9 results on '"Kurt R. Schumacher"'
Search Results
2. Diversity of Dystrophin Gene Mutations and Disease Progression in a Contemporary Cohort of Duchenne Muscular Dystrophy
- Author
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Katheryn E. Gambetta, Michael A. McCulloch, Ashwin K. Lal, Kenneth Knecht, Ryan J. Butts, Chet R. Villa, Jonathan N. Johnson, Jennifer Conway, Matthew J. Bock, Kurt R. Schumacher, Sabrina P. Law, Joshua M. Friedland-Little, Shriprasad R. Deshpande, Shawn C. West, Irene D. Lytrivi, and Carol A. Wittlieb-Weber
- Subjects
Pediatrics, Perinatology and Child Health ,Cardiology and Cardiovascular Medicine - Published
- 2022
3. Birth Location in Infants with Prenatally Diagnosed Hypoplastic Left Heart Syndrome
- Author
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Mehul D. Patel, Kurt R. Schumacher, Sowmya Balasubramanian, Sunkyung Yu, Karen Uzark, Jennifer C. Romano, Katherine E. Bates, and Sarah Gelehrter
- Subjects
Mechanical ventilation ,Pediatrics ,medicine.medical_specialty ,Heart disease ,business.industry ,medicine.medical_treatment ,Vascular surgery ,Logistic regression ,medicine.disease ,Cardiac surgery ,Hypoplastic left heart syndrome ,Pediatrics, Perinatology and Child Health ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Full Term ,Cohort study - Abstract
There are conflicting data on how delivery location impacts outcomes in neonates with ductal-dependent heart disease. Our goal was to evaluate the impact of delivery location on hospital length of stay and survival in infants with prenatally diagnosed hypoplastic left heart syndrome (HLHS) after stage 1 palliation (S1P). A multicenter cohort study was performed utilizing the National Pediatric Cardiology Quality Improvement Collaborative dataset for infants with prenatally diagnosed HLHS who underwent S1P from August 2016 to December 2018. Univariate comparisons of demographics, clinical, and outcome data were made and multivariable logistic regression was performed between groups stratified by distance from surgical center. A total of 790 patients from 33 centers were analyzed: 85% were born
- Published
- 2021
4. Establishing Baseline Metrics of Heart Failure Medication Use in Children: A Collaborative Effort from the ACTION Network
- Author
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Joseph Stidham, Justin Godown, Paige Krack, Kurt R. Schumacher, J.A. Spinner, Brian Feingold, Angela Lorts, David N. Rosenthal, Christopher S. Almond, Jack F. Price, and Danielle S. Burstein
- Subjects
medicine.medical_specialty ,Angiotensin receptor ,education.field_of_study ,Acute decompensated heart failure ,business.industry ,medicine.drug_class ,Population ,Cardiomyopathy ,030204 cardiovascular system & hematology ,Vascular surgery ,medicine.disease ,Cardiac surgery ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Heart failure ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,medicine ,Cardiology and Cardiovascular Medicine ,business ,education ,Beta blocker - Abstract
Heart failure metrics specific to the pediatric population are required to successfully implement quality improvement initiatives in children with heart failure. Medication use at the time of discharge following admission for decompensated heart failure has been identified as a potential quality metric in this population. This study aimed to report medication use at discharge in the current era for children admitted with acute decompensated heart failure. All patients
- Published
- 2020
5. Acute Hemodynamic Effects of Negative Extrathoracic Pressure in Fontan Physiology
- Author
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Heang M Lim, Nichole Rottach, Kurt R. Schumacher, Albert P. Rocchini, David M. Peng, Jeffrey D. Zampi, Ray Lowery, Lori Q. Riegger, Sunkyung Yu, and Susan M Smith
- Subjects
Adult ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Adolescent ,Haemodynamic response ,Ventilators, Negative-Pressure ,Hemodynamics ,Pilot Projects ,030204 cardiovascular system & hematology ,Fontan Procedure ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,medicine ,Humans ,Child ,Heart Failure ,business.industry ,fungi ,Vascular surgery ,medicine.disease ,Respiration, Artificial ,Cardiac surgery ,medicine.anatomical_structure ,030228 respiratory system ,Heart failure ,Pediatrics, Perinatology and Child Health ,Pulmonary artery ,Vascular resistance ,Breathing ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
We sought to assess acute hemodynamic changes after implementation of negative extrathoracic pressure (NEP) in spontaneously breathing ambulatory Fontan patients with symptomatic heart failure. We hypothesized that application of NEP would result in an acute decrease in pulmonary artery pressure. Ten patients with clinical evidence of Fontan failure underwent baseline hemodynamic catheterization while breathing spontaneously. Hemodynamic measurements were then repeated after 30 min of continuous NEP. After 30 min of continuous NEP, 4/10 patients had a decrease in their Fontan pressure by 2 mmHg and one patient had a decrease by 1 mmHg. There were three patients that had an increase in Fontan pressure by 2 mmHg. In 7/10 patients, indexed pulmonary vascular resistance decreased by an average of 31%. In symptomatic Fontan patients with a favorable hemodynamic response to NEP during catheterization, potential benefit of longer-term NEP to improve clinical status should be explored.
- Published
- 2019
6. Center Variation in Hospital Costs for Pediatric Heart Transplantation: The Relationship Between Cost and Outcomes
- Author
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Debra A. Dodd, Andrew H. Smith, Cary Thurm, Brian Feingold, Kurt R. Schumacher, Justin Godown, David W. Bearl, Bret A. Mettler, Matthew Hall, and Jonathan H. Soslow
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Male ,medicine.medical_specialty ,Adolescent ,Databases, Factual ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Article ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Humans ,Medicine ,In patient ,Hospital Mortality ,Registries ,Hospital Costs ,Child ,Proportional Hazards Models ,Heart transplantation ,Inpatient care ,business.industry ,Hazard ratio ,Infant ,Patient survival ,Vascular surgery ,United States ,Cardiac surgery ,Survival Rate ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Heart Transplantation ,Female ,Pediatric heart transplantation ,Cardiology and Cardiovascular Medicine ,business - Abstract
There are limited published data addressing the costs associated with pediatric heart transplantation and no studies evaluating the variation in costs across centers. We aimed to describe center variation in pediatric heart transplant costs and assess the association of transplant hospitalization costs with patient outcomes. Using a linkage between the Pediatric Health Information System and Scientific Registry of Transplant Recipients databases, hospital costs were assessed for patients (
- Published
- 2018
7. Incidence of Fever and Positive Bacterial Cultures in Neonates Receiving Prostaglandin
- Author
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Kurt R. Schumacher, Fares Alghanem, Gabe E. Owens, and Stephanie L. Rakestraw
- Subjects
Male ,medicine.medical_specialty ,Microbiological culture ,Fever ,Population ,Sensitivity and Specificity ,Asymptomatic ,Diagnosis, Differential ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,Humans ,Medicine ,030212 general & internal medicine ,education ,Retrospective Studies ,Bacteriological Techniques ,education.field_of_study ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,Retrospective cohort study ,Bacterial Infections ,Length of Stay ,medicine.disease ,Anti-Bacterial Agents ,Surgery ,Pneumonia ,Logistic Models ,ROC Curve ,Bacteremia ,Pediatrics, Perinatology and Child Health ,Prostaglandins ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Prostaglandin E (PGE1) is necessary to maintain ductus arteriosus patency in many newborns with congenital heart disease. Because PGE1 therapy commonly leads to fever, and given this population's fragile state, a complete sepsis workup is often performed in febrile, but otherwise asymptomatic, patients. This practice of liberal evaluation with bacterial cultures, empiric antibiotic treatment, and delays in essential surgical intervention may result in poor resource utilization and lead to increased iatrogenic morbidity. This study sought to determine the incidence of fever and culture-positive infection in patients receiving PGE1, and identify diagnostic variables that predict culture-positive infection. The study included a single-center retrospective review of all neonates receiving PGE1 between 2011 and 2014. Logistic regression and receiver operator characteristic analysis were used to identify significant predictors of positive bacterial cultures. Among 435 neonates, 175 (40%) had fevers (≥ 38.3 °C) while concurrently receiving PGE1, but only 9 (2%) had culture-positive infection and 1 (
- Published
- 2017
8. The Use and Outcomes of Small, Medium and Large Premounted Stents in Pediatric and Congenital Heart Disease
- Author
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Brian A. Boe, Aimee K. Armstrong, Jeffrey D. Zampi, Kurt R. Schumacher, and Sunkyung Yu
- Subjects
Heart Defects, Congenital ,medicine.medical_specialty ,medicine.medical_treatment ,Constriction, Pathologic ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Child ,Retrospective Studies ,business.industry ,Stent ,Vascular surgery ,equipment and supplies ,medicine.disease ,Surgery ,Cardiac surgery ,Catheter ,Stenosis ,Treatment Outcome ,surgical procedures, operative ,Pediatrics, Perinatology and Child Health ,Stents ,Radiology ,Implant ,Cardiology and Cardiovascular Medicine ,business ,Vascular Stenosis - Abstract
We sought to describe the use and outcomes of small, medium and large premounted stents in patients with congenital heart disease, including incidence of and risk factors for re-intervention and development of in-stent stenosis. Premounted stents offer several advantages over traditional manually crimped bare-metal stents, especially in small patients. There are no data describing the medium-term effectiveness and outcomes of premounted stents in congenital heart disease. We performed a single-center retrospective review of all small, medium and large premounted stents implanted over an 8-year period. Premounted stents were implanted in 71 vessels within 59 patients with a 97 % success rate. Regardless of implantation site, premounted stent implantation resulted in significant improvements in vessel size and pressure gradient (p
- Published
- 2016
9. Demographic Characteristics and Estimated Prevalence of Fontan-Associated Plastic Bronchitis
- Author
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Mollie Kempa, Erin Gulbransen, Regine L. Caruthers, Kathleen A. Stringer, Kurt R. Schumacher, Elizabeth Kelly, Angela Loo, Jennifer C. Hirsch, and Steven R. Erickson
- Subjects
Heart Defects, Congenital ,Male ,Michigan ,medicine.medical_specialty ,Pediatrics ,Heart disease ,medicine.medical_treatment ,Population ,Fontan Procedure ,Article ,Hypoplastic left heart syndrome ,Fontan procedure ,Age Distribution ,Postoperative Complications ,Sex Factors ,Risk Factors ,Bronchoscopy ,Prevalence ,Humans ,Medicine ,Sex Distribution ,Bronchitis ,education ,Prospective cohort study ,Retrospective Studies ,education.field_of_study ,business.industry ,Age Factors ,Retrospective cohort study ,medicine.disease ,Cardiac surgery ,Child, Preschool ,Population Surveillance ,Pediatrics, Perinatology and Child Health ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Plastic bronchitis (PB) is a poorly understood disease that can complicate any underlying pulmonary disease. However, it appears to most often occur in patients with surgically palliated congenital heart disease, particularly after the Fontan procedure. Few data exist about the prevalence and etiology of PB in this population. In an effort to establish data about prevalence, we conducted a retrospective study of an existing Fontan surgery database (n = 654) comprised of data, including sex, age at date of surgery, alive/dead status, New York Heart Association classification at last follow-up, right-ventricular end-diastolic pressure and pulmonary artery pressure before Fontan surgery, and the presence of a Fontan fenestration. An initial medical record review of 173 patients in the database who were followed at the University of Michigan identified seven patients with PB resulting in an estimated prevalence of 4 %. Subsequently, 14 % of 211 surveyed patients reported that they presently expectorate mucus or fibrin plugs (casts). Demographic and clinical variables did not differ between patients with or without possible PB. Collectively, these findings suggest that Fontan patients presently with PB may range from 4 to 14 %, indicating potential under-diagnosis of the disease. There were no remarkable physical or hemodynamic indicators that differentiated patients with or without possible PB. These data also highlight the need for more elaborate, prospective studies to improve our understanding of PB pathogenesis so that more definitive diagnostic criteria for this devastating disease can be established and its prevalence more accurately determined.
- Published
- 2012
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