ABSTRACT
A disproportionately large number of youth and adults with fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE) seem to be coming into conflict with the legal system. Learning and behavioral difficulties associated with FAS/FAE may make them more susceptible to criminal behavior. This study determined the prevalence of FAS/FAE among youth who were remanded for a forensic psychiatric/psychological assessment. All youth remanded to a forensic psychiatric inpatient assessment unit over a 1-year period were evaluated for FAS/FAE. Of the 287 youth, 67 (23.3%) had an alcohol-related diagnosis: 3 (1.0%) had a diagnosis of FAS and 64 (22.3%) had a diagnosis of FAE. Thus, this group is disproportionately represented in the juvenile justice system, indicating the need for increased education and awareness among those in the criminal justice system involved with these youth.
Subject(s)
Crime , Fetal Alcohol Spectrum Disorders/epidemiology , Juvenile Delinquency , Adolescent , Adult , Catchment Area, Health , Child , Child Behavior Disorders/etiology , Child Behavior Disorders/rehabilitation , Female , Fetal Alcohol Spectrum Disorders/complications , Fetal Alcohol Spectrum Disorders/diagnosis , Hospitalization , Humans , Intellectual Disability/etiology , Male , Prevalence , Retrospective Studies , Severity of Illness IndexABSTRACT
The pharmacokinetics and bacteriologic efficacy of four beta-lactam antibiotics were studied in the serum and cerebrospinal fluid (CSF) of rabbits using two test strains, Escherichia coli type K1 and group B Streptococcus type III, and 24 gram-positive isolates. Although moxalactam, cefotaxime, cefoperazone, and rocephin are active in vitro against gram-negative bacilli, the gram-positive bacteria Listeria monocytogenes and Streptococcus faecalis were resistant to all four drugs; group B streptococci were resistant to moxalactam. In rabbit CSF, moxalactam had the greatest concentration and penetration, but rocephin had the longest half-life and duration of bactericidal activity. These two drugs were most effective in the CSF of E. coli K1-infected rabbits. Except for moxalatam, the four drugs were comparable to ampicillin in reducing counts of group B Streptococcus type III in CSF. Drug accumulation in CSF and appreciable bacterial killing were observed in E. coli K1-infected animals give moxalactam either periodically or by constant infusion.
Subject(s)
Cephalosporins/metabolism , Meningitis/drug therapy , Ampicillin/metabolism , Ampicillin/pharmacology , Animals , Cefoperazone , Cefotaxime , Ceftriaxone , Cephalosporins/pharmacology , Cephamycins/metabolism , Cephamycins/pharmacology , Escherichia coli/drug effects , Humans , Kinetics , Listeria monocytogenes/drug effects , Male , Meningitis/metabolism , Moxalactam , Penicillin Resistance , Rabbits , Streptococcus agalactiae/drug effectsABSTRACT
Moxalactam (LY127935) is a 1-oxa-beta-lactam which was active in vitro against the majority of 128 strains of gram-negative enteric bacilli isolated from meningitis in neonates. Pharmacokinetics and bacteriological efficacy of LY127935 were studied in a lapin meningitis model. The average penetration of this investigational oxa-cephalosporin into cerebrospinal fluid of infected rabbits was 23% compared with 25% for netilmicin and 11% for ampicillin. The cerebrospinal fluid concentrations of LY127935 produced median bactericidal titers of 1:64 to 1:128 against five coliform organisms (two Escherichia coli K1 strains, Klebsiella pneumoniae, Salmonella saint-paul, and Citrobacter diversus) used in these experiments compared with median titers of 1:2 to 1:8 for netilmicin and 1:2 to 1:4 for ampicillin. LY127935 was statistically significantly more effective than netilmicin or ampicillin in reducing cerebrospinal fluid bacterial colony counts and in sterilizing cerebrospinal fluid of experimentally infected rabbits. These results suggest that LY127935 has theoretical advantages over netilmicin and ampicillin for therapy of gram-negative bacillary meningitis.
