The Use of Dexamethasone in Premature Infants at Risk for Bronchopulmonary Dysplasia or Who Already Have Developed Chronic Lung Disease: A Cautionary Note

PEDIATRICS ◽  
1991 ◽  
Vol 88 (2) ◽  
pp. 413-414
Author(s):  
LEE FRANK
Keyword(s):  
Risk Factors ◽  
Bronchopulmonary Dysplasia ◽  
Animal Studies ◽  
Very Low Birth Weight ◽  
Double Blind Study ◽  
Dexamethasone Treatment ◽  
Double Blind ◽  
High Incidence ◽  
Potential Risk Factors ◽  
Clinical Problems

To the Editor.— The distressingly high incidence of bronchopulmonary dysplasia (BPD) in today's very low birth weight premature infant population and the prolonged morbidity and tumultuous clinical problems associated with BPD in these tiny infants have led to a trial usage of dexamethasone treatment to try to assuage these problems in this patient population. The report of Kazzi et al1 is noteworthy because the authors not only indicate in clear fashion the failure of relatively prolonged dexamethasone treatment to ameliorate the hospital course of infants with BPD (in a randomized prospective double-blind study), but they also clearly identify potential risk factors associated with dexamethasone treatment that are of concern to them as clinical investigators, risk factors based both on clinical and experimental animal studies.

Neonatal Intracranial Hemorrhage and Phenobarbital

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 315-315
Author(s):  
KARL C. K. KUBAN ◽  
ELIZABETH BROWN ◽  
ALAN LEVITON ◽  
KALPATHY KRISHNAMOORTHY
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Flow Pattern ◽  
Intracranial Hemorrhage ◽  
Double Blind Study ◽  
Inclusion Criteria ◽  
Blood Flow Pattern ◽  
Double Blind ◽  
Ultrasound Testing

In Reply.— We appreciate the comments by Dr Battisti et al. As noted in the inclusion criteria for our study,1 all intubated babies with birth weights less than 1,751 g were eligible for the study. One of the advantages of a randomized double-blind study is that babies with other risk factors, including presence of a fluctuating cerebral blood flow pattern on Doppler ultrasound testing, should have equal chances of being in the treated and placebo groups.

Long-term Effect of Glimepiride and Rosiglitazone on Non-conventional Cardiovascular Risk Factors in Metformin-treated Patients Affected by Metabolic Syndrome: A Randomized, Double-blind Clinical Trial

2005 ◽  
Vol 33 (3) ◽  
pp. 284-294 ◽  
Author(s):  
G Derosa ◽  
AV Gaddi ◽  
L Ciccarelli ◽  
E Fogari ◽  
M Ghelfi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Plasma Glucose ◽  
Double Blind Study ◽  
Model Assessment ◽  
Rapid Improvement ◽  
Double Blind

We evaluated the effect of glimepiride plus metformin and rosiglitazone plus metformin on glucose, and on cardiovascular risk parameters such as lipoprotein(a) (Lp[a]) and homocysteine (HCT) in patients with type 2 diabetes and metabolic syndrome. Ninety-nine patients in the multicentre, randomized, double-blind study took metformin (1500 mg/day) plus glimepiride (2 mg/day) or rosiglitazone (4 mg/day) for 12 months. Changes in body mass index, glycosylated haemoglobin (HbA1c), Lp(a) and HCT were primary efficacy variables. Fasting plasma glucose (FPG), post-prandial plasma glucose (PPG) and homeostasis model assessment index were also used to assess efficacy. On average, HbA1c decreased by 9.1% and 8.1%, FPG decreased by 7.3% and 10.9%, and PPG decreased by 7.6% and 10.5%, respectively, in the glimepiride and rosiglitazone groups after 12 months. Patients receiving rosiglitazone experienced more rapid improvement in glycaemic control than those on glimepiride, and showed a significant improvement in insulin resistance-related parameters. There was a statistically significant decrease in basal homocysteinaemia in glimepiride-treated patients (−27.3%), but not in rosiglitazone-treated patients. Rosiglitazone plus metformin significantly improved long-term control of insulin resistance-related parameters compared with glimepiride plus metformin, although glimepiride treatment was associated with a slight improvement in cholesterolaemia, not observed in the rosiglitazone-treated patients, and with significant improvements in non-traditional risk factors for cardiovascular disease, such as basal homocysteinaemia and plasma Lp(a) levels.

scholarly journals Anemia in relation to severity of retinopathy of prematurity in preterm babies born in tertiary care centre in South India

2020 ◽  
Vol 7 (10) ◽  
pp. 2005
Author(s):  
Hrishikesh S. Pai ◽  
Rojo Joy ◽  
Varghese Cherian ◽  
Preethy Peter
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Tertiary Care ◽  
Oxygen Requirement ◽  
Tertiary Care Centre ◽  
Potential Risk Factors ◽  
Preterm Babies

Background: Retinopathy of prematurity (ROP) is a vaso proliferative disorder of retina among preterm infants. Significant cause of blindness in children with increased survival of premature infants with improved neonatal care. Potential risk factors for development of ROP include low gestational age, low birth weight, bronchopulmonary dysplasia, sepsis, acidosis, oxygen therapy. Anemia as a cause for retinopathy of prematurity has been postulated but there are very few studies addressed the effect of anemia on incidence and severity of ROP. The objective of this study was to determine the effect of anemia on incidence and severity of retinopathy of prematurity and to determine other factors associated with development of retinopathy of prematurity.Methods: Retrospective descriptive study of 120 babies born premature less than 34 weeks for the development of Retinopathy of prematurity and its severity and for associated conditions. All babies screened for retinopathy of prematurity at 3 weeks of age and further followed up for progression of ROP. Factors analysed included hemoglobin levels at 3 weeks of life, number of blood transfusions, days on ventilator, gestational age, birth weight, duration of oxygen requirement, bronchopulmonary dysplasia for the development of retinopathy of prematurity. Findings described in simple descriptive manner.Results: Anemia and increased requirement for blood transfusion are associated with higher incidence and severity of ROP. Low gestational age, birth weight, prolonged oxygen requirement, intraventricular hemorrhage (IVH), sepsis are other risk factors.Conclusions: It is significant to screen preterm babies for ROP and to anticipate in the background of these risk factors. Minimise oxygen duration and blood loss for sampling to prevent anemia and reduce transfusions.

scholarly journals Risk factors for gastroesophageal reflux disease in very low birth weight infants with bronchopulmonary dysplasia

2008 ◽  
Vol 84 (2) ◽  
pp. 154-159 ◽  
Author(s):  
Thaís B. Mendes ◽  
Maria Aparecida M.S. Mezzacappa ◽  
Adyléia A. D. C. Toro ◽  
José Dirceu Ribeiro
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gastroesophageal Reflux Disease ◽  
Low Birth Weight ◽  
Gastroesophageal Reflux ◽  
Bronchopulmonary Dysplasia ◽  
Reflux Disease ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants

scholarly journals Immunogenicity, Lot Consistency, and Extended Safety of rVSVΔG-ZEBOV-GP Vaccine: A Phase 3 Randomized, Double-Blind, Placebo-Controlled Study in Healthy Adults

2019 ◽  
Vol 220 (7) ◽  
pp. 1127-1135 ◽  
Author(s):  
Scott A Halperin ◽  
Rituparna Das ◽  
Matthew T Onorato ◽  
Kenneth Liu ◽  
Jason Martin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ebola Virus ◽  
Geometric Mean ◽  
Healthy Adults ◽  
Controlled Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
High Dose ◽  
Double Blind Study ◽  
Virus Envelope ◽  
Double Blind

Abstract Background This double-blind study assessed immunogenicity, lot consistency, and safety of recombinant vesicular stomatitis virus-Zaire Ebola virus envelope glycoprotein vaccine (rVSVΔG-ZEBOV-GP). Methods Healthy adults (N = 1197) were randomized 2:2:2:2:1 to receive 1 of 3 consistency lots of rVSVΔG-ZEBOV-GP (2 × 107 plaque-forming units [pfu]), high-dose 1 × 108 pfu, or placebo. Antibody responses pre-/postvaccination (28 days, 6 months; in a subset [n = 566], months 12, 18, and 24) were measured. post hoc analysis of risk factors associated with arthritis following vaccination was performed. Results ZEBOV-GP enzyme-linked immunosorbent assay (ELISA) geometric mean titers (GMTs) increased postvaccination in all rVSVΔG-ZEBOV-GP groups by 28 days (>58-fold) and persisted through 24 months. The 3 manufacturing lots demonstrated equivalent immunogenicity at 28 days. Neutralizing antibody GMTs increased by 28 days in all rVSVΔG-ZEBOV-GP groups, peaking at 18 months with no decrease through 24 months. At 28 days, ≥94% of vaccine recipients seroresponded (ZEBOV-GP ELISA, ≥2-fold increase, titer ≥200 EU/mL), with responses persisting at 24 months in ≥91%. Female sex and a history of arthritis were identified as potential risk factors for the development of arthritis postvaccination. Conclusions Immune responses to rVSVΔG-ZEBOV-GP persisted to 24 months. Immunogenicity and safety results support continued rVSVΔG-ZEBOV-GP development. Clinical Trials Registration NCT02503202.

scholarly journals Regional Variation on Rates of Bronchopulmonary Dysplasia and Associated Risk Factors

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
María Ximena Rojas ◽  
Mario Augusto Rojas ◽  
Juan Manuel Lozano ◽  
Martín Alonso Rondón ◽  
Laura Patricia Charry
Keyword(s):  
Risk Factors ◽  
Bronchopulmonary Dysplasia ◽  
Management Practices ◽  
Population Characteristics ◽  
Disease Rates ◽  
Respiratory Management ◽  
High Incidence ◽  
Traditional Risk Factors ◽  
Associated Risk Factors ◽  
Control Study

Background. An abnormally high incidence (44%) of bronchopulmonary dysplasia with variations in rates among cities was observed in Colombia among premature infants. Objective. To identify risk factors that could explain the observed high incidence and regional variations of bronchopulmonary dysplasia. Study Design. A case-control study was designed for testing the hypothesis that differences in the disease rates were not explained by differences in city-of-birth specific population characteristics or by differences in respiratory management practices in the first 7 days of life, among cities. Results. Multivariate analysis showed that premature rupture of membranes, exposure to mechanical ventilation after received nasal CPAP, no surfactant exposure, use of rescue surfactant (instead of early surfactant), PDA, sepsis and the median daily FIO2, were associated with a higher risk of dysplasia. Significant differences between cases and controls were found among cities. Models exploring for associations between city of birth and dysplasia showed that being born in the highest altitude city (Bogotá) was associated with a higher risk of dysplasia (OR 1.82 95% CI 1.31–2.53). Conclusions. Bronchopulmonary dysplasia was manly explained by traditional risk factors. Findings suggest that altitude may play an important role in the development of this disease. Prenatal steroids did not appear to be protective at high altitude.

scholarly journals Comparing the Effects of Low Dose of Ketamine, Tramadol, and Ondansetron in Prevention of Post Spinal Anesthesia Shivering in Cesarean Section

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ali Mohammadzadeh Jouryabi ◽  
Seyedeh Hajar Sharami ◽  
Mandana Mansour Ghanaie ◽  
Abbas Sedighinejad ◽  
Vali Imantalab ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Gold Standard ◽  
Low Dose ◽  
Demographic Variables ◽  
Double Blind Study ◽  
Double Blind ◽  
Apgar Scores ◽  
Significant Difference ◽  
High Incidence

Background: Shivering frequently occurs in cesarean section (CS) under spinal anesthesia (SA), resulting in several complications. To date, pethidine has been considered as the gold standard for post-SA shivering control, but it is contraindicated in breastfeeding women. Methods: This randomized, double-blind study was conducted at Alzahra hospital in Guilan, Iran, From January 2019 to November 2020. A total of 508 eligible term parturient women were enrolled and randomly divided into four groups of low dose ketamine (K), tramadol (T), ondansetron (O), and placebo (P). The incidence and severity of shivering and patients’ complications were recorded and compared among the groups. Results: The patients were homogenous in terms of demographic variables. Shivering was witnessed in 68 (53.5%), 26 (20.5%), 75 (59.1%), and 82 (64.6%) patients in K, T, O, and P groups, respectively (P = 0.0001). Regarding shivering severity, there was a significant difference among the four groups (P = 0.0001). In addition, a significant difference was seen regarding Apgar scores at the first minute, but not at the fifth minute (P = 0.168). Conclusions: Considering the high incidence of shivering in placebo group, prophylactic intervention in CS under SA seems to be necessary. Among the studied drugs, tramadol was the most effective one, followed by a low dose of ketamine and ondansetron.

Improved Survival Accounts for Most, but Not All, of the Increase in Bronchopulmonary Dysplasia

PEDIATRICS ◽  
1992 ◽  
Vol 90 (5) ◽  
pp. 663-668 ◽  
Author(s):  
Robert A. Parker ◽  
Daniel P. Lindstrom ◽  
Robert B. Cotton
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Hyaline Membrane Disease ◽  
Logistic Regression Models ◽  
Changes In Risk ◽  
Adjusted Incidence ◽  
Minute Apgar Score

The incidence of bronchopulmonary dysplasia (BPD) increased from 10.6% in 1976 through 1980, to 21.7% (1981 through 1985), and to 32.9% (1986 through 1990) in very low birth weight neonates (1500 g or less) admitted to the Vanderbilt Neonatal Intensive Care Unit, while there was a concurrent decline in incidence of neonatal death (NEOD) during the same periods (26.4%, 18.3%, and 15.9%, respectively). Population changes in risk factors (birth weight, sex, race, location of birth, gestational age, diagnosis of hyaline membrane disease, and 5-minute Apgar score) over time do not account for this increase. To estimate the proportion of the increase in BPD attributable to the concurrent decline in NEOD during these periods, separate logistic regression models for NEOD and BPD were calculated from patients born during 1976 through 1985. These results were used to predict the expected number of cases of NEOD and BPD during 1986 through 1990, assuming that the adjusted incidence of NEOD and BPD remained constant from 1976 through 1985, to 1986 through 1990. The increase in the combined outcome, NEOD/BPD, over the three time periods (34.2%, 36.1%, and 43.5%) remained statistically significant after adjustment for the risk factors listed above. During 1986 through 1990, the predicted number of NEOD was 83 more than the number observed, while the predicted number with BPD was 115 less than the number observed. If all 83 averted cases of NEOD during 1986 through 1990 had developed BPD, then 83 (72%) of the 115 excess cases of BPD could be attributed to averted NEOD. The approximate 95% confidence interval for this estimate was 58% to 87%. These results indicate that while most of the excess cases of BPD in 1986 through 1990 could be explained by neonates who previously would have died, there were still additional cases of BPD that were not explained by the risk factors included in this analysis.

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