Subject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Dermatologic Agents/adverse effects , Latent Tuberculosis/epidemiology , Psoriasis/drug therapy , Adult , Clinical Trials as Topic , Female , Humans , Interleukin-17/antagonists & inhibitors , Interleukin-17/immunology , Latent Tuberculosis/diagnosis , Latent Tuberculosis/immunology , Male , Middle Aged , Prevalence , Psoriasis/diagnosis , Psoriasis/immunology , Severity of Illness Index , Treatment Outcome , Tuberculin TestABSTRACT
AIM: To evaluate rectal hydrocortisone as an emergency glucocorticoid replacement therapy in adrenal insufficient children. METHODS: A parental questionnaire evaluated preferred treatment, problems or benefits of i.m. and rectal hydrocortisone, frequency and indications for administration and who administered treatment. Admissions of children with adrenal insufficiency were monitored. RESULTS: There were 39/52 families who responded to the questionnaire. 93% (26/28) preferred rectal hydrocortisone. Parents or children who previously received emergency treatment from a doctor now self-administered rectal hydrocortisone. The cost of suppositories and i.m. hydrocortisone is similar; however, storage of suppositories was inconvenient. One girl presented with pneumonia and collapse despite rectal hydrocortisone and a hydrocortisone level at admission of >2000 nmol/l with normal electrolytes. CONCLUSIONS: Rectal hydrocortisone is an acceptable and safe emergency therapy. We still advise i.m. hydrocortisone if rectal administration is not possible or with suppository extrusion.
Subject(s)
Administration, Rectal , Adrenal Insufficiency/drug therapy , Hydrocortisone/administration & dosage , Vomiting/drug therapy , Adolescent , Adrenal Insufficiency/complications , Adrenal Insufficiency/diagnosis , Child , Child, Preschool , Female , Hormone Replacement Therapy/methods , Humans , Hydrocortisone/blood , Hydrocortisone/pharmacokinetics , Infant , Injections, Intramuscular/economics , Male , Patient Compliance , Suppositories/economics , Suppositories/pharmacokinetics , Surveys and Questionnaires , Time Factors , Vomiting/complicationsABSTRACT
PURPOSE: To evaluate potential toxic effects of indocyanine green dye on cultured human retinal pigment epithelial cells. METHODS: Controlled laboratory experiment. Cultured human retinal pigment epithelial cells were exposed to balanced saline solution, balanced saline solution with endoillumination, indocyanine green or indocyanine green with endoillumination. Cells were evaluated by light microscopy, electron microscopy, and a mitochondrial dehydrogenase assay. RESULTS: Retinal pigment epithelial cells exposed to indocyanine green showed no histologic or ultrastructural changes. Those exposed to indocyanine green alone or indocyanine green plus light demonstrated a significant decrease in mitochondrial enzyme activity (P = 0.0002 and 0.005, respectively). CONCLUSION: Brief exposure of cultured human retinal pigment epithelial cells to indocyanine green results in decreased mitochondrial enzyme activity but does not appear to influence cellular morphology or ultrastructure.
Subject(s)
Coloring Agents/pharmacology , Indocyanine Green/pharmacology , Pigment Epithelium of Eye/drug effects , Retinal Perforations/surgery , Cells, Cultured , Enzyme-Linked Immunosorbent Assay , Humans , Mitochondria/drug effects , Mitochondria/enzymology , Oxidoreductases/metabolism , Pigment Epithelium of Eye/enzymology , Pigment Epithelium of Eye/ultrastructureABSTRACT
In the wake of the neurobiological "revolution," do mental health professionals still assign etiological responsibility for emotional and behavioral disorders to deficient or harmful parenting? This study investigated differences in attributions of causality by theoretical orientation, professional discipline, areas of practice, familiarity with parent support groups, and demographic characteristics. Implications for policy, research, and practice are discussed.
Subject(s)
Affective Symptoms/psychology , Attitude of Health Personnel , Child Behavior Disorders/psychology , Parenting/psychology , Social Responsibility , Child , Child Psychiatry , Humans , Psychology, Child , Social WorkABSTRACT
Helicobacter pylori is associated with primary antral gastritis, duodenal ulceration, and gastric cancer. Current regimens for treating infection in children using bismuth and antibiotics for two to six weeks are cumbersome. The aim of this study was to evaluate a one week course of treatment. All children undergoing endoscopy were assessed for the presence of H pylori by culture, histology, rapid urease test, and 13C urea breath test. Infected children received a one week course of colloidal bismuth subcitrate 480 mg/1.73 m2/day (maximum 120 mg four times a day), combined with metronidazole 20 mg/kg/day (maximum 200 mg three times a day), and clarithromycin 15 mg/kg/day (maximum 250 mg twice a day). To optimise compliance, drugs were dispensed in a 'Redidose' box containing a compartment for each day, and subcompartments marked 'breakfast', 'lunch', 'dinner', and 'bedtime'. Compliance and side effects were assessed immediately after treatment. A urea breath test was performed at least one month after treatment. Twenty two children infected with H pylori were entered into the study; 20 of these took all doses; two children suffered significant side effects (diarrhoea and vomiting). H pylori was eradicated in 21 of the 22 children (95.45%; 95% confidence interval 77% to 100%). This study shows that H pylori infection in children can be cleared by a one week course of treatment.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Gastritis/drug therapy , Helicobacter Infections/drug therapy , Helicobacter pylori , Organometallic Compounds/administration & dosage , Adolescent , Antitrichomonal Agents/administration & dosage , Bismuth , Breath Tests , Child , Child, Preschool , Clarithromycin/administration & dosage , Clarithromycin/therapeutic use , Drug Administration Schedule , Drug Therapy, Combination , Gastritis/microbiology , Gastroscopy , Helicobacter Infections/diagnosis , Humans , Infant , Metronidazole/administration & dosageSubject(s)
Form Perception , Pattern Recognition, Visual , Printing , Reading , Female , Humans , Male , Time FactorsSubject(s)
Alcoholism/therapy , Community Mental Health Services , Adult , Aged , Female , Hospitalization , Humans , Male , Middle Aged , Patient Care Team , PennsylvaniaABSTRACT
A history of pet contact and/or apparent clinical sensitivity was obtained in 65 (55%) of 118 unselected asthmatic children. These 65 children were skin tested and their sera examined for specific IgE using the radioallergosorbent test. Those children who had apparent clinical sensitivities had larger skin test reactions and were more likely to have positive specific IgE results than those without apparent sensitivities. Positive skin tests were very common (80%), but the larger the skin test reaction (weal diameter greater than 4 mm diameter) the more likely was there to be a positive history or a positive specific IgE result. Hence a large skin test reaction can provide a helpful pointer to animal allergy of clinical importance. Commercially available animal extracts have limitations for diagnostic tests. A questionnaire survey of 150 day schools emphasized the potential opportunities for contact with animal allergens at school.
