RESUMO
Infants are at increased risk for morbidity and mortality due to influenza. Until recently, few data were available with which to optimize oseltamivir dosing in this high-risk population. Here, data for 133 infants were pooled from two prospective pharmacokinetic/pharmacodynamic safety studies to develop a population pharmacokinetic model. A three-compartment model with allometric scaling of all clearance and volume parameters described the disposition of oseltamivir and its carboxylate metabolite (OC). Weight dependence, OC clearance, and volume of distribution increased linearly with age. Analyses showed no association between OC exposure and viral clearance, the development of resistance (phenotypic/genotypic), normalization of body temperature, or safety endpoints. Pharmacokinetic bridging showed that a 3 mg/kg dose yielded acceptable OC exposure and good tolerability while minimizing the risk of underexposure and resistance/treatment failure. These pharmacological analyses formed the basis of the US Food and Drug Administration's recent approval of oseltamivir treatment for infants with influenza aged as young as 2 weeks.
Assuntos
Antivirais/farmacocinética , Cálculos da Dosagem de Medicamento , Influenza Humana/tratamento farmacológico , Modelos Biológicos , Oseltamivir/farmacocinética , Administração Oral , Fatores Etários , Antivirais/administração & dosagem , Antivirais/efeitos adversos , Antivirais/sangue , Disponibilidade Biológica , Biotransformação , Peso Corporal , Ácidos Carboxílicos/metabolismo , Simulação por Computador , Farmacorresistência Viral , Feminino , Humanos , Lactente , Recém-Nascido , Influenza Humana/sangue , Influenza Humana/diagnóstico , Influenza Humana/virologia , Modelos Lineares , Masculino , Oseltamivir/administração & dosagem , Oseltamivir/efeitos adversos , Oseltamivir/sangueAssuntos
Colo Sigmoide/cirurgia , Número de Gestações , Complicações na Gravidez/cirurgia , Resultado da Gravidez , Ultrassonografia Pré-Natal , Ureter/cirurgia , Fístula Vesicovaginal/cirurgia , Adulto , Cesárea , Parto Obstétrico/métodos , Feminino , Morte Fetal , Seguimentos , Idade Gestacional , Gana , Humanos , Gravidez , Complicações na Gravidez/diagnóstico por imagem , Medição de Risco , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos/métodos , Fístula Vesicovaginal/diagnóstico por imagemRESUMO
Plesiomonas shigelloides is a rare cause of self-limiting gastroenteritis. We report a case of extraintestinal P. shigelloides infection in an adolescent with sickle-cell disease who presented with bacteremia complicated by a splenic abscess. Despite the high mortality rate reported in extraintestinal P. shigelloides infection, the patient survived after drainage of the abscess and treatment with antibiotics.
Assuntos
Abscesso , Anemia Falciforme/complicações , Bacteriemia/microbiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Plesiomonas/isolamento & purificação , Baço , Adolescente , Feminino , HumanosRESUMO
A comparative study of vesico-vaginal fistulae cases and controls was carried out at two tertiary hospitals in Maiduguri, Nigeria. The fistulae cases were significantly shorter in height, younger in age at marriage and had a higher divorce rate. Prolonged labour, traditional surgical practice of "gishiri cut" and ignorance were identified as the commonest causes of the fistulae. The health and socio-economic consequences to the patient are discussed. Patients are considered to have brought shame to themselves and their families and quite often lose the support of the husband. It is recommended that maternity services be firmly integrated and given a higher priority in primary health care. In the long-term increase in the literacy level of females is desirable.
Assuntos
Fístula Vesicovaginal/epidemiologia , Adolescente , Adulto , Fatores Etários , Estatura , Criança , Feminino , Humanos , Medicina Tradicional , Nigéria/epidemiologia , Complicações do Trabalho de Parto , Gravidez , Fatores de Risco , Fístula Vesicovaginal/etiologia , Fístula Vesicovaginal/psicologiaRESUMO
"This report describes a family planning survey [involving 172 women] conducted at an antenatal clinic in Maiduguri, Nigeria between June and August 1984. The level of education of respondents is generally low and appears to have a negative effect on knowledge, approval, and use of family planning. Breast feeding is widespread but not many respondents practiced it as a method of family planning. While there is limited knowledge and some approval of family planning, a desire for large families continues and there is relatively little practice of family limitation. The prospects for a decrease in fertility in the near future is not encouraging."
