Walker Anderson Long

Antenatal steroids and neonatal outcomes in controlled clinical trials of surfactant replacement

A substantial body of scientific data stretching over more than 20 years indicates that prenatal steroids are safe and effective in improving pregnancy outcome among women in premature labor.‘-* A meta-analysis published in 1990 of more than 3000 infants in 12 different randomized clinical trials of antenatal steroids conducted before surfactant showed conclusively that prenatal steroids significantly reduced necrotizing enterocolitis (NEC), intraventricular hemorrhage (MI), and neonatal mortality.’ Nevertheless, prenatal steroids were and still are far from universally used among women at risk of preterm labor, particularly in the United States. The purpose of this article is to describe the results of retrospective analyses of the association of prenatal steroids with perinatal morbidity and mortality among infants enrolled in randomized clinical trials of surfactant replacement therapy.

Childhood traumatic infarction causing left ventricular aneurysm: Diagnosis by two-dimensional echocardiography

After being struck by an automobile, a 9 year old boy developed transient right bundle branch block followed by electrocardiographic changes of inferior wall myocardial infarction and an increase of serum cardiac enzymes. Two-dimensional echocardiography demonstrated a prominent septal aneurysm. Subsequent cardiac catheterization confirmed septal aneurysm and demonstrated an additional inferior aneurysm. Six weeks after the accident, resection of the inferior aneurysm was performed. At 1 year follow-up study, residual septal aneurysm and cardiomegaly are present, but the boy is asymptomatic.