ABSTRACT
BACKGROUND: Modern neonatal and pediatric intensive care includes a sophisticated pharmacotherapy with numerous drugs, mainly administered intravenously. Often, despite the use of multi-lumen central venous lines, more peripheral venous accesses are required. To reduce the necessity of numerous venous lines on one hand and on the other hand to avoid complications from incompatibilities of the administered drugs, we compiled a compatibility chart, encompassing more substances than covered in previously available charts. METHODS: Information on compatibility of commonly prescribed drugs was collected by analysis of manufacturers' information, medical and pharmaceutical handbooks, and a literature research. RESULTS: Available data on compatibility of 78 drugs were displayed in a two-dimensional chart. Beside the pH of each drug, compatibility of drug combinations was encoded for simultaneous infusion. Special emphasis was on security of the therapy. CONCLUSION: The compatibility chart gives quick reference for Data on compatibility of intravenously administered drugs in neonatal and pediatric intensive care.
Subject(s)
Drug Incompatibility , Drug Information Services , Intensive Care Units, Neonatal , Intensive Care Units, Pediatric , Pharmaceutical Preparations/administration & dosage , Catheterization, Central Venous , Child , Child, Preschool , Drug Therapy, Combination , Humans , Hydrogen-Ion Concentration , Infant , Infant, Newborn , Infusions, IntravenousABSTRACT
BACKGROUND: Griscelli syndrome is a rare disorder with poor prognosis. It is characterized by silver-grey hair or strands of silver-grey hair in childhood, and variable cellular immunodeficiency. The course of the untreated disease is fatal. Recurrent episodes of fever and lymphohistocytic infiltration of organs lead to hepatosplenomegaly, lymphadenopathy, pancytopenia, and progressive neurological impairment. Prognosis on morbidity and lethality depends on an early diagnosis. PATIENT: The girl we report on suffers from Griscelli syndrome. She developed normally and only her grey strands of hair, grey eyebrows, and eyelids were conspicuous. With the age of 4 years, she presented with a first episode of illness. RESULTS: Cytostatic treatment seemed to ameliorate the course of the disease although further accelerated phases could not be prevented. The only therapeutic option is a bone marrow transplantation, which we conferred upon our patient. CONCLUSION: The finding of grey hairs in childhood should alert clinicians to consider Griscelli syndrome since an early diagnosis is life and health saving.
Subject(s)
Chediak-Higashi Syndrome/genetics , Immunity, Cellular/genetics , Immunologic Deficiency Syndromes/genetics , Piebaldism/genetics , Administration, Oral , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chediak-Higashi Syndrome/diagnosis , Chediak-Higashi Syndrome/therapy , Child, Preschool , Chromosome Mapping , Chromosomes, Human, Pair 15 , Diagnosis, Differential , Disease Progression , Etoposide/administration & dosage , Female , Humans , Immunity, Cellular/immunology , Immunologic Deficiency Syndromes/diagnosis , Immunologic Deficiency Syndromes/therapy , Injections, Spinal , Methotrexate/administration & dosage , Neurologic Examination , Piebaldism/diagnosis , Piebaldism/therapy , Prednisone/administration & dosage , Prognosis , Vinblastine/administration & dosageABSTRACT
Glycation of basement membrane collagen IV has been implicated as a major pathogenetic process leading to diabetic microvascular complications. To evaluate the relevance of carbohydrate-induced modifications on collagen IV in diabetic nephropathy, we isolated the cross-linking domains 7S and NC1 from the glomerular basement membrane (GBM) of patients with diabetes mellitus. Modifications characteristic for glycated proteins were identified when the domains from diabetic kidney were compared with the same domains from human placenta as an unmodified control. In both domains a marked formation of inter-and intramolecular cross links could be demonstrated by SDS-PAGE. Furthermore circular dichroism studies showed a decrease in helicity of the 7S domain from human diabetic kidneys of 13%, indicating denaturation already at room temperature. Thermal transition profiles, showing a shift of the denaturation temperature towards a lower temperature, with loss of a distinct second melting point, confirmed this observation. Our data provide further evidence for a possible role of protein-modification by glycoxidative reactions in the onset of diabetic nephropathy in vivo.
