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Woei Bing Poon, Keng Yean Wong
Functional echocardiography (fECHO) refers to a bedside, limited assessment of the ductus arteriosus, myocardial performance and pulmonary or systemic haemodynamics that is brief in nature and addresses a specific clinical question or management dilemma. This point-of-care ultrasonography is increasingly used internationally and locally among neonatal units to assist with management of neonatal haemodynamic conditions. This article intends to explain the modality, its indications, interpretation and implications for management, and how it impacts long-term outcomes, particularly in chronic lung disease for premature infants born before 32 weeks of gestation...
May 2017: Singapore Medical Journal
Jay Aikat, Thomas M Carsey, Karamarie Fecho, Kevin Jeffay, Ashok Krishnamurthy, Peter J Mucha, Arcot Rajasekar, Stanley C Ahalt
The era of "big data" has radically altered the way scientific research is conducted and new knowledge is discovered. Indeed, the scientific method is rapidly being complemented and even replaced in some fields by data-driven approaches to knowledge discovery. This paradigm shift is sometimes referred to as the "fourth paradigm" of data-intensive and data-enabled scientific discovery. Interdisciplinary research with a hard emphasis on translational outcomes is becoming the norm in all large-scale scientific endeavors...
March 2017: Big Data
Mark E Sandhouse, Diana Shechtman, Gregory Fecho, Elena M Timoshkin
CONTEXT: The effects of osteopathic cranial manipulative medicine (OCMM) on visual function have been poorly characterized in the literature. Based on a pilot study conducted by their research group, the authors conducted a study that examined whether OCMM produced a measurable change in visual function in adults with cranial asymmetry. STUDY DESIGN: Randomized, controlled, double-blinded clinical trial. The intervention and control (sham therapy) were applied during 8 weekly visits, and participants in both groups received 8 weekly follow-up visits...
November 1, 2016: Journal of the American Osteopathic Association
James P Evans, Kirk C Wilhelmsen, Jonathan Berg, Charles P Schmitt, Ashok Krishnamurthy, Karamarie Fecho, Stanley C Ahalt
INTRODUCTION: In genomics and other fields, it is now possible to capture and store large amounts of data in electronic medical records (EMRs). However, it is not clear if the routine accumulation of massive amounts of (largely uninterpretable) data will yield any health benefits to patients. Nevertheless, the use of large-scale medical data is likely to grow. To meet emerging challenges and facilitate optimal use of genomic data, our institution initiated a comprehensive planning process that addresses the needs of all stakeholders (e...
2016: EGEMS
Daryl R Cheng, Stacey Peart, Kenneth Tan, Arvind Sehgal
AIM: Use of inhaled nitric oxide (iNO) in preterm infants is not supported by current evidence. In 2013, in Australia and New Zealand, 14% infants' ≤25 weeks of gestations were administered iNO. Within the cohort administered iNO, we aimed to identify subgroups where it may be more efficacious and compared characteristics before and after the set-up of the functional echocardiography (fEcho) programme. METHODS: A retrospective audit for the period 2000-2013 involving preterm infants administered iNO in the first four weeks of life was performed...
February 2016: Acta Paediatrica
Sandra M Gomez-Amaya, Mary F Barbe, William C de Groat, Justin M Brown, Gerald F Tuite, Jacques Corcos, Susan B Fecho, Alan S Braverman, Michael R Ruggieri
During the past century, diverse studies have focused on the development of surgical strategies to restore function of a decentralized bladder after spinal cord or spinal root injury via repair of the original roots or by transferring new axonal sources. The techniques included end-to-end sacral root repairs, transfer of roots from other spinal segments to sacral roots, transfer of intercostal nerves to sacral roots, transfer of various somatic nerves to the pelvic or pudendal nerve, direct reinnervation of the detrusor muscle, or creation of an artificial reflex pathway between the skin and the bladder via the central nervous system...
February 2015: Nature Reviews. Urology
Rachel Anastasia Coulter, Annette Bade, Yin Tea, Gregory Fecho, Deborah Amster, Erin Jenewein, Jacqueline Rodena, Kara Kelley Lyons, G Lynn Mitchell, Nicole Quint, Sandra Dunbar, Michele Ricamato, Jennie Trocchio, Bonnie Kabat, Chantel Garcia, Irina Radik
PURPOSE: To compare testability of vision and eye tests in an examination protocol of 9- to 17-year-old patients with autism spectrum disorder (ASD) to typically developing (TD) peers. METHODS: In a prospective pilot study, 61 children and adolescents (34 with ASD and 27 who were TD) aged 9 to 17 years completed an eye examination protocol including tests of visual acuity, refraction, convergence (eye teaming), stereoacuity (depth perception), ocular motility, and ocular health...
January 2015: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Arun Sasi, Arvind Sehgal
OBJECTIVES: To conduct a regional survey of neonatal intensive care unit (NICU) Directors in Australia and New Zealand (ANZ) to ascertain current practice. BACKGROUND: Use of inhaled nitric oxide (iNO) therapy in infants < 34 weeks gestational age is not supported by current evidence. METHODS: A cross-sectional electronic survey based on structured questionnaire was conducted amongst the Directors of all the tertiary neonatal intensive care units in Australia and New Zealand Neonatal Network (ANZNN)...
July 2014: Heart & Lung: the Journal of Critical Care
Richelle N Olsen, Jennifer Shepherd, Anup Katheria
Objective. Abnormal umbilical artery Doppler (UAD) studies are associated with poor neonatal outcomes. We sought to determine if postnatal measures of systemic blood flow (SBF), as measured by functional echocardiography (fECHO), could identify which fetuses with abnormal UAD were at the highest risk of adverse outcomes. Study Design. This is a retrospective review of fetuses with abnormal UAD who received fECHO in the first 72 hours of life. Measures of SBF (right ventricular output (RVO) and superior vena cava (SVC) flow) were performed and compared with prenatal variables and postnatal outcomes...
2014: ISRN Obstetrics and Gynecology
Eric Borsting, G Lynn Mitchell, Marjean Taylor Kulp, Mitchell Scheiman, Deborah M Amster, Susan Cotter, Rachael A Coulter, Gregory Fecho, Michael F Gallaway, David Granet, Richard Hertle, Jacqueline Rodena, Tomohiko Yamada
PURPOSE: To determine whether treatment of symptomatic convergence insufficiency (CI) has an effect on Academic Behavior Survey (ABS) scores. METHODS: The ABS is a six-item survey developed by the Convergence Insufficiency Treatment Trial Group that quantifies the frequency of adverse school behaviors and parental concern about school performance on an ordinal scale from 0 (never) to 4 (always) with total scores ranging from 0 to 24. The ABS was administered at baseline and after 12 weeks of treatment to the parents of 218 children aged 9 to 17 years with symptomatic CI, who were enrolled in the Convergence Insufficiency Treatment Trial and randomized into (1) home-based pencil push-ups; (2) home-based computer vergence/accommodative therapy and pencil push-ups; (3) office-based vergence/accommodative therapy with home reinforcement; and (4) office-based placebo therapy with home reinforcement...
January 2012: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Angela Pennell, Victoria Salo-Coombs, Amy Herring, Fred Spielman, Karamarie Fecho
INTRODUCTION: This study described anesthesia and analgesia-related preferences and outcomes of women who used a birth plan for labor and birth. METHODS: A prospective cohort study was conducted (N = 63). Data were abstracted from medical records, birth plans, and a follow-up survey. Descriptive statistics were used for analysis. RESULTS: Women who elected birth plans were primarily white, college-educated, primigravida, and under the care of a certified nurse-midwife...
July 2011: Journal of Midwifery & Women's Health
Dharmesh M Shah, Martin Kluckow
AIM: Poor neonatal outcome of preterm premature rupture of membranes (PPROM) < 24 weeks' gestational age (GA) is probably a result of abnormalities in both airway and vascular developments, ventilation perfusion mismatch, and possibly persistent pulmonary hypertension of the newborn (PPHN). Perinatal mortality of 50-90% has been reported in the past, with recent literature reporting significant improvement in neonatal survival. We report our 8-year experience in this group of infants using early diagnostic functional echocardiography (fECHO), high-frequency ventilation (HFV) and inhaled nitric oxide (iNO)...
June 2011: Journal of Paediatrics and Child Health
Bridget M Marroquin, Karamarie Fecho, Victoria Salo-Coombs, Fred J Spielman
STUDY OBJECTIVE: To determine whether parturients can reliably identify their midline during epidural or spinal needle insertion, and to determine whether parturient feedback helps the anesthesiologist successfully identify the midline. DESIGN: Survey instrument completed by anesthesiologists. SETTING: Labor and delivery unit of a university-based, tertiary-care hospital. MEASUREMENTS: Completed questionnaires were obtained for 554 of 904 (61...
February 2011: Journal of Clinical Anesthesia
S H Wilson, K Fecho, J Marshall, F Spielman
BACKGROUND: This study aimed to determine the distribution of operative delivery times for uncomplicated parturients undergoing elective cesarean delivery with neuraxial anesthesia. A secondary aim was to explore patient and surgical factors associated with longer cesarean delivery times. METHODS: A prospective observational study of 331 parturients undergoing elective cesarean delivery with neuraxial anesthesia was conducted. Factors examined included age, body mass index, ethnicity, number of previous cesarean deliveries, stretch mark and scar severity and surgical experience...
October 2010: International Journal of Obstetric Anesthesia
Stephanie Vanterpool, Randall Coombs, Karamarie Fecho
BACKGROUND: This study retrospectively compared the continuous epidural infusion of morphine with a single epidural injection of extended-release morphine for postoperative pain control after arthroplasty. METHODS: Medical records were reviewed for subjects who had total knee or hip arthroplasty (THA) under spinal anesthesia and received either a continuous epidural infusion of morphine (Group EPID; n = 101) or an extended-release epidural morphine (Group EREM; n = 109) for postoperative pain...
2010: Therapeutics and Clinical Risk Management
Katherine B Rosenberg, Catherine Monk, Julie S Glickstein, Stephanie M Levasseur, Lynn L Simpson, Charles S Kleinman, Ismee A Williams
BACKGROUND: Referral for fetal echocardiography (fECHO) is an acute stressor that may induce significant maternal anxiety. To promote good clinical management of expectant mothers in this situation, including adequate screening for possible psychiatric interventions, data are needed regarding the psychosocial functioning of women scheduled for fECHO procedures. OBJECTIVE: To investigate the association between fECHO and maternal anxiety. METHODS: Pregnant women answered two questionnaires before first fECHO...
June 2010: Journal of Psychosomatic Obstetrics and Gynaecology
Hedwig Schroeck, Karamarie Fecho, Kathleen Abode, Ann Bailey
OBJECTIVE: In children undergoing bronchoscopy for evaluation of stridor or respiratory symptoms, movement of the vocal cords is routinely assessed at the conclusion of flexible bronchoscopy with children still anesthetized. The effect of anesthesia on vocal cord function is not well described. This study aimed to characterize the relationship between depth of propofol anesthesia, as measured by Bispectral Index (BIS), and vocal cord movement in pediatric patients. METHODS: Children between 6 months and 12 years of age presenting for diagnostic flexible bronchoscopy were enrolled in this prospective observational study...
May 2010: Pediatric Pulmonology
Koert de Waal, Martin Kluckow
Functional echocardiography (fECHO) is the bedside use of ultrasound to longitudinally assess myocardial function, systemic and pulmonary blood flow, and intra and extracardiac shunts. This review will focus on fECHO as a tool for the clinician to assess the hemodynamic condition of sick neonates and describe situations where fECHO can help determine a pathophysiological choice for cardiovascular support. The very low birth weight infant with hypotension during the first 24h of life, assessment and monitoring of the ductus arteriosus, assessment and response to treatment of infants with pulmonary hypertension, the infant with perinatal asphyxia and the infant with sepsis and cardiovascular compromise are reviewed...
March 2010: Early Human Development
Karamarie Fecho, Freeman Jackson, Frances Smith, Frank J Overdyk
PURPOSE: "Code Blue" is a standard term used to alertt hospital staff that a patient requires resuscitation. This study determined rates of survival from Code Blue events and the role of opioids and other factors on survival. METHODS: Data derived from medical records and the Code Blue and Pharmacy databases were analyzed for factors affecting survival. RESULTS: During 2006, rates of survival from the code only and to discharge were 25.9% and 26...
2009: Therapeutics and Clinical Risk Management
Amy Judge, Karamarie Fecho
As the second most common cause for professional liability in anesthetic practice, nerve injuries are a well-recognized complication. We present a case of lateral antebrachial cutaneous neuropathy after prolonged general anesthesia for left medial meniscal transplant and microfracture surgery. In the orthopedic and sports medicine literature, <100 cases have been described. We discuss the possible causes and propose surgical positioning as the most likely cause of postoperative lateral antebrachial cutaneous neuropathy in our patient...
January 1, 2010: Anesthesia and Analgesia
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