Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus.

Ultrasound is a safe bedside imaging tool that obviates the use of ionizing radiation diagnostic procedures. Due to its convenience, the lung ultrasound has received increasing attention from neonatal physicians. Nevertheless, clear reference standards and guideline limits are needed for accurate application of this diagnostic modality.

Classification of acute respiratory disorders of all newborns in a tertiary care center.

Objective: To assess the usefulness of current diagnostic criteria in the understanding of neonatal respiratory distress in a tertiary care hospital.

Methods: We prospectively studied 2824 consecutive deliveries to determine the frequency of respiratory disorders of all types. We used definitions based on standard texts, with borderline cases being classified as having the disease in question.

Comparison of once-daily versus twice-daily gentamicin dosing regimens in infants > or = 2500 g.

Objective: There is no uniformity in the current recommendations of dosing regimen of gentamicin for neonates. We conducted a prospective, randomized, controlled trial to compare a once-daily dosing regimen to the twice-daily dosing regimen for neonates > or = 2500 g during the first 7 days after birth.

Study Design: Infants > or = 2500 g admitted to the Neonatal Intensive Care Unit and prescribed gentamicin for suspected bacterial infection were randomized to receive either 4 mg/kg every 24 hours, study group (n=20), or a standard regimen of 2.

Comparison of two gentamicin dosing schedules in very low birth weight infants.

Background: Several dosing schedules for gentamicin have been recommended for very low birth weight infants during the early neonatal period. We conducted a prospective, randomized, controlled trial to compare efficacy and pharmacokinetics of two dosing schedules in preterm neonates.

Methods: Fifty-eight very low birth weight infants (600 to 1500 g), prescribed gentamicin for treatment of suspected sepsis during the first week after birth, were randomized to receive either the new dosing schedule [every 48 h (q48h)] or the existing dosing schedule [every 24 h (q24h)].

Cockroach allergy appears early in life in inner-city children with recurrent wheezing.

Background: Cockroach allergy and exposure to high levels of this allergen are important in the increasing asthma-related health problems among young inner-city children. However, there are very little data regarding the prevalence of cockroach allergy in infants and young children with asthma.

Objective: This retrospective study was designed to test the hypothesis that cockroach allergy appears early in life in young children with recurrent wheezing.

Asthma care practices, perceptions, and beliefs of Chicago-area asthma specialists. Chicago Asthma Surveillance Initiative Project Team.

Introduction: Few studies have closely explored how well physicians who consider themselves specialists in asthma adhere to national guideline recommendations for the diagnosis and treatment of asthma. The purpose of this study is to characterize current knowledge, attitudes, beliefs, and self-reported treatment practices of the asthma specialists working in one large metropolitan area.

Methods: In 1997, a cross-sectional survey was mailed to asthma specialists (allergists or pulmonologists) engaged in direct patient care with a practice location in the Chicago area (Cook County or one of the five surrounding counties).

Observations on emerging patterns of asthma in our society.

Epidemiologic studies of temporal and geographic variation in asthma morbidity have identified asthma as an important public health concern. Knowledge gained from these studies has resulted in intense focus on this condition by agencies such as the National Institutes of Health and the World Health Organization. In this report, studies of recent asthma trends and patterns are explored.

Youth counseled for HIV testing at school- and hospital-based clinics.

The prevalence of human immunodeficiency virus (HIV) in adolescents is difficult to assess as few adolescents consent to testing. This prospective study characterized urban youth requesting HIV testing at two types of health settings, inner-city school-based and hospital-based clinics. Data were obtained on 1652 inner-city youths aged 13 to 19 years who consented to individualized HIV counseling and testing from January 1993 to January 1994.

Cryptococcal rib osteomyelitis in a pediatric patient.

A case of cryptococcal rib osteomyelitis in a pediatric patient is described. Isolated cryptococcal osteomyelitis in pediatric patients is a rare entity, and only 10 cases have been reported in the literature. The radiological findings are reviewed to include chest films, nuclear bone scan, and computed tomographic imaging scan.

Effect of dexamethasone therapy on the neonatal ductus arteriosus.

Patent ductus arteriosus (PDA) is believed to be a contributing factor in the etiopathogenesis of bronchopulmonary dysplasia (BPD). We studied the effects of early dexamethasone therapy on persistent ductal patency and the role of PDA in the etiopathogenesis of BPD during the course of a randomized double-blind trial of dexamethasone to prevent BPD. Infants, who weighed between 700 and 999 g, had severe RDS, and had been given surfactant, were randomized to receive a 12-day course of dexamethasone (n = 13) or placebo (n = 17) starting within the first 12 hours of postnatal life.

A prospective randomized trial of feeding methods in very low birth weight infants.

Objective: To test the hypothesis that very low birth weight infants fed by continuous nasogastric gavage (CNG) would achieve full enteral feedings (100 kcal/kg/d) at an earlier postnatal age and have less feeding intolerance (FI) than infants fed by intermittent bolus gavage (IBG).

Methods: Eighty infants were stratified by birth weight (700 to 1000 g and 1001 to 1250 g) and randomized into CNG or IBG feeding groups. CNG infants were comparable with IBG in birth weight, gestational age, sex, race, and day of onset of feeding (5.

Neonatal early-onset Escherichia coli disease. The effect of intrapartum ampicillin.

Background: Maternal intrapartum ampicillin has been recommended for the prevention of neonatal group B streptococcal disease.

Objectives: To assess the effect of this practice, if any, on neonatal early-onset Escherichia coli infection and to delineate the clinical characteristics of infected neonates.

Patients And Methods: All neonates with early-onset E coli infection who were born at Cook County Children's Hospital, Chicago, Ill, from January 1, 1982, through December 31, 1993, were identified from a microbiological register of all neonatal bacteremias and infections.

Relation of parental birth weights to infant birth weight among African Americans and whites in Illinois: a transgenerational study.

The authors used a transgenerational data set of Illinois vital records to ascertain the relation between parental birth weights and infant birth weight. The infant generation consisted of all African Americans and whites born in Illinois during 1989-1991. The parent generation included the mothers and fathers who were also born in Illinois between 1956 and 1975.

Differing birth weight among infants of U.S.-born blacks, African-born blacks, and U.S.-born whites.

Background: In the United States, the birth weights of infants of black women are lower than those of infants of white women. The extent to which the lower birth weights among blacks are related to social or genetic factors is unclear.

Methods: We used vital records for 1980 through 1995 from Illinois to determine the distribution of birth weights among infants born to three groups of women -- U.

The elusive goal of informed consent by adolescents.

While parents have traditionally provided proxy consent for minors to participate in research, this has proven inadequate for adolescents who are mentally and emotionally capable of making their own decisions. Research has proven that even young children, and certainly most adolescents, are developmentally prepared to make such decisions for themselves. The author challenges the assumption that both consent and assent are static concepts, and proposes that a sliding scale of competence be created to ascertain the adolescent's comprehension of the proposed research by shifting the burden of proof to those who believe a particular adolescent is unable to provide informed consent.

Nebulized furosemide in infants with bronchopulmonary dysplasia.

The effects of 0.1 mg, 0.25 mg, 0.

Life and near-death in the intensive care unit. A personal experience.

Being seriously ill, even once, is an experience from which one learns a great deal. To feel the loss of control, the pain, and the worry about unfulfilled responsibilities at home and at work forever provides one with the motivation to deal with these issues when confronted with sick people. To understand that each illness has unique effects on a patient and that these patients almost always trust us, gives us the confidence to use our training and experience to do what we know is right for them.

Measles antibody titers in early infancy.

Objective: To determine the prevalence of measles seronegativity among infants younger than 6 months and to ascertain their serologic response to measles vaccine.

Design: Cross-sectional measles antibody survey during the 1989 measles epidemic in Chicago, Ill.

Setting: Inner-city perinatal center.

Evaluation of the relationship between cocaine and intraventricular hemorrhage.

To evaluate the relationship of cocaine to intraventricular hemorrhage in preterm (< or = 37 weeks gestation) infants, the charts of infants admitted to an intensive care nursery over a 2-year period were reviewed. Data were extracted regarding intrauterine exposure to cocaine, head ultrasonography, and specific independent variables: gestational age, 5-minute Apgar score, and the presence of pneumothorax. These variables were classified into high-, moderate-, and low-risk groups for the development of intraventricular hemorrhage.

The effect of low-dose dopamine infusion on cardiopulmonary and renal status in premature newborns with respiratory distress syndrome.

To study the effects of infusion of low doses of dopamine hydrochloride on cardiopulmonary and renal status in premature newborns with respiratory distress syndrome, 49 newborns were randomly assigned to three groups: group 1 (18 patients) received no dopamine and was the control group; group 2 (16 patients) was infused with a dose of dopamine measuring 1.0 micrograms/kg of body weight per minute for 72 hours; and group 3 (15 patients) was infused with a dose of dopamine measuring 2.5 micrograms/kg of body weight per minute for 72 hours.

Plasma amino acid patterns in very low birth weight infants during parenteral nutrition.

Plasma amino acids were measured in eight very low birth weight infants (less than or equal to 1000 gm) before and after infusion of parenteral alimentations with Freamine III. Significant elevation in serum threonine, valine, isoleucine, methionine, serine, proline, glycine and ornithine was noted after twenty four hours of infusion. On the other hand, significant decreases in taurine and tyrosine levels were noted.