NOVEL ECHOCARDIOGRAM ANALYSIS OF CARDIAC DYSFUNCTION IS ASSOCIATED WITH MORTALITY IN PEDIATRIC SEPSIS.

Objectives: The objective of our study was to semiautomatically generate echocardiogram indices in pediatric sepsis using novel algorithms and determine which indices were associated with mortality. We hypothesized that strain and diastolic indices would be most associated with mortality. Design: Retrospective cohort study of children with sepsis from 2017 to 2022.

Risk factors for 1-year allograft loss in pediatric heart transplant patients using machine learning: An analysis of the pediatric heart transplant society database.

Background: Pediatric heart transplant patients are at greatest risk of allograft loss in the first year. We assessed whether machine learning could improve 1-year risk assessment using the Pediatric Heart Transplant Society database.

Methods: Patients transplanted from 2010 to 2019 were included.

Transcatheter Systemic AV Valve-in-Valve Implantation in a Patient With LTGA and Ebstein Anomaly.

We present the first in-human transcatheter systemic atrioventricular valve-in-valve implantation in a 37-year-old patient with Ebstein anomaly, levo-transposition of the great arteries, and prior systemic valve replacement. She had severe bioprosthetic valve regurgitation and reduced systolic function. She had high surgical risk and was planned for transcatheter intervention.

The complication rate of intravascular ultrasound (IVUS) in a multicenter pediatric heart transplant population: A study of the international pediatric IVUS consortium.

Background: Our purpose was to determine the complication rate from intravascular ultrasound (IVUS) in a large, multicenter cohort of pediatric heart transplant (PHT) patients.

Methods: We retrospectively reviewed all PHT who underwent IVUS at 5 institutions (2006-2014). Rates of major and minor complications were calculated.

Comparison of Segmental Versus Longitudinal Intravascular Ultrasound Analysis for Pediatric Cardiac Allograft Vasculopathy.

Intravascular ultrasound (IVUS) has been routinely used in some centers to investigate cardiac allograft vasculopathy in pediatric heart transplant recipients. We present an alternative method using more sophisticated imaging software. This study presents a comparison of this method with an established standard method.

The effects of orthoses, footwear, and walking aids on the walking ability of children and adolescents with spina bifida: A systematic review using International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a reference framework.

Background: To date no review has been published that analyzes the efficacy of assistive devices on the walking ability of ambulant children and adolescents with spina bifida and, differentiates between the effects of treatment on gait parameters, walking capacity, and walking performance.

Objectives: To review the literature for evidence of the efficacy of orthotic management, footwear, and walking aids on gait and walking outcomes in ambulant children and adolescents with spina bifida.

Study Design: Systematic literature review.

Preoperative physical therapy for elective cardiac surgery patients.

Background: After cardiac surgery, physical therapy is a routine procedure delivered with the aim of preventing postoperative pulmonary complications.

Objectives: To determine if preoperative physical therapy with an exercise component can prevent postoperative pulmonary complications in cardiac surgery patients, and to evaluate which type of patient benefits and which type of physical therapy is most effective.

Search Methods: Searches were run on the Cochrane Central Register of Controlled Trials (CENTRAL) on the Cochrane Library (2011, Issue 12 ); MEDLINE (1966 to 12 December 2011); EMBASE (1980 to week 49, 2011); the Physical Therapy Evidence Database (PEDro) (to 12 December 2011) and CINAHL (1982 to 12 December 2011).

Changes in left ventricular longitudinal strain with anthracycline chemotherapy in adolescents precede subsequent decreased left ventricular ejection fraction.

Background: Pediatric cancer survivors who have been exposed to anthracycline (ANT) chemotherapy are an ever increasing population at risk for premature cardiac disease. Studies have shown that ANT is associated with impaired left ventricular (LV) myocardial deformation, but this has not been shown to be associated with traditional echocardiographic measures of LV systolic dysfunction. The aim of this study was to test the hypothesis that changes in LV longitudinal peak systolic strain (LPSS) would correlate with parameters of LV systolic dysfunction.

Oxygen uptake efficiency slope in healthy children.

The objective of this study was to investigate the characteristics of the submaximal Oxygen Uptake Efficiency Slope (OUES) in a healthy pediatric population. Bicycle ergometry exercise tests with gas-analyses were performed in 46 healthy children aged 7-17 years. Maximal OUES, submaximal OUES, VO(2)peak, V(E)peak, and ventilatory threshold (VT) were determined.

The oxygen uptake efficiency slope: what do we know?

Purpose: To summarize what is currently known about the oxygen uptake efficiency slope (OUES) as an objective and independent submaximal measure of cardiorespiratory fitness in health and disease.

Methods: A literature search was performed within the following electronic databases--PubMed, Cochrane Library, Embase, Web of Science, CINAHL, PsycINFO, Scopus, and MEDLINE--using the search terms "OUES," "oxygen uptake efficiency slope," and "ventilatory efficiency." The search identified 51 articles.

Moderate acute rejection detected during annual catheterization in pediatric heart transplant recipients.

Background: Acute rejection commonly occurs within the first year after heart transplantation, and then decreases in frequency with time. Recently, the long-term utility of endomyocardial biopsy during routine annual catheterization has been questioned. The purpose of this study was to retrospectively review the prevalence of biopsy-proven rejection during routine annual catheterization in our patient population, determine whether biopsies late after transplant are useful, and identify factors that correlate with late unsuspected rejection.

Unenhanced limited CT of the abdomen in the diagnosis of appendicitis in children: comparison with sonography.

Objective: The purpose of this investigation is to determine the sensitivity, specificity, and accuracy of unenhanced limited CT of the abdomen in children with suspected appendicitis and compare these results with graded compression sonography.

Materials And Methods: Seventy-six children underwent unenhanced limited CT over a 11-month period for evaluation of suspected appendicitis. A historical cohort of 86 consecutive children who had undergone graded compression sonography was identified.

Pediatric renal masses: Wilms tumor and beyond.

A variety of pediatric renal masses may be differentiated from Wilms tumor on the basis of their clinical and imaging features. Wilms tumor is distinguished by vascular invasion and displacement of structures and is bilateral in approximately 10% of cases. Nephroblastomatosis occurs most often in neonates and is characterized by multiple bilateral subcapsular masses, often associated with Wilms tumors.

Outcome of infants with hypoplastic left heart syndrome who undergo atrial septostomy before heart transplantation.

This study evaluated the procedural and long-term outcome of infants who underwent atrial septostomy while awaiting transplant. The results suggest that septostomy improved outcome in these patients although infants needing a transseptal perforation were at higher risk.

Appendicolith revealed on CT in children with suspected appendicitis: how specific is it in the diagnosis of appendicitis?

Objective: The purpose of this study was to determine the sensitivity, specificity, and positive and negative predictive values of a diagnosis of appendicitis when CT without enteric contrast material reveals an appendicolith in children with suspected appendicitis.

Materials And Methods: A retrospective review of children who underwent abdominal CT for suspected appendicitis over a 25-month period was performed to identify patients with an appendicolith. An age-matched group of patients examined for trauma served as controls.

Somatic growth in infant heart transplant recipients.

Unlabelled: Infant heart transplantation is now entering its second decade of clinical experience. To understand better issues relating to somatic growth, this retrospective study will describe growth patterns in a group of infant heart transplant recipients. Early growth: growth velocity from birth to transplantation in 77 infants transplanted before 6 months of age was compared with growth velocity from transplant to 3 months.

Pediatric heart transplantation at Loma Linda: 1985 to 1996.

Pediatric heart transplantation at Loma Linda is now in its second decade with 299 infants and children having received 309 transplant procedures. Overall survival is 73% with 10 year actuarial survival of 66% for all ages. Newborn recipients have a 77% actuarial survival at 11 years.

Pretransplant risk factors and causes of death or graft loss after heart transplantation during early infancy. Pediatric Heart Transplant Team, Loma Linda.

Background: This study was performed to report causes of death or graft loss and to identify possible pretransplant risk factors for death or graft loss in infants after heart transplantation.

Methods And Results: Pretransplant risk factors were compared for 153 infants registered for heart transplantation within 90 days of life and transplanted from November 1985 to June 1994. Factors assessed were diagnosis, age at transplantation, race, weight, blood type, sex, donor/recipient blood type match, sex match, weight ratio, fetal registration, locale of pretransplant waiting period, mechanical ventilation, ischemic time, and the need for atrial septostomy or septectomy pretransplantation.