The Journal of pediatrics
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The Journal of pediatrics · Jun 1995
Comparative StudyEconomic comparison of a tissue adhesive and suturing in the repair of pediatric facial lacerations.
To determine, from the societal perspective, the most cost efficient of the three methods commonly used to repair pediatric facial lacerations: nondissolving sutures, dissolving sutures, or a tissue adhesive (Histoacryl blue). ⋯ Tissue adhesive is the preferred method of closure of pediatric facial lacerations because it results in the most efficient use of resources and is preferred by the majority of parents.
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The Journal of pediatrics · Jun 1995
A reexamination of the risk factors for the sudden infant death syndrome.
To determine which risk factors are specific for the sudden infant death syndrome (SIDS) rather than characteristic of postneonatal deaths in general. ⋯ Among characteristics generally thought to be risk factors, only maternal smoking during pregnancy was independently associated with SIDS. Data from this nationally representative sample indicate that if women refrained from smoking while pregnant, up to 30% of SIDS might be prevented.
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The Journal of pediatrics · Jun 1995
Effect of airway pressure on inferior vena cava pressure as a measure of central venous pressure in children.
We evaluated the effect of elevated airway pressure on the validity of intravascular pressure obtained in the distal inferior vena cava (IVC) as a measure of central venous pressure (CVP) in a group of children receiving mechanical ventilation. The IVC pressure correlated well with CVP in the patients without abdominal distention, but the disparity was wider in those with abdominal distention. Elevated mean airway pressure or positive end-expiratory pressure had no effect on the relationship of IVC to CVP.
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The Journal of pediatrics · May 1995
Randomized Controlled Trial Comparative Study Clinical TrialClinical trial of vitamin A as adjuvant treatment for lower respiratory tract infections.
To test the efficacy of a high dose of vitamin A as adjuvant treatment for radiographically confirmed cases of acute lower respiratory tract infection (ALRI). ⋯ Treatment with high doses of vitamin A over and above standard care for infants and children with non-measles-related ALRI is not efficacious for the current episode. Additional trials among populations in which vitamin A deficiency is more prevalent and severe should be considered.
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The Journal of pediatrics · May 1995
Randomized Controlled Trial Multicenter Study Clinical TrialDouble-blind, randomized, placebo-controlled Canadian multicenter trial of two doses of synthetic surfactant or air placebo in 224 infants weighing 500 to 749 grams with respiratory distress syndrome. Canadian Exosurf Neonatal Study Group.
In a multicenter, double-masked, placebo-controlled rescue trial conducted at 12 Canadian hospitals, two 5 ml/kg doses of a synthetic surfactant or air placebo were administered to 224 infants with birth weights of 500 to 749 gm who had established respiratory distress syndrome and an arterial/alveolar oxygen tension ratio of less than 0.22. The first dose was given between 2 and 24 hours of age; the second dose was given 12 hours later to the infants continuing to receive mechanical ventilation. Infants were stratified at study entry by birth weight and gender. ⋯ Similarly, neither the incidence of bronchopulmonary dysplasia (37% vs 30%, air placebo group vs synthetic surfactant group; p = 0.089) nor the incidence of survival without BPD through 28 days (17% vs 26%, respectively; p = 0.070) was significantly different in the two groups. No significant differences in the incidence of safety-related outcomes or in adverse effects such as apnea or pulmonary hemorrhage were noted. These findings indicate that rescue therapy with synthetic surfactant results in physiologic improvements in very tiny premature infants, but improvements in overall mortality or other complications of respiratory distress syndrome were not documented in the sample evaluated.