In a prospective Swiss multicenter study, 119 children (aged three weeks to 15.5 years) with acute bacterial meningitis were treated with single daily doses of ceftriaxone (100 mg/kg on days one and two and 60 mg/kg thereafter). All patients were randomly assigned to either short course (four, six, seven days) or full course (eight, 12, 14 days) therapy depending on whether they had contracted meningococcal, Haemophilus influenzae type b or pneumococcal meningitis. Bacteriological cure was obtained in 92 children who fully completed the study and in all the 20 culture-positive of the 27 children secondarily excluded from the study for failure to meet all bacteriological and initial safety criteria for continuation in protocol (secondary exclusions). Complete clinical recovery was noted in 105 of 119 patients (88%) and was as frequent in the short course (91%) as in the full course (89%), and as in the secondary exclusion (81%) group. All patients survived. At follow-up examination three to six months after hospital discharge only seven infants and seven children (11.8%), mostly those with poor presentation on admission (p = 0.0012), showed residual neurological sequelae. Side effects of antibiotic therapy were minor but more frequent, albeit not statistically significant (p = 0.065), in children receiving the full course therapy. The results of this study suggest that short course treatment of acute bacterial meningitis in children with single daily ceftriaxone monotherapy is as efficacious as full course therapy and at least as well tolerated.

Adolescent↗

PubMedDate not supplied

Short course single daily ceftriaxone monotherapy for acute bacterial meningitis in children: results of a Swiss multicenter study. Part II: Bacteriological results.

The in vitro activity of ceftriaxone, ampicillin and chloramphenicol was studied at a reference laboratory against the isolates of the first 33 patients enrolled in a pediatric Swiss Multicenter Meningitis Study. The predictive value of the MIC data of 31 of the strains was further corroborated by two sets of bacterial killing curves in broth supplemented with 2 g/l of albumin. Ceftriaxone had the lowest geometric mean MIC values against all groups of isolates except for ampicillin against Streptococcus agalactiae. The bactericidal activity of ceftriaxone and that of ampicillin, alone and in combination with chloramphenicol, was compared at six times the respective MICs and at pharmacologically readily achievable concentrations in cerebrospinal fluid. The bactericidal power of ceftriaxone at six times the MIC was as good or better than that of ampicillin alone or in combination against Neisseria meningitidis and Streptococcus pneumoniae despite the very low drug concentrations of ceftriaxone compared to that of the competitors; and it was barely lower at six times the MIC and at 1 mg/l (a level that is readily surpassed in CSF at the 24 h trough level after a single daily dose of ceftriaxone of 100 mg/kg (neonates 50 mg/kg) than that of ampicillin and chloramphenicol at much higher concentrations against Haemophilus influenzae type b.

Adolescent↗

PubMedDate not supplied

[Ergonomic analysis of heavy work carried out by female workers in the textile industry].

Work and recovery pulse were measured with 22 female workers doing heavy work. The proposed limit of capacity under continuous operating conditions of 25 work pulses was surpassed by 10 of the 22 workers. Recovery pulse made it possible to detect illness in two cases and correlates significantly with the total duration of relaxing operation. Similar results could not be obtained with work pulse. As the recovery pulse is quickly and easily measurable, it was in the frame of this study a more interesting value than the work pulse.

Female↗

PubMedDate not supplied

[The effect of a monotonous repetitive task on flicker fusion and subjective feelings].

The effects of a uniform repetitive and of an activating task on critical flicker fusion (cff) and subjective feelings were measured on 15 subjects under laboratory conditions. With the uniform repetitive task the cff decreased significantly and the subjective feelings showed marked changes. With the activating task we could determine changes neither for cff nor for subjective feelings (except factor "subjective recovery").

Boredom↗

PubMedDate not supplied

Intraoperative high dose rate brachytherapy in recurrent or metastatic colorectal carcinoma.

BACKGROUND: The survival of patients with recurrent or metastatic colorectal cancer usually is less than 12 months. In an attempt to improve this dismal prognosis, we investigated the role of intraoperative high dose rate brachytherapy (IOHDR) in the management of these patients. METHODS: From April 1992 to December 1996, 26 patients with locally recurrent or metastatic colorectal carcinoma were treated with maximal surgical resection and IOHDR. Intraoperative radiation dose ranged from 10 to 20 Gy, prescribed at 0.5 cm depth. The residual tumor irradiated was microscopic in 16 patients (62%) and gross residual in 10 patients (38%). Six patients received postoperative external beam radiation therapy. RESULTS: After a median follow-up of 28 months (range 6 to 54 months), seven of 15 evaluable patients (47%) failed in the area treated with IOHDR. The median time to local failure was 21 months (range 4 to 52 months). The median survival was 23 months (microscopic 24 months; gross 17 months), with a 4-year actuarial survival rate of 36%. Major morbidity was observed in 7 patients (47%) and usually was surgery-related. CONCLUSION: The use of IOHDR in association with radical resection increases local control in patients with recurrent or metastatic colorectal cancer. Patients with microscopic residual disease achieved a better result than do those with gross residual disease. Future strategies include the addition of limited EBRT dose to IOHDR, even for previously irradiated patients.

Actuarial Analysis↗

PubMedDate not supplied

Unilateral centrifugation of the otoliths as a new method to determine bilateral asymmetries of the otolith apparatus in man.

Ten healthy subjects were eccentrically rotated with constant speed on a Barany chair. Setting of a luminous line (LL) to the subjective vertical and ocular counter-roll (OCR) were evaluated. During eccentric position rotation subjects consistently reported illusory rotation and set the LL to an angle correlating to centrifugal force. At the same time an OCR of opposite direction was measured. In one patient, labyrinthectomized on the right side, only counterclockwise rotation of the luminous line was observed. Differences between "inner" and "outer" eye were evident for luminous line settings and OCR in some subjects. The results indicate that eccentric rotation is a valuable method to test for bilateral otolith asymmetries. The method can be applied to preflight tests of astronaut candidates for susceptibility to spacesickness. It is also offered for clinical evaluation of unilateral otolith impairments.

Adult↗

PubMedDate not supplied

MRI following severe perinatal asphyxia: preliminary experience.

In 30 children suffering from severe perinatal asphyxia an attempt was made to determine the early prognostic signs of severe hypoxic-ischemic brain injury with magnetic resonance imaging (MRI). Ten early (1-4 days of age), 16 intermediate (2-4 weeks of age), and 38 late MRI (older than 1 month of age) procedures were performed on a 2.35 T MR-system. Severe cerebral necrosis was suspected by T2 hyperintensity of the white matter, with blurred limits to the cortex in early MRI, and was confirmed by T1 hyperintensity of the cortex in intermediate MRI. Severe cerebral necrosis was established at 3 months of age. Of the 11 children with this pattern (group A), 8 had severe and 3 had moderate cerebral palsy on subsequent examination. Thirteen children (group B) had normal late MRI scans; none developed severe cerebral palsy or marked mental retardation. Two children (group C) had focal ischemic lesions. Four children had intracranial hemorrhage (group D). Groups A and B did not differ in the severity of their perinatal histories and findings, suggesting that MRI during the first 3 months is of significant prognostic value.

Asphyxia Neonatorum↗