The Effects of CPE on Primary Relationships--Is It Worth Exploring?

Clinical Pastoral Education (CPE) can be a life transforming experience for students, but does it also transform students' primary relationships? An online survey of past CPE students at Royal Perth Hospital, Western Australia, found that--overall--CPE had a positive effect on primary relations in key areas, in particular communication, intimacy and spirituality. Recent relationships were more negatively affected. Some relationships did not survive CPE.

Chest pain on exertion after the Takeuchi repair of anomalous origin of the left coronary artery: right ventricular ischemia due to severe pulmonary outflow tract obstruction.

Right ventricular (RV) outflow obstruction (in the form of valvar or supravalvular pulmonary stenosis) is a well-known complication of the Takeuchi procedure. We describe a 13-year-old male with exertional chest pain, pulmonary stenosis, RV hypertrophy, and consequent RV ischemia, which was confirmed using stress echocardiography and single-photon emission tomography.

Management of nine cases of Wilms' tumour with intracardiac extension - a single centre experience.

Aim: The aim of this study was to review the management of children with Wilms' tumour who have intracardiac extension.

Patients And Methods: Data were collected from patient notes regarding presentation, operative details, and outcome.

Results: From 1984 through 2011, 264 children with Wilms' tumour were treated at our hospital.

Left ventricular sub-valvar mitral aneurysms.

We retrospectively reviewed the surgical treatment of 12 patients (nine female, mean age 16.1+/-8.7 years) with sub-mitral aneurysms managed in our institution between 1991 and 2002.

The lactate:pyruvate ratio following open cardiac surgery in children.

Objective: To explore the relationship between lactate:pyruvate ratio, hyperlactataemia, metabolic acidosis, and morbidity.

Design And Setting: Prospective observational study in the paediatric intensive care unit (PICU) of a university hospital.

Patients: Ninety-seven children after open cardiac surgery.

Regional cerebral oxygenation monitoring--intraoperative management in a patient with severe left ventricular dysfunction.

Intraoperative near-infrared spectroscopy cerebral oxygenation monitoring assists intraoperative decision-making in environments without extracorporeal membrane oxygenation (ECMO), left ventricular assist device (LVAD) or access to cardiac transplantation. We report a case of an anomalous left coronary artery arising from the pulmonary artery (ALCAPA), undergoing cardiac surgery. A 4-month-old infant presented in extremis with cardiac failure.

The Budd-Chiari syndrome in children: the spectrum of management.

The Budd-Chiari syndrome (BCS), characterized by hepatic venous outflow occlusion, is rare in children. We describe the cases of 3 patients with BCS who presented at different stages of liver dysfunction that required tailored management. A 10-year-old boy who presented with a weeklong history of abdominal discomfort received an early diagnosis.

The challenge of pediatric cardiac services in the developing world.

Pediatric cardiac services are too expensive for most developing nations. Problems other than cardiac disease take priority when it comes to budget allocations. Poor health infrastructure and referral systems, malnutrition, and the HIV/AIDS pandemic aggravate the situation, and the increasing economic divide is threatening what services do exist.