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PubMed2002

Epilepsy in The Alienist and Neurologist, 1880-1920.

PURPOSE: To study the history of epilepsy from 1880 to 1920. METHODS: We reviewed all 40 volumes of The Alienist and Neurologist and identified articles concerning primarily epilepsy. We analyzed three of these articles in greater detail. RESULTS: The Alienist and Neurologist published "Original Contributions,""Selections," (abstracts from other journals written by the editorial board), "Editorials," and (book) "Reviews." Of 258 epilepsy articles, there were 40 Original Contributions, 164 Selections, 39 Editorials, and 15 Reviews. These articles included 71 on therapy (41 medication, 13 surgery, and 17 other therapies); 66 general discussions; 46 on etiology or symptoms; 34 case studies; 28 social/legal articles; and 13 autopsy or pathology articles. CONCLUSIONS: Analysis of The Alienist and Neurologist provides a unique and valuable perspective on the clinical practice and academic world of epileptology during the decades around the turn of the twentieth century.

Epilepsy↗
PubMed2004

[Cognitive-behavioral therapy in prevention of depression relapses and recurrences: a review].

OBJECTIVES: To revise theories and the available evidence about Cognitive Behavioral Therapy (CBT) role on the relapse and recurrence prevention of depressive episodes. METHODS: Review of random and controlled clinical trials that investigated CBT efficacy on the relapse and recurrence prevention of depressive episodes. The following databases were used: Medline, Lilacs, Cochrane, Biosis and Embase. The reference sections of the selected articles, review articles and specialized books were consulted. RESULTS: Fifteen studies with different experimental design were found, several with methodological problems. The majority of them compared CBT with antidepressants at the acute treatment phase. In 12 studies CBT significantly lowered the relapse/recurrence rate. Recent papers pointed to the CBT usefulness for treating residual depressive symptoms as a recurrence prevention strategy. CONCLUSION: CBT was effective for the depression relapse reduction. Its relationship with antidepressants as a prevention tool and CBT strategies (using it only in the acute phase, or during acute and maintenance phases, or after antidepressants withdrawal as a maintenance treatment, or focusing residual symptoms) need to be better investigated.

Antidepressive Agents↗
PubMed1991

Alternatives in the control of influenza.

OBJECTIVE: To review recent developments in the control of influenza, including the use of antiviral drugs and vaccines, in the context of the overall burden of respiratory viral illness. DATA SOURCES: English language literature search using MEDLINE, Index Medicus, reviews, text book articles and relevant papers. STUDY SELECTION: Approximately 100 publications were examined. Particular emphasis was given to selecting reviews and papers relating to vaccine efficacy. DATA EXTRACTION: Articles were selected according to their quality in relation to the very large available literature on influenza virus, the disease and its prevention. Reliable data on the significance of influenza in relation to other respiratory infections were the most difficult to obtain. DATA SYNTHESIS: Conventional subunit vaccines in key target groups, including the aged and the immunosuppressed, are less efficient than is desirable. The widespread use of antiviral drugs is unlikely without increases in the availability of methods for rapid diagnosis. Vaccines involving the use of newer technologies seem unlikely to have a place in influenza prophylaxis. Oral vaccines could be useful, if problems associated with intestinal viral degradation can be overcome. Intranasally administered live attenuated vaccines should be the most efficacious of all. CONCLUSIONS: In the short term there is considerable scope for the improvement of subunit vaccines by the use of adjuvants. However, in the longer term, live attenuated vaccines, because of their great theoretical advantages over conventional vaccines with non-replicating antigens, may be accepted as the public health measure of choice for the prophylaxis of influenza.

Adjuvants, Immunologic↗
PubMed1992

Cervical cancer--what role for human papillomavirus?

OBJECTIVE: To review the role of human papillomavirus (HPV) as a causative agent of cancer of the cervix. DATA SOURCES, data synthesis, study selection: Medical journals, recently published text books related to cancer of the cervix and HPV and Papillomavirus Reports were examined to review the pathology of cervical cancer and its precursor lesions, its epidemiology in Australia and overseas, methods of detection of HPV (in particular molecular biology techniques used to diagnose HPV) and evidence linking HPV with genital neoplasia. CONCLUSION: While there is compelling evidence strongly linking certain HPV types with genital cancer, a causative role is yet to be proven and the aetiology is most likely multifactorial. Detection and typing of high risk genotypes of HPV in the genital tract as a diagnostic exercise to identify those women most at risk of developing genital neoplasia is not currently recommended.

Female↗
PubMed1993

Genetic relatedness of lymphoid malignancies. Transformation of chronic lymphocytic leukemia as a model.

OBJECTIVE: Studies concerning the genetic relatedness between chronic lymphocytic leukemia and the more aggressive B-cell cancers that develop in about 10% of affected persons were reviewed. These B-cell cancers include large B-cell lymphoma (the Richter syndrome), prolymphocytic transformation, acute lymphoblastic leukemia, and multiple myeloma. Two possible relations were evaluated: development from the chronic lymphocytic leukemia clone (clonal evolution) and development of a genetically unrelated, independent second cancer. DATA SOURCES: An English-language medical literature search was done using MEDLINE (1982 to 1992) and CANCERLIT (1982 to 1992). An extensive manual search of the literature that included meeting abstracts and reports was also done. Approximately 500 articles, abstracts, and book chapters were identified; 102 were selected for detailed analysis. DATA ANALYSIS: Analysis of genetic relatedness between the two cancers considered concordance for immunoglobulin gene rearrangements, for immunoglobulin isotypes and idiotypes, and for cytogenetic abnormalities. CONCLUSIONS: In the case of large B-cell lymphoma, generally thought to arise from the chronic lymphocytic leukemia clone, approximately one half of the patients had genetically unrelated cancers. In prolymphocytic transformation, all cases studied appeared to evolve from the chronic lymphocytic leukemia clone. The few studies of acute lymphoblastic leukemia and multiple myeloma showed genetic relatedness in some cases and unrelatedness in others. These data indicate that progression to more aggressive B-cell cancers in persons with chronic lymphocytic leukemia can result from either clonal evolution or from an independent transforming event.

Burkitt Lymphoma↗
PubMedDate not supplied

Attitudes of low-income parents toward seeking help with parenting: implications for practice.

Fifty-two low-income parents were surveyed to determine attitudes toward parenting and help seeking. Although a majority agreed that most parents, even "good" parents, need help or advice about parenting and thought they would seek help with parenting, low-income parents were less likely to believe in or seek out help than those with higher incomes. The most frequently selected sources of help were family, books and videos, telephone help-lines, and friends. The least likely sources of help were child protective services, school personnel, clergy, and social service/counseling agencies. Parent support and education groups were likely sources of support for only one in four low-income parents.

Adolescent↗
PubMed2002

Management of nephropathy in patients with type 2 diabetes.

PURPOSE: To review evidence-based management of nephropathy in patients with type 2 diabetes. DATA SOURCES: A literature search (MEDLINE 1966 to 2000) was performed using the key word "diabetic nephropathy". Relevant book chapters were also reviewed. STUDY SELECTION: Well-controlled, prospective landmark studies and expert review articles on diabetic nephropathy were selected. DATA EXTRACTION: Data and conclusions from the selected articles that provide solid evidence to the optimal management of diabetic nephropathy were extracted and interpreted in light of our clinical research experience with many thousands of Hong Kong Chinese patients. RESULTS: Hypertension, long diabetes duration, poor glycaemic control and central obesity are the most important risk factors. Microalbuminuria is a practical marker to predict overt nephropathy in type 2 diabetic patients. Risk factor modification, renal function monitoring and combined therapies are the current integrated approaches to manage patients with diabetic kidney disease. Optimal glycaemic control is the mainstay of treatment but effective antihypertensive therapy is also key to delaying the progression of diabetic nephropathy. Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists have important renoprotective actions independent of their blood pressure lowering actions. CONCLUSIONS: Diabetic nephropathy is the leading cause of end-stage renal disease worldwide. Monitoring renal function and screening for microalbuminuria will allow the identification of patients with nephropathy at a very early stage for intervention. Tight glycaemic control and aggressive antihypertensive treatment as well as the use of renin-angiotensin system inhibitors should substantially delay the progression of nephropathy.

Albuminuria↗
PubMed2002

Hemorrhagic shock.

OBJECTIVE: To review the clinical aspects of hemorrhagic shock and provide recommendations for therapy. OPTIONS: Early recognition of hemorrhagic shock and prompt systematic intervention will help avoid poor outcomes. OUTCOMES: Establish guidelines to assist in early recognition of hemorrhagic shock and to conduct resuscitation in an organized and evidence-based manner. EVIDENCE: Medline references were sought using the MeSH term "hemorrhagic shock." All articles published in the disciplines of obstetrics and gynaecology, surgery, trauma, critical care, anesthesia, pharmacology, and hematology between 1 January 1990 and 31 August 2000 were reviewed, as well as core textbooks from these fields. Selected references from these articles and book chapters were also obtained and reviewed. The level of evidence has been determined using the criteria described by the Canadian Task Force on the Periodic Health Examination. RECOMMENDATIONS: 1. Clinicians should be familiar with the clinical signs of hemorrhagic shock. (III-B) 2. Clinicians should be familiar with the stages of hemorrhagic shock. (III-B) 3. Clinicians should assess each woman's risk for hemorrhagic shock and prepare for the procedure accordingly. (III-B) 4. Resuscitation from hemorrhagic shock should include adequate oxygenation. (II-3A) 5. Resuscitation from hemorrhagic shock should include restoration of circulating volume by placement of two large-bore IVs, and rapid infusion of a balanced crystalloid solution. (I-A) 6. Isotonic crystalloid or colloid solutions can be used for volume replacement in hemorrhagic shock (I-B). There is no place for hypotonic dextrose solutions in the management of hemorrhagic shock (I-E). 7. Blood component transfusion is indicated when deficiencies have been documented by clinical assessment or hematological investigations (II-2B). They should be warmed and infused through filtered lines with normal saline, free of additives and drugs (II-3B). 8. Vasoactive agents are rarely indicated in the management of hemorrhagic shock and should be considered only when volume replacement is complete, hemorrhage is arrested, and hypotension continues. They should be administered in a critical care setting with the assistance of a multidisciplinary team. (III-B) 9. Appropriate resuscitation requires ongoing evaluation of response to therapy, including clinical evaluation, and hematological, biochemical, and metabolic assessments. (III-B) 10. In hemorrhagic shock, prompt recognition and arrest of the source of hemorrhage, while implementing resuscitative measures, is recommended. (III-B)VALIDATION: These guidelines have been reviewed by the Clinical Practice Obstetrics Committee and approved by Executive and Council of the Society of Obstetricians and Gynaecologists of Canada. SPONSORS: The Society of Obstetricians and Gynaecologists of Canada.

Blood Transfusion↗
PubMedDate not supplied

Short lever, specific contact articular chiropractic technique.

OBJECTIVE: To identify what has been theorized and/or written about the manual techniques generically classified as direct, but using specific contacts on short levers while using forces that may vary in speed and amplitude. DATA SOURCES: A search of the MEDLINE bibliographic database using MeSH key words (chiropractic/methods; osteopathic manipulation) was conducted. The Index to Chiropractic Literature and Chiropractic Research Abstracts Collection were searched through the past 10 yr using the key terms of chiropractic-methods; chiropractic techniques; manipulation, chiropractic; manipulation, osteopathic, manipulation, spinal; and manipulation, joint. A hand search of text-books was undertaken as well as review of the references included in books, monographs and collected papers. STUDY SELECTION: Studies in English were included, but it must be noted that these include publications that are not peer reviewed or refereed in any way. DATA EXTRACTION: Descriptions that discussed aspects of manipulative procedures with the appropriate characteristics were extracted by a single author. DATA SYNTHESIS: Very little was found or accessible using traditional methods of literature retrieval. Lack of common terminology as well as multiple technique systems developed in isolation contributed to the problem. Descriptions of characteristics for the attributes of techniques which use specific contacts on short levers are provided. The high-velocity, low-amplitude thrust technique is presented as one of the oldest and most widely used forms of manual medicine and remains one of the most frequently used forms of manual medicine. Derivation of applied forces as well as speculation as to the roll of specificity are discussed. CONCLUSIONS: This type of review is considered the first step in the evaluative process for a chiropractic technique procedure. It demonstrates that very little has been written in an accessible fashion relative to techniques which use specific contacts on short levers while applying forces that may vary in speed and amplitude. Statements made concerning the appropriateness or effectiveness consist of opinions only, with no reference to any form of injury or testing. The need for clinical trials and studies comparing different techniques is great.

Biomechanical Phenomena↗
PubMed2004

The role of inflammatory stress in acute coronary syndrome.

OBJECTIVE: To summarize current understanding of the roles of anti-inflammatory and proinflammatory mechanisms in the development of atherosclerosis and acute coronary syndrome and to postulate the novel concept of inflammation stress as the most important factor triggering acute coronary syndrome. Moreover, markers of inflammation stress and ways to block involved pathways are elucidated. DATA SOURCES: A literature search (MEDLINE 1997 to 2002) was performed using the key words "inflammation and cardiovascular disease". Relevant book chapters were also reviewed. STUDY SELECTION: Well-controlled, prospective landmark studies and review articles on inflammation and acute coronary syndrome were selected. DATA EXTRACTION: Data and conclusions from the selected articles providing solid evidence to elucidate the mechanisms of inflammation and acute coronary syndrome were extracted and interpreted in the light of our own clinical and basic research. DATA SYNTHESIS: Inflammation is closely linked to atherosclerosis and acute coronary syndrome. Chronic and long-lasting inflammation stress, present both systemically or in the vascular walls, can trigger acute coronary syndrome. CONCLUSIONS: Inflammation stress plays an important role in the process of acute coronary syndrome. Drugs which can modulate the balance of pro- and anti-inflammatory processes and attenuate inflammation stress, such as angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers, statins, and cytokine antagonists may play active roles in the prevention and treatment of acute coronary syndrome when used in addition to conventional therapies (glycoprotein IIb/IIIa receptor antagonists, mechanical intervention strategies, etc).

Angina Pectoris↗
PubMed1988

[Unusual historical cases of uterine inversion].

Professor Martial Dumont presents four cases of inverted uterus which are quite old. They come from the book by Mr Planque, M.D., entitled: "Selected Medical Library, from periodical publications, French as well as Foreign", published in Paris in 1748, by D'Houry senior, publisher and bookseller of His Royal Highness the Duke of Orleans, rue de la Vieille Boucherie. These findings are reported in Volume One, pages 406-413.

Female↗
PubMed1995

[Knowledge of the nursing consultation in primary health care].

OBJECTIVE: To find how much is known about the nursing surgeries in our health district. To compare the level of knowledge/use between the population covered and those with medical records. SETTING: Las Fuentes Norte health district, Zaragoza. PARTICIPANTS: Sample A (population): systematic random sampling of families, selecting 100 homes from the telephone book. 212 interviews with people over 18. Sample B (institutional). Simple and proportional random sampling of 100 patients with records at the centre. DESIGN: A crossover descriptive study using a telephone survey. MEASUREMENTS AND MAIN RESULTS: 86.3% of sample A had attended the centre on some occasion since its opening. 42% of sample A and 60% of B knew that the nursing surgeries existed. 27% of A and 46% of B had used it. By age, in sample A those over 65 used it more; in B, those between 51 and 65. The most widely known nursing activities were: taking blood pressure (20.3% in sample A and 33% in B); weight monitoring (13.7% and 20%, respectively). 37.7% of sample A knew their nurse; 60% of B. CONCLUSIONS: The nurse is still mainly identified with activities he/she has "classically" performed, like taking blood pressure and weight. Other more recent nursing activities, such as monitoring drug-dietetic treatments, preventive activities, check-ups of healthy children etc., are still not perceived by the general population.

Adolescent↗
PubMed1993

Manual force, mechanically assisted articular chiropractic technique using long and/or short level contacts.

OBJECTIVE: To identify what has been theorized and/or written about the manual techniques generically classified as manual force, mechanically assisted articular chiropractic technique that utilize either short-lever contacts or a combination of short- and long-lever contacts. DATA SOURCES: A search of the Medline bibliographic database using MeSH key words (chiropractic/methods; osteopathic manipulation) was performed. The Index to Chiropractic Literature and Chiropractic Research Abstracts Collection (CRAC) were searched for the past 10 yr using the key terms of chiropractic-methods; chiropractic techniques; manipulation, chiropractic, manipulation, osteopathic, manipulation, spinal; and manipulation, joint. A hand search of textbooks was undertaken as well as review of the references included in books, monographs and collected papers. STUDY SELECTION: Studies in English were included, but it must be noted that these include publications that are not peer reviewed or refereed in any way. DATA EXTRACTION: Descriptions that discussed aspects of manipulative procedures with the characteristics were extracted by a single author. DATA SYNTHESIS: Very little was found or accessible with traditional methods of literature retrieval. Descriptions of characteristics for the attributes of techniques which use mechanical assistance to impart a force applied to specific contacts in combination with short and long levers are provided. The technique procedures which fall into this category use the mechanical assistance of specialized table parts, including drop sections and distracting sections, to achieve functional changes in the vertebral three-joint complex. Conjecture and speculation as to the advantages of mechanical assistance are presented. CONCLUSIONS: This type of review is considered the first step in the evaluative process for a chiropractic technique procedure. It demonstrates that very little has been written in an accessible fashion relative to techniques which are classified as manual force, mechanically assisted articular chiropractic techniques that utilize either short-lever contacts or a combination of short- and long-lever contacts. Controlled prospective clinical trials to evaluate efficacy in using these technique procedures are nonexistent. Furthermore, there are no comparison studies to determine whether the techniques which fit into this category are any more effective or efficient in producing a positive clinical outcome than techniques in other categories. The proponents of these technique procedures should be performing the studies and publishing the results that either support or deny the usefulness of these procedures.

Chiropractic↗
PubMedDate not supplied

Color changes in the red-green plates of the 50-year-old AO HRR color vision test.

The original AO HRR color vision test has been considered by many as one of the best plate tests. It is still accepted by many governmental agencies for color vision certification. In their 1954 publication, Hardy, Rand, and Rittler stated that specially compounded inks were used for printing to avoid color changes with time. Fifty years later, it is both important and interesting to determine whether the wear and tear cause significant color changes. The chance finding of a never-used second edition offers an opportunity to evaluate the color changes. A GretagMacbeth Spectrolino spectrophotometer was used to measure the chromaticities of the never-used book, and an extensively used book. Four plates (#4, 7, 13, 16), selected randomly from the four red-green sections, were analyzed. The colored dots from each of the eight plates were plotted on a CIE chromaticity diagram. Isocolor lines were drawn to evaluate chromatic alignment. Chromaticities for plates #4 and 7 are significantly different between the two books. With regard to alignment with isocolor lines, the extensively used book is better than the never-used book for plate #4. There is significant misalignment on plate #7 for both books. Chromaticities for plates #13 and 16 are essentially identical between books, all with good alignment with isocolor lines. The overall comparison shows that the chromatic alignment characteristics of the extensively used book are not worse than the never-used book. Since colors in these plates have to be aligned with both the protan and deutan axes, any significant color changes would have disturbed this delicate requirement. The findings of many plates with good alignment, and the lack of differences on plates #13 and 16 between books, suggest that there are no significant color changes over time. Differences between books on plates #4 and 7 were likely the result of the original printing process.

Color↗
PubMed1992

The legacy of New Jersey physician book collectors.

This article offers a brief history of the development of New Jersey's major history of medicine collection, and an overview of selected resources currently available to researchers. Old and rare medical books now are available to a new generation of physicians and scholars.

Book Collecting↗
PubMed1984

Home births in England and Wales, 1979: perinatal mortality according to intended place of delivery.

A survey was carried out of all 8856 births occurring at home in England and Wales in 1979. Of these births, 67% had been booked for delivery at home, 21% had been booked for delivery in hospital, 3% had not been booked, and for 9% the intended place of delivery was unknown. The perinatal mortality varied almost 50-fold according to the intended place of delivery, ranging from 4.1/1000 births in those booked for delivery at home to 196.6/1000 unbooked births. Deliveries that occurred at home but had been booked for a hospital consultant unit were associated with a perinatal mortality of 67.5/1000. Births that had been booked for delivery at home included the smallest proportion of babies of low birth weight: 2.5% weighed 2500 g or less compared with 18% of those booked for consultant units and 29% of those not booked. Within these low birthweight groups there were noticeable differences in perinatal mortality; births booked to occur at home had the lowest mortality and unbooked births had the highest. Perinatal mortality among babies who weighed more than 2500 g was generally low irrespective of the intended place of delivery; the only exception was in babies whose delivery had not been booked. In all groups perinatal mortality was considerably higher in nulliparous than parous women. Women booking a delivery at home are clearly a selected group, and some may have been transferred to hospital during labour and were thus not included in the survey. Nevertheless, these data suggest that the perinatal mortality among births booked to occur at home is low, especially for parous women.

Adult↗
PubMed2000

Refractive Error Study in Children: results from Shunyi District, China.

PURPOSE: To assess the prevalence of refractive errors and vision impairment in school-age children in Shunyi District, northeast of Beijing, the Peoples Republic of China. METHODS: Random selection of village-based clusters was used to identify a sample of children 5 to 15 years of age. Resident registration books were used to enumerate eligible children in the selected villages and identify their current school. Ophthalmic examinations were conducted in 132 schools on children from 29 clusters during May 1988 to July 1998, including visual acuity measurements, cycloplegic retinoscopy, cycloplegic autorefraction, ocular motility evaluation, and examination of the external eye, anterior segment, media, and fundus. Independent replicate measurements of all children with reduced vision and a sample of those with normal vision were done for quality assurance monitoring in three schools. RESULTS: A total of 6,134 children from 4,338 households were enumerated, and 5,884 children (95.9%) were examined. The prevalence of uncorrected, presenting, and best visual acuity 0.5 (20/40) or worse in at least one eye was 12.8%, 10.9%, and 1.8%, respectively; 0.4% had best visual acuity 0.5 or worse in both eyes. Refractive error was the cause in 89.5% of the 1,236 eyes with reduced vision, amblyopia in 5%, other causes in 1.5%, with unexplained causes in the remaining 4%. Myopia -0.5 diopter or less in either eye was essentially absent in 5-year-old children, but increased to 36.7% in males and 55.0% in females by age 15. Over this same age range, hyperopia 2 diopters or greater decreased from 8.8% in males and 19.6% in females to less than 2% in both. Females had a significantly higher risk of both myopia and hyperopia. CONCLUSIONS: Reduced vision because of myopia is an important public health problem in school-age children in Shunyi District. More than 9% of children could benefit from prescription glasses. Further studies are needed to determine whether the upward trend in the prevalence of myopia continues far beyond age 15 and whether the development of myopia is changing for more recent birth cohorts.

Adolescent↗
PubMed2000

Intravenous or enteral loop diuretics for preterm infants with (or developing) chronic lung disease.

BACKGROUND: Lung disease in preterm infants is often complicated with lung edema. OBJECTIVES: The aim of this review was to assess the risks and benefits of administration of a diuretic acting on the loop of Henle (loop diuretic) in preterm infants with or developing chronic lung disease (CLD). Primary objectives were to assess changes in need for oxygen or ventilatory support and effects on long-term outcome, and secondary objectives were to assess changes in pulmonary mechanics and potential complications of therapy. SEARCH STRATEGY: We used the standard search method of the Cochrane Neonatal Review Group. We used the following keywords: ¿ or ¿ and , limited to and limited to or . We searched Medline (1966-1998), Embase (1974-1998) and the Cochrane Controlled Trials Register (CCTR) from the Cochrane Library (1998, issue 4). In addition, we hand searched several abstract books of national and international American and European Societies. SELECTION CRITERIA: We included in this analysis trials in which preterm infants with or developing chronic lung disease and at least 5 days of age were all randomly allocated to receive a loop diuretic either enterally or intravenously. Eligible studies needed to assess at least one of the outcome variables defined a priori for this systematic review. Primary outcome variables included important clinical outcomes, and secondary outcome variables included toxicity and pulmonary mechanics (e.g., lung compliance and airway resistance). DATA COLLECTION AND ANALYSIS: We used the standard method for the Cochrane Collaboration which is described in the Cochrane Collaboration Handbook. Two investigators extracted, assessed and coded separately all data for each study, using a form that was designed specifically for this review. Any disagreement was resolved by discussion. We combined parallel and cross-over trials and, whenever possible, transformed baseline and final outcome data measured on a continuous scale into change scores using Follmann's formula. MAIN RESULTS: The only loop diuretic used in the studies which met the selection criteria was furosemide. Most studies focused on pathophysiological parameters and did not assess effects on important clinical outcomes defined in this review, or the potential complications of diuretic therapy. In preterm infants < 3 weeks of age developing CLD, furosemide administration has either inconsistent effects or no detectable effect. In infants > 3 weeks of age with CLD, a single intravenous dose of 1 mg/kg of furosemide improves lung compliance and airway resistance for 1 hour. Chronic administration of furosemide improves both oxygenation and lung compliance. REVIEWER'S CONCLUSIONS: In preterm infants > 3 weeks of age with CLD, acute and chronic administration of furosemide improve lung compliance. Chronic administration of intravenous or enteral furosemide improves oxygenation. In view of the lack of data from randomized trials concerning effects on important clinical outcomes, routine or sustained use of systemic loop diuretics in infants with (or developing) CLD cannot be recommended based on current evidence. Randomized trials are needed to assess the effects of furosemide administration on survival, duration of ventilatory support and oxygen administration, length of hospital stay, potential complications and long-term outcome.

Chronic Disease↗