Methods: A questionnaire survey of the British Society for Paediatric Endocrinology and Diabetes (BSPED) membership was undertaken, examining current clinical practice in neonatal CH.
Results were compared with published management guidelines from Europe and the UK. Results: The response rate was 86%. The majority Selleck JQ-EZ-05 were largely compliant with both guidelines. 43% review newly referred infants on the day of notification. However, 26% treat severe CH with <10 mu g/kg/day thyroxine and nearly 20% do not follow up until at least 14 days after initiating treatment, in contrast to both guidelines. Despite a new liquid T4 preparation being licensed, respondents preferred
Conclusion: Rapidity of assessment and adequate follow up of suspected CH is critical to outcome. Existing European and UK guidelines should be reviewed and expanded to incorporate new evidence, together with increased advice on
preparation and administration of T4.”
“Background: The HeartMate II (Thoratec, Pleasanton, CA) is an effective bridge to transplantation (BTT) but requires anti-coagulation with warfarin and aspirin. We evaluated the risk of thromboembolism and hemorrhage related to the degree of anti-coagulation as reflected by the international normalized ratio (INR).
Methods: INRs were measured monthly for 6 months in all discharged HeartMate II BTT patients and at an event. Each INR was assigned to ranges of INRs. Adverse events analyzed were ischemic
and hemorrhagic stroke, pump S63845 thrombosis, and bleeding requiring surgery or transfusion. Events were correlated to the INR during the event and at the start of the month.
Results: In 331 patients discharged on support, 10 had thrombotic events (9 ischemic strokes, 3 pump thromboses), and 58 had hemorrhagic events (7 strokes, 4 hemorrhages requiring surgery, and 102 requiring transfusions). The median INR was 2.1 at discharge and 1.90 at 6 months. Although the incidence of stroke was low, 40% of ischemic strokes occurred in patients MAPK inhibitor with INRs < 1.5 and 33% of hemorrhagic strokes were in patients with INRs > 3.0. The highest incidence of bleeding was at INRs > 2.5.
Conclusions: The rate of thromboembolism during long-term outpatient support with the HeartMate H is low. The low number of thrombotic events appears to be offset by a greater number of hemorrhagic events. An appropriate target INR is 1.5 to 2.5 in addition to aspirin therapy. In patients having recurrent episodes of bleeding, the risk of lowering the target INR appears to be small. J Heart Lung Transplant 2009;28: 881-7. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation.”
“Aim: To assess the effect of antenatal betamethasone use on adrenal gland size and adrenal hormones in preterm neonates who had gestational ages of 27-36 weeks.