Pediatrics
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A randomized, controlled trial comparing two different continuous positive airway pressure systems for the successful extubation of extremely low birth weight infants.
To determine whether the use of the Infant Flow continuous positive airway pressure (IF CPAP) system reduces the rate of extubation failure among extremely low birth weight (ELBW) infants (infants with birth weight <1000 g) when compared with conventional CPAP delivered with a conventional ventilator and nasal prongs. ⋯ Extubation failure is a common problem, occurring in nearly 40% of ELBW infants who require mechanical ventilation. IF CPAP was as effective but no more effective than conventional CPAP in preventing extubation failure among ELBW infants. New strategies are needed to identify predictors of extubation success and to treat apnea/bradycardia, the most common cause of extubation failure, thereby reducing the likelihood of prolonged intubation in this high-risk cohort of premature infants.
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Multicenter Study Comparative Study
Cognitive and academic consequences of bronchopulmonary dysplasia and very low birth weight: 8-year-old outcomes.
To examine the effects of bronchopulmonary dysplasia (BPD) and very low birth weight (VLBW) on the cognitive and academic achievement of a large sample of 8-year-old children. ⋯ BPD and duration on oxygen have long-term adverse effects on cognitive and academic achievement above and be beyond the effects of VLBW. The problems that have been identified at 8 years of age highlight the need for continued monitoring of the learning, behavior, and development of BPD children to intervene with children who are at risk for school problems.
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Streptococcus pneumoniae infections in the neonate (SPIN) are relatively unusual events (1%-11% of neonatal sepsis) but are associated with substantial morbidity and mortality. Previous reports suggest that invasive SPIN is associated with prolonged rupture of membranes, maternal colonization/illness, prematurity, early-onset pneumonia presentation (<72 hours), and high mortality (50%). The aim of this study was to review the current epidemiology and clinical course of SPIN. ⋯ Compared with previous studies of neonates with pneumococcal infection, this series showed that infants with SPIN were usually 2 to 3 weeks of age at presentation; likely to be full term; and ill with pneumonia, meningitis, and otitis media. This late-onset presentation was associated with an overall mortality rate of 10.3% (14.3% for invasive disease).
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To evaluate the feasibility of implementing a smoking cessation intervention for parents at the time of the pediatric visit. ⋯ This study demonstrates the feasibility of engaging parents in a smoking cessation intervention at the time of a child's clinic visit. This approach may be an effective way to reach smokers who otherwise are unlikely to access smoking cessation interventions. High rates of program enrollment, use of NRT, and completion of telephone counseling in this study support the hypothesis that a child's clinic visit is a teachable moment to address parental smoking cessation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Low glycemic index breakfasts and reduced food intake in preadolescent children.
Recent reports have suggested that a low glycemic index (GI) diet may have a role in the management of obesity through its ability to increase the satiety value of food and modulate appetite. To date, no long-term clinical trials have examined the effect of dietary GI on body weight regulation. The majority of evidence comes from single-day studies, most of which have been conducted in adults. The purpose of this study was to investigate the effect of 3 test breakfasts-low-GI, low-GI with 10% added sucrose, and high-GI-on ad libitum lunch intake, appetite, and satiety and to compare these with baseline values when habitual breakfast was consumed. ⋯ These results suggest that low-GI foods eaten at breakfast have a significant impact on food intake at lunch. This is the first study to observe such an effect in a group of normal and overweight children and adds to the growing body of evidence that low-GI foods may have an important role in weight control and obesity management. The potentially confounding effect of differences in the macronutrient and dietary fiber content of the test breakfasts warrants additional study. In addition, the impact of GI on food intake and body weight regulation in the long term needs to be investigated.