The Journal of pediatrics
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The Journal of pediatrics · Dec 1996
Randomized Controlled Trial Clinical TrialIntravenous magnesium therapy for moderate to severe pediatric asthma: results of a randomized, placebo-controlled trial.
To evaluate the efficacy of intravenous magnesium (IVMg) therapy for moderate to severe asthma exacerbations in pediatric patients. ⋯ Children treated with intravenous magnesium infusions for moderate to severe asthma had significantly greater improvement in short-term pulmonary function without any significant alteration in blood pressure, suggesting a role for this agent as an adjunct in the treatment of such patients.
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The Journal of pediatrics · Dec 1996
Review Case ReportsVitreous hemorrhage as an ophthalmic complication of galactosemia.
A major complication of galactosemia is cataracts. This is usually considered to be the sole ophthalmic feature of this disorder. However, we have encountered vitreous hemorrhage, a very rare ophthalmic finding, in five neonates with galactosemia and have found four probable additional cases in the literature. ⋯ Retinal abnormalities were present in the involved eyes of the five neonates of whom we have direct knowledge. Thus we believe that retinal hemorrhage is the most likely source of the vitreous hemorrhage and that the coagulopathy associated with neonatal disease in galactosemia leads to vitreous hemorrhage. Prompt recognition and therapy for the coagulopathy would likely prevent vitreous hemorrhage in galactosemia.
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The Journal of pediatrics · Dec 1996
Case Reports Comparative StudyEffect of methylene blue on refractory neonatal hypotension.
Excess nitric oxide is a mediator of the hypotension in septic shock. Nitric oxide dilates vascular smooth muscle through activation of soluble guanylate cyclase. We report the increase in blood pressure caused by methylene blue (MB), a soluble guanylate cyclase inhibitor, in five neonates with presumed septic shock unresponsive to colloids, inotropic agents, and corticosteroids. ⋯ Three of five patients were weaned from inotropic support within 72 hours. Three of five patients survived and were discharged home. We suggest that MB increased blood pressure in these neonates with refractory hypotension.
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The Journal of pediatrics · Nov 1996
Comparative StudyChanging patterns of red blood cell transfusion in very low birth weight infants.
Anemia develops in increasing numbers of critically ill very low birth weight (VLBW) infants who survive the neonatal period, and they receive multiple red blood cell (RBC) transfusions. Despite their need for prolonged medical treatment, we hypothesized that VLBW infants presently receive fewer RBC transfusions as a result of the growing awareness of transfusion risks and improvement of neonatal care. ⋯ Overall administration of neonatal transfusions has decreased markedly, most likely because of multiple factors. Because most RBC transfusions are given to infants weighing 1 kg or less in the first weeks of life, therapeutic strategies should focus on this group of VLBW infants during this critical period. The temporal changes observed in transfusion patterns emphasize the importance of including concurrent controls in future studies evaluating transfusion interventions.