The Journal of pediatrics
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The Journal of pediatrics · Jul 1989
Clinical Trial Controlled Clinical TrialNatural history of food hypersensitivity in children with atopic dermatitis.
Patients with atopic dermatitis and food hypersensitivity who were adhering to an elimination diet underwent repeat double-blind, placebo-controlled oral food challenges annually for follow-up of their food allergy. After 1 year, 19 of 75 patients lost all signs of clinical food hypersensitivity (15 of 45 patients allergic to one food, and 4 of 21 allergic to two foods). Of the individual foods, 38 of 121 no longer elicited symptomatic responses. ⋯ Total serum IgE and prick skin tests were not useful for predicting loss of symptomatic food hypersensitivity. There was no significant decrease in skin test wheal size corresponding to loss of clinical food hypersensitivity. Patients developing only skin symptoms during the initial challenge were most likely to lose symptomatic food hypersensitivity.
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The Journal of pediatrics · Feb 1989
Insulin infusion with parenteral nutrition in extremely low birth weight infants with hyperglycemia.
From Nov. 7, 1983, to Nov. 6, 1986, all infants with birth weight less than or equal to 1000 gm admitted to Oregon Health Sciences University who had persistent hyperglycemia and glycosuria were treated with graded insulin infusion while energy intake was increased to at least 100 kcal/kg/day (419 kilojoules/kg/day). The records of these infants were reviewed to define the clinical characteristics of infants likely to develop hyperglycemia and to see whether insulin administration would allow goals for energy intake to be met. There were 76 surviving infants; 34 received insulin and 42 did not. ⋯ The initial dose was 40 to 100 mU/gm of dextrose infused (57 to 142 nmol/mol) and then gradually decreased. Less than 0.5% of blood glucose values were 25 to 40 mg/dl (1.4 to 2.2 mmol/L). We conclude that insulin infusion improves glucose tolerance in extremely low birth weight infants and allows hyperglycemic infants to achieve adequate energy intake similar to that of infants who do not become hyperglycemic.
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The Journal of pediatrics · Dec 1988
Abnormalities of diaphragmatic muscle in neonates with ventilated lungs.
Several infants and neonates who had received long-term ventilatory assistance had subnormal diaphragmatic muscle mass on gross necropsy examination. We conducted a retrospective study of our hospital infant necropsy files to determine whether prolonged ventilatory support was associated with diminution in myofiber cross-sectional area selectively affecting the diaphragm. We found that long-term ventilatory assistance may predispose diaphragmatic myofibers to disuse atrophy or to failure or normal growth. This phenomenon may contribute to difficulties in weaning infants from ventilatory support.