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Norwood variation

Bijou R Hunt, Charlotte Picard, Jana L Hirschtick, Nancy Glick
While data on HIV testing prevalence is readily available at the national, state, and more rarely at the city level, few data are available on HIV testing at the community level, where public health initiatives may be most effectively implemented. Community-level data are necessary given that city, state, and national estimates mask variation occurring at the community level in large urban areas. This type of data is crucial for informing education efforts both within the community and among providers. The current study uses the Sinai Community Health Survey 2...
July 2018: AIDS Care
Kimberly E McHugh, Sara K Pasquali, Matthew A Hall, Mark A Scheurer
BACKGROUND: The Norwood operation is associated with high health care utilization, and prior studies reported substantial variability in Norwood costs across centers. However, specific factors driving this cost variation are unclear. We assessed center variability in Norwood costs and underlying mechanisms in a multicenter cohort. METHODS: Clinical data from the Pediatric Heart Network Single Ventricle Reconstruction trial were linked with cost data from the Children's Hospital Association Inpatient Essentials database...
March 2018: Annals of Thoracic Surgery
Thomas Scodellaro, Jane M McKenzie, Yves d'Udekem, Warwick Butt, Siva P Namachivayam
OBJECTIVES: To identify the prevalence, causes, risk factors, and outcomes associated with extubation failure following first stage single ventricle reconstruction surgery. DESIGN: Retrospective cohort analysis of neonates who underwent a first stage single ventricle reconstruction operation. Extubation failure was defined as endotracheal reintubation within 48 hours of first extubation attempt. SETTING: The Royal Children's Hospital, Melbourne...
December 2017: Pediatric Critical Care Medicine
Andrés E Pérez-Rojas, Beatriz Palma, Avantika Bhatia, John Jackson, Earta Norwood, Jeffrey A Hayes, Charles J Gelso
Countertransference is an important aspect of the therapeutic relationship that exists in therapies of all theoretical orientations, and depending on how it is managed, it can either help or hinder treatment. Management of countertransference has been measured almost exclusively with the Countertransference Factors Inventory (Van Wagoner, Gelso, Hayes, & Diemer, 1991) and its variations, all of which focus on 5 therapist qualities theorized to facilitate management: self-insight, conceptualizing ability, empathy, self-integration, and anxiety management...
September 2017: Psychotherapy
E A Hod, C Brugnara, M Pilichowska, L M Sandhaus, H S Luu, S K Forest, J C Netterwald, G M Reynafarje, A Kratz
OBJECTIVES: Automated cell counters have replaced manual enumeration of cells in blood and most body fluids. However, due to the unreliability of automated methods at very low cell counts, most laboratories continue to perform labor-intensive manual counts on many or all cerebrospinal fluid (CSF) samples. This multicenter clinical trial investigated if the GloCyte System (Advanced Instruments, Norwood, MA), a recently FDA-approved automated cell counter, which concentrates and enumerates red blood cells (RBCs) and total nucleated cells (TNCs), is sufficiently accurate and precise at very low cell counts to replace all manual CSF counts...
February 2018: International Journal of Laboratory Hematology
Edward C Kirkpatrick, Jessica Steltzer, Pippa Simpson, Amy Pan, Andrea Dragulescu, Christine B Falkensammer, Sarah Gelehrter, Wyman W Lai, Jami Levine, Stephen Miller, Thomas A Miller, Jay Pruetz, Ritu Sachdeva, Deepika Thacker, Peter Frommelt
The aim of this study was to describe serial changes in echocardiographic Doppler pulmonary vein flow (PVF) patterns in infants with single right ventricle (RV) anomalies enrolled in the Single Ventricle Reconstruction trial. Measurement of PVF peak systolic (S) and diastolic (D) velocities, velocity time integrals (VTI), S/D peak velocity and VTI ratios, and frequency of atrial reversal (Ar) waves were made at three postoperative time points in 261 infants: early post-Norwood, pre-stage II surgery, and 14 months...
August 2017: Pediatric Cardiology
Waldemar F Carlo, James F Cnota, Robert J Dabal, Jeffrey B Anderson
OBJECTIVE: The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) was established in 2008 to improve outcomes of hypoplastic left heart syndrome (HLHS) during the interstage period. They evaluated changes in patient variables and practice variation between early and late eras. DESIGN: Data including demographic, operative, discharge, and follow-up variables from the first 100 patients (6/2008-1/2010) representing 18 centers were compared with the most recent 100 patients (1/2014-11/2014) from these same centers...
May 2017: Congenital Heart Disease
Arnav Agarwal, Mohammed Firdouse, Nishaan Brar, Andy Yang, Panos Lambiris, Anthony K Chan, Tapas K Mondal
BACKGROUND: The stage 1 Norwood procedure and its variants represent the first step of palliation for hypoplastic left heart syndrome. Although appropriate postoperative thromboprophylaxis is integral, significant variance remains across institutional practices. The purpose of this systematic review is to estimate the incidence of thrombosis and thromboembolism following the Norwood or modified Blalock-Taussig shunt procedure and examine current thromboprophylaxis regimens. METHODS: Ovid MEDLINE and Embase were searched from January 2000 to June 2016 for primary studies explicitly reporting incidence of thrombosis, thromboembolism (strokes and pulmonary embolisms), or shunt occlusion in neonates, infants, and children undergoing the Norwood procedure or any variant...
November 2017: Clinical and Applied Thrombosis/hemostasis
C A Blanar, M Hewitt, M McMaster, J Kirk, Z Wang, W Norwood, D J Marcogliese
Parasite communities have been shown to be structured by processes at scales ranging from continental to microhabitat, but few studies have simultaneously considered spatial and environmental variables, measured at different scales, to assess their relative influences on parasite abundance, species richness, and community similarity. Parasite abundance, diversity, and community similarity in Athabasca River trout-perch (Percopsis omiscomaycus) were examined in relation to water quality, substrate profile, metal and organic compound levels in water and sediment, and landscape use patterns at different scales, as well as distance among sites and upstream-downstream position along the river...
October 2016: Parasitology Research
L Seliske, T A Norwood, J R McLaughlin, S Wang, C Palleschi, E Holowaty
BACKGROUND: An important public health goal is to decrease the prevalence of key behavioural risk factors, such as tobacco use and obesity. Survey information is often available at the regional level, but heterogeneity within large geographic regions cannot be assessed. Advanced spatial analysis techniques are demonstrated to produce sensible micro area estimates of behavioural risk factors that enable identification of areas with high prevalence. METHODS: A spatial Bayesian hierarchical model was used to estimate the micro area prevalence of current smoking and excess bodyweight for the Erie-St...
June 7, 2016: BMC Public Health
Hannah L Maxey, Connor W Norwood, Ziyue Liu
OBJECTIVES: To determine whether and to what extent the state policy environment for the dental hygiene workforce affects the availability of dental services at Federally Qualified Health Centers (FQHCs). METHODS: We examined data drawn from the Uniform Data System on 1,135 unique FQHC grantees receiving community health center funding from the U.S. Health Center program between 2004 and 2012. The Dental Hygiene Professional Practice Index was used to quantify variations in state policy environment...
September 2016: Journal of Public Health Dentistry
Bahaaldin Alsoufi, Brian Schlosser, Makoto Mori, Courtney McCracken, Timothy Slesnick, Brian Kogon, Christopher Petit, Ritu Sachdeva, Kirk Kanter
BACKGROUND: Tricuspid atresia (TA) is a heterogeneous single-ventricle anomaly in which initial presentation and, consequently, timing and mode of palliation vary based on morphology and degree of pulmonary or systemic outflow obstruction. We report current era palliation outcomes and examine whether morphologic and, subsequently, surgical factors influence survival. METHODS: From 2002 to 2012, 105 infants with TA underwent surgical palliation. Competing risks analyses modeled events after first-stage surgery (Glenn versus death) and after Glenn (Fontan versus death) and examined risk factors affecting outcomes...
October 2015: Annals of Thoracic Surgery
Sarah B Clauss, Jeffrey B Anderson, Carole Lannon, Stacey Lihn, Robert H Beekman, John D Kugler, Gerard R Martin
PURPOSE OF REVIEW: The National Pediatric Quality Improvement Collaborative (NPCQIC) was established to improve outcomes and quality of life in children with hypoplastic left heart syndrome and other single ventricle lesions requiring a Norwood operation. The NPCQIC consists of a network of providers and families collecting longitudinal data, conducting research, and using quality improvement science to decrease variations in care, develop and spread best practices, and decrease mortality...
October 2015: Current Opinion in Pediatrics
Brett R Anderson, Adam J Ciarleglio, David J Cohen, Wyman W Lai, Matthew Neidell, Matthew Hall, Sherry A Glied, Emile A Bacha
BACKGROUND: Hypoplastic left heart syndrome is the most expensive birth defect managed in the United States, with a 5-year survival rate below 70%. Increasing evidence suggests that hospital volumes are inversely associated with mortality for infants with single ventricles undergoing stage 1 surgical palliation. Our aim was to examine the relative effects of surgeon and institutional volumes on outcomes and resource utilisation for these children. METHODS: A retrospective study was conducted using the Pediatric Health Information System database to examine the effects of the number of procedures performed per surgeon and per centre on mortality, costs, and post-operative length of stay for infants undergoing Risk Adjustment for Congenital Heart Surgery risk category six operations at tertiary-care paediatric hospitals, from 1 January, 2004 to 31 December, 2013...
April 2016: Cardiology in the Young
Cynthia A Rossi, Brian J Kearney, Scott P Olschner, Priscilla L Williams, Camenzind G Robinson, Megan L Heinrich, Ashley M Zovanyi, Michael F Ingram, David A Norwood, Randal J Schoepp
Development and evaluation of medical countermeasures for diagnostics, vaccines, and therapeutics requires production of standardized, reproducible, and well characterized virus preparations. For filoviruses this includes plaque assay for quantitation of infectious virus, transmission electron microscopy (TEM) for morphology and quantitation of virus particles, and real-time reverse transcription PCR for quantitation of viral RNA (qRT-PCR). The ViroCyt® Virus Counter (VC) 2100 (ViroCyt, Boulder, CO, USA) is a flow-based instrument capable of quantifying virus particles in solution...
March 2015: Viruses
Jeffrey B Anderson, Robert H Beekman, John D Kugler, Geoffrey L Rosenthal, Kathy J Jenkins, Thomas S Klitzner, Gerard R Martin, Steven R Neish, Lynn Darbie, Eileen King, Carole Lannon
BACKGROUND: Growth failure is common in infants with single ventricle. This study evaluated the use of a learning network, the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC), to spread optimized nutritional practices and improve infant growth. METHODS: A previously identified Nutritional Bundle was spread among NPC-QIC sites. PRIMARY OUTCOME: interstage weight-for-age z-score change (ΔWAZ) between discharge from stage 1 palliation (S1) and stage 2 surgical palliation (S2)...
November 2014: Congenital Heart Disease
P Mirmirani, M Consolo, P Oyetakin-White, E Baron, P Leahy, P Karnik
BACKGROUND: There are regional variations in the scalp hair miniaturization seen in androgenetic alopecia (AGA). Use of topical minoxidil can lead to reversal of miniaturization in the vertex scalp. However, its effects on other scalp regions have been less well studied. OBJECTIVES: To determine whether scalp biopsies from men with AGA show variable gene expression before and after 8 weeks of treatment with minoxidil topical foam 5% (MTF) vs. placebo. METHODS: A placebo-controlled double-blinded prospective pilot study of MTF vs...
June 2015: British Journal of Dermatology
K Kieu, C Li, Y Fang, G Cohoon, O D Herrera, M Hildebrand, K H Sandhage, R A Norwood
Diatoms are a renewable (biologically reproducible) source of three-dimensional (3-D) nanostructured silica that could be attractive for a variety of photonic devices, owing to the wide range of quasi-periodic patterns of nano-to-microscale pores available on the silica microshells (frustules) of various diatom species. We have investigated the optical behavior of the silica frustule of a centric marine diatom, Coscinodiscus wailesii, using a coherent broadband (400-1700 nm) supercontinuum laser focused to a fine (20 µm diameter) spot...
June 30, 2014: Optics Express
Caren S Goldberg, Minmin Lu, Lynn A Sleeper, William T Mahle, J William Gaynor, Ismee A Williams, Kathleen A Mussatto, Richard G Ohye, Eric M Graham, Deborah U Frank, Jeffrey P Jacobs, Catherine Krawczeski, Linda Lambert, Alan Lewis, Victoria L Pemberton, Renee Sananes, Erica Sood, Stephanie B Wechsler, David C Bellinger, Jane W Newburger
OBJECTIVE: To measure neurodevelopment at 3 years of age in children with single right-ventricle anomalies and to assess its relationship to Norwood shunt type, neurodevelopment at 14 months of age, and patient and medical factors. STUDY DESIGN: All subjects in the Single Ventricle Reconstruction Trial who were alive without cardiac transplant were eligible for inclusion. The Ages and Stages Questionnaire (ASQ, n = 203) and other measures of behavior and quality of life were completed at age 3 years...
September 2014: Journal of Pediatrics
Chiara Corsini, Giovanni Biglino, Silvia Schievano, Tain-Yen Hsia, Francesco Migliavacca, Giancarlo Pennati, Andrew M Taylor
BACKGROUND: The size of the modified Blalock-Taussig shunt and the additional presence of aortic coarctation can affect the hemodynamics of the Norwood physiology. Multiscale modeling was used to gather insight into the effects of these variables, in particular on coronary perfusion. METHODS: A model was reconstructed from cardiac magnetic resonance imaging data of a representative patient, and then simplified with computer-aided design software. Changes were systematically imposed to the semi-idealized three-dimensional model, resulting in a family of nine models (3-, 3...
August 2014: Annals of Thoracic Surgery
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