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1.
J Pediatr ; 138(5): 699-704, 2001 May.
Artículo en Inglés | MEDLINE | ID: mdl-11343046

RESUMEN

OBJECTIVE: To determine the clinical consequences of acquiring Pseudomonas aeruginosa infection during early childhood in children with cystic fibrosis (CF). DESIGN: Prospective, observational cohort study of 56 children with CF identified by newborn screening during 1990-92. Each child underwent an annual bronchial lavage during the first 2 to 3 years of life. Clinical outcome was determined at 7 years of age. RESULTS: P aeruginosa infection was diagnosed in 24 (43%) cohort subjects. Four children died before 7 years of age, all of whom had been infected with a multi-resistant, mucoid strain of P aeruginosa (P =.04). In survivors, P aeruginosa infection was associated with significantly increased morbidity as measured by lower National Institutes of Health scores, greater variability in lung function, increased time in the hospital, and higher rates of recombinant human deoxyribonuclease therapy (P <.01). In this young CF cohort, best forced expiratory volume in 1 second was an insensitive measure of increased morbidity. CONCLUSIONS: Acquisition of P aeruginosa was common by 7 years of age in this CF birth cohort and was associated with increased morbidity and mortality. An improved disease severity score would improve the evaluation and study of early CF lung disease.


Asunto(s)
Fibrosis Quística/complicaciones , Infecciones por Pseudomonas/complicaciones , Factores de Edad , Antibacterianos , Niño , Preescolar , Fibrosis Quística/fisiopatología , Quimioterapia Combinada/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Pronóstico , Estudios Prospectivos , Infecciones por Pseudomonas/tratamiento farmacológico , Pseudomonas aeruginosa , Pruebas de Función Respiratoria , Factores de Tiempo , Resultado del Tratamiento
2.
J Pediatr ; 107(2): 216-8, 1985 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-4020544

RESUMEN

Twenty children who had endoscopically confirmed laryngomalacia were reviewed at 8 to 16 years of age. All had developed stridor in the first 6 weeks of life; stridor had stopped or largely resolved by age 4 years. Proximal airway function was assessed by expiratory and inspiratory flow volume loops and compared with control values. These children as a group had variable extrathoracic obstruction to inspiratory airflow, as indicated by a significantly low maximal inspiratory flow at 50% of vital capacity and a high mean ratio of maximal expiratory to maximal inspiratory flow at 50% vital capacity. Although limitation to inspiratory airflow was detectable in later childhood, it was not associated with troublesome symptoms. Significant stridor always resolved by 4 years of age, but some children experienced minor stridor under stress in later childhood.


Asunto(s)
Enfermedades de la Laringe/fisiopatología , Mediciones del Volumen Pulmonar , Adolescente , Niño , Femenino , Humanos , Enfermedades de la Laringe/congénito , Masculino , Ruidos Respiratorios/fisiopatología
3.
J Pediatr ; 88(6): 1010-4, 1976 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-1271171

RESUMEN

The Hering-Breuer inspiratory inhibitory reflex was studied serially in a group of premature infants and in a group of term infants in the immediate postnatal period. The premature infants had a stronger inspiratory inhibitory reflex than did the term infants at birth; this reflex decreased with maturation of the premature. Development in the extrauterine environment significantly delayed the rate of disappearance of this reflex. This may indicate that premature delivery retards the neurologic maturation of the human infant. The term infant showed no change in the activity of the inspiratory inhibitory reflex in the first five days of life.


Asunto(s)
Recien Nacido Prematuro , Reflejo , Respiración , Femenino , Edad Gestacional , Humanos , Recién Nacido , Pulmón/inervación , Embarazo
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