Surfactant Therapy In Neonates With Respiratory Deterioration Due to Pulmonary Hemorrhage

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 32-36
Author(s):  
Paresh B. Pandit ◽  
Michael S. Dunn ◽  
Enza A. Colucci
Keyword(s):  
Repeated Measures ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Case Series ◽  
Pulmonary Hemorrhage ◽  
Oxygenation Index ◽  
Surfactant Therapy ◽  
Exogenous Surfactant ◽  
Retrospective Case ◽  
Clinically Significant

Objective. To study the effect of exogenous bovine surfactant on oxygen and ventilatory requirements in neonates with respiratory deterioration due to pulmonary hemorrhage. Design. Retrospective case series. Setting. Three regional neonatal intensive care units. Methods. Infants who received surfactant following a clinically significant pulmonary hemorrhage during the time period July 1991 to December 1993 were identified from a database. Infants were excluded if any other cause was found to explain their deterioration. The primary outcome was change in respiratory status following surfactant therapy, as reflected by oxygenation index (OI) and arterial/Alveolar oxygen ratio. Data points were taken as averages of 3 through 6 hours and 0 through 3 hours for the 6 hours before and after surfactant. Differences were analyzed using analysis of variance for repeated measures, with treatment and time as co-variates. Results. Fifteen patients fulfilled inclusion criteria. Median values (range): birth weight, 960 g (595 to 4045); age at pulmonary hemorrhage, 24.4 hours (0.3 to 62); and interval between pulmonary hemorrhage and surfactant therapy, 10 hours (3.7 to 46.5). Mean OI improved from 24.6, at 0 to 3 hours presurfactant, to 8.6 at 3 to 6 hours postsurfactant (P .001). No patient deteriorated following surfactant therapy. The primary respiratory diagnosis was respiratory distress syndrome (RDS) in 8, meconium aspiration syndrome in 3, and isolated pulmonary hemorrhage in 4. All those with RDS had also received surfactant before their pulmonary hemorrhage. Conclusions. Exogenous surfactant appears to be useful adjunctive therapy in neonates with a clinically significant pulmonary hemorrhage. Its use for this indication should be further investigated by a randomized controlled trial.

scholarly journals Surfactant Replacement Therapy for Respiratory Distress Syndrome in the Newborn: A Review

2017 ◽  
Vol 40 (1) ◽  
pp. 26-30
Author(s):  
Tahsinul Amin ◽  
Mohammod Shahidullah
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Pulmonary Hemorrhage ◽  
Surfactant Therapy ◽  
Respiratory Morbidity ◽  
Exogenous Surfactant ◽  
Surfactant Replacement ◽  
Surfactant Deficiency ◽  
Surfactant Replacement Therapy

Respiratory failure secondary to surfactant deficiency is a major cause of morbidity and mortality in low birth weight premature infants. Surfactant therapy substantially reduces mortality and respiratory morbidity for this population. Exogenous surfactant therapy has become well established in newborn infants with respiratory distress. Many aspects of its use have been well evaluated in high-quality trials and systematic reviews. Secondary surfactant deficiency also contributes to acute respiratory morbidity in late-preterm and term neonates with meconium aspiration syndrome, pneumonia/ sepsis, and perhaps pulmonary hemorrhage; surfactant replacement may be beneficial for these infants. This article summarizes the evidence and gives recommendations for the use of surfactant therapy for respiratory distress syndrome (RDS) in newborn.Bangladesh J Child Health 2016; VOL 40 (1) :26-30

Over-under cartilage tympanoplasty: technique, results and a call for improved reporting

2020 ◽  
Vol 134 (10) ◽  
pp. 875-881
Author(s):  
I D Erbele ◽  
M R Fink ◽  
G Mankekar ◽  
L S Son ◽  
R Mehta ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Senior Author ◽  
Retrospective Case ◽  
Closure Rate ◽  
Hearing Results ◽  
Middle Ear Cholesteatoma ◽  
Cartilage Tympanoplasty ◽  
The Mean ◽  
Clinically Significant

AbstractObjectiveThis study aimed to describe the microscopic over-under cartilage tympanoplasty technique, provide hearing results and detail clinically significant complications.MethodThis was a retrospective case series chart review study of over-under cartilage tympanoplasty procedures performed by the senior author between January 2015 and January 2019 at three tertiary care centres. Cases were excluded for previous or intra-operative cholesteatoma, if a mastoidectomy was performed during the procedure or if ossiculoplasty was performed. Hearing results and complications were obtained.ResultsSixty-eight tympanoplasty procedures met the inclusion criteria. The median age was 13 years (range, 3–71 years). The mean improvement in pure tone average was 6 dB (95 per cent confidence interval 4–9 dB; p < 0.0001). The overall perforation closure rate was 97 per cent (n = 66). Revision surgery was recommended for a total of 6 cases (9 per cent) including 2 post-operative perforations, 1 case of middle-ear cholesteatoma and 3 cases of external auditory canal scarring.ConclusionOver-under cartilage tympanoplasty is effective at improving clinically meaningful hearing with a low rate of post-operative complications.

scholarly journals Bibliometric Analysis of Early COVID-19 Research: The Top 50 Cited Papers

2020 ◽  
Vol 13 ◽  
pp. 117863372096293 ◽  
Author(s):  
Hassan ElHawary ◽  
Ali Salimi ◽  
Nermin Diab ◽  
Lee Smith
Keyword(s):  
Controlled Trial ◽  
Case Series ◽  
Inclusion Criteria ◽  
Radiological Findings ◽  
Retrospective Case ◽  
Scientific Publications ◽  
Randomized Controlled ◽  
Study Characteristics ◽  
Number Of Citations ◽  
Number Of Authors

Introduction: The COVID-19 pandemic is rapidly evolving with the number of cases exponentially rising. The research scientific community has reacted promptly as evidenced by an outstanding number of COVID-19 related publications. As the number of scientific publications rapidly rises, there is a need to dissect the factors that lead to highly impactful publications. To that end, the present paper summarizes the characteristics of the top 50 cited COVID-19-related publications that emerged early during the pandemic. Methods: A systematic search of the Web of Science, Scopus, and Google Scholar was performed, using keywords related to COVID-19 and SARS-CoV-19. Two independent authors reviewed all the search results, screening for the top 50 cited COVID-19-related articles. Inclusion criteria comprised any publication on COVID-19 or the SARS-CoV-2 virus. Data extracted included the type of study, journal, number of citations, number of authors, country of publication, and study content. Results: As of May 29th, the top 50 cited articles were cited 63849 times during the last 4 months. On average, 14 authors contributed to each publication. Over half of the identified articles were published in only 3 journals. Furthermore, 42% and 26% of the identified articles were retrospective case series and correspondence/viewpoints, respectively, while only 1 article was a randomized controlled trial. In terms of content, almost half (48%) of the identified publications reported clinical/radiological findings while only 7 out of the 50 articles investigated potential treatments. Conclusion: By highlighting the characteristics of the top 50 cited COVID-19-related articles, the authors hope to disseminate information that could assist researchers to identify the important topics, study characteristics, and gaps in the literature.

scholarly journals Clinical features of 35 COVID-19 patients with hospitalization for more than 20 days

2020 ◽  
Author(s):  
Yiling Zhang ◽  
Cheng Zhang ◽  
Hongmei Yao ◽  
Li Zhao ◽  
Ying Hu ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Antiviral Therapy ◽  
Clinical Features ◽  
Distress Syndrome ◽  
Case Series ◽  
Oxygenation Index ◽  
Retrospective Case ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Nucleic Acid Tests

Abstract Background: As we know, some patients with Coronavirus disease 2019 (COVID-19) may stay longer in the hospital, but whether the different hospitalization days are associated with different clinical features is not clear yet. Methods: This study is a single-centered, observational and retrospective case series.97 patients with COVID-19 were divided into two groups:patients with hospitalization for more than 20 days (Group1,n=35)and those with hospitalization for less than 20 days (Group2,n=62).Data were collected Results Acute Respiratory Distress Syndrome(ARDS) and Hospital acquired pneumonia (HAP)were more common in Group1 than in Group2 . There were more patients administered quadruple antiviral therapy in Group1 than in Group2 . In group1, 14.3% patients’ specimens showed positive again after they were discharged from the hospital.Compared with Group2,Group1 had higher percentages of oxygenation index<300mmHg leucopenia and lymphopenia. In Group1, 19 patients were treated with chloroquine phosphate,whose nucleic acid tests were negative soon,but 5 patents who hadn’t used the medicine had positive testing again . Conclusions: COVID-19 patients with longer hospitalization are more severe and need more quadruple antiviral therapy ;For patients who don't use chloroquine phosphate, the nucleic acid tests are more likely to return to positive again even if they have no symptoms at that time .

scholarly journals Metacognitive Therapy in Treatment-Resistant Psychosis: A Multiple-Baseline Study

2013 ◽  
Vol 42 (2) ◽  
pp. 166-185 ◽  
Author(s):  
Paul Hutton ◽  
Anthony P. Morrison ◽  
Melissa Wardle ◽  
Adrian Wells
Keyword(s):  
Control Strategies ◽  
Controlled Trial ◽  
Paranoid Schizophrenia ◽  
Case Series ◽  
Multiple Baseline ◽  
Series Data ◽  
Metacognitive Therapy ◽  
Treatment Resistant ◽  
Clinically Significant

Background:More effective psychological treatments for psychosis are required. Case series data and pilot trials suggest metacognitive therapy (MCT) is a promising treatment for anxiety and depression. Other research has found negative metacognitive beliefs and thought-control strategies may be involved in the development and maintenance of hallucinations and delusions. The potential of MCT in treating psychosis has yet to be investigated.Aims:Our aim was to find out whether a short number of MCT sessions would be associated with clinically significant and sustained improvements in delusions, hallucinations, anxiety, depression and subjective recovery in patients with treatment-resistant long-standing psychosis.Method:Three consecutively referred patients, each with a diagnosis of paranoid schizophrenia and continuing symptoms, completed a series of multiple baseline assessments. Each then received between 11 and 13 sessions of MCT and completed regular assessments of progress, during therapy, post-therapy and at 3-month follow-up.Results:Two out of 3 participants achieved clinically significant reductions across a range of symptom-based outcomes at end-of-therapy. Improvement was sustained at 3-month follow-up for one participant.Conclusions:Our study demonstrates the feasibility of using MCT with people with medication-resistant psychosis. MCT was acceptable to the participants and associated with meaningful change. Some modifications may be required for this population, after which a controlled trial may be warranted.

scholarly journals Warfarin Dose Requirements in Adults Hospitalized With COVID-19 Infection: A Retrospective Case Series

2021 ◽  
pp. 089719002110007
Author(s):  
Madison N. Irwin ◽  
Sarah Adie ◽  
Katherine Sandison ◽  
Sarah A. Alsomairy ◽  
Adamo Brancaccio
Keyword(s):  
Hospital Mortality ◽  
Case Series ◽  
Warfarin Dose ◽  
Retrospective Chart Review ◽  
Retrospective Case ◽  
Available N ◽  
Percentage Decrease ◽  
The Mean ◽  
Clinically Significant ◽  
The Impact

Purpose: To describe the impact of hospitalization with COVID-19 infection on warfarin dose requirements in adult inpatients. Summary: A retrospective chart review of 8 adults on warfarin admitted to Michigan Medicine with COVID-19 infection was conducted and reported as a case series. Outcomes of interest were difference in average daily dose of warfarin prior to admission (PTA) and while inpatient (IP), warfarin sensitivity, time in therapeutic range (TTR), confirmed or suspected thromboembolic event, any major or clinically significant bleeding episodes, and in-hospital mortality. IP average daily warfarin doses were lower when compared to PTA average daily doses [1.3 mg (1.3) vs. 6.2 mg (4.1)]. The mean percentage decrease in dose was 68.8% (23) and the mean absolute dose difference was 4.8 mg (4.3). Mean IP percentage tests in range was 30.8% (24.6) and mean IP warfarin sensitivity was 4.2 (3.8), both of which differed from PTA TTR and warfarin sensitivity for those with data available (n = 3, n = 6, respectively). One patient was treated for suspected acute pulmonary embolism while on warfarin and one patient experienced clinically relevant bleeding. In-hospital mortality was zero, mean length of stay (LOS) was 17 days (14.4), and mean intensive care unit (ICU) LOS for the 3 patients requiring ICU level care was 14.3 days (4.5). Conclusion: Decreased warfarin dose requirements were evident in this group of adults hospitalized with COVID-19 infection. These findings suggest lower doses of warfarin may be needed to achieve therapeutic anticoagulation while inpatient.

Clinical Tolerance of In-Neonatal Intensive Care Unit Administration of Rotavirus Vaccine

2019 ◽  
Author(s):  
Courtney Briggs-Steinberg ◽  
David Aboudi ◽  
Gabrielle Hodson ◽  
Shetal Shah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Adverse Events ◽  
Neonatal Intensive Care Unit ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Rank Test ◽  
Retrospective Case ◽  
Clinically Significant ◽  
Historical Controls

Abstract Objective This article determines the tolerance of neonatal intensive care unit (NICU)-based administration of RV5 in premature infants. This article also aims to compare the rate of clinically significant adverse events after RV5 immunization to the standard 2-month shot series and to historical controls who were not immunized. Study Design This is a retrospective case–control study of 201 premature infants immunized with RV5. Infants were evaluated for clinically significant events 7 days before and after immunization and were compared with events after the 2-month shot series and to 189 historical controls. Wilcoxon signed rank test and McNemar's test were used for all paired analysis. Results There was no increase in number of infants with clinically significant adverse events when comparing after RV5 to prior to RV5, after the 2-month shot series, or to the historical controls. Conclusion RV5 is well tolerated in premature infants and does not result in clinically significant adverse events when administered in NICU-hospitalized infants.

scholarly journals N-Acetylcysteine Advancement of Surfactant Therapy in Experimental Meconium Aspiration Syndrome: Possible Mechanisms

2014 ◽  
pp. S629-S642 ◽  
Author(s):  
J. KOPINCOVÁ ◽  
D. MOKRÁ ◽  
P. MIKOLKA ◽  
M. KOLOMAZNÍK ◽  
A. ČALKOVSKÁ
Keyword(s):  
Oxidative Damage ◽  
Therapeutic Effect ◽  
Neutrophil Migration ◽  
Oxygenation Index ◽  
Meconium Aspiration Syndrome ◽  
Surfactant Therapy ◽  
Total Leukocyte Count ◽  
Exogenous Surfactant ◽  
Meconium Aspiration ◽  
Respiratory Parameters

Meconium aspiration syndrome (MAS) is meconium-induced respiratory failure of newborns associated with activation of inflammatory and oxidative pathways. For severe MAS, exogenous surfactant treatment is used which improves respiratory functions but does not treat the inflammation. Oxidative process can lead to later surfactant inactivation; hence, surfactant combination with antioxidative agent may enhance the therapeutic effect. Young New Zealand rabbits were instilled by meconium suspension and treated by surfactant alone, N-acetylcysteine (NAC) alone or by their combination and oxygen-ventilated for 5 h. Blood samples were taken before and 30 min after meconium application and 30 min, 1, 3 and 5 h after the treatment for evaluating of oxidative damage, total leukocyte count, leukocyte differential count and respiratory parameters. Leukocyte differential was assessed also in bronchoalveolar lavage fluid. NAC alone had only mild therapeutic effect on MAS. However, the combination of NAC and surfactant facilitated rapid onset of therapeutic effect in respiratory parameters (oxygenation index, PaO2/FiO2) compared to surfactant alone and was the only treatment which prevented neutrophil migration into the lungs, oxidative damage and lung edema. Moreover, NAC suppressed IL-8 and IL-β formation and thus seems to be favorable agent for improving surfactant therapy in MAS.

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