The Journal of pediatrics
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The Journal of pediatrics · May 2014
Randomized Controlled Trial Comparative StudyRemifentanil versus morphine-midazolam premedication on the quality of endotracheal intubation in neonates: a noninferiority randomized trial.
To compare remifentanil and morphine-midazolam for use in nonurgent endotracheal intubation in neonates. ⋯ In our cohort, remifentanil was at least as effective as the morphine-midazolam regimen for endotracheal intubation. Thus, premedication using this very-short-acting opioid can be considered in urgent intubations and is advantageous in rapid extubation.
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The Journal of pediatrics · May 2014
Randomized Controlled Trial Comparative StudyTidal breathing in preterm infants receiving and weaning from continuous positive airway pressure.
To compare tidal breathing on different continuous positive airway pressure (CPAP) devices and pressures and to serially measure tidal breathing during weaning off CPAP using electromagnetic inductive plethysmography. ⋯ At different pressure settings, on all CPAP devices the measured MV/kg was similar either through increasing VT/kg and decreasing fR (nCPAP and nBiPAP) or maintaining both (bCPAP). Serial tidal breathing measurements may aid weaning from CPAP.
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To investigate whether birth by cesarean delivery rather than vaginal delivery is a risk factor for later childhood obesity. ⋯ Cesarean delivery may increase the risk of obesity in early childhood. Our results do not support the hypothesis that an increasing rate of cesarean delivery contributes to obesity in childhood.
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The Journal of pediatrics · May 2014
Randomized Controlled TrialThe effects of umbilical cord milking on hemodynamics and neonatal outcomes in premature neonates.
To determine whether umbilical cord milking (UCM) improves systemic blood flow and reduces neonatal morbidities compared with immediate cord clamping (ICC). ⋯ We demonstrate greater systemic blood flow with UCM in preterm neonates compared with ICC. Future large prospective trials are needed to determine whether UCM reduces intraventricular hemorrhage and other long-term morbidities.
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The Journal of pediatrics · May 2014
Clinical TrialMammalian target of rapamycin inhibitors for intractable epilepsy and subependymal giant cell astrocytomas in tuberous sclerosis complex.
To evaluate the efficacy and side effects of oral mammalian target of rapamycin (mTOR) inhibitors in children and adolescents with tuberous sclerosis complex (TSC) and intractable epilepsy or subependymal giant cell astrocytoma (SEGA). ⋯ This case series suggests that mTOR inhibitors can improve seizures in those with TSC and refractory epilepsy. They are also an effective treatment for reducing the volume of SEGAs in patients with TSC not amenable to surgery with an acceptable side effect profile.