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M C Sherwood

Publications and source records attributed to M C Sherwood.

9 recordsLinked to original sources
PubMed2001

Three-dimensional echocardiography of the atrial septum.

This article details the important contribution of three-dimensional echocardiography for catheterization device closure of secundum atrial septal defects. Aspects presented include three-dimensional echocardiographic application in preselection of patients and in selection of the type and size of the atrial septal occluder devices. Unique three-dimensional echocardiographic imaging planes are shown that depict the size and shape of the defect, the important rim tissue surrounding the defect, and the images that demonstrate successful device placement. Details of the acquisition phase, digital reformatting, and the eventual rendering of standard three-dimensional echocardiographic imaging planes of the atrial septum are shown. Three-dimensional echocardiography not only provides important additional information, but also enhances understanding of standard two-dimensional studies.

Cardiac Catheterization↗
PubMed1999

Prognostic significance of clinically silent coronary artery fistulas.

Symptomatic coronary artery fistulas (CAF) are associated with significant morbidity and mortality. With the advent of high-resolution 2-dimensional and color Doppler echocardiography, the detection rate of clinically silent CAF has increased, but their clinical significance and outcome have not been defined. The clinical, echocardiographic, electrocardiographic, and angiographic findings and documented follow-up of 31 patients with an echocardiographic finding of a clinically silent coronary artery fistula from 1986 to 1997 were analyzed. Mean age at diagnosis was 7.2+/-8.4 years. Indications for echocardiography were murmur (n = 23), congenital heart disease (n = 2), cardiomegaly (n = 2), chest pain (n = 1), stridor (n = 1), syncope (n = 1), and chest trauma (n = 1). CAF were detected with color Doppler flow mapping in all patients. The origin of the fistula was from the left coronary artery system (n = 27), right coronary artery system (n = 3), and bilateral (n = 1). The exit sites were the pulmonary artery (n = 18), right ventricle (n = 8), right atrium (n = 2), and left ventricle (n = 3). Global and regional left ventricular function were normal in all patients at presentation and follow-up. Spontaneous closure of the fistula was documented in 7 patients (23%) at mean follow-up of 2.6+/-2.0 years. In 23 patients the fistula persisted without intervention. All patients remained asymptomatic, without adverse clinical events or evidence of ischemia at a mean age at follow-up of 9.3+/-9.1 years (range 4 months to 42.0). Based on this experience, there is no evidence that clinically silent CAF diagnosed incidentally by color Doppler echocardiography are associated with adverse clinical outcome in childhood and adolescence. Conservative management with continued follow-up of these patients appears to be appropriate.

Adolescent↗
PubMed1998

Adenosine in the management of supraventricular tachycardia in children.

OBJECTIVE: To assess the efficacy and safety of adenosine in the management of supraventricular tachycardia in children. METHODOLOGY: A review of 43 children with supraventricular tachycardia who received intravenous adenosine between June 1992 and July 1995. RESULTS: Thirty-five patients had re-entrant supraventricular tachycardia and eight patients had atrial tachydysrhythmias. Reversion to sinus rhythm occurred in 75% of episodes in all patients treated for supraventricular tachycardia, and in 96% of episodes in patients with re-entrant supraventricular tachycardia. Early re-initiation of supraventricular tachycardia after reversion to sinus rhythm occurred in 25% of episodes. Sixteen percent of patients reverted with the recommended 0.05 mg/kg starting dose, and 35% reverted with a dose of 0.1 mg/kg. Four patients were given adenosine as a diagnostic procedure to elicit occult pre-excitation. The most common side effects were brief feelings of discomfort. No serious side effects occurred. CONCLUSION: Adenosine is safe and effective in the management of supraventricular tachycardia in children. A commencing dose of 0.1 mg/kg is appropriate.

Adenosine↗
PubMed1998

Randomised trial of three doses of inhaled nitric oxide in acute respiratory distress syndrome.

BACKGROUND: Inhaled nitric oxide (iNO) is a potential therapeutic agent for the management of acute respiratory distress syndrome (ARDS). Concerns remain, however, regarding the potential toxicity from iNO and/or its oxidative derivatives and methaemoglobinaemia. AIMS: To determine the risk of toxicity from iNO, which includes worsening of lung injury, a prospective study evaluating the acute effects of three concentrations of iNO on gas exchange and haemodynamics in 12 children with ARDS was performed in a tertiary paediatric intensive care unit. INTERVENTION: iNO was administered for one hour at three concentrations (1, 10, and 20 parts per million (ppm)) in a random order of possible dosing schedules to avoid dose accumulation bias. Arterial blood gas, methaemoglobin concentrations, and haemodynamic parameters were obtained at baseline before commencement of iNO, at the end of each study hour, and after iNO was discontinued. Nitric oxide and nitrogen dioxide concentrations were continuously monitored during the study. RESULTS: iNO significantly improved the oxygenation ratio (Pao2/Fio2) from a mean (SEM) baseline of 11.9 (1.7) kPa to 20 (3.9) kPa, 24 (4.5) kPa, and 21.6 (3.9) kPa at 1, 10, and 20 ppm iNO, respectively. There was no significant difference in the improvement in oxygenation achieved between the three concentrations. Correspondingly, there was a significant improvement in oxygenation index (pre-iNO 28.3 (5) v post-iNO 18 (3) (1 ppm), 15 (3) (10 ppm), 16 (3) (20 ppm)). No toxicity from methaemoglobinaemia or nitrogen dioxide was seen during iNO administration. CONCLUSION: The results show that a low concentration of iNO (1 ppm) is as effective as higher concentrations (10 and 20 ppm) in improving oxygenation in children with ARDS and may be important in minimising toxicity during iNO use.

Blood Pressure↗
PubMed1987

Dominantly inherited glomerulonephritis and an unusual skin disease.

An unusual association of uncommon facies including telangiectasia in a butterfly distribution, a similar skin lesion on extensor areas, sparse hair, and membranoproliferative glomerulonephritis is described in a 4 year old boy and his father. The mode of inheritance of these features seems to be autosomal dominant.

Child, Preschool↗
PubMed1986

Diabetes insipidus and occult intracranial tumours.

We describe four patients with intracranial tumours who presented with diabetes insipidus and subsequently developed an evolving anterior pituitary endocrinopathy. The delay in imaging the tumours varied between 2.1 and 11.2 years (mean 5.4 years).

Brain Neoplasms↗
PubMedDate not supplied

Three-dimensional echocardiography in congenital heart disease: a continuum of unfulfilled promises? No. A presently clinically applicable technology with an important future? Yes.

Three-dimensional echocardiography has important clinical applications to congenital heart disease. Such applications include assessment of ventricular volumes, and unique imaging planes and projections of septae and atrio-ventricular and semi-lunar valves. Advances in ultrasound and computer technology will improve the process of three-dimensional echocardiography to continue to bring it to everyday clinical utility application.

Artificial Intelligence↗