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Pediatric cardiovascular surgery

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https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#1
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27904844/cardiothoracic-surgical-experience-in-ghana
#2
REVIEW
Mark Tettey, Martin Tamatey, Frank Edwin
Ghana is one of the few low-to-middle-income countries in sub-Saharan Africa able to consistently sustain a cardiothoracic program with locally trained staff for more than two decades. Cardiothoracic surgery practice in Ghana started in 1964 but faltered from a combination of political and the economic problems. In 1989, Dr. Kwabena Frimpong-Boateng, a Ghanaian cardiothoracic surgeon trained in Hannover, rekindled interest in cardiothoracic surgery and in establishing a National Cardiothoracic Centre. His vision and leadership has brought cardiothoracic surgery practice in Ghana to its current high level...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27866783/characterizing-cardiac-arrest-in-children-undergoing-cardiac-surgery-a-single-center-study
#3
Punkaj Gupta, Andrew Wilcox, Tommy R Noel, Jeffrey M Gossett, Stephanie R Rockett, Brian K Eble, Mallikarjuna Rettiganti
OBJECTIVES: To characterize cardiac arrest in children undergoing cardiac surgery using single-center data from the Society of Thoracic Surgeons and Pediatric Advanced Life Support Utstein-Style Guidelines. METHODS: Patients aged 18 years or less having a cardiac arrest for 1 minute or more during the same hospital stay as heart operation qualified for inclusion (2002-2014). Patients having a cardiac arrest both before or after heart operation were included. Heart operations were classified on the basis of the first cardiovascular operation of each hospital admission (the index operation)...
October 24, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27857048/myocardial-scarring-after-repair-of-anomalous-origin-of-the-left-coronary-artery-from-pulmonary-artery
#4
(no author information available yet)
OBJECTIVES: Prognosis of patients with anomalous origin of the left coronary artery from pulmonary artery has dramatically improved as a result of both, early diagnosis and improvements in surgical techniques. Post surgical complications are rare and most patients show quick improvement of the left ventricular performance after repair with complete functional recovery within one year after surgery. Exercise-induced electrocardiographic changes have been found in patients postoperatively and scars and perfusion deficits of the left ventricle may not be detected by standard echocardiographic evaluation...
September 18, 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/27792123/acute-kidney-injury-in-patients-undergoing-the-extracardiac-fontan-operation-with-and-without-the-use-of-cardiopulmonary-bypass
#5
Claudia A Algaze, Andrew M Koth, Lisa W Faberowski, Frank L Hanley, Catherine D Krawczeski, David M Axelrod
OBJECTIVES: To describe the prevalence and risk factors for acute kidney injury in patients undergoing the extracardiac Fontan operation with and without cardiopulmonary bypass, and to determine whether acute kidney injury is associated with duration of mechanical ventilation, cardiovascular ICU and hospital postoperative length of stay, and early mortality. DESIGN: Single-center retrospective cohort study. SETTING: Pediatric cardiovascular ICU, university-affiliated children's hospital...
October 27, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27737413/thoughts-regarding-the-situation-of-the-pediatric-cardiovascular-surgery-in-brazil
#6
Ulisses A Croti, Domingo M Braile
No abstract text is available yet for this article.
May 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27737404/analysis-of-surgical-mortality-for-congenital-heart-defects-using-rachs-1-risk-score-in-a-brazilian-single-center
#7
Candice Torres de Melo Bezerra Cavalcante, Nayana Maria Gomes de Souza, Valdester Cavalcante Pinto, Klébia Magalhães Pereira Castello Branco, Ronald Guedes Pompeu, Andreia Consuelo de Oliveira Teles, Rodrigo Cardoso Cavalcante, Giselle Viana de Andrade
Introduction: Risk Adjustment for Congenital Heart Surgery 1 (RACHS-1) score is a simple model that can be easily applied and has been widely used for mortality comparison among pediatric cardiovascular services. It is based on the categorization of several surgical palliative or corrective procedures, which have similar mortality in the treatment of congenital heart disease. Objective: To analyze the in-hospital mortality in pediatric patients (<18 years) submitted to cardiac surgery for congenital heart disease based on RACHS-1 score, during a 12-year period...
May 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27713672/outcomes-in-postoperative-pediatric-cardiac-surgical-patients-who-received-an-antiepileptic-drug
#8
Mindl M Messinger, Kimberly L Dinh, Erin J McDade, Brady S Moffett, Angus A Wilfong, Antonio G Cabrera
BACKGROUND: Advances in cardiac operations over the last few decades, including corrective operations in early life, have dramatically increased the survival of children with congenital heart disease. However, postoperative care has been associated with neurologic complications, with seizures being the most common manifestation. The primary objective of this study is to describe the outcomes in pediatric patients who received an antiepileptic drug (AED) post-cardiac surgery. METHOD: A retrospective cohort study was performed in all patients less than 18 years of age who received an AED in the cardiovascular intensive care unit at Texas Children's Hospital from June 2002 until June 2012...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27706523/rapid-response-team-activations-in-pediatric-surgical-patients
#9
Shannon N Acker, Beth Wathen, Genie E Roosevelt, Lauren R S Hill, Anna Schubert, Jenny Reese, Denis D Bensard, Ann M Kulungowski
Introduction The rapid response team (RRT) is a multidisciplinary team who evaluates hospitalized patients for concerns of nonemergent clinical deterioration. RRT evaluations are mandatory for children whose Pediatric Early Warning System (PEWS) score (assessment of child's behavior, cardiovascular and respiratory status) is ≥4. We aimed to determine if there were differences in characteristics of RRT calls between children who were admitted primarily to either medical or surgical services. We hypothesized that RRT activations would be called for less severely ill children with lower PEWS score on surgical services compared with children admitted to a medical service...
October 5, 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27688650/pediatric-non-alcoholic-fatty-liver-disease-recent-solutions-unresolved-issues-and-future-research-directions
#10
REVIEW
Maria Grazia Clemente, Claudia Mandato, Marco Poeta, Pietro Vajro
Non-alcoholic fatty liver disease (NAFLD) in children is becoming a major health concern. A "multiple-hit" pathogenetic model has been suggested to explain the progressive liver damage that occurs among children with NAFLD. In addition to the accumulation of fat in the liver, insulin resistance (IR) and oxidative stress due to genetic/epigenetic background, unfavorable lifestyles, gut microbiota and gut-liver axis dysfunction, and perturbations of trace element homeostasis have been shown to be critical for disease progression and the development of more severe inflammatory and fibrotic stages [non-alcoholic steatohepatitis (NASH)]...
September 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27623142/prevalence-of-diabetes-mellitus-in-the-surgical-population-of-the-university-of-puerto-rico-affiliated-hospitals-a-study-using-the-surgery-database
#11
Norma I Cruz, Elvis Santiago, Anwar Abdul-Hadi
OBJECTIVE: To evaluate the prevalence of diabetes mellitus in the surgical population of the University of Puerto Rico (UPR)-affiliated hospitals. METHODS: We examined all the surgical cases that were entered into the Surgical Database from April 1, 2014 through September 30, 2014. This database collects patient and procedural information from different surgical services of various UPR-affiliated hospitals (the University District Hospital, the University Pediatric Hospital, the UPR Carolina Hospital, the Dr...
September 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27621853/sufficient-myocardial-protection-of-del-nido-cardioplegia-regardless-of-ventricular-mass-and-myocardial-ischemic-time-in-adult-cardiac-surgical-patients
#12
Ji Seong Kim, Jin Hee Jeong, Sin Ju Moon, Hyuk Ahn, Ho Young Hwang
BACKGROUND: Del Nido (DN) cardioplegic solution (CPS) has been widely used during pediatric cardiac surgery. However, its use in the field of adult cardiac surgery is not popular yet. We evaluated efficacy of DN cardioplegia in adult cardiac surgical patients. METHODS: Fifty-three adult patients (mean age, 54±16 years) who underwent cardiovascular surgery using DN cardioplegia were enrolled. Myocardial troponin I (TnI) level up to three days after surgery and early clinical outcomes were evaluated...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27508837/-op-7c-05-aortic-stiffness-and-pulse-wave-analysis-in-children-and-adolescents-with-marfan-syndrome
#13
A Grillo, A Pini, L Gao, G Trifirò, S Marelli, F Viecca, L Salvi, P Salvi, M Rovina, R Carretta, G Parati
OBJECTIVE: Marfan syndrome (MFS) is an autosomal dominant genetic disorder characterized by aortic root dilation beginning in childhood. Aortic stiffness is increased in patients with MFS but data in pediatric age are lacking. Aim of this study was to evaluate aortic stiffness and pulse wave analysis in children and adolescents with MFS, compared to general pediatric population, and its association with aortic root diameters. DESIGN AND METHOD: Fifty-two children with MFS (age: 12...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27429539/progression-of-chronic-kidney-disease-after-acute-kidney-injury
#14
Prasad Devarajan, John Lynn Jefferies
The incidence of chronic kidney disease (CKD) in children and adults is increasing. Cardiologists have become indispensable members of the care provider team for children with CKD. This is partly due to the high incidence of CKD in children and adults with congenital heart disease, with current estimates of 30-50%. In addition, the high incidence of acute kidney injury (AKI) due to cardiac dysfunction or following pediatric cardiac surgery that may progress to CKD is also well documented. It is now apparent that AKI and CKD are uniquely intertwined as interconnected syndromes...
June 2016: Progress in Pediatric Cardiology
https://www.readbyqxmd.com/read/27372617/status-of-turkey-s-top-publications-in-cardiovascular-medicine-revisited-after-4-years
#15
Altan Onat
OBJECTIVE: The aim of the present assessment was to identify "genuine" medical papers generated by Turkey's institutions that have contributed most to cardiovascular medicine. METHODS: Based on Web of Science data, 160 papers were identified as having received 40 or more citations as of late July 2015. Papers with more than minor contribution from international authors were excluded. RESULTS: A total of 127 primary authors generated 160 papers, each receiving ≥40 (95% confidence interval 40-165) citations...
June 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/27365335/effects-of-liver-transplantation-on-lipids-and-cardiovascular-disease-in-children-with-homozygous-familial-hypercholesterolemia
#16
Mercedes Martinez, Susan Brodlie, Adam Griesemer, Tomoaki Kato, Patricia Harren, Bruce Gordon, Thomas Parker, Daniel Levine, Theodore Tyberg, Thomas Starc, Iksung Cho, James Min, Kimberly Elmore, Steven Lobritto, Lisa Cooper Hudgins
Homozygous familial hypercholesterolemia (HoFH) is a rare, inherited, life-threatening, metabolic disorder of low-density lipoprotein (LDL) receptor function characterized by elevated serum LDL cholesterol (LDL-C) and rapidly progressive atherosclerotic cardiovascular disease (ACVD). Since LDL receptors are predominantly found on hepatocytes, orthotopic liver transplantation (OLT) has emerged as a viable intervention for HoFH because LDL receptor activity is restored. This study assessed the effects of OLT on ACVD and ACVD risk factors in pediatric patients with HoFH...
August 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27146240/is-preoperative-eosinopenia-an-independent-predictor-of-early-mortality-for-coronary-artery-bypass-surgery
#17
Özge Korkmaz, Hakki Kaya, Osman Beton, Ali Zorlu, Sabahattin Göksel, Müslim Gül, İlker İnce, Öcal Berkan, Mehmet Birhan Yılmaz
OBJECTIVE: Coronary artery bypass graft surgery in one of the most effective and widely used methods employed in the treatment of ischemic heart disease, but many factors to various degrees are directly associated with perioperative and postoperative problems. In this study, we evaluated the relationship between preoperative eosinophil count and postoperative mortality in patients who underwent coronary artery bypass graft operation. METHODS: A total of 241 patients (157 males, 84 females) who underwent isolated on-pump coronary artery bypass graft operation between 2011 and 2013 in two centers were evaluated retrospectively...
2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27134303/implementation-of-a-multidisciplinary-bleeding-and-transfusion-protocol-significantly-decreases-perioperative-blood-product-utilization-and-improves-some-bleeding-outcomes
#18
Joseph G Timpa, L Carlisle O'Meara, Kellen G Goldberg, Jay P Phillips, Jack H Crawford, Kimberly W Jackson, Jeffrey A Alten
Perioperative transfusion of blood products is associated with increased morbidity and mortality after pediatric cardiac surgery. We report the results of a quality improvement project aimed at decreasing perioperative blood product administration and bleeding after pediatric cardiopulmonary bypass (CPB) surgery. A multidisciplinary team evaluated baseline data from 99 consecutive CPB patients, focusing on the variability in transfusion management and bleeding outcomes, to create a standardized bleeding and transfusion management protocol...
March 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27107409/laryngeal-ultrasound-and-vocal-fold-movement-in-the-pediatric-cardiovascular-intensive-care-unit
#19
Julina Ongkasuwan, Elena Ocampo, Brandon Tran
OBJECTIVES/HYPOTHESIS: Vocal fold motion impairment (VFMI) is a known sequela of cardiovascular surgery. The gold standard for the evaluation of vocal fold movement is flexible nasolaryngoscopy (FNL). Although safe, FNL does cause measurable physiologic changes. Noxious stimuli in cardiovascular intensive care unit (CVICU) neonates may cause imbalance between the pulmonary and systemic circulations and potentially circulatory collapse. The goals of this project were to determine the accuracy of laryngeal ultrasound (LUS) compared to FNL to identify VFMI in CVICU neonates and compare their physiologic impact...
April 23, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27011138/journey-of-excellence-implementing-a-shared-decision-making-model
#20
Karen Murray, Sabrina Yasso, Roberta Schomburg, Molly Terhune, Marissa Beidelschies, Devin Bowers, Caryl Goodyear-Bruch
Research has shown that nurses who participate in shared decision making (SDM) have more control over their practice and greater job satisfaction, and hospitals that have instituted SDM have lower rates of nurse turnover and better patient outcomes. The purpose of this article is to describe the implementation of an SDM structure at a pediatric hospital. The hospital's chief nurse officer charged a group of nurses with developing SDM guidelines to outline the purpose, structure, and function of unit councils...
April 2016: American Journal of Nursing
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