Problems of classification of human immunodeficiency virus-seropositive pediatric patients.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to E Massironi.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A total of 110 children with acute otitis media were assigned randomly to treatment with 60 mg/kg per day amoxicillin in a twice-daily (group A) or a thrice-daily (group B) regimen for 10 days. Patients were scheduled for follow-up examinations at mid-treatment, 5 days after the end of therapy and 30, 60, 90 days after starting therapy. At 15 days 6 out of 55 patients (10.9%) treated with amoxicillin twice daily were considered treatment failures compared to 4 children (7.2%) in the thrice daily group. Rates of cure, recurrent otitis media and persistent middle ear effusion were comparable in the two groups of patients at later time intervals. By 90 days the total cure rate was 42.3% (22/52) in children treated twice daily and 41.5% (22/53) in those who had received amoxicillin thrice daily. At the same time persistence of bilateral and unilateral effusion was noted in 12/52 (23.1%) and 8/52 (15.3%) children in group A and in 16/53 (30.1%) and in 10/53 (18.9%) in group B respectively. No significant difference was noted in the two treatment regimens with regard to adverse side effects. Because reduction in division of the amoxicillin dose caused no significant difference in the efficacy of antibiotic treatment of acute otitis media in infants and children, we think that this simplified scheme of therapy can routinely be used in clinical practice and thus improve compliance to antibiotic administration.
This study was designed to explore whether C-reactive protein (CRP) in serum is helpful in assessing the etiologic diagnosis of acute otitis media (AOM) in children. CRP was measured serially by a radial immunodiffusion method in sera from 67 children with AOM and in 67 matched controls, affected by noninfectious neurologic disorders. In the study group 43 (64%) children had a confirmed bacterial AOM and 24 (36%) showed no bacterial growth from middle ear fluid. The upper limit of CRP in controls was 15 mg/liter. Concentrations of CRP in patients with bacterial AOM ranged from less than 6 to 150 mg/liter; in 71% of the cases the value was greater than 15 mg/liter. In the patients with sterile middle ear fluid CRP ranged from less than 6 to 110 mg/liter; in 67% of the cases the level was greater than 15 mg/liter. CRP greater than 15 mg/liter showed sensitivity of 72%, specificity of 33%, predictive value of a positive test of 66% and predictive value of a negative test of 40%, in detecting bacterial AOM. Measurement of CRP should not be used in the decision regarding antimicrobial therapy for AOM in children.
A case of prolonged Q-T interval syndrome without deafness (Romano-Ward syndrome) is reported. A 2-month-old female was seen in consultation because of a near-miss event (syncopal attack). An EKG showed a long Q-T interval. Successful therapy was achieved with propanolol.