Comparison of Infasurf (calf lung surfactant extract) to Survanta (Beractant) in the treatment and prevention of respiratory distress syndrome

OBJECTIVE: To compare the relative safety and efficacy of Infasurf (calf lung surfactant extract; ONY, Inc, Amherst, NY, IND #27169) versus Survanta (Beractant, Ross Laboratories, Columbus, OH) in reducing the acute severity of respiratory distress syndrome (RDS) when given at birth and to infants with established RDS. DESIGN: A prospective, randomized, double-blind, multicenter clinical trial. SETTING: Thirteen neonatal intensive care units participated in the treatment arm: seven of these concurrently participated in the prevention arm. PATIENTS: The treatment arm enrolled infants of 相似文献   

Does spasticity result from hyperactive stretch reflexes? Preliminary findings from a stretch reflex characterization study

Purpose:?To characterize the stretch reflex response of the biceps brachii in stroke patients with elbow spasticity (prior to or within 15?min of treatment with botulinum toxin) and non-impaired volunteers with the aim of quantifying the stretch reflex excitability and observe the differences between the groups.

Methods:?A cross-sectional study. Stretch reflexes from the biceps brachii were elicited following a controlled elbow extension. The amplitude, latency, rise time and duration, calculated from surface EMG recordings from the biceps brachii, were used to characterize the stretch reflex response.

Results:?Seventeen non-impaired and 14 stroke patients participated. The amplitude was significantly lower in stroke patients than in non-impaired volunteers (p?<?0.05). The latency was significantly shorter in stroke patients than in non-impaired volunteers (p?<?0.05). There were no significant differences in rise time or duration (p?>?0.10).

Discussion:?Reduction in the amplitude in stroke patients was unexpected suggesting the stretch reflex is not necessarily hyper-excitable in people with clinically diagnosed spasticity. Latency differences suggest decreased presynaptic inhibition and/or increased motor neurone excitability can occur following a stroke. However, carry over effects from previous botulinum toxin treatment may have confounded amplitude measurements. Further work evaluating the excitability of the stretch reflex independent of Botulinum toxin and its contribution to resistance to passive stretching is being conducted.     

The incidence,aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital

Background  

Acute seizures are a common cause of paediatric admissions to hospitals in resource poor countries and a risk factor for neurological and cognitive impairment and epilepsy. We determined the incidence, aetiological factors and the immediate outcome of seizures in a rural malaria endemic area in coastal Kenya.     

Optimal needle size for renal biopsy: in vitro and in vivo evaluation

To evaluate the success and complication rates of small (16- and 18- gauge) needles in biopsy of the kidney, the authors performed in vitro biopsy in a cadaveric kidney and in vivo renal biopsy in 141 patients. Best results were obtained with a 16-gauge modified Menghini needle. In vitro, 9.7 +/- 5.7 (mean +/- standard deviation) glomeruli were retrieved, and the average length of tissue cores was 17.8 mm +/- 8.2. In vivo, 10.63 +/- 6.64 intact glomeruli were retrieved, and a definitive histologic diagnosis was achieved in 86% of patients. The frequency of major complications with this needle was 3.5%, and of minor complications, 5.8%. No major complications occurred after biopsy was performed with 18-gauge needles of the same design. However, the retrieval rate of glomeruli with these smaller needles was insufficient. An 18-gauge needle with two cutting edges yielded tissue cores of 11.0 mm +/- 3.5 in length. In vitro, 6.6 +/- 2.3 glomeruli were retrieved; in vivo, 9.92 +/- 6.65. A definitive histologic diagnosis was achieved with this needle in 75% of patients, and rates of 7.1% for major complications and 10.7% for minor complications were encountered.     

Liver Damage in Long-Term Anticonvulsant Therapy: A Serological and Histological Study

The prevalence of liver damage in patients receiving long-termanticonvulsant therapy was determined, using a new marker ofliver disease, the serum F protein concentration. Abnormal serumF protein concentrations were detected in 50 per cent of 34patients receiving anticonvulsant therapy. A retrospective analysisof post-mortem liver samples showed common histological abnormalitiesin three out of seven patients who had died whilst receivinganticonvulsant therapy. These changes were not seen in controlpatients. We suggest that chronic anticonvulsant therapy maycause significant hepatocellular damage.