Scott T. Maurer, MD Pediatric Cardiology Wake Forest Baptist Health
My name is Scott Maurer, I'm a pediatric cardiologist on staff here at Wake Forest University. So I'm a pediatric cardiologist and I'm a general pediatric cardiologist which means I see a broad array of things. I don't do surgery or heart catheterization or specialized pacemakers, but I take care of pretty much everything else. I take care of women who are pregnant who have heart defects, I take care of babies before they're even born, I can diagnose them with heart defects. I take care of them after birth. I see a wide range of patients and a wide.
Range of ages. Everything from heart defects to acquired heart problems like hypertension or heart failure, pulmonary hypertension and even in those who had heart defects as a child but have grown up to an older age. They still really need pediatric cardiology care I take care of adults as well. So pretty much any patient who has had a heartrelated condition that started in their youth. So my patient care philosophy is that I want people to feel comfortable with me and with their child and I want them to walk out knowing everything that's going on.
I come from a rural background and I'm a straight shooter. I don't beat around the bushes, but I want everybody to sort of know exactly what's going on. But also in words they'll understand and a concept they'll understand. I want them to feel close enough and warm enough in that relationship to come back and see me again and to continue to work with them for a long period of time. What I enjoy most I think is that there's a misconception, if you have a heart problem, you can't do anything, you have to be protected.
Reggae Shark Key of Awesome 89 Animated
Gonna tell you da story Of a reggae shark. There are hundreds of sharks livin' under da sea. Great whites, hammerheads, and white tip reefs. But the one shark Discovery always leave out is the dreadlock Rasta fish I'm talkin' about. Reggae Shark! Reggae Shark is real. Reggae Shark! Him got a band with the seals. Reggae Shark! He don't want to harm ya. Reggae Shark! He just want your ganja. Reggae Shark! After dark Reggae Shark come cruisin'. Some say Reggae Shark's part human. Him was cursed by an evil Jelly Witch.
Didn't have no reason, she was just a bitch. Some kids were boatin' and smokin' a spliff. Reggae Shark swam over to ask for a hit. The kids start screamin' and one of them drowned. Now the sheriff and his posse gonna hunt him down. Reggae Shark got no political agenda. Reggae Shark! He just wants redemption. Reggae Shark! And he also wants ganja. But ya can't light a spliff when you live underwater. One day a drug boat had to drop its load. Reggae Shark come along and him eat it whole.
Now he's starving like Marvin, got the munchies. Then him see the evil sheriff and all his flunkies. He put his fins in the air and said, It wasn't me fault! But the sheriff said fire and the rifles shot. But it was just a shark decoy tied to a raft 'cause the Reggae Shark's a master of of da arts and crafts. Reggae Shark!He jumped on the boat. And the sheriff fell down his throat. The townspeople cheered and said, You brought us peace. You took a bite of corruption in the town police..
They threw him a huge ticker tape parade 'cause they know that he balances the food chain. They gave him the key to Kingstontown You should see the tourism he brings in now. You've redeemed yourself said the Jelly Witch. Me can reverse that curse and grant your wish. Him looked at the witch and he say, Nay. 'Cause I'm a Reggae Shark and that's the way I'll stay! Reggae Shark! Reggae Shark! Reggae Shark! Reggae Shark! Reggae Shark! Reggae Shark! They Key of Awesome. Hey, thanks for watching The Key of Awesome. If you want to see all the other Key of Awesomes,.
Click in the link in the description. And I want to thank the Reggae Shark for being in this tutorial. Thanks for sharing your story. And I want to thank The Key of Awesome for having us. So is there like a channel where they can hear some more of your songs Nah, nah, me don't have no channel. There ain't no Internet connection underwater. But you can buy this here song on iTunes. Other than that if you want to hear my music, just go down to Jamaica, get in the water, and follow the sound.
Going Home After a Pediatric Liver Transplant CHOP 5 of 5
Gtgt SOONER THAN YOU THINK, IT WILL BE TIME TO LEAVE THE HOSPITAL AND GO HOME. THE FIRST MONTH AFTER THE TRANSPLANT IS A BUSY TIME. YOU WILL BE VISITING THE LIVER TRANSPLANT CLINIC OFTEN, AND YOU MAY HAVE TO HAVE BLOOD WORK DONE BETWEEN CLINIC VISITS. IT'S ALSO A TIME TO ADJUST TO BEING OUT OF THE HOSPITAL ENVIRONMENT TO TAKING CARE OF YOUR CHILD AT HOME AND TO GETTING LIFE BACK TO NORMAL. AFTER THE TRANSPLANT, ESPECIALLY IN THE FIRST YEAR, YOU WILL HAVE TO BE ON THE LOOKOUT FOR SIGNS.
OF REJECTION. EARLY SIGNS MAY INCLUDE FEVER OR ABDOMINAL PAIN. LATER SIGNS ARE JAUNDICE OR YELLOW COLOR OF THE SKIN AND EYES, AND CHANGES IN STOOL OR URINE COLOR. YOUR CHILD WILL ALSO NEED TO TAKE MEDICINES TO PREVENT INFECTIONS, WHICH ARE MORE LIKELY TO OCCUR BECAUSE THE IMMUNE SYSTEM IS BEING SUPPRESSED. MANY OF THESE WILL BE STOPPED BY ABOUT ONE YEAR AFTER THE TRANSPLANT. YOUR PHYSICIAN MAY ALSO PRESCRIBE HIGH BLOOD PRESSURE MEDICINE OR A STRONGER ANTIREJECTION MEDICINES AS NEEDED. WHEN CHILDREN ARE DISCHARGED FROM THE HOSPITAL, THEY ARE GENERALLY TAKING TWO MEDICATIONS TO PREVENT.
REJECTION, AND SIX TO EIGHT MEDICATIONS TO PREVENT SIDE EFFECTS FROM THE FIRST TWO. OVER THE FIRST FEW MONTHS, ONE OF THE REJECTION MEDICATIONS WILL BE GRADUALLY DISCONTINUED, AND THE SECOND WILL BE DECREASED. THE OTHER MEDICATIONS CAN THEN GRADUALLY BE STOPPED SO THAT BY THE END OF YEAR ONE, MOST CHILDREN TAKE A SINGLE MEDICATION TWICE A DAY. YOU WILL RECEIVE INSTRUCTIONS ON HOW TO ADMINISTER YOUR CHILD'S MEDICATION ONCE YOU'RE HOME. IT IS IMPORTANT THAT YOU LEARN WHY EACH MEDICATION IS BEING TAKEN AND FOLLOW THE DIRECTIONS EXACTLY. IT WILL HELP YOU IF YOU DEVELOP A PLAN AND FOLLOW.
THE SAME ROUTINE EVERY DAY. NEVER LET YOUR CHILD'S MEDICATIONS RUN OUT. ALWAYS REFILL THEM AT LEAST A WEEK AHEAD OF TIME. AND IF YOU HAVE ANY PROBLEMS WITH REFILLS, CALL YOUR TRANSPLANT COORDINATOR RIGHT AWAY TO GET THE PROBLEM SORTED OUT. IF YOU NOTICED ANY CHANGES IN YOUR CHILD'S HEALTH, A PERSISTENT COLD OR A FEVER, ESPECIALLY IN THE FIRST FEW MONTHS AFTER LEAVING THE HOSPITAL, CALL YOUR TRANSPLANT COORDINATOR. DON'T GIVE YOUR CHILD ANY MEDICATIONS THAT HAVEN'T BEEN PRESCRIBED BY THE TRANSPLANT TEAM WITHOUT CHECKING FIRST. LIVING WITH A TRANSPLANT IS A LIFELONG PROCESS.
CHILDREN WITH TRANSPLANTS TAKE IMMUNOSUPPRESSANTS AND OTHER MEDICATIONS TO PREVENT REJECTION FOR THE REST OF THEIR LIVES. REGULAR CHECKUPS AND FOLLOWUPS WILL CONTINUE INTO THEIR ADULT YEARS. THEY'LL HAVE TO LEARN HOW AND WHY TO TAKE THEIR MEDICATIONS ON THEIR OWN AS THEY GROW UP AND BECOME MORE INDEPENDENT. BUT THAT'S ABOUT IT. ALMOST ALL KIDS WHO RECEIVE A LIVER TRANSPLANT ARE ABLE TO LIVE NORMAL LIVES WITH VERY FEW RESTRICTIONS. THEY ARE EXPECTED TO RETURN TO A FULL RANGE OF AGEAPPROPRIATE ACTIVITIES. IN FACT, AFTER THE TRANSPLANT, THEY OFTEN FIND THAT THEY CAN DO MOST THINGS BETTER.
THAN BEFORE BECAUSE THEY DON'T FEEL SICK ALL THE TIME. IN GENERAL, CHILDREN WHO HAVE UNDERGONE LIVER TRANSPLANTATION ARE ABLE TO PARTICIPATE IN SCHOOL, WORK, AND CAN EXPECT TO HAVE CHILDREN OF THEIR OWN. EVERY CHILD IS UNIQUE, AND EVERY TRANSPLANT IS DIFFERENT. RESEARCH TO IMPROVE THE PROCESS, MUCH OF IT CONDUCTED RIGHT HERE AT THE CHILDREN'S HOSPITAL OF PHILADELPHIA, IS CONSTANTLY UNDER WAY. TODAY, WE HAVE EVERY REASON TO BELIEVE THAT CHILDREN WHO HAVE LIVER TRANSPLANTS CAN LIVE LONG AND HEALTHY LIVES. THEY CAN GET BACK TO THE BUSINESS OF BEING KIDS AGAIN.
Your Brain on Drugs Marijuana
For centuries, humans have been using substances to alter their state of mind. From caffeine, cigarettes and alcohol to more extreme drugs. But as the most commonly used illicit drug in North America, Where does marijuana fit in and how exactly does it affect your brain First, we need to understand how the brain functions. Neurons are the cells that process information in the brain. By releasing chemicals called neurotransmitters from the axon of one neuron to the dendrite of another they change the electrical charge of the receiving neuron consequently exciting or inhibiting it.
If excited, the signal is passed on. Though it sounds simple these signals work together and the effect is quickly compouned into complex configurations within milliseconds flashing over the entire brain. This is what happens every single time you think, breathe or move. So what is going on inside your brain when you're smoking marijuana Well unlike alcohol, which contains molecules nothing like those in our body, cannabis contains molecules that resemble those produced in our very own brains cannabonoids. Although naturally these cannabonoids circulate at much lower quantities compared to the large influx imposed by smoking,.
Specifically the chemical tetrahydrocannabinol or THC resembles a natural transmitter called anandamide. These cannabonoids are specialized neurotransmitters released by neurons having just fired. Neurons temporarily become unresponsive after firing to prevent them from overracting or being too dominant. This allows your brain to function in a calm and controlled manner. But cannabonoids interrupt this approach in some parts of the brain. Instead, they remove the refractory period of neurons that are already active and can cause your thoughts, imagination, and perception to utterly magnify itself. This means, once you begin your train of thought.
It becomes the most significant and profound thing ever. You can't see the big picture or even recall your last epiphany because you're caught up in the momentum of a particular idea and your neurons keep firing until a new idea takes hold and you go off on a new tangent. These cannabonoids also affect the levels of dopamine and norepinephrine in your brain often leading to a sense of euphoria, relaxation, pain modulation and general enhancement of an experience, though sometimes causing anxiety. Furthermore, there are cannabonoid receptors in areas controlling shortterm memory, learning, coordination, movement control.
What is Persistent Pulmonary Hypertension in Newborns New York Attorney Bernard Daskal Explains
What is persistent pulmonary hypertension in newborns Hi. I'm Bernard Daskal of Lynch Daskal Emery in New York City. I represent individuals who've been harmed by pharmaceuticals or medical devices. And today I'm going to answer this important question for you. Our lungs perform an important function in our bodies. They take in oxygen, transmit that oxygen through our blood stream, but also expel carbon dioxide from our systems. In unborn babies, the task of oxygenating the blood is performed by the placenta not by the lungs. Therefore in an unborn baby the blood vessels to the lungs are.
Very constricted. After birth the umbilical cord is cut, those blood vessels to the lungs dilate, and the lungs take over the task of oxygenating the blood. Unfortunately, in some babies, those blood vessels to the lungs remain constricted causing pressure to build up in the pulmonary vessels. When that happens, you have pulmonary hypertension. If it's persistent if it doesn't go away that is a very serious condition because it means not enough oxygen is getting to the body's organs. Some studies have suggested that certain medications and particular SSRIs that's Selective Serotonin.
Delivery of Babies with Congenital Diaphragmatic Hernia CDH 4 of 11
Gtgt A LOT OF FAMILIES ASK US, AM I GOING TO HAVE TO HAVE A CSECTION BECAUSE MY BABY'S GOING TO BE SO ILL AND I THINK THAT, OVERALL, VAGINAL DELIVERY IS PREFERABLE. gtgt MOST INFANTS WITH CDH WILL UNDERGO A FAIRLY ROUTINE LABOR. THEY'LL BE MONITORED TYPICALLY, AND MOST OF THEM UNDERGO A VAGINAL DELIVERY. gtgt WE WERE SURPRISED BECAUSE WE THOUGHT THAT IT WOULD BE BETTER FOR THEM JUST TO GET HER OUT REAL FAST AND BE ABLE TO DO WHAT THEY NEEDED TO DO WITH HER. BUT THEY ACTUALLY TOLD US THAT IT WOULD BE BETTER FOR HER TO BE.
DELIVERED NATURALLY. SO WE DID THAT, AND SHE WAS BORN NATURALLY. gtgt MANY TIMES WHAT WE WILL DO IS SCHEDULE AN INDUCTION OF LABOR, AS LONG AS THE CERVIX IS FAVORABLE. SUCH THAT EVERYBODY HAS A HEADSUP AND IS READY AND WAITING FOR THE BABY WHEN IT'S BORN. gtgt IT'S A BIG DEAL TO COORDINATE EVERYTHING. SO IT'S IMPORTANT THAT OBSTETRICIANS AND THE SURGEONS AND THE NEONATOLOGISTS AND THE ECMO TEAM AND THE NURSING STAFF KNOW WHEN THAT BABY'S COMING, BECAUSE WE ALL WANT TO BE THERE, AND WE WANT TO BE READY.
Gtgt THE FETUS AND THE NEWBORN WITH THE SEVERE DIAPHRAGMATIC HERNIA PROBLEM IS AS FRAGILE AS ANY BABY WE TAKE CARE OF AT THE CHILDREN'S HOSPITAL OF PHILADELPHIA. gtgt AND ONE OF THE THINGS THAT'S IMPORTANT IS TO MONITOR LABOR PROGRESS AND THE STATUS OF THE FETUS IN UTERO JUST PRIOR TO LABOR AND BE ABLE TO HAND THE NEONATOLOGIST A BABY WHO IS AN OPTIMAL CONDITION FOR RESUSCITATION. gtgt THE ISSUE IS TO MINIMIZE INCREMENTAL RISK FACTORS THAT COULD LEAD TO THE BABY DYING. AND ONE SUCH RESOURCE, WHICH IS AMAZING,.
IS THE SPECIAL DELIVERY UNIT, WHERE ALL OF THE BABY'S CARE, ALL OF THE MOTHER'S CARE CAN OCCUR IN ONE PLACE. gtgt THE SPECIAL DELIVERY UNIT, OR SDU, IS A UNIT THAT WAS DESIGNED ESPECIALLY FOR A BABY BORN WITH AN ANOMALY, WHO'S GOING TO NEED AN INTERVENTION SHORTLY AFTER BIRTH. gtgt ALL OF THE BABY'S CARE, ALL OF THE MOTHER'S CARE CAN OCCUR IN ONE PLACE WITH STATEOFTHEART RESOURCES, BEFORE BIRTH, DURING BIRTH, AND AFTER BIRTH. gtgt SO THE BABY WITH CONGENITAL DIAPHRAGMATIC HERNIA, WHO NEEDS EXPERT MULTIDISCIPLINARY CARE FROM.
THE FIRST MOMENT, IS THE PERFECT EXAMPLE OF THE TYPE OF PREGNANCY THAT WE FEEL SHOULD BE DELIVERED IN THE SDU. gtgt WE WEREN'T EXPECTING HER TO CRY. SO SHE CRIED OUT AND SHE LOOKED SHE OPENED HER EYES AND LOOKED AT US. gtgt THEY LET US SAY HELLO AND WHISKED HER INTO THE NEXT ROOM TO START TAKING CARE OF HER. gtgt THE BABY REQUIRES PROMPT INTUBATION WITH AN ENDOTRACHEAL TUBE, REQUIRES PLACEMENT OF A NASOGASTRIC TUBE, WHICH DECOMPRESSES WHAT IS OFTEN A DILATED STOMACH. gtgt REMEMBER, THE STOMACH IS IN THE CHEST.
SO, IF THE BABY GULPS AIR, THE STOMACH EXPANDS, TAKES UP EVEN MORE SPACE IN THE CHEST. gtgt REQUIRES PLACEMENT OF INTRAVENOUS LINES, MONITORING LINES, USUALLY AN UMBILICAL ARTERIAL LINE, FOR ARTERIAL BLOOD PRESSURE MONITORING AND FOR BLOOD GASES, ALL THAT NEEDS TO BE DONE QUICKLY AND EXPERTLY. gtgt AND THEN, ONCE THE BABY IS STABILIZED, THEY TRANSPORT THE BABY OVER TO THE NEONATAL INTENSIVE CARE UNIT, WHERE ADDITIONAL PERSONNEL FROM THE TEAM ARE READY AND WAITING FOR THE BABY TO FURTHER EVALUATE THE BABY AND DECIDE WHAT THE BEST MEDICAL MANAGEMENT IS.
What Cardiac Evaluation Should Young Athletes Receive
This is a very controversial topic. Obviously the impact to a family who has lost a child is tremendous. However, on the other side the incidence of this type of event is quite rare estimated at around 1 in 100,000 sports participants of school age Screening examinations in histories have not been typically thought to be useful in detecting a called heart disease. However, the electrocardiogram has not shown a significant difference in many populations in terms of increasing that yield. Some of the conflicting information includes reports from Italy that suggested the incidence.
Of sudden death dropped dramatically after instituting a mandatory screening process. However, that final rate that they achieved was really only about the same rate as is present here in the United State already. In addition to subsequent study from Israel showed that there was no improvement in mortality after institution of a screening programme. The additional burden of running down the abnormal findings that so called false positives, is also something to deal with. It is a tremendous expense particularly for a rare disease. Many children do not have the resources to undergo this testing, and will opt not to do the recommended power.
Additional testing that has been recommended includes the echocardiogram. This is a test where an image is made of the heart particularly to look for abnormal thickening of the valve muscle known as hypertrophic cardiomyopathy. Other conditions such as a poorly working heart muscle known as cardiomyopathy or abnormal valve structures and occasionally abnormal coronary arteries can be detected. However, this study is done in a screening fashion rather quickly in a period of about five minutes as opposed to a complete study which might take up to 45 minutes. The exclusion of coronary artery anomalies is not possible in the screening test, and.
These accounts were at the second leading cause of sudden death in young athletes. There are a number of other conditions that even with the complete echocardiogram and a very thorough electrocardiogram cannot be detected because they do not manifest on either of these tests. Such that the screening may give a fall sense of security to the participant, and that there is no heart disease whatsoever. Clearly, if there is a family history suggestive of heart disease that may be inherited, or there are warning signs or symptoms, and a list of these has been provided by the American.
Blood Pressure Facts Normal Blood Pressure Ranges In Children
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