OBJECTIVETo study the clinical efficiency of transcatheter closure of large patent ductus arteriosus (PDA) using Amplatzer ductal occluder in children.

METHODSA retrospective review was performed for 227 children with large PDA, including 63 cases with pulmonary artery hypertension. All cases accepted the transcatheter closure using Amplatzer ductal occluders. The median age of the patients was 3.2 years, and the median weight was 10.6 kg. The median of the narrowest diameter of arterial ducts was 5.7 mm.

RESULTSSuccessful occlusion was achieved in 216 (95.2%) of the 227 cases. The mean pulmonary artery pressure in children with pulmonary artery hypertension decreased from 45±19 mm Hg before operation to 22±12 mm Hg after operation (P<0.05). In the 216 children achieving a successful occlusion, 109 children (50.5%) showed a complete occlusion immediately after operation by aortography and 181 children (83.8%) showed a complete occlusion by echocardiography 24 hrs after operation. No residual shunt was found in children who achieved a successful occlusion according to the results of echocardiography 6 and 12 months after operation.

CONCLUSIONSThe transcatheter occlusion of large PDA using Amplatzer ductal occluders is effective and safe in children.

Adolescent ; Balloon Occlusion ; instrumentation ; Cardiac Catheterization ; Child ; Child, Preschool ; Ductus Arteriosus, Patent ; therapy ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Retrospective Studies

OBJECTIVETo evaluate the efficacy and safety of loratadine, a new generation of antihistaminics, in the treatment of childhood asthma.

METHODSThe papers related to loratadine treatment for childhood asthma were searched in the database of PubMed, MEDLINE, EMBASE, Cochrance, CNKI and CBMdisc (January 1990 to December 2010) electronically and manually. According to the Cochrane reviewer's handbook, the quality of the enrolled papers was assessed and a systematic review was performed.

RESULTSA total of 179 papers were obtained. Eleven randomized controlled trials met the criteria and were included in this study. The 11 trials included 317 children with asthma: 159 cases in the loratadine treatment group and 158 cases in the control group. All included studies belonged to the B class according to the quality evaluation criteria. Meta analysis showed that the clinical symptoms were improved more, the forced expiratory volume in 1 second (FEV1) 4 and 8 weeks posttreatment and the peak expiratory flow rate (PEFR) 8 weeks posttreatment were higher in the loratadine treatment group than in the control group. The treatment-related adverse effects, fatigue, tachycardia and palpitation, occurred less in the loratadine treatment group compared with the control group.

CONCLUSIONSLoratadine is safe and effective for the treatment of childhood asthma.

Anti-Allergic Agents ; therapeutic use ; Asthma ; drug therapy ; physiopathology ; Forced Expiratory Volume ; Humans ; Loratadine ; adverse effects ; therapeutic use ; Peak Expiratory Flow Rate