The impact of neonatologist performed echocardiography in an Italian neonatal unit

2021 ◽  
pp. 1-6
Author(s):  
A. Casani ◽  
N. Tozzi ◽  
F. Cocca
Keyword(s):  
Heart Diseases ◽  
Heart Defects ◽  
Neonatal Unit ◽  
Hemodynamic Changes ◽  
Hemodynamic Assessment ◽  
Structural Abnormalities ◽  
Structural Heart Diseases ◽  
Neonatal Care Unit ◽  
The Impact ◽  
Additional Role

BACKGROUND: The main goal of neonatologist performed echocardiography is to timely assess hemodynamic changes in order to properly manage unsteady neonates. Detailed structural heart assessment remains the domain of pediatric cardiologists. Nonetheless, many neonatologists take on an additional role in diagnosis of congenital heart defects, mostly compelled by the lack of in-house pediatric cardiology services. The experience of neonatologist performed echocardiography in an Italian neonatal unit was reported and the risk benefit profile of this practice was discussed. MATERIAL AND METHODS: We retrospectively reviewed the echocardiograms undertaken by the neonatologist on infants admitted to the neonatal unit and postnatal ward of the Hospital San Pio in Benevento, over a 2-year period. Details of scans and concordance between neonatologist and cardiologist were analyzed. RESULTS: A total of 160 echocardiographic studies were done by the neonatologist on 136 infants. The ECG was requested in a minority of infants. The most common reason for performing the echocardiogram was admission to the neonatal care unit. Around half of the echocardiograms were normal. The remaining scans resulted in functional and structural abnormalities, transitional changes, and doubtful findings. Cardiac anomalies were significantly more likely found in cases of echocardiograms performed for fetal indications. Only 28 patients were eventually referred to the cardiology services. The inter-rater agreement was satisfactory. CONCLUSIONS: The hemodynamic assessment of sick infants, as well as triaging and referral of neonates with structural heart diseases are valuable advantages of the echocardiography run by neonatologists. Collaboration with pediatric cardiologists and robust training and accreditation programs are essential to ensure safety and quality service.

The impact of physical exercise on the occurence of arrhythmias in athletes – recommendations

2018 ◽  
Vol 1 (46) ◽  
pp. 11-15
Author(s):  
Jakub Szwed ◽  
Michał Kowara ◽  
Marcin Grabowski
Keyword(s):  
Physical Exercise ◽  
Heart Diseases ◽  
Sudden Cardiac Arrest ◽  
Endurance Sports ◽  
Endurance Sport ◽  
Sport Training ◽  
Negative Results ◽  
Structural Heart Diseases ◽  
Long Time ◽  
The Impact

The aim of this article is to demonstrate the impact of physical exercise on the development of arrhytmias in athletes. The studies show that this relation exist and concerns endurance sports practiced for a long time. In addition, this article contains review of the most common arrhythmias in athletes and appropriate recommendations. The time of arrhythmias onset depends on the presence of structural heart diseases. If the cardiac disorder is absent the arrhythmias appear at the age 40-50. If the structural heart diseases exist, the arrhythmias occur in young athletes and are more dangerous (can lead to sudden cardiac arrest). The most common arrhythmia in endurance athletes is atrial fibrillation. In order to avoid negative results of endurance sports, such as cardiac arrhythmias, the reliable examinations are necessary, especially to exclude structural cardiac diseases. These examinations should be undertaken before initiation of endurance sport training and routinely later, in course of follow-up.

scholarly journals The Impact of Complex Preoperative Preparation of Patients with Aortic Heart Diseases on the Level of Postoperative Anemia

2020 ◽  
pp. 37-42
Author(s):  
B. M. Gumeniuk ◽  
V. V. Popov ◽  
A. K. Logutov ◽  
E. V. Aksenov
Keyword(s):  
Surgical Treatment ◽  
Serum Iron ◽  
Heart Diseases ◽  
Heart Defects ◽  
Intervention Group ◽  
Artificial Circulation ◽  
Normal Range ◽  
Group A ◽  
Group B ◽  
The Impact

In patients undergoing surgical treatment of aortic heart defects under artificial circulation, pre-operative correction of serum iron levels, and application of blood-saving techniques during surgery reduce the level of postoperative anemia. The aim. To investigate the combined influence of preoperative correction of serum iron levels and blood-saving techniques in the early postoperative anemia in the surgical treatment of aortic heart defects under artificial circulation. Material and methods. This study involves 133 patients with acquired aortic heart diseases undergoing surgical treatment under artificial circulation and aims at identifying the combined effect of preoperative correction of serum iron (III) hydroxide levels and blood-saving techniques on the level of postoperative anemia. The levels of iron, transport enzymes, blood corpuscles, Hb and Ht were investigated. All the patients were divided into 3 groups. Group A (control group) included 52 patients in whom iron levels were within the normal range and donated blood components were used during the intervention. Group B (study group) included 43 patients in whom iron levels were within the normal range and blood-saving techniques were used during the intervention. Group C (adjustment group) included 38 patients with low iron levels and anemia, which was interpreted as anemia of chronic disease (ACD). Preoperative correction of serum iron levels and intraoperative blood-saving techniques were applied in this group. Results. For the purpose of perioperative anemia correction, transfusion of 539.8 ± 9.1 ml (p¤0.05) of packed red blood cells and 582.4 ± 77.2 ml (p¤0.05) of fresh frozen plasma was given in Group A patients. In the Group B, the use of blood-saving techniques during the intervention allowed us to obtain good clinical effect without perioperative transfusion of blood products. It was established that in Group C preoperative correction of serum iron enabled to achieve 5.6 times higher level of serum iron (p¤0.05), 2 times higher transferrin saturation, and 7.3 times higher ferritin activity (p¤0.05), as well as increase preoperative Hb level by 9.5 % and decrease postoperative anemia by 8.7 %. Conclusions. Correction of low baseline serum iron in patients with chronic anemia (ACD) provides 5.6 times increase in preoperative serum iron (SI) (p¤0.05), increases hemoglobin by 9.5% (p¤0.05), and reduces the level of postoperative anemia in patients undergoing surgical treatment of aortic heart defects under artificial circulation with the use of blood-saving techniques and without the use of donor blood and Cell Saver.

Structural diseases of the heart: genetics of congenital heart diseases

ESC CardioMed ◽  
2018 ◽  
pp. 716-719
Author(s):  
Daniela Q. C. M. Barge-Schaapveld ◽  
Marco C. DeRuiter ◽  
Conny C. van Munsteren ◽  
Monique R. M. Jongbloed
Keyword(s):  
Congenital Heart ◽  
Heart Diseases ◽  
Heart Defects ◽  
Reproductive Age ◽  
Congenital Defects ◽  
Clinical Genetics ◽  
Incomplete Penetrance ◽  
Number Of Patients ◽  
The Impact ◽  
Practical Recommendations

Congenital heart defects are the most common congenital defects. As a substantial number of patients with congenital heart disease (CHD) now reach reproductive age, the cardiologist dealing with grown-up patients with CHD is confronted with questions from patients regarding the impact of their CHD on pregnancy and offspring, and genetic counselling is becoming more relevant to clinical practice. Developments in the field of clinical genetics do not always facilitate clinicians’ knowledge and reasoning. Interpretation of the often large DNA datasets is challenging, especially in the light of phenotypic heterogeneity and incomplete penetrance, and requires specific expertise. In this chapter, the genetics of CHD are addressed. An overview of ‘causative’ genes is provided, that is, genes with a high likelihood to be involved in the development of human CHD and found so far to harbour (likely) pathogenic mutations in patients. In addition, the challenges and limitations in determining such genes are addressed and pitfalls in interpreting DNA variants in these genes discussed. The fact that single genes may in some instances be associated with different forms of CHD, may be explained by the broad range of cellular contributions during embryology, which will be briefly addressed. Finally, practical recommendations in addressing the genetics of CHD are provided.

scholarly journals The features of nutritional status in children with congenital heart disease

2019 ◽  
Vol 64 (5) ◽  
pp. 194-198
Author(s):  
D. I. Sadykova ◽  
Z. R. Khabibrakhmanova ◽  
A. R. Shakirova ◽  
L. Z. Safina
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Nutritional Status ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Heart Defects ◽  
High Risk Group ◽  
Incidence And Mortality ◽  
The Impact

Malnutrition is a common problem in children with congenital heart defects, regardless of the type of defect and the presence / absence of cyanosis. Children born with heart defects form a high-risk group of nutritional deficiency. Surgical treatment of congenital heart defects is often accompanied by metabolic changes and increased needs of energy and protein. Correction of nutritional status in children with congenital heart diseases improves the condition of patients after cardiac surgery. The purpose of our study was to assess the nutritional status of children with congenital heart defects hospitalized to the cardiac surgery department, and to correct their enteral nutrition. The authors analyzed anthropometric data on the Z-score (weight – age) of children admitted to the department for examination and correction of heart disease. The authors concluded that there is need for further studies to assess the impact of changes in nutritional status on the incidence and mortality of patients with congenital heart defects and the possibility of optimal correction of nutritional status.

scholarly journals Fibrosis and Conduction Abnormalities as Basis for Overlap of Brugada Syndrome and Early Repolarization Syndrome

2021 ◽  
Vol 22 (4) ◽  
pp. 1570
Author(s):  
Bastiaan J. Boukens ◽  
Mark Potse ◽  
Ruben Coronel
Keyword(s):  
Brugada Syndrome ◽  
Heart Diseases ◽  
Imaging Techniques ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Early Repolarization ◽  
Structural Abnormalities ◽  
Structural Heart Diseases ◽  
The Right ◽  
Early Repolarization Syndrome

Brugada syndrome and early repolarization syndrome are both classified as J-wave syndromes, with a similar mechanism of arrhythmogenesis and with the same basis for genesis of the characteristic electrocardiographic features. The Brugada syndrome is now considered a conduction disorder based on subtle structural abnormalities in the right ventricular outflow tract. Recent evidence suggests structural substrate in patients with the early repolarization syndrome as well. We propose a unifying mechanism based on these structural abnormalities explaining both arrhythmogenesis and the electrocardiographic changes. In addition, we speculate that, with increasing technical advances in imaging techniques and their spatial resolution, these syndromes will be reclassified as structural heart diseases or cardiomyopathies.

Association and treatment of diabetes in patients affected by Covid-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1198-1201
Author(s):  
Syed Yasir Afaque
Keyword(s):  
Diabetes Mellitus ◽  
Prognostic Value ◽  
Heart Diseases ◽  
The Novel ◽  
The World ◽  
Treatment Of Diabetes ◽  
Coronavirus Infection ◽  
Composite Outcomes ◽  
Novel Coronavirus ◽  
The Impact

In December 2019, a unique coronavirus infection, SARS-CoV-2, was first identified in the province of Wuhan in China. Since then, it spread rapidly all over the world and has been responsible for a large number of morbidity and mortality among humans. According to a latest study, Diabetes mellitus, heart diseases, Hypertension etc. are being considered important risk factors for the development of this infection and is also associated with unfavorable outcomes in these patients. There is little evidence concerning the trail back of these patients possibly because of a small number of participants and people who experienced primary composite outcomes (such as admission in the ICU, usage of machine-driven ventilation or even fatality of these patients). Until now, there are no academic findings that have proven independent prognostic value of diabetes on death in the novel Coronavirus patients. However, there are several conjectures linking Diabetes with the impact as well as progression of COVID-19 in these patients. The aim of this review is to acknowledge about the association amongst Diabetes and the novel Coronavirus and the result of the infection in such patients.

scholarly journals Personalized Genetic Diagnosis of Congenital Heart Defects in Newborns

2021 ◽  
Vol 11 (6) ◽  
pp. 562
Author(s):  
Olga María Diz ◽  
Rocio Toro ◽  
Sergi Cesar ◽  
Olga Gomez ◽  
Georgia Sarquella-Brugada ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart Defects ◽  
Congenital Malformations ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Heart Defects ◽  
Genetic Diagnosis ◽  
Single Nucleotide Variants ◽  
Personalized Approach

Congenital heart disease is a group of pathologies characterized by structural malformations of the heart or great vessels. These alterations occur during the embryonic period and are the most frequently observed severe congenital malformations, the main cause of neonatal mortality due to malformation, and the second most frequent congenital malformations overall after malformations of the central nervous system. The severity of different types of congenital heart disease varies depending on the combination of associated anatomical defects. The causes of these malformations are usually considered multifactorial, but genetic variants play a key role. Currently, use of high-throughput genetic technologies allows identification of pathogenic aneuploidies, deletions/duplications of large segments, as well as rare single nucleotide variants. The high incidence of congenital heart disease as well as the associated complications makes it necessary to establish a diagnosis as early as possible to adopt the most appropriate measures in a personalized approach. In this review, we provide an exhaustive update of the genetic bases of the most frequent congenital heart diseases as well as other syndromes associated with congenital heart defects, and how genetic data can be translated to clinical practice in a personalized approach.

scholarly journals Consumption of dairy products and cardiovascular disease risk: results from the French prospective cohort NutriNet-Santé

2021 ◽  
pp. 1-37
Author(s):  
Laury Sellem ◽  
Bernard Srour ◽  
Kim G. Jackson ◽  
Serge Hercberg ◽  
Pilar Galan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Dairy Products ◽  
Disease Risk ◽  
Heart Diseases ◽  
Cardiovascular Disease Risk ◽  
Dietary Intakes ◽  
Cvd Risk ◽  
Dairy Consumption ◽  
Fermented Dairy ◽  
The Impact

Abstract In France, dairy products contribute to dietary saturated fat intake, of which reduced consumption is often recommended for cardiovascular disease (CVD) prevention. Epidemiological evidence on the association between dairy consumption and CVD risk remains unclear, suggesting either null or inverse associations. This study aimed to investigate the associations between dairy consumption (overall and specific foods) and CVD risk in a large cohort of French adults. This prospective analysis included participants aged ≥ 18 years from the NutriNet-Santé cohort (2009–2019). Daily dietary intakes were collected using 24h-dietary records. Total dairy, milk, cheese, yogurts, fermented and reduced-fat dairy intakes were investigated. CVD cases (n=1,952) included cerebrovascular (n=878 cases) and coronary heart diseases (CHD, n=1,219 cases). Multivariable Cox models were performed to investigate associations. This analysis included n=104,805 French adults (mean age at baseline 42.8 years (SD 14.6)), mean follow-up 5.5 years (SD 3.0, i.e. 579,155 persons years). There were no significant associations between dairy intakes and total CVD or CHD risks. However, the consumption of at least 160 g/d of fermented dairy (e.g. cheese and yogurts) was associated with a reduced risk of cerebrovascular diseases compared to intakes below 57 g/d (HR=0.81 [0.66-0.98], p-trend=0.01). Despite being a major dietary source of saturated fats, dairy consumption was not associated with CVD or CHD risks in this study. However, fermented dairy was associated with a lower cerebrovascular disease risk. Robust randomized controlled trials are needed to further assess the impact of consuming different dairy foods on CVD risk and potential underlying mechanisms.

scholarly journals How do caregivers of children with congenital heart diseases access and navigate the healthcare system in Ethiopia?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sugy Choi ◽  
Heesu Shin ◽  
Jongho Heo ◽  
Etsegenet Gedlu ◽  
Berhanu Nega ◽  
...  
Keyword(s):  
Health Care ◽  
Cardiac Surgery ◽  
Health Care System ◽  
Low Income ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Heart Defects ◽  
Care Facility ◽  
Long Distance ◽  
Care System

Abstract Background Surgery can correct congenital heart defects, but disease management in low- and middle-income countries can be challenging and complex due to a lack of referral system, financial resources, human resources, and infrastructure for surgical and post-operative care. This study investigates the experiences of caregivers of children with CHD accessing the health care system and pediatric cardiac surgery. Methods A qualitative study was conducted at a teaching hospital in Ethiopia. We conducted semi-structured interviews with 13 caregivers of 10 patients with CHD who underwent cardiac surgery. We additionally conducted chart reviews for triangulation and verification. Interviews were conducted in Amharic and then translated into English. Data were analyzed according to the principles of interpretive thematic analysis, informed by the candidacy framework. Results The following four observations emerged from the interviews: (a) most patients were diagnosed with CHD at birth if they were born at a health care facility, but for those born at home, CHD was discovered much later (b) many patients experienced misdiagnoses before seeking care at a large hospital, (c) after diagnosis, patients were waiting for the surgery for more than a year, (d) caregivers felt anxious and optimistic once they were able to schedule the surgical date. During the care-seeking journey, caregivers encountered financial constraints, struggled in a fragmented delivery system, and experienced poor service quality. Conclusions Delayed access to care was largely due to the lack of early CHD recognition and financial hardships, related to the inefficient and disorganized health care system. Fee waivers were available to assist low-income children in gaining access to health services or medications, but application information was not readily available. Indirect costs like long-distance travel contributed to this challenge. Overall, improvements must be made for district-level screening and the health care workforce.

scholarly journals Unique Pattern of True Foreign-Body Ingestion in the Valley of Kashmir; Sharp Foreign Bodies Outnumbering the Blunt Ones

2019 ◽  
Vol 10 (01) ◽  
pp. 028-032
Author(s):  
Nisar Ahmad Shah ◽  
Showkat Ahmad Kadla ◽  
Asif Iqbal Shah ◽  
Bilal Ahmad Khan ◽  
Inaam Ul Haq ◽  
...  
Keyword(s):  
Foreign Body ◽  
Success Rate ◽  
Foreign Bodies ◽  
Foreign Body Ingestion ◽  
Young Females ◽  
The People ◽  
Early Endoscopy ◽  
Normal Individuals ◽  
Structural Abnormalities ◽  
The Impact

ABSTRACT Background and Aims: Foreign-body ingestion is a common phenomenon, especially in children. In normal adults, foreign-body ingestion is usually accidental and mostly ingestion occurs with food and impaction is a result of structural abnormalities of the upper gastrointestinal tract (UGIT). However, accidental ingestion of nonfood products is unusual; especially ingestion of pins (scarf or safety pins) and needles is unknown. We come across ingestion of these unusual/sharp foreign bodies routinely from the past few years. The aim of this study was to observe, over a period of 1 year, the spectrum of nonfood or true foreign-body ingestion in our community and to see the impact of an early endoscopy on outcome or retrieval of the ingested objects. Materials and Methods: In a prospective observational study, we studied the profile of foreign-body ingestion in normal individuals of all ages and both sexes, excluding the individuals with any structural abnormalities of the gut and the people with psychiatric ailment. Results: Of total 51 patients with foreign-body ingestion, 42 (82%) were 20 or <20 years of age with females constituting 86.3% of the total and males constituting only 13.7%. Foreign bodies ingested included 38 pins (74.5%), seven coins (13.7%), four needles (7.8%), and one denture and a nail (2%) each. Overall 26 (51%) foreign bodies were seen in UGIT (within reach of retrieval) at the time of endoscopy and all of them were retrieved. Nineteen (37.3%) patients reported within 6 h of ingestion, and majority of them (16 = 84.2%) had foreign bodies within UGIT and all of them were removed. Those patients (n = 32; 62.7%) who reported beyond 6 h, only 10 (31.25%) had foreign bodies in UGIT as a result of which the success rate of removal in these patients was only 32%. Conclusion: Most of our patients were young females and the common foreign bodies ingested were sharp including scarf pins followed by coins and needles. The success rate of retrieval was high in those who reported within 6 h of ingestion of foreign body. The rate of retrieval was 100% if foreign body was found on esophagogastroduodenoscopy. Hence, we recommend an early endoscopy in these patients and some alternative to use of scarf pins.

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