Objectives: To determine the risk of bronchopulmonary dysplasia(BPD) in subgroups of infants with and without patent ductus arteriosus (PDA) who were randomized to indomethacin prophylaxis or placebo, and to examine w...Objectives: To determine the risk of bronchopulmonary dysplasia(BPD) in subgroups of infants with and without patent ductus arteriosus (PDA) who were randomized to indomethacin prophylaxis or placebo, and to examine whether adverse drug effects on edema formation and oxygenation may explain why indomethacin prophylaxis does not reduce BPD. Study design:We studied 999 extremely low birth weight infants who participated in the Trial of Indomethacin Prophylaxis in Preterms(TIPP) and who survived to a postmenstrual age of 36 weeks.Results: The incidence of BPD in the 2 subgroups of infants with PDA was 52%(55/105) after indomethacin prophylaxis and 56%(137/246) after placebo. In contrast, rates of BPD in the 2 subgroups without a PDA were 43%(170/391) after indomethacin prophylaxis and 30%(78/257) after placebo (P[interaction] = 0.015). Logistic regression analysis with adjustment for prognostic base line factors showed that adverse and independent effects of indomethacin prophylaxis on the need for supplemental oxygen and on weight loss by the end of the first week of life may increase the risk of BPD in infants without PDA. Conclusions: Harmful side effects on oxygenation and edema formation may explain why indomethacin prophylaxis does not prevent BPD even though it reduces PDA.展开更多
Background: Human herpesvirus 6 (HHV-6), a widesp- read virus and causative agent of exanthema subitum in children, has been asso ciated with a number of neurologic disorders including cranial nerve palsies, se izures...Background: Human herpesvirus 6 (HHV-6), a widesp- read virus and causative agent of exanthema subitum in children, has been asso ciated with a number of neurologic disorders including cranial nerve palsies, se izures, encephalitis, meningitis, and multiple sclerosis. Patient: A 31-year-old man presented with bilateral optic neuropathy, disc edema, and unilateral ton ic pupil, which were found to be associated with acute HHV-6 infection. The pat ient had been suffering from juvenile diabetes for 5 years. One week after onset of intravenous antiviral therapy with foscarnet, disc edema subsided, and tonic pupil reaction was no longer detectable. Conclusions: HHV6 infection may play a role as a causative agent in patients with optic neuropathy and tonic pupil.展开更多
To test whether indomethacin prophylaxis has sex-mediated effects on severe intraventricular hemorrhage (grade III and IV) and on long-term outcomes in extremely-low-birth-wei-ght infants. A secondary analysis was per...To test whether indomethacin prophylaxis has sex-mediated effects on severe intraventricular hemorrhage (grade III and IV) and on long-term outcomes in extremely-low-birth-wei-ght infants. A secondary analysis was performed in the entire “Trial of Indomethacin Prophylaxis in Preterms study”cohort. The results suggest a weak differential treatment effect of indomethacin by sex.展开更多
文摘Objectives: To determine the risk of bronchopulmonary dysplasia(BPD) in subgroups of infants with and without patent ductus arteriosus (PDA) who were randomized to indomethacin prophylaxis or placebo, and to examine whether adverse drug effects on edema formation and oxygenation may explain why indomethacin prophylaxis does not reduce BPD. Study design:We studied 999 extremely low birth weight infants who participated in the Trial of Indomethacin Prophylaxis in Preterms(TIPP) and who survived to a postmenstrual age of 36 weeks.Results: The incidence of BPD in the 2 subgroups of infants with PDA was 52%(55/105) after indomethacin prophylaxis and 56%(137/246) after placebo. In contrast, rates of BPD in the 2 subgroups without a PDA were 43%(170/391) after indomethacin prophylaxis and 30%(78/257) after placebo (P[interaction] = 0.015). Logistic regression analysis with adjustment for prognostic base line factors showed that adverse and independent effects of indomethacin prophylaxis on the need for supplemental oxygen and on weight loss by the end of the first week of life may increase the risk of BPD in infants without PDA. Conclusions: Harmful side effects on oxygenation and edema formation may explain why indomethacin prophylaxis does not prevent BPD even though it reduces PDA.
文摘Background: Human herpesvirus 6 (HHV-6), a widesp- read virus and causative agent of exanthema subitum in children, has been asso ciated with a number of neurologic disorders including cranial nerve palsies, se izures, encephalitis, meningitis, and multiple sclerosis. Patient: A 31-year-old man presented with bilateral optic neuropathy, disc edema, and unilateral ton ic pupil, which were found to be associated with acute HHV-6 infection. The pat ient had been suffering from juvenile diabetes for 5 years. One week after onset of intravenous antiviral therapy with foscarnet, disc edema subsided, and tonic pupil reaction was no longer detectable. Conclusions: HHV6 infection may play a role as a causative agent in patients with optic neuropathy and tonic pupil.
文摘To test whether indomethacin prophylaxis has sex-mediated effects on severe intraventricular hemorrhage (grade III and IV) and on long-term outcomes in extremely-low-birth-wei-ght infants. A secondary analysis was performed in the entire “Trial of Indomethacin Prophylaxis in Preterms study”cohort. The results suggest a weak differential treatment effect of indomethacin by sex.
