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1.
JACC Case Rep ; 15: 101834, 2023 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-37283835

RESUMEN

Purulent bacterial pericarditis is rare and associated with significant short- and long-term morbidity. We report a case of purulent bacterial pericarditis caused by Group A Streptococcus in an immunocompetent young child presenting with a pericardial mass. She was successfully treated with a combined medical and early surgical approach. (Level of Difficulty: Intermediate.).

2.
AJP Rep ; 13(2): e29-e34, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37168107

RESUMEN

Objective Maternal anti-Ro (SSA) and/or anti-La (SSB) antibodies are a risk factor for congenital complete heart block (CHB). Because detailed analysis of the incidence of CHB after 24 weeks of gestational age (GA) is lacking, we aimed to ascertain the risk of "later-onset" CHB among offspring of SSA/SSB-positive mothers in the published literature. Study Design Using search terms "neonatal lupus heart block" and "autoimmune congenital heart block" on PubMed and Ovid, we gathered prospective studies of SSA/SSB-positive mothers with fetal echo surveillance starting from before CHB diagnosis and retrospective cases of fetal CHB diagnosis after 24 weeks of GA (if there was prior normal heart rate) or after birth. Results Ten prospective studies included 1,248 SSA/SSB-positive pregnancies with 24 cases of CHB diagnosed during pregnancy (1.9%). Among these, three (12.5%) were after 24 weeks-at weeks 25, 26, and 28. Our retrospective studies revealed 50 patients with CHB diagnosis in late fetal life and neonatal period and 34 in the nonneonatal childhood period. An additional four cases were diagnosed after age 18 years. Conclusion Later-onset autoimmune CHB in offspring of SSA/SSB-positive mothers does occur. Our analysis suggests that prenatal surveillance should continue beyond 24 weeks of GA but is limited by inconsistent published surveillance data.

3.
J Card Surg ; 37(7): 1854-1860, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35434814

RESUMEN

Tricuspid atresia with an absent pulmonary valve is a rare congenital cardiac defect. Although extensive pathological reviews have been published in the past, there are only a handful of cases that have been successfully palliated to the stage of Fontan. We hereby describe the successful management of one such case and review the surgical strategies described in the literature.


Asunto(s)
Procedimiento de Fontan , Atresia Pulmonar , Válvula Pulmonar , Atresia Tricúspide , Humanos , Atresia Pulmonar/diagnóstico por imagen , Atresia Pulmonar/cirugía , Válvula Pulmonar/anomalías , Válvula Pulmonar/diagnóstico por imagen , Válvula Pulmonar/cirugía , Atresia Tricúspide/diagnóstico por imagen , Atresia Tricúspide/cirugía
4.
JTCVS Tech ; 8: 116-123, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34401829

RESUMEN

OBJECTIVE: Although the right ventricle (RV) to pulmonary artery conduit in stage 1 Norwood operation results in improved interstage survival, the long-term effects of the ventriculotomy used in the traditional technique remain a concern. The periscopic technique (PT) of RV to pulmonary artery conduit placement has been described as an alternative technique to minimize RV injury. A retrospective study was performed to compare the effects of traditional technique and PT on ventricular function following Norwood operation. METHODS: A retrospective study of all patients who underwent Norwood operation from 2012 to 2019 was performed. Patients with baseline RV dysfunction and significant tricuspid valve regurgitation were excluded. Prestage 2 echocardiograms were reviewed by a blinded experienced imager for quantification of RV function (sinus and infundibular RV fractional area change) as well as for regional conduit site wall dysfunction (normal or abnormal, including hypokinesia, akinesia, or dyskinesia). Wilcoxon rank-sum tests were used to assess differences in RV infundibular and RV sinus ejection fraction and the Fisher exact test was used to assess differences in regional wall dysfunction. RESULTS: Twenty-two patients met inclusion criteria. Eight underwent traditional technique and 14 underwent PT. Median infundibular RV fractional area change was 49% and 37% (P = .02) and sinus RV fractional area change was 50% and 41% for PT and traditional technique (P = .007) respectively. Similarly qualitative regional RV wall function was better preserved in PT (P = .002). CONCLUSIONS: The PT for RV to pulmonary artery conduit in Norwood operation results in better preservation of early RV global and regional systolic function. Whether or not this benefit translates to improved clinical outcome still needs to be studied.

5.
Echocardiography ; 37(12): 2144-2147, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33084030

RESUMEN

Diagnosis of anomalous origin of the right subclavian artery (AORSA) from the right pulmonary artery (RPA) is usually made using CT, MRI, or invasive angiography. We report a patient diagnosed using transthoracic echocardiography (TTE). A newborn girl prenatally known to have d-TGA presented with cyanosis sparing the right hemithorax and arm. Oxygen saturations on the right hand were persistently higher than on the right ear and other extremities. Repeat TTE using a modified echocardiographic imaging plane allowed for full visualization of the entire subclavian artery course, revealing AORSA from RPA. We discuss further the approach to echocardiographic diagnosis and surgical implications.


Asunto(s)
Arteria Pulmonar , Transposición de los Grandes Vasos , Ecocardiografía , Femenino , Humanos , Recién Nacido , Arteria Pulmonar/diagnóstico por imagen , Arteria Subclavia/diagnóstico por imagen , Transposición de los Grandes Vasos/diagnóstico por imagen , Transposición de los Grandes Vasos/cirugía
6.
Curr Allergy Asthma Rep ; 17(8): 55, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28741144

RESUMEN

PURPOSE OF REVIEW: Every day in the USA, approximately 4000 adolescents begin smoking and the adolescent brain is particularly susceptible to nicotine addiction. We present current pediatric trends on tobacco use and exposures, various new products used by adolescents, the adverse biological and behavioral effects of tobacco use and exposures, and tobacco control strategies to eliminate tobacco-related illnesses and deaths in the pediatric population. RECENT FINDINGS: Twelve-20% of women continue to smoke during pregnancy. New research reveals cognitive differences and behavior-control disorders are seen in elementary school children from prenatal and postnatal exposures. Traditional cigarette smoking has decreased in adolescents; novel and appealing tobacco products have captured their attention, particularly electronic cigarettes, and rates double and often triple from middle to high school. Children with asthma and those living in multi-housing units have higher rates of secondhand smoke exposure than non-asthmatics and children living in single-home dwellings. There is no "safe or risk-free" level of tobacco use or exposure. Tobacco use and exposure in childhood and adolescence must be decreased using evidenced-based strategies to improve child health.


Asunto(s)
Contaminación por Humo de Tabaco , Uso de Tabaco , Sistema Cardiovascular/efectos de los fármacos , Niño , Conducta Infantil/efectos de los fármacos , Sistemas Electrónicos de Liberación de Nicotina , Exposición a Riesgos Ambientales , Femenino , Humanos , Riñón/efectos de los fármacos , Obesidad/epidemiología , Embarazo , Efectos Tardíos de la Exposición Prenatal , Sistema Respiratorio/efectos de los fármacos , Instituciones Académicas , Humo , Productos de Tabaco/efectos adversos , Productos de Tabaco/economía , Productos de Tabaco/legislación & jurisprudencia , Contaminación por Humo de Tabaco/efectos adversos , Contaminación por Humo de Tabaco/legislación & jurisprudencia , Contaminación por Humo de Tabaco/prevención & control , Uso de Tabaco/efectos adversos , Uso de Tabaco/legislación & jurisprudencia , Uso de Tabaco/prevención & control , Uso de Tabaco/tendencias
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