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Topical treatment with propranolol gel as a supplement to the existing treatment of hemangiomas
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Markus Schneider, Andreas Reimer, Hansjoerg Cremer, Peter Ruef |
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Topical treatment with propranolol gel as a supplement to the existing treatment of hemangiomas
Markus Schneider, Andreas Reimer, Hansjoerg Cremer, Peter Ruef
Heilbronn, Germany
Author Affiliations: Children's Hospital Heilbronn (Schneider M, Cremer H, Ruef P); Hospital Heilbronn, 74074 Heilbronn, Germany (Reimer A)
Corresponding Author: Markus Schneider, MD, SLK-Klinikum am Gesundbrunnen, Klinik f¨¹r Kinder- & Jugendmedizin/Perinatalzentrum Heilbronn, Am Gesundbrunnen 20-26, Germany (Tel: +49-7131-49-3702; Fax: +49-7131-49-3709; Email: markus.schneider@slk-kliniken.de)
doi: 10.1007/s12519-014-0509-6
Background: Systemic treatment with propranolol is proven to be effective for patients with hemangiomas with less side-effect. We used a propranolol gel for topical use on hemangiomas.
Methods: In this retrospective study, we analyzed 148 patients who had been treated topically with propranolol gel for 12 weeks. We analyzed the data of patients and clinically gave each hemangioma a "hemangioma score" to determine the treatment success.
Results: In 147 of the 148 patients, strong signs of resolution under treatment included lightening, paling, and less vascularization. The hemangioma score showed a significant decrease during the treatment. Relevant serum levels of propranolol were not found. Adverse effects were rare and not related to propranolol.
Conclusion: Topical treatment with propranolol gel is suitable for specific hemangiomas in addition to cryotherapy and systemic treatment with propranolol.
World J Pediatr 2014;10(4):313-317
Key words: hemangioma;
hemangioma score;
propranolol;
propranolol gel;
topical treatment |
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[Abstract] [Full Text] [PDF]
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Anthropometric assessment of a Middle Eastern group of autistic children
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Nagwa A Meguid, Wafaa A Kandeel, Khaled E Wakeel, Aly A El-Nofely |
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Anthropometric assessment of a Middle Eastern group of autistic children
Nagwa A Meguid, Wafaa A Kandeel, Khaled E Wakeel, Aly A El-Nofely
Cairo, Egypt
Author Affiliations: Department of Research on Children with Special Needs, National Research Centre (NRC), Cairo, Egypt (Meguid NA); Department of Biological Anthropology, NRC, Cairo, Egypt (Kandeel WA, Wakeel KE, El-Nofely AA)
Corresponding Author:Nagwa A Meguid, MD, Human Genetics, Research on Children with Special Needs Department, National Research Centre, Tahrir street, Cairo, Egypt (Tel: 0201223316372; Fax: 202 37601877; Email: meguidna@yahoo.com)
doi: 10.1007/s12519-014-0510-0
Background: Growth abnormalities are uniquely associated with autism spectrum disorders (ASD); however, the extent to which growth abnormalities are present has hardly been investigated. The current study aims to compare the differences in anthropometric parameters in a group of autistic Egyptian children and the healthy normal population.
Methods: We recruited 100 children with ASD from the Outpatient Clinic for "Autistic Children" at the Medical Research Hospital of Excellence, National Research Centre in Cairo, Egypt. They were diagnosed by DSM-IV criteria of the American Psychiatric Association, Autism Diagnostic Interview-Revised, and Childhood Autism Rating Scale. Of these children at age of 3-10 years, 71 were males and 29 females. Eight anthropometric parameters were assessed in view of data of the healthy Egyptians of pertinent sex and age.
Results: Weight and body mass index increased because of a significant increase in subcutaneous fat thickness. This tendency with a probable decrease in muscle mass was more evident in male or in older children, likely resulting from sedentary life style and food selectivity.
Conclusions: The Z head circumference score and its variance significantly increased especially in males or older children, suggesting the relative overgrowth of the brain in a substantial percentage of Egyptian children with autism. We concluded that increased fat composition in Egyptian autistic children with decreased muscle mass necessitates tailoring a specially designed food supplementation program to ameliorate the severity of autism symptoms.
World J Pediatr 2014;10(4):318-323
Key words: anthropometry;
autism spectrum disorders;
Egypt;
growth |
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[Abstract] [Full Text] [PDF]
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Transient occult cardiotoxicity in children receiving continuous beta-agonist therapy
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Christopher L Carroll, Melinda Coro, Allison Cowl, Kathleen A Sala, Craig M Schramm |
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Christopher L Carroll, Melinda Coro, Allison Cowl, Kathleen A Sala, Craig M Schramm
Hartford, CT, USA
Author Affiliations: Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT, USA (Carroll CL, Coro M, Cowl A, Sala KA, Schramm CM)
Corresponding Author: Christopher L Carroll, Division of Pediatric Critical Care, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, USA (Tel: 860 545-9805; Fax: 860 545-9800; Email: ccarrol@ccmckids.org)
doi: 10.1007/s12519-014-0467-z
Background: Continuous beta-agonist therapy, typically in the form of inhaled albuterol, is the first line therapy for the treatment of acute and severe bronchospasm in children. Although this treatment is commonly used, concerns about cardiotoxicity have been raised. We aimed to investigate the cardiotoxic effects of continuous beta-agonist therapy in children.
Methods: We conducted a retrospective review of children admitted to the intensive care unit (ICU) between May 2008 and April 2009, who were treated with continuous beta-agonist therapy (intravenous and nebulized).
Results: Twenty of the 36 children treated with continuous albuterol had repeated serum troponin-T and lactate levels measured. Eleven patients (55%) were also treated with continuous intravenous terbutaline. Elevated levels of troponin-T levels were found in 25% of children, and elevated lactate levels were found in 60%. However, all returned to normal levels within 48 hours of ICU admission, despite continued beta-agonist therapy. No children experienced arrhythmias during therapy. There was no association between intravenous terbutaline use and elevated troponin-T [odds ratio (OR), 1.3; 95% CI, 0.2-10.3] or with elevated serum lactate (OR, 0.6; 95% CI, 0.1-3.7). There was also no association between elevated troponin-T or lactate and ICU or hospital length of stay.
Conclusions: In this small study, a significant proportion of children had elevated serum troponin-T and lactate levels while receiving inhaled continuous beta-agonist therapy, irrespective of intravenous therapy. However, these abnormal values all returned to normal within 48 hours of ICU admission and were not associated with increased duration of hospitalization.
World J Pediatr 2014;10(4):324-329
Key words: asthma;
beta-agonist;
pediatric |
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[Abstract] [Full Text] [PDF]
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Increased risk of emergency hospital admissions for children with renal diseases during heatwaves in Brisbane, Australia
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Xiao-Yu Wang, Adrian Barnett, Yu-Ming Guo, Wei-Wei Yu, Xiao-Ming Shen, Shi-Lu Tong |
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Increased risk of emergency hospital admissions for children with renal diseases during heatwaves in Brisbane, Australia
Xiao-Yu Wang, Adrian Barnett, Yu-Ming Guo, Wei-Wei Yu, Xiao-Ming Shen, Shi-Lu Tong
Shanghai, China
Author Affiliations: School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (Wang XY, Barnett A, Guo YM, Yu WW, Tong SL); MOE Shanghai Key Laboratory of Environment and Children's Health, Shanghai Jiao Tong University, Shanghai, China (Shen XM)
Corresponding Author: Shi-Lu Tong, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia (Tel: +61-7-3138 9745; Fax: +61-7-3138 3369; Email: s.tong@qut.edu.au)
doi: 10.1007/s12519-014-0469-x
Background:Heatwaves have a significant impact on population health including both morbidity and mortality. In this study we examined the association between heatwaves and emergency hospital admissions (EHAs) for renal diseases in children (aged 0-14 years) in Brisbane, Australia.
Methods: Daily data on EHAs for renal diseases in children and exposure to temperature and air pollution were obtained for Brisbane city from January 1, 1996 to December 31, 2005. A time-stratified case-crossover design was used to compare the risks for renal diseases between heatwave and non-heatwave periods.
Results: There were 1565 EHAs for renal diseases in children during the study period. Heatwaves exhibited a significant impact on EHAs for renal diseases in children after adjusting for confounding factors (odds ratio: 3.6; 95% confidence interval: 1.4-9.5). The risk estimates differed with lags and the use of different heatwave definitions.
Conclusions: There was a significant increase in EHAs for renal diseases in children during heatwaves in Brisbane, a subtropical city where people are well accustomed to warm weather. This finding may have significant implications for pediatric renal care, particularly in subtropical and tropical regions.
World J Pediatr 2014;10(4):330-335
Key words: climate change;
environmental health;
hot temperature;
renal diseases |
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[Abstract] [Full Text] [PDF]
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Upper arm composition and nutritional status of school children and adolescents in Abeokuta, Southwest Nigeria
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Idowu Odunayo Senbanjo, Kazeem Adeola Oshikoya, Olisamedua Fidelis Njokanma |
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Upper arm composition and nutritional status of school children and adolescents in Abeokuta, Southwest Nigeria
Idowu Odunayo Senbanjo, Kazeem Adeola Oshikoya, Olisamedua Fidelis Njokanma
Lagos, Nigeria
Author Affiliations: Department of Pediatrics and Child Health, Lagos State University College of Medicine, PMB 21266, Ikeja, Lagos State 100001, Nigeria (Senbanjo IO, Njokanma OF); Pharmacology Department, Lagos State University College of Medicine, PMB 21266, Ikeja, Lagos, Nigeria (Oshikoya KA); Academic Division of Child Health, Medical School, University of Nottingham, Derbyshire Children's Hospital, Uttoxeter Road, Derby DE22 3DT, UK (Oshikoya KA)
Corresponding Author: Idowu Odunayo Senbanjo, Pediatric Gastro-enterology/Hepatology/Nutrition Unit, Department of Pediatrics and Child Health, Lagos State University College of Medicine, PMB 21266, Ikeja, Lagos 100001, Nigeria (Tel: +234-08067777363; Email: senbanjo001@yahoo.com)
doi: 10.1007/s12519-014-0470-4
Background: Upper arm composition is a reflection of body protein and calorie reserves. However, there is a paucity of data on upper arm composition of children from African countries, including Nigeria. This study aimed to determine the composition of upper arm and nutritional status of school children in Abeokuta, Nigeria and to compare with international reference standards. The sensitivity and specificity of upper arm muscle area by height (UAMAH) as a nutritional assessment tool was also determined.
Methods: Five hundred and seventy children aged 5 to 19 years were selected from seven schools using multi-stage random sampling. Weight, height, mid-upper arm circumference (MUAC) and triceps skin fold thickness (TSF) were measured. Body mass index, upper arm muscle area (UAMA), upper arm fat area (UAFA), fat percentage and UAMAH were derived.
Results: The TSF, UAFA and fat percentage were significantly higher in females than males at each age group. MUAC and UAMA were significantly higher in female children aged 10-14 years, whereas UAMA was significantly higher in male children aged 15-19 years. UAMA and UAFA of the children were lower than those of Americans but similar to those of Zimbabweans, and higher than those of Indians. The sensitivity and specificity of UAMAH for detecting wasting were 80.8% and 63.9%, respectively, whereas the corresponding values for stunting were 32.2% and 58.2%, respectively.
Conclusions: The school children studied have a combination of poor calorie and protein reserve. UAMAH may be a valuable tool for complete evaluation of the nutritional status of school children.
World J Pediatr 2014;10(4):336-342
Key words: nutritional status;
school children;
upper arm fat; upper arm muscle |
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[Abstract] [Full Text] [PDF]
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Hemoglobin cut-off values in healthy Turkish infants
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Ahmet Arvas, EmelG¨¹r, DurmuşDoğan |
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Hemoglobin cut-off values in healthy Turkish infants
Ahmet Arvas, EmelG¨¹r, DurmuşDoğan
Istanbul, Turkey
Author Affiliations: Department of Pediatrics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey (Arvas A, G¨¹r E, Doğan D)
Corresponding Author: Ahmet Arvas, Department of Pediatrics, Cerrahpasa Medical Faculty, Istanbul University, PK. 34303, Cerrahpasa-Fatih, Istanbul, Turkey (Tel: +90 212 4143000/21475; Fax: +90 212 4143177; Email: aarvas@istanbul.edu.tr)
doi: 10.1007/s12519-014-0468-y
Background: Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality. This study was undertaken to determine the cut-off value of hemoglobin for infant anemia.
Methods: A cross-sectional retrospective study was carried out at well-baby clinics of a tertiary care hospital. A total of 1484 healthy infants aged between 4 to 24 months were included in the study. The relationship of hemoglobin (Hb) levels with mother age, birth weight, weight gain rate, feeding, and gender was evaluated.
Results: The Hb levels were assessed in four age groups (4 months, 6 months, 9-12 months, and 15-24 months) and the cut-off values of Hb were determined. Hb cut-off values (5th percentile for age) were detected as 97 g/L and 93 g/L at 4 months and 6 months, respectively. In older infants, the 5th percentile was 90.5 g/L and 93.4 g/L at 9-12 months and 15-24 months, respectively. The two values were lower than the World Health Organization criteria for anemia, which could partly due to the lack of information on iron status in our population. However, this difference highlights the need for further studies on normal Hb levels in healthy infants in developing countries. Hb levels of females were higher in all age groups; however, a statistically significant difference was found in gender in only 6 month-old infants. No statistically significant difference was found among Hb levels, mother's age, birth weight, weight gain rate, and nutritional status.
Conclusion:Hb cut-off values in infants should be re-evaluated and be compatible with growth and development of children in that community.
World J Pediatr 2014;10(4):343-347
Key words: cut-off value;
hemoglobin;
infant |
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[Abstract] [Full Text] [PDF]
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Novel and functional DNA sequence variants within the GATA5 gene promoter in ventricular septal defects
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Ji-Ping Shan, Xiao-Li Wang, Yuan-Gang Qiao, Hong-Xin Wan Yan, Wen-Hui Huang, Shu-Chao Pang, Bo Yan |
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Novel and functional DNA sequence variants within the GATA5 gene promoter in ventricular septal defects
Ji-Ping Shan, Xiao-Li Wang, Yuan-Gang Qiao, Hong-Xin Wan Yan, Wen-Hui Huang, Shu-Chao Pang, Bo Yan
Jining, China
Author Affiliations: Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Jining Medical University Affiliated Hospital, Jining Medical University (Shan JP, Qiao YG, Wan Yan HX, Huang WH, Pang SC, Yan B); Division of Magnetic Resonance Imaging, Jining Medical University Affiliated Hospital, Jining Medical University (Wang XL); Shandong Provincial Sino-US Cooperation Research Center for Translational Medicine, Jining Medical University Affiliated Hospital, Jining Medical University, Jining, Shandong, China (Yan B)
Corresponding Author: Bo Yan, MD, PhD, Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Jining Medical University Affiliated Hospital, Jining Medical University, 79 Guhuai Road, Jining, Shandong 272029, China (Tel: +86-0537-2903579; Fax: +86-0537-2213030; Email: yanbo@mail.jnmc.edu.cn; yanbmd@gmail.com)
doi: 10.1007/s12519-014-0511-z
Background: Congenital heart disease (CHD) is the most common human birth defect. Genetic causes for CHD remain largely unknown. GATA transcription factor 5 (GATA 5) is an essential regulator for the heart development. Mutations in the GATA5 gene have been reported in patients with a variety of CHD. Since misregulation of gene expression have been associated with human diseases, we speculated that changed levels of cardiac transcription factors, GATA5, may mediate the development of CHD.
Methods: In this study, GATA5 gene promoter was genetically and functionally analyzed in large cohorts of patients with ventricular septal defect (VSD) (n=343) and ethnic-matched healthy controls (n=348).
Results: Two novel and heterozygous DNA sequence variants (DSVs), g.61051165A>G and g.61051463delC, were identified in three VSD patients, but not in the controls. In cultured cardiomyocytes, GATA5 gene promoter activities were significantly decreased by DSV g.61051165A>G and increased by DSV g.61051463delC. Moreover, fathers of the VSD patients carrying the same DSVs had reduced diastolic function of left ventricles. Three SNPs, g.61051279C>T (rs77067995), g.61051327A>C (rs145936691) and g.61051373G>A (rs80197101), and one novel heterozygous DSV, g.61051227C>T, were found in both VSD patients and controls with similar frequencies.
Conclusion: Our data suggested that the DSVs in the GATA5 gene promoter may increase the susceptibility to the development of VSD as a risk factor.
World J Pediatr 2014;10(4):348-353
Key words: congenital heart disease;
GATA5 promoter;
ventricular septal defect |
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[Abstract] [Full Text] [PDF]
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Antenatal use of bosentan and/or sildenafil attenuates pulmonary features in rats with congenital diaphragmatic hernia
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Mar¨ªa de Lourdes Lemus-Varela, Amed Soliz, Belinda Claudia G¨®mez-Meda, Ana Lourdes Zamora-Perez, Jos¨¦ Manuel Ornelas-Aguirre, Valery Melnikov, Blanca Miriam Torres-Mendoza, Guillermo Mois¨¦s Z¨²ñiga-Gonz¨¢lez |
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Antenatal use of bosentan and/or sildenafil attenuates pulmonary features in rats with congenital diaphragmatic hernia
Mar¨ªa de Lourdes Lemus-Varela, Amed Soliz, Belinda Claudia G¨®mez-Meda, Ana Lourdes Zamora-Perez, Jos¨¦ Manuel Ornelas-Aguirre, Valery Melnikov, Blanca Miriam Torres-Mendoza, Guillermo Mois¨¦s Z¨²ñiga-Gonz¨¢lez
Guadalajara, M¨¦xico
Author Affiliations: Division of Neonatology, High Specialty Medical Unit, Pediatric Hospital, Western National Medical Center, Mexican Social Security Institute, Guadalajara, Jalisco, M¨¦xico (Lemus-Varela ML); Neonatal Intensive Care Unit, Division of Neonatology, Miami Children's Hospital, Miami FLD, USA (Soliz A); Molecular Biology in Medicine Institute, Molecular Biology and Genomic Department, Health Sciences University Center, University of Guadalajara, Guadalajara, Jalisco, M¨¦xico (G¨®mez-Meda BC, Zamora-Perez AL); Odontology Research Institute, Integrated Odontology Clinic Department, Health Sciences University Center, University of Guadalajara, Guadalajara, Jalisco, M¨¦xico (Zamora-Perez AL); Pathology Department, High Specialty Medical Unit, North-western National Medical Center, Mexican Social Security Institute, Ciudad Obreg¨®n, Sonora, M¨¦xico (Ornelas-Aguirre JM); School of Medicine, University of Colima, Colima, M¨¦xico (Melnikov V); Division of Neurosciences, Western Biomedical Research Center, Mexican Social Security Institute and Department of Clinics, Health Sciences University Center, University of Guadalajara, Guadalajara, Jalisco, M¨¦xico (Torres-Mendoza BM); Mutagenesis Laboratory, Western Biomedical Research Center, Mexican Social Security Institute, Guadalajara, Jalisco, M¨¦xico (Z¨²ñiga-Gonz¨¢lez GM)
Corresponding Author: Guillermo Mois¨¦s Z¨²ñiga-Gonz¨¢lez, PhD, Laboratorio de Mutag¨¦nesis, Centro de Investigaci¨®n Biom¨¦dica de Occidente, Instituto Mexicano del Seguro Social, Sierra Mojada 800, Colonia Independencia, C.P. 44340, Guadalajara, Jalisco, M¨¦xico (Tel: +52(33)36683000 ext 31937, Fax: +52(33)36181756; Email: mutagenesis95@hotmail.com)
doi: 10.1007/s12519-014-0512-y
Background: Lung hypoplasia, pulmonary persistent hypertension of the newborn and its morphological changes are the main features in congenital diaphragmatic hernia (CDH). This study was undertaken to investigate if antenatal use of sildenafil and/or bosentan attenuates vascular remodeling, promotes branching, and improves alveolarization in experimental nitrofen-induced CDH.
Methods: Nitrofen (100 mg) was gavage-fed to pregnant rats at post conception day (PCD) 9 to induce CDH. The rats were randomized to 5 groups: 1) control; 2) nitrofen; 3) nitrofen+sildenafil 100 mg/kg per day at PCD 16-20; 4) nitrofen+bosentan 30 mg/kg per day, at PCD 16-20, and 5) nitrofen+bosentan+sildenafil, same doses and administration days. After cesarean delivery, the offsprings were sacrificed. The diaphragmatic defect and pulmonary hypoplasia were identified, and the lungs were dissected. Arterial wall thickness, bronchiolar density and alveolarization were assessed.
Results: The offsprings with CDH were characterized by severe pulmonary hypoplasia (lung weight-to-body weight ratio: 0.0263 [95% confidence interval (CI) 0.0242-0.0278)] in the nitrofen group versus 0.0385 (95% CI 0.0355-0.0424) in the control group (P=0.0001). Pulmonary arterial wall thickness was decreased to 3.0 (95% CI 2.8-3.7) µm in the nitrofen+sildenafil group versus 5.0 (95% CI 4.1-4.9) µm in the nitrofen group (P=0.02). Terminal bronchioles increased to 13.7 (95% CI 10.7-15.2) µm in the nitrofen+bosentan group in contrast to 8.7 (95% CI 7.2-9.4) µm in the nitrofen group (P=0.002). More significant differences (P=0.0001) were seen in terminal bronchioles in the nitrofen+sildenafil+bosentan group than in the nitrofen group [14.0 (95% CI 12.5-15.4) µm versus 8.5 (95% CI 7.1-9.3) µm]. Pulmonary arterial wall thickness was also decreased in the former group.
Conclusions: In this rat model, antenatal treatment with sildenafil attenuates vascular remodeling. Bosentan promotes the development of terminal bronchioles in nitrofen-induced CDH.
World J Pediatr 2014;10(4):354-359
Key words: antenatal treatment;
bosentan;
congenital diaphragmatic hernia;
pulmonary hypoplasia;
sildenafil |
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[Abstract] [Full Text] [PDF]
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