***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Background . The kidney is the most damaged organ in asphyxiated full-term infants . Experiments in rabbits and rats have shown that renal adenosine acts as a vasoconstrictive metabolite in the kidney after hypoxemia and /or ischemia , contributing to the fall in glomerular filtration rate ( GFR ) and filtration fraction . Vasoconstriction produced by adenosine can be inhibited by the nonspecific adenosine receptor antagonist , theophylline . Gouyon and Guignard performed studies in newborn and adult rabbits subjected to normocapnic hypoxemia . Their results clearly showed that the hypoxemia-induced drop in GFR could be avoided by the administration of low doses of theophylline . Objective . This study was design ed to determine whether theophylline could prevent and /or ameliorate renal dysfunction in term neonates with perinatal asphyxia . Setting . Buenos Aires , Argentina . Study Design . We r and omized 51 severe asphyxiated term infants to receive intravenously a single dose of either theophylline ( 8 mg/kg ; study group : n = 24 ) or placebo ( control group : n = 27 ) during the first 60 minutes of life . The 24-hour fluid intake and the urine volumes formed were recorded during the first 5 days of life . Daily volume balances ( water output/input ratio and weights ) were determined . Severe renal dysfunction was defined as serum creatinine elevated above 1.50 mg/dL , for at least 2 consecutive days after a fluid challenge , or rising levels of serum creatinine ( .3 mg/dL/day ) . The GFR was estimated during the second to third days of life by endogenous creatinine clearance ( mL/minute/1.73 m2 ) and using Schwartz 's formula : GFR ( mL/minute/1.73 m2 ) = .45 × length (cm)/plasma creatinine ( mg/100 mL ) during the first 5 days of life . Tubular performance was assessed as the concentration of β2-microglobulin ( β2 M ) determined by enzyme immunoassay , on the first voided urine 12 hours after theophylline administration . The statistical analysis for the evaluation of the differences between the groups was performed with Student'st and χ2 tests as appropriate . Results . During the first day of life , the 24-hour fluid balance was significantly more positive in the infants receiving placebo compared with the infants receiving theophyline . Over the next few days , the change in fluid balance favored the theophyline group . Significantly higher mean plasma values were recorded in the placebo group from the second to the fifth days of life . Severe renal dysfunction was present in 4 of 24 ( 17 % ) infants of the theophylline group and in 15 of 27 ( 55 % ) infants of the control group ( relative risk : .30 ; 95 % confidence interval : .12–.78 ) . Mean endogenous creatinine clearance of the theophylline group was significantly increased compared with the creatinine clearance in infants receiving placebo ( 21.84 ± 7.96 vs 6.42 ± 4.16 ) . The GFR ( estimated by Schwartz 's formula ) was markedly decreased in the placebo group . Urinary β2 M concentrations were significantly reduced in the theophylline group ( 5.01 ± 2.3 mg/L vs 11.5 ± 7.1 mg/L ) . Moreover , 9 ( 33 % ) patients of the theophylline group versus 20 ( 63 % ) infants of the control group had urinary β2 M above the normal limit ( < .018 ) . There was no difference in the severity of the asphyxia between infants belonging to the theophylline and control groups in regards of Portman 's score . Except for renal involvement , a similar frequency of multiorganic dysfunction , including neurologic impairment , was observed in both groups . The theophylline group achieved an average serum level of 12.7 μg/mL ( range : 7.5–18.9 μg/mL ) at 36 to 48 hours of live versus traces ( an average serum level of .87 μg/mg ) in the placebo group . Conclusions . Our data suggest that prophylactic theophylline , given early after birth , has beneficial effects on reducing the renal dysfunction in asphyxiated full-term infants . A single dose of 8 mg/kg of theophylline within the first postnatal hour in term neonates with severe perinatal asphyxia results in a significant decrease in serum creatine and urinary β2 M , together with a significant increase in the creatine clearance . The potential clinical relevance of the data would be the avoidance of the contributory role of hypoxemia in the development of acute renal failure . Additional studies will be necessary before the use of theophylline in asphyxiated newborns can be considered for clinical practice Objective : Recent studies have suggested direct pulmonary effects of furosemide in asthmatics and infants with bronchopulmo- nary dysplasia . We tested the hypothesis that intratracheally administered furosemide also increases respiratory compliance in children after cardiac surgery , and investigated whether furosemide has a topical and /or systemic action . Study design : Prospect i ve study with intra-individual control . In twelve infants and toddlers ( age : 10 ± 8 months , weight : 6.9 ± 3 kg ) mechanically ventilated for compromised lung mechanics after cardiac surgery ,  0.5 mg/kg furosemide was intratracheally administered to the lungs  . Lung mechanics were serially assessed using a computerised system ( Sensormedics 2600 ) during a 2 h control and 2 h intervention period . Urine output was measured by an indwelling bladder catheter and levels of furosemide  were determined in blood and tracheal aspirates . Results : Static compliance improved within 30 min in all patients , reached a maximum of 44 ( 20–85 ) % above baseline and remained improved throughout the study ( p < 0.05 ) . An immediate , short and significant diuretic effect of intratracheally applied furosemide was observed . Furosemide levels 1 h after intervention were 795 ng/ml in the blood and 431 μg/ml ( i. e. 1000-fold higher ) in the tracheal aspirate . Changes in compliance were correlated only to urine output values over the 2 h ( r = 0.82 , p = 0.044 , n = 9 ) after furosemide administration . Conclusion : We conclude that intratracheally applied furosemide  improves static compliance in infants and toddlers with compromised lung mechanics after cardiac surgery . We demonstrated that furosemide is absorbed from the lung and has a systemic effect within 15 min after its intratracheal instillation The effect of postnatally administered aminophylline on the development of respiratory distress syndrome was evaluated in 25 premature infants weighing less than 1,500 gm . By r and om allocation , 14 infants were treated with aminophylline intravenously , and 11 infants served as controls . In the treated infants , a loading dose of 6 mg/kg of aminophylline was administered on the first day of life , and maintenance dosages of 4 mg/kg/day were given for the next three days . Respiratory distress syndrome developed in seven infants in the treated group and seven infants in the control group . Ten infants in each group required mechanical ventilation . More cases of intraventricular hemorrhage were diagnosed in the control group , but more deaths occurred in the treated group . These findings led to the conclusion that aminophylline administered postnatally did not appreciably modify the course of respiratory distress syndrome 40 preterm , ventilated infants ( gestational ages 24 - 33 weeks ) were entered into a double-blind r and omised trial to assess the effect of oral theophylline on lung function and ventilator dependence . Theophylline administration was associated with a significant improvement in compliance ( P less than 0.05 ) and hastened weaning from ventilation ( P less than 0.01 ) The efficacy of a bovine surfactant preparation ( SF-RI 1 ) to increase survival without bronchopulmonary dysplasia ( BPD ) was studied in very premature infants in a multicenter , r and omized sequential trial . Thirty-four infants were r and omized to surfactant treatment , whereas 35 infants served as controls . As part of the study , pharmacotherapy with antibiotics , sedatives , catecholamines , diuretics , methylxanthines , mucolytics , muscle relaxants , digoxin , and indomethacin was registered during week 1 and weeks 2 - 4 . As to the endpoint of the study a significantly increased survival rate without BPD was observed in surfactant-treated infants ( 76 % ) compared to controls ( 40 % ) . Significant differences concerning drug utilization were found through week 1 with increased use of methylxanthines in surfactant-treated infants , which persisted during weeks 2 - 4 as well as a reduced incidence of diuretic therapy  in surfactant-treated infants during weeks 2 - 4 . These differences may be attributed to the shorter interval of mechanical ventilation in surfactant-treated infants ( 11 days ) compared to controls ( 27 days ) , and to the above mentioned increased survival rate without BPD The effect of artificial surfactant therapy on renal function and the onset of spontaneous diuresis was prospect ively evaluated in 19 infants with hyaline membrane disease in a double-blind , controlled study . Twelve infants were in the surfactant group ; seven infants received placebo ( 0.9 % saline solution ) . There was no difference in the time of onset of spontaneous diuresis ( as defined by output greater than or equal to 80 % of intake ) . The glomerular filtration rate , determined by endogenous creatinine clearance , was also similar in the surfactant- and placebo-treated infants during the first 3 days of life . The fractional excretion of sodium was significantly higher in the placebo group at 24 hours and 36 hours . Infants in the placebo group had a higher negative sodium balance than those in the surfactant group . Ventilatory status improved significantly soon after surfactant treatment , as evidence d by improvement in the alveolar/arterial oxygen pressure ratio and by a lower mean airway pressure . These data suggest that ventilatory status can be improved without diuresis ; the factors that regulate diuresis are multiple and not fully understood OBJECTIVE To evaluate the relation between risk factors for childhood unintentional injury  and requests for injury prevention interventions as part of the Nottingham Safe at Home project , a primary care based controlled intervention study assessing the effectiveness of a package of injury prevention interventions . SETTING 17 practice s in Nottingham r and omly selected from 55 practice s volunteering to take part in the study . METHODS Postal question naire to all parents of children aged 3 to 12 months registered with the intervention practice s ( n = 1124 ) to assess risk factors for injury and to elicit requests for three injury prevention interventions : free home safety checks , low cost safety equipment , and free first aid training . RESULTS 73 % of parents responded to the question naire . The distribution of sociodemographic variables among responders was similar to that for the population of Nottingham . One third of parents ( 34 % ) requested one intervention , 21 % requested two interventions , and 10 % requested three . Receipt of means tested benefits , ethnicity , and residence in a deprived area were independently associated with requesting home safety checks . Non-owner occupation , lack of access to a car , receipt of means tested benefits , ethnicity , and unemployment were independently associated with requesting low cost safety equipment . Non-owner occupiers were less likely to request first aid training . CONCLUSIONS Families with risk factors for childhood unintentional injury do request  home safety checks  and low cost safety equipment , but they are less likely to request first aid training . Other methods for providing first aid advice may be needed to reach such families Furosemide stimulates the renal synthesis of prostagl and in E2 , a potent dilator of the ductus arteriosus . We administered this drug to 33 premature infants with the respiratory-distress syndrome , to determine whether it increased the incidence of patent ductus arteriosus .  Chlorothiazide , a diuretic that does not stimulate prostagl and in E synthesis , was used as the control drug in 33 other infants . During the study , the incidence of patent ductus arteriosus was significantly higher ( P less than 0.02 ) in the furosemide group ( 18 of 33 infants ) than in the chlorothiazide group ( 8 of 33 ) . Eleven infants in the furosemide group and seven in the chlorothiazide group required ductal ligation ( P greater than 0.2 ) . An additional six infants ( all from the furosemide group ) who did not have evidence of a patent ductus during the study were later found to have one . Overall survival was 76 and 61 per cent in the furosemide and chlorothiazide groups , respectively ( P greater than 0.2 ) . Small ( less than twofold ) increases in the urinary excretion of prostagl and in E were seen after the initial dose of both drugs . When the analysis was repeated after the fifth day of life , prostagl and in E excretion tripled after furosemide administration , whereas no increase occurred with chlorothiazide . We conclude that furosemide increases the inc 
    Output:
    
Furosemide administration had no long-term benefits .
Furosemide-induced transient improvement in pulmonary function did not outweigh an increased risk for patent ductus arteriosus and for hemodynamic instability .
REVIEW ER 'S CONCLUSIONS There are no current data to support routine diuretic administration in preterm infants with RDS .