ratnayaka, Joshua P Kanter, Anthony Z Faranesh, Elena K Grant, Laura J Olivieri, Russell R Cross, Ileen F Cronin, Karin S Hamann, Adrienne E Campbell-Washburn, Kendall J O'Brien, Toby Rogers, Michael S Hansen, Robert J Lederman
BACKGROUND: Children with heart disease may require repeated X-Ray cardiac catheterization procedures, are more radiosensitive, and more likely to survive to experience oncologic risks of medical radiation. Cardiovascular magnetic resonance (CMR) is radiation-free and offers information about structure, function, and perfusion but not hemodynamics. We intend to perform complete radiation-free diagnostic right heart catheterization entirely using CMR fluoroscopy guidance in an unselected cohort of pediatric patients; we report the feasibility and safety...
September 6, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28874075/congenital-heart-disease-a-primer-for-the-pediatric-neuropsychologist
#6
Adam R Cassidy, Dawn Ilardi, Susan R Bowen, Lyla E Hampton, Kimberley P Heinrich, Michelle M Loman, Jacqueline H Sanz, Kelly R Wolfe
Congenital heart disease (CHD) affects millions of people worldwide, including over one million children in the United States. Approximately 25% of children born with CHD require intensive surgical intervention within the first year of life. Despite improved rates of survival into adulthood - rates that exceed 90% in the modern era - children and adolescents with CHD remain at risk for neurological injury and a range of neurobehavioral and psychosocial challenges that pose a threat to quality of life across the lifespan...
September 6, 2017: Child Neuropsychology: a Journal on Normal and Abnormal Development in Childhood and Adolescence
https://www.readbyqxmd.com/read/28830854/a-mobile-device-app-to-reduce-medication-errors-and-time-to-drug-delivery-during-pediatric-cardiopulmonary-resuscitation-study-protocol-of-a-multicenter-randomized-controlled-crossover-trial
#7
Johan N Siebert, Frederic Ehrler, Christian Lovis, Christophe Combescure, Kevin Haddad, Alain Gervaix, Sergio Manzano
BACKGROUND: During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusions is complex and time-consuming. The need for individual specific weight-based drug dose calculation and preparation places children at higher risk than adults for medication errors. Following an evidence-based and ergonomic driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion...
August 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28818338/spinal-anesthesia-for-pediatric-urological-surgery-reducing-the-theoretic-neurotoxic-effects-of-general-anesthesia
#8
Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
August 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28795324/the-fgf23-klotho-axis-and-cardiac-tissue-doppler-imaging-in-pediatric-chronic-kidney-disease-a-prospective-cohort-study
#9
Ylva Tranæus Lindblad, Hannes Olauson, Georgios Vavilis, Ulf Hammar, Maria Herthelius, Jonas Axelsson, Peter Bárány
BACKGROUND: Chronic kidney disease-associated mineral bone disorder (CKD-MBD) is common in pediatric kidney disease patients and a risk factor for future cardiovascular disease (CVD). Fibroblast growth factor-23 (FGF23) and Klotho are novel key players in CKD-MBD, and has been suggested to be involved in the development of CVD. METHODS: This prospective cohort study included 74 pediatric patients; 31 with CKD (age range 0.8-18.8 years, glomerular filtration rate (GFR) range 9-68 mL/min/1...
August 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28762646/predicting-unplanned-readmissions-to-a-pediatric-cardiac-intensive-care-unit-using-predischarge-pediatric-early-warning-scores
#10
Ashley R Kroeger, Jacqueline Morrison, Andrew H Smith
OBJECTIVE: Unplanned readmission to the pediatric cardiac intensive care unit (CICU) is associated with significant morbidity and mortality. The Pediatric Early Warning Score (PEWS) predicts ward patients at risk for decompensation but has not been previously reported to identify at-risk patients with cardiac disease prior to ward transfer. This study aimed to determine whether PEWS prior to transfer may serve as a predictor of unplanned readmission to the CICU. DESIGN: All patients discharged from a tertiary children's hospital CICU from September 2012 through August 2015 were included for analysis...
August 1, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28727288/complications-preceding-early-deaths-in-black-and-white-children-with-acute-myeloid-leukemia
#11
Lena E Winestone, Kelly D Getz, Tamara P Miller, Yimei Li, Yuan-Shung Huang, Alix E Seif, Brian T Fisher, Richard Aplenc
Black patients have a twofold increased risk of induction mortality compared to White patients with acute myeloid leukemia (AML). We reviewed diagnosis and billing data from Pediatric Health Information System for 28 AML Induction I deaths to investigate conditions preceding death in White and Black patients. Half of deaths occurred within 10 days of initial diagnostic admission. Respiratory, cardiac, renal, and infectious complications were common prior to both White and Black deaths. Deaths in White patients were more commonly preceded by intracranial hemorrhage compared to deaths in Black patients...
July 20, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28712586/platelet-testing-to-guide-aspirin-dose-adjustment-in-pediatric-patients-after-cardiac-surgery
#12
Sirisha Emani, David Zurakowski, Michelle Mulone, James A DiNardo, Cameron C Trenor, Sitaram M Emani
OBJECTIVES: Thrombosis is associated with increased morbidity and mortality in pediatric patients undergoing cardiac surgery. Although aspirin commonly is used for thromboprophylaxis, the utility of laboratory-based tests that assess aspirin efficacy have not been evaluated. We sought to determine the relationship between platelet aggregation testing and aspirin dose adjustment on thrombosis rates in this population. METHODS: Pediatric patients undergoing cardiac surgery who received aspirin and underwent platelet testing were studied retrospectively...
June 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28704161/cardiovascular-safety-of-low-dose-fenfluramine-in-dravet-syndrome-a-review-of-its-benefit-risk-profile-in-a-new-patient-population
#13
An-Sofie Schoonjans, Fabienne Marchau, Bernard P Paelinck, Lieven Lagae, Arnold Gammaitoni, Milka Pringsheim, Martin G Keane, Berten Ceulemans
OBJECTIVE: Dravet syndrome (DS) is a rare, treatment-resistant epilepsy syndrome for which current treatment regimens are often ineffective. Fenfluramine is currently in development for treatment of DS, based on reports in the 1980s and 1990s of its anti-epileptic activity in pediatric patients with intractable epilepsy. However, fenfluramine was withdrawn from global markets in 1997 following reports of its association with pulmonary hypertension and heart valve disease in adult patients treated for obesity...
October 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28696877/multicenter-quality-improvement-project-to-prevent-sternal-wound-infections-in-pediatric-cardiac-surgery-patients
#14
MULTICENTER STUDY
Cathy Woodward, Richard Taylor, Minnette Son, Roozbeh Taeed, Marshall L Jacobs, Lauren Kane, Jeffrey P Jacobs, S Adil Husain
BACKGROUND: Children undergoing cardiac surgery are at risk for sternal wound infections (SWIs) leading to increased morbidity and mortality. Single-center quality improvement (QI) initiatives have demonstrated decreased infection rates utilizing a bundled approach. This multicenter project was designed to assess the efficacy of a protocolized approach to decrease SWI. METHODS: Pediatric cardiac programs joined a collaborative effort to prevent SWI. Programs implemented the protocol, collected compliance data, and provided data points from local clinical registries using Society of Thoracic Surgery Congenital Heart Surgery Database harvest-compliant software or from other registries...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28689198/influence-of-the-method-of-definition-on-the-prevalence-of-left-ventricular-hypertrophy-in-children-with-chronic-kidney-disease-data-from-the-know-ped-ckd-study
#15
Heeyeon Cho, Hyun Jin Choi, Hee Gyung Kang, Il-Soo Ha, Hae Il Cheong, Kyung Hee Han, Seong Heon Kim, Min Hyun Cho, Jae Il Shin, Joo Hoon Lee, Young Seo Park
BACKGROUND/AIMS: Children with chronic kidney disease (CKD) have a high risk of cardiovascular disease. Left-ventricular (LV) hypertrophy (LVH) is an early marker of cardiovascular disease in pediatric CKD, and the prevalence of LVH in pediatric CKD is approximately 20-30% in pre-dialysis CKD patients. However, there is no consensus on the ideal method of defining LVH in pediatric CKD patients. Previous studies have typically used the LV mass index (LVMI), which is calculated as LV mass in grams divided by height in meters to the 2...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28665334/early-desquamating-perineal-erythema-in-a-febrile-infant-a-characteristic-clinical-feature-of-kawasaki-disease
#16
Chiara Isidori, Lisa Sebastiani, Maria Chiara Cardellini, Giuseppe Di Cara, Donato Rigante, Susanna Esposito
Background: The occurrence of a distinctive perineal eruption that appears early in infants with Kawasaki disease (KD), the most relevant type of febrile vasculitis of childhood, has received little attention in pediatric reports. KD diagnosis is based on clinical criteria, which can be supported by laboratory abnormalities or positive echocardiography findings: difficulty in diagnosis can be increased by incomplete or atypical presentations, but a timely diagnostic process is essential in the youngest patients who are more prone to the risk of cardiac sequelae resulting from KD...
June 30, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28658196/late-term-gestation-is-associated-with-improved-survival-in-neonates-with-congenital-heart-disease-following-postoperative-extracorporeal-life-support
#17
Jane M McKenzie, Thomas Scodellaro, Yves d'Udekem, Roberto Chiletti, Warwick Butt, Siva P Namachivayam
OBJECTIVE: Several population-based studies have shown that gestational age 39-40 weeks at birth is associated with superior outcomes in various pediatric settings. A high proportion of births for neonates with congenital heart disease occur before 39 weeks. We aimed to assess the influence of late-term gestation (39-40 wk) on survival in neonates requiring extracorporeal life support following surgery for congenital heart disease. DESIGN: Retrospective cohort study...
September 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28615900/predictors-of-outcome-in-children-with-status-epilepticus-during-resuscitation-in-pediatric-emergency-department-a-retrospective-observational-study
#18
Indumathy Santhanam, Sangeetha Yoganathan, V Akila Sivakumar, Rubini Ramakrishnamurugan, Sharada Sathish, Murali Thandavarayan
OBJECTIVES: To study the clinical profile and predictors of outcome in children with status epilepticus (SE) during resuscitation in pediatric emergency department. MATERIALS AND METHODS: This retrospective study was carried out in a tertiary care teaching hospital. Admission and resuscitation data of children, aged between 1 month and 12 years, treated for SE, between September 2013 and August 2014, were extracted using a standard data collection form. Our SE management protocol had employed a modified pediatric assessment triangle to recognize and treat acute respiratory failure, cardiovascular dysfunction (CD), and subtle SE until all parameters resolved...
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28598945/long-term-outcomes-of-pediatric-cardiac-patients-supported-by-extracorporeal-membrane-oxygenation
#19
Matthew D Elias, Barbara-Jo Achuff, Richard F Ittenbach, Chitra Ravishankar, Thomas L Spray, Stephanie Fuller, Lisa M Montenegro, J William Gaynor, Matthew J O'Connor
OBJECTIVE: Extracorporeal membrane oxygenation is an important form of short-term mechanical support in children with cardiac disease, but information on long-term outcomes and quality of life is limited. The primary objective of this study was to determine the long-term outcomes of children previously supported by extracorporeal membrane oxygenation for cardiac etiologies. DESIGN: A retrospective analysis was performed on patients with cardiac disease managed with extracorporeal membrane oxygenation between January 1, 1995, and December 31, 2012, at the Children's Hospital of Philadelphia...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28592829/speckle-tracking-stress-echocardiography-uncovers-early-subclinical-cardiac-involvement-in-pediatric-patients-with-inflammatory-bowel-diseases
#20
Kai O Hensel, Francisca E Abellan Schneyder, Lucia Wilke, Andreas Heusch, Stefan Wirth, Andreas C Jenke
Inflammatory bowel disease (IBD) is an established risk factor for cardiovascular disease (CVD). However, whether cardiac consequences present early in IBD is unknown. This is the first study in children aiming to unmask altered myocardial mechanics in IBD. We enrolled 50 consecutive normotensive children with Crohn's disease (CD) (n = 28) or ulcerative colitis (UC) (n = 22). The study groups consisted of 18 patients with active inflammatory disease (mean age 14.6 ± 2.5 years) and 32 children with IBD in remission (14...
June 7, 2017: Scientific Reports
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