First successful use of eltrombopag before surgery in a child with MYH9-related thrombocytopenia.

MYH9-related disease (MYH9-RD) is one of the most frequent autosomal-dominant forms of inherited macrothrombocytopenias and is caused by mutations in MYH9 (nonmuscle myosin IIA), the gene coding for the heavy chain of the nonmuscle myosin IIA. Affected individuals can present with isolated thrombocytopenia, and whereas only some will have bleeding events requiring intervention, nearly all will require the use of prophylactic platelet transfusions before surgery. Here we report the first prophylactic use of eltrombopag before surgery in a child with MYH9-RD. Our patient was a 13-year-old girl with an MYH9 S96L missense mutation who required a tympanoplasty due to chronic otitis media. Pretreatment microscopic platelet count was 10 × 10(9)/L. The child was treated with eltrombopag starting 4 weeks before her planned surgery. On the day of surgery her platelet count was 70 × 10(9)/L. She required no platelet transfusions and no abnormal bleeding was reported either during surgery or postoperatively. Given these results, the first reported in a child, we suggest that the use of this thrombopoietic agent should be further evaluated as a useful presurgical prophylactic option in this hereditary thrombocytopenia, thus avoiding the use of platelet transfusions and their associated risks, which include alloimmunization and the transmission of infectious agents.

[Determination of plasma ciprofloxacin levels in children treated with 0.2% topical ciprofloxacin for tympanic perforation]. / Determinación de niveles plasmáticos de ciprofloxacino en niños tratados con ciprofloxacino tópico al 0,2% en presencia de perforación timpánica.

Topical drug use can produce locally adverse effects by direct action or systemic effects as a result of drug absorption. Local tolerance of topically-administered ciprofloxacin (ear drops) and serum antibiotic levels after 7-10 days of treatment were evaluated in 30 children with tympanic membrane perforation and suppuration. There were no signs of local intolerance or ototoxicity and significant serum ciprofloxacin levels were not detected. We conclude that ciprofloxacin ear drops can be safely used in children with suppurative otitis media and tympanic perforation.

Determinación de niveles plasmáticos de ciprofloxacino en niños tratados con ciprofloxacino tópico al 0,2 por ciento en presencia de perforación timpánica / Determination of plasma ciprofloxacin levels in children treated with 0.2 por ciento topical ciprofloxacin for tympanic perforation

La administración de un fármaco, por vía tópica puede producir efectos secundarios a nivel local por la propia acción del fármaco o a nivel sistémico como consecuencia de la absorción del mismo. En el presente estudio, realizado en una población infantil en presencia de una perforación timpánica, se determinan la tolerancia local de ciprofloxacino cuando se administra por vía tópica ótica y los niveles plasmáticos del mismo después de un tratamiento tópico ótico de 7-10 días de duración. En ninguno de los 30 casos estudiados se presentó intolerancia local ni signos de ototoxicidad ni se determinaron niveles significativos de ciprofloxacino en plasma (AU)

Topical drug use can produce locally adverse effects by direct action or systemic effects as a result of drug absorption. Local tolerance of topically-administered ciprofloxacin (ear drops) and serum antibiotic levels after 7-10 days of treatment were evaluated in 30 children with tympanic membrane perforation and suppuration. There were no signs of local intolerance or ototoxicity and significant serum ciprofloxacin levels were not detected. We conclude that ciprofloxacin ear drops can be safely used in children with suppurative otitis media and tympanic perforation (AU)