Latest & greatest articles for children

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Top results for children

9021. Ceftriaxone versus ampicillin and chloramphenicol for treatment of bacterial meningitis in children. (Abstract)

Ceftriaxone versus ampicillin and chloramphenicol for treatment of bacterial meningitis in children. 78 patients with bacterial meningitis were evaluated in a prospective, randomised study comparing twice-daily ceftriaxone as single-drug therapy with ampicillin and chloramphenicol given every 6 h. The groups were comparable in age, sex, days of illness before admission, and bacterial colony counts in cerebrospinal fluid (CSF). The pathogens were Haemophilus influenzae type b (54 cases

1983 Lancet Controlled trial quality: uncertain

9022. Aerosol treatment of bronchoconstriction in children, with or without a tube spacer. (Abstract)

Aerosol treatment of bronchoconstriction in children, with or without a tube spacer. To assess whether an extension tube between the aerosol source and the patient improves drug-inhalation therapy in children with acute bronchoconstriction, we treated 20 children under double-blind conditions with placebo or terbutaline delivered by a conventional aerosol or an aerosol with a tube spacer. Both terbutaline treatments resulted in a significant increase in forced expiratory volume in one second (...) , as compared with placebo (P less than 0.001), but treatment with the tube-spacer aerosol produced significantly more improvement than did treatment with the conventional aerosol (P less than 0.01). The number of errors in inhalation technique was reduced when the spacer aerosol was used, and this reduction may account for the greater improvement in the children treated with the spacer.

1983 NEJM Controlled trial quality: uncertain

9023. Penicillin in infants weighing two kilograms or less with early-onset Group B streptococcal disease. (Abstract)

Penicillin in infants weighing two kilograms or less with early-onset Group B streptococcal disease. We studied the effect of penicillin on early-onset Group B streptococcal disease over a 52-month period in neonates who were at high risk of infection. Shortly after birth, 1187 neonates weighing 2000 g or less had blood samples taken for cultures and were randomized into an early-treatment group (given intramuscular penicillin G within 60 minutes of birth) or a control group. The incidence (...) of early-onset disease was 20 per 1000 live births (24 of 1187); the number of infants in the early-treatment group who had disease (10 of 589) was similar to that in the control group (14 of 598). The fatality rates were similar in both groups (6 of 10 vs. 8 of 14). Cultures from blood obtained with one hour of birth were positive in 21 of the 24 infants with disease; 22 of the 24 were symptomatic within four hours of birth. Thus, infection was well established before the first hour of postnatal life

1983 NEJM Controlled trial quality: uncertain

9024. Comparison of intermediate-dose methotrexate with cranial irradiation for the post-induction treatment of acute lymphocytic leukemia in children. Full Text available with Trip Pro

Comparison of intermediate-dose methotrexate with cranial irradiation for the post-induction treatment of acute lymphocytic leukemia in children. We compared two regimens with respect to their ability to prolong disease-free survival in 506 children and adolescents with acute lymphocytic leukemia. All responders to induction therapy were randomized to treatment with 2400 rad of cranial irradiation plus intrathecal methotrexate or to treatment with intermediate-dose methotrexate plus intrathecal

1983 NEJM Controlled trial quality: uncertain

9025. Childhood non-Hodgkin's lymphoma. The results of a randomized therapeutic trial comparing a 4-drug regimen (COMP) with a 10-drug regimen (LSA2-L2). (Abstract)

Childhood non-Hodgkin's lymphoma. The results of a randomized therapeutic trial comparing a 4-drug regimen (COMP) with a 10-drug regimen (LSA2-L2). Members of the Childrens Cancer Study Group treated 234 eligible patients in a randomized trial designed to study the relative effectiveness of two therapy programs for the treatment of childhood and adolescent non-Hodgkin's lymphoma. Two chemotherapeutic strategies were compared: a 4-drug regimen (COMP) and a 10-drug regimen (modified LSA2-L2

1983 NEJM Controlled trial quality: uncertain

9026. Furosemide promotes patent ductus arteriosus in premature infants with the respiratory-distress syndrome. (Abstract)

Furosemide promotes patent ductus arteriosus in premature infants with the respiratory-distress syndrome. Furosemide stimulates the renal synthesis of prostaglandin E2, a potent dilator of the ductus arteriosus. We administered this drug to 33 premature infants with the respiratory-distress syndrome, to determine whether it increased the incidence of patent ductus arteriosus. Chlorothiazide, a diuretic that does not stimulate prostaglandin E synthesis, was used as the control drug in 33 other (...) infants. During the study, the incidence of patent ductus arteriosus was significantly higher (P less than 0.02) in the furosemide group (18 of 33 infants) than in the chlorothiazide group (8 of 33). Eleven infants in the furosemide group and seven in the chlorothiazide group required ductal ligation (P greater than 0.2). An additional six infants (all from the furosemide group) who did not have evidence of a patent ductus during the study were later found to have one. Overall survival was 76 and 61

1983 NEJM Controlled trial quality: uncertain

9027. Lack of efficacy of a decongestant-antihistamine combination for otitis media with effusion ("secretory" otitis media) in children. Results of a double-blind, randomized trial. (Abstract)

Lack of efficacy of a decongestant-antihistamine combination for otitis media with effusion ("secretory" otitis media) in children. Results of a double-blind, randomized trial. In a double-blind, randomized trial of 553 infants and children who had otitis media with effusion ("secretory" otitis media), we compared the efficacy of a four-week course of an oral decongestant-antihistamine combination (pseudoephedrine hydrochloride, 4 mg per kilogram of body weight per day, and chlorpheniramine (...) -antihistamine combinations do not appear to be indicated for the treatment of otitis media with effusion in infants and children.

1983 NEJM Controlled trial quality: uncertain

9028. Growth and biochemical response of preterm infants fed human milk or modified infant formula. (Abstract)

Growth and biochemical response of preterm infants fed human milk or modified infant formula. My colleagues and I compared the biochemical status and rates of growth of three groups of preterm infants: one group was fed milk obtained early from mothers of preterm infants; one group received milk produced during the mature stage of lactation by mothers of term infants; and one group received a whey-based infant formula. Sixty healthy preterm infants with birth weights of 1600 g or less were (...) randomly assigned to one of the three feedings groups. The 20 infants in each group were followed until they reached a weight of 1800 g. The mean (+/- S.E.M.) number of days required to regain birth weight was similar for infants receiving the formula (10.3 +/- 0.8) and those receiving milk from mothers of preterm infants (11.4 +/- 0.8); both were significantly less than the number (18.8 +/- 1.7) for infants receiving milk from mothers of term infants (P less than 0.001). Subsequent rates of weight

1983 NEJM Controlled trial quality: uncertain

9029. Diet and antibody response to vaccinations in healthy infants. (Abstract)

Diet and antibody response to vaccinations in healthy infants. Antibody responses to poliovirus, diphtheria, pertussis, or tetanus vaccine were compared in five groups of infants. The 62 infants had been brought up on breast milk or on one of four types of artificial feed in the first five months of life. The types of artificial feed varied in quality and quantity of protein; they were high or low protein cow's milk, an adapted formula (with a casein/albumin ratio of 40/60), and a formula based (...) on soy flour. After the age of 5 months, all infants were put on the same diet. The general pattern of antibody responses as determined by antibody levels when the infants were 5 and 8 months old was that those fed on breast milk or high-protein cow's milk had adequate and sustained antibody responses; those fed on the adapted formula had a high but temporary response; and those fed on low-protein cow's milk or the soy-based formula had poor responses.

1983 Lancet Controlled trial quality: uncertain

9030. A randomized trial of sodium intake and blood pressure in newborn infants. (Abstract)

A randomized trial of sodium intake and blood pressure in newborn infants. We studied the effect of dietary sodium on BP in a double-blind randomized trial with 245 newborn infants assigned to a normal-sodium diet and 231 to a low-sodium diet during the first six months of life. The sodium intake of the normal-sodium group was almost three times that of the low-sodium group. Systolic BP was measured every month from the first week until the 25th week. At 25 weeks, systolic pressure was 2.1 mm

1983 JAMA Controlled trial quality: uncertain

9031. Childhood lead poisoning. A controlled trial of the effect of dust-control measures on blood lead levels. (Abstract)

Childhood lead poisoning. A controlled trial of the effect of dust-control measures on blood lead levels. Lead-contaminated house dust is one factor in childhood lead poisoning; however, most lead-reduction programs do not emphasize the control of house dust. We studied whether lead-reduction plus dust-control measures would lower blood lead levels in children with Class II or III poisoning (blood lead levels, 30 to 49 micrograms per deciliter) more effectively than lead reduction alone (...) . An experimental group of 14 children and a control group of 35 children whose homes had already been treated were studied. In experimental homes, sites with elevated lead levels (greater than 100 micrograms per 930 cm2) were wet-mopped twice monthly and families were encouraged to clean and to wash the child's hands frequently. After one year blood lead levels fell an average of 6.9 micrograms per deciliter in the experimental group, as compared with 0.7 micrograms per deciliter in controls (P less than 0.001

1983 NEJM

9032. Diet and sleep patterns in newborn infants. (Abstract)

Diet and sleep patterns in newborn infants. Sleep behavior is modulated by serotonergic neurons within the brain, and the synthesis and release of serotonin by such neurons is thought to be influenced by the availability of tryptophan, the amino acid precursor of serotonin. We investigated the effects on the sleep patterns of newborn infants of variations in diet designed to affect tryptophan availability. Twenty healthy newborns (two to three days of age) were randomly assigned to receive (...) a feeding consisting either of tryptophan in 10 per cent glucose or valine in 5 per cent glucose (valine competes with tryptophan for entry into the brain). Sleep patterns during the three hours after this feeding were compared with those after a feeding of routine formula (Similac). The infants fed tryptophan entered active sleep 14.1 minutes sooner than they did after Similac, and entered quiet sleep 20 minutes sooner. Those fed valine entered active sleep 15.8 minutes later than they did after

1983 NEJM Controlled trial quality: uncertain

9033. Phenobarbitone for prevention of periventricular haemorrhage in very low birth-weight infants. A randomised double-blind trial. (Abstract)

Phenobarbitone for prevention of periventricular haemorrhage in very low birth-weight infants. A randomised double-blind trial. A double-blind randomised trial was carried out in 60 infants with a birth-weight of less than 1500 g or a gestational age below 31 weeks. 30 infants received phenobarbitone (20 mg/kg) within 4 h of birth and 30 infants received a placebo. The two groups of infants were similar in birth-weight, gestational age, frequency of vaginal delivery, sex, Apgar scores (...) , ventilator dependence before the injection, pneumothorax, hypercapnia, and acidosis. Cranial ultrasound scans were carried out daily for 14 days. 12 out of 30 phenobarbitone-treated infants and 11 out of 30 placebo-treated infants had PVH, with parenchymal haemorrhages in 2 of the placebo group. Plasma phenobarbitone was over 15 micrograms/ml in 28 out of 30 of the phenobarbitone-treated infants during the first 72 h. 7 out of 17 spontaneously breathing infants became ventilator-dependent within 12 h

1983 Lancet Controlled trial quality: predicted high

9034. Economic evaluation of neonatal intensive care of very low birth weight infants Full Text available with Trip Pro

limited data. 2)There wereno health omissions 3)The sensitivity analysis was adequate. 4)Costing was extensive, excluding production gains. Source of funding Ontario Ministry of Health Bibliographic details Boyle M H, Torrance G W, Sinclair J C, Horwood S P. Economic evaluation of neonatal intensive care of very low birth weight infants. New England Journal of Medicine 1983; 308(22): 1330-1337 PubMedID DOI Indexing Status Subject indexing assigned by NLM MeSH Adolescent; Child; Child, Preschool; Cost (...) Economic evaluation of neonatal intensive care of very low birth weight infants Economic evaluation of neonatal intensive care of very low birth weight infants Economic evaluation of neonatal intensive care of very low birth weight infants Boyle M H, Torrance G W, Sinclair J C, Horwood S P Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions

1983 NHS Economic Evaluation Database.

9035. Use or abuse of phototherapy for physiological jaundice of newborn infants. (Abstract)

Use or abuse of phototherapy for physiological jaundice of newborn infants. To investigate the need for and effects of phototherapy in full-term otherwise healthy babies with physiological jaundice, 40 consecutive babies with serum bilirubin levels of 250 mumol/l or more were assigned at random to two treatment groups. Phototherapy was started in the early group (n = 20) when serum bilirubin was 250 mumol/l and in the late group (n = 20) when serum bilirubin reached 320 mumol/l; however, only 3 (...) therefore curtailed the rise and duration of hyperbilirubinaemia, but the effect was small. Jaundice subsided spontaneously in most of these mature infants, especially girls. Phototherapy can separate mother from baby, and it is physiologically stressful. Treatment may be safely withheld until serum bilirubin exceeds 320 mumol/l.

1982 Lancet Controlled trial quality: uncertain

9036. Oral rehydration therapy of infantile diarrhea: a controlled study of well-nourished children hospitalized in the United States and Panama. (Abstract)

Oral rehydration therapy of infantile diarrhea: a controlled study of well-nourished children hospitalized in the United States and Panama. Although oral glucose-electrolyte solutions containing 90 mmol of sodium per liter have been widely used in the treatment of acute diarrhea among under-nourished children in the developing world, they have rarely been studied in well-nourished children. We therefore conducted a controlled randomized study among well-nourished children three months to two (...) years who were hospitalized with acute diarrhea (52 in the United States, and 94 in Panama), to compare the efficacy of this solution with that of one containing 50 mmol of sodium per liter and with standard intravenous therapy. Oral rehydration with both solutions according to protocol was successful in 97 of 98 children (one required unscheduled intravenous therapy), and in 87 (89 per cent) no intravenous therapy was required. All of six children admitted with hypernatremia were successfully

1982 NEJM Controlled trial quality: uncertain

9037. Human leukocyte interferon for the treatment of varicella in children with cancer. (Abstract)

Human leukocyte interferon for the treatment of varicella in children with cancer. Human leukocyte interferon was evaluated as a treatment for varicella in a randomized double-blind, placebo-controlled study carried out in two phases. A total of 44 children being treated for cancer were enrolled within 72 hours of the appearance of the exanthem. The mean number of days of new lesion formation was 3.8 +/- 1.89 (+/- S.D.) in the interferon recipients and 5.3 +/- 2.56 in the placebo recipients (P

1982 NEJM Controlled trial quality: uncertain

9038. Final report of study on hypertension during pregnancy: the effects of specific treatment on the growth and development of the children. (Abstract)

Final report of study on hypertension during pregnancy: the effects of specific treatment on the growth and development of the children. 195 (97.5%) children born to hypertensive women participating in a trial of methyldopa treatment during pregnancy were followed from birth and were extensively examined at the age of 7 1/2 years. The frequency of problems with health, physical or mental handicap, sight, hearing, and behaviour was the same in children of treated and untreated women. Sons (...) of the untreated women were heavier and taller than those of treated women, as were their mothers. Among children of women who entered the trial between 16 and 20 weeks' gestation, sons of untreated women had larger heads than sons of treated women, but there was no difference in mean intelligence quotients. There were no significant differences between the children in the treated and untreated groups in standing and supine blood pressures, or fourteen tests of ability. Methyldopa therefore seems safe to use

1982 Lancet Controlled trial quality: uncertain

9039. A randomised trial of oral gammaglobulin in low-birth-weight infants infected with rotavirus. (Abstract)

A randomised trial of oral gammaglobulin in low-birth-weight infants infected with rotavirus. Oral human gammaglobulin or placebo was given with each feed during the first week of life to 75 low-birth-weight babies. All were in a nursery where rotavirus was known to be endemic, 25 of the babies excreted rotavirus during the first 2 weeks of life. This group was regarded as the "challenge" group. Gammaglobulin administration was associated with delayed excretion of rotavirus and with milder (...) symptoms of infection. Rotavirus-associated diarrhoea necessitating low-lactose feeds developed in 6 of 11 babies given placebo and 1 of 14 babies given gammaglobulin. Oral human gammaglobulin seems to protect low-birth-weight infants from diarrhoea caused by rotavirus.

1982 Lancet Controlled trial quality: uncertain

9040. Safety and immunogenicity of a new Haemophilus influenzae type b vaccine in infants under one year of age. (Abstract)

Safety and immunogenicity of a new Haemophilus influenzae type b vaccine in infants under one year of age. 64 healthy infants 2-3 months old, were randomly assigned to one of three vaccination groups which received either diphtheria-pertussis-tetanus (DPT) vaccine, Haemophilus influenzae type b capsular polysaccharide polyribosyl-ribitol phosphate (PRP) vaccine, or PRP + P (with pertussis adjuvant) vaccine in three doses at intervals of 2 months. Local and systemic reactions occurred most (...) frequently after DPT vaccination and least frequently for PRP alone. Data for 60 infants from whom complete sera sets were available indicated that 70% of the infants who received three doses of PRP + P showed 2-fold or greater increases in titres of antibody to PRP with final values above the level assumed to give protection against invasive H. influenzae type b disease (greater than or equal to 0.15 microgram/ml). In contrast, less than 10% of the infants who received PRP vaccine alone showed 2-fold

1981 Lancet Controlled trial quality: uncertain