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  1. Article ; Online: Unlocking the key: Delving into implicit bias in pediatric heart transplantation.

    Bogle, Carmel

    Pediatric transplantation

    2023  Volume 28, Issue 2, Page(s) e14733

    MeSH term(s) Humans ; Child ; Bias, Implicit
    Language English
    Publishing date 2023-10-30
    Publishing country Denmark
    Document type Editorial
    ZDB-ID 1390284-2
    ISSN 1399-3046 ; 1397-3142
    ISSN (online) 1399-3046
    ISSN 1397-3142
    DOI 10.1111/petr.14733
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4947: Show issues Location:
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  2. Article ; Online: Cardiovascular Management of Patients Undergoing Hematopoietic Stem Cell Transplantation: From Pretransplantation to Survivorship: A Scientific Statement From the American Heart Association.

    Hayek, Salim S / Zaha, Vlad G / Bogle, Carmel / Deswal, Anita / Langston, Amelia / Rotz, Seth / Vasbinder, Alexi / Yang, Eric / Okwuosa, Tochukwu

    Circulation

    2024  Volume 149, Issue 16, Page(s) e1113–e1127

    Abstract: Hematopoietic stem cell transplantation can cure various disorders but poses cardiovascular risks, especially for elderly patients and those with cardiovascular diseases. Cardiovascular evaluations are crucial in pretransplantation assessments, but ... ...

    Abstract Hematopoietic stem cell transplantation can cure various disorders but poses cardiovascular risks, especially for elderly patients and those with cardiovascular diseases. Cardiovascular evaluations are crucial in pretransplantation assessments, but guidelines are lacking. This American Heart Association scientific statement summarizes the data on transplantation-related complications and provides guidance for the cardiovascular management throughout transplantation. Hematopoietic stem cell transplantation consists of 4 phases: pretransplantation workup, conditioning therapy and infusion, immediate posttransplantation period, and long-term survivorship. Complications can occur during each phase, with long-term survivors facing increased risks for late effects such as cardiovascular disease, secondary malignancies, and endocrinopathies. In adults, arrhythmias such as atrial fibrillation and flutter are the most frequent acute cardiovascular complication. Acute heart failure has an incidence ranging from 0.4% to 2.2%. In pediatric patients, left ventricular systolic dysfunction and pericardial effusion are the most common cardiovascular complications. Factors influencing the incidence and risk of complications include pretransplantation therapies, transplantation type (autologous versus allogeneic), conditioning regimen, comorbid conditions, and patient age. The pretransplantation cardiovascular evaluation consists of 4 steps: (1) initial risk stratification, (2) exclusion of high-risk cardiovascular disease, (3) assessment of cardiac reserve, and (4) optimization of cardiovascular reserve. Clinical risk scores could be useful tools for the risk stratification of adult patients. Long-term cardiovascular management of hematopoietic stem cell transplantation survivors includes optimizing risk factors, monitoring, and maintaining a low threshold for evaluating cardiovascular causes of symptoms. Future research should prioritize refining risk stratification and creating evidence-based guidelines and strategies to optimize outcomes in this growing patient population.
    MeSH term(s) Adult ; Humans ; Child ; Aged ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/therapy ; Survivorship ; American Heart Association ; Transplantation Conditioning/adverse effects ; Hematopoietic Stem Cell Transplantation/adverse effects ; Heart Diseases/etiology
    Language English
    Publishing date 2024-03-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIR.0000000000001220
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ui IV Zs.60: Show issues Location:
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  3. Article ; Online: Cardiovascular health in pediatric heart transplant patients.

    Bogle, Carmel / Marma Perak, Amanda / Wilkens, Sarah J / Aljiffry, Alaa / Rychlik, Karen / Costello, John M / Lloyd-Jones, Donald M / Pahl, Elfriede

    BMC cardiovascular disorders

    2022  Volume 22, Issue 1, Page(s) 139

    Abstract: Background: Ideal "cardiovascular health" (CVH)-optimal diet, exercise, nonsmoking, BMI, BP, lipids, and glucose-is associated with healthy longevity in adults. Pediatric heart transplant (HT) patients may be at risk for suboptimal CVH.: Methods: ... ...

    Abstract Background: Ideal "cardiovascular health" (CVH)-optimal diet, exercise, nonsmoking, BMI, BP, lipids, and glucose-is associated with healthy longevity in adults. Pediatric heart transplant (HT) patients may be at risk for suboptimal CVH.
    Methods: Single-center retrospective study of HT patients 2003-2014 who survived 1 year post-transplant. Five CVH metrics were collected at listing, 1, 3 and 5 years post-transplant (diet and exercise were unavailable). CVH was scored by summing individual metrics: ideal = 2, intermediate = 1, and poor = 0 points; total scores of 8-10 points were considered high (favorable). CVH was compared between HT patients and the US pediatric population (GP) utilizing NHANES 2007-2016. Logistic regression was performed to examine the association of CVH 1 year post-transplant with a composite adverse outcome (death, re-listing, coronary vasculopathy, or chronic kidney disease) 3 years post-transplant.
    Results: We included 110 HT patients (median age at HT: 6 years [range 0.1-21]) and 19,081 NHANES participants. CVH scores among HT patients were generally high at listing (75%), 1 (74%), 3 (87%) and 5 (76%) years post-transplant and similar to GP, but some metrics (e.g., glucose) were worse among HT patients. Among HT patients, CVH was poorer with older age and non-Caucasian race/ethnicity. Per 1-point higher CVH score, the demographic-adjusted OR for adverse outcomes was 0.95 (95% CI, 0.7-1.4).
    Conclusions: HT patients had generally favorable CVH, but some metrics were unfavorable and CVH varied by age and race/ethnicity. No significant association was detected between CVH and adverse outcomes in this small sample, but study in a larger sample is warranted.
    MeSH term(s) Adolescent ; Adult ; Cardiovascular Diseases/epidemiology ; Child ; Child, Preschool ; Cross-Sectional Studies ; Heart Transplantation/adverse effects ; Humans ; Infant ; Nutrition Surveys ; Retrospective Studies ; Risk Factors ; Young Adult
    Language English
    Publishing date 2022-04-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059859-2
    ISSN 1471-2261 ; 1471-2261
    ISSN (online) 1471-2261
    ISSN 1471-2261
    DOI 10.1186/s12872-022-02575-z
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  4. Article ; Online: Treatment Strategies for Cardiomyopathy in Children: A Scientific Statement From the American Heart Association.

    Bogle, Carmel / Colan, Steven D / Miyamoto, Shelley D / Choudhry, Swati / Baez-Hernandez, Nathanya / Brickler, Molly M / Feingold, Brian / Lal, Ashwin K / Lee, Teresa M / Canter, Charles E / Lipshultz, Steven E

    Circulation

    2023  Volume 148, Issue 2, Page(s) 174–195

    Abstract: This scientific statement from the American Heart Association focuses on treatment strategies and modalities for cardiomyopathy (heart muscle disease) in children and serves as a companion scientific statement for the recent statement on the ... ...

    Abstract This scientific statement from the American Heart Association focuses on treatment strategies and modalities for cardiomyopathy (heart muscle disease) in children and serves as a companion scientific statement for the recent statement on the classification and diagnosis of cardiomyopathy in children. We propose that the foundation of treatment of pediatric cardiomyopathies is based on these principles applied as personalized therapy for children with cardiomyopathy: (1) identification of the specific cardiac pathophysiology; (2) determination of the root cause of the cardiomyopathy so that, if applicable, cause-specific treatment can occur (precision medicine); and (3) application of therapies based on the associated clinical milieu of the patient. These clinical milieus include patients at risk for developing cardiomyopathy (cardiomyopathy phenotype negative), asymptomatic patients with cardiomyopathy (phenotype positive), patients with symptomatic cardiomyopathy, and patients with end-stage cardiomyopathy. This scientific statement focuses primarily on the most frequent phenotypes, dilated and hypertrophic, that occur in children. Other less frequent cardiomyopathies, including left ventricular noncompaction, restrictive cardiomyopathy, and arrhythmogenic cardiomyopathy, are discussed in less detail. Suggestions are based on previous clinical and investigational experience, extrapolating therapies for cardiomyopathies in adults to children and noting the problems and challenges that have arisen in this experience. These likely underscore the increasingly apparent differences in pathogenesis and even pathophysiology in childhood cardiomyopathies compared with adult disease. These differences will likely affect the utility of some adult therapy strategies. Therefore, special emphasis has been placed on cause-specific therapies in children for prevention and attenuation of their cardiomyopathy in addition to symptomatic treatments. Current investigational strategies and treatments not in wide clinical practice, including future direction for investigational management strategies, trial designs, and collaborative networks, are also discussed because they have the potential to further refine and improve the health and outcomes of children with cardiomyopathy in the future.
    MeSH term(s) Humans ; American Heart Association ; Cardiomyopathies/diagnosis ; Cardiomyopathies/therapy ; Cardiomyopathies/etiology ; Cardiomyopathy, Restrictive ; Heart Diseases/complications ; Phenotype ; Child
    Language English
    Publishing date 2023-06-08
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIR.0000000000001151
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ui IV Zs.60: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
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  5. Article ; Online: Burnout, professional fulfillment, and post-traumatic stress among pediatric solid organ transplant teams.

    Cousino, Melissa K / Bogle, Carmel / Lim, Heang M / McCormick, Amanda D / Sturza, Julie / Fredericks, Emily M / Magee, John C / Blume, Elizabeth D

    Pediatric transplantation

    2021  Volume 25, Issue 4, Page(s) e14020

    Abstract: Background: Adverse effects of clinician burnout have been studied across multiple specialties; however, there have been no studies examining rates of burnout among pediatric solid organ transplant teams. This study aimed to measure burnout, work ... ...

    Abstract Background: Adverse effects of clinician burnout have been studied across multiple specialties; however, there have been no studies examining rates of burnout among pediatric solid organ transplant teams. This study aimed to measure burnout, work exhaustion, professional fulfillment, and post-traumatic stress symptoms among clinicians and administrators practicing in this high-stress field.
    Methods: This cross-sectional study utilized a 50 item web-based survey that included the Personal Fulfillment Index and the IES-R. This survey was distributed across four pediatric solid organ transplant centers in North America. Basic demographics, clinician characteristics, and information regarding wellness and self-care activities were collected. Descriptive and correlational analyses were performed.
    Results: One hundred and thirty five participants completed the survey, 76% were female and 78% were Caucasian. One-third (34%) of participants endorsed burnout, while 43% reported professional fulfillment. Approximately 15% of respondents endorsed clinically significant levels of post-traumatic stress symptoms related to patient deaths, with female clinicians more likely to endorse symptoms (p = .01). Nearly 80% of participants reported engaging in self-care activities outside of work and only 10% of participants reported participation in hospital-sponsored wellness programs.
    Conclusions: Pediatric solid organ transplant team members exhibited moderate levels of burnout, professional fulfillment, and post-traumatic stress. Female clinicians were the most likely to experience both work exhaustion and post-traumatic stress symptoms. Transplant centers are encouraged to consider interventions and programming to improve clinician wellness.
    MeSH term(s) Adult ; Aged ; Burnout, Professional/diagnosis ; Burnout, Professional/epidemiology ; Burnout, Professional/etiology ; Burnout, Professional/prevention & control ; Cross-Sectional Studies ; Female ; Health Surveys ; Humans ; Job Satisfaction ; Male ; Middle Aged ; Organ Transplantation/psychology ; Patient Care Team ; Pediatrics ; Psychological Tests ; Risk Factors ; Self Report ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/etiology ; Stress Disorders, Post-Traumatic/prevention & control
    Language English
    Publishing date 2021-04-16
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 1390284-2
    ISSN 1399-3046 ; 1397-3142
    ISSN (online) 1399-3046
    ISSN 1397-3142
    DOI 10.1111/petr.14020
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    Zs.A 4947: Show issues Location:
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  6. Article ; Online: Obesity and dyslipidemia predict cardiac allograft vasculopathy and graft loss in children and adolescents post-heart transplant: A PHTS multi-institutional analysis.

    Bogle, Carmel / Cantor, Ryan / Koehl, Devin / Lochridge, Jillien / Kirklin, James K / Barnes, Aliessa / Wallis, Gonzalo / Amdani, Shahnawaz / Ameduri, Rebecca / Pahl, Elfriede / Simpson, Kathleen E / Blume, Elizabeth D

    Pediatric transplantation

    2022  Volume 26, Issue 5, Page(s) e14244

    Abstract: Background: Obesity and dyslipidemia afflict children of all ages. We explored the prevalence of obesity and dyslipidemia in pediatric heart transplant (HT) recipients and its effects on cardiac allograft vasculopathy (CAV) and survival.: Methods: ... ...

    Abstract Background: Obesity and dyslipidemia afflict children of all ages. We explored the prevalence of obesity and dyslipidemia in pediatric heart transplant (HT) recipients and its effects on cardiac allograft vasculopathy (CAV) and survival.
    Methods: This study included primary HT recipients (≤18 years) transplanted between 01/1996 and 12/2018 included in the Pediatric Heart Transplant Society database. Obesity was categorized according to WHO/CDC guidelines and dyslipidemia according to the National Cholesterol Education Program. Kaplan-Meier analyses for CAV and graft loss stratified for BMI and lipid panels were generated and risk factors identified using multivariate analyses.
    Results: Among 6291 HT patients (median age [range] at HT = 4.3 [0.6-12.8] years; 45% Female; 68% White), 56% had a normal BMI at HT. Obese patients at HT had an increased risk for graft loss (HR 1.19, 95% CI 1.01-1.4, p = .04). Poor total cholesterol (TC), LDL-C, and TG were associated with the risk of both CAV (HR 1.79, p < .0001; HR 1.65, p = .0015; HR 1.53, p < .0001, respectively) and graft loss (HR 1.58, p = .0008; HR 1.22, p = .04; HR 1.43, p = .0007, respectively).
    Conclusions: Pediatric patients who are obese at the time of HT and dyslipidemic at 1 year post-HT are at an increased risk for CAV and graft loss. Preventative interventions may reduce morbidity and mortality among this cohort.
    MeSH term(s) Adolescent ; Allografts ; Child ; Child, Preschool ; Dyslipidemias/complications ; Dyslipidemias/epidemiology ; Female ; Graft Rejection/complications ; Graft Rejection/epidemiology ; Heart Diseases/etiology ; Heart Transplantation/adverse effects ; Humans ; Male ; Obesity/complications ; Retrospective Studies ; Risk Factors
    Language English
    Publishing date 2022-02-05
    Publishing country Denmark
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1390284-2
    ISSN 1399-3046 ; 1397-3142
    ISSN (online) 1399-3046
    ISSN 1397-3142
    DOI 10.1111/petr.14244
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