Intertrigo-like eruption caused by pegylated liposomal doxorubicin (PLD)

Pegylated liposomal doxorubicin (PLD) is a drug whose use is increasingly common. It has been associated with a lower rate of haematologic and cardiac side effects than its nonencapsulated form. However, mucocutaneous toxicity is quite frequent and can be severe. Here we provide a case report of a patient who developed an intertrigolike eruption during treatment with PLD.     

Activity Pattern Profiles: Relationship With Affect,Daily Functioning,Impairment, and Variables Related to Life Goals

The aim of this cross-sectional study was to identify subgroups of patients on the basis of their activity patterns and to investigate their relationship with life goals, optimism, affect, and functioning. The sample was comprised of 276 patients with chronic musculoskeletal pain. Hierarchical cluster analysis was performed on the activity pattern variables and the resulting clusters were compared using 1-way analysis of variance. The 4-cluster was the optimal solution. The 4 clusters comprised: 1) avoiders: patients with high levels of avoidance and low levels of persistence, who use pacing to reduce pain, 2) doers: patients with high levels of persistence and low levels of pacing and avoidance, 3) extreme cyclers: patients with high levels of avoidance and persistence and low levels of pacing, and 4) medium cyclers: patients with moderately high levels of avoidance and persistence and high levels of pacing. Comparison of the clusters showed that doers had the most adaptive profile, whereas avoiders, followed by extreme cyclers, had unhealthy profiles. Doers showed a high level of optimism and a good balance between goal value, expectancy, and conflict.

Clinical Comparison of Cefuroxime Axetil with Cefixime in the Treatment of Acute Bronchitis

Acute bronchitis is the ninth most common outpatient illness seen by physicians in the United States. Oral antibiotic treatment is usually directed empirically against the most common bacterial pathogens associated with acute bronchitis, such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Although cefuroxime axetil and cefixime are both approved in the United States for treatment of acute bronchitis, currently they have not undergone direct clinical comparison for this indication. This randomized, investigator-blind, multicenter study was designed to compare the efficacy and safety of 250 mg cefuroxime axetil administered twice daily with that of 400 mg cefixime administered once daily in the treatment of acute bronchitis. Outpatients had to be greater-than-or-equal12 years of age and have signs and symptoms of acute bronchitis to be eligible for this study. Patients were randomly assigned to receive 10 days of oral treatment with either 250 mg cefuroxime axetil taken twice daily or 400 mg cefixime taken once daily. Patients were assessed for both clinical and bacteriologic responses once during treatment (3--5 days) and twice after treatment (1--3 days and 14 days). Bacteriologic assessments were based on sputum specimen cultures obtained pretreatment and posttreatment when possible. Of 465 patients with acute bronchitis who were enrolled in the study, 227 received cefuroxime axetil and 238 received cefixime. Organisms were isolated from the pretreatment sputum specimens in 172 of the 465 (37%) patients, with the primary pathogens being Haemophilus influenzae, Streptococcus pneumoniae, Morazella catarrhalis, and Staphylococcus aureus (30%, 14%, 14%, and 14% of isolates, respectively). A satisfactory clinical outcome (cure or improvement) was achieved in 88% (130 of 148) and 91% (152 of 167) of the clinically evaluable patients who had received cefuroxime axetil or cefixime, respectively (p = 0.36). Regarding the eradication of bacterial pathogens, a satisfactory outcome (cure or presumed cure) was obtained in 89% (47 of 53) and 91% (41 of 45) of bacteriologically evaluated patients who had received cefuroxime axetil or cefixime, respectively (p = 0.75). Treatment with cefixime was associated with a significantly higher incidence of drug-related gastrointestinal adverse events than was treatment with cefuroxime axetil (18% versus 10%, respectively; p = 0.01). This difference primarily reflects a higher incidence of drug-related diarrhea (15% versus 5%, p = 0.001). These results indicated the cefuroxime axetil taken twice daily is as effective as cefixime taken once daily in the treatment of acute bronchitis and that cefuroxime axetil produces fewer gastrointestinal adverse events, particularly diarrhea.     

Quality of life of adolescents with end-stage renal disease and kidney transplant

The health-related quality of life (HRQOL) of adolescents with end-stage renal disease (ESRD) is an important marker of disease burden. Our aims were to investigate HRQOL in a group of children and adolescents with ESRD and to compare them with the reference population norms. Ours was a cross-sectional study of 81 patients aged 10 years to 21 years with ESRD (68 with kidney transplants and 13 on dialysis) at five Spanish paediatric nephrology centres. HRQOL was investigated with the Spanish version of the child health and illness profile, adolescent edition (CHIP-AE). Clinical variables such as underlying diagnosis, number of rejection episodes, pre-emptive transplantation, anaemia and height were also analysed. No differences were found between patients with kidney transplants and their healthy peers in any domain or sub-domain of CHIP-AE. The group on dialysis scored lower than healthy controls and patients with transplants for satisfaction with health. Discomfort was higher in patients with transplants who had suffered one rejection episode. Physical discomfort was increased in anaemic patients with transplants. Short patients scored less in the satisfaction domain, with lower self-esteem and lower satisfaction with health. Adolescents with kidney transplants had better satisfaction with health than the group on dialysis, which matched the level of a healthy population. Further long-term prospective research is warranted. The work was carried out at the Divisions of Paediatric Nephrology of the following hospitals in Spain: Central de Asturias (Oviedo), Clínico de Santiago, Infantil La Paz (Madrid), Miguel Servet (Zaragoza) and Cruces (Bilbao)