Pediatrics
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Randomized Controlled Trial Multicenter Study Comparative Study
A pilot randomized, controlled trial of later treatment with a peptide-containing, synthetic surfactant for the prevention of bronchopulmonary dysplasia.
Oxidant injury and lung inflammation in extremely premature infants are associated with the development of bronchopulmonary dysplasia. Surfactant dysfunction resulting from these events may contribute to the pathogenesis of bronchopulmonary dysplasia. Treatment with exogenous surfactant may decrease the incidence or severity of bronchopulmonary dysplasia. We conducted a masked, multicenter, multinational, randomized, controlled, pilot study to estimate the effects of treating infants at high risk for developing bronchopulmonary dysplasia with lucinactant, a synthetic, peptide-containing surfactant, on safety during dosing and the incidence of death or bronchopulmonary dysplasia. ⋯ There were trends toward lower oxygen requirements and toward a lower incidence of mortality or bronchopulmonary dysplasia at 36 weeks' postmenstrual age in infants who received the higher dose of lucinactant, and this warrants further investigation.
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Randomized Controlled Trial Comparative Study
Effect of bimonthly supplementation with oral cholecalciferol on serum 25-hydroxyvitamin D concentrations in HIV-infected children and adolescents.
Vitamin D insufficiency occurs commonly in HIV-infected youth in the United States. In light of the importance of vitamin D for skeletal and nonskeletal health, including innate immunity, developing methods for improving vitamin D status in HIV-infected children and adolescents is an important area of clinical research. The objective of this study was to evaluate the effect of administration of oral cholecalciferol, 100,000 IU every 2 months, and 1 g/day calcium on serum 25-hydroxyvitamin D concentrations, serum and urine calcium, and HIV disease progression during a 12-month period. ⋯ Administration of oral cholecalciferol to HIV-infected children and adolescents at a dosage of 100,000 IU every 2 months, together with 1 g/day calcium, is safe and results in significant increases in serum 25-hydroxyvitamin D concentrations.
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To review the use of inhaled corticosteroids on asthma control in children by using the new therapeutic paradigm outlined in the Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. ⋯ Treatment with inhaled corticosteroids improves the asthma-control domains of impairment and risk in children. Differences in study protocols make detailed comparisons difficult. Specific needs for additional trials include (1) more studies using appropriate indicators for impairment (eg, rescue-medication use; symptoms scores; asthma/episode-free days) and risk (eg, forced expiratory volume in 1 second in children who can perform spirometry; exacerbations requiring oral corticosteroids; urgent care usage) and (2) more studies evaluating adolescents; the majority of the data reported were for children up to the age of 12 years, and data for adolescents are often lost (either grouped with adults [eg, studies in patients > or =12 years old] or not included [eg, studies of school-aged children < or =12 years old]). Attention should be given to standardizing variables that will permit comparison of outcomes between trials.