Extracorporeal Life Support in Multisystem Smooth Muscle Dysfunction Syndrome.

We describe an infant with congenital mydriasis, patent ductus arteriosus (PDA), pulmonary hypertension, and cystic lung disease. She had all the major components of multisystemic smooth muscle dysfunction syndrome. Due to progressive respiratory deterioration, she required surgical PDA interruption, extracorporeal life support, and subsequent prolonged respiratory support.

Collaborative DTM reduces hospitalization and healthcare costs in patients with diabetes treated with polypharmacy.

Objectives: To evaluate the effects of a collaborative pharmacy benefits manager (PBM)/ health plan-administered drug therapy management (DTM) program on healthcare utilization and costs in patients with diabetes treated with polypharmacy.

Study Design: Retrospective quasi-experimental design with comparison group.

Methods: This DTM program was a collaborative effort between the PBM, PerformRx, and the care management departments of Keystone First (KF) and AmeriHealth Caritas Pennsylvania (ACP) care management departments, targeting patients with diabetes using >15 medications.

Commotio cordis and ventricular pseudoaneurysm.

A case of an eight-year-old boy who experienced commotio cordis with the development of myocardial infarction and a ventricular pseudoaneurysm is described. Progressive enlargement of the aneurysm resulted in distortion and compression of the overlying coronary arteries, causing myocardial ischemia.

The effectiveness of transtelephonic monitoring of pacemaker function in pediatric patients.

Background: To determine the sensitivity and specificity, rate of compliance, and predictors of failure of telephone transmission of pacemaker function in a pediatric population.

Methods: A total of 2,638 pacemaker transmission records were reviewed retrospectively. Standard calculations of sensitivity, specificity, and positive and negative predictive values were performed.

Successful use of an intravenous infusion of flecainide and amiodarone for a refractory combination of postoperative junctional and ectopic tachycardias.

After repair of an atrioventricular septal defect with common atrioventricular junction in a 2-month-old girl, rapid atrial tachycardia, in combination with junctional ectopic tachycardia, led to severe postoperative cardiovascular compromise. Intercurrent runs of ectopic atrial tachycardia made atrial pacing impossible, despite high doses of intravenous amiodarone. Following the addition of flecainide to the infusion, we were able to control the rhythm, and when combined with atrial pacing, this led to an immediate haemodynamic improvement.