Prenatal diagnosis of hypoplastic left heart syndrome on ultrasound using artificial intelligence: How does performance compare to a current screening programme?

Background: Artificial intelligence (AI) has the potential to improve prenatal detection of congenital heart disease. We analysed the performance of the current national screening programme in detecting hypoplastic left heart syndrome (HLHS) to compare with our own AI model.

Methods: Current screening programme performance was calculated from local and national sources.

Exploring a new paradigm for the fetal anomaly ultrasound scan: Artificial intelligence in real time.

Objective: Advances in artificial intelligence (AI) have demonstrated potential to improve medical diagnosis. We piloted the end-to-end automation of the mid-trimester screening ultrasound scan using AI-enabled tools.

Methods: A prospective method comparison study was conducted.

Postnatal Outcome Following Prenatal Diagnosis of Discordant Atrioventricular and Ventriculoarterial Connections.

Discordant atrioventricular and ventriculoarterial connection(s) (DAVVAC) are a rare group of congenital heart lesions. DAVVAC can be isolated or associated with a variety of other cardiac abnormalities. Previous studies examining the outcome of prenatally diagnosed DAVVAC have described only fetal and early postnatal outcome in small cohorts.

Idiopathic pulmonary arterial hypertension with coexisting CHD.

Sinus venosus atrial septal defect can result in an increase in pulmonary blood flow and vascular resistance, leading to pulmonary hypertension. Rarely, the degree of pulmonary hypertension is out of proportion to the degree of intra-cardiac shunting. This case outlines the differences between pulmonary hypertension secondary to CHD and idiopathic pulmonary hypertension, and illustrates the investigation and management strategy used in a patient with features of both.

Chylothorax following paediatric cardiac surgery: a case-control study.

Objectives: The aims of this study were to investigate risk factors for the development of postoperative chylothorax following paediatric congenital heart surgery and to investigate the impact of a management guideline on management strategies and patient outcome.

Methods: All patients with chylothorax following cardiac surgery at the Royal Children's Hospital, Melbourne, over a 48-month period beginning in January 2008 were identified. A control group, matched for age, date of surgery, and sex, was identified.

The association between blood pressure and carotid intima-media thickness in children: a systematic review.

High blood pressure is a risk factor for atherosclerosis in adults, but whether the same is true in children and young people is not known. This is important to guide management of high blood pressure in children and young people. We aimed to investigate the association in children and young people between blood pressure and carotid intima-media thickness, a non-invasive marker of atherosclerosis, through a systematic review.

Feasibility and outcomes of ajmaline provocation testing for Brugada syndrome in children in a specialist paediatric inherited cardiovascular diseases centre.

Objectives: Brugada syndrome (BrS) is an inherited arrhythmia syndrome that causes sudden cardiac death in the young. The class Ia antiarrhythmic ajmaline can be used to provoke the diagnostic ECG pattern. Its use has been established in adults, but little data exist on the ajmaline provocation test in children.

Autoinflammatory gene polymorphisms and susceptibility to UK juvenile idiopathic arthritis.

Background: To investigate the autoinflammatory hereditary periodic fever syndrome genes MVK and TNFRSF1A, and the NLRP1 and IL1 genes, for association with juvenile idiopathic arthritis (JIA).

Methods: For MVK, TNFRSF1A and NLRP1 pair-wise tagging SNPs across each gene were selected and for IL1A SNPs from a prior meta-analysis were included. 1054 UK Caucasian JIA patients were genotyped by Sequenom iPlex MassARRAY and allele and genotype frequencies compared with 5380 unrelated healthy UK Caucasian controls.

A triad: cardiac rhabdomyosarcoma, stroke and tamponade.

The case report describes a 9-year-old boy who presented with an acute cerebrovascular accident and was found to have cardiac tamponade caused by cardiac rhabdomyosarcoma. Symptoms of rhabdomyosarcoma can be indolent and nonspecific, even with metastatic disease. Echocardiography and cardiac magnetic resonance imaging are explored as adjuncts to diagnosis.

Cluster of neurological manifestations of rotavirus infection in children.

Rotavirus infection in children in the resource-rich countries is usually benign but complications are reported rarely. Four children presented within 4 weeks with neurological symptoms and stool virology positive for rotavirus. All four made a quick recovery and were discharged home after a few days without medication.

An unusual case of incomplete Kawasaki disease in an adolescent returning from holiday in Montana.

Here we present an unusual case of incomplete Kawasaki disease in a 15-year-old boy returning from a holiday with his family in Montana. His symptoms were initial diarrhoea and lethargy, with fever, rash, conjunctivitis, and arthralgia developing during the course of his illness. His condition worsened while he was at his local hospital, and he was transferred to the regional tertiary paediatric hospital.

Association between hemolysis and albuminuria in adults with sickle cell anemia.

Studies have questioned whether renal dysfunction in sickle cell disease is linked to hemolysis-associated vasculopathy. We have investigated renal function and markers of hemolysis in a cohort of 424 adult African-British patients with sickle cell disease. While significant associations were found in HbSS and HbSβ(0) (sickle cell anemia) patients with and without controlling for covariates between hemolytic markers and albuminuria, the associations were not significant in patients with HbSC.

Changing pattern of hospital admissions of children with sickle cell disease over the last 50 years.

A study published in 1981 examined the causes of hospital admission for a cohort of children with sickle cell disease (SCD). Since that time, the incidence and prevalence of SCD has increased markedly in the UK, and there have been many changes in the management of this disease. We undertook a study examining the causes of hospital admission of children with SCD to the same hospital as the previous study, over the 2-year period from 2008 to 2009.

Is manipulation of mediastinal chest drains useful or harmful after cardiac surgery?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in patients who have undergone cardiothoracic surgery does manipulation of drainage tubes affect drainage volumes or post-surgical outcome? Altogether 681 papers were found using the reported search, of which four represented the best evidence to answer the clinical question. Duncan and Erickson in 1982 found that chest tube stripping can lead to very low negative intrathoracic pressures.

Motor neuron disease mortality in Great Britain continues to rise: examination of mortality rates 1975 - 2004.

Motor neuron disease (MND) mortality rates are rising in Europe and the USA. The most comprehensive UK study was conducted more than 15 years ago. This study examines trends in mortality from MND in England & Wales, and Scotland, between 1975 and 2004.

In patients undergoing cardiac surgery, thoracic epidural analgesia combined with general anaesthesia results in faster recovery and fewer complications but does not affect length of hospital stay.

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the use of thoracic epidural anaesthesia (TEA) in combination with general anaesthesia during adult cardiac surgery resulted in a faster recovery, fewer complications and shorter length of hospital stay. Altogether 313 papers were identified on Medline and 368 on Embase using the reported search of which 15 represented the best evidence on the topic.