Papers by Andrea Hernandez
Journal of Bodywork and Movement Therapies
Eighty-four prenatally depressed women were randomly assigned to yoga, massage therapy or standar... more Eighty-four prenatally depressed women were randomly assigned to yoga, massage therapy or standard prenatal care control groups to determine the relative effects of yoga and massage therapy on prenatal depression and neonatal outcomes. Following 12 weeks of twice weekly yoga or massage therapy sessions (20 min each) both therapy groups versus the control group had a greater decrease on depression, anxiety and back and leg pain scales and a greater increase on a relationship scale. In addition, the yoga and massage therapy groups did not differ on neonatal outcomes including gestational age and birthweight, and those groups, in turn, had greater gestational age and birthweight than the control group. ª
Pediatric Radiology, 2010
Background The sensitivity and specificity of evaluating clubfoot deformity by MR in high-risk fe... more Background The sensitivity and specificity of evaluating clubfoot deformity by MR in high-risk fetuses is currently unknown. Objective To correlate fetal MRI with US in the assessment of clubfoot and to identify the MRI features most characteristic of clubfoot. Materials and methods With IRB approval and informed consent, the presence of fetal clubfoot was prospectively evaluated in mothers referred for MRI for a fetus with myelomeningocele. Two radiologists blind to the US results independently reviewed the MRI for the presence of clubfoot. MRI results were compared with US results obtained the same day and birth outcomes. Results Of 20 patients enrolled, there were 13 clubfeet. Interobserver agreement for the presence of clubfoot was 100%. The sensitivity of the MRI exam was 100% and the specificity 85.2%. A dedicated sagittal imaging plane through the ankle region allowed the most confident diagnosis; medial deviation of the foot relative to the leg was seen in all 13 fetuses with clubfoot. Conclusion The correlation of fetal MRI with US in the evaluation of clubfoot yields a sensitivity of 100% and specificity of 85.2%. The sagittal plane provided the most useful information.
Pediatric Radiology, 2009
Background Pulmonary embolism (PE) is an underdiagnosed entity in the pediatric population in par... more Background Pulmonary embolism (PE) is an underdiagnosed entity in the pediatric population in part because of the low level of suspicion and awareness in the clinical world. Objective To examine its relative prevalence, associated risk factors and imaging features in our pediatric population. Materials and methods A total of 92 patients age 21 years and younger with a high clinical suspicion of PE and who had available radiographic studies were identified from January 2003 to September 2006. Patients with a positive CT scan or a high probability ventilation/perfusion scan formed the case group; patients with a high clinical suspicion of PE and no radiographic evidence of PE or deep venous thrombosis (DVT), randomly matched in age and sex, became the matched control group. We reviewed the charts of both groups and analyzed the imaging studies. Results In our hospital, the prevalence of PE in patients with a strong suspicion of PE was 14%. The overall prevalence of thromboembolic disease (PE and/or DVT) was 25%. Recent surgery or orthopedic procedure, blood dyscrasias and contraceptive use were more common in patients with PE. No child died of PE in our study. The youngest child with PE in our study was 13 years. Girls were twice as likely to develop PE as boys. Conclusion PE is a relatively common diagnosis in our tertiary care pediatric population when the clinical suspicion is high. We suggest increased awareness and index of suspicion in order to initiate prompt diagnostic imaging and treatment.
Pediatric Radiology, 2007
Diffusion-weighted imaging (DWI) is a powerful tool that has recently been applied to evaluate se... more Diffusion-weighted imaging (DWI) is a powerful tool that has recently been applied to evaluate several pediatric musculoskeletal disorders. DWI probes abnormalities of tissue structure by detecting microscopic changes in water mobility that develop when disease alters the organization of normal tissue. DWI provides tissue characterization at a cellular level beyond what is available with other imaging techniques, and can sometimes identify pathology before gross anatomic alterations manifest. These features of early detection and tissue characterization make DWI particularly appealing for probing diseases that affect the musculoskeletal system. This article focuses on the current and future applications of DWI in the musculoskeletal system, with particular attention paid to pediatric disorders. Although most of the applications are experimental, we have emphasized the current state of knowledge and the main research questions that need to be investigated.
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Papers by Andrea Hernandez