Please select the eligibility criteria that correspond to the clinical trial below.
Title: Propranolol vs Prednisolone for Infant Hemangiomas-A Clinical and Molecular Study
Brief Summary: Hemangiomas are relatively common lesions in infants. Most go away spontaneously after one year of life and do not need treatment. Others require treatment because they cause significant symptoms such as pain, or difficulty with breathing, eating or ambulating. Steroids have classically been used to treat hemangiomas and help to shrink them in 1/3 - 2/3 of patients. Unfortunately, steroids have many side effects in babies so physicians have sought other ways to treat them. Recently, the use of propranolol, a heart medication, was serendipitously found to reduce the size of hemangiomas. It appears to have many fewer side effects than steroids but it is not yet known if it works as well as steroids. This study seeks to compare the effect and the side effects of propranolol versus steroids for treating hemangiomas that cause symptoms in infants.


Options:
A: Inclusion Criteria:

* Proliferating IH (target hemangioma) requiring systemic therapy anywhere on the body except on the diaper area with largest diameter of at least 1.5 cm

Exclusion Criteria:

- The patient presents with one or more of the following medical conditions: Congenital hemangioma; Kasabach-Merritt syndrome; bronchial asthma; bronchospasm; hypoglycaemia (\< 40 mg/dl or at risk); untreated phaeochromocytoma; hypotension (\< 50/30 mmHg); second or third degree heart block; cardiogenic shock; metabolic acidosis; bradycardia (\< 80 bpm); severe peripheral arterial circulatory disturbances; Raynaud's phenomenon; sick sinus syndrome; uncontrolled heart failure or Prinzmetal's angina; documented PHACES syndrome with central nervous system involvement

* The patient has previously been treated for IH, including any surgical and/or medical procedures (e.g. laser therapy)
* The patient is known to have a hypersensitivity to propranolol and/or any other beta-blockers
* One or more of the following types of IH are present:

  * Life-threatening IH
  * Function-threatening IH (e.g. those causing impairment of vision, respiratory compromise caused by airway lesions, etc.)
  * Ulcerated IH (whatever the localisation) with pain and lack of response to simple wound care measures
* The patient was born prematurely and has not yet reached his/her term equivalent age (e.g. an infant born 2 months prematurely cannot be included before the age of 2 months)
* LVEF (left ventricular systolic function) ≤40% and/or cardiomyopathy and/or hereditary arrhythmia disorder
B: Inclusion Criteria:

* Healthy infants aged 2-12 months.
* Superficial or mixed hemangiomas in proliferative phase (growing in size in the last 1-2 months).
* Hemangiomas must be less than 10X10 cm and must not be ulcerated.

Exclusion Criteria:

* Preterm infant (less than 36 weeks of gestation).
* Ulceration of hemangioma prior to treatment.
* Immunosuppression.
* Hemangioma located on the eyelid or perianal region.
* Prior treatment of the hemangioma.
* Concomitant diseases.
* Presence of multiple hemangiomas and/or hemangiomas that would require systemic drug treatment.
* Potential difficulties with follow-up (patient from another town,difficult access to the hospital , etc.).
* History of allergy to any of the components of the drug preparation.
* Hemangiomas more than 10X 10 cm or ulcerated before the start of the treatment.
C: Inclusion Criteria:

* preterm infants \<=34 weeks GA with hemangioma

Exclusion Criteria:

* no hemangioma
D: Inclusion Criteria:

* infants with symptomatic hemangiomas

Exclusion Criteria:

* asthma
* diabetes
* hypertension
* hypotension
* hypoglycemia
* liver failure
* previous treatment for hemangiomas

Answer: D