The Experts below are selected from a list of 219 Experts worldwide ranked by ideXlab platform
S Lenoirpiat - One of the best experts on this subject based on the ideXlab platform.
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randomised controlled trial of prophylactic Etamsylate follow up at 2 years of age
Archives of Disease in Childhood-fetal and Neonatal Edition, 2001Co-Authors: Diana Elbourne, Susan Ayers, H Dellagrammaticas, A Johnson, M Leloup, S LenoirpiatAbstract:AIM To assess the role of Etamsylate* in reducing the risk of haemorrhagic brain damage and its consequences. DESIGN Follow up of babies recruited into a randomised controlled trial. METHODS A total of 334 infants born before 33 weeks gestation in France and Greece were randomly allocated within the first four hours of birth either to receive Etamsylate or to act as controls. The principal outcomes in the trial were death or impairment and/or disability at the age of 2 years. RESULTS Fifty nine children were lost to follow up. A total of 115 (34%) either died or had some impairment or disability, and 88 (26%) either died or had severe impairment or disability at 2 years of age. These outcomes did not differ significantly between the two randomised groups: relative risks and 95% confidence intervals 1.14 (0.78 to 1.4) and 1.17 (0.82 to 1.68) respectively. The findings were similar for all the prespecified subgroup analyses stratified by key prognostic factors at trial entry: country of birth, gestational age CONCLUSION These findings do not support the use of Etamsylate. Other strategies need to be evaluated for the prevention of mortality and morbidity in these vulnerable infants. Key messages The findings from the only published follow up of children from a randomised controlled trial of Etamsylate do not support its use when given within the first four hours of birth to infants born before 33 weeks gestation Centres in Greece and France recruited 334 infants into the trial, and did not find that Etamsylate reduced the risk of haemorrhagic brain damage or its consequences in terms of death or impairment and/or disability Other strategies need to be evaluated for the prevention of mortality and morbidity in these vulnerable infants
B D Speidel - One of the best experts on this subject based on the ideXlab platform.
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developmental outcome of the use of Etamsylate for prevention of periventricular haemorrhage in a randomised controlled trial
Archives of Disease in Childhood-fetal and Neonatal Edition, 2005Co-Authors: J Schulte, J Osborne, J W T Benson, R W I Cooke, M Drayton, J Murphy, Janet M Rennie, B D SpeidelAbstract:Objective: To compare neurodevelopmental outcome of survivors of the multicentre trial of Etamsylate (the iRNN for ethamsylate) for prevention of periventricular haemorrhage in very low birthweight infants. Design: Double blind, single observer, prospective follow up of placebo controlled study. Setting: Six neonatal intensive care units in the United Kingdom. Neurodevelopmental outcome was assessed in health premises or children’s homes. Subjects: 268 of 276 survivors of the original study were seen between 3.5 and 4.2 years of age. All were inborn and weighed 1500 g or less at birth. Intervention: Etamsylate 12.5 mg/kg or placebo six hourly from within one hour of delivery for four days. Main outcome measures: McCarthy scales of children’s abilities, standardised neurological examination, full physical examination, functional assessment, seven letter Stycar vision test, and audiometry. Results: There was no difference between the groups in neuromotor outcome (cerebral palsy) or in the general cognitive index (GCI) of the McCarthy scales (mean GCI was 93.3 for the Etamsylate group (n = 133) and 89.7 for the placebo group (n = 131); p = 0.10). There were more children with GCI Conclusions: Etamsylate was not associated with a reduction in cerebral palsy. Severe cognitive impairment was reduced, but more children died and the improvement may be because fewer survived with low GCI.
Rod W Hunt - One of the best experts on this subject based on the ideXlab platform.
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Etamsylate for prevention of periventricular haemorrhage
Archives of Disease in Childhood-fetal and Neonatal Edition, 2005Co-Authors: Rod W HuntAbstract:A perspective on the paper by Schulte et al (see page 31) Despite the many advances of newborn intensive care over the past 20 years, periventricular haemorrhage (PVH) remains a significant cause of morbidity and mortality for the preterm infant. About 15% of infants with birth weight less than 1500 g develop PVH,1 and its presence significantly increases the risk of neurodevelopmental impairment. New insights have been gained into the pathophysiology of PVH. The germinal matrix, a fragile network of blood vessels lining the ventricular system, is prone to bleeding in the preterm infant. The beagle puppy model of PVH has provided insight into our current understanding of the pathogenetic role of ischaemia and reperfusion.2 In the human preterm infant, depression of cerebral blood flow, associated with initial reduction in myocardial performance and presence of a patent ductus arteriosus, provides an environment in which ischaemia and reperfusion are likely, and PVH occurs more commonly under these circumstances.3 The absence of one unifying aetiological pathway to PVH has left those who practice neonatal medicine without a specific therapeutic strategy that has the capacity to decrease the incidence of PVH. Many therapeutic agents have been investigated over the past 30 years, in the hope of developing such a strategy. One such agent is Etamsylate (diethylammonium 1,4-dihydroxy-3-benzenesulphonate). This non-steroidal drug was shown to be effective in reducing blood loss from menorrhagia4 and after trans-urethral resection of the prostate.5 The benefits of Etamsylate in reduction …
Diana Elbourne - One of the best experts on this subject based on the ideXlab platform.
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randomised controlled trial of prophylactic Etamsylate follow up at 2 years of age
Archives of Disease in Childhood-fetal and Neonatal Edition, 2001Co-Authors: Diana Elbourne, Susan Ayers, H Dellagrammaticas, A Johnson, M Leloup, S LenoirpiatAbstract:AIM To assess the role of Etamsylate* in reducing the risk of haemorrhagic brain damage and its consequences. DESIGN Follow up of babies recruited into a randomised controlled trial. METHODS A total of 334 infants born before 33 weeks gestation in France and Greece were randomly allocated within the first four hours of birth either to receive Etamsylate or to act as controls. The principal outcomes in the trial were death or impairment and/or disability at the age of 2 years. RESULTS Fifty nine children were lost to follow up. A total of 115 (34%) either died or had some impairment or disability, and 88 (26%) either died or had severe impairment or disability at 2 years of age. These outcomes did not differ significantly between the two randomised groups: relative risks and 95% confidence intervals 1.14 (0.78 to 1.4) and 1.17 (0.82 to 1.68) respectively. The findings were similar for all the prespecified subgroup analyses stratified by key prognostic factors at trial entry: country of birth, gestational age CONCLUSION These findings do not support the use of Etamsylate. Other strategies need to be evaluated for the prevention of mortality and morbidity in these vulnerable infants. Key messages The findings from the only published follow up of children from a randomised controlled trial of Etamsylate do not support its use when given within the first four hours of birth to infants born before 33 weeks gestation Centres in Greece and France recruited 334 infants into the trial, and did not find that Etamsylate reduced the risk of haemorrhagic brain damage or its consequences in terms of death or impairment and/or disability Other strategies need to be evaluated for the prevention of mortality and morbidity in these vulnerable infants
J Schulte - One of the best experts on this subject based on the ideXlab platform.
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developmental outcome of the use of Etamsylate for prevention of periventricular haemorrhage in a randomised controlled trial
Archives of Disease in Childhood-fetal and Neonatal Edition, 2005Co-Authors: J Schulte, J Osborne, J W T Benson, R W I Cooke, M Drayton, J Murphy, Janet M Rennie, B D SpeidelAbstract:Objective: To compare neurodevelopmental outcome of survivors of the multicentre trial of Etamsylate (the iRNN for ethamsylate) for prevention of periventricular haemorrhage in very low birthweight infants. Design: Double blind, single observer, prospective follow up of placebo controlled study. Setting: Six neonatal intensive care units in the United Kingdom. Neurodevelopmental outcome was assessed in health premises or children’s homes. Subjects: 268 of 276 survivors of the original study were seen between 3.5 and 4.2 years of age. All were inborn and weighed 1500 g or less at birth. Intervention: Etamsylate 12.5 mg/kg or placebo six hourly from within one hour of delivery for four days. Main outcome measures: McCarthy scales of children’s abilities, standardised neurological examination, full physical examination, functional assessment, seven letter Stycar vision test, and audiometry. Results: There was no difference between the groups in neuromotor outcome (cerebral palsy) or in the general cognitive index (GCI) of the McCarthy scales (mean GCI was 93.3 for the Etamsylate group (n = 133) and 89.7 for the placebo group (n = 131); p = 0.10). There were more children with GCI Conclusions: Etamsylate was not associated with a reduction in cerebral palsy. Severe cognitive impairment was reduced, but more children died and the improvement may be because fewer survived with low GCI.