Gregersenmattingly2848

factor for pulmonary homograft dysfunction.

We sought to assess the effectiveness of 12 weeks of a physical exercise program (PEP) in child rugby players with lower-limb overpronation during gait.

This was a randomized clinical trial. A total of 123 young athletes (mean ± standard deviation age, 10.35 ± 1.22 years) were evaluated, 20 of whom had lower-limb overpronation (n = 40 extremities). Participants were randomly assigned to 2 groups the experimental group, who performed their normal training and a PEP for 12 weeks, and the control group, who continued with their normal training for the same time. The PEP was focused on stretching the hypertonic muscle and potentiating the weakened muscles of the lower body. All participants underwent biomechanical analysis including the Helbing angle, the femorotibial angle, and the Fick angle in both limbs.

All participants (n = 20) completed the study. Baseline measurements showed no significant differences between groups in any of the variables tested. After 12 weeks, there were significant differences between groups (P < .001 for all angles). No improvement was found in the control group; however, meaningful improvement was found in all variables in the experimental group Helbing angle (175°, P < .001, effect size [ES] = 1.94), femorotibial angle (173°, P < .001, ES = 1.77), Fick angle (12°, P < .001, ES = 1.55). The number needed to treat was 2 for femorotibial angle and Helbing angle, and 3 for Fick angle.

A 12-week PEP produced significant improvements in these 3 biomechanical variables. We also conclude that young athletes with a pathological gait pattern reached a normal gait pattern.

A 12-week PEP produced significant improvements in these 3 biomechanical variables. We also conclude that young athletes with a pathological gait pattern reached a normal gait pattern.

The purpose of this study was to compare 2 alternative methods, the radiologic Harrison Posterior Tangent Method (HPTM) and the nonradiologic Spinal Mouse (SM), to the Cobb angle for measuring lumbar lordosis.

Sixteen participants with previously existing lateral lumbopelvic radiographs underwent nonradiographic lordosis assessment with a Spinal Mouse. Then 2 investigators analyzed each radiograph twice using the Harrison Posterior Tangent Method and Cobb angle. Correlations were analyzed between HPTM, the Cobb angle, and SM using the Spearman rank correlation coefficient; intraexaminer and interexaminer agreement were analyzed for HPTM and the Cobb angle using intraclass correlation coefficients.

The HPTM correlated highly with the Cobb angle (Spearman ρ = 0.936, P < .001); SM had moderate to strong correlations with the Cobb angle (ρ = 0.737, P = .002) and HPTM (ρ = 0.707, P = .003). Intraexaminer and interexaminer agreement for the Cobb angle and HPTM were excellent (all intraclass correlation coefficients > 0.90). One participant had slight kyphosis according to HPTM and SM analyses (which consider the entire lumbar region), whereas the Cobb angle, based only on L1 and L5, reported mild lordosis for that participant.

In this sample, HPTM measurements showed high correlation with the commonly used Cobb angle, but this method requires more time and effort, and normal values have not been established. The SM may be an alternative when radiographs are inappropriate, but it measures soft tissue contours rather than lordosis itself.

In this sample, HPTM measurements showed high correlation with the commonly used Cobb angle, but this method requires more time and effort, and normal values have not been established. The SM may be an alternative when radiographs are inappropriate, but it measures soft tissue contours rather than lordosis itself.Autoimmune hypophysitis is a rare complication of immune checkpoint inhibitors. Immune checkpoint inhibitors have been used for advanced stages of melanoma, renal cell carcinoma, and lung cancer. Multiple endocrinopathies, among them hypophysitis, could result as a reverse event from this therapy. MRI is the imaging modality of choice and usually demonstrates pituitary gland hypertrophy, irregular thickening of the pituitary infundibulum, and diffuse enhancement. We present a case of stage IV metastatic renal cell carcinoma complicated with hypophysitis secondary to combined nivolumab and ipilimumab therapy.The coronavirus disease-2019 (COVID-19) pandemic has overwhelmed healthcare systems around the world, resulting in morbidity, mortality, and a dramatic economic downturn In the United States. Urgent responses to the pandemic halted routine hospital workflow in an effort to increase hospital capacity, maintain staffing, and ration protective gear. Most notably, New York saw the largest surge of COVID-19 cases nationwide. Healthcare personnel and physician leaders at Northwell Health, the largest healthcare system in New York, have worked together to successfully implement operational changes resulting in a paradigm shift in cardiac care delivery. In this manuscript, we detail specific protocol adjustments made in our cardiology department, cardiology service line, and healthcare system in the face of the COVID-19 pandemic. #link# We discuss the sustainability of this shift moving forward and the opportunity to optimize care for cardiovascular patients in the post COVID-19 era.The risk of syncope occurring while driving has implications for personal and public safety. Little is thought about the medical considerations related to the driving of motor vehicles. Physicians treating patients with cardiovascular disease need to acquire basic competences to be able to advise them about their fitness to drive. Current knowledge, governmental regulations, and recommendations concerning fitness to drive in patients with syncope and/or cardiovascular disease are presented. Narrative review with educational and clinical advice. Cardiovascular disease can make a driver lose control of a vehicle without warning and thereby lead to an accident. link2 The main pathophysiological mechanisms of sudden loss of control are disturbances of brain perfusion (eg, syncope with or without cardiac arrhythmia, sudden cardiac death due to ventricular fibrillation or asystole, stroke, etc.) and marked general weakness (eg, after major surgery or in heart failure). Patients with syncope and/or cardiovascular disease should be properly advised by their physicians about their fitness to drive, and restrictions should be documented.Artificial intelligence (AI) in the last decade centered primarily around digitizing and incorporating the large volumes of patient data from electronic health records. AI is now poised to make the next step in health care integration, with precision medicine, imaging support, and development of individual health trends with the popularization of wearable devices. Future clinical pediatric cardiologists will use AI as an adjunct in delivering optimum patient care, with the help of accurate predictive risk calculators, continual health monitoring from wearables, and precision medicine. Physicians must also protect their patients' health information from monetization or exploitation.This article aims to summarize some of the key advances in congenital interventional cardiology over the past few years, from novel imaging technologies, such as virtual reality, fusion imaging, and 3-dimensional printed models, to newly available devices and techniques to facilitate complex procedures including percutaneous pulmonary valve replacement and hybrid procedures. It is an exciting time for the field, with rapid development of techniques, devices, and imaging tools that allow a minimally invasive approach for many congenital cardiac defects with progressively less radiation and contrast doses.There is a growing population of patients living with congenital heart disease (CHD), now with more adults living with CHD than children. Adults with CHD have unique health care needs, requiring a thoughtful approach to cardiac, neurocognitive, mental, and physical health issues. GW441756 Trk receptor inhibitor have increased risk of anxiety, depression, pragmatic language impairment, limited social cognition, worse educational attainment and unemployment, and delayed progression into independent adulthood. As a result, it is important to establish an individualized approach to obtain successful transition and transfer of care from the pediatric to adult health care world in this patient population.Hypoplastic left heart syndrome (HLHS) is a complex form of congenital heart disease defined by anatomic and functional inadequacy of the left side of the heart with nonviability of the left ventricle to perform systemic perfusion. Lethal if not treated, a strategy for survival currently is well established, with continuing improvement in outcomes over the past 30 years. Prenatal diagnosis, good newborn care, improved surgical skills, specialized postoperative care, and unique strategies for interstage monitoring all have contributed to increasing likelihood of survival. The unique life with a single right ventricle and a Fontan circulation is a focused area of investigation.Although progress had been made in reducing cardiovascular disease (CVD) mortality, the positive trend has reversed in recent years, and CVD remains the most common cause of mortality in US women and men. link3 Youth represent the future of CVD prevention; emerging evidence suggests exposure to risk factors in children contributes to atherosclerosis and results in vascular changes and increased CVD events. The contributors to CVD include those commonly seen in adults. This article reviews hypercholesterolemia, hypertension, obesity, diabetes, and smoking. It discusses the prevalence of each disease, diagnosis, treatment, and cardiovascular complications.Pulmonary hypertension (PH), the syndrome of increased pressure in the pulmonary arteries, is associated with significant morbidity and mortality for affected children and is associated with a variety of potential underlying causes. Several pulmonary arterial hypertension-targeted therapies have become available to reduce pulmonary artery pressure and improve outcome, but there is still no cure for most patients. This review provides a description of select causes of PH encountered in pediatrics and an update on the most recent data pertaining to evaluation and management of children with PH. Available evidence for specific classes of PH-targeted therapies in pediatrics is discussed.Pediatric heart failure (PHF) affects 0.87 to 7.4 per 100,000 children. It has a 5-year mortality or heart transplant rate of 40%. Diagnosis often is delayed because initial symptoms are similar to common pediatric illnesses. Disease progression is tracked by symptoms, echocardiogram, and biomarkers. Treatment is extrapolated from mostly adult heart failure (HF) literature. Recent studies demonstrate differences between pediatric and adult HF pathophysiology. Increased collaboration among PHF programs is advancing the management of PHF. Unfortunately, there are patients who ultimately require heart transplantation, with increasing numbers supported by a ventricular assist device as a bridge to transplantation.