Katrina Hughes | Baylor College of Medicine (original) (raw)

Papers by Katrina Hughes

Research paper thumbnail of Epidemiology of Methicillin-Resistant <i>Staphylococcus aureus</i> in a University Medical Center Day Care Facility

Infection Control and Hospital Epidemiology, Oct 1, 2009

Objective.Few data are available on methicillin-resistant Staphylococcus aureus (MRSA) colonizati... more Objective.Few data are available on methicillin-resistant Staphylococcus aureus (MRSA) colonization in day care. We performed a study in a medical university child care center to study the epidemiology of MRSA in this population.Design.Survey.Setting.A child care center on the campus of a university medical center.Methods.One hundred four children who attended the child care center and 32 employees gave samples that were cultured for MRSA. Seventeen household members of the children and employee found to be colonized with MRSA also gave samples that were cultured. Parents and employees completed questionnaires about demographic characteristics, medical conditions and treatments, and possible exposure risks outside the child care center. In addition, 195 environmental samples were taken from sites at the childcare center. Isolates were analyzed for relatedness by use of molecular typing, and statistical analysis was performed.Results.The prevalence of MRSA in the children was 6.7%. One employee (3.1%) was colonized with MRSA. Cultures of samples given by 6 of 17 (35.3%) family members of these children and the employee yielded MRSA. MRSA was recovered from 4 of 195 environmental samples. Molecular typing revealed that many of the MRSA isolates were indistinguishable, and 18 of the 21 isolates were community-associated MRSA. Multivariable analysis revealed that receipt of macrolide antibiotics (P = .002; odds ratio, 39.6 [95% confidence interval, 3.4—651.4]) and receipt of asthma medications (P = .024; odds ratio, 26.9 [95% confidence interval, 1.5-500.7]) were related to MRSA colonization.Conclusions.There was a low prevalence of MRSA colonization in children and employees in the child care center but a higher prevalence of colonization in their families. Molecular typing showed that transmission of MRSA likely occurred in the child care center. The use of macrolide antibiotics and asthma medications may increase the risk of MRSA colonization in this population.

Research paper thumbnail of The significance of hindbrain herniation reversal following prenatal repair of neural tube defects

Journal of Neurosurgery: Pediatrics

OBJECTIVE The aim of this study was to determine whether reversal of hindbrain herniation (HBH) o... more OBJECTIVE The aim of this study was to determine whether reversal of hindbrain herniation (HBH) on MRI following prenatal repair of neural tube defects (NTDs) is associated with reduced rates of ventriculoperitoneal (VP) shunt placement or endoscopic third ventriculostomy (ETV) within the 1st year of life. METHODS This is a secondary analysis of prospectively collected data from all patients who had prenatal open repair of a fetal NTD at a single tertiary care center between 2012 and 2020. Patients were offered surgery according to inclusion criteria from the Management of Myelomeningocele Study (MOMS). Patients were excluded if they were lost to follow-up, did not undergo postnatal MRI, or underwent postnatal MRI without a report assessing hindbrain status. Patients with HBH reversal were compared with those without HBH reversal. The primary outcome assessed was surgical CSF diversion (i.e., VP shunt or ETV) within the first 12 months of life. Secondary outcomes included CSF leakag...

Research paper thumbnail of The significance of hindbrain herniation reversal following prenatal surgery for fetal neural tube defects

American Journal of Obstetrics and Gynecology, 2022

Background: There is an idea that the level of medical college graduates is less than the expecte... more Background: There is an idea that the level of medical college graduates is less than the expected. The improvement of medical training level for the undergraduates in medical schools need a re-evaluation and improvement for creation of new training programs including a better surgical training.

Research paper thumbnail of Postnatal Intracranial Findings Following Fetal Repair of Spinal Dysraphisms

Journal of Computer Assisted Tomography, 2020

Objective: Our objective is to document the imaging appearance in the intracranial compartment at... more Objective: Our objective is to document the imaging appearance in the intracranial compartment at the time of the infants' first postnatal brain MR imaging after fetal repair for spinal dysraphisms. Methods: Twenty-nine patients were evaluated on fetal and postnatal magnetic resonance imaging for a series of features of Chiari II malformation. Results: Of the 29 infants, 55% had resolution of tonsillar ectopia, and 62% showed a dorsal outpouching of the near the foramen magnum on postnatal magnetic resonance imaging. The majority had persistence of Chiari II features including: prominent massa intermedia (93%), tectal beaking (93%), towering cerebellum (55%), flattening of the fourth ventricle (90%), hypoplastic tentorium (97%), and tonsillar hypoplasia (59%). Conclusions: Normally positioned or minimally descended, oftentimes hypoplastic tonsils in the presence of a posterior fossa configuration typical of Chiari II, was the most common presentation. An additional documented feature was an outpouching of the dorsal thecal sac between the opisthion and the posterior arch of C1.

Research paper thumbnail of Epidemiology of methicillin-resistant Staphylococcus aureus in a university medical center day care facility

Infection Control and Hospital Epidemiology the Official Journal of the Society of Hospital Epidemiologists of America, Oct 1, 2009

Research paper thumbnail of Prenatal and Postnatal Imaging Findings After Fetal Repair of Spinal Dysraphisms Using Cryopreserved Human Umbilical Cord Patch: A Case Series of 4 Patients

Journal of Computer Assisted Tomography

We describe a case series of imaging findings of 4 patients who underwent spinal dysraphisms repa... more We describe a case series of imaging findings of 4 patients who underwent spinal dysraphisms repair in utero with novel patch material, cryopreserved human umbilical cord, in our institution. In our study, the prenatal and postnatal magnetic resonance imaging and ultrasound are reviewed and showed cord tethering and syrinx progression in all cases. Our report is the first description of magnetic resonance imaging and ultrasound findings in the context of using this novel patch in severe cases of spinal dysraphisms.

Research paper thumbnail of Epidemiology of Methicillin-Resistant <i>Staphylococcus aureus</i> in a University Medical Center Day Care Facility

Infection Control and Hospital Epidemiology, Oct 1, 2009

Objective.Few data are available on methicillin-resistant Staphylococcus aureus (MRSA) colonizati... more Objective.Few data are available on methicillin-resistant Staphylococcus aureus (MRSA) colonization in day care. We performed a study in a medical university child care center to study the epidemiology of MRSA in this population.Design.Survey.Setting.A child care center on the campus of a university medical center.Methods.One hundred four children who attended the child care center and 32 employees gave samples that were cultured for MRSA. Seventeen household members of the children and employee found to be colonized with MRSA also gave samples that were cultured. Parents and employees completed questionnaires about demographic characteristics, medical conditions and treatments, and possible exposure risks outside the child care center. In addition, 195 environmental samples were taken from sites at the childcare center. Isolates were analyzed for relatedness by use of molecular typing, and statistical analysis was performed.Results.The prevalence of MRSA in the children was 6.7%. One employee (3.1%) was colonized with MRSA. Cultures of samples given by 6 of 17 (35.3%) family members of these children and the employee yielded MRSA. MRSA was recovered from 4 of 195 environmental samples. Molecular typing revealed that many of the MRSA isolates were indistinguishable, and 18 of the 21 isolates were community-associated MRSA. Multivariable analysis revealed that receipt of macrolide antibiotics (P = .002; odds ratio, 39.6 [95% confidence interval, 3.4—651.4]) and receipt of asthma medications (P = .024; odds ratio, 26.9 [95% confidence interval, 1.5-500.7]) were related to MRSA colonization.Conclusions.There was a low prevalence of MRSA colonization in children and employees in the child care center but a higher prevalence of colonization in their families. Molecular typing showed that transmission of MRSA likely occurred in the child care center. The use of macrolide antibiotics and asthma medications may increase the risk of MRSA colonization in this population.

Research paper thumbnail of The significance of hindbrain herniation reversal following prenatal repair of neural tube defects

Journal of Neurosurgery: Pediatrics

OBJECTIVE The aim of this study was to determine whether reversal of hindbrain herniation (HBH) o... more OBJECTIVE The aim of this study was to determine whether reversal of hindbrain herniation (HBH) on MRI following prenatal repair of neural tube defects (NTDs) is associated with reduced rates of ventriculoperitoneal (VP) shunt placement or endoscopic third ventriculostomy (ETV) within the 1st year of life. METHODS This is a secondary analysis of prospectively collected data from all patients who had prenatal open repair of a fetal NTD at a single tertiary care center between 2012 and 2020. Patients were offered surgery according to inclusion criteria from the Management of Myelomeningocele Study (MOMS). Patients were excluded if they were lost to follow-up, did not undergo postnatal MRI, or underwent postnatal MRI without a report assessing hindbrain status. Patients with HBH reversal were compared with those without HBH reversal. The primary outcome assessed was surgical CSF diversion (i.e., VP shunt or ETV) within the first 12 months of life. Secondary outcomes included CSF leakag...

Research paper thumbnail of The significance of hindbrain herniation reversal following prenatal surgery for fetal neural tube defects

American Journal of Obstetrics and Gynecology, 2022

Background: There is an idea that the level of medical college graduates is less than the expecte... more Background: There is an idea that the level of medical college graduates is less than the expected. The improvement of medical training level for the undergraduates in medical schools need a re-evaluation and improvement for creation of new training programs including a better surgical training.

Research paper thumbnail of Postnatal Intracranial Findings Following Fetal Repair of Spinal Dysraphisms

Journal of Computer Assisted Tomography, 2020

Objective: Our objective is to document the imaging appearance in the intracranial compartment at... more Objective: Our objective is to document the imaging appearance in the intracranial compartment at the time of the infants' first postnatal brain MR imaging after fetal repair for spinal dysraphisms. Methods: Twenty-nine patients were evaluated on fetal and postnatal magnetic resonance imaging for a series of features of Chiari II malformation. Results: Of the 29 infants, 55% had resolution of tonsillar ectopia, and 62% showed a dorsal outpouching of the near the foramen magnum on postnatal magnetic resonance imaging. The majority had persistence of Chiari II features including: prominent massa intermedia (93%), tectal beaking (93%), towering cerebellum (55%), flattening of the fourth ventricle (90%), hypoplastic tentorium (97%), and tonsillar hypoplasia (59%). Conclusions: Normally positioned or minimally descended, oftentimes hypoplastic tonsils in the presence of a posterior fossa configuration typical of Chiari II, was the most common presentation. An additional documented feature was an outpouching of the dorsal thecal sac between the opisthion and the posterior arch of C1.

Research paper thumbnail of Epidemiology of methicillin-resistant Staphylococcus aureus in a university medical center day care facility

Infection Control and Hospital Epidemiology the Official Journal of the Society of Hospital Epidemiologists of America, Oct 1, 2009

Research paper thumbnail of Prenatal and Postnatal Imaging Findings After Fetal Repair of Spinal Dysraphisms Using Cryopreserved Human Umbilical Cord Patch: A Case Series of 4 Patients

Journal of Computer Assisted Tomography

We describe a case series of imaging findings of 4 patients who underwent spinal dysraphisms repa... more We describe a case series of imaging findings of 4 patients who underwent spinal dysraphisms repair in utero with novel patch material, cryopreserved human umbilical cord, in our institution. In our study, the prenatal and postnatal magnetic resonance imaging and ultrasound are reviewed and showed cord tethering and syrinx progression in all cases. Our report is the first description of magnetic resonance imaging and ultrasound findings in the context of using this novel patch in severe cases of spinal dysraphisms.