Literature
The Assessment of Diastolic and Systolic Function in Kawasaki Disease Using Myocardial Strain Imaging and Tissue Doppler Imaging: A Systematic Review and Meta-Analysis.
Evidence suggests Kawasaki disease patients demonstrate selective cardiac dysfunction patterns detectable through advanced imaging techniques. The meta-analysis of 1821 KD patients showed reduced global longitudinal strain, circumferential strain, and left atrial reservoir strain compared to healthy controls, while other parameters remained unaffected. Worth noting that these abnormalities persisted in younger patients (≤5 years) and male-predominant cohorts, indicating strain imaging may detect subclinical myocardial impairment not evident through conventional measures.
These findings indicate selective abnormalities detected by myocardial strain imaging and TDI rather than uniform systolic and diastolic impairment, with subgroup results interpreted as exploratory.
Relevance: Directly relevant to profile diagnosis dx-kawasaki. This systematic review and meta-analysis evaluates myocardial systolic and diastolic function in Kawasaki disease patients using strain imaging and tissue Doppler imaging, assessing impact on cardiac function - a core clinical concern in KD management.
PMID: 41961048Echocardiography (Mount Kisco, N.Y.)(Journal Article) Literature
Understanding the burden of pulmonary arterial hypertension among patients and caregivers through narrative medicine: data from Italian multicentre observational INSPECTIO study.
Signal observed that integrating patient narratives with clinical data reveals alignment between subjective experiences and standardized quality-of-life measures in pulmonary arterial hypertension. The INSPECTIO study found that patients reporting domestic life limitations, shame, or ongoing treatment issues had higher emPHasis-10 scores, while 62% described their condition as manageable at 12 months. Evidence suggests narrative medicine approaches may provide valuable insights for patient-centered PAH management beyond traditional outcome measures.
NCT04567602.
Relevance: Related to research interest pulmonary hypertension in adult population. This observational study examines quality of life and burden in adult PAH patients treated with macitentan and selexipag. While addressing PAH management and outcomes, it concerns adult rather than pediatric patients.
PMID: 41956554BMJ open respiratory research(Journal Article) Literature
Case report of a patient with acenocoumarol resistance following therapy for infective endocarditis with rifampicin and gentamicin combination therapy.
Evidence suggests rifampicin significantly compromises vitamin K antagonist effectiveness through CYP2C9 induction, creating challenging anticoagulation scenarios. This case demonstrated that escalating warfarin and acenocoumarol doses failed to achieve therapeutic INR levels during rifampicin therapy, requiring low molecular weight heparin bridging until rifampicin discontinuation allowed INR stabilization with dramatically reduced VKA doses. Worth noting the importance of alternative anticoagulation strategies when rifampicin co-administration is unavoidable.
Close INR monitoring, dose adjustments and alternative strategies, such as twice-daily VKA dosing or LMWH bridging, are crucial for maintaining therapeutic anticoagulation.
Relevance: Related to formulary drug drug-warfarin in adult patients. This case report discusses warfarin and acenocoumarol resistance during rifampicin therapy in an adult with mechanical valve replacements and endocarditis. While not pediatric, it addresses VKA management and drug interactions relevant to pediatric anticoagulation research interests.
PMID: 41960787Cardiovascular journal of Africa(Case Reports)