PubMed · 15574537
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Gordon L Klein, David N Herndon. 2004. Burns.. https://pubmed.ncbi.nlm.nih.gov/15574537/
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AIM: To report effects of weight-based recombinant human insulin-like growth factor-I (rhIGF-I) on IGF axis parameters in children with hyperinsulinism. METHODS: Open label trial with subcutaneous rhIGF-I (40 microg/kg/dose). Patients studied were children (1 month to 11 years) with diffuse hyperinsulinism (n = 7). Serial serum IGF and insulin-like growth factor binding protein (IGFBP) concentrations were measured by RIA and analyzed by linear Pearson regression. RESULTS: Following the initial rhIGF-I dose, total insulin-like growth factor-I (IGF-I) rose by 56% at 30 min (p < 0.01) and 85% at 120 min (p < 0.02). Serum IGF-II, IGFBP-2, and IGFBP-3 levels did not change. Peak serum IGF-I levels within 12 h of the initial rhIGF-I dose were 167-700 mg/ml. The variable peak IGF-I response is attributable in part to IGFBP-3 differences across this pediatric age range. Models of rhIGF-I dosing based upon body surface area (BSA) or initial IGFBP-3 resulted in predictable peak serum IGF-I levels (r = 0.78; p < 0.03). Recalculating rhIGF-I dosing based upon the BSA . IGFBP-3 product correlated closely with peak IGF-I level (r = 0.85; p < 0.007). CONCLUSIONS: Weight-based IGF-I dosing in this cohort resulted in variable IGF-I levels. Considering BSA and serum IGFBP-3 concentration in children is appropriate for subcutaneous IGF-I administration. A combination of these values may yield predictable individualization of rhIGF-I dosing.
AIM: The technique of chest compression recommended in the recent international guidelines is different from that which was traditionally used in Hungary. While compression force, location, frequency and duty cycle are all identical, the position of the hand on the chest is different. The aim of our study was to compare these two methods concerning the area and location of the surface compressed on the chest wall. METHODS: Thirty-eight doctors were trained in both compression methods. Compressions were carried out on an AMBU Man-C manikin. The compressed surface, marked by using a carbon paper, was projected on to a standardised 10 mm x 10 mm matrix to measure the area and location. The chest surface was marked subsequently as green, yellow and red areas to identify the correct position, incorrect position and dangerous areas. All subjects did chest compressions using both techniques (I, International; H, traditional Hungarian) in a random order each for 30 s. RESULTS: The surface area compressed was significantly larger by the H method than the I method (73.46 (+/-17.11) versus 41.75 (+/-11.08), p<0.005). 8.07 (+/-1.91) cm2 of an area considered dangerous were compressed by the H method compared to 2.93 (+/-0.78) cm2 by the I method (p<0.005). CONCLUSION: Comparing the two different methods of chest compressions, the hand position recommended by the recent international guidelines seems to be more safe as it compresses a smaller area which might cause injury.