Understanding Genetics and Pediatric Cardiac Health

The Role of Nurses in Fetal Cardiology Programs: An Integrative Review

BACKGROUND

Fetal cardiology programs are evolving quickly and include multiple interdisciplinary health care professionals whose roles could benefit from clear definition. Nurses provide an essential function in this field; however, descriptions or definitions of nursing practice, education and knowledge requirements, and responsibilities are limited and vary across institutions and disciplines.

PURPOSE

To conduct an integrative review summarizing the literature to determine the role of nurses in fetal cardiology programs.

METHODS

We conducted an integrative review as per Whittemore and Knafl's (2005) methodology of current literature to reveal strengths and opportunities in describing nursing practice as fetal cardiology nurses. The search strategy included five electronic databases: CINAHL, Medline, PsycINFO, Web of Science, and Google Scholar. Peer-reviewed English-language articles discussing nursing practices in fetal cardiology published between 2015 and 2022 were selected. Data extraction and analysis were completed on a final sample of 26 articles.

RESULTS

Four themes were identified on fetal cardiac nursing practice from nursing and medical perspectives: multidisciplinary key team member, psychosocial family support and counselor, coordinator or navigator, and role description.

CLINICAL IMPLICATIONS

More discussion in the literature is needed to better understand and define fetal cardiac nursing practice. Although most experts agree nurses are an important member of the interdisciplinary fetal cardiology team, their roles and educational requirements are poorly described and defined. Quality metrics and benchmarks are needed to ensure safe and effective fetal cardiology care.

Effective degradation of chloramphenicol in wastewater by activated peroxymonosulfate with Fe-rich porous biochar derived from petrochemical sludge

Excess sludge produced from biological wastewater treatment plant in petroleum industry is a kind of hazardous solid waste. Converting the sludge into biochar catalysts may help to reduce its environmental risk, recover resources and increase economic efficiency. However, the role of the sludge biochar in persulfate activation remains unclear, limiting its application in removing organic pollutants from water body. In this study, metal-rich petrochemical sludge was used to produce activated sludge biochar (ASC) via a two-step method of pyrolytic carbonization (400 °C-800 °C) and subsequent KOH activation (abbreviated as ASC 400-800). The physio-chemical properties of ASC 400-800 were characterized by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Scanning electron microscopy (SEM), Brunauer-Emmett-Teller (BET) and Raman. The chloramphenicol (CAP) removal performances of ASC 400-800/peroxymonosulfate (PMS) systems were evaluated. Results showed that porous sludge biochar was successfully prepared by the two-step method. At 800 °C, the specific surface area of ASC reached the highest value of 202.92 m2 g-1. At 600-800 °C, Fe3O4, Fe0, and graphitized carbon were formed in ASC. Among ASC 400-800, ASC 800 exhibited the best CAP removal performance in ASC 800/PMS system by adsorption combined with catalytic degradation. The optimal conditions identified for 0.31 mM CAP removal were ASC 800 2.0 g L-1, PMS 6.2 mM, and pH 2.0. SO4•-, •OH, and 1O2 may contribute to CAP degradation. The degradation pathways of CAP were proposed based on the identified degradation intermediates. Overall, this study confirmed that porous biochar derived from petrochemical sludge was an effective adsorbent or PMS catalyst to remove organic pollutants from wastewater.

An Exploratory Analysis of Maternal Health Variables Increasing the Severity of Congenital Heart Disease in Infants

BACKGROUND

Congenital heart defects (CHD) are the most prevalent birth anomaly and leading cause of infant morbidity and mortality worldwide. Heart defects are often attributed to chromosomal abnormality or environmental factors, but most causes remain unknown. The purpose of this analysis was to explore maternal health variables and the relationships to birth outcomes in infants with CHD.

METHODS

Secondary analysis of data from the Wisconsin Pediatric Cardiac Registry.

RESULTS

Maternal history of CHDs (odds ratio [OR] = 2.38; 95% confidence interval [CI], 1.42-3.98) and serious health conditions (OR = 1.537; 95%: CI, 1.08-2.17) increase infant risk and CHD severity. Maternal history of hypertension, serious health conditions, CHD, obesity, and income were predictors of birth weight (R² = 0.049, P < .05). Maternal history of hypertension, influenza, serious health conditions, and housing were predictors of gestational age (R2 = 0.045, P < .05). Birth weight (BW) and gestational age (GA) did not correlate to the severity of CHD in this study (simple vs complex, BW = -0.014, GA = 0.011, r).

DISCUSSION

Maternal well-being influences the health of infants born with CHD. Positive maternal health contributes to near-normal birth weight and gestational age.

CONCLUSION

Nurses must discuss optimal reproductive life planning strategies for decreasing risk of CHD and other infant disorders.

Absence of GATA4 Mutations in Moroccan Patients with Atrial Septal Defect (ASD) Provides Further Evidence of Limited Involvement of GATA4 in Major Congenital Heart Defects

Objective

Atrial septal defect (ASD) is one of the most common types of congenital heart disease (CHD). It is mainly caused by mutations of NK2 homeobox 5, GATA binding protein 4 (GATA4), and myosin heavy chain 6 in non-syndromic cases. This study aims to carry out, for the first time, the GATA4 mutation screening in a Moroccan population affected by ASD and compare the obtained mutation rate across populations.

Materials and Methods

A total of 33 patients were enrolled in this study. DNAs were extracted from peripheral blood samples, and we performed PCR-sequencing for GATA4 coding regions. Sequences were analyzed by sequence alignment and functional impact prediction tools. Mutation rate comparisons were performed by R software using the appropriate statistical tests.

Results

We detected 7 variants, but no pathogenic mutation was revealed, except for Asn352= that was assessed by human splicing finder algorithms to have a potential impairing effect on the splicing mechanism. Until proven by in vitro functional studies, the current pathogenic mutation rate in our cohort seems to be 0%. Statistical comparison with previous studies from all over the world shows no significant difference. Seemingly, comparison of previous GATA4 mutation rates among tetralogy of Fallot (TOF) populations shows no significant difference.

Conclusion

The low rates of GATA4 mutations observed throughout ASD and TOF international populations may suggest a limited causality of GATA4 mutations in the main CHDs, which further confirms the co-involvement of additional genetic and/or environmental factors in the manifestation of these phenotypes.