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Sabella C.,Cleveland Clinic | Cunningham R.J.,Ochsner Medical Center for Children
Cleveland Clinic Intensive Review of Pediatrics: Fourth Edition | Year: 2013

Users will build confidence and reduce anxiety as they prepare for the American Board of Pediatrics certification and recertification exams. Written primarily by distinguished Cleveland Clinic faculty, this detailed and practical review is organized into subspecialty sections, each concluding with a board simulation chapter to build users test-taking skills. Numerous bulleted lists, tables, and illustrations improve retention of essential facts. Two practice board exams at the end of the book provide opportunities for self-assessment. Convenient companion website offers the fully searchable text, an image bank, and 100 online-only questions with answers. The Fourth Edition includes new board simulation in sports medicine, detailed rationales for each response, and self-assessment features in all board simulation chapters that let users evaluate their strengths and weaknesses. This is the tablet version which does not include access to the supplemental content mentioned in the text. © 2013 by Lippincott Williams & Wilkins, a Wolters Kluwer business © 2010, 2006, 2003 Lippincott Williams & Wilkins. All rights reserved.

Thomas P.E.,Texas Childrens Hospital | Thomas P.E.,Ochsner Medical Center for Children | Carlo W.F.,Texas Childrens Hospital | Carlo W.F.,University of Alabama at Birmingham | And 7 more authors.
Archives of Pediatrics and Adolescent Medicine | Year: 2011

Objective: To evaluate the impact of the American Heart Association (AHA) scientific statement regarding electrocardiograms (ECGs) and stimulant medications on the practice of community pediatricians. Design: Retrospective evaluation and survey analysis. Setting: Academic tertiary care center. Participants: Patients with ECGs referred to our institution by pediatricians with an indication of stimulant medication screening in the year after the AHA statement. Intervention: We compared the ECG ordering practices of community pediatricians and the outcomes of further evaluation and estimated the associated cost before and after the AHA scientific statement. Main Outcome Measures: Abnormal ECG findings, further workup, and change in clinical practice. Results: In the year after publication of the 2008 AHA scientific statement, 372 ECGs were ordered with an indication of stimulant medication screening. Before publication of this statement, a mean (SD) of 6.9 (3.2) ECGs per month were referred for this indication. Despite continuing controversy, this number increased 4-fold to 31.2 (9.5) ECGs per month in the subsequent year. Twenty-four ECGs (6.4%) had abnormal findings. Eighteen patients were referred for further evaluation, and, at last follow-up, none had been found to have definitive disease. Six of 24 patients with abnormal ECG findings (25.0%) had a perceived significant delay in therapy because of the process. In responding pediatricians, 34.6% reported that the scientific statement had clearly affected their practice. Conclusions: The clinical practice of community pediatricians in regard to screening ECGs and stimulant medications has been affected by the recent AHA scientific statement. The yield of performing ECGs with an indication of stimulant medication screening is very low. ©2011 American Medical Association. All rights reserved.

PubMed | Ochsner Medical Center for Children
Type: Case Reports | Journal: Congenital heart disease | Year: 2010

We present a case of congenital complete atrioventricular block in a preterm microcephalic male with multiple additional congenital anomalies, including spinal and rib abnormalities. The heart was structurally normal, and maternal tests for autoimmune disorders were negative. The brain had an immature lissencephalic appearance, suggestive of an insult early in gestation. Genetic testing was normal, virtually excluding chromosomal disorders that are known to cause lissencephaly. Viral studies were suggestive of cytomegalovirus infection during early gestation, and we believe that the patients clinical presentation was most likely the result of an early cytomegalovirus infection. The finding of complete atrioventricular block in a patient with presumed cytomegalovirus infection would represent a very rare complication. Isolated complete atrioventricular block in a fetus should be considered an incentive for an extensive work-up in search for a possible etiology, rather than accepted as a final diagnosis.

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