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Article ; Online: American College of Cardiology Body Mass Index Counseling Quality Improvement Initiative.

Harahsheh, Ashraf S / Sabati, Arash / Anderson, Jeffrey / Jenkins, Kathy / Wilhelm, Carolyn M / Jedeikin, Roy / Chowdhury, Devyani

Pediatric cardiology

2021 Volume 42, Issue 5, Page(s) 1190–1199

Abstract: Overweight/obesity, prevalent cardiovascular risk factors in children, can be associated with increased risk of adverse outcomes in children with heart disease. The American College of Cardiology (ACC) developed quality metrics including a BMI metric ... ...

Abstract	Overweight/obesity, prevalent cardiovascular risk factors in children, can be associated with increased risk of adverse outcomes in children with heart disease. The American College of Cardiology (ACC) developed quality metrics including a BMI metric related to identifying and counseling overweight and obese children presenting to cardiology clinics. This metric was used for a multicenter collaborative learning Quality improvement (QI) Project through the ACC Quality Network (QNet). Our aim was to increase the percentage of children between ages 3 and 18 years presenting to cardiology clinics at participating centers with BMI > 85th percentile who received appropriate counseling. Participating centers submitted data quarterly to QNet for a sample of patients who received counseling. A Key Driver Diagram was created to help teams drive improvement. Individual centers customized interventions and participated in network-wide educational learning sessions about QI and shared experience. Statistical process control charts were used. From 04/01/2017 to 09/30/2019, 27,511 patient visits were included. Among 32 participating centers, overall counseling rate was 54%. The BMI counseling rate increased from 25% in 2017Q2 to 54% in 2019Q3. There was a wide variation from 10 to 100% in the performance of individual centers. The overall rate of identification and counseling of overweight and obese children presenting to ambulatory cardiology clinics in participating centers is low. There is wide variation in the performance of centers, providing an opportunity for improvement. Using this multicenter learning approach, individual centers have demonstrated improvement. This demonstrates that collaborative learning approaches in QI can increase implementation of the metric.
MeSH term(s)	Adolescent ; Body Mass Index ; Cardiology/standards ; Child ; Child, Preschool ; Counseling/methods ; Counseling/statistics & numerical data ; Humans ; Obesity/therapy ; Quality Improvement ; United States
Language	English
Publishing date	2021-04-15
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	800857-7
ISSN	1432-1971 ; 0172-0643
ISSN (online)	1432-1971
ISSN	0172-0643
DOI	10.1007/s00246-021-02600-6
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Zs.A 1528: Show issues

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Article ; Online: Development of quality metrics for ambulatory pediatric cardiology: Chest pain.

Lu, Jimmy C / Bansal, Manish / Behera, Sarina K / Boris, Jeffrey R / Cardis, Brian / Hokanson, John S / Kakavand, Bahram / Jedeikin, Roy

Congenital heart disease

2017

Abstract: Objective: As part of the American College of Cardiology Adult Congenital and Pediatric Cardiology Section effort to develop quality metrics (QMs) for ambulatory pediatric practice, the chest pain subcommittee aimed to develop QMs for evaluation of ... ...

Abstract	Objective: As part of the American College of Cardiology Adult Congenital and Pediatric Cardiology Section effort to develop quality metrics (QMs) for ambulatory pediatric practice, the chest pain subcommittee aimed to develop QMs for evaluation of chest pain. Design: A group of 8 pediatric cardiologists formulated candidate QMs in the areas of history, physical examination, and testing. Consensus candidate QMs were submitted to an expert panel for scoring by the RAND-UCLA modified Delphi process. Recommended QMs were then available for open comments from all members. Patients: These QMs are intended for use in patients 5-18 years old, referred for initial evaluation of chest pain in an ambulatory pediatric cardiology clinic, with no known history of pediatric or congenital heart disease. Results: A total of 10 candidate QMs were submitted; 2 were rejected by the expert panel, and 5 were removed after the open comment period. The 3 approved QMs included: (1) documentation of family history of cardiomyopathy, early coronary artery disease or sudden death, (2) performance of electrocardiogram in all patients, and (3) performance of an echocardiogram to evaluate coronary arteries in patients with exertional chest pain. Conclusions: Despite practice variation and limited prospective data, 3 QMs were approved, with measurable data points which may be extracted from the medical record. However, further prospective studies are necessary to define practice guidelines and to develop appropriate use criteria in this population.
Language	English
Publishing date	2017-06-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274321-2
ISSN	1747-0803 ; 1747-079X
ISSN (online)	1747-0803
ISSN	1747-079X
DOI	10.1111/chd.12509
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Zs.A 6693: Show issues

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Article: Supraventricular dysrhythmias in the adolescent.

Jedeikin, R

Pediatrician

1986 Volume 13, Issue 4, Page(s) 199–209

Abstract: Supraventricular dysrhythmias are the most common cause of rhythm disturbance in the adolescent. With advances in surgical techniques and medical management, more children will be entering adolescence and, as a result, a higher incidence of dysrhythmias ... ...

Abstract	Supraventricular dysrhythmias are the most common cause of rhythm disturbance in the adolescent. With advances in surgical techniques and medical management, more children will be entering adolescence and, as a result, a higher incidence of dysrhythmias will be encountered. Appropriate management of supraventricular tachycardia requires precise determination of the mechanism, symptomatology, and presence or absence of structural heart disease. Antidysrhythmic drugs have a wide spectrum of electrophysiologic effects. An understanding of the mechanisms underlying the different types of supraventricular tachycardia makes management less empiric and more rational. Surgical ablation, as well as endocardial catheter ablation, offer new therapeutic modalities for the management of refractory tachycardias.
MeSH term(s)	Adolescent ; Anti-Arrhythmia Agents ; Atrioventricular Node/surgery ; Humans ; Pacemaker, Artificial ; Tachycardia, Supraventricular/classification ; Tachycardia, Supraventricular/etiology ; Tachycardia, Supraventricular/therapy
Chemical Substances	Anti-Arrhythmia Agents
Language	English
Publishing date	1986
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	185550-5
ISSN	0300-1245
ISSN	0300-1245
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Zs.A 874: Show issues

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Article: Acute respiratory depression as a complication of nebulised morphine.

Lang, E / Jedeikin, R

Canadian journal of anaesthesia = Journal canadien d'anesthesie

1998 Volume 45, Issue 1, Page(s) 60–62

Abstract: Purpose: To present a case of respiratory depression following the administration of nebulised morphine.: Clinical features: A 74-yr-old, 51-kg woman with a history of hypertension controlled with 5 mg.day-1 enalapril and 50 mg.day-1 atenolol was ... ...

Abstract	Purpose: To present a case of respiratory depression following the administration of nebulised morphine. Clinical features: A 74-yr-old, 51-kg woman with a history of hypertension controlled with 5 mg.day-1 enalapril and 50 mg.day-1 atenolol was admitted for evaluation of low back pain, loss of appetite, and weight loss. Investigation revealed advanced metastatic disease with a probable primary in the right lung. The patient's pain was well controlled with 10 mg continuous release morphine p.o. three times daily, and 10 mg immediate release morphine p.o. for breakthrough pain as required. During the two weeks following the commencement of this treatment she occasionally complained of shortness of breath. Examination revealed a fully conscious patient with slight dyspnoea and mild wheezing which responded to oxygen 30% and nebulised bronchodilators. An oncological consultation recommended 4 mg nebulised morphine and 4 mg dexamethasone in saline as treatment for the bouts of breathlessness. Approximately 15 min after the first administration of nebulised morphine the patient became markedly bradypneic (respiratory rate: 4-5 bpm), hypotensive (BP 70/40 mmHg), and responded only partially to command. The pupils were pinpoint. The trachea was immediately intubated and the lungs ventilated with oxygen 40% for four hours. Following this occurrence of respiratory depression nebulised morphine was discontinued and no further events occurred. Conclusion: Patients receiving inhaled morphine should be closely monitored and resuscitation equipment should be readily available.
MeSH term(s)	Acute Disease ; Administration, Inhalation ; Administration, Oral ; Aged ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/adverse effects ; Analgesics, Opioid/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Anti-Inflammatory Agents/administration & dosage ; Anti-Inflammatory Agents/therapeutic use ; Antihypertensive Agents/therapeutic use ; Bone Neoplasms/drug therapy ; Bone Neoplasms/secondary ; Bronchodilator Agents/administration & dosage ; Bronchodilator Agents/therapeutic use ; Dexamethasone/administration & dosage ; Dexamethasone/therapeutic use ; Dyspnea/chemically induced ; Dyspnea/therapy ; Enalapril/therapeutic use ; Female ; Glucocorticoids/administration & dosage ; Glucocorticoids/therapeutic use ; Humans ; Hypertension/drug therapy ; Intubation, Intratracheal ; Lung Neoplasms/drug therapy ; Lung Neoplasms/pathology ; Morphine/administration & dosage ; Morphine/adverse effects ; Morphine/therapeutic use ; Nebulizers and Vaporizers ; Oxygen Inhalation Therapy ; Pain/drug therapy ; Palliative Care ; Respiration/drug effects ; Respiration, Artificial ; Respiratory Insufficiency/chemically induced ; Respiratory Sounds/drug effects ; Respiratory Sounds/physiopathology
Chemical Substances	Analgesics, Opioid ; Angiotensin-Converting Enzyme Inhibitors ; Anti-Inflammatory Agents ; Antihypertensive Agents ; Bronchodilator Agents ; Glucocorticoids ; Enalapril (69PN84IO1A) ; Morphine (76I7G6D29C) ; Dexamethasone (7S5I7G3JQL)
Language	English
Publishing date	1998-01
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	91002-8
ISSN	1496-8975 ; 0832-610X
ISSN (online)	1496-8975
ISSN	0832-610X
DOI	10.1007/BF03011995
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Zs.A 109: Show issues

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Article: Anaesthesia for caesarean delivery: low-dose epidural bupivacaine plus fentanyl.

Shapiro, A / Fredman, B / Olsfanger, D / Jedeikin, R

International journal of obstetric anesthesia

2004 Volume 7, Issue 1, Page(s) 23–26

Abstract: To determine the acceptability of epidural bupivacaine-induced sixth thoracic (T6) sensory blockade and the analgesic efficacy of epidural fentanyl 50 microg, 24 parturients undergoing elective caesarean section were given a test dose of lidocaine 60 mg ... ...

Abstract	To determine the acceptability of epidural bupivacaine-induced sixth thoracic (T6) sensory blockade and the analgesic efficacy of epidural fentanyl 50 microg, 24 parturients undergoing elective caesarean section were given a test dose of lidocaine 60 mg plus epinephrine followed by 10 ml of either 0.5 % bupivacaine (control group) or 0.5 % bupivacaine plus 50 microg fentanyl (fentanyl group) in a randomized double-blind manner. Fifteen minutes later loss of pinprick sensation was determined. Additional local anaesthetic was titrated to achieve T6 sensory blockade. Intraoperative pain intensity was assessed using a 10 cm visual analogue scale (VAS); total dose of bupivacaine and need for i.v. rescue fentanyl were recorded. The incidence of intraoperative respiratory depression, nausea, vomiting and pruritus were documented. Mean (+/- SD) volume of bupivacaine was 14.1 +/- 3.05 ml versus 13 +/- 1.48 ml for the control and fentanyl groups respectively. The most severe intraoperative VAS for pain was significantly (P=0.023) lower in the fentanyl group (0.4 +/- 0.08 cm) than in the control group (3.1 +/- 0.3 cm). Rescue fentanyl was administered in 40% and 0% of patients in the control and fentanyl groups respectively. The incidence of side-effects was unaffected by treatment group. Apgar scores were similar in the two groups. We conclude that following administration of 10-15 ml 0.5% bupivacaine plus fentanyl 50 microg, T6 sensory blockade is associated with good intraoperative analgesia without obvious maternal or neonatal respiratory depression.
Language	English
Publishing date	2004-08-05
Publishing country	Netherlands
Document type	Clinical Trial ; Journal Article ; Randomized Controlled Trial
ZDB-ID	1086024-1
ISSN	1532-3374 ; 0959-289X
ISSN (online)	1532-3374
ISSN	0959-289X
DOI	10.1016/s0959-289x(98)80024-1
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Zs.A 3311: Show issues

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Article: Horseshoe lung with left lung hypoplasia and critical pulmonary venous stenosis.

Lutterman, Joel / Jedeikin, Roy / Cleveland, David C

The Annals of thoracic surgery

2004 Volume 77, Issue 3, Page(s) 1085–1087

Abstract: Horseshoe lung is a rare congenital anomaly characterized by an isthmus of the pulmonary parenchyma that extends posterior to the pericardial reflection at the cardiac apex and across the midline. There is unilateral, usually right-lung hypoplasia and ... ...

Abstract	Horseshoe lung is a rare congenital anomaly characterized by an isthmus of the pulmonary parenchyma that extends posterior to the pericardial reflection at the cardiac apex and across the midline. There is unilateral, usually right-lung hypoplasia and most cases are associated with the scimitar syndrome. We present the case of an infant with horseshoe lung but with hypoplasia of the left lung and levocardia that was not associated with the scimitar syndrome.
MeSH term(s)	Constriction, Pathologic ; Fatal Outcome ; Humans ; Infant, Newborn ; Lung/abnormalities ; Pulmonary Veins/abnormalities ; Pulmonary Veins/pathology
Language	English
Publishing date	2004-03
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/S0003-4975(03)01213-X
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Zs.A 252: Show issues

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Article: Unipolar ventricular pacing reduces inappropriate shocks from a separate cardioverter defibrillator in a post-Fontan patient.

Cohen, Mitchell I / Jedeikin, Roy / Pfeiffer, Sharon / Pedersen, Scott

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

2006 Volume 8, Issue 4, Page(s) 293–296

Abstract: This report describes a 20-year-old man with complex congenital heart disease and inappropriate epicardial implantable cardioverter defibrillator (ICD) shocks secondary to double counting of ventricular-paced spikes and QRS complexes from a separate ... ...

Abstract	This report describes a 20-year-old man with complex congenital heart disease and inappropriate epicardial implantable cardioverter defibrillator (ICD) shocks secondary to double counting of ventricular-paced spikes and QRS complexes from a separate bipolar epicardial dual-chamber pacemaker. Adjusting to a unipolar paced-ventricular mode resolved any double counting via pacemaker-ICD interaction.
MeSH term(s)	Adult ; Cardiac Pacing, Artificial/methods ; Defibrillators, Implantable ; Electrocardiography ; Fontan Procedure ; Heart Defects, Congenital/physiopathology ; Heart Defects, Congenital/surgery ; Humans ; Male ; Treatment Outcome
Language	English
Publishing date	2006-04
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1449879-0
ISSN	1532-2092 ; 1099-5129
ISSN (online)	1532-2092
ISSN	1099-5129
DOI	10.1093/europace/euj047
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Zs.A 5434: Show issues

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Article: Delivery room analgesia: an analysis of maternal satisfaction.

Shapiro, A / Fredman, B / Zohar, E / Olsfanger, D / Jedeikin, R

International journal of obstetric anesthesia

2004 Volume 7, Issue 4, Page(s) 226–230

Abstract: On the first post-partum day, 324 mothers completed a questionnaire designed to assess maternal perception of delivery room experience. Antenatal pain expectation, actual pain severity, analgesia received, as well as maternal satisfaction and choice of ... ...

Abstract	On the first post-partum day, 324 mothers completed a questionnaire designed to assess maternal perception of delivery room experience. Antenatal pain expectation, actual pain severity, analgesia received, as well as maternal satisfaction and choice of analgesia for future deliveries were recorded. Forty-five percent of primiparae and 36% of multiparae reported that they anticipated suffering extreme pain during delivery. The incidence of unbearable pain was similar among patients who received no analgesia or intravenous pethidine but significantly (P<0.0001) higher when compared to epidural analgesia. During the first stage of labour, continuous epidural analgesia was associated with severe or unbearable pain in 51% and 58% of primiparae and multiparae, respectively. The incidence of severe or unbearable pain during the second stage of labour was 43% and 46% for primiparae and multiparae, respectively. Patient satisfaction with epidural analgesia did not correlate with subjective pain scores. Among mothers who received continuous epidural analgesia 70% described their experience as good or excellent and 65.8% indicated that they would request similar pain relief in the future. Despite advances in obstetric analgesia, women anticipate and actually experience severe pain during childbirth. However, due to psychological and cultural factors, as well as possible post-partum euphoria, satisfaction with the delivery room experience is high.
Language	English
Publishing date	2004-08-05
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1086024-1
ISSN	1532-3374 ; 0959-289X
ISSN (online)	1532-3374
ISSN	0959-289X
DOI	10.1016/s0959-289x(98)80043-5
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Zs.A 3311: Show issues

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Article: Spinal epidural anaesthesia. A new combination system.

Lifschitz, R / Jedeikin, R

Anaesthesia

1992 Volume 47, Issue 6, Page(s) 503–505

Abstract: We present our experience with a new combined spinal epidural system through which regional anaesthesia was performed in 30 male patients undergoing suprapubic prostatectomy. The technique consists of two needles, a 17 G Tuohy needle with a hole in its ... ...

Abstract	We present our experience with a new combined spinal epidural system through which regional anaesthesia was performed in 30 male patients undergoing suprapubic prostatectomy. The technique consists of two needles, a 17 G Tuohy needle with a hole in its distal curve (back eye) and a 29 G spinal needle which is passed through the back eye before being introduced into the subarachnoid space. We found the back eye combined spinal-epidural system effective and simple to use. The Tuohy needle with its back eye did not impede insertion of the epidural catheter and was a suitable introducer for the thin 29 G spinal needle.
MeSH term(s)	Aged ; Aged, 80 and over ; Anesthesia, Epidural/instrumentation ; Anesthesia, Epidural/methods ; Anesthesia, Spinal/instrumentation ; Anesthesia, Spinal/methods ; Humans ; Male ; Middle Aged ; Needles ; Pilot Projects ; Prostatectomy
Language	English
Publishing date	1992-06
Publishing country	England
Document type	Journal Article
ZDB-ID	80033-8
ISSN	1365-2044 ; 0003-2409
ISSN (online)	1365-2044
ISSN	0003-2409
DOI	10.1111/j.1365-2044.1992.tb02276.x
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Zs.A 388: Show issues

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Article: Transcatheter coil closure of a right pulmonary artery to left atrial fistula in an ill neonate.

Slack, M C / Jedeikin, R / Jones, J S

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

2000 Volume 50, Issue 3, Page(s) 330–333

Abstract: Although rare, a congenital direct fistula connection between the proximal right pulmonary artery and the left atrium can present as cyanosis in the newborn. We report the first case in which catheter-based coil closure of such a fistula in a neonate ... ...

Abstract	Although rare, a congenital direct fistula connection between the proximal right pulmonary artery and the left atrium can present as cyanosis in the newborn. We report the first case in which catheter-based coil closure of such a fistula in a neonate resulted in rapid clinical improvement, obviating the need for surgical repair.
MeSH term(s)	Embolization, Therapeutic ; Female ; Heart Atria/abnormalities ; Heart Defects, Congenital/therapy ; Humans ; Infant, Newborn ; Pulmonary Artery/abnormalities
Language	English
Publishing date	2000-07
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1459995-8
ISSN	1522-726X ; 1522-1946
ISSN (online)	1522-726X
ISSN	1522-1946
DOI	10.1002/1522-726x(200007)50:3<330::aid-ccd12>3.0.co;2-t
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