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Baijal RG, Fakarar H, Sinton J, Huang X, Staggers K, Mossad EB. Perioperative Risk Assessment in Children With Congenital Heart Disease Undergoing Noncardiac Procedures. J Cardiothorac Vasc Anesth 2023:S1053-0770(23)00226-4. [PMID: 37137750 DOI: 10.1053/j.jvca.2023.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To risk-stratify children with congenital heart disease undergoing noncardiac surgery or diagnostic procedures for perioperative cardiopulmonary complications using the authors' established institutional guidelines. DESIGN A retrospective cohort study. SETTING The study was conducted in an academic, tertiary-care children's hospital. PARTICIPANTS A total of 1,005 children, from birth to 19 years of age with a diagnosis of congenital heart disease, who underwent a noncardiac surgery or diagnostic procedure from January 2017 to December 2018, were included in the study. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The incidence of a severe perioperative complication, defined as a perioperative cardiac arrest or death within 30 days of the procedure, was 1.6%. Age, an emergent surgery/procedure, a preoperative renal abnormality, preoperative mechanical ventilation, and a preoperative pericardial effusion were significant for severe perioperative complications, in the multivariate analysis. The area under the receiver operating characteristic curve for severe complications was 0.936. However, the area under the curve for moderate perioperative complications was 0.679, in which moderate complications were defined as (1) an escalation in anticipated postoperative disposition (from planned disposition), (2) an escalation in postoperative disposition (from preoperative location), (3) an escalation of preoperative airway support, (4) an administration of any intraoperative vasoactive medication/infusion, (5) a noncardiac surgery reoperation within 30 days of the procedure (if related to the primary procedure or change in physiology), or (6) unplanned readmission with 24 hours of the procedure. CONCLUSIONS A robust model for severe perioperative complications was developed within the authors' institutional clinical guidelines, identifying 5 predictors for perioperative cardiac arrest or death. The usual markers of critical illness were not found to be predictive of a moderate perioperative complication, regardless of the level of anesthesiologist training, suggesting that many of these children with congenital heart disease undergoing noncardiac procedures can be treated by a general pediatric anesthesiologist rather than a pediatric cardiac anesthesiologist within an institution that has or can establish clinical guidelines for these children.
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Affiliation(s)
- Rahul G Baijal
- Department of Pediatric Anesthesiology, Perioperative, and Pain Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
| | - Heydiye Fakarar
- Department of Pediatric Anesthesiology, Perioperative, and Pain Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Jamie Sinton
- Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Xiofan Huang
- Dan L Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
| | - Kristen Staggers
- Dan L Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
| | - Emad B Mossad
- Department of Pediatric Anesthesiology, Perioperative, and Pain Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
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Sinton J, Stayer S. An Additional Risk of Transesophageal Echocardiography in Infants. Pediatr Crit Care Med 2017; 18:988-989. [PMID: 28976462 DOI: 10.1097/pcc.0000000000001265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Jamie Sinton
- Department of Pediatric Anesthesiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
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Edwards RD, Liu Y, He G, Yin Z, Sinton J, Peabody J, Smith KR. Household CO and PM measured as part of a review of China's National Improved Stove Program. Indoor Air 2007; 17:189-203. [PMID: 17542832 DOI: 10.1111/j.1600-0668.2007.00465.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
UNLABELLED In 2001-2003, a team of researchers from the United States and China performed an independent, multidisciplinary review of China's National Improved Stove Program carried out since the 1980s. As part of a 3500-household survey, a subsample of 396 rural households were monitored for particulate matter less than 4 microm (PM(4)) in kitchens and living rooms over 24 h, of which 159 were measured in both summer and winter. Carbon monoxide was measured in a 40% subsample. The results of this indoor air quality (IAQ) component indicate that for nearly all household stove or fuel groupings, PM(4) levels were higher than - and sometimes more than twice as high as - the national PM(10) standard for indoor air (150 microg PM(10)/m(3)). If these results are typical, then a large fraction of China's rural population is now chronically exposed to levels of pollution far higher than those determined by the Chinese government to harm human health. Further, we observed highly diverse fuel usage patterns in these regions in China, supporting the observations in the household survey of multiple stoves being present in many kitchens. Improved stoves resulted in reduced PM(4) from biomass fuel combinations, but still not at levels that meet standards, and little improvement was observed in indoor pollution levels when other unimproved stoves were present in the same kitchen. As many households change fuels according to daily and seasonal factors, resulting in different seasonal concentrations in living rooms and kitchens, assessing health implications from fuel use requires longitudinal evaluation of fuel use and IAQ levels, combined with accurate time-activity information. PRACTICAL IMPLICATIONS Leaving aside the difficult issue of enforcement, it is uncertain whether Chinese household IAQ standards represent realistic objectives for current attainment given current patterns of energy consumption in rural China, which rely so heavily on unprocessed solid fuels. Even when used with chimneys, these fuels emit substantial pollution into the household environment. It is probable that low-emission technologies involving gaseous/liquid fuels or high combustion - efficiency biomass stoves need to be promoted in order to achieve these standards for the greater part of the population.
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Affiliation(s)
- R D Edwards
- Epidemiology Department, School of Medicine, University of California at Irvine, California 92697-3957, USA.
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Valaitis R, Hesch R, Passarelli C, Sheehan D, Sinton J. A systematic review of the relationship between breastfeeding and early childhood caries. Can J Public Health 2001. [PMID: 11200729 DOI: 10.1007/bf03404819] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This systematic review investigated the relationship between early childhood caries (ECC) and breastfeeding. The systematic review methodology used by the Cochrane Collaboration was modified and adopted for this review. 28 of 151 articles (18.5%) were relevant for the study and were rated as strong (0), moderate (3), weak (9) or very weak (16). Validity scores indicated whether a study met the reviewer's criteria for research rigour. The percentage of studies that received a passing score for each criterion examined were: study design (3.6%), confounders (21%), data collection method (54%), definition of ECC (57%), dental health practices (28%) and infant feeding practices (4%). A lack of methodological consistency related to the study of the association of breastfeeding and ECC, and inconsistent definitions of ECC and breastfeeding, make it difficult to draw conclusions. Moderate articles indicate that breastfeeding for over one year and at night beyond eruption of teeth may be associated with ECC. Due to conflicting findings in less rigorous research studies, no definitive time at which an infant should be weaned was determined, and parents should begin an early and consistent mouth care regime.
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Affiliation(s)
- R Valaitis
- Hamilton-Wentworth, Social and Public Health Services Division, McMaster University.
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Valaitis R, Hesch R, Passarelli C, Sheehan D, Sinton J. A systematic review of the relationship between breastfeeding and early childhood caries. Can J Public Health 2000; 91:411-7. [PMID: 11200729 PMCID: PMC6979979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/28/1999] [Accepted: 04/03/2000] [Indexed: 02/19/2023]
Abstract
This systematic review investigated the relationship between early childhood caries (ECC) and breastfeeding. The systematic review methodology used by the Cochrane Collaboration was modified and adopted for this review. 28 of 151 articles (18.5%) were relevant for the study and were rated as strong (0), moderate (3), weak (9) or very weak (16). Validity scores indicated whether a study met the reviewer's criteria for research rigour. The percentage of studies that received a passing score for each criterion examined were: study design (3.6%), confounders (21%), data collection method (54%), definition of ECC (57%), dental health practices (28%) and infant feeding practices (4%). A lack of methodological consistency related to the study of the association of breastfeeding and ECC, and inconsistent definitions of ECC and breastfeeding, make it difficult to draw conclusions. Moderate articles indicate that breastfeeding for over one year and at night beyond eruption of teeth may be associated with ECC. Due to conflicting findings in less rigorous research studies, no definitive time at which an infant should be weaned was determined, and parents should begin an early and consistent mouth care regime.
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Affiliation(s)
- R Valaitis
- Hamilton-Wentworth, Social and Public Health Services Division, McMaster University.
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Sinton J, Valaitis R, Passarelli C, Sheehan D, Hesch R. A systematic overview of the relationship between infant feeding caries and breast-feeding. Ont Dent 1998; 75:23-7. [PMID: 10518896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- J Sinton
- Hamilton-Wentworth Regional Public Health Department
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Sinton J. Rights discourse and mandatory HIV testing of pregnant women and newborns. J Law Policy 1997; 6:187-245. [PMID: 16596752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Strelow ER, Warren DH, Sonnier BJ, Riesen AH, Kay L, Sinton J. Behavioral observations of sensory substitution in neonate macaques (Macaca arctoides). Behav Neurosci 1987. [PMID: 3675854 DOI: 10.1037//0735-7044.101.5.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The ability of neonate macaque monkeys to learn to respond to artificial spatial sensory information was studied through the use of compact, head-worn, electronic spatial sonars with audible displays, which translate spatial information into auditory dimensions specifying distance, direction, and surface characteristics. Three animals were born in the dark and raised without vision for 1 to 3 months while wearing either the Binaural Sensory Aid (Animal 1; Kay, 1974) or the Trisensor (Animals 2 and 3; Easton & Jackson, 1983) airborne sonars. Each animal demonstrated alertness to information transmitted by the devices in spontaneous reaching or reinforced discrimination tasks, and more device-related, perceptual-motor activities were observed when the sensors were switched on than when they were switched off. The results show that neonate monkeys can learn effective use of information obtained from sensory substitution devices through unstructured interaction with the environment.
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Affiliation(s)
- E R Strelow
- Department of Electrical Engineering, University of Canterbury, New Zealand
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Strelow ER, Warren DH, Sonnier BJ, Riesen AH, Kay L, Sinton J. Behavioral observations of sensory substitution in neonate macaques (Macaca arctoides). Behav Neurosci 1987; 101:738-41. [PMID: 3675854 DOI: 10.1037/0735-7044.101.5.738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The ability of neonate macaque monkeys to learn to respond to artificial spatial sensory information was studied through the use of compact, head-worn, electronic spatial sonars with audible displays, which translate spatial information into auditory dimensions specifying distance, direction, and surface characteristics. Three animals were born in the dark and raised without vision for 1 to 3 months while wearing either the Binaural Sensory Aid (Animal 1; Kay, 1974) or the Trisensor (Animals 2 and 3; Easton & Jackson, 1983) airborne sonars. Each animal demonstrated alertness to information transmitted by the devices in spontaneous reaching or reinforced discrimination tasks, and more device-related, perceptual-motor activities were observed when the sensors were switched on than when they were switched off. The results show that neonate monkeys can learn effective use of information obtained from sensory substitution devices through unstructured interaction with the environment.
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Affiliation(s)
- E R Strelow
- Department of Electrical Engineering, University of Canterbury, New Zealand
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Sinton J. [Seen, but not heard]. Sykepleien 1977; 64:1030. [PMID: 244026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Sinton J. Were you there? Minor operation. Nurs Mirror Midwives J 1976; 142:69. [PMID: 1047355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sinton J. Nurses are human, too. Nurs Mirror Midwives J 1976; 142:68. [PMID: 1046658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sinton J. Were you there? Seen, but not heard. Nurs Mirror Midwives J 1976; 142:60. [PMID: 1042973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sinton J. A natural process. Nurs Mirror Midwives J 1975; 141:52. [PMID: 1042853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sinton J. Were you there?. What can the matter be? Nurs Mirror Midwives J 1975; 141:73. [PMID: 1042803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sinton J. The natural transition. Nurs Mirror Midwives J 1975; 141:68. [PMID: 1041380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sinton J. TO PRESERVE LIFE! Nurs Mirror Midwives J 1975; 140:73. [PMID: 1038641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sinton J. The generation gap. Nurs Mirror Midwives J 1975; 140:68. [PMID: 1090909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sinton J. Another one gone! Were you on duty? Nurs Mirror Midwives J 1975; 140:59. [PMID: 1038087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sinton J. The right to die? Nurs Mirror Midwives J 1974; 139:41. [PMID: 4496103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Sinton J. Were you there? The other side of the bed. Nurs Mirror Midwives J 1974; 138:58. [PMID: 4494951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Sinton J. Were you there? Ladies' night. Nurs Mirror Midwives J 1974; 138:67. [PMID: 4496306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Sinton J. Were you there? 7. Windmills of your mind. Nurs Mirror Midwives J 1974; 138:66. [PMID: 4494738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Sinton J. Were you there? 5. Discipline. Nurs Mirror Midwives J 1974; 138:72. [PMID: 4494715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Sinton J. Were you there? 4. Casualty. Nurs Mirror Midwives J 1974; 138:75. [PMID: 4494701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Sinton J. Were you there? 3. The angel. Nurs Mirror Midwives J 1974; 138:52. [PMID: 4494689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Sinton J. Were you there? 2. The colour of fear. Nurs Mirror Midwives J 1974; 138:48. [PMID: 4494677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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