Third Month Of Follow-up Research Articles

Intraperitoneal Pressure in Children: Fill-Volume Related and Impacted by Body Mass Index

♦ Objective Prescription of intraperitoneal volume (IPV) in children on peritoneal dialysis (PD) should be individualized in order to optimize both efficiency and tolerance. Intraperitoneal pressure (IPP) can be used as an objective assessment of IPV. Despite IPP being correlated with IPV, there is an important interindividual variability presumed to be secondary to other implicated factors. ♦ Design Over the past 2 years, we conducted a prospective study in our patients on PD ( N = 17). For each child, we recorded, at every third month of follow-up, IPV (in milliliters per square meter body surface area), age, gender, body mass index (BMI), and IPP (measured as centimeters of water), collecting a total of 53 data points. ♦ Results There was a positive correlation between IPV and IPP ( r= 0.36), but this correlation was weak in contrast to the strong correlation noted between BMI and IPP ( r= 0.82). Age had a different influence on IPP: in the younger-aged group (< 2 years), IPP decreased with age; in the older-aged group (≥ 2 years), IPP increased with age. In some infants, we noted a paradoxical result: a low IPV with a high IPP. ♦ Conclusions The strong correlation noted between IPP and BMI gives a better understanding of the interindividual variability of the previously described unique relationship between IPP and IPV. The more obese the child ( i.e., the higher the BMI), the higher is his IPP for a fixed IPV.

Levodopa-carbidopa with occlusion in older children with amblyopia

Purpose: To study the role of levodopa-carbidopa in supplementing occlusion therapy in older children with strabismic or anisometropic amblyopia. Methods: A clinical study was performed on 40 amblyopic children (19 strabismic and 21 anisometropic), 6 to 18 years old (mean age, 10.9 years). They received an average dose of 1.86 mg/kg/day (1.33-2.36 mg/kg/day) of levodopa and carbidopa (4:1 ratio) or a placebo in 3 divided doses over a 4-week period, combined with full-time occlusion. The occlusion was continued for the study duration of 3 months. Early Treatment Diabetic Retinopathy Study visual acuity charts and Cambridge low-contrast gratings for contrast sensitivity (CS) were used to assess visual functions. Tolerance and compliance with occlusion and capsule consumption were assessed. Results: Visual acuity of the nonamblyopic eye did not deteriorate during the study in either group. CS decreased by 22 units in the levodopa group and increased in the placebo group by 53 units at the first month. The CS in the levodopa group recovered later by the third month of follow-up. Both the levodopa and the placebo groups showed significant improvement in visual function in the amblyopic eye (P <.001). Overall changes in logarithm of minimum angle of resolutionvalues and CS in the amblyopic eyes were similar in both groups (P >.05). Strabismic and anisometropic amblyopes did not behave differently. Drug tolerance, occlusion compliance, and capsule ingestion compliance were similar between the groups, with no significant side effects. Conclusions: Clinically, levodopa supplementation does not offer any advantage over occlusion alone. Moreover, the risk of occlusion amblyopia could increase with the use of drugs like levodopa that might affect the plasticity of the visual cortex. (J AAPOS 2002;6:368-72)