Long-term sequelae of postnatal surfactant and corticosteroid therapies for BPD.

OBJECTIVE: This retrospective analysis assessed the relationship between medical treatment (postnatal steroids, surfactant) received neonatally and outcomes at 3 and 8 years using a longitudinal sample of children with bronchopulmonary dysplasia (BPD). STUDY DESIGN: Four groups were formed retrospectively based on the type of neonatal medical treatment received: no drug intervention (n=37), surfactant only (n=29), postnatal steroids only (n=13) and combined surfactant and postnatal steroids (n=16). Groups were compared on neurological and medical outcomes. RESULT: Combined postnatal steroids and surfactant treatment was associated with more days on supplemental oxygen than no intervention or surfactant only. Surfactant replacement therapy alone was not associated with adverse consequences; however, postnatal steroid exposure appeared to be related. CONCLUSION: Although retrospective analyses make statements about causation impossible, the differential relationships of therapies with cognitive outcomes argues for careful monitoring of therapeutic agents with very low birth weight infants.

Solution-focused brief therapy: a review of the outcome research.

Solution-focused brief therapy (SFBT) is a new and increasingly used therapeutic approach that focuses on helping clients construct solutions rather than solve problems. The approach evolved in a clinical context amid many anecdotal reports of success from both therapists and clients, but it has not been subjected to controlled empirical testing until very recently. In this article we critically review all of the controlled outcome studies of SFBT to date (N = 15) to assess the extent to which SFBT has received empirical support. Five studies were well-controlled and all showed positive outcomes--four found SFBT to be better than no treatment or standard institutional services, and one found SFBT to be comparable to a known intervention: Interpersonal Psychotherapy for Depression (IPT). Findings from the remaining 10 studies, which we consider moderately or poorly controlled, were consistent with a hypothesis of SFBT effectiveness. We conclude that the 15 studies provide preliminary support for the efficacy of SFBT but do not permit a definitive conclusion. Our critique highlights areas where methodology in future studies can be strengthened to provide more conclusive evidence of SFBT efficacy.