Journal club articles, by date with most recent first
Oral co-amoxiclav alone effective for first episode of pyelonephritis in children
published 29-08-2007
Views : 1188
Times marked as favorite : 116
A study reported in this week's BMJ found that oral co-amoxiclav was as effective as parenteral ceftriaxone in the treatment of first-episode pyelonephritis in children. The randomized, controlled trial found that children did as well when given the oral antibiotic for the first three days as they did when given ceftriaxone. The accompanying editorial and summary of guidance for diagnosis and management of UTI in children support the strength of the results. The guidelines now suggest treatment with oral antibiotics in children aged 3 months and older with with acute pyelonephritis or upper urinary tract infection. ... continued
Cutaneous M. Avium Complex Infection As A Manifestation Of IRIS in an HIV-infected Child
published 17-08-2007
Views : 506
Times marked as favorite : 43
"Abstract: We report a 13-year-old boy with human immunodeficiency virus infection who developed cutaneous Mycobacterium avium complex infection 2 months after commencing highly active antiretroviral therapy. The case illustrates that cutaneous Mycobacterium avium complex may present as a manifestation of the immune reconstitution syndrome in human immunodeficiency virus-infected children."
"METHODS. A novel, once-daily dosing regimen of 3 antiretroviral drugs, emtricitabine, didanosine, and efavirenz, was tested in 37 therapy-naive HIV-infected children and adolescents between 3 and 21 years of age (inclusive). ..."
"CONCLUSIONS. A once-daily regimen of emtricitabine, didanosine, and efavirenz proved to be safe and tolerable and demonstrated good immunologic and virologic efficacy in this 2-year study."
"Conclusions Systematic screening with echocardiography, as compared with clinical screening, reveals a much higher prevalence of rheumatic heart disease (approximately 10 times as great). Since rheumatic heart disease frequently has devastating clinical consequences and secondary prevention may be effective after accurate identification of early cases, these results have important public health implications."
Along with editorial, argues for the importance of more sensitive screening (like echocardiography) in order to detect the cases of RHD and provide proper secondary prevention.
Progesterone markedly reduces risk of premature delivery in women with short cervix at mid-term
published 10-08-2007
Views : 1233
Times marked as favorite : 110
Women with a short cervix at mid-gestation are known to be at high risk for premature delivery. The authors randomized 250 women with short cervix (less than 15 mm) to receive placebo or progesterone treatment from the 24th through the 33rd week of gestation. The progesterone was given as "200-mg capsules of micronized progesterone (Utrogestan, Besins International Belgium)" vaginally each night.
Women treated with progesterone had a statistically significant 44% reduction in premature delivery (before 34 weeks). Thirty-six percent of the placebo-treated women, but only 21% of the ones in the progesterone group, delivered prematurely. This translates to 15 premature deliveries avoided for 100 women treated.
Only 1.6% of the 24,620 women screened fell into the short-cervix group, so this treatment is not something that would apply to everyone, but it certainly appears very promising for this high-risk group.
Comparison of rapid tests for malaria in Madagascar: CareStart found most sensitive
published 08-08-2007
Views : 524
Times marked as favorite : 46
This study compared rapid antigen tests with microscopy and found sensitivities (with microscopy as standard) of:
97% for the CareStart™ Malaria test,
89.4% for the SD Malaria Antigen Bioline™ test, and
92.6% for the OptiMAL-IT™ test.
All the tests were less sensitive to non-falciparum infections and in patients with parasite loads of less than 500 parasites/µL for falciparum and less than 5,000 parasites/µL for other species.
"On the basis of World Health Organization recommendations, only the CareStart™ Malaria test and the OptiMAL-IT™ test had sensitivities greater than 95% for samples with parasitemias ≥ 100 parasites/µL."
