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- Ahola, T, et al.
(författare)
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N-acetylcysteine does not prevent bronchopulmonary dysplasia in immature infants: A randomized controlled trial
- 2003
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Ingår i: Journal of Pediatrics. - 1097-6833 .- 0022-3476. ; 143:6, s. 713-719
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate whether N-acetyleysteine (NAC) infusion during the first week of life reduces the risk of death or bronchopulmonary dysplasia (BPD in infants with extremely low birth weight. Study design In a Nordic multicenter, double-blind trial, infants (n = 391) weighing 500 to 999 g and on ventilator or nasal continuous positive airway pressure were randomized before the age of 36 hours to receive NAC 16 to 32 mg/kg/d (n = 194) or placebo (n = 197) intravenously for 6 days. Primary end points were death or BPD, defined as supplementary oxygen requirement at 36 weeks' gestational age. Results There was no difference in the combined incidence of the primary end points death or BPD, 51% vs. 49%, between the NAC group and control group. Also similar was the incidence of BPD in survivors at 36 weeks' gestational age, 40% vs. 40%, and the mean oxygen requirement at the age of 28 days, 31.2% vs. 30.7%, respectively. The severity of BPD was similar in both groups. Conclusions A 6-day course of intravenous N-acetylcysteine at the dosage used does not prevent BPD or death in infants with extremely low birth weight.
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| 2. |
- Bachrach, BE, et al.
(författare)
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Glycogen synthase deficiency (glycogen storage disease type 0) presenting with hyperglycemia and glucosuria: Report of three new mutations
- 2002
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Ingår i: Journal of Pediatrics. - : Elsevier BV. - 1097-6833 .- 0022-3476. ; 140:6, s. 781-783
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Tidskriftsartikel (refereegranskat)abstract
- Although glycogen storage disease type 0 (GSD0) is included in the differential diagnosis of ketotic hypoglycemia, it usually is not considered in the evaluation of glucosuria or hyperglycemia. We describe two children with GSD0, confirmed by mutation analysis, who had glucosuria and hyperglycemia. Because of the variable presentation of this disorder and previous dependence on liver biopsy to confirm diagnosis, it is likely that GSD0 is underdiagnosed.
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| 3. |
- Boman, Krister K, et al.
(författare)
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Serious illness in childhood : the different threats of cancer and diabetes from a parent perspective.
- 2004
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Ingår i: Journal of Pediatrics. - : Elsevier BV. - 0022-3476 .- 1097-6833. ; 145, s. 373-379
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To compare the incidence of disease-related distress symptoms in parents of children with cancer and diabetes. Study design A total of 675 parents of patients with cancer, patients with diabetes, and control subjects were assessed for 11 distress symptom clusters. Patient and control parent mean differences were tested by 2-tailed t tests, illness groups were compared by means of analysis of variance. Distress variations as a function of time since diagnosis were examined by regression analysis. Results The distress levels of patient parents exceeded those of control parents for global distress (P < .0001) and for most symptom subcategories. Distress levels of parents of patients with cancer (CP) significantly exceeded those of parents of patients with diabetes (DP) in anxiety (P < .0001), physical and psychologic distress (P < .0001), depression (P < .005), and loneliness (P < .05). Levels in DP matched those of CP in uncertainty, loss of control/the patient, self-esteem, disease-related fear, and sleep disturbances. Distress levels were lower in CP most distant hi time from diagnosis, whereas DP showed a reversed trend. Conclusions Parental distress patterns in childhood illness depend on illness type and time passed since diagnosis. Symptom profiles verify the need for psyehosocial attention at the initial shock after the cancer diagnosis and indicate long-term consequences for many parents. In pediatric diabetes, the persistence or intensification of distress over time is of specific clinical relevance.
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| 5. |
- Domellöf, Magnus, 1963-, et al.
(författare)
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Iron supplementation of breast-fed Honduran and Swedish infants from 4 to 9 months of age.
- 2001
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Ingår i: Journal of Pediatrics. - : Elsevier. - 0022-3476 .- 1097-6833. ; 138:5, s. 679-687
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective was to study the effects of iron supplementation on hemoglobin and iron status in 2 different populations. Study design: In a randomized, placebo-controlled, masked clinical trial, we assigned term Swedish (n = 101) and Honduran (n = 131) infants to 3 groups at 4 months of age: (1) iron supplements, 1 mg/kg/d, from 4 to 9 months, (2) placebo, 4 to 6 months and iron, 6 to 9 months, and (3) placebo, 4 to 9 months. All infants were breast-fed exclusively to 6 months and partially to 9 months. RESULTS: From 4 to 6 months, the effect of iron (group 1 vs 2 + 3) was significant and similar in both populations for hemoglobin, ferritin, and zinc protoporphyrin. From 6 to 9 months, the effect (group 2 vs group 3) was significant and similar at both sites for all iron status variables except hemoglobin, for which there was a significant effect only in Honduras. In Honduras, the prevalence of iron deficiency anemia at 9 months was 29% in the placebo group and 9% in the supplemented groups. In Sweden, iron supplements caused no reduction in the already low prevalence of iron deficiency anemia at 9 months (<3%). CONCLUSION: Iron supplementation from 4 to 9 months or 6 to 9 months significantly reduced iron deficiency anemia in Honduran breast-fed infants. The unexpected hemoglobin response at 4 to 6 months in both populations suggests that regulation of hemoglobin synthesis is immature at this age.
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| 6. |
- Hanås, Ragnar, 1951, et al.
(författare)
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Indwelling catheters used from the onset of diabetes decrease injection pain and pre-injection anxiety
- 2002
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Ingår i: J Pediatr. - : Elsevier BV. - 0022-3476 .- 0022-3476 .- 1097-6833. ; 140:3, s. 315-20
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate the use of indwelling catheters as injection aids at diabetes onset to reduce injection pain and pre-injection anxiety. STUDY DESIGN: Forty-one patients aged 8.1 +/- 3.7 years (range, 1-15) participated in this open, controlled randomized study. A 10-cm VAS with faces was used for scoring. A local anesthetic cream was used before all insertions. The control group used insulin pens with standard needles. After one week, the indwelling catheter group could choose regular injections but were included in the "intention to treat" analysis. RESULTS: Injection pain and anxiety decreased from day 1 to 15 in both groups (average, 4.1 injections/day). Pain was significantly lower for indwelling catheter injections when scored by parents (median, 1.2 cm vs 2.7 cm; P =.002), children/teenagers (0.8 cm vs 1.5 cm; P =.006), and nurses (1.4 cm vs 3.0 cm; P =.002). Parental pre-injection anxiety was also lower (1.2 cm vs 2.9 cm; P =.016). Taking injections, including inserting catheters, was found to be less problematic with an indwelling catheter (1.6 cm vs 3.3 cm;P =.009). During the 6-month follow-up, injection pain and injection problems were significantly lower in the catheter group. Mean catheter indwelling time was 3.7 days. Median pain for catheter insertion was 2.1 cm and for glucose testing was 0.9 cm. Sixteen of 20 patients continued to use indwelling catheters after 2 weeks, and 9 of 20 after 6 months. CONCLUSIONS: We found an evident relief of pre-injection anxiety and injection pain when using indwelling catheters for introducing insulin injections at the onset of diabetes.
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| 7. |
- Tanaka, H, et al.
(författare)
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Blood pressure and cardiovascular autonomic function in healthy children and adolescents
- 2000
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Ingår i: Journal of Pediatrics. - : Elsevier BV. - 0022-3476 .- 1097-6833. ; 137:1, s. 63-67
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the relationship between blood pressure levels and cardiovascular autonomic function in adolescents and preadolescents. Study design: We measured variability of beat-to-beat arterial pressure and R-R intervals using power spectral analysis in 56 adolescents (aged 13-16 16 years, mean age, 9.0 +/- 1.4 years) and 71 preadolescents (6-12 years, mean age, 13.5 +/- 1.1 years) in the supine and standing positions. Results: Adolescents had higher levels of systolic arterial pressure and lower high-frequency power of RR intervals than preadolescents. Correlation between the basal level of arterial pressure and autonomic function rn as observed in adolescents but not in preadolescents. Tn adolescents, multivariate analysis indicated that tho basal level of arterial pressure was inversely related with the high-frequency power of RR intervals and positively with the ratio of low-frequency and high-frequency pow er. No significant relation was found in preadolescents. During standing, adolescents had a more marked increase in diastolic arterial pressure, heart rate, low frequency of R-R intervals, and low frequency of arterial pressure compared with those of preadolescents, Changes in diastolic pressure showed a significant negative correlation with changes in high frequency of R-R intervals. Conclusion: Cardiovascular autonomic function plays an important role in increasing blood pressure levels associated with increased modulation of vagal tone of the heart after puberty but does not in the preadolescent.
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| 8. |
- Westrup, Björn, et al.
(författare)
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Evaluating neonatal developmental care
- 2003
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Ingår i: Journal of Pediatrics. - : Elsevier BV. - 1097-6833 .- 0022-3476. ; 142:5, s. 591-593
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 25. |
- Welin-Berger, K., et al.
(författare)
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In vitro-in vivo correlation in man of a topically applied local anesthetic agent using numerical convolution and deconvolution
- 2003
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Ingår i: International Journal of Pharmaceutics. - : Elsevier BV. - 0378-5173 .- 1873-3476 .- 0022-3549. ; 92:2, s. 398-406
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the relevance of the in vitro permeation method used at our laboratory in predicting in vivo dermal and transdermal absorption. Two different emulsions, a submicron oil-in-water (o/w) emulsion and a semisolid water-in-oil (w/o) emulsion, containing a model compound were investigated. The in vitro permeation rate of the compound from these emulsions was measured using static diffusion cells with human skin as membrane. The emulsions were allowed to remain in contact with the skin in the donor chamber for 15, 60, and 240 min. The study was monitored for 240 min and the steady state flux was calculated. The systemic concentration of the compound was measured in vivo as a function of time after dermal application to healthy volunteers with 15 and 60 min of application. A short-lasting i.v. infusion study in healthy volunteers was used to simulate the i.v. bolus dose. Numerical convolution was used to predict the in vivo plasma concentration of the compound while the in vivo absorption rate of the compound was estimated using numerical deconvolution. To establish correlation, the predicted in vivo flux was compared with the corresponding observed in vitro parameter after adjusting for the lag time. No major differences were seen in the systemic plasma levels between the two emulsions, which is in close agreement with the steady state flux measured in vitro. A linear correlation representing a point-to-point relationship was established for each of the investigated formulations and application times. The longer application time was predicted more accurately for both emulsions.
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