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https://www.readbyqxmd.com/read/28558846/perioperative-antibiotics-in-pediatric-cardiac-surgery-protocol-for-a-systematic-review
#1
Vijay Anand, Angela Bates, Robin Featherstone, Srinivas Murthy
BACKGROUND: Post-operative infections in pediatric cardiac surgery are an ongoing clinical challenge, with rates between 1 and 20%. Perioperative antibiotics remain the standard for prevention of surgical-site infections, but the type of antibiotic and duration of administration remain poorly defined. Current levels of practice variation through informal surveys are very high. Rates of antibiotic-resistant organisms are increasing steadily around the world. METHODS/DESIGN: We will identify all controlled observational studies and randomized controlled trials examining prophylactic antibiotic use in pediatric cardiac surgery...
May 30, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28547923/pediatric-heart-disease-simulation-curriculum-educating-the-pediatrician
#2
Tyler H Harris, Mark Adler, Sharon M Unti, Mary E McBride
BACKGROUND: Training guidelines state that pediatricians should be able to diagnose, manage, and triage patients with heart disease. Acutely ill cardiac patients present infrequently and with high acuity, yet residents receive less exposure to acute cardiac conditions than previous generations. Trainees must learn to manage these situations despite this gap. Simulation has been used successfully to train learners to provide acute care. We hypothesized that a simulation-based cardiac curriculum would improve residents' ability to manage cardiac patients...
May 26, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28514463/pediatric-psoriasis-comorbidity-screening-guidelines
#3
Emily Osier, Audrey S Wang, Megha M Tollefson, Kelly M Cordoro, Stephen R Daniels, Andrew Eichenfield, Joel M Gelfand, Alice B Gottlieb, Alexa B Kimball, Mark Lebwohl, Nehal N Mehta, Amy S Paller, Jeffrey B Schwimmer, Dennis M Styne, Abby S Van Voorhees, Wynnis L Tom, Lawrence F Eichenfield
Importance: Psoriasis is a complex inflammatory skin condition associated with serious medical comorbidities in adults, including obesity, hypertension, dyslipidemia, type 2 diabetes mellitus, psoriatic arthritis, nonalcoholic fatty liver disease, depression, anxiety, and decreased quality of life. Because psoriasis begins in childhood in almost one-third of patients, early identification of risk may be critical to minimizing effects on future health. Objective: To develop the first set of guidelines for comorbidity screening for patients with pediatric psoriasis based on current evidence...
May 17, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28469533/effect-of-a-pediatric-prescription-medication-discharge-program-on-reducing-hospital-readmission-rates
#4
Laura A Leathers, Kristy L Brittain, Kelly Crowley
OBJECTIVES: To evaluate the pediatric prescription medication discharge delivery and counseling program, implemented at an 186-bed children's hospital integrated within a larger academic medical center, and its effectiveness on reducing hospital readmissions. METHODS: This study was a retrospective chart review of existing data in the electronic medical record from patients <21 years of age who were discharged from our institution between September 1, 2014, and November 30, 2014...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#5
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28436742/training-pediatric-fellows-in-palliative-care-a-pilot-comparison-of-simulation-training-and-didactic-education
#6
Katharine E Brock, Harvey J Cohen, Barbara M Sourkes, Julie J Good, Louis P Halamek
BACKGROUND: Pediatric fellows receive little palliative care (PC) education and have few opportunities to practice communication skills. OBJECTIVE: In this pilot study, we assessed (1) the relative effectiveness of simulation-based versus didactic education, (2) communication skill retention, and (3) effect on PC consultation rates. DESIGN: Thirty-five pediatric fellows in cardiology, critical care, hematology/oncology, and neonatology at two institutions enrolled: 17 in the intervention (simulation-based) group (single institution) and 18 in the control (didactic education) group (second institution)...
April 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28425226/a-review-of-pediatric-pulmonary-hypertension-with-new-guidelines
#7
Serdar Kula, Ayhan Pektaş
This study aims to review pediatric pulmonary hypertension (PH) by comparing the guidelines of the European Society of Cardiology (ESC)/European Respiratory Society (ERS), the American Heart Association (AHA)/American Thoracic Society (ATS), and the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). All three sets of guidelines define PH as having a mean pulmonary artery pressure of ≥25 mmHg and accept the validity of the World Health Organization (WHO) classification system. Every child with a high index of suspicion for PH should undergo an initial work-up of chest X-rays, electrocardiography, and echocardiography...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28319472/infective-endocarditis-in-children-an-update
#8
Garth Dixon, Georgi Christov
PURPOSE OF REVIEW: Infective endocarditis in children remains a clinical challenge. Here, we review the impact of the updated 2015 American Heart Association and European Society of Cardiology guidelines on management as well as the significance of the new predisposing factors, diagnostic and treatment options, and the impact of the 2007-2008 change in prophylaxis recommendations. RECENT FINDINGS: The new 2015 infective endocarditis guidelines introduced the endocarditis team, added the new imaging modalities of computer tomography and PET-computer tomography into the diagnostic criteria and endorsed the concept of safety of relatively early surgical treatment...
June 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28289528/clinical-cardiac-regenerative-studies-in-children
#9
REVIEW
Imre J Pavo, Ina Michel-Behnke
Although the incidence of pediatric heart failure is low, the mortality is relatively high, with severe clinical symptoms requiring repeated hospitalization or intensive care treatment in the surviving patients. Cardiac biopsy specimens have revealed a higher number of resident human cardiac progenitor cells, with greater proliferation and differentiation capacity, in the neonatal period as compared with adults, demonstrating the regeneration potential of the young heart, with rising interest in cardiac regeneration therapy in critically ill pediatric patients...
February 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28277918/concordance-of-fetal-echocardiography-in-the-diagnosis-of-congenital-cardiac-disease-utilizing-updated-guidelines
#10
Marijo Aguilera, Kirsten Dummer
OBJECTIVE: We sought to examine the concordance of prenatally diagnosed congenital cardiac disease with postnatal echocardiography. STUDY DESIGN: Patients who underwent fetal echocardiograms performed by pediatric cardiologists at a single referral center from January to December 2014 were reviewed. Fetal echocardiography exams were performed in accordance with guidelines by the American Institute of Ultrasound in Medicine (AIUM) and the American Heart Association (AHA) guidelines (2013 and 2014, respectively)...
March 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28271153/low-iron-stores-in-otherwise-healthy-children-affect-electrocardiographic-markers-of-important-cardiac-events
#11
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/28255743/the-role-and-limitations-of-cochrane-reviews-at-the-bedside-a%C3%A2-systematic-synopsis-of-five-pediatric-subspecialties
#12
Sascha Meyer, Martin Poryo, Sara Khosrawikatoli, Yvonne Goda, Michael Zemlin
BACKGROUND: Cochrane meta-analyses provide the physician at the bedside with the most relevant, up-to-date clinical information. However, implementation of evidence-based medicine (EBM) at the bedside may be difficult for a variety of reasons. The aim of this study was to assess relevant issues and obstacles related to implementing EBM in pediatrics in real life at the bedside/cotside. METHODS: We performed five systematic literature reviews of all published Cochrane reviews in neonatology (1996-2010), pediatric neurology (1996-2010), pediatric gastroenterology (1993-2012), pediatric cardiology (2001-2015), and complementary and alternative medicine (1996-2012; CAM) in children and neonates...
March 2, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28239752/potential-and-limitations-of-cochrane-reviews-in-pediatric-cardiology-a-systematic-analysis
#13
Martin Poryo, Sara Khosrawikatoli, Hashim Abdul-Khaliq, Sascha Meyer
Evidence-based medicine has contributed substantially to the quality of medical care in pediatric and adult cardiology. However, our impression from the bedside is that a substantial number of Cochrane reviews generate inconclusive data that are of limited clinical benefit. We performed a systematic synopsis of Cochrane reviews published between 2001 and 2015 in the field of pediatric cardiology. Main outcome parameters were the number and percentage of conclusive, partly conclusive, and inconclusive reviews as well as their recommendations and their development over three a priori defined intervals...
February 27, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28225219/educational-intervention-for-improving-the-appropriateness-of-transthoracic-echocardiograms-ordered-by-pediatric-cardiologists
#14
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)...
May 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28153110/development-of-quality-metrics-in-ambulatory-pediatric-cardiology
#15
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
#16
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
#17
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...
May 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/27924361/prevalence-of-non-cardiovascular-findings-on-ct-angiography-in-children-with-congenital-heart-disease
#18
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...
March 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/27863016/appropriateness-and-diagnostic-yield-of-inpatient-pediatric-echocardiograms
#19
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
#20
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...
June 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
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