Banksmacleod5806

This study examines the function of the right ventricle (RV) using two-dimensional (2D) strain analysis after aortic coarctation (CoA) repair, as well as relationships between potential RV strain abnormalities and patient characteristics. The study examined 39 patients (61% male, age 32 ± 16 years) with CoA repair (33 post end-to-end anastomosis/sub-clavian flap, 6 post stenting/bypass/Teflon patch) and 42 controls. The structure and function of the left ventricle (LV), left atrium (LA), and RV were assessed using 2D standard echocardiography, tissue Doppler imaging, and 2D strain imaging. The characteristics examined included global RV longitudinal strain (RV-GLS), global LV longitudinal strain (LV-GLS), and LA longitudinal strain (LA strain). KI696 price RV dysfunction was defined by RV-GLS lower than the mean minus 2 standard deviations (SDs) of the control group value. LV mass and mitral E/Ea were significantly higher in the CoA group. Septal Ea, LV-GLS, and LA strain were significantly lower in the CoA group. RV dysfunction (RV-GLS >  - 16%) was present in 10 (25.6%) CoA patients. RV-GLS was correlated with lateral Ea, LV-GLS, and LA strain (r =  - 0.35, p = 0.02; r =  - 0.54, p  less then  0.001; and r =  - 0.44, p = 0.005, respectively). Patients who had a stenting/bypass/Teflon patch as the first initial repair exhibited significantly lower RV-GLS. RV systolic strain abnormalities may occur in patients late after CoA repair. RV strain was correlated with parameters of LV dysfunction. Further large-scale studies are required to confirm these findings and to determine the mechanisms and prognostic implications of RV strain in such patients.Accurate assessment of LV systolic function remains a challenge, especially in the pediatric population. Myocardial strain measurement by 2D speckle tracking echocardiography (2DSTE) is a relatively new modality for assessment of regional and global myocardial wall motion. This study aims to establish the normative value among various pediatric age groups at a large pediatric tertiary care institution and to describe the challenges encountered in establishing such strain data. Transthoracic echocardiograms were acquired in 121 healthy children (age 0-21 years) and were retrospectively analyzed. The global longitudinal strain (GLS) was obtained by 2D speckle tracking using Philips Epiq7® and QLAB post processing software. The normative value for left ventricular GLS (%) obtained in our study was - 20.8 ± 2.3 ( less then  1 year); - 21.4 ± 2.2 (1-4 years); - 19.6 ± 2.4 (5-9 years); - 19.4 ± 2.6 (10-14 years); - 18.9 ± 3.0 (15-21 years). There was a statistically significant difference in GLS between the different age groups. The BMI (kg/m2) of assessed subjects were 14.6 ± 2.3 ( less then  1 year); 16.3 ± 1.5 (1-4 years); 16.7 ± 2.3 (5-9 years); 21.3 ± 4.6 (10-14 years); 23.9 ± 5.9 (15-21 years). There was no significant difference in GLS by gender or by BMI found in our study. We present our experience with establishment of normative values of 2DSTE in our pediatric echocardiography lab. This study shows that age is the major determinant of variation in peak GLS in healthy subjects, emphasizing the importance of establishment of normative data among various age groups in pediatrics.PURPOSE We examined the association between surveillance for deep vein thrombosis (DVT) among medical-surgical critically ill patients by twice-weekly ultrasonography and 90-day all-cause mortality. METHODS This was a pre-planned sub-study of the Pneumatic Compression for Preventing Venous Thromboembolism (PREVENT) trial (Clinicaltrials.gov NCT02040103) that compared addition of intermittent pneumatic compression (IPC) to pharmacologic prophylaxis versus pharmacologic prophylaxis alone. The surveillance group included enrolled patients in the trial, while the non-surveillance group included eligible non-enrolled patients. Using logistic regression and Cox proportional hazards models, we examined the association of surveillance with the primary outcome of 90-day mortality. Secondary outcomes were DVT and pulmonary embolism (PE). RESULTS The surveillance group consisted of 1682 patients and the non-surveillance group included 383 patients. Using Cox proportional hazards model with bootstrapping, surveillance was associated with a decrease in 90-day mortality (adjusted HR 0.75; 95% CI 0.57, 0.98). Surveillance was associated with earlier diagnosis of DVT [(median 4 days (IQR 2, 10) vs. 20 days (IQR 16, 22)] and PE [median 4 days (IQR 2.5, 5) vs. 7.5 days (IQR 6.1, 28.9)]. There was an increase in diagnosis of DVT (adjusted HR 5.49; 95% CI 2.92, 13.02) with no change in frequency in diagnosis of PE (adjusted HR 0.56; 95% CI 0.19, 1.91). CONCLUSIONS Twice-weekly surveillance ultrasonography was associated with an increase in DVT detection, reduction in diagnostic testing for non-lower limb DVT and PE, earlier diagnosis of DVT and PE, and lower 90-day mortality. TRIAL REGISTRATION The PREVENT trial is registered at ClinicalTrials.gov, ID NCT02040103. Registered on 3 November 2013; Current controlled trials, ID ISRCTN44653506. Registered on 30 October 2013.Adenoidectomy, paracentesis, and tonsillar interventions are the most common operations in childhood. Hypertrophy of the lymphatic tissue of Waldeyer's ring can lead to individually distinct, acute, and chronic symptoms as well as anatomical and functional changes. When presented with affected children in otolaryngologic practice, the combination of parental interview, questionnaire-based screening for obstructive sleep apnea syndrome, and physical examination including ear microscopy, inspection of the oropharynx and, if necessary, the nasopharynx, has proven its worth. Audiometric diagnosis for detection of tympanic effusion should be mandatory. The treatment of choice is adenoidectomy, if necessary plus tonsillotomy and paracentesis with a tympanic tube insert. However, the indication remains controversial, as the effectiveness of the interventions seems to depend on the preoperative severity of symptoms. With a correct indication, effective symptom reduction, improvement in quality of life, and high parent satisfaction can be expected.