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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/28153110/development-of-quality-metrics-in-ambulatory-pediatric-cardiology
#2
REVIEW
Devyani Chowdhury, Michelle Gurvitz, Ariane Marelli, Jeffrey Anderson, Carissa Baker-Smith, Karim A Diab, Thomas C Edwards, Tom Hougen, Roy Jedeikin, Jonathan N Johnson, Peter Karpawich, Wyman Lai, Jimmy C Lu, Stephanie Mitchell, Jane W Newburger, Daniel J Penny, Michael A Portman, Gary Satou, David Teitel, Juan Villafane, Roberta Williams, Kathy Jenkins
The American College of Cardiology Adult Congenital and Pediatric Cardiology (ACPC) Section had attempted to create quality metrics (QM) for ambulatory pediatric practice, but limited evidence made the process difficult. The ACPC sought to develop QMs for ambulatory pediatric cardiology practice. Five areas of interest were identified, and QMs were developed in a 2-step review process. In the first step, an expert panel, using the modified RAND-UCLA methodology, rated each QM for feasibility and validity. The second step sought input from ACPC Section members; final approval was by a vote of the ACPC Council...
February 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28150025/initial-field-test-of-a-cloud-based-cardiac-auscultation-system-to-determine-murmur-etiology-in-rural-china
#3
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/27981915/variability-of-antithrombotics-use-in-patients-with-hypoplastic-left-heart-syndrome-and-its-variants-following-first-and-second-stage-palliation-surgery-a-national-report-using-the-national-pediatric-cardiology-quality-improvement-collaborative-registry
#4
Preeti Ramachandran, Eileen King, Ashley Nebbia, Robert H Beekman, Jeffrey B Anderson
: Purpose Patients with hypoplastic left heart syndrome and its variants following palliation surgery are at risk for thrombosis. This study examines variability of antithrombotic practice, the incidence of interstage shunt thrombosis, and other adverse events following Stage I and Stage II palliation within the National Pediatric Cardiology Quality Improvement Collaborative registry. METHODS: We carried out a multicentre, retrospective review using the National Pediatric Cardiology Quality Improvement Collaborative registry including patients from 2008 to 2013 across 52 surgical sites...
August 30, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27924361/prevalence-of-non-cardiovascular-findings-on-ct-angiography-in-children-with-congenital-heart-disease
#5
Archana Malik, Jeffrey C Hellinger, Sabah Servaes, Mathew C Schwartz, Marc S Keller, Monica Epelman
BACKGROUND: CT angiography is gaining broader acceptance in the evaluation of children with known or suspected congenital heart disease. These studies include non-cardiovascular structures such as the mediastinum, lung parenchyma and upper abdominal organs. It is important to inspect all these structures for potential abnormalities that might be clinically important and, in some cases, may impact care plans. OBJECTIVE: To determine the prevalence of non-cardiovascular findings in CT angiography of children with congenital heart disease...
December 6, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27863016/appropriateness-and-diagnostic-yield-of-inpatient-pediatric-echocardiograms
#6
Sean M Lang, Elijah Bolin, Joshua A Daily, Xinyu Tang, R Thomas Collins
OBJECTIVE: Multiple reports have shown echocardiograms for certain indications are neither cost-effective nor of high diagnostic yield. Given the ease with which tests can be obtained at a tertiary academic children's hospital, our aims were to: (1) determine the diagnostic yield of inpatient studies by in-hospital location; (2) evaluate inpatient echocardiograms to determine indications and level of appropriateness; and (3) evaluate the frequency of cardiology involvement prior to those echocardiograms...
November 8, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27860542/successful-fetal-tele-echo-at-a-small-regional-hospital
#7
Julianna Brown, Brian Holland
BACKGROUND: Prenatal diagnosis of complex congenital heart disease (CHD) has been shown to improve newborn outcomes. The rate of prenatal diagnosis and access to fetal echocardiography vary widely across the United States. INTRODUCTION: A clinical fetal tele-echo service was established at King's Daughters Medical Center (KDMC) in Ashland, KY, a region in eastern Kentucky that is 3 h from the nearest congenital heart surgeon. The aim of this study was to determine if fetal tele-echo utilizing local sonographers at a small regional hospital can accurately and efficiently identify fetuses with complex CHD...
November 18, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27826707/diagnostic-yield-of-outpatient-pediatric-echocardiograms-impact-of-indications-and-specialty
#8
Sean M Lang, Elijah Bolin, Sarah Hardy, Xinyu Tang, R Thomas Collins
Multiple reports have shown that echocardiograms are neither cost-effective nor of high diagnostic yield for a number of indications. This study sought to evaluate the impact of indications and provider type on the diagnostic yield of first-time outpatient pediatric echocardiograms. All initial echocardiograms interpreted at our institution from February 2009 to December 2014 were reviewed retrospectively. Positive findings were defined as any abnormality of structure or function. Ordering physicians were grouped as Primary Care, Subspecialist, or Cardiologist...
January 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/27822442/cardiovascular-risk-factor-screening-and-management-of-obese-patients-at-an-outpatient-pediatric-cardiology-center
#9
Margaret Greco, Arun Sood, Soyang Kwon, Adolfo J Ariza
OBJECTIVE: To evaluate documentation of cardiovascular (CV) risk factors and obesity management by pediatric cardiologists. STUDY DESIGN: Review of medical records of obese (≥95th body mass index percentile) 2-17 year-old children presenting to outpatient pediatric cardiology over 1 year. Subjects were categorized as: heart disease (HD) with increased risk for atherosclerosis; HD with average risk for atherosclerosis; or no HD. Data were evaluated on documentation of the assessment of seven CV risk factors [including recognition of elevated blood pressure (BP)] and management of obesity...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27761557/safety-and-efficacy-of-transthoracic-versus-transesophageal-echocardiography-in-transcatheter-closure-of-atrial-septal-defects-reporting-a-single-center-experience-from-saudi-arabia
#10
Ahmad S Azhar
OBJECTIVES: To assess the safety and effectiveness of transthoracic echocardiography (TTE) in monitoring transcatheter closure of atrial septal defect (ASD), in comparison with conventional technique using transesophageal echocardiography (TEE).  Methods: A retrospective review of all cases of transcatheter closure of isolated ostium secundum ASDs operated from 2005 to 2015, at the Pediatric Interventional Cardiology Department, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia...
November 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27749513/the-utility-of-brain-natriuretic-peptide-in-pediatric-cardiology-a-review
#11
Ana L Neves, Tiago Henriques-Coelho, Adelino Leite-Moreira, José C Areias
OBJECTIVE: The aim of this article is to evaluate the clinical utility of brain natriuretic peptide in pediatric patients, examining the diagnostic value, management, and prognostic relevance, by critical assessment of the literature. DATA SOURCES: In December 2015, a literature search was performed (PubMed access to MEDLINE citations; http://www.ncbi.nlm.nih.gov/PubMed/) and included these Medical Subject Headings and text terms for the key words: "brain natriuretic peptide," "amino-terminal pro-brain natriuretic peptide," "children," "neonate/s," "newborn/s," "infant/s," and "echocardiography...
November 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27669416/reproducibility-of-search-strategies-is-poor-in-systematic-reviews-published-in-high-impact-pediatrics-cardiology-and-surgery-journals-a-cross-sectional-study
#12
Jonathan B Koffel, Melissa L Rethlefsen
BACKGROUND: A high-quality search strategy is considered an essential component of systematic reviews but many do not contain reproducible search strategies. It is unclear if low reproducibility spans medical disciplines, is affected by librarian/search specialist involvement or has improved with increased awareness of reporting guidelines. OBJECTIVES: To examine the reporting of search strategies in systematic reviews published in Pediatrics, Surgery or Cardiology journals in 2012 and determine rates and predictors of including a reproducible search strategy...
2016: PloS One
https://www.readbyqxmd.com/read/27649041/implementation-of-a-clinical-pathway-for-chest-pain-in-a-pediatric-emergency-department
#13
Shaun Mohan, Deipanjan Nandi, Paul Stephens, Mirna MʼFarrej, R Lee Vogel, Christopher P Bonafide
OBJECTIVE: To evaluate the impact of a pediatric emergency department (ED) chest pain clinical pathway on resource utilization. METHODS: Motivated by perceived overuse of cardiology consultation for non-cardiac chest pain in the ED, clinicians from the Divisions of Cardiology and Emergency Medicine collaboratively developed a chest pain clinical pathway, educated staff, and implemented the pathway on March 1, 2014. We reviewed records of children aged 3 to 18 years without prior diagnoses of heart disease who presented to the ED with chest pain between March 1, 2013, and April 22, 2015...
September 20, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27583584/protocolized-care-for-early-shock-resuscitation
#14
Matthew Goodwin, Kaori Ito, Arielle H Gupta, Emanuel P Rivers
PURPOSE OF REVIEW: Protocolized care for early shock resuscitation (PCESR) has been intensely examined over the last decade. The purpose is to review the pathophysiologic basis, historical origin, clinical applications, components and outcome implications of PCESR. RECENT FINDINGS: PCESR is a multifaceted systems-based approach that includes early detection of high-risk patients and interventions to rapidly reverse hemodynamic perturbations that result in global or regional tissue hypoxia...
October 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27583409/new-guidelines-for-managing-pulmonary-hypertension-what-the-pediatrician-needs-to-know
#15
Steven H Abman
PURPOSE OF REVIEW: Pediatric pulmonary vascular disease contributes to morbidities and death in diverse clinical settings, ranging from idiopathic or heritable forms of pediatric arterial hypertension, congenital heart disease, developmental lung disorders, chronic lung disease, left heart disease, sickle cell disease, oncologic disease, and systemic disorders. Despite its impact on the clinical courses in so many diseases, information is limited on how to best approach the diagnosis and evaluation of pediatric pulmonary hypertension...
October 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27564559/use-of-anesthesia-for-imaging-studies-and-interventional-procedures-in-children
#16
Yolanda Y Huang, Lucy Li, Matthew Monteleone, Lynne Ferrari, Lisa J States, James J Riviello, Steven G Kernie, Ali A Mencin, Sumit Gupta, Lena S Sun
Ongoing investigation from the Pediatric Anesthesia NeuroDevelopment Assessment (PANDA) study hopes to examine the long-term effect on cognitive and language development of a single anesthetic exposure in children undergoing inguinal hernia repair. The fifth PANDA Symposium, held in April 2016, continued the mission of previous symposia to examine evidence from basic science and clinical studies on potential neurotoxic effects of anesthetics on developing brain. At the 2016 Symposium, a panel of specialists from nonsurgical pediatric disciplines including anesthesiology, radiology, neurology, gastroenterology, oncology, cardiology, and critical care reviewed use of anesthesia in their practices, including how concern over possible neurodevelopmental effects of early childhood anesthetic exposure has changed discussion with patients and families regarding risks and benefits of imaging studies and interventional procedures involving sedation or anesthesia...
August 25, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27554517/developing-quality-measures-for-adult-cochlear-implant-centers-preliminary-findings
#17
Peter M Vila, Judith E C Lieu, Timothy E Hullar, Craig A Buchman
The study objective was to develop quality measures for adult cochlear implant centers. A modified Delphi design beginning with focus groups of surgeons and audiologists was used, as adapted from the American College of Cardiology / American Heart Association method for creating quality measures. Two academic cochlear implant programs and 1 private program participated. Qualitative focus group analysis yielded 58 candidate measures. An additional 5 candidate measures were added from a systematic review of the literature...
November 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/27381537/the-spectrum-of-congenital-heart-diseases-in-down-syndrome-a-retrospective-study-from-northwest-saudi-arabia
#18
Mohamed M Morsy, Osama O Algrigri, Sherif S Salem, Mostafa M Abosedera, Ashraf R Abutaleb, Khaled M Al-Harbi, Ibrahim S Al-Mozainy, Abdulhameed A Alnajjar, Abdelhadi M Habeb, Hany M Abo-Haded
OBJECTIVES: To to define the frequency and patterns of congenital heart disease (CHD) among children with Down syndrome (DS) in Northwest Saudi Arabia.  METHODS: We included children with confirmed DS referred to the regional pediatric cardiology unit in Madinah Maternity and Children Hospital between January 2008 and December 2013. Children were identified from the unit's data-base and the charts were reviewed retrospectively. We excluded term and preterm children with patent ducts arteriosus (PDA) and persistent foramen oval spontaneously resolved during the first 4 weeks of life...
July 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27282847/appropriate-use-and-clinical-impact-of-echocardiographic-evaluation-of-murmur-in-pediatric-patients
#19
Kirsten Rose-Felker, Michael S Kelleman, Robert M Campbell, Matthew E Oster, Ritu Sachdeva
OBJECTIVE: To determine the appropriateness and yield of transthoracic echocardiograms (TTE) for murmur evaluation based on the pediatric Appropriate Use Criteria (AUC) and study the influence of patient age and physician experience on TTE appropriateness, yield, and ordering frequency. DESIGN: Retrospective review of medical records of patients referred to our practice for murmur evaluation from April to September 2014. Data collected included indication for TTE, patient age, physician experience since fellowship, TTE findings and exit diagnosis...
December 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27266868/a-cluster-randomized-trial-of-a-transition-intervention-for-adolescents-with-congenital-heart-disease-rationale-and-design-of-the-chapter-2-study
#20
Andrew S Mackie, Gwen R Rempel, Adrienne H Kovacs, Miriam Kaufman, Kathryn N Rankin, Ahlexxi Jelen, Cedric Manlhiot, Samantha J Anthony, Joyce Magill-Evans, David Nicholas, Renee Sananes, Erwin Oechslin, Dimi Dragieva, Sonila Mustafa, Elina Williams, Michelle Schuh, Brian W McCrindle
BACKGROUND: The population of adolescents and young adults with congenital heart disease (CHD) is growing exponentially. These survivors are at risk of late cardiac complications and require lifelong cardiology care. However, there is a paucity of data on how to prepare adolescents to assume responsibility for their health and function within the adult health care system. Evidence-based transition strategies are required. METHODS: The Congenital Heart Adolescents Participating in Transition Evaluation Research (CHAPTER 2) Study is a two-site cluster randomized clinical trial designed to evaluate the efficacy of a nurse-led transition intervention for 16-17 year olds with moderate or complex CHD...
June 6, 2016: BMC Cardiovascular Disorders
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