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  • 1
    ISSN: 1432-1041
    Keywords: moxalactam ; antibiotic ; plasma level ; cerebrospinal fluid ; high performance liquid chromatography ; assay method
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary A sensitive and reproducible method for the measurement of moxalactam in plasma and cerebrospinal fluid is described. Plasma proteins were removed by precipitation with ice-cold methanol at pH 5.6 and centrifugation. The supernatant was analysed by HPLC on a µ-Bondapack/phenyl column, with a mobile phase of acetonitrile/water/PIC Reagent A (20/80/1), and detection at 280 nm. The calibration curve was linear for plasma concentrations from 10 µg/ml to 60 µg/ml. Reproducibility was 4.7% (coefficient of variation) for within-day analysis and 13.8% for day-to-day analysis. Plasma concentrations in 9 moxalactam-treated patients with severe infections ranged from 0.9 µg/ml to 409 µg/ml. Individual pharmacokinetic parameters were calculated using a personal computer. In selected cases moxalactam concentrations were also determined in cerebrospinal fluid and tracheal aspirates.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 138 (1982), S. 105-109 
    ISSN: 1432-1076
    Keywords: Chlamydia trachomatis ; Pneumonia in infants ; Interstitial pneumonia ; Eosinophilic pneumonia ; Pertussoid pneumonia ; Afebrile pneumonia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Clinical manifestations, diagnostic studies and management of chlamydial pneumonia were reviewed in 115 infants and compared to those from 21 infants with interstitial pertussoid eosinophilic pneumonia. The identity of these two forms of subacute afebrile pneumonia is suggested. Chlamydial pneumonia is natally acquired, essentially occurs during the second and third month of life, and its frequency in the United States is surprisingly high. Gradual onset of respiratory tract symptoms, lack of possible infection from symptomatic persons, afebrile course and staccato cough represent the typical anamnesis. Presence of conjunctivitis and serous otitis is common. Distinctive diagnostic studies include slight eosinophilia (lhen300 eosinophils/mm3), elevated serum immunoglobulins M and G, depressed PO2 and normal PCO2 in arterial blood under room air, and both interstitial infiltrates and hyperexpansion of nhe lungs on chest roentgenogram. Chlamydial cultures of nasopharyngeal secretions or tracheal aspirates, and determination of antichlamydial antibody titers in serum are indicated in establishing the etiology. Adequate management consists of antichlamydial chemotherapy and general supportive care, including chest physiotherapy and oxygen and parenteral fluids when needed.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1076
    Keywords: Fusidic acid ; Cystic fibrosis ; Sputum penetration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report the sputum penetration and efficacy of fusidic acid in 16 children with cystic fibrosis (CF) who were hospitalized because of acute respiratory tract infection due to Staphylococcus aureus. Penetration into sputum and response to therapy were evaluated after intravenous and oral drug administration. Oral fusidic acid therapy (approximately 1,000 mg/m2/day) achieved highly satisfactory serum (10–50 μg/ml) and sputum (0.6–4.0 μg/ml) concentrations which were several fold greater than the MIC of the infecting S. aureus strains. The average percentage penetration into sputum during the steady state phase of the concentration-time curve was between 5 and 10%. The efficacy of treatment is reflected by improvement in clinical findings and laboratory data. Eradication of S. aureus from the sputum was documented in 14 of the 16 patients, although 6 months later this was shown to be transient in half of them (7 of 14 patients). No staphylococci resistant to fusidic acid were found. Nine of the 14 children with documented staphylococcal eradication from the sputum had received gentamicin in addition to fusidic acid therapy which could have added antistaphylococcal efficacy. Further investigations are needed to formulate the definitive role of fusidic acid in the antistaphylococcal therapy of patients with CF.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1076
    Keywords: Human immunodeficiency virus ; Intravenous immune globulin therapy ; Paediatric AIDS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Seven paediatric patients with symptomatic human immunodeficiency virus (HIV) infection were prospectively studied for 6–24 months after the start of intravenous immune globulin (IVIG) therapy. There was substantial clinical benefit during IVIG treatment with marked reduction of febrile and infectious episodes, normalization of physical and psychomotor development, and absence of mortality. The immunologic monitoring revealed some discrete objective improvements. The results of this study favourably compare to previous reports. It is concluded that IVIG should be standard therapy for symptomatic childhood HIV infection.
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  • 5
    ISSN: 1432-1076
    Keywords: HIV infections ; HIV seroprevalence ; Child ; Transmission ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A nationwide study involving 286 children of human immunodeficiency virus (HIV)-infected mothers living in Switzerland has been performed with the participation of all paediatricians interested in HIV infection in the country. Of these children 201 could be followed up prospectively from birth up to a median age of 22 months. Prevalence of HIV infection in Swiss parturients was estimated at 0.1% and apparently remained stable from 1986 to 1989. Vertical transmission rate was estimated at 14%–20%. Variables of maternal or perinatal history were not associated with transmission rate. Transmission to pairs of siblings of the same mothers was discordant in 33% (6 of 18), with always the elder sibling being infected. Postneonatal mortality in infants of HIV-infected mothers followed up from birth was increased 15-fold over the general population with a very high incidence (2 in 100) of sudden infant death apparently unrelated to HIV infection.
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  • 6
    ISSN: 1432-1076
    Keywords: HIV infections ; Infant newborn ; Pregnancy ; Parity ; Caesarean section
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Abstract In a national prospective study of risk factors for mother-tochild transmission of human immunodeficiency virus (HIV), 316 children of HIV-positive mothers were followed up for at least 6 months. Infection status was determined in 254 of them and 46 were found to be infected giving a transmission rate of 18.1%. Univariate analysis of potential risk factors for mother-to-child transmission showed an association between primiparity and increased transmission rate: odds ratio 2.2, 95% confidence interval (CI) 1.1–4.6,P〈0.05. Analysis by logistic regression confirmed this association (adjusted odds ratio 2.4) and showed, in addition, a negative association between transmission rate and elective Caesarean section (adjusted odds ratio 0.36, 95% CI 0.13–0.97,P〈0.05). The effect of primiparity was less pronounced in combination with elective Caesarean section (odds ratio 1.7) than with other delivery modes (odds ratio 2.5, difference not significant. HIV-infected children were less likely to experience the birth of a younger sibling during the observation period than their uninfected counterparts (2 of 46 vs 27 of 208,P〈0.05 by logrank test). Conclusions Primiparous women appear to transmit HIV to their children at a higher rate. This could be explained by increased intrapartum transmission because of longer and more complicated labour in primiparas and/or by a self-selection of women with lower risk of transmission among those deciding to have additional children.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 150 (1991), S. 282-286 
    ISSN: 1432-1076
    Keywords: Brain abscess ; Paediatrics ; Follow up studies ; Prognosis ; Treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A retrospective evaluation was performed on 28 cases of paediatric brain abscess (male∶female ratio 2.5∶1; mean age 9.4 years; range 2.8–16 years) diagnosed between 1967 and 1987. In 46%, congenital cyanotic heart disease was identified as a predisposing factor, likewise sinusitis, otitis media or mastoiditis in 29% and immunodeficiency in 11%. Pathogenesis remained unclear in 14%. Initial symptoms and signs were predominantly nonspecific; loss of consciousness occurred in 32% of cases, neurological deficit and seizures each in 25%. Since the availability of CT, both diagnostic delay after hospital admission and mortality were substantially reduced: mean delay from 8.4 to 3.0 days, and mortality from 23% to 0%. Seventeen patients (61%) had follow up examinations 9.6 years (mean) after the acute illness (range 1–21 years). Neurological sequelae were diagnosed in 35% of cases, epilepsy in 29%, epileptic potentials during EEG in 12%, and CNS scars in 50%. Psychological testing revealed no statistically significant differences compared to normal populations. CNS scars, and epilepsy and/or epileptic potentials were more common after excision (7 patients) when compared to patients treated by aspiration and/or antibiotics alone (21 patients). It is concluded that excision of brain abscess should be avoided whenever possible. Therapy of choice consists of the administration of adequate antibiotics with or without CT-guided needle aspirations.
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  • 8
    ISSN: 1432-1076
    Keywords: Combined immunodeficiency ; T-cell defect B-cell defect ; Cerebellar hypoplasia Pancytopenia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A male infant with primary combined immunodeficiency, microcephaly with marked cerebellar hypoplasia, and growth failure of prenatal onset is presented. He developed progressive pancytopenia in the 3rd year of life and died at 42 months from disseminated aspergillosis. Laboratory studies and post mortem examination failed to reveal any known aetiology for his disorder. Hreidarsson et al. [3] previously described a syndrome of progressive pancytopenia with microcephaly, cerebellar hypoplasia and growth failure in three boys, with similar clinical and laboratory findings. Although extensive immunological investigations were not performed in those previous patients, recurrent infections in two of them are suggestive of immunodeficiency. In the light of the immunological findings in our patient, we propose that the condition of the four patients belongs to the same syndrome, which has to be considered as a primary combined immunodeficiency syndrome. This syndrome can be distinguished from the other known immunodeficiency syndromes by its associated characteristic features, namely microcephaly with cerebellar hypoplasia, growth failure of prenatal onset and progressive pancytopenia.
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  • 9
    ISSN: 1432-1076
    Keywords: Key words: Combined immunodeficiency – T-cell defect – B-cell defect – Cerebellar hypoplasia – Pancytopenia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A male infant with primary combined immunodeficiency, microcephaly with marked cerebellar hypoplasia, and growth failure of prenatal onset is presented. He developed progressive pancytopenia in the 3rd year of life and died at 42 months from disseminated aspergillosis. Laboratory studies and post mortem examination failed to reveal any known aetiology for his disorder. Hreidarsson et al. [3] previously described a syndrome of progressive pancytopenia with microcephaly, cerebellar hypoplasia and growth failure in three boys, with similar clinical and laboratory findings. Although extensive immunological investigations were not performed in those previous patients, recurrent infections in two of them are suggestive of immunodeficiency. In the light of the immunological findings in our patient, we propose that the condition of the four patients belongs to the same syndrome, which has to be considered as a primary combined immunodeficiency syndrome. This syndrome can be distinguished from the other known immunodeficiency syndromes by its associated characteristic features, namely microcephaly with cerebellar hypoplasia, growth failure of prenatal onset and progressive pancytopenia.
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  • 10
    ISSN: 1420-9071
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
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