We compared 23 patients (ages 4 to 18 years) who were receiving long-term oral prednisone therapy with 31 normal controls (ages 7 to 16 years). Indications for corticosteroid treatment included renal transplant in 11 patients, nephrotic syndrome in 7, glomerulonephritis in 4, and vasculitis without renal disease in 1. The mean duration of prednisone therapy was 5.0 +/- 3.5 years, and the mean dose at the time of examination was 0.29 +/- 0.18 mg/kg/day. Mean intraocular pressure was 16.0 +/- 3.0 mm Hg (range, 12 to 25 mm Hg) in the prednisone group and 15.4 +/- 2.1 mm Hg (range, 12 to 20 mm Hg) in the control group. The difference between the means was 0.6 mm Hg (P = 0.35). Posterior subcapsular cataracts were present in seven (30%) of the prednisone patients, but in none of the controls (P = .001). None of the cataracts were visually significant. We found no evidence that pediatric patients on long-term, low-dose prednisone have higher intraocular pressures (IOPs) than normal children, although they are more likely to develop posterior subcapsular cataracts.

Adolescent↗

PubMedDate not supplied

Infection prophylaxis for the patient with cancer.

Despite major advances in treatment, patients with cancer still are plagued by infections. Anti-infection prophylaxis begins with attempts to enhance host defenses, minimize natural barrier alterations, and reduce the number of pathogenic organisms in the patient's environment. Prevention of infection via immunomodulation also is effective to some extent. Immunoglobulin administration, leukocyte transfusion, vaccines, and lithium carbonate are integral parts of this approach to prophylaxis. Antimicrobial modulation also has been attempted. Oral nonabsorbable antibiotics have been used to reduce the number of potentially pathogenic gastrointestinal organisms. Systemic antibiotics have been evaluated for their prophylactic efficacy in patients with cancer. Obstacles to effective systemic prophylaxis include the risk of developing resistant populations of microorganisms and the inordinately large number of potentially pathogenic organisms. The oncology nurse must assume specific responsibilities when administrating prophylactic regimens. There are three crucial issues to be considered: risk factors, aspects of cost and reimbursement, and availability of the most recent treatment options.

Anti-Bacterial Agents↗

PubMedDate not supplied

Participant observation: a research technique in public health nursing.

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Humans↗