scholarly journals Risk Factors for Major Early Adverse Events Related to Cardiac Catheterization in Children and Young Adults With Pulmonary Hypertension: An Analysis of Data From the IMPACT (Improving Adult and Congenital Treatment) Registry

2018 ◽  
Vol 7 (5) ◽  
Author(s):  
Michael L. O'Byrne ◽  
Kevin F. Kennedy ◽  
Joshua P. Kanter ◽  
John T. Berger ◽  
Andrew C. Glatz
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Young Adults ◽  
Adverse Events ◽  
Cardiac Catheterization ◽  
Children And Young Adults ◽  
The Impact

Risk Factors for Adverse Events in Children with Pulmonary Hypertension Undergoing Cardiac Catheterization

2021 ◽  
Author(s):  
Danish Vaiyani ◽  
Michael Kelleman ◽  
Laura A. Downey ◽  
Usama Kanaan ◽  
Christopher J. Petit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Adverse Events ◽  
Cardiac Catheterization

Prevalence and Associated Risk Factors of Pulmonary Embolism in Children and Young Adults With Nephrotic Syndrome

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Haitao Zhu ◽  
Jianchen Qi ◽  
Joseph Schoepf ◽  
Rock H. Savage ◽  
Chunxiang Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Young Adults ◽  
Nephrotic Syndrome ◽  
Children And Young Adults ◽  
Associated Risk Factors

Assessing Barriers to Medication Adherence in Pediatric and Adolescent and Young Adult (AYA) Patients on Anticoagulation

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 9-10
Author(s):  
Kevin E Todd ◽  
Meghan E Mcgrady ◽  
Anne Blackmore ◽  
Carrie Hennessey ◽  
Lori Luchtman-Jones
Keyword(s):  
Young Adults ◽  
Linear Regression ◽  
Medication Administration ◽  
Self Report ◽  
Adolescent And Young Adult ◽  
The Past ◽  
Children And Young Adults ◽  
The Impact ◽  
The Relationship ◽  
Lower Adherence

Background: Medication nonadherence rates as high as 50-75% have been widely reported in children and adolescents with chronic medical conditions. Anticoagulation nonadherence is associated with increased morbidity and mortality from hemorrhagic and thrombotic complications, reported mostly in older adult populations. As direct oral anticoagulant use increases, it is critical that pediatric clinicians understand the prevalence, adverse sequelae, and predictors of nonadherence for various anticoagulants prescribed for children and young adults to facilitate self-management in this population. To begin to address these critical knowledge gaps, this study explored the frequency of reported barriers to anticoagulation adherence and the relationship between reported barriers and adherence among a cohort of children and young adults who were prescribed anticoagulants through a pediatric thrombosis clinic. Methods: Data for this abstract were collected as part of a quality improvement (QI) initiative in the pediatric thrombosis clinic from May 2019 to November 2019. This QI initiative included the administration of a self-report measure which asked families to rate the presence/absence of 19 barriers to adherence and respond to two items assessing adherence ("How many anticoagulation doses did you/your child miss in the past 7 days?"; "Did you/your child miss any anticoagulation doses in the past month?"). Patients aged > 10 years (yr.) and/or their caregivers (for patients 0-17 yr.) visiting the clinic for anticoagulation follow-up completed the measure. With IRB approval, results from 161 anonymous measures from 130 families (n = 37 caregivers; n = 62 patients; n = 31 patient/caregiver dyads) were analyzed. Descriptive statistics were used to summarize the most frequent barriers, rates of adherence, and concordance of barriers within patient/caregiver dyads. Linear regression was used to explore relationships between barriers and adherence after controlling for medication administration type (injections versus oral). To ensure only one measure per family was included in this analysis, the regression was run on the subset of measures completed by caregivers of children < 18 yr. and patients ≥ 18 yr. (n = 105 [37 caregivers + 62 patients + 31 caregivers from patient/caregivers dyad = 130 families; 130 - 25 families with missing adherence data = 105 families]). Results: Of 161 reporters, 120 reported at least 1 barrier. The most common barriers were medication side effects (n = 44), alterations in lifestyle secondary to medication (n = 44) and forgetting to take the medications (n = 37). The distributions of barriers by reporter and medication type are illustrated in Figure 1. Of 31 dyads, 26 reported 1 or more barriers. Only 6 caregiver/child dyads reported the same set of barriers. The remaining 77% (n = 20) of caregivers endorsed different barriers than their children. On average, patients and caregivers reported 1.85 barriers (SD = 1.95, range 0 - 10) and that they/their child took 96% of prescribed doses (SD= 9%, range = 71 - 100%). The linear regression was significant (F(2, 102) = 4.19, p = 0.02, R2 = 0.08). After controlling for medication type (p = 0.06), a greater number of barriers was significantly associated with lower adherence (t = -2.63, p = 0.01). Every one unit increase in total barriers (1 additional barrier reported) was associated with a decrease of .26% in adherence. Discussion: Although self-reported adherence was high, 75% of patients and caregivers reported 1 or more barriers to adherence. A greater number of barriers is associated with lower adherence, regardless of medication route, suggesting that addressing reported barriers might improve adherence. The spectrum of reported barriers was diverse, differing even within patient and caregiver dyads. Therefore, it is important to evaluate both patients and caregivers to fully assess the burden of barriers. Future studies are needed to evaluate the impact of addressing barriers and the relationship between anticoagulation adherence, barriers, and health outcomes. Figure 1 Disclosures Luchtman-Jones: Corgenix: Other: Provided discounted kits for study; Accriva Diagnostics: Other: Provided kits for study.

scholarly journals Zonisamide Induces Crystalluria without Urinary pH Changes in Children and Young Adults

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Tohshin Go
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Drug Treatment ◽  
Antiepileptic Drug ◽  
Childhood Onset ◽  
Urinary Ph ◽  
Alkaline Urine ◽  
Antiepileptic Drug Treatment ◽  
Children And Young Adults ◽  
Disabled Patients

Purpose. Adjunctive zonisamide therapy was demonstrated to be beneficial for multiple-disabled patients with refractory childhood-onset epilepsy. Zonisamide is well tolerated, but urolithiasis and calcium sludge in the bladder were sometimes described in patients treated with antiepileptic drug polytherapy including zonisamide. In previous studies, alkaline urine and crystalluria were shown to be risk factors for urolithiasis. Therefore, the effects of zonisamide addition and withdrawal on the urinary pH and crystalluria were investigated in patients treated with antiepileptic drug polytherapy to clarify the cause of urolithiasis induced by zonisamide. Methods. The urinary pH and the degree of crystalluria were retrospectively studied in epilepsy patients one month after the addition or withdrawal of zonisamide as part of their antiepileptic drug treatment regimen over the previous three years. Results. A total of 27 zonisamide-on patients and 16 zonisamide-off patients were enrolled in the study. The urinary pH did not change after the addition or withdrawal of zonisamide. However, the degree of crystalluria significantly increased after the addition () of zonisamide and decreased after its withdrawal (). Conclusions. Zonisamide induces crystalluria without alkalinization of the urine. Crystalluria should be carefully monitored in patients treated with zonisamide to prevent urolithiasis.

scholarly journals The effect of the duration of the procedure on the risk of complications during pediatric cardiac catheterization

2020 ◽  
Vol 28 (3) ◽  
pp. 467-473
Author(s):  
Kübra Evren Şahin
Keyword(s):  
Risk Factors ◽  
Adverse Events ◽  
Cardiac Catheterization ◽  
Risk Score ◽  
Potential Risk ◽  
Pediatric Patients ◽  
Heart Catheterization ◽  
Serious Adverse Events ◽  
Cardiac Catheterization Laboratory ◽  
Study Results

Background: This study aims to evaluate the frequency of and associated risk factors for adverse events caused by cardiac catheterization procedures in pediatric patients. Methods: Between January 2009 and January 2012, a total of 599 pediatric patients (320 males, 279 females; mean age 5.4±4.7 years; range, 1 day to 21 years) who underwent cardiac catheterization in our cardiac catheterization laboratory were retrospectively analyzed. Demographic and clinical data of the patients including the duration of the procedure, management of anesthesia, the American Society of Anesthesiologists class, and Catheterization Risk Score for Pediatrics, and procedure-related serious adverse events were recorded. Results: The incidence of procedure-related serious adverse events was 9.18%. Potential risk factors associated with serious adverse events were identified as interventional heart catheterization, high scores obtained from the Catheterization Risk Score for Pediatrics, the use of endotracheal tube in airway control, and prolonged procedural duration. Conclusion: Our study results suggest that prolonged duration of catheterization is a potential risk factor for procedure-related adverse events and the duration of the procedure needs to be included as a variable in the Catheterization Risk Score for Pediatrics scoring system for predicting procedure-related adverse events.

W1186 Outcomes and Adverse Events in Children and Young Adults with Steroid-Refractory Colitis Treated with Tacrolimus

2009 ◽  
Vol 136 (5) ◽  
pp. A-673
Author(s):  
Sheree Watson ◽  
Licia Pensabene ◽  
Paul D. Mitchell ◽  
Athos Bousvaros
Keyword(s):  
Young Adults ◽  
Adverse Events ◽  
Children And Young Adults ◽  
Steroid Refractory

scholarly journals The impact of eNOS, MTR and MTHFR polymorphisms on renal graft survival in children and young adults

2009 ◽  
Vol 24 (9) ◽  
pp. 2931-2937
Author(s):  
L. Artifoni ◽  
E. Benetti ◽  
S. Centi ◽  
S. Negrisolo ◽  
G. M. Ghiggeri ◽  
...  
Keyword(s):  
Young Adults ◽  
Graft Survival ◽  
Mthfr Polymorphisms ◽  
Renal Graft ◽  
Children And Young Adults ◽  
The Impact ◽  
Renal Graft Survival

Abstract 368: Family History of Premature Cardiac Events and Sub Clinical Atherosclerosis in Children and Young Adults: A Systematic Review

2013 ◽  
Vol 33 (suppl_1) ◽  
Author(s):  
Pragya Sinha ◽  
Jamal S Rana ◽  
Ebenezer T Oni ◽  
Ehimen C Aneni ◽  
Roger S Blumenthal ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Family History ◽  
Endothelial Dysfunction ◽  
Subclinical Atherosclerosis ◽  
Vascular Inflammation ◽  
Positive Family History ◽  
Cardiac Risk Factor ◽  
Children And Young Adults ◽  
The Impact

BACKGROUND The association between a positive family history (PFH) of premature cardiovascular disease (PCVD) and atherosclerosis has been explored in numerous studies. In adults, various studies have confirmed a significant positive correlation between a PFH and PCVD. Scant literature however, focuses on young individuals. Nevertheless, it is important to understand the impact that a PFH has in young people because the foundations of atherosclerosis and adverse cardiac behaviors develop in youth. In this paper, we aimed to systematically review the evidence linking a PFH of PCVD to indirect markers of subclinical atherosclerosis. METHODS The search was conducted on Medline, Web of Science and Embase. ‘Family history’, ‘children/young adults’ and ‘subclinical atherosclerosis’ were the three main concepts used. Increase in mean carotid IMT (cIMT), endothelial dysfunction and vascular inflammation were used as indirect measures of subclinical atherosclerosis. RESULTS 1191 articles were identified in the initial search. 24 papers with 5400 participants were included in the final review. There were five cohort studies and nineteen case control studies from twelve countries. Mean cIMT was found to be significantly increased in those with a PFH by eleven of the fourteen papers reviewed. Endothelial dysfunction, measured by flow mediated dilatation (FMD), was found to be significantly increased in five of the seven included studies. The evidence on vascular inflammation was somewhat inconsistent with only ten of the nineteen studies demonstrating significance. The results tend to suggest that an elevated mean cIMT, as well as a greater degree of endothelial dysfunction are seen in children and young adults with a PFH of PCVD. Moreover, these differences exist in asymptomatic children as young as 8-9 years (4 studies) in the absence of any other cardiac risk factor. DISCUSSION Individuals with a PFH of PCVD have evidence of subclinical atherosclerosis in their youth demonstrating an accelerated tendency to acquire cardiovascular disease. Some of this risk may be attributable to behavioral risk clustering in families. However, a significant proportion of this elevated risk is related solely to a positive family history and needs attention.

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