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Latest & greatest articles for infants
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by the sensitivity analysis were not adequately justified. Bibliographic details Berwick D M, Cretin S, Keeler E. Cholesterol, children, and heart disease: an analysis of alternatives. Pediatrics 1981; 68(5): 721-730 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Adult; Child; Child, Preschool; Cholesterol /blood; Cholesterol, Dietary /adverse effects; Cost-Benefit Analysis; Heart Diseases /etiology /prevention & Humans; Male; Mass Screening /economics; Surveys and Questionnaires; control (...) Cholesterol, children, and heart disease: an analysis of alternatives Cholesterol, children, and heart disease: an analysis of alternatives Cholesterol, children, and heart disease: an analysis of alternatives Berwick D M, Cretin S, Keeler E Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment
The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction. We studied the effects of a supportive lay woman ("doula") on the length of labor and on mother-infant interaction after delivery in healthy Guatemalan primigravid women. Initial assignment of mothers to the experimental (doula) or control group was random, but controls showed a higher rate (P less than 0.001) of subsequent perinatal problems (e.g. cesarean section and meconium staining
Controlled trial of an electrostatic precipitator in childhood asthma. A cross-over trial was conducted on 10 children with moderate to severe asthma, who had positive skin tests to Dermatophagoides pteronyssinus and nocturnal wheeze. An electrostatic precipitator was used during the night to remove airborne particles from the bedroom. During use of the precipitator peak expiratory flow rates were no better than in a control period.
Partial supplementation with expressed breast-milk for prevention of infection in low-birth-weight infants. In a prospective controlled study the anti-infective properties of breast-milk were evaluated in 70 high-risk low-birth-weight infants. 32 babies (group I) were given fresh expressed breast-milk during the day and milk formula at night. 38 infants (group II) received only milk formula and served as controls. The two groups were matched for other factors that could influence the occurrence
Response to pneumococcal polysaccharide vaccine in patients with untreated Hodgkin's disease. Children's Cancer Study Group Report. Patients with Hodgkin's disease (HD) have a high risk of overwhelming pneumococcal infections after splenectomy. Previous studies have shown that HD patients given polyvalent pneumococcal polysaccharide (PPS) vaccine after immunosuppressive therapy have a suboptimum antibody response. This study shows significant antibody response in HD patients to PPS vaccine
Single-dose penicillin prophylaxis against neonatal group B streptococcal infections. A controlled trial in 18,738 newborn infants. Neonatal Group B streptococcal infections may not respond to antimicrobial therapy and have been associated with case fatality rates of 50 per cent or greater. We evaluated the effect on colonization and disease rates of a single intramuscular dose of aqueous penicillin G given at birth in a prospectively controlled study of 18,738 neonates during a 25-month period (...) . The colonization rate in the mothers was 26.6 per cent, with 50 per cent concordance in the untreated infants and 12.2 per cent in the penicillin-treated infants (P < 0.001). There was a significant decrease in the incidence of disease caused by all penicillin-susceptible organisms in the penicillin group (0.64 vs. 2.26 cases per thousand live births, P = 0.005). Disease caused by penicillin-resistant pathogens was increased in the penicillin-treated group during the first year of the study but was unaffected
Effect of fluid administration on the development of symptomatic patent ductus arteriosus and congestive heart failure in premature infants. We studied 170 premature infants with birth weights between 751 and 2000 g in a randomized sequential trial comparing "high" and "low" volumes of fluid intake. Beginning on the third day of life, the low-volume group received only enough water to meet average estimated requirements, and the high-volume group received an excess of at least 20 ml per (...) kilogram of body weight per day (mean excess, 47 ml per kilogram per day). Sequential analysis showed that the risk of patent ductus arteriosus with congestive heart failure was greater in infants receiving the high-volume regimen. Thirty-five of 85 infants in the high-volume group acquired murmurs consistent with patent ductus arteriosus, and 11 of these 35 had congestive heart failure. Only nine of 85 infants in the low-volume group had murmurs consistent with patent ductus arteriosus, and two
Intraventricular gentamicin therapy in gram-negative bacillary meningitis of infancy. Report of the Second Neonatal Meningitis Cooperative Study Group. In a multicentre controlled trial in the U.S.A. and Latin America 52 infants with meningitis and ventriculitis were randomly assigned to receive either systemic ampicillin and gentamicin or intraventricular gentamicin plus systemic antimicrobial agents. The aetiological agents most often encountered were Escherichia coli in the U.S. infants (...) and Salmonella spp. in Latin American infants. Infants receiving systemic antibiotics plus intraventricular gentamicin had a significantly higher mortality rate (42.9%) than those who received systemic therapy only (12.5%). Duration of positive CSF cultures and morbidity rates were not significantly different in the two treatment groups. The concentrations of gentamicin in ventricular and lumbar CSF 1--6 h after an intraventricular dose of 2.5 mg gentamicin were 10--130 microgram/ml and 8--85 microgram/ml
Reduction by aspirin of intestinal fluid-loss in acute childhood gastroenteritis. Soluble aspirin was given by mouth in therapeutic doses in a double-blind trial to malnourished infants and young children with gastroenteritis and dehydration. Faecal fluid-losses were reduced and weight-grain was enhanced in the group given aspirin. These effects were statistically significant when compared with those obtained with a placebo preparation and in a group of patients given supportive therapy (...) but no specific drug treatment. The results suggest that aspirin may be useful in reducing intestinal fluid-loss in childhood gastroenteritis. Before the widespread use of aspirin can be recommended, its effects in patients not under hospital supervision must be determined.
Persistence of middle-ear effusion after acute otitis media in children. We observed the frequent occurrence of persistent middle-ear effusion in children with acute otitis media and followed them according to standard procedures for otologic diagnosis. We performed a life-table analysis to identify risk factors for such persistent disease. Sixty-two patients were free of middle-ear effusion at one or more clinic visits two to 13 weeks after presentation and were considered cured; 45 had (...) effusion at all clinic visits during this period and were defined as having persistent effusion. The life-table analysis showed that the relative risk for persistence was 3.8 times higher in children less than 24 months of age as compared with children 24 months of age or older (P less than 0.001) and that this risk was 2.8 times greater for white as compared with black children (P less than 0.01). Other factors examined were not identified as significant risk factors. Persistent middle-ear effusion
Gradual reintroduction of full-strength milk after acute gastroenteritis in children. 46 children (26 boys and 20 girls) admitted with mild acute gastroenteritis were randomly allocated to a regimen of continuing on full-strength milk, or to one of taking clear fluids until the diarrhoea settled before full-strength milk was reintroduced either immediately, or gradually in quarter-strength steps. There was no difference in length of hospital stay between the three groups.
Comparison of sucrose with glucose in oral therapy of infant diarrhoea. In a randomised double-blind trial, 51 5--10% dehydrated infants were rehydrated with oral electrolyte solutions containing sucrose or glucose. Most infants in both groups were successfully rehydrated, but the sucrose solution produced a slower correction of electrolyte abnormalities and a higher percentage of patients who needed more than 24 h of therapy. Where there is adequate knowledge of the oral therapy method sucrose
Abnormal CT scans of the brain in asymptomatic children with acute lymphocytic leukemia after prophylactic treatment of the central nervous system with radiation and intrathecal chemotherapy. Thirty-two asymptomatic patients with acute lymphocytic leukemia, who had received prophylactic cranial radiation (2400 rads) and either intrathecal methotrexate or cytosine arabinoside were studied by computed tomography of the brain 19 to 67 months after initiation of prophylaxis. Seventeen of 32 (53 per
Controlled study of hypertransfusion during remission induction in childhood acute lymphocytic leukaemia. In a prospective, controlled trial 26 anaemic, neutropenic children with newly diagnosed acute lymphocytic leukaemia were randomised in pairs to receive either transfusion to a haemoglobin of 10--12 g/dl where clinically indicated (group A) or hypertransfusion to a haemoglobin of 16--18 g/dl (group B). Compared with group A (11 of 13 transfused), group B (all transfused) had a significantly (...) more rapid rise in neutrophils at 7 and 10 days post-transfusion, a lower incidence of infection, and less interruption to chemotherapy. Hypertransfusion restored the myeloid/erythroid ratio to normal in bone-marrow of 5 of 6 children and the proportion of early myeloid precursors was greater than in controls.
Controlled trial of hyposensitisation to Dermatophagoides pteronyssinus in children with asthma. Hyposensitisation with Dermatophagoides pteronyssinus tyrosine absorbate in asthmatic children with bronchial sensitivity to D. pteronyssinus was effective in a 12-month double-blind controlled clinical trial. Compared with controls, treated children used a smaller quantity of drugs while maintaining clinical and lung function improvements. In most children who improved there was no change
Low positioning of umbilical-artery catheters increases associated complications in newborn infants. We performed a randomized prospective study of the effect of placement position of umbilical-artery catheters on complication rates in high-risk newborn infants. A higher complication rate (31 of 40 vs. 13 of 33) (P less than 0.005) occurred in the group with the catheter tip at the third to fourth lumbar segment, as compared to those with the tip at the seventh to eighth thoracic segment, owing
Weight-gain inhibition by lactose in Australian Aboriginal children. A controlled trial of normal and lactose hydrolysed milk. Weight-gain in 35 slightly undernourished Australian Aboriginal infants was studied in hospital (49 admissions) during a blind controlled trial of a pre-hydrolysed low-lactose milk preparation and reconstituted full-cream milk powder. Infants fed the lactose hydrolysed milk gained 70% more weight than those receiving normal milk. Better weight-gains were achieved (...) in those on the lactose hydrolysed milk irrespective of percentage standard weight for age, the presence of diarrhoea on admission to the trial, and stool sugar concentrations. The use of low-lactose milk should be considered in nutritional aid programmes for undernourished children throughout the world.
A pharmacologic evaluation of penicillin in children with purulent meningitis. We undertook a prospective study of the pharmacokinetics of penicillin G (administered intravenously every four hours for a total of b50,000 U per kilogram per day) in the cerebrospinal fluid of children with purulent meningitis. Both the absolute mean cerebrospinal-fluid penicillin concentration (0.8, 0.7 and 0.3 microgram per milliliter) and the percentage of the simultaneous serum penicillin concentration (...) and meningococcal meningitis in children; an increased dosage may be necessary when the minimal inhibitory concentration of penicillin to the etiologic agent is unusually high.
Evidence of stem-cell competition in children with malignant disease. A controlled study of hypertransfusion. In a prospective, randomized controlled study, 30 children who were receiving chemotherapy for malignant disease and who were anaemic and neutropenic, were randomized: 18 to receive transfusion to a Hb of 10-12 g/dl (group A) and 12 to receive moderate hypertransfusion to a Hb of 14-16 g/dl (group B). Children in group B had a significantly more rapid rise in polymorph count, lower
Streptococcal pharyngitis in children. A comparison of four treatment schedules with intramuscular penicillin G benzathine. Four hundred children with streptococcal pharyngitis were treated randomly with single injections in groups of 100 each (1) with 600,000 units of penicillin G benzathine, (2) 1.2 million units of penicillin G benzathine, (3) 600,000 units of penicillin G benzathine and 600,000 units of penicillin G procaine, or (4) 900,000 units of penicillin G benzathine and 300,000 units (...) therapy for streptococcal pharyngitis in the pediatric age group.