Quantitatively comparing weekly changes in retinal vascular characteristics of eyes eventually treated versus not treated for retinopathy of prematurity.

Purpose: To quantitatively compare retinal vascular characteristics over time in eyes eventually treated versus not treated for retinopathy of prematurity (ROP), using ROPtool analysis of narrow-field retinal images.

Methods: This longitudinal study used prospectively collected narrow-field retinal images of infants screened for ROP, prior to treatment, if needed. Images were analyzed using a methodology that combines quadrant-level measures from several images of the same eye.

NICU Fathers: Improving the Quality of Paternal Support in the NICU.

Background: Parental support in the neonatal intensive care unit (NICU) is critical; yet, the nursing staff may struggle to provide optimal support to NICU fathers. Generally, fathers are not viewed as equally competent caregivers when compared with mothers, and fathers often impart these beliefs on themselves. Increasing the nursing staff's knowledge and understanding of paternal support can change attitudes and foster positive behavior changes, enhancing the perception of support received by NICU fathers.

ROPtool analysis of plus and pre-plus disease in narrow-field images: a multi-image quadrant-level approach.

Background: The presence of plus disease is important in determining when to treat retinopathy of prematurity (ROP), but the diagnosis of plus disease is subjective. Semiautomated computer programs (eg, ROPtool) can objectively measure retinal vascular characteristics in retinal images, but are limited by image quality. The purpose of this study was to evaluate whether ROPtool can accurately identify pre-plus and plus disease in narrow-field images of varying qualities using a new methodology that combines quadrant-level data from multiple images of a single retina.

Patient preferences for treatment of metastatic melanoma.

Aim: To investigate patient preferences for clinical attributes of first-line metastatic melanoma treatments.

Materials & Methods: A discrete-choice experiment and best-worst scaling exercise were used to assess relative preferences for treatment attributes.

Results: The 200 survey respondents had distinct preferences.

Evaluating a Portable, Noncontact Fundus Camera for Retinopathy of Prematurity Screening by Nonophthalmologist Health Care Workers.

Purpose: To evaluate (1) the feasibility of non-ophthalmologist healthcare workers (HCWs) to obtain images of sufficient quality for retinopathy of prematurity (ROP) screening using a FDA-approved portable, non-contact, narrow-field fundus camera (i.e., Pictor™), and (2) the accuracy of grading these images to identify infants who developed treatment-warranted (type 1) ROP.

The Role of Circadian Rhythms in Postpartum Sleep and Mood.

Women often experience sleep disturbances and worsening sleep quality throughout pregnancy and postpartum. Circadian rhythms are closely linked to sleep problems and mood disorders. This systematic review provides a summary of studies of circadian rhythms and associated sleep problems and maternal distress, among postpartum women.

Non-contact retinal imaging compared to indirect ophthalmoscopy for retinopathy of prematurity screening: infant safety profile.

Objective: Most retinopathy of prematurity screening involves an ophthalmologist performing indirect ophthalmoscopy, which can be stressful to infants. The purpose of this study is to evaluate the safety profile (using cardiopulmonary events as an indicator) of imaging infants with a non-contact retinal camera compared to examining them using indirect ophthalmoscopy.

Study Design: Prospective cohort study of 99 infants at a community hospital who were examined using indirect ophthalmoscopy and imaged using a non-contact retinal camera for retinopathy of prematurity.

Identification of two novel mutations in families with X-linked ocular albinism.

Purpose: Our goal was to evaluate the OA1 gene, also known as G-protein coupled receptor 143 (GPR143), in two United States families, one from the mid-west and one from the mid-south, who had clinical features of X-linked ocular albinism. Both families had previously tested negative for mutations.

Methods: Selected family members underwent a detailed ophthalmologic evaluation.

Fundus albipunctatus in a 6-year old girl due to compound heterozygous mutations in the RDH5 gene.

We report a case study of Fundus Albipunctatus (FA) due to compound heterozygous mutations in RDH5, the gene encoding for the 11-cis-retinal dehydrogenase (RDH). A 6-year old Hispanic American female with a clinical presentation suggestive of FA underwent dark-adapted full-field flash electroretinography (ERG) at 30 and 120 min. The pattern of ERG abnormalities was consistent with the working diagnosis FA.

Macular pigment optical density in the elderly: findings in a large biracial Midsouth population sample.

Purpose: To report the macular pigment optical density (MPOD) findings at 0.5 degrees of eccentricity from the fovea in elderly subjects participating in ARMA, a study of aging and age-related maculopathy (ARM) ancillary to the Health, Aging, and Body Composition (Health ABC) Study.

Methods: MPOD was estimated with a heterochromatic flicker photometry (HFP) method in a large biracial population sample of normal 79.

Estimation of macular pigment optical density in the elderly: test-retest variability and effect of optical blur in pseudophakic subjects.

The reproducibility of macular pigment optical density (MPOD) estimates in the elderly was assessed in 40 subjects (age: 79.1+/-3.5).

Retinitis pigmentosa associated with rhodopsin mutations: Correlation between phenotypic variability and molecular effects.

Similar retinitis pigmentosa (RP) phenotypes can result from mutations affecting different rhodopsin regions, and distinct amino acid substitutions can cause different RP severity and progression rates. Specifically, both the R135L and R135W mutations (cytoplasmic end of H3) result in diffuse, severe disease (class A), but R135W causes more severe and more rapidly progressive RP than R135L. The P180A and G188R mutations (second intradiscal loop) exhibit a mild phenotype with regional variability (class B1) and diffuse disease of moderate severity (class B2), respectively.

Facial submandibular cellulitis associated with late-onset group B streptococcal infection.

A complete history and systematic physical examination are important first steps in assessing any infant. In some instances these steps may provide immediate clues to a potentially life-threatening illness. This article presents the case of a former 26-week male infant, who presented on day of life 42, 32 weeks gestation corrected, with increased respiratory distress and an evolving lesion on the left lower cheek.

Reading with Abby: a case study of individual tutoring with a young adult with Down syndrome.

This case study examined the impact of a series of tutoring sessions on the literacy development of a young woman with Down syndrome. The sessions were conducted within the LATCH-ON (Literacy and Technology-Hands On) program at the Schonell Special Education Centre at the University of Queensland and made use of technology resources in addition to other methods of instruction. The first author assumed the role of participant observer through the reported sessions and acted as an individual tutor to the young woman.

Accuracy of interpretation of full-length pediatric echocardiograms transmitted over an integrated services digital network telemedicine link.

Background: Transmission of echocardiograms via telemedicine links has allowed remote hospitals direct access to pediatric cardiology subspecialty care. This study assessed the accuracy of echocardiogram interpretation across an integrated services digital network (ISDN) telemedicine link.

Methods: Telemedicine systems were installed between Cape Fear Valley Medical Center neonatal intensive care unit and University of North Carolina Hospitals.

Early dexamethasone-attempting to prevent chronic lung disease.

Background: We previously demonstrated improved survival and early outcomes in a pilot trial of 2 doses of intravenous dexamethasone for infants with surfactant-treated respiratory distress syndrome. (1) A multicenter, randomized, double-blind trial was undertaken to confirm these results.

Methods: Infants <30 weeks' gestation were eligible if they had respiratory distress syndrome, required mechanical ventilation at 12 to 18 hours of age, and had received at least 1 dose of exogenous surfactant.

The effect of a neonatal telecardiology system on respiratory therapy in very low birthweight infants.

Factors in the U.S. healthcare system have shifted the site of care of many newborns to hospitals where subspecialty services are unavailable.

Accuracy and reliability of weight change determinations in a model infant weighing less than 750 grams.

We designed a study to address the accuracy and reliability of the weighing process for tiny infants ( < 750 gm). A model was made with intravenous bags and stockinette and the following equipment was added: umbilical artery and venous catheters, endotracheal tube, pulse oximeter probe, electrodes, and orgastric tube. The models weight was changed in intervals of 2 to 43 gm and it was then weighed on two different types of scales.

Effects of dexamethasone and triiodothyronine on oligohydramnios-induced pulmonary hypoplasia.

We observed for differential effects of maternal treatment with dexamethasone, triiodothyronine (T3), or both in late gestation on the growth of fetal rat lungs during oligohydramnios-induced pulmonary hypoplasia (PH). Timed-pregnant mothers were randomly selected into four treatment groups: controls (no hormone treatment); dexamethasone only; T3 only; and both dexamethasone and T3. Each underwent amniocentesis of one uterine horn on day 15 of gestation.

Orogastric tube insertion length in very low birth weight infants.

We determined the minimal insertion lengths for appropriate placement of orogastric tubes in very low birth weight infants (< 1500 gm). Feeding tubes marked in centimeter increments were placed orogastrically by using standard neonatal intensive care unit protocol. When radiographs were taken, the centimeter marking at the lip was recorded, and an investigator blinded to the recorded measurement scored the orogastric tube position on radiograph as high (too short), low (too far), or adequate.

Comprehensive computerized neonatal intensive care unit data system including real-time, computer-generated daily progress notes.

A neonatal intensive care unit patient data system, NeoData, which was developed using microcomputers connected by a local area network, is described. The system allows for real-time generation of daily progress notes, as well as admission and discharge summaries. It includes two databases: one for daily patient data and one for admission/discharge summary data.

Effect of diet-induced sodium deficiency on normal and compensatory growth of the lung in young rats.

Sodium deficiency is associated with decreased muscle growth and protein synthesis. We investigated the influence of diet-induced sodium deficiency on the rate and extent of compensatory growth of the right lung after left pneumonectomy in young rats of 83 +/- 1 g body weight. Starting 1 wk before surgery, all rats were fed a diet deficient only in sodium (2-9 mumol Na+/g of food) ad libitum.

Gamma-carboxyglutamic acid excretion into rat amniotic fluid during late gestation.

The amino acid gamma-carboxyglutamate is the product of post-translational vitamin K-dependent carboxylation of peptide bound glutamic acid residues. Activity of the microsomal vitamin K-dependent carboxylase which catalyzes gamma-carboxyglutamate formation has been studied in numerous tissues, including liver and lung. Catabolism of gamma-carboxyglutamate containing proteins leads to gamma-carboxyglutamate excretion into the urine, thus quantitation of urinary gamma-carboxyglutamate can be used to assess vitamin K status, as well as the turnover of gamma-carboxyglutamate containing proteins.