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Gaurav Gupta
Email:
[email protected] |
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Intermittent versus daily montelukast versus placebo in
Episodic Asthma - what works ? (Ann Allergy Asthma Immunol
2011;106: 518-26) |
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To assess the regimen-related efficacy of montelukast in treating severe
intermittent asthma a multicenter, randomized, double-blind, 52-week study
was performed in children 6 months to 5 years of age comparing placebo (n=591)
with two regimens of montelukast 4 mg: (1) daily (n=589); or (2)
episode-driven (n=591) for 12 days beginning with signs/symptoms
consistent with imminent cold or breathing problem. Montelukast did not
reduce the number of asthma episodes culminating in asthma attack over 1
year in children 6 months to 5 years of age, although numerical
improvements occurred in some endpoints.
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Fetal Effects of Anticonvulsant Polytherapies: Are
there different risks from different drug combinations? (Arch
Neurology Jun 13, 2011. Epub ahead of print) |
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To determine the frequency of malformations among infants born to women
who had taken lamotrigine or carbamazepine as part of polytherapy during
the first trimester of pregnancy a cohort of 6857 pregnant women was
enrolled in the North American AED (Antiepileptic Drug) Pregnancy Registry
between 1997 and 2010. The risk of malformations was 1.9% among infants
exposed to lamotrigine as monotherapy (n = 1441). Among the infants
exposed to lamotrigine as polytherapy (n = 505), the risks were
9.1% for lamotrigine plus valproate sodium and 2.9% for lamotrigine plus
any other AEDs. Similarly, the risk of malformations was 2.9% for the
infants exposed to carbamazepine monotherapy (n = 1012). For the
infants exposed to carbamazepine as polytherapy (n = 365), the risks were
15.4% for carbamazepine plus valproate and 2.5% for carbamazepine plus any
other AEDs. Confounding by factors such as periconceptional vitamin use,
cigarette smoking, alcohol use, and chronic maternal diseases did not
explain the results. Authors concluded that the risk of malformations
among infants exposed to lamotrigine and carbamazepine as polytherapy was
higher than the corresponding monotherapies only when the polytherapy
includes valproate. These findings suggest that counseling for fetal risks
from AED polytherapy should be based on the specific drugs included.
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Functional endoscopic sinus surgery in children: what
are the predictive factors of outcome? (Eur Arch Otorhinolaryngol.
2011 Jun 26. Epub ahead of print) |
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This study included 87 children who underwent pediatric endoscopic sinus
surgery (PESS) for chronic rhinosinusitis (CRS) with nasal allergy (n=45),
CRS without nasal allergy (n=36) and CRS with polyposis (n=6) from
2005 to 2010. The overall success rate was 87.7% (CRS with nasal allergy:
87.5%, CRS without nasal allergy: 85.7%, and CRS with polyposis: 93%).
Postoperative improvement was significantly correlated with extent of
preoperative disease, adenoidectomy and second look operation and not
significantly correlated with type of the preoperative disease or previous
surgery. The results of PESS are influenced by age group, a younger age
group is associated with more adhesions and recurrences.
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Which pressure to believe? A comparison of direct
arterial with indirect blood pressure measurement techniques in the
pediatric intensive care unit (Pediatr Crit Care Med. 2011 Jun 9.
Epub ahead of print) |
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Forty children (birth to 17 yrs) admitted to the pediatric intensive care
unit with various clinical conditions requiring a radial arterial catheter
for continuous arterial blood pressure monitoring were enrolled. Each
subject had measurements taken every 6 hrs over a 24-hr period for: direct
arterial blood pressure, indirect blood pressure using the Phillips
automated oscillometric device, and indirect blood pressure using the
sphygmomanometer and Doppler ultrasound. There were no significant
differences between the methods of blood pressure measurement when groups
were analyzed based on age. When analyzed by age-specific normo-, hypo-,
and hypertensive criteria, outside the normotensive range, the automated
readings were higher during hypotension and lower during hypertension
compared with the arterial and Doppler ultrasound methods. The arterial
blood pressure was closer to the gold standard Doppler ultrasound blood
pressure in all three blood pressure groups.
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