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Biomedical subjects

A Rothman

Publications and source records attributed to A Rothman.

105 records · Page 6Linked to original sources
PubMedDate not supplied

Ambiguity and mistakes in the pediatric cardiology vernacular.

The pediatric cardiology vernacular is replete with ambiguous and erroneous terminology. This article discusses several examples in a plea to bring the accuracy and precision of the scientific method to the clinical pediatric cardiology vernacular.

Cardiology↗
PubMedDate not supplied

Enlarged left vitelline vein remnant as a cause of cyanosis after the Fontan procedure: resolution with an Amplatzer vascular plug.

A 6-year-old girl with heterotaxy and a functional single ventricle had persistent cyanosis 4 years after a fenestrated Fontan procedure. Cardiac catheterization revealed a large venous fistula from a left-sided hepatic vein to the coronary sinus, resulting in desaturation. The anomalous vein was occluded with an Amplatzer vascular plug.

Child↗
PubMedDate not supplied

A comparison of fetal echocardiography in university and health maintenance organization settings.

Fetal echocardiographic findings, and decisions to continue or to terminate affected pregnancies, may differ between university (UNIV) and health maintenance organization (HMO) settings. The aim of this study was to review the fetal echocardiographic experience at a combined university/health maintenance organization program over a 4-year period. Imaging and counseling for affected pregnancies were provided by the same, single investigator at both sites. Out of a total of 1382 studies (940 UNIV, 442 HMO), 127 abnormals were identified (94 UNIV, 33 HMO). Among the 127 pregnancies with fetal heart disease, 24 (19%) underwent elective termination, 16% at UNIV and 27% at HMO (p = 0.2). Mean gestational age at the time of diagnosis was 25.2 weeks at UNIV compared with 22.3 weeks at HMO (p = 0.002). At UNIV, only 51% of diagnoses were made before 24 weeks compared with 79% at HMO (p = 0.003). Screening fetal sonograms, performed between 18 and 20 weeks on every pregnancy at HMO but not at UNIV, enabled earlier detection of congenital heart disease (CHD) and allowed more women with severely affected pregnancies the option to terminate. In both settings, indications with the highest yields for CHD included a right-sided stomach, abnormal four-chamber view, sustained bradycardia, abnormal fetal karyotype, fetal omphalocele, and maternal indomethacin. An echogenic reflector was identified in 86 pregnancies (7%) and did not represent a risk factor for CHD. No major differences in CHD were found between UNIV and HMO. In summary, this study found a significantly earlier diagnosis of CHD at HMO than at UNIV. This discrepancy between programs may explain, at least in part, the trend toward a higher frequency of decisions to terminate affected pregnancies at HMO than at UNIV, despite similar fetal findings.

Abortion, Induced↗
PubMedDate not supplied

Pediatric cardiovascular embolization therapy.

Transcatheter embolization of superfluous vascular structures has assumed an important role in pediatric interventional cardiology. A variety of devices and materials are being used to treat an increasing number of unwanted arterial, venous, and surgically created vascular connections. In general, the occlusion techniques are simple, the results are good, and the complication rates are low. The current indications, devices, materials, methods, applications, and results of pediatric cardiovascular embolization therapy are described.

Blood Vessels↗
PubMedDate not supplied

Pulmonary hypertension and trisomy 16.

An infant girl, born small for gestational age, with abnormal single creases on the fifth digits, subsequent severe developmental delay, hypertelorism, bilateral equinovalgus deformities, grade IV genitourinary reflux and mild right hydronephrosis, was found to have an inverted duplication of the short arm of chromosome 16 [46,XX; inv dup (16) (p 13.3-->p 11.2]. The cardiac anomalies included a large perimembranous ventricular septal defect (VSD) and a moderate-sized atrial septal defect (ASD). Cardiac catheterization at 6 months of age revealed systemic level pulmonary artery pressure, bilateral pulmonary venous desaturation, and in room air a pulmonary/systemic blood flow ratio (Qp/Qs) of 0.8:1.0, which did not change significantly with administration of oxygen and nitric oxide. To our knowledge, this is the first description of early nonreactive pulmonary vascular disease in a patient with duplication 16p and a large VSD.

Chromosome Aberrations↗
PubMedDate not supplied

A model of heat production and transport in a water calorimeter.

The heat diffusion equation for a water calorimeter under isothermal and adiabatic boundary conditions has been solved analytically for a general source function. Based upon this model an interactive computer program has been developed and employed to predict the temporal variation of the temperature distribution in a water calorimeter irradiated with 250 kV, 4-, 6-, and 25-MV x rays and 7-, 13-, and 32-MeV electrons. The model requires central-axis depth dose curves as inputs and allows for any number of alternate heating and cooling periods. It is found that the shape of the cooling curve following an irradiation period depends upon the location of the point of measurement, the choice of boundary conditions, and the thermal history of the calorimeter.

Calorimetry↗
PubMedDate not supplied

Retention of neonatal resuscitation skills and knowledge: a randomized controlled trial.

BACKGROUND AND OBJECTIVES: This study compared the effectiveness of two booster strategies designed to improve retention of skills and knowledge in neonatal resuscitation by family practice residents. METHODS: Residents were randomly allocated to one of three groups: video, hands on, or control. Residents in the two experimental groups received a "booster" 3-5 months after the Neonatal Resuscitation Program (NRP) course. All participants completed the follow-up test 6-8 months after taking the course. The main outcome measures consisted of the NRP written examination and the performance checklists. RESULTS: A total of 44 residents completed the study (video, n = 13; hands-on, n = 14; control, n = 17). Overall, participants had significantly lower scores at follow-up than at baseline, indicating deterioration in both neonatal skills and knowledge. Residents in the hands-on booster group made significantly fewer errors across all five checklists in life-supporting but not in lifesaving scores than those allocated to the control and video groups. CONCLUSIONS: The beneficial effect of mannequin practice or video boosters on skills and knowledge retention was less than what had been anticipated, and no benefit could be demonstrated in comparison to the control group. Deteriorating knowledge and skills remain a major concern, since boostering by hands-on or video at 3-5 months do not seem to have an impact on the retention of knowledge or lifesaving skills.

Adult↗