bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prolonged apnea and oxyhemoglobin desaturation in asymptomatic premature infants
Authors: Spear Michael L. , Stefano John L. , Spitzer Alan R. 
Published: March 2007

AbstractSeventy‐eight longitudinal four‐channel recordings of heart rate, thoracic impedance, nasal thermistry, and pulse oximetry were performed on 26 asymptomatic premature infants (gestational age, 29.9 ± 1.58 weeks; birth weight, 1,753 ± 226 grams; postconceptional age, 34.3 ± 2.0 weeks; postnatal age, 4.41 ± 2.40 weeks; all values mean ± SD). Tracings were scored for central and obstructive apnea, bradycardia, periodic breathing, apnea density, and prolonged apnea. The studies demonstrated 585 episodes (7.41/recording) of oxyhemoglobin desaturation with < 80% and 1,193 episodes (15.1/recording) desaturation with < 90%. Recordings had a mean of 16.1 episodes of central apnea, 3.04 episodes of obstructive apnea, and 2.34 episodes of bradycardia. Periodic breathing and short obstructive apneas correlated significantly with the total number of oxyhemoglobin desaturations of < 80% and 90%. Episodes of prolonged apnea were seen in 20 of 78 recordings. In the latter a significantly higher number of total desaturations < 90%), desaturations < 80% and 90% in association with apnea and with bradycardia, longer desaturations, desaturations during sleep, and isolated bradycardia were observed. Variations in heart rate, thoracic impedance, nasal air flow, and pulse oximetry are associated with episodes of oxyhemoglobin desaturation in asymptomatic premature infants. These infants, although asymptomatic, may be at risk for impaired tissue oxygenation. © 1992 Wiley‐Liss, Inc.
Gas exchange during exercise in diabetic children
Authors: Baraldi Eugenio , Monciotti Carla , Filippone Marco , Santuz Pierantonio , Magagnin Giampiero , Zanconato Stefania , Zacchello Franco 
Published: March 2007

AbstractThe purpose of this study was to evaluate the cardiorespiratory and metabolic response to exercise in 33 children, aged 9 to 15 years, affected by type I diabetes mellitus, in comparison with 47 age‐, sex‐, weight‐, and height‐matched healthy children. All diabetic children were on a mixed split‐dose insulin regimen, consisting of both regular and long‐acting insulin in the morning and evening. The last insulin injection was administered on average 6 hours before the test. The mean duration of diabetes mellitus was 5.0 ± 3.1 years. The metabolic control was evaluated on the basis of HbA1 levels (mean, 8.9 ± 1.8%). Pulmonary function tests and progressive exercise tests on the treadmill were performed. Gas exchange, ventilation, and heart rate (HR) were monitored during the tests. The O2 pulse (V/HR) was calculated. There was no difference in the baseline oxygen uptake (\documentclass{article}\pagestyle{empty}\begin{document}$ \mathop {\rm V}\limits^. $ \end\end{document}) between the diabetic children and the control group. \documentclass{article}\pagestyle{empty}\begin{document}$ \mathop {\rm V}\limits^. $ \end{document} peak was significantly lower (P < 0.01) in the diabetic adolescents (41.2 ± 5.9 mL/min/kg) compared to control subjects (46.3 ± 9.6 mL/min/kg) and it was achieved at an earlier (P < 0.01) time of run (7.5 ± 1.8 vs. 9.1 ± 2.8 min). Anaerobic threshold and minute ventilation were similar in the two groups. The O2 pulse throughout the test was significantly lower (ANOVA, P < 0.001) in the diabetic group compared to the controls. No differences were found in resting and post‐exercise spirometric values. In conclusion, our study shows that well‐controlled diabetic adolescents have a reduced working capacity. The lower O2 pulse reflects a reduced peripheral oxygen utilization that might suggest early microvascular disease. © 1992 Wiley‐Liss, Inc.
Clinical observations of nebulized flunisolide in infants and young children with asthma and bronchopulmonary dysplasia
Authors: König Peter , Shatley Miriam , Levine Clive , Mawhinney Thomas P. 
Published: March 2007

AbstractSevere bronchopulmonary dysplasia (BPD) is frequently associated with asthma. The combination is often severe enough to necessitate corticosteroid therapy. There are no commercially available nebulizer solutions of corticosteroids for use in infants and young children. Seven infants and small children with very severe BPD and asthma aged 6–24 months, were treated with flunisolide, 187–250 μg q.i.d. in the form of nasal spray delivered by nebulizer. After treatment for 2.5–20 months, four patients showed clinical improvement, one initially improved but later deteriorated and died of cardiac failure, and two patients showed no improvement and died within 3 months. The number of days of hospitalization was significantly reduced from 8.4/month to 2.5/month (P < 0.05). No side‐effects were detected and it was felt that the three patients who died, did so as a consequence of very severe BPD and its cardiac consequences. The suspension remained stable for 80 min when mixed with normal saline, cromolyn sodium, albuterol, or acetylcysteine. It is concluded that nebulized flunisolide is a potentially useful treatment for infants and young children with asthma and BPD. © 1992 Wiley‐Liss, Inc.
Diet in infancy and bronchial hyperreactivity later in childhood
Authors: Pöysä L. , Pulkkinen A. , Korppi M. , Remes K. , Juntunen‐Backman K. 
Published: March 2007

AbstractSixty‐seven atopy‐prone children (atopic family group, AFG) and 52 children with no family history of atopy (NAFG) were followed for 10 years. During infancy, the mothers of the newborn AFG children were advised to adjust their infants' diet, with a view toward minimizing the risk of atopy, and not to keep pets. Pulmonary function tests, methacholine inhalation challenge (MIC), and skin prick tests (SPT) were done in order to evaluate the bronchial reactivity and skin reactivity in the two groups. A pathological result in MIC was found in 20 (30%) of the AFG children and in 10 (19%) of the NAFG children. Such results of MIC were more common in the children with positive SPT results than in those without (67% vs. 24%). In regard to the diet consumed in infancy, MIC was pathological in 23% of children with and in 36% without prophylactic diet in infancy. © 1992 Wiley‐Liss, Inc.For MIC, using the new, Spira electro 2 dosimeter equipment, the sensitivity was 75% and specificity 97%, but the predictive value for diagnosing bronchial asthma was only 25%. The important advantage of our method is that the degree of bronchial reactivity can be estimated by responses to increasing provocative doses.Our observations confirm that the new method is suitable for detecting bronchial asthma in clinical practice but it seems not to be optimal for epidemiological studies. We concluded that later bronchial hyperreactivity can not be diminished by avoiding home pets or providing a hypoallergenic diet during infancy.
Reproducibility of late phase pulmonary response to exercise and its relationship to bronchial hyperreactivity in children with chronic asthma
Authors: Boner A. L. , Vallone G. , Chiesa Mo M. , Spezia E. , Fambri Mid L. , Sette Yd L. 
Published: March 2007

AbstractTo determine the reproducibility of the delayed response to exercise and its effect on bronchial hyperreactivity, we had 26 asthmatic children perform treadmill exercise challenge on two occasions 1 week apart. Both challenges were preceded by 2 control days and 1 histamine challenge day, and were followed by another histamine challenge day. Peak expiratory flow rate (PEFR) was measured hourly for 12 hours on each control day and for 12 hours after each exercise or histamine challenge. During the first week, five patients showed a late reaction (PEFR change > 15%) after exercise, which was present in only two of them the following week. These two patients, however, also showed a spontaneous fall > 15% of PEFR from baseline during the other control study days. A similar pattern was seen in two other patients who had a late response during the second exercise challenge but not during the first. No significant change occurred in histamine PC‐20 FEV1 between before and after the exercise challenges. An apparent late asthmatic response after exercise challenge may represent a within‐day fluctuation in pulmonary mechanics that develops spontaneously in children with asthma. © 1992 Wiley‐Liss, Inc.
Validation of respiratory inductance plethysmography (“Respitrace”®) for the measurement of tidal breathing parameters in newborns
Authors: Stick S. M. , Ellis E. , Lesouëf P. N. , Sly P. D. 
Published: March 2007

AbstractIntroduction: The ratio of the time to reach peak (maximum) tidal expiratory flow (Tme) to total expiratory time (Te) is smaller in infants who later develop lower respiratory tract disease. In previous studies infants have been sedated and flow measured using a pneumotachograph with face‐mask. These methodological factors are known to affect tidal breathing, and the frequent need for sedation limits the use of the technique to relatively small studies. The aim of this study was to validate uncalibrated respiratory inductance plethysmography (Respitrace®) to measure Tme/Te in unsedated newborns.Methods: Nineteen normal term infants were studied during quiet sleep. Agreement between Tme/Te measured directly using a pneumotachograph and with Respitrace was assessed in 15 infants. Repeatability of the Respitrace technique was assessed in 10 infants.Results: The mean Tme/Te for the 19 infants using Respitrace was 0.46 (S.D. 0.14). The mean difference between Tme/Te obtained using Respitrace and that measured with a pneumotachograph was −0.014; 95% of Respitrace readings were between −0.042 and 0.070 of the pneumotachograph values. The mean difference between repeat Respitrace values was 0.02 with 95% of the second measurements within 0.066 of the first.Conclusions: These results indicate that Respitrace can be used to determine Tme/Te accurately. © 1992 Wiley‐Liss, Inc.
Primary pulmonary tumors in childhood: A review of 31 years' experience and the literature
Authors: Cohen Marta C. , Kaschula R. O. C. 
Published: March 2007

AbstractPrimary pulmonary tumors are infrequent in childhood, therefore an accurate diagnosis and treatment is often delayed. We review the English language literature and report the clinical and pathological features of eight tumors arising in the lungs of pre‐adolescent children, accessioned between 1960 and 1991 in the pathology department of a children's hospital in South Africa. The ratio of pulmonary primary tumors to secondary neoplasms and to non‐neoplastic lesions of the lung examined during this period was 1:5:60. Over the last 31 years we received three plasma cell granulomas, two pleuro‐pulmonary blastomas, a mucoepidermoid carcinoma, an endobronchial fibrosarcoma, and a hemangioma. All patients presented with cough unresponsive to medical treatment. The incidence and spread of primary lung tumors in children was similar to that reported from other centers. Plasma cell granuloma is the most common primary tumor in the lungs of children. Agressive behavior is most frequently encountered with pleuro‐pulmonary blastoma and rhabdomyosarcoma, and because of their association with cystic lesions careful examination of lungs is required in such cases. Most other malignant neoplasms, such as muco‐epidermoid carcinoma and primary fibrosarcoma, are usually of a low grade of malignancy. A decreasing incidence of bronchogenic carcinoma seems to be reported during the first two decades of life. © 1992 Wiley‐Liss, Inc.
Assessment of exercise capacity in asthmatic children with various degrees of activity
Authors: Fink Gershon , Kaye Clive , Blau Hanna , Spitzer Shimon A. 
Published: March 2007

AbstractPhysical fitness in a group of 49 stable asthmatic children was determined by an incremental exercise test. Thirty‐one normal children served as a control group. The asthmatic children were divided into three groups. Group 1 was comprised of 16 children who actively participated in organized sports, Group 2 of 16 children who did not participate in organized sports but who engaged in free‐play, and Group 3 of 17 children with a sedentary life‐style who avoided even free‐play. The results of cardiopulmonary evaluation before and after maximal incremental exercise testing have shown that Groups 1 and 2 behaved like the control group and their physical fitness was similar. Group 3 whose life‐style was sedentary had poor physical fitness as compared to the other asthmatics and to the control group. This was the result of poor cardiovascular conditioning and was unrelated to the respiratory limitation. We conclude that poor physical fitness in asthmatic children is the result of a sedentary life‐style and can be potentially normalized. © 1993 Wiley‐Liss, Inc.
Elevated exoenzyme expression by Pseudomonas aeruginosa is correlated with exacerbations of lung disease in cystic fibrosis.
Authors: Grimwood K. , To M. , Semple R. A. , Sokol P. A. , Woods D. E. 
Published: March 2007

AbstractTwo studies were conducted to determine whether Pseudomonas aeruginosa exoenzyme expression was increased during pulmonary exacerbations of cystic fibrosis (CF) and if it was reduced by antibiotic therapy. The first study was retrospective comparing in vitro exoenzyme levels expressed by P. aeruginosa sputum isolates from seriously ill, hospitalized patients with CF to those from P. aeruginosa strains isolated from CF clinic patients who were in relatively better health. Exoenzyme values were significantly greater in P. aeruginosa strains isolated from ill, hospitalized patients than in clinic patients (P = 0.0001). In the prospective study, in vitro exoenzyme levels were measured from sputum p. aeruginosa isolates of 9 hospitalized patients with CF. Exoenzyme values were greatest in nonmucoid strains on admission (P < 0.0025), and P. aeruginosa exoenzyme expression decreased significantly during hospitalization (P < 0.0025). Deterioration in CF lung disease was accompanied by increased P. aeruginosa exoenzyme production, especially by nonmucoid strains. Antibiotic treatment during hospitalization resulted in mean improvement of % predicted forced expiratory volume in 1 sec (FEV1) from 39 to 53% (P = 0.002). Thus, antibiotics may improve pulmonary function in patients with CF by decreasing P. aeruginosa exoenzyme expression. © 1993 Wiley‐Liss, Inc.
Pulmonary follow‐up 2.5 years after a randomized, controlled, multiple dose bovine surfactant study of preterm newborn infants
Authors: Couser Robert J. , Ferrara T. Bruce , Wheeler William , McNamara John , Falde Brenda , Johnson Katie , Hoekstra Ronald E. 
Published: March 2007

AbstractForty‐seven preterm infants, who were previously enrolled in a prospective, randomized, blinded study at birth to assess the effects of multiple doses of exogenous bovine surfactant to prevent respiratory distress syndrome, underwent lung function evaluation and review of their medical histories at 21/2 years of age. During their initial hospitalization there were no differences between the 17 control infants and the 30 surfactant‐treated infants in the duration of ventilator or oxygen therapy and the incidence of bronchopulmonary dysplasia. At the follow‐up both groups were similar in chronological and corrected ages, weights, lengths, and sex ratios and there were no differences in the occurrence of allergy, asthma, bronchiolitis, eczema, pneumonia, and wheezing. In addition, there was no significant difference regarding the incidence of chest illnesses lasting either 3 or 7 days and in the total number of required rehospitalizations. Functional residual capacity (FRC), tidal volume (VT/kg), compliance (Crs/kg), resistance (R‐), and time constant of the respiratory system were not significantly different between the two groups at 21/2 years of age. We conclude that bovine surfactant, when given during the neonatal period, has little long‐term effect on lung function. Neonatal bovine surfactant therapy neither improves nor produces any adverse effects on the developing respiratory system. © 1993 Wiley‐Liss, Inc.
The effect of frequency and mean airway pressure on volume delivery during high‐frequency oscillation
Authors: Chan V. , Greenough A. , Milner A. D. 
Published: March 2007

AbstractThe performance of a commercially available oscillator (SensorMedics 31 00) at different frequencies was assessed. A frequency response curve of a pneumotachcgraph system was constructed and this was used to measure the volume delivered by the oscillator to a lung model. The volume delivered by a constant diaphragm displacement was demonstrated to be inversely proportional to the frequency, but unaffected by increasing mean airway pressure from 15 to 25 cm H2O. The volume delivered during high frequency oscillation (HFO) was then asessed in 8 infants, median gestational age 29 weeks. The infants were studied at two frequencies, 10 and 15 Hz, both of which were used at two levels of mean airway pressure (MAP): 2 and 5 cm H2O above the MAP level previously used during conventional ventilation. The delivered volume was not significantly different at the two MAP levels, but was significantly greater at 10 than 15 H t at both MAP levels (P < 0.03); at MAP +2 cm H2O above baseline the reduction in delivered volume was from a median of 1.54 mL/kg (range, 0.88–3.12) at 10 Hz to 1.18 mL/kg (range, 0.6545) at 15 Hz. These results suggest that higher frequencies would require an increase in the oscillator displacement if effective gas exchange is to be maintained. © 1993 Wiley‐Liss, Inc.
Poor agreement between reported and recorded nocturnal cough in asthma
Authors: Falconer A. , Oldman C. , Helms P. 
Published: March 2007

AbstractReported presence or absence of night cough was compared with tape recorded cough in 15 children with perennial asthma (median age, 9 years; range, 7–14) who reported troublesome nocturnal symptoms. Measurements were made and diaries kept for 7 consecutive nights. Cough was reported on 66 of 105 (66%) and recorded on 93 (90%) available nights with poor overall agreement (Cohen's coefficient of assessment, kappa +0.30, range −0.17 to +l). The poor agreement between subjective and objective assessment of an important symptom of nocturnal asthma raises questions on the validity of symptom reporting and may in part explain the not infrequent disagreement between medical and patient assessment of disease severity. © 1993 Wiley‐Liss, Inc.
Postnatal expression of myosin lsoforms in the genioglossus and diaphragm muscles.
Authors: Brozanski Beverly S. , Daood Monica J. , Watchko Jon F. , Laframboise William A. , Guthrie Robert D. 
Published: March 2007

AbstractWe studied the expression of myosin heavy chain (MHC) and native myosin isoforms in the genioglossus (GG) and costal diaphragm (DIA) muscles of the rat during postnatal development using both denaturing and nondenaturing gel electrophoresis. Primary myotubes in both fast and slow muscles homogeneously express slow as well as embryonic myosin. Since the adult GG is comprised primarily of fast MHC isoforms, whereas the adult DIA is characterized by a mixture of MHC slow and fast isoforms, we hypothesized that the GG and DIA would be subject to different temporal patterns of MHC isoform expression during postnatal development. Native myosin and MHC gels demonstrated a persistence of neonatal MHC (MHC neo) on day 25 in the GG, whereas this isoform was not detected beyond day 21 in the DIA. The MHC phenotype in GG of the adult demonstrated a predominance of MHC 2× (35% ± 8) and MHC 28 (45% ± 10) with a smaller proportion of MHC 2A (19% ± 5). In contrast, the MHC phenotype in adult DIA was characterized by approximately equal proportions of MHC slow (25% ± 3), MHC 2A (34% ± 10), and MHC 2× (31% ± 12) with a small percentage of MHC 2B (9% ± 7). These data suggest that postnatal regulation of MHC expression in the GG and DIA is muscle specific. © 1993 Wiley‐Liss, Inc.
Fluid dynamics during initial aeration of mature fetal lung and effect of temperature
Authors: Scarpelli Emile M. , Antonio‐Santiago Maria T. , Clutario Bella C. , Mautone Alan J. 
Published: March 2007

AbstractAir volume‐pressure (VP) curves were recorded simultaneously on pairs of mature rabbit fetuses from the same litter with one member of the pair at 37°C and the other at 22°C. lntrasaccular bubbles, formed primarily during inflation, were assessed for stability and surface tension (y). Average air flow rates (dV/dt) were calculated from the VP data. In separate experiments, liquid VP curves were recorded at 37° and 22°C: maximal liquid V was matched to maximal air V at 37° and 22° C, respectively. Fetal pulmonary liquid (FPL) viscosity (q) and density (p) were determined by standard methods. Both the effect of temperature on lung mechanics as reported previously, and the reliability of the rabbit model were confirmed in the paired fetuses. Analysis of fluid dynamics revealed that of the six parameters relevant to initial inflation‐deflation of FPL‐filled lungs, liquid p. distensibility (recoil), and γy were not altered significantly by temperature increase from 22° to 37°C. Enhanced lung mechanics at 37°C (including enhanced inflation at lower P, higher maximal V, increased production of intrasaccular bubbles, and higher V at end‐deflation) was primarily due to lowering of FPL η at the higher temperature which appears to have an effect by augmenting bulk liquid flow and liquid drainage. Lower ηl increases bulk flow through airways directly. Consequent recruitment and distention of these conducting units effectively increases radius (r) and further enhances flow. (The ultimate “brake” to airways flow at both temperatures is counter P from γ at air/liquid menisci.) Lower η also increases liquid drainage during the process of intrasaccular bubble production. This effect, along with temperature enhancement of surfactant solubility, increases the rate of bubble formation within peripheral units. © 1993 Wiley‐Liss, Inc.
High‐frequency jet ventilation in children with the adult respiratory distress syndrome complicated by pulmonary barotrauma
Authors: Smith David W. , Frankel Lorry R. , Derish Melinda T. , Moody Robert R. , Black Lehman E. , Chipps Bradley E. , Mathers Lawrence H. 
Published: March 2007

AbstractHigh‐frequency jet ventilation (HFJV) was used in 29 children with severe ARDS complicated by pulmonary barotrauma (PST). Treatment with HFJV was begun when PBT was progressing over a 24‐h period while receiving conventional ventilation (CV). The mean (±SD) age was 0.95 ± 1.21 years (range, 0.03‐4 years). The most common diagnosis was viral pneumonia (n = 17); other diagnoses included aspiration pneumonitis (n = 4), bacterial pneumonia (n = 3), multiple trauma (n = 2), and near‐drowning (n = 3). The Bunnell Life‐Pulse ventilator was used at a rate of 240/min or 300/min, with inspiratory time of 0.02 sec. Twenty children survived (69%). Survivors and nonsurvivors had equal disease severity prior to HFJV as assessed by ventilator settings, alveolar‐to‐arterial oxygen tension gradient, oxygenation index, and blood gas values. Survivors had spent significantly less time on conventional ventilation prior to HFJV than nonsurvivors, with a mean (±SD) of 3.7 ± 2.1 days vs 9.6 5 4.5 days, respectively (P < 0.05). Survivors underwent an average of 4.4 ± 3.9 days of HFJV, which supported adequate gas exchange with lower airway pressures, and produced resolution or significant improvement in airleak on chest radiograph. In conclusion, we speculate that the application of HFJV early in the course of severe hypoxemic respiratory failure complicated by airleak, allows the reduction of airway pressures, thereby minimizing pulmonary barotrauma and allowing the lung to recover from the underlying insult. Further controlled evaluation of HFJV in this high risk group of patients is warranted. © 1993 Wiley‐Liss, Inc.