Eighty-five infants and children were prospectively randomized to receive cefotaxime or ampicillin and chloramphenicol for therapy of bacterial meningitis. The two therapy groups of patients were comparable as to sex, age, clinical status on admission, prior administration of antibiotics and etiology. Three infants (7%) died in each therapy group. Mean number of days of positive cerebrospinal fluid cultures, time to defervescence and duration of treatment and of hospital stay and complications developing during treatment were similar for the two treatment regimens. Median cerebrospinal fluid bactericidal titers against the patients' pathogens in cefotaxime-treated patients (1:64) were larger than those in patients who received conventional therapy (1:8). Mild to moderate motor sequelae were more frequent in those given conventional therapy at the time of discharge only, and not at 4 months or longer of follow-up. We conclude that cefotaxime has similar efficacy when compared with conventional therapy for the management of bacterial meningitis in pediatric patients.

Ampicillin↗

PubMedDate not supplied

Preliminary study on the efficacy and tolerability of newer anticonvulsants in a population of epileptic patients.

OBJECTIVE: To study the efficacy and safety of newer antiepileptic drugs. SUBJECTS AND METHODS: Clinical records of 461 epileptic patients attending the Consorcio General Hospital, Valencia, Spain, were reviewed. Demographic data, adverse reactions and clinical outcome were recorded. RESULTS: One hundred and five patients experienced a total of 151 adverse drug reactions to antiepileptic medications. Adverse drug reactions occurred in the central nervous system (54.9%), skin (17.0%), gastrointestinal tract (13.2%), liver (4.9%), mouth (4.4%) and others (5.6%). The newer anticonvulsants were withdrawn in 19.1% of patients because of side effects, while older drugs were withdrawn in 9.3% of patients. Of the 461 patients, 78 (17.4%) experienced a > or = 50% reduction in seizure frequency when one of the newer anticonvulsants was added to their therapy. Older anticonvulsants were better tolerated than newer drugs. Tiagabine was the worst tolerated of all the drugs. CONCLUSION: Our findings show that patients with simple partial secondary generalized epilepsy had a greater benefit when a newer anticonvulsant was added to the treatment regimen.

Adolescent↗

PubMedDate not supplied

Cardiac arrhythmias in experimental subarachnoid hemorrhage.

Experimental subarachnoid hemorrhage (SAH) in dogs was produced by introducing blood into the subarachnoid space through a catheter connected to an artery of the animal. The intact animals and those with preserved vagi and heart sympathetic innervation, developed arrhythmias with short latencies which correlated with the sudden increase in the intracranial pressure. The animals with sections of both vagi and heart sympathetic innervation, but with an intact spinal cord, developed arrhythmias that were delayed and did not correlate with the changes in intracranial pressure. These arrhythmias were preceded by changes in the QT interval, T wave and ST segment. It was concluded that the arrhythmias could be produced either by direct autonomic discharges to the heart or by increased circulating and tissue catecholamines. The clinical implications of these findings are discussed.

Animals↗

PubMedDate not supplied

Human Lp(a): regions in sequences of apoproteins similar to domains in signal transduction proteins.

The major apoproteins of Lp(a)--apo(a) and apo B-100--are linked by only one intermolecular disulfide bond. This linkage has been suggested to be located between apo(a) Cys4057 and apo B-100 Cys3734. Several studies, however, have suggested other noncovalent interactions between different regions of apo(a) and apo B-100. One possible mechanism for these interactions may involve the apo(a) proline-rich interkringle regions that share sequence similarities with the proline-rich regions of Src homology 3 (SH3) domain-binding proteins such as 3BP-1. SH3 and SH2 domains, and their respective ligands, proline-rich regions, and phosphotyrosine motifs, are noncatalytic segments common to signal transduction proteins. Therefore, we used sequence comparison algorithms and molecular modeling programs to identify corresponding SH3 and SH2 candidate regions as well as potential phosphotyrosine sites in the apo B-100 sequence. Six SH2 and 16 SH3 candidate regions, along with 21 potential phosphotyrosine sites, are contained in the apo B-100 sequence. In Lp(a), these regions of apo B-100 may be involved in the noncovalent, protein-protein interactions between apo(a) and apo B-100. The presence of candidate SH3 and SH2 regions in apo B-100, and potential phosphotyrosine sites in apo B-100, apo(a), and apo A-I, suggests an alternative signaling pathway unrelated to the known B/E receptor.

Journal Article↗