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Comparing the efficacy and safety of low,medium,and high dosages of selexipag for treating pulmonary hypertension:A systematic review and meta-analysis

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Animal Models and Experimental medicine 2024年第1期7卷 56-70页

作者： Shang Wang Yi Yan Jian Zhang Ping Yuan Ci-Jun Luo Hong-Ling Qiu Hui-Ting Li Jian Xu Lan Wang Tian-Lan Li Rong Jiang department of Cardio-pulmonary Circulation Shanghai Pulmonary HospitalSchool of MedicineTongji UniversityShanghaiChina Heart Center and Shanghai Institute of pediatric Congenital Heart Disease Shanghai Children's Medical CenterNational Children's Medical CenterShanghai Jiaotong University School of MedicineShanghaiChina department of Respiratory and Critical Care medicine The 416 Hospital of Nuclear IndustryThe Second Affiliated Hospital of Chengdu Medical CollegeChengduChina department of Hematology The Affiliated Hospital of Qingdao UniversityQingdaoChina

Background:The maintenance dosage of selexipag is categorized as low,medium or *** order to assess the efficacy and safety of different dosages of selexipag for the risk stratification of pulmonary arterial hypertension(PAH),we performed a sys-tematic review and ***:Studies assessing PAH risk stratification indices,such as the World Health Organization functional class(WHO-FC),six-minute walk distance(6MWD),N-terminal pro-B-type natriuretic peptide(NT-proBNP)level,right atrial pressure(RAP),cardiac index(CI)and mixed venous oxygen saturation(SvO2),were ***:Thirteen studies were *** led to improvements in the 6MWD(MD:24.20 m,95%CI:10.74-37.67),NT-proBNP(SMD:-0.41,95%CI:-0.79-0.04),CI(MD:0.47 L/min/m^(2),95%CI:0.17-0.77)and WHO-FC(OR:0.564,95%CI:0.457-0.697).Subgroup analysis demonstrated that all three dosages improved the 6MWD.A moderate dosage led to improvements in the CI(MD:0.30 L/min/m^(2),95%CI:0.15-0.46)and WHO-FC(OR:0.589,95%CI:0.376-0.922).Within 6 months of treatment,only the WHO-FC and CI were significantly improved(OR:0.614,95%CI:0.380-0.993;MD:0.30 L/min/m^(2),95%CI:0.16-0.45,respectively).More than 6 months of treatment significantly improved the 6MWD,WHO-FC and NT-proBNP(MD:40.87 m,95%CI:10.97-70.77;OR:0.557,95%CI:0.440-0.705;SMD:-0.61,95%CI:-1.17-0.05,respectively).Conclusions:Low,medium,and high dosages of selexipag all exhibited good *** treatment lasted for more than 6 months,selexipag exerted obvious effects,even in the low-dosage *** finding is important for guiding individualized treatments.

关键词： individualized treatments meta-analysis prostacyclin receptor agonist risk stratification systematic review

Prognosis and outcome of intrauterine treatment of fetuses with critical congenital heart disease

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Chinese Medical Journal 2024年第12期137卷 1431-1436页

作者： Liqing Zhao Lei Wang Hongping Xia Yurong Wu Xianting Jiao Hong Zhu Sun Chen Kun Sun department of pediatric Cardiology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China department of Diagnosis and Treatment Center for in utero pediatric Disease Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China department of Neonatology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China

Background:Intrauterine valvuloplasty is an innovative therapy,which promotes ventricular growth and function in some congenital heart diseases(CHDs).The technique remains challenging and can only be performed in a few *** study aimed to assess the feasibility and mid-term outcomes of fetal cardiac intervention(FCI)in fetuses with critical CHD in an experienced tertiary ***:Five fetal aortic valvuloplasty(FAV)or fetal pulmonary valvuloplasty(FPV)procedures were performed in our fetal heart center between August 2018 and May *** success was defined as crossing the aortic or pulmonary valve and balloon inflation,followed by evidence of increased blood flow across the valve and/or new ***-up clinical records and echocardiography were obtained during the prenatal and postnatal ***:Five fetuses received FAV or FPV,including critical aortic stenosis(n=2)and pulmonary atresia with intact ventricular septum(n=3).The mean maternal age was 33.0±2.6 *** median gestational age(GA)at diagnosis was 24 weeks(range,22-26 weeks).The median GA at intervention was 29 weeks(range,28-32 weeks).All five cases underwent successful or partially successful *** patient had pulmonary valve perforation without balloon *** procedure-related deaths or significant complications ***,one neonatal death occurred due to heart and renal *** median follow-up period was 29.5 months(range,8.0-48.0 months).The four surviving patients had achieved biventricular circulation,exhibited improved valve,and ventricular development at the last follow-up ***:Intrauterine FCI could be performed safely with good prognosis in critical CHD.

关键词： Fetal cardiac intervention Valvuloplasty pulmonary atresia Critical aortic stenosis Congenital heart disease

Traumatic brain injury and variants of shock index

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World Journal of Critical Care medicine 2024年第3期13卷 1-4页

作者： Sai Doppalapudi Muhammad Adrish Sai Doppalapudi Department of Pulmonary and Critical Care MedicineBronxCare Health System/Icahn School of Medicine at Mount SinaiBronxNY 10467United States Section of pulmonary Critical Care and Sleep MedicineBaylor College of MedicineHoustonTX 77030United States

Traumatic Brain Injury is a major cause of death and long-term *** early identification of patients at high risk of mortality is important for both management and *** many modified scoring systems have been developed for improving the prediction accuracy in patients with trauma,few studies have focused on prediction accuracy and application in patients with traumatic brain *** shock index(SI)which was first introduced in the 1960s has shown to strongly correlate degree of circulatory shock with increasing *** this editorial we comment on a publication by Carteri et al wherein they perform a retrospective analysis studying the predictive potential of SI and its variants in populations with severe traumatic brain injury.

关键词： Predictive tools Traumatic brain injury Shock index Neurocardiogenic stress Myocardial ischemia

pulmonary artery diameter ratio as a prognostic indicator of congenital diaphragmatic hernia

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World Journal of pediatric Surgery 2024年第1期7卷 20-25页

作者： Yuichiro Miyake Hiroyuki Koga Shuko Nojiri Shunsuke Yamada Takanori Ochi Go Miyano Geoffrey J Lane Atsuyuki Yamataka Tadaharu Okazaki department of pediatric General and Urogenital Surgery Juntendo University School of MedicineBunkyo-kuTokyoJapan department of Medical Technology Innovation Center Juntendo UniversityBunkyo-ku TokyoJapan department of pediatric Surgery Juntendo University Urayasu HospitalUrayasuChibaJapan

Background Following on from an earlier study published in 2008 about left pulmonary artery(LPA)flow measured on serial echocardiography being strongly prognostic in left-sided congenital diaphragmatic hernia(CDH)and the ratio of LPA to right pulmonary artery(RPA)diameters being a simple and reliable indicator for commencing nitric oxide(NO)therapy,the ratio of LPA:RPA diameters(PA ratio orPAR)was hypothesized to possibly reflect cardiopulmonary stresses accompanying CDH *** Subjects with isolated left-sided CDH treated between 2007 and 2020 at a single pediatric surgical center were recruited and classified according to *** obtained retrospectively for subject demographics,clinical course,LPA/RPA diameters,and PAR were compared between survivors and *** value of PAR for optimizing the prognostic value of PA diameter data in CDH were analyzed with receiver operating characteristic(ROC)curve *** Of 65 subjects,there were 54 survivors(82.3%)and 11 non-survivors(17.7%);7 of 11 non-survivors died before surgical repair could be *** PAR for survivors(0.851±0.152)was significantly higher than for non-survivors(0.672±0.108)(p=0.0003).Mean PAR for non-survivors was not affected by surgical *** of survivors were:LPA≥2 mm(n=52 of 54;mean PAR=0.866±0.146)and RPA≥3mm(n=46 of 54;mean PAR=0.857±0.152).Non-survivors with similar LPA and RPA diameters to survivors had significantly lower mean *** curve cut-off for PAR was *** with high PAR(≥0.762)required high-frequency oscillatory ventilation/NO less than subjects with low PAR(pulmonary instability in CDH.

关键词： hernia congenital diameters

Clinical-based phenotypes in children with pediatric post-COVID-19 condition

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World Journal of pediatrics 2024年第7期20卷 682-691页

作者： Lieke C.E.Noij Jelle M.Blankestijn Coen R.Lap Marlies A.van Houten Giske Biesbroek Anke-Hilse Maitland-van der Zee Mahmoud I.Abdel-Aziz Johannes B.van Goudoever Mattijs W.Alsem Caroline L.H.Brackel Kim J.Oostrom Simone Hashimoto Suzanne W.J.Terheggen-Lagro department of pediatric Pulmonology and Allergy Amsterdam UMCLocation AMCEmma Children’s HospitalAmsterdam University Medical CenterRoom G2-222Meibergdreef 91105AZAmsterdamThe Netherlands department of pulmonary medicine Amsterdam UMCAmsterdamThe Netherlands department of pediatrics Spaarne GasthuisHoofddorpThe Netherlands department of pediatrics Emma Children’s HospitalAmsterdam University Medical CenterAmsterdamThe Netherlands department of Rehabilitation medicine Amsterdam Movement SciencesMeibergdreef 9AmsterdamThe Netherlands department of Paediatric Pulmonology Department of PaediatricsTergooi MCHilversumThe Netherlands department of Child and Adolescent Psychiatry and Psychosocial Care Amsterdam UMCAmsterdam Reproduction and DevelopmentAmsterdamThe Netherlands

Background pediatric post coronavirus disease 2019(COVID-19)condition(PPCC)is a heterogeneous syndrome,which can significantly affect the daily lives of *** study aimed to identify clinically meaningful phenotypes in children with PPCC,to better characterize and treat this *** Participants were children with physician-diagnosed PPCC,referred to the academic hospital Amsterdam UMC in the Netherlands between November 2021 and March *** factors and information on post-COVID symptoms,comorbidities,and impact on daily life were *** clusters were identified using an unsupervised and unbiased approach for mixed data *** Analysis of 111 patients(aged 3–18 years)revealed three distinct clusters within *** 1(n=62,median age=15 years)predominantly consisted of girls(74.2%).These patients suffered relatively more from exercise intolerance,dyspnea,and smell *** 2(n=33,median age=13 years)contained patients with an even gender distribution(51.5%girls).They suffered from relatively more sleep problems,memory loss,gastrointestinal symptoms,and *** 3(n=16,median age=11 years)had a higher proportion of boys(75.0%),suffered relatively more from fever,had significantly fewer symptoms(median of 5 symptoms compared to 8 and 10 for clusters 1 and 2 respectively),and experienced a lower impact on daily *** This study identified three distinct clinical PPCC phenotypes,with variations in sex,age,symptom patterns,and impact on daily *** findings highlight the need for further research to understand the potentially diverse underlying mechanisms contributing to post-COVID symptoms in children.

关键词： Adolescents Clusters Long COVID pediatric Phenotypes Post-COVID syndrome

Impact of Social Determinants of Health on Self-Perceived Resilience: An Exploratory Study of Two Cohorts of Adults with Congenital Heart Disease

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Congenital Heart Disease 2024年第1期19卷 33-48页

作者： Albert Osom Krysta S.Barton Katie Sexton Lyndia Brumback Joyce P.Yi-Frazier Abby R.Rosenberg Ruth Engelberg Jill M.Steiner department of Biostatistics University of WashingtonSeattleWA98195USA Biostatistics Epidemiology and Analytics for Research(BEAR)Core Seattle Children’s Research InstituteSeattleWA98101USA College of medicine University of WashingtonSeattleWA98195USA Center for Clinical and Translational Research Seattle Children’s Research InstituteSeattleWA98101USA department of Psychosocial Oncology and Palliative Care Dana-Farber Cancer InstituteDepartment of MedicineBoston Children’s HospitalBostonMA02215USA department of pediatrics Harvard Medical SchoolBostonMA02215USA Division of pulmonary Critical Care and Sleep MedicineDepartment of Medicine&Cambia Palliative Care Center of ExcellenceUniversity of WashingtonHarborview Medical CenterSeattleWA98104USA Division of Cardiology Department of Medicine&Cambia Palliative Care Center of ExcellenceUniversity of WashingtonSeattleWA98195USA

Social determinants of health(SDOH)affect quality of *** investigated SDOH impacts on self-perceived resilience among people with adult congenital heart disease(ACHD).Secondary analysis of data from two com-plementary studies:a survey study conducted May 2021–June 2022 and a qualitative study conducted June 2020–August *** was assessed through CD-RISC10 score(range 0–40,higher scores reﬂect greater self-perceived resilience)and interview *** and SDOH(education,employment,living situa-tion,monetary stability,ﬁnancial dependency,area deprivation index)data were collected by healthcare record review and *** used linear regression with robust standard errors to analyze survey data and performed a thematic analysis of interview *** participants(N=127)mean age was 42±14 years;51%were female,87%*** was moderate(75%)or complex(25%);41%functional class C or ***(mean 30±7)varied by monetary stability:compared to people with difﬁculty paying bills,resilience was 15.0 points higher(95%CI:6.9–23.1,p<0.001)for people reporting having enough money and 14.2 points higher(95%CI:5.9–22.4,p=0.001)for those reporting just enough *** participants’(N=25)mean age was 32 years(range 22–44);52%were female,72%*** was moderate(56%)or complex(44%);76%functional class C or *** discussed factors affecting resilience aligned with each of the major SDOH,prominently,economic stability and healthcare access and *** stability may be important for supporting self-perceived resi-lience in *** knowledge can inform the development of resilience interventions for this population.

关键词： Social determinants of health adult congenital heart disease resilience ﬁnancial stability

Community-acquired pneumonia:The importance of the early detection of drug-resistant organisms

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World Journal of Critical Care medicine 2024年第2期13卷 11-14页

作者： Sai Doppalapudi Muhammad Adrish department of medicine Bronx Care Health SystemNew York Affiliated with The Icahn School of Medicine at Mount SinaiBronxNY 10457United States Section of pulmonary Critical Careand Sleep MedicineBaylor College of MedicineHoustonTX 77030United States

Pneumonia is a disease associated with significant healthcare burden with over 1.5 million hospitalizations annually and is the eighth leading cause of death in the United *** community-acquired pneumonia(CAP)is generally considered an acute time-limited illness,it is associated with high long-term mortality,with nearly one-third of patients requiring hospitalization dying within one *** increasing trend of detecting multidrug-resistant(MDR)organisms causing CAP has been observed,especially in the Western *** this editorial,we discuss about a publication by Jatteppanavar et al which reported that a case of a MDR organism was the culprit in developing pneumonia,bacteremia,and infective endocarditis that led to the patient’s *** early detection of these resistant organisms helps improve patient *** advances have been made in the biotechnological and research space,but preventive measures,diagnostic techniques,and treatment strategies need to be developed.

关键词： Methicillin-resistant Staphylococcus aureus Polymerase chain reaction Antibiotic resistance Bacterial colonization Infective endocarditis

COVID-19 mutations:An overview

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World Journal of Methodology 2024年第3期14卷 7-22页

作者： Malay Sarkar Irappa Madabhavi department of pulmonary medicine Indira Gandhi Medical CollegeShimla 171001Himachal PradeshIndia department of Medical and pediatric Oncology and Hematology J N Medical Collegeand KAHERBelagaviKarnataka 590010India department of Medical and pediatric Oncology and Hematology Kerudi Cancer HospitalBagalkotKarnataka 587103India

The severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)belongs to the genus Beta coronavirus and the family of *** is a positive-sense,non-segmented single-strand RNA *** common types of human coronaviruses circulate globally,particularly in the fall and winter *** are responsible for 10%-30% of all mild upper respiratory tract infections in *** are 229E,NL63 of the Alfacoronaviridae family,OC43,and HKU1 of the Betacoronaviridae ***,there are three highly pathogenic human coronaviruses:SARS-CoV-2,Middle East respiratory syndrome coronavirus,and the latest pandemic caused by the SARS-CoV-2 *** viruses,including SARS-CoV-2,have the inherent tendency to ***-CoV-2 is still evolving in ***,due to the development of herd immunity,prior infection,use of medication,vaccination,and antibodies,the viruses are facing immune *** the replication process and due to immune pressure,the virus may undergo *** SARS-CoV-2 variants,including the variants of concern(VOCs),such as B.1.1.7(Alpha),B.1.351(Beta),B.1.617/B.1.617.2(Delta),P.1(Gamma),and B.1.1.529(Omicron)have been reported from various parts of the *** VOCs contain several important mutations;some of them are on the spike *** mutations may lead to enhanced infectivity,transmissibility,and decreased neutralization efficacy by monoclonal antibodies,convalescent sera,or *** may also lead to a failure of detection by molecular diagnostic tests,leading to a delayed diagnosis,increased community spread,and delayed *** searched PubMed,EMBASE,Covariant,the Stanford variant Database,and the CINAHL from December 2019 to February 2023 using the following search terms:VOC,SARS-CoV-2,Omicron,mutations in SARS-CoV-2,*** review discusses the various mutations and their impact on infectivity,transmissibility,and neutralization efficacy.

关键词： Variant of concern SARS-CoV-2 Omicron N501Y mutation E484K mutation

A 63-Year-Old Male with D-Transposition of the Great Arteries Who Had an Early Form of the Arterial Switch Operation

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Congenital Heart Disease 2024年第1期19卷 65-68页

作者： Michael A.Rebolledo Jane S.Yao Jason N.Johnson Umar S.Boston Benjamin R.Waller III Division of pediatric Cardiology Department of PediatricsThe University of Tennessee Health Science CenterThe Heart InstituteLe Bonheur Children’s HospitalMemphisUSA College of medicine The University of Tennessee Health ScienceMemphisUSA Division of pediatric Cardiothoracic Surgery Department of SurgeryThe University of Tennessee Health Science CenterHeart InstituteLe Bonheur Children’s HospitalMemphisUSA

We describe a 63-year-old male who appears to have undergone an early form of the arterial switch operation for D-transposition of the great arteries performed in the *** review the clinical and imaging data that support our *** had a diagnostic cardiac catheterization which demonstrated severe pulmonary hypertension responsive to epoprostenol and *** case may represent one example of the experimental surgical work done prior to *** Jatene’s description of theﬁrst successful arterial switch performed in 1975.

关键词： Adult congenital heart disease arterial switch operation great vessel anomaly imaging(all modalities)