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Biomedical subjects

N Principi

Publications and source records attributed to N Principi.

At least 109 records · Page 6Linked to original sources
PubMed1989

Early diagnosis of HIV infection in infants.

Eighteen infants born to anti-HIV-positive mothers were tested bimonthly for immunoglobulin M (IgM) anti-HIV by Western blot and HIV p24 antigen (Ag) by enzyme-linked immunosorbent assay (ELISA) in order to determine the role of these markers in the early diagnosis of HIV infection. Twelve healthy infants were also studied as a control group. In 11 out of 18 children (61.1%) an IgM response was demonstrable, in 13 out of 18 (72.2%) IgM anti-HIV and/or p24 antigen (Ag) were detected. Two patterns of IgM response were identified: a precocious IgM positivity (group of five children positive at birth) and a later appearance of IgM, always within the third month (six cases). Early p24 antigenemia occurred in one infant. Three out of four children who developed antigenemia after birth were symptomatic within the sixth month. No clinical or immunological abnormalities were found among the three children who were persistently negative for both IgM anti-HIV and p24 Ag. Serial IgM anti-HIV and p24 Ag testing may be helpful in the early identification of HIV-infected patients.

AIDS Serodiagnosis↗
PubMed1987

Effect of miocamycin on theophylline kinetics in children.

The interaction between a new macrolide antibiotic, miocamycin, and theophylline was evaluated in a single cross-over study in 5 asthmatic children. Each patient received a single dose of theophylline (4.3 mg/kg) delivered in 15 min using a constant-rate infusion pump, immediately before and after a 10 day course of miocamycin 17.5 mg/kg b.d. The pharmacokinetics of theophylline were calculated for each phase of the study. The elimination rate constant (3.92 vs 3.74 h-1), the mean total body clearance (1.71 vs 1.8 ml X min X kg-1) and the mean apparent volume of distribution (0.57 vs 0.581 X kg-1) did not differ. The result can be explained by the inability of the antibiotic to form inactive cytochrome P-450 metabolite complexes which can interfere with the metabolism of theophylline. Thus, miocamycin can safely be administered to asthmatic children requiring theophylline treatment, when they have an infection due to susceptible pathogens.

Asthma↗
PubMed1987

Upper respiratory tract infections in children: antibiotic treatment.

Upper respiratory tract infections, particularly pharyngitis and acute otitis media (AOM) are the commonest diseases in children. Although viruses are the main causative agents, bacteria may play an important role. With regard to antibiotic therapy, clinicians must solve two problems: differentiation between viral and bacterial aetiology and choice of the optimal drug for each bacterial disease. In patients with pharyngitis the identification of group A haemolytic streptococci as the causative agent may be very difficult if only clinical and haematological data are considered. Throat culture is time consuming and difficult to perform in ambulatory practice; the recent techniques for rapid detection of streptococcal antigens are a possible answer to this problem. In bacterial pharyngitis a single injection of benzathine penicillin is considered to be first choice. However local pain and the significant increase of the relative risk of allergic problems in comparison with the decrease of incidence of rheumatic fever may shift therapeutic preference towards macrolides. The recently marketed ones, especially miocamycin, seem to offer easier administration, fewer side-effects and better efficacy. With regard to AOM, the differentiation between bacterial and viral disease is less important because over 70% of cases are of bacterial origin. Besides, an exact aetiological diagnosis is possible only by tympanocentesis, an invasive method. In Italy amoxicillin is still the drug of choice: a twice-daily regimen has been demonstrated to be as effective as the traditional thrice-daily schedule.

Anti-Bacterial Agents↗
PubMed1987

New trends in paediatric antibiotic therapy.

Recently many new antibiotics have been marketed for use in paediatrics. Most of them offer no real advantage in comparison to older drugs and their prescription is questionable, particularly because they are highly expensive. Only a few have a number of special characteristics which permit in certain patients a significant improvement of antibiotic therapy. Among these there are some third-generation cephalosporins such as ceftazidime and cefsulodin, aztreonam and the new macrolides. Ceftazidime and cefsulodin are highly active, particularly against Pseudomonas spp., thus offering new therapeutic possibilities in life-threatening infections due to these bacteria. Aztreonam is the first monobactam and has a spectrum of activity limited to the aerobic Gram-negative bacilli. Its indications are therefore very similar to those of the aminoglycosides but its use seems to be safer because it has none of the important side-effects of those drugs. Alone or in combination, it may become the drug of choice to treat children with infection due to Gram-negative bacteria. New macrolides are active against erythromycin-resistant bacteria, have a lower risk of gastrointestinal side-effects and have no interference with concomitant administered drugs such as theophylline. Therefore they may be used with higher compliance and better efficacy, especially in the areas where erythromycin-resistant Gram-positive strains are increasingly evident.

Aminoglycosides↗
PubMed1987

Simple clinical score and laboratory-based method to predict bacterial etiology of acute diarrhea in childhood.

We describe a two-step predictive method to assess the probability of bacterial etiology in cases of diarrhea. The patients are divided into three probability groups (high, intermediate, low) according to a clinical score. Thereafter the patients in the intermediate group are further assigned to the high or low probability group according to the presence or absence of fecal leukocytes. We developed the method in an initial series of 157 children with acute diarrhea; the reproducibility of the method was tested in a second series of 180 cases. Eighty-six percent of patients in the first series and 81% in the second were correctly classified by our method. We suggest its use, especially in pediatric practice, to identify children with the highest probability of bacterial diarrhea, thus reserving stool culture to a few selected cases because only a minority of children with diarrhea have a recognized bacterial etiology.

Adolescent↗
PubMed1986

Correlation between dosage and antipyretic effect of aspirin in children.

One hundred and forty-five children aged 3 months to 11.5 years, with rectal temperatures greater than 38.9 degrees C, were randomly treated with aspirin 5, 10 or 15 mg/kg p.o. Temperatures were recorded just before medication, every 30 min thereafter for 4 h and subsequently hourly up to 6 h. In all dosage regimens the average temperature was significantly reduced in the time interval 1-6 h after drug administration; the antipyretic effect, however, was significantly greater with the 10 and 15 mg/kg doses. Both had significantly better and comparable clinical efficacy, defined as reduction in fever below 38.9 degrees C. The duration of the clinical effect was not dose-related. A dose of 10 mg/kg appears rational for the treatment of children with fever.

Aspirin↗
PubMed1986

Amoxicillin twice daily in the treatment of acute otitis media in infants and children.

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.

Acute Disease↗
PubMed1986

Possibility of interaction among antibiotics and mucolytics in children.

A controlled clinical trial in children with acute infections of the lower respiratory tract was carried out to see whether or not treatment with ambroxol could bring about faster and better results. One hundred twenty children with acute lower respiratory tract infections were all given antibiotics plus, at random, either ambroxol (1.5-2.0 mg/kg body weight orally) or a placebo. The duration of the trial was ten days. All the patients in both groups were cured clinically. However, remission of the cough, of the chest pathological signs, as well as the improvement of the lung radiographical pictures were significantly more rapid in children treated with ambroxol than in those who received the antibiotic alone. Ambroxol was tolerated perfectly by all the children.

Ambroxol↗
PubMed1985

Single-dose netilmicin therapy of complicated and uncomplicated lower urinary tract infections in children.

Thirty children (age 3 months to 10 years) with complicated and uncomplicated lower urinary tract infections were treated with a single intramuscular injection of netilmicin 4.5 mg/kg. The diagnosis of lower urinary tract infection was based on the absence of fever and the presence of normal values for erythrocyte sedimentation rate, C-reactive protein concentration and urinary excretion of N-acetyl-beta-D-glucosaminidase. Follow-up urine cultures in all children demonstrated a cure rate of 97% and reinfection and relapse rates each of 7% respectively. The subgroup (12 children) with radiological abnormalities of urinary tract showed a cure rate of 92%, and reinfection and relapse rates of 9% respectively. The rates of cure, reinfection and relapse in the complicated and uncomplicated urinary tract infections were not statistically different (p greater than 0.05). A pharmacokinetic study (performed in 5 children) demonstrated that netilmicin urinary concentrations were over the MIC's of the infecting organisms up to 96 hours after the single-dose injection. Netilmicin was well tolerated and no side effects appeared during treatment. Single-dose netilmicin therapy is an effective and safe regimen for complicated and uncomplicated urinary tract infections in children. The response to single-dose netilmicin therapy seems to be related to its prolonged urinary elimination.

Bacterial Infections↗