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https://www.readbyqxmd.com/read/27863016/appropriateness-and-diagnostic-yield-of-inpatient-pediatric-echocardiograms
#1
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
#2
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
#3
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...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27822442/cardiovascular-risk-factor-screening-and-management-of-obese-patients-at-an-outpatient-pediatric-cardiology-center
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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...
August 23, 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
#13
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
#14
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
#15
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...
2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27244826/lessons-learned-from-newborn-screening-for-critical-congenital-heart-defects
#16
Matthew E Oster, Susan W Aucott, Jill Glidewell, Jesse Hackell, Lazaros Kochilas, Gerard R Martin, Julia Phillippi, Nelangi M Pinto, Annamarie Saarinen, Marci Sontag, Alex R Kemper
Newborn screening for critical congenital heart defects (CCHD) was added to the US Recommended Uniform Screening Panel in 2011. Within 4 years, 46 states and the District of Columbia had adopted it into their newborn screening program, leading to CCHD screening being nearly universal in the United States. This rapid adoption occurred while there were still questions about the effectiveness of the recommended screening protocol and barriers to follow-up for infants with a positive screen. In response, the Centers for Disease Control and Prevention partnered with the American Academy of Pediatrics to convene an expert panel between January and September 2015 representing a broad array of primary care, neonatology, pediatric cardiology, nursing, midwifery, public health, and advocacy communities...
May 2016: Pediatrics
https://www.readbyqxmd.com/read/27220370/feasibility-of-a-team-approach-to-complex-congenital-heart-defect-neurodevelopmental-follow-up-early-experience-of-a-combined-cardiology-neonatal-intensive-care-unit-follow-up-program
#17
Olena Chorna, H Scott Baldwin, Jamie Neumaier, Shirley Gogliotti, Deborah Powers, Amanda Mouvery, David Bichell, Nathalie L Maitre
Infants with complex congenital heart disease are at high risk for poor neurodevelopmental outcomes. However, implementation of dedicated congenital heart disease follow-up programs presents important infrastructure, personnel, and resource challenges. We present the development, implementation, and retrospective review of 1- and 2-year outcomes of a Complex Congenital Heart Defect Neurodevelopmental Follow-Up program. This program was a synergistic approach between the Pediatric Cardiology, Cardiothoracic Surgery, Pediatric Intensive Care, and Neonatal Intensive Care Unit Follow-Up teams to provide a feasible and responsible utilization of existing infrastructure and personnel, to develop and implement a program dedicated to children with congenital heart disease...
July 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27207965/angiotensin-converting-enzyme-inhibitor-initiation-and-dose-uptitration-in-children-with-cardiovascular-disease-a-retrospective-review-of-standard-clinical-practice-and-a-prospective-randomized-clinical-trial
#18
S Lucy Roche, Kathryn Timberlake, Cedric Manlhiot, Mervin Balasingam, Judith Wilson, Kristen George, Brian W McCrindle, Paul F Kantor
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) are a mainstay of medical management in pediatric cardiology. However, there are no data defining how best to initiate and uptitrate the dose of these medications in children. METHODS AND RESULTS: Retrospective chart review revealed only 24% of our pediatric cardiology inpatients were discharged on predefined optimal doses of ACEIs and few underwent further dose uptitration in the 8 weeks after hospital discharge...
May 20, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27124564/hemodynamic-bedside-ultrasound-image-quality-and-interpretation-after-implementation-of-a-training-curriculum-for-pediatric-critical-care-medicine-providers
#19
Thomas W Conlon, Maki Ishizuka, Adam S Himebauch, Meryl S Cohen, Robert A Berg, Akira Nishisaki
OBJECTIVE: Bedside ultrasound for hemodynamic evaluation in critically ill children is increasingly recognized as an important skill for pediatric critical care medicine providers. Our institution implemented a training curriculum leading to institutional credentialing for pediatric critical care providers in nonprocedural bedside ultrasound core applications. We hypothesized that hemodynamic studies performed or supervised by credentialed providers (credentialed providers group) have better image quality and greater accuracy in interpretation than studies performed by non-credentialed providers without supervision (non-credentialed providers group)...
July 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/26956424/rates-of-icu-transfers-after-a-scheduled-night-shift-interprofessional-huddle
#20
Ross E Newman, Michael A Bingler, Paul N Bauer, Brian R Lee, Keith J Mann
OBJECTIVES: To evaluate a scheduled interprofessional huddle among pediatric residents, nursing staff, and cardiologists on the number of high-risk transfers to the ICU. METHODS: A daily, night-shift huddle intervention was initiated between the in-house pediatric residents and nursing staff covering the cardiology ward patients with the at-home attending cardiologist. Retrospective cohort chart review identified high-risk transfers from the inpatient floor to the ICU over a 24-month period (eg, inotropic support, intubation, and/or respiratory support within 1 hour of ICU transfer)...
April 2016: Hospital Pediatrics
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