Randomized controlled trial of propranolol on social communication and anxiety in children and young adults with autism spectrum disorder.

Rationale: Autism spectrum disorder (ASD) is characterized by impaired social communication and is also frequently characterized by co-occurring anxiety. Propranolol is widely utilized to treat performance and public speaking anxiety. Single-dose psychopharmacological challenge studies suggested benefits using propranolol for verbal tasks and social interaction.

Interventricular Septal Pseudoaneurysm After Blunt Chest Trauma in a 6 Year Old: An Illustrative Case and Review.

Motor vehicle accident is the most common cause of blunt cardiac injury (BCI) in children (85.3%) due to the height of the child in relation to proper restraints and the compliant pediatric rib cage (J Trauma. 1996;40:200-202).

The role of α-adrenergic receptors in mediating beat-by-beat sympathetic vascular transduction in the forearm of resting man.

Sympathetic vascular transduction is commonly understood to act as a basic relay mechanism, but under basal conditions, competing dilatory signals may interact with and alter the ability of sympathetic activity to decrease vascular conductance. Thus, we determined the extent to which spontaneous bursts of muscle sympathetic nerve activity (MSNA) mediate decreases in forearm vascular conductance (FVC) and the contribution of local α-adrenergic receptor-mediated pathways to the observed FVC responses. In 19 young men, MSNA (microneurography), arterial blood pressure and brachial artery blood flow (duplex Doppler ultrasound) were continuously measured during supine rest.

Caregiver anxiety upon discharge for neonates with congenital heart disease.

Introduction:   Parents of children with congenital heart disease (CHD) have been shown to be at an increased risk of having psychosocial morbidities including anxiety, depression, and somatization. Little is known about the anxiety level of these parents during the initial hospital course. The goal of this study was to evaluate the anxiety level of the parents at the time of hospital discharge and to determine if certain characteristics predict higher anxiety levels.

Mild Tessier No. 7 cleft with PHACE syndrome: the case for pulmonary vascular steal.

We describe an unusual case of PHACE syndrome that provides a demonstration of the role of vascular anomalies in the causation of external ear and facial anomalies. The child in our case was characterized by a small segmental hemangioma of the face, tetralogy of Fallot, and anomalous origin of left common carotid artery from pulmonary artery with retrograde blood flow. This presumably resulted in hypoperfusion of the left side of the face resulting in a Tessier number 7 cleft and left ear anomaly explained by pulmonary vascular steal phenomenon.

Management of adults with congenital heart disease with cardiovascular computed tomography.

Objective: The purpose of this study was to evaluate the role of cardiac computed tomography (CT) in the care of adults with congenital heart disease (CHD).

Methods: A retrospective analysis of adult patients with CHD who underwent cardiac CT from April 2005 to May 2006 was performed. Data collected included diagnosis, presence or absence of cardiac symptoms, presence or absence of a pacemaker or defibrillator, anatomic and functional abnormalities, and the need for subsequent surgical or transcatheter intervention based on cardiac CT findings.

Acute dilated cardiomyopathy in a patient with deficiency of long-chain 3-hydroxyacyl-CoA dehydrogenase.

Deficiency of long-chain 3-hydroxyacyl-coenzyme A (CoA) dehydrogenase (LCHADD) is a rare inborn error of metabolism. It is associated with hypertrophic cardiomyopathy and less frequently with dilated cardiomyopathy. The incidence and pathophysiology of cardiac involvement in LCHADD is poorly understood.

Increased calcium supplementation is associated with morbidity and mortality in the infant postoperative cardiac patient.

Objective: The purpose of this study was to assess the association of calcium replacement therapy with morbidity and mortality in infants after cardiac surgery involving cardiopulmonary bypass.

Design: Retrospective chart review.

Setting: The cardiac intensive care unit at a tertiary care children's hospital.

Hyperglycemia is a marker for poor outcome in the postoperative pediatric cardiac patient.

Objective: Hyperglycemia in critical care populations has been shown to be a risk factor for increased morbidity and mortality. Minimal data exist in postoperative pediatric cardiac patients. The goal of this study was to determine whether hyperglycemia in the postoperative period was associated with increased morbidity or mortality.

Argatroban for anticoagulation during cardiopulmonary bypass in an infant.

Heparin induced thrombocytopenia (HIT) is a rare, but potentially life-threatening complication of heparin therapy. In patients with HIT, alternative means of anticoagulation are necessary. The authors present an infant with HIT who required anticoagulation during cardiopulmonary bypass for tricuspid valve excision in the treatment of bacterial endocarditis.

Vasopressin: applications in clinical practice.

Arginine vasopressin is a peptide produced in the posterior pituitary whose primary physiologic role is fluid homeostasis. Recent investigations have demonstrated a therapeutic role for arginine vasopressin in adult cardiac arrest as well as adult and pediatric vasodilatory shock. We review the physiology of arginine vasopressin and examine the supporting data behind the developing clinical applications of this naturally produced peptide.