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  1. Article ; Online: Variation in prenatal surveillance and management of anti-SSA/Ro autoantibody positive pregnancies.

    Howley, Lisa W / Eyerly-Webb, Stephanie A / Killen, Stacy A S / Paul, Erin / Krishnan, Anita / Gropler, Melanie R F / Drewes, Bailey / Dion, Eric / Lund, Amy / Buyon, Jill P / Cuneo, Bettina F

    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

    2024  Volume 37, Issue 1, Page(s) 2323623

    Abstract: Objective: To describe international surveillance and treatment strategies for managing anti-SSA/Ro autoantibody positive pregnancies.: Study design: An electronic REDCap questionnaire was distributed to Fetal Heart Society and North American Fetal ... ...

    Abstract Objective: To describe international surveillance and treatment strategies for managing anti-SSA/Ro autoantibody positive pregnancies.
    Study design: An electronic REDCap questionnaire was distributed to Fetal Heart Society and North American Fetal Therapy Network members which queried institution-based risk stratification, surveillance methods/frequency, conduction abnormality treatments, and postnatal anti-SSA/Ro pregnancy assessment.
    Results: 101 responses from 59 centers (59% US, 17% international) were collected. Most (79%) do not risk stratify pregnancies by anti-SSA/Ro titer; those that do use varied cutoff values. Many pregnant rheumatology patients are monitored for cardiac abnormalities regardless of maternal anti-SSA/Ro status. Surveillance strategies were based on maternal factors (anti-SSA/Ro status 85%, titer 25%, prior affected child 79%) and monitoring durations varied. Most respondents treat 2° and 3° fetal atrioventricular block, commonly with dexamethasone and/or IVIG.
    Conclusions: Wide variation exists in current fetal cardiac surveillance and treatment for anti-SSA/Ro autoantibody positive pregnancies, highlighting the need for evidence-based protocols to optimize care.
    MeSH term(s) Child ; Female ; Pregnancy ; Humans ; Atrioventricular Block ; Autoantibodies ; Fetal Heart ; Health Facilities ; Prenatal Care ; Vitamins
    Chemical Substances Autoantibodies ; Vitamins
    Language English
    Publishing date 2024-03-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2077261-0
    ISSN 1476-4954 ; 1057-0802 ; 1476-7058
    ISSN (online) 1476-4954
    ISSN 1057-0802 ; 1476-7058
    DOI 10.1080/14767058.2024.2323623
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3510: Show issues Location:
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  2. Article: Classic and atypical Wenckebach periodicity in a late gestation fetus with maternal anti-Ro/SSA antibodies.

    Gropler, Melanie R F / von Alvensleben, Johannes / Benson, D Woodrow / Cuneo, Bettina F

    HeartRhythm case reports

    2021  Volume 7, Issue 9, Page(s) 611–614

    Language English
    Publishing date 2021-06-22
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2834871-0
    ISSN 2214-0271
    ISSN 2214-0271
    DOI 10.1016/j.hrcr.2021.06.002
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  3. Article ; Online: Can smartphone wireless ECGs be used to accurately assess ECG intervals in pediatrics? A comparison of mobile health monitoring to standard 12-lead ECG.

    Gropler, Melanie R F / Dalal, Aarti S / Van Hare, George F / Silva, Jennifer N Avari

    PloS one

    2018  Volume 13, Issue 9, Page(s) e0204403

    Abstract: Background: Arrhythmias in children are often paroxysmal, complicating the ability to capture the abnormal rhythm on routine ECG during an outpatient visit. The Alivecor Kardia Mobile (KM) device is a wireless mobile health (mHealth) device that ... ...

    Abstract Background: Arrhythmias in children are often paroxysmal, complicating the ability to capture the abnormal rhythm on routine ECG during an outpatient visit. The Alivecor Kardia Mobile (KM) device is a wireless mobile health (mHealth) device that generates a single lead ECG tracing with a FDA-approved algorithm for detection of atrial fibrillation in adults.
    Objective: The goal of this study is to assess the accuracy of interval measurements on KM tracings by directly comparing to standard 12-lead ECGs in pediatric patients.
    Methods: This single center, prospective study enrolled pediatric outpatients, age <18 years presenting for cardiology clinic visits, into 3 groups based on age: 0-5 years, 6-10 years, and 11-18 years. Patients were excluded if 12-lead ECG was not ordered during the visit. Each enrolled subject underwent standard 12-lead ECG followed by 30-second KM tracing. ECG parameters were batch read by 2 blinded pediatric electrophysiologists.
    Results: Thirty patients were recruited with 10 patients/group. Structural heart disease and/or conduction abnormality was present in 20 patients (67%). Majority of tracings (27/30, 90%) were of diagnostic quality on first attempt. Overall, the ΔPR was 15.2±10.8ms (r = 0.86), ΔQRS was 9.6±8ms (r = 0.86), and ΔQTc was 15.6±12.7ms (r = 0.83). There were 9 patients with ΔQTc measurements >20ms with 4/9 (44%) having a conduction disorder and 2/9 (22%) having marked sinus arrhythmia. Bland-Altman method of agreement demonstrated strong agreement for QRSd and QTc. The AF algorithm reported 4/30 (13%) false positive "possible AF" diagnoses (rhythm over-read on KM demonstrated n = 3 marked sinus arrhythmia, n = 1 sinus rhythm with aberrated PACs) resulting in a specificity of 87%.
    Conclusion: The Alivecor Kardia device produces accurate single lead ECG tracings in both healthy children and children with cardiac disease or rhythm abnormalities across the pediatric spectrum. This mHealth application provides an accurate, non-invasive, real-time approach for ambulatory ECG monitoring in children and adolescents.
    MeSH term(s) Adolescent ; Arrhythmias, Cardiac/diagnosis ; Arrhythmias, Cardiac/physiopathology ; Child ; Child, Preschool ; Electrocardiography, Ambulatory/instrumentation ; Electrocardiography, Ambulatory/methods ; Female ; Heart Defects, Congenital/diagnosis ; Heart Defects, Congenital/physiopathology ; Humans ; Infant ; Infant, Newborn ; Male ; Mobile Applications ; Prospective Studies ; Smartphone ; Telemedicine/methods ; Wireless Technology
    Language English
    Publishing date 2018-09-27
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0204403
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  4. Article ; Online: Pediatric and adult dilated cardiomyopathy are distinguished by distinct biomarker profiles.

    Gropler, Melanie R F / Lipshultz, Steven E / Wilkinson, James D / Towbin, Jeffrey A / Colan, Steven D / Canter, Charles E / Lavine, Kory J / Simpson, Kathleen E

    Pediatric research

    2021  Volume 92, Issue 1, Page(s) 206–215

    Abstract: Background: Emerging evidence suggests that pediatric and adult dilated cardiomyopathy (DCM) represent distinct diseases. Few diagnostic tools exist for pediatric cardiologists to assess clinical status and prognosis. We hypothesized that pediatric DCM ... ...

    Abstract Background: Emerging evidence suggests that pediatric and adult dilated cardiomyopathy (DCM) represent distinct diseases. Few diagnostic tools exist for pediatric cardiologists to assess clinical status and prognosis. We hypothesized that pediatric DCM would have a unique biomarker profile compared to adult DCM and controls.
    Methods: We utilized a DNA aptamer array (SOMAScan) to compare biomarker profiles between pediatric and adult DCM. We simultaneously measured 1310 plasma proteins and peptides from 39 healthy children (mean age 3 years, interquartile range (IQR) 1-14), 39 ambulatory subjects with pediatric DCM (mean age 2.7 years, IQR 1-13), and 40 ambulatory adults with DCM (mean age 53 years, IQR 46-63).
    Results: Pediatric and adult DCM patients displayed distinct biomarker profiles, despite similar clinical characteristics. We identified 20 plasma peptides and proteins that were increased in pediatric DCM compared to age- and sex-matched controls. Unbiased multidimensionality reduction analysis suggested previously unrecognized heterogeneity among pediatric DCM subjects. Biomarker profile analysis identified four subgroups of pediatric DCM with distinguishing clinical characteristics.
    Conclusions: These findings support the emerging concept that pediatric and adult DCM are distinct disease entities, signify the need to develop pediatric-specific biomarkers for disease prognostication, and challenge the paradigm that pediatric DCM should be viewed as a single disease.
    Impact: Pediatric and adult DCM patients displayed distinct biomarker profiles, despite similar clinical characteristics and outcomes. Our findings suggest that pediatric DCM may be a heterogeneous disease with various sub-phenotypes, including differing biomarker profiles and clinical findings. These data provide prerequisite information for future prospective studies that validate the identified pediatric DCM biomarkers, address their diagnostic accuracy and prognostic significance, and explore the full extent of heterogeneity amongst pediatric DCM patients.
    MeSH term(s) Biomarkers ; Cardiomyopathy, Dilated/diagnosis ; Humans ; Phenotype ; Prospective Studies
    Chemical Substances Biomarkers
    Language English
    Publishing date 2021-08-17
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-021-01698-x
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    Zs.A 564: Show issues Location:
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    Zs.MO 373: Show issues

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  5. Article ; Online: Long-Term Outcomes of Coarctation Repair Through Left Thoracotomy.

    Gropler, Melanie R F / Marino, Bradley S / Carr, Michael R / Russell, William W / Gu, Hongjie / Eltayeb, Osama M / Mongé, Michael C / Backer, Carl L

    The Annals of thoracic surgery

    2018  Volume 107, Issue 1, Page(s) 157–164

    Abstract: Background: Optimal surgical approach for repair of coarctation of the aorta (CoA) remains controversial. This study aimed to evaluate reintervention rates and its predictors by using a strategy of resection with extended end-to-end anastomosis (REEEA) ... ...

    Abstract Background: Optimal surgical approach for repair of coarctation of the aorta (CoA) remains controversial. This study aimed to evaluate reintervention rates and its predictors by using a strategy of resection with extended end-to-end anastomosis (REEEA) through left thoracotomy.
    Methods: A retrospective analysis was performed for all patients who underwent isolated CoA repair or simultaneous repair of CoA and ventricular septal defect repair by REEEA between January 2000 and December 2015 at Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. Patients with complex congenital heart disease were excluded. Transverse arch hypoplasia was defined as echocardiographic z-score lower than -2 or by documentation in medical or operative reports. Reintervention was defined as the need for balloon angioplasty or reoperation. Hypertension was defined as antihypertensive medication use or blood pressure greater than or equal to the 95th percentile.
    Results: A total of 251 patients with median age at repair of 14.6 days met inclusion criteria. Repair was by left thoracotomy in 226 (90%). Follow-up data were available for 186 of 251 patients, with median follow-up time of 5.4 years (range, 0.2 to 15.3 years); 169 (91%) of these patients underwent thoracotomy. There were no early deaths or early reoperations. A proximal transverse arch z-score lower than -4.1 or a distal transverse arch z-score of less than -2.8 was predictive of repair through sternotomy. Only 4 (2%) patients required reintervention (2 patients had balloon angioplasties, 2 had reoperations). Transverse arch hypoplasia was a risk factor for reintervention (p = 0.048), but surgical approach was not (p = 0.35). Late hypertension was identified in only 33 of 186 (18%) patients.
    Conclusions: Repair of CoA, even with associated transverse arch hypoplasia, by REEEA through left thoracotomy has a low mortality, low reintervention rate, and low incidence of late hypertension.
    MeSH term(s) Anastomosis, Surgical/methods ; Aorta, Thoracic/diagnostic imaging ; Aorta, Thoracic/surgery ; Aortic Coarctation/diagnosis ; Aortic Coarctation/surgery ; Echocardiography ; Female ; Follow-Up Studies ; Forecasting ; Humans ; Infant ; Male ; Reconstructive Surgical Procedures/methods ; Retrospective Studies ; Thoracotomy/methods ; Treatment Outcome ; Vascular Surgical Procedures/methods
    Language English
    Publishing date 2018-09-08
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2018.07.027
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    Zs.A 252: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Anomalous Origin of Left Pulmonary Artery From the Aorta: A Rare Entity in Congenital Heart Disease.

    Gropler, Melanie R F / Dalal, Aarti S / Bierhals, Andrew J / Romberg, Erin / Singh, Gautam K / Manning, Peter B

    The Annals of thoracic surgery

    2018  Volume 107, Issue 3, Page(s) e181–e182

    Abstract: Anomalous origin of the left pulmonary artery (ALPA) from the aorta is a rare form of congenital heart disease, leading to long-term morbidity if not treated early. There is a reported association of this anomaly with 22q11 microdeletion syndrome. ... ...

    Abstract Anomalous origin of the left pulmonary artery (ALPA) from the aorta is a rare form of congenital heart disease, leading to long-term morbidity if not treated early. There is a reported association of this anomaly with 22q11 microdeletion syndrome. Surgical repair is commonly performed by direct reimplantation to the main pulmonary artery with or without patch or flap techniques. This report presents two unique cases of ALPA, describing embryologic considerations for morphogenesis of ALPA with 22q11 microdeletion syndrome and a novel surgical technique involving unroofing of the unique anatomy of the common wall between the left and main pulmonary arteries.
    MeSH term(s) Abnormalities, Multiple ; Aorta, Thoracic/abnormalities ; Aorta, Thoracic/diagnostic imaging ; Cardiac Surgical Procedures/methods ; Computed Tomography Angiography ; Echocardiography ; Heart Defects, Congenital/diagnosis ; Heart Defects, Congenital/surgery ; Humans ; Imaging, Three-Dimensional ; Infant, Newborn ; Male ; Pulmonary Artery/abnormalities ; Pulmonary Artery/diagnostic imaging ; Rare Diseases ; Vascular Malformations/diagnosis ; Vascular Malformations/surgery
    Language English
    Publishing date 2018-09-29
    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/j.athoracsur.2018.07.083
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    Zs.A 252: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Online: Knowledge is power: regarding SMFM Consult Series #64: Systemic lupus erythematosus in pregnancy.

    Cuneo, Bettina F / Buyon, Jill P / Sammaritano, Lisa / Jaeggi, Edgar / Arya, Bhawna / Behrendt, Nicholas / Carvalho, Julene / Cohen, Jennifer / Cumbermack, Kristopher / DeVore, Greggory / Doan, Tam / Donofrio, Mary T / Freud, Lindsay / Galan, Henry L / Gropler, Melanie R F / Haxel, Caitlin / Hornberger, Lisa K / Howley, Lisa W / Izmirly, Peter /
    Killen, Stacy S / Kaplinski, Michelle / Krishnan, Anita / Lavasseur, Stephanie / Lindblade, Christopher / Matta, Jyothi / Makhoul, Majd / Miller, Jena / Morris, Shaine / Paul, Erin / Perrone, Erin / Phoon, Colin / Pinto, Nelangi / Rychik, Jack / Satou, Gary / Saxena, Amit / Sklansky, Mark / Stranic, James / Strasburger, Janette F / Srivastava, Shubhika / Srinivasan, Sharda / Tacy, Theresa / Tworetzky, Wayne / Uzun, Orhan / Yagel, Simcha / Zaretsky, Michael V / Moon-Grady, Anita J

    American journal of obstetrics and gynecology

    2023  Volume 229, Issue 4, Page(s) 361–363

    MeSH term(s) Pregnancy ; Female ; Humans ; Lupus Erythematosus, Systemic/diagnosis ; Pregnancy Complications/diagnosis ; Pregnancy Complications/therapy
    Language English
    Publishing date 2023-07-01
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2023.06.040
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