bluuebunny/crossref_metadata_2025_split huggingface dataset:
New peripherally inserted midline catheter: A better alternative for intravenous antibiotic therapy in patients with cystic fibrosis
Authors: Harwood Ivan R. , Greene Linda M. , Kozakowski‐Koch Jo Ann , Rasor Julia S. 
Published: March 2007

AbstractA study was performed on outpatients with cystic fibrosis (CF) to evaluate the performance of an over‐the‐needle peripherally inserted midline catheter for the delivery of 2‐week courses of antibiotic therapy. The midline is a 7‐inch catheter inserted in the antecubital region with the tip located in the axillary region. It is made of a newly developed biomaterial that softens and expands upon contact with body fluids. The hypotheses for the study were that the midline catheter: 1) is useful for intermediate‐length therapies; 2) can prevent multiple 3‐day conventional peripheral catheter restarts; 3) can prevent or delay the use of more invasive central devices; 4) is comfortable for patients; and 5) is economical. A total of 41 midlines were inserted in 27 patients with an average age and weight of 22 years and 109 pounds, respectively. Prior to this study implanted ports and primarily conventional short peripheral catheters were used to administer I.V. therapy to these patients; fifty percent of these short peripheral catheters failed within 2.6 days. At 2 weeks of dwell, 80% of the midline catheters placed in these patients were still indwelling. Also, 80% of all midline catheter removals were for non‐catheter‐related reasons. There were no cases of midline catheter phlebitis. In contrast, the phlebitis rates published for peripherally inserted central catheters (PICCs) and conventional short peripheral catheters at 7 days of dwell are 20% and >51% respectively. The midline catheters were comfortable and well liked by most patients and became more economical than conventional peripheral catheters for therapies lasting approximately 6 days through 1 to 2 months. These data indicate that the low complication rate and the cost savings of the midline catheter make it a better alternative than conventional peripheral catheters or central devices for most I.V. antibiotic therapies lasting for 1 week or longer in patients with CF.
Allergic alveolitis in a 12‐year‐old boy: Treatment with budesonide nebulizing solution
Authors: Carlsen Kai‐håkon , Leegaard Jens , Lund Odd Due , Skjærvik Håvard 
Published: March 2007

AbstractAllergic alveolitis due to bird antigens was diagnosed in a 12‐year‐old boy. He suffered from cough, dyspnea, easy fatigue, anorexia, and severe weight loss. The diagnosis was verified by a gradual improvement when he was removed from the birds, exacerbation upon re‐exposure, and the demonstration of serum precipitating antibodies against bird antigens. The patient recovered completely after a short course of oral prednisolone, treatment with inhaled nebulized budesonide for 3 months, and removal of the birds from his home.
Comparison of nap and overnight polysomnography in children
Authors: Marcus Carole L. , Keens Thomas G. , Ward Sally L. Davidson 
Published: March 2007

AbstractOvernight polysomnography is the “gold standard” for diagnosing sleep‐disordered breathing. However, the limited number of resources for pediatric polysomnography make the availability of a screening test for sleep‐disordered breathing highly desirable. Therefore, we compared 1 hour daytime nap polysomnography to overnight polysomnography in 40 children [mean age, 5.4 ± 0.8 (SE) years] with sleep‐disordered breathing; 76% of children were sedated with chloral hydrate for nap polysomnography; none was sedated for overnight polysomnography. Studies were done 26 ± 4 days apart. Chest wall motion, ECG, end‐tidal PCO2 (PETCO2), arterial oxygen saturation (Sa), and electrooculogram were monitored. Nap studies had a sensitivity of 74%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 17% in predicting sleep‐disordered breathing. Significantly more children had obstructive apnea and desaturation (Sa < 90%) during overnight polysomnography. The peak PETCO2 and the Sa nadir were significantly worse during overnight polysomnography. However, the percentage of time during which abnormalities were manifested did not differ between nap and overnight polysomnography. Despite the use of sedation, nap polysomnography underestimated sleep‐disordered breathing. We conclude that sleep‐disordered breathing detected by nap polysomnography is always confirmed by overnight polysomnography and speculate that nap polysomnography may be an effective screening method for sleep‐disordered breathing. However, overnight polysomnography should be performed if nap polysomnography is inconclusive. Chloral hydrate may be used effectively to facilitate sleep for nap polysomnography in children. © 1992 Wiley‐Liss, Inc.
Efficacy of salbutamol and ipratropium bromide in decreasing bronchial hyperreactivity in children with cystic fibrosis
Authors: Avital Avi , Sanchez Ignacio , Chernick Victor 
Published: March 2007

AbstractA proportion of patients with cystic fibrosis (CF) suffer from increased airway hyperreactivity but their response to bronchodilators is variable. Adrenergic agents may produce an increase, no change or a decrease in forced expiratory volume in 1 second (FEV1). We hypothesized that the variable response might be related to poor aerosol distribution caused by the presence of secretions. Therefore, in 11 children with CF and airway hyperreactivity the influence of pretreatment with either 0.9% saline, salbutamol, or ipratropium bromide on the methacholine challenge test was evaluated in a double‐blind, randomized, cross‐over study. FEV1 (mean ± S.E.) did not change following pretreatment with saline, salbutamol, or ipratropium (1.64 ± 0.22, 1.63 ± 0.16 and 1.67 ± 0.19, respectively). All patients demonstrated airway hyperreactivity with a PC20 below 8 mg/mL (geometric mean, 0.41 mg/mL) after saline pretreatment. Salbutamol inhalation significantly increased the PC20 to 1.24 mg/mL (P < 0.01), but ipratropium bromide was found to be even more effective than salbutamol (PC20 = 7.37 mg/mL) (P < 0.0001). We conclude that the variable response to bronchodilator is not secondary to impaired aerosol distribution since ipratropium bromide effectively blocked the response to methacholine. The improvement in PC20 without a change in baseline FEV1 following salbutamol suggests that the adrenergic agent altered the contractile mechanism of smooth muscle. © 1992 Wiley‐Liss, Inc.
Cardiopulmonary response to exercise in anorexia nervosa
Authors: Lands Larry , Pavilanis Alan , Charge Thomas D. , Coates Allan L. 
Published: March 2007

AbstractMalnutrition is associated with a number of systemic diseases that are often accompanied by severe exercise limitation. Anorexia nervosa (AN) is a disease characterized by malnutrition due to psychological factors rather than systemic disease. Diminished exercise capacity in AN has been attributed to a loss of muscle mass, dysfunction of remaining muscle, and impaired cardiovascular responses. In order to evaluate the role of malnutrition in the cardiopulmonary response to exercise, nine adolescent girls with AN were evaluated during progressive and steady‐state exercise testing using a cycle ergometer. Nutritional status was assessed by body mass percentile (BMP) and percent ideal weight (PIWT). Cardiac output was measured by the indirect (CO2 rebreathing) Fick method. Maximum work capacity (Wmax) was expressed as a percent of predicted for sex and height, and cardiac output as a percent of predicted for oxygen consumption. To ensure that the laboratory values were comparable to the predicted values, a control group consisting of ten adolescents was studied concurrently. Wmax was below the 95% confidence interval in six of nine of the AN group (mean ± SD; 70 ± 22% predicted), whereas two of ten controls were below and one above this interval (112 ± 37%). Wmax correlated with nutritional status (BMP: r = 0.75; P < 0.001; PIWT: r = 0.8, P < 0.001). Ventilatory responses for CO2 production at steady state and for Wmax were appropriate in both groups. Cardiac output was appropriate in both the controls (103 ± 12%) and the AN group (104 ± 14%). This was accomplished in the AN group with a relatively low stroke volume (86 ± 19%) and high heart rate (107 ± 13%), both expressed as percent predicted for sex and work. With appropriate cardiac and ventilatory responses, exercise capacity in AN appears to be limited primarily by diminished muscle mass and/or dysfunction of the existing muscle. © 1992 Wiley‐Liss, Inc.
Snoring in French preschool children
Authors: Teculescu Dan B. , Caillier Isabella , Perrin Philippe , Rebstock Eve , Rauch Anne 
Published: March 2007

AbstractThe prevalence of habitual snoring and its associations with respiratory symptoms, personal and familial risk factors, ear, nose, and throat (ENT) abnormalities, and its influence on ventilatory function were studied in a sample of 190 children aged 5 to 6 years from nine kindergartens in Nancy (northeastern France). Nineteen (10%; 95% Cl 5.7–14.3%) of the children were habitual snorers; the prevalence was the same in boys and girls. In univariate analysis habitual snoring was significantly associated with a personal history of exercise‐induced bron‐chospasm [relative risk (RR) 4.50]; a history of adenotonsillectomy (RR, 2.56); a personal history of allergy (RR, 2.83); a sibling history of atopy (RR, 2.39); and doctor‐assessed tonsillar hypertrophy (RR, 2.51). These factors were entered into a logistic regression model that retained as independent determinants exercise‐induced asthma, personal history of allergy, sibling history of allergy, and tonsillar hypertrophy. The height‐adjusted peak expiratory flow rate was slightly, non‐significantly lower in habitual snorers as compared to non‐snorers (2.01 ± 0.32 vs 2.10 ± 0.38 L/s/m2). Due to the limited numbers in the sample, the increased risk for paternal (RR, 1.8) and maternal (RR, 1.6) smoking at home remained nonsignificant. © 1992 Wiley‐Liss, Inc.
Early treatment of respiratory distress syndrome with bovine surfactant in very preterm infants: A multicenter controlled clinical trial
Authors: Gortner L. , Bartmann P. , Pohlandt F. , Bernsau U. , Porz F. , Hellwege H. H. , Seitz R. C. , Hieronimi G. , Bremer C. , Jorch G. , Hentschel R. , Reiter H. L. , Wolf H. , Ball F. 
Published: March 2007

AbstractTo determine the effect of bovine surfactant (SF‐RI 1, Alveofact) administered during the first hour following birth to very premature infants [gestational age (GA). 25‐30 weeks] in a multicenter, controlled trial. Hypothesis: Survival without bronchopulmonary dysplasia (BPD; definition: ventilator dependency or FiO2 > 0.3 during spontaneous respiration) at day 28 is increased in surfactant‐treated infants (sequential analysis). Patients and methods: Thirty‐four infants [GA 28.0 ± 1.5 SD weeks, birth weight (BW), 1,048 ± 299 g] received 50 mg/kg BW surfactant, whereas 35 infants (GA, 27.6 ± 1.5 weeks, BW 969 ± 269 g) served as controls. Retreatment with surfactant (up to three identical doses) 12‐24 hours after the previous dose was permitted if FiO2 was > 0.5. Results: Survival without BPD was significantly higher in surfactant treated infants (26/34) compared to controls (14/35; P=0.003). but in the incidence of pulmonary air leaks, patent ductus arteriosus, intracranial hemorrhage, and nosocomial infections they were not different. Conclusion: Bovine surfactant treatment improves survival without BPD in very premature infants at risk for neonatal respiratory distress syndrome (RDS). © 1992 Wiley‐Liss, Inc.
Transcutaneous blood gas monitoring during salbutamol inhalations in young children with acute asthmatic symptoms
Authors: Holmgren D. , Bjure J. , Engström I. , Sixt R. , Sten G. , Wennergren G. 
Published: March 2007

AbstractThe effect of salbutamol inhalations on transcutaneous blood gases was investigated in 23 children (aged 11 months‐2.5 years) with asthmatic symptoms. After one salbutamol inhalation there was a mean increase in transcutaneous Po2 (tcP) of 0.5 kPa (P < 0.01); after a second dose given 30 minutes later, the mean increase was 1.2 kPa (P < 0.001). The increase in tcP, after only one dose of salbutamol was significantly correlated to age (P < 0.01). No such correlation was observed after a second dose. The overall increase in tcP after two salbutamol inhalations showed a negative correlation to the duration of the current symptomatic period (P < 0.05). We conclude that salbutamol inhalations have beneficial effects in young children with acute asthmatic symptoms, even below the age of 18 months, provided that an adequate dose reaches the lung and preferably at an early stage of obstruction. © 1992 Wiley‐Liss, Inc.
Transcutaneous and arterial blood gas monitoring during acute asthmatic symptoms in older children
Authors: Holmgren D. , Sixt R. 
Published: March 2007

AbstractThe relationship between transcutaneous and arterial blood gases was investigated in 14 children with asthmatic symptoms, aged 7–15 years, before and after the inhalation of salbutamol. The degree of bronchial obstruction was assessed by forced expiratory volume in one second (FEV1) and maximum expiratory flow when 25% of FVC remained to be expelled (MEF25). On average the transcutaneous Po2 (tcPo2,) was 1.3 kPa (range, 2.6–0 kPa) lower and the transcutaneous Pco2 was 0.6 kPa (range, 0–1.5 kPa) higher than the corresponding arterial values (P < 0.01). The difference between arterial and transcutaneous Po2, was the same over the whole range of values studied (7.5–14 kPa). After the inhalation of salbutamol, the relationship between transcutaneous and arterial blood gases was not significantly changed. Changes in transcutaneous Po2 correlated to changes in MEF25 (P < 0.05). indicating a common denominator, probably the conditions in the peripheral airways.We conclude that the close relationship between transcutaneous and arterial blood gases, even after the inhalation of a beta‐2 agonist, indicates that the transcutaneous technique can be used for monitoring acute bronchial obstruction and for evaluating the effects of treatment in children of different ages. © 1992 Wiley‐Liss, Inc.
Intratracheal administration of pulmonary vasodilator agents
Authors: D'Angeli Marisa A. , Goetzman Boyd W. 
Published: March 2007

AbstractWe compared intravenous and intratracheal administration of histamine (0.4 and 1.6 kg/kg, respectively) and nitroglycerin (5.0 and 20.0 μg/kg, respectively) in seven hypoxemic 2 week old lambs, during right lung only perfusion, to see if intratracheal administration could limit their vasodilator action to the pulmonary vessels. The hemodynamic variables: pulmonary artery pressure (Ppa), left atrial pressure (Pla), pulmonary blood flow per kilogram (Q/kg), and aortic pressure (Pao) were measured at baseline and in each experimental state, then pulmonary vascular resistance (PVR) and systemic vascular input resistance (SVR) were determined. We found that intravenous histamine showed some pulmonary vasodilator selectivity in that it caused a 19% decrease of Ppa from baseline (P < 0.002), a 23% decrease of PVR from baseline (P < 0.002). and an 8% decrease of SVR from baseline (P < 0.05). Intratracheal histamine produced smaller effects, decreasing Ppa by 11% from baseline (P < 0.02), and PVR by 14% from baseline (P < 0.02), while SVR was unaffected. Intravenous nitroglycerin decreased cardiac output by 16% from baseline (P < 0.02), and also decreased SVR by 8% while producing a small increase in PVR. Intratracheal nitroglycerin caused a similar 17% (P < 0.01) decrease in cardiac output, and again an increased PVR but a decreased SVR. This study confirms that histamine has some intrinsic pulmonary vasodilator selectivity. Furthermore, the data suggest that intratracheal administration may accentuate pulmonary selectivity by lessening systemic effects. Nitroglycerin, on the other hand, had untoward hemodynamic effects in the presence of hypoxia. © 1992 Wiley‐Liss, Inc.
Adaptive control of inspired oxygen delivery to the neonate
Authors: Bhutani Vinod K. , Taube John C. , Antunes Michael J. , Delivoria‐Papadopoulos Maria 
Published: March 2007

AbstractAdaptive adjustment of inspired oxygen (Fio2), based on a desired percent arterial hemoglobin saturation (S02) was achieved by on‐line bedside control of the oxygen concentration delivered to the neonate. Fourteen infants with bronchopulmonary dysplasia (BW, 860 ± 80 g; GA, 26 ± 1 weeks; study age, 41 ± 8 days) receiving oxygen‐air mixtures by hood were studied. The desired range of S, from 92 to 96% with a target value of 95% was determined by pulse oximetry and maintained with adjustment of Fio2 using three modes: (1) standard neonatal intensive care protocol with oxygen delivery evaluated at 20 minute intervals; (2) bedside manual control with Fio2 manipulation every 2 to 5 minutes; and (3) adaptive control with on‐line adjustment of Fio2 according to a specifically designed adaptive program. Each study period was of 40 minute duration. So2, values within a steady 94 to 96% range was achieved for 54010 of the time with standard protocol, compared to 69% (P < 0.01) with bedside manual control and 81% (P < 0.01) with adaptive control. In addition, fluctuations in So2, values and overshoots were less apparent with adaptive control of oxygen delivery. These data describe adaptive Fio2, control as an efficient alternative technique for achieving a stable desired range of oxygenation in neonates. © 1992 Wiley‐Liss, Inc.
Evaluation of the Oxford and Sheffield SIDS risk prediction scores
Authors: Brooks John G. , Fleming Peter J. , Berry Peter J. , Golding Jean 
Published: March 2007

AbstractStudy objective:To evaluate the clinical usefulness (sensitivity and specificity) of the Oxford and Sheffield birth scores for prospective identification of infants at high risk of SIDS.Design:Retrospective medical record reviews of prospectively identified, autopsy‐validated SIDS and living control infants.Study subjects:Consecutive sample of 140 infants, born between 1/1/83 and 12/31/87, who died suddenly and unexpectedly in the Avon Area Health Authority in southwest England between 1/1/84 and 12/31/88. Seventeen of the cases were excluded: 6 because they lacked adequate clinical records, 11 because they were not SIDS. The 637 control infants were comprised of every 80th delivery between 1/1/83 and 12/31/87 in the three major hospitals in the area.Results:SIDS incidence was 2.85/1,000 live births. Using standard cut scores to define high SIDS risk (2.0 for Oxford and 500 for Sheffield), sensitivities were 0.55 and 0.35 and specificities were 0.78 and 0.89 for the Oxford and Sheffield scores, respectively. SIDS risk for infants in the high risk group was 7.3/1,000 (Oxford) and 9.3/1,000 (Sheffield).Conclusions:Since there is no intervention with proven efficacy for SIDS prevention, and since approximately one half of SIDS cases occur in low risk groups, clinical use of these scoring systems for allocation of health care resources or personnel for the sole purpose of SIDS prevention is not justified. Pediatr Pulmonol. © 1992 Wiley‐Liss, Inc.
Delayed compliance increase in infants with respiratory distress syndrome following synthetic surfactant
Authors: Armsby David H. , Bellon Gabriel , Carlisle Kathy , Rector David , Baldwin Roger , Long Walker , Stevenson David K. , Ariagno Ronald L. 
Published: March 2007

AbstractRecent research has demonstrated that Exosurf (EXSF), a newly synthesized artificial surfactant, increases survival when administered endotracheally to premature infants with RDS. This study examines the effects of EXSF on static respiratory system compliance (Crs). Thirty‐four patients received two doses of EXSF in this rescue protocol. Crs (mL/cmH2O/kg) did not significantly change within the first 4 hours after either dose. However, Crs values did increase significantly (paired Student's t‐test, P = 0.005) when data collected after the second dose (0.36 ± 0.13 mL/cmH2O/kg) were compared to first week follow‐up data (0.51 ± 0.21 mL/cmH2O/kg). Crs data collected between 2 and 4 weeks after treatments were again not significantly different from non‐concurrent control data collected at 34 weeks of life. The measurement of Crs in infants receiving EXSF may have been affected by an increase in lung inflation, which could mask an increase in Crs. We speculate that improved lung inflation may occur with less barotrauma in the first week of life due to surfactant replacement treatment and may in part explain the improved Crs seen at 1 week of age. Many investigators using different surfactants, dosing schedules, and pulmonary function methodologies to evaluate lung mechanics have reported that the improvement in compliance after surfactant treatment usually follows the clinical improvement in gas exchange. Additional studies are needed to explain the mechanism of early improvement following surfactant replacement in infants with RDS. © 1992 Wiley‐Liss, Inc.
Acoustic vs. spirometric assessment of bronchial responsiveness to methacholine in children.
Authors: Sanchez Ignacio , Avital Avi , Wong Isaac , Tal Asher , Pasterkamp Hans 
Published: March 2007

AbstractTo study wheezing as an indicator of bronchial responsiveness during methacholine challenge (MC) in children, we used computer analysis of respiratory sounds and compared wheeze measurements to routine spirometry. MC was performed in 30 symptomatic subjects (sympt), age 11 ± 3.1 years (mean ± SD), with suspected asthma and in 12 controls (contr), age 10 ± 3.4 years. Respiratory rate (RR), spirometry, arterial oxygen saturation (Sa, O2), and cough were registered until the concentration provoking a ≥ 20% fall in forced expiratory flow in 1 second (FEV1; PC20), or the end point (8 mg/mL) was reached. For 1 min after each inhalation, sounds over the trachea and posterior right lower lobe were recorded together with calibrated airflow. Computer analysis of respiratory sounds was used for objective wheeze quantification. Wheezing was measured as its duration relative to inspiration (Tw/Ti,) and expiration (Tw/Te,). Seventeen of the sympt group developed wheezing (sympt/W) with ≥ Tw/Ti, or ≥ 5% Tw/Te Thirteen of the sympt did not wheeze (sympt/no W). Three contr developed wheeze (contr/w) while 9 did not (contr/no W). In sympt/W, RR increased from 20 ± 6.2 per min at baseline to 25 ± 9.2 (P < 0.05) at the MC concentration provoking wheeze (PCw), and SaO2, decreased from 97.4 ± 1.2% to 95.3 ± 2.4 (P < 0.05). In contr/W, RR did not change, but SaO2, decreased from 97.3 ± 1.5% to 95.7% ± 1.2% (P < 0.05). Wheezing occurred at both recording sites and was as common during inspiration as during expiration. In subjects who had both PCw and PC20, these variables correlated well (r = 0.82, P < 0.0001). Three SW did not reach PC20 (maximum fall in FEV1 8%, 12%, and 18%). On the other hand, 6 of 13 sympt/no W and 2 of 12 contr/no W had a positive MC. Thus, wheezing during MC had a sensitivity of 68% and a specificity of 82%. Acoustic measurements were reproducible in 14 subjects who performed a second MC within 2–10 months. We conclude that wheezing during MC in children strongly suggests airway hyperresponsiveness; however, wheeze detection cannot fully replace spirometry in bronchial provocation testing. © 1993 Wiley‐Liss, Inc.
Complications following oat head aspiration
Authors: Maayan C. H. , Avital A. , Elpeleg O. N. , Springer C. , Katz S. H. , Godfrey S. 
Published: March 2007

AbstractWe report 5 cases of oat head aspiration in children that resulted in serious complications due to the unidirectional migration of the oat head to the periphery of the lung. The complications included pneumothorax, pneumomediastinum, recurrent hemoptysis, chronic lung disease, bronchiectasis, lobectomy, bronchopleural and bronchocutaneous fistulae, pleural effusion, empyema cavity, and, one not described before, osteomylitis of the rib. Physicians should be aware of the dangers with this particular foreign body aspiration. © 1993 Wiley‐Liss, Inc.