The Journal of pediatrics
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The Journal of pediatrics · Oct 1993
Comparative StudyGrowth and neurodevelopmental outcome of very low birth weight infants with intrauterine growth retardation: comparison with control subjects matched by birth weight and gestational age.
Eighty-one very low birth weight (VLBW) infants were followed for 3 years to assess the relative impact of intrauterine growth retardation on growth and development; 27 small for gestational age (SGA) infants were compared with 27 gestation-matched infants with appropriate size for gestational age (AGA) and 27 birth weight-matched AGA infants. It was hypothesized that growth and neurodevelopmental outcomes in SGA VLBW infants are poorer than those of AGA gestation-matched (AGA-GA) infants but do not differ from those of birth weight-matched (AGA-BW) control infants. Gestational ages of the SGA, AGA-GA, and AGA-BW infants were 29 +/- 2, 29 +/- 1, 26 +/- 2 weeks, and birth weights were 821 +/- 178, 1124 +/- 85, and 848 +/- 141 gm, respectively. ⋯ The SGA infants scored lower on developmental tests at 1, 2, and 3 years than AGA-GA infants but had scores similar to those of the AGA-BW group. We conclude that intrauterine growth retardation in VLBW infants has a significant long-term impact on growth. Although 3-year development of SGA infants is significantly lower than that of gestation-matched control infants, it does not differ from that of weight-matched control infants.
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The Journal of pediatrics · Oct 1993
Comparative StudyNo resuscitation and withdrawal of therapy in a neonatal and a pediatric intensive care unit in Canada.
To compare and contrast the modes of death in a neonatal (NICU) and a pediatric (PICU) intensive care unit. ⋯ This study confirms that both withdrawal of therapy and no-CPR orders are part of current clinical practice in both the NICU and PICU settings. The ethical foundations and implications of these practices need further elaboration.
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The Journal of pediatrics · Oct 1993
Persistent hyperinsulinemic hypoglycemia of infancy: long-term octreotide treatment without pancreatectomy.
Eight patients with persistent hyperinsulinemic hypoglycemia of infancy who were treated with octreotide without pancreatectomy are described. All had severe, early-onset disease that would have required partial pancreatectomy had octreotide not been available. Along with octreotide, frequent feedings and raw cornstarch at night were required by all. ⋯ The remaining three patients (aged 5 to 9 months) are still being treated with octreotide. We conclude that, with the use of octreotide, pancreatectomy can be avoided in some patients. Particularly in light of our findings of a high incidence of diabetes years after partial pancreatectomy, and clinical improvement after months to years of octreotide treatment, we believe that aggressive medical therapy, when effective, is preferable to partial pancreatectomy.