Comparative study of once-weekly azithromycin and once-daily amoxicillin treatments in prevention of recurrent acute otitis media in children.

Continuous chemoprophylaxis is effective in the prevention of new episodes of acute otitis media (AOM) in otitis-prone children, but compliance can be a problem and thus efficacy can be decreased. Intermittent chemoprophylaxis has so far shown conflicting results. Azithromycin, which has a peculiar pharmacokinetics, resulting, even after a single dose, in persistently elevated concentrations in respiratory tissues, could permit a periodic administration with higher compliance. We compared a 6-month course of once-weekly azithromycin (5 or 10 mg/kg of body weight) with that of once-daily amoxicillin (20 mg/kg) in a single-blind, randomized study of prophylaxis for recurrent AOM in 159 children aged 6 months to 5 years with at least three episodes of AOM in the preceding 6 months. In the amoxicillin group, 23 (31.1%) of 74 children developed 29 episodes of AOM, while in the 10-mg/kg azithromycin group, 11 (14.9%) of 74 children experienced 15 episodes. The 5-mg/kg/week azithromycin trial was prematurely interrupted after nine cases, due to the high occurrence rate of AOM (55.5%). During the 6-month prophylaxis period, the proportion of children with middle ear effusion declined similarly in both groups. No substantial modification of the nasopharyngeal flora was noted at the end of prophylaxis in both antimicrobial groups. In the 6-month-postprophylaxis follow-up period, about 40% of children in both groups again developed AOM. Azithromycin at 10 mg/kg once weekly can be regarded as a valid alternative to once-daily low-dose amoxicillin for the prophylaxis of AOM. Although in the present study no microbiological drawback was noted, accurate selection of children eligible for prophylaxis is mandatory to avoid the risk of emergence of resistant strains.     

Immunochemical studies of antisera to human fibrinopeptide-B

The immunochemical specificity of rabbit antisera to human fibrinopeptide-B (FPB) has been studied by comparing the relative abilities of FPB and of various proteins and peptides containing the NH2-terminal segment of the B beta-chain of human fibrinogen to inhibit the binding of a radioiodinated FPB derivative by each of seven anti- FPB sera. Anti-FBP sera varied in the extent to which they cross- reacted with fibrinogen, the NH2-terminal disulfide knot of fibrinogen (N-DSK), B beta 1(Pyr)-118(Met), B beta 1(Pyr)-42(Arg), and desarginyl- FPB. Anti-FPB sera have been identified that discriminate effectively between FPB and larger FBP-containing peptides; such antisera can be used to measure FPB in the absence of the larger peptides or to demonstrate the presence of larger peptides such as B beta 1(Pyr)- 42(Arg) in extracts of clinical plasma samples by means of an increase in FPB immunoreactivity following thrombin treatment. One anti-FPB serum has been identified that is capable of detecting desarginyl-FPB, and this antiserum has been used in the development of a radioimmunoassay for desarginyl-FPB. Thus, by precisely defining the specificity of anti-FPB sera, it has been possible to identify antisera that are useful, not only in the measurement of FPB, but also in the detection of other important related molecules, such as B beta 1(Pyr)- 42(Arg) and desarginyl-FPB. The immunochemical detection of these FPB- related peptides should provide useful information concerning the action of proteolytic enzymes, such as plasmin on the NH2-terminal segment of the B beta-chain of fibrinogen, and of carboxypeptidase-B on free FPB, in human plasma.     

Clinical interventions for venous leg ulcers: Proposals to improve the quality of clinical leg ulcer research

The present status of clinical leg ulcer healing research was reviewed by 25 experts over 2 days on September 28 and 29, 2015. Multiple clinical effectiveness reviews were presented suggesting that published clinical wound healing research often does not meet present (2015) evidence based standards. Specific areas requiring remediation were highlighted and approaches to overcoming existing challenges were proposed. Participants using anonymous voting technology developed an action plan to resolve perceived deficiencies. Statements were accepted if 75% of participants agreed. Older patients with a high frequency of comorbid conditions posed particular difficulties in designing clinical research protocols and better diagnostic categorization is necessary A standardized model template for collecting information about diagnosis and evaluation of the effect of interventions on healing of all types of leg ulcers was considered a high priority. Such a model template could be modified depending on the specific etiology of the leg ulcers. Generally agreed on quantifiable standards to establish degree of morbidity was considered a high priority. There was universal agreement that sources of funding and conflicts of interest needed to be disclosed in presentations and all publications. All clinical research studies should be registered with appropriate authorities. There was substantial enthusiasm for a clinical research network with quality standards for membership and an advisory research core available to investigators. Such a network should be funded and actively managed to insure long‐term viability. The governance of such an entity needs to be established by the wound care community. The present trend to integrate patients into the clinical research process was endorsed and there was enthusiasm to develop patient advocacy for wound healing research.     

Early onset of spontaneous renal preneoplastic and neoplastic lesions in young conventional rats in toxicity studies

Although occurring in aged laboratory rodents, spontaneous renal tumour are unknown in animals younger than 18 weeks. A survey on renal preneoplastic and neoplastic lesions has been performed on Sprague-Dawley rats from general toxicology studies over the period January 2004 - May 2006. Data from 2249 rats necropsied and 1206 rats (688 males and 518 females) examined microscopically from 52 studies, are reported. The age range at necropsy was between 12 and 18 weeks and all the animals were obtained from the same supplier. Three cases of tubular carcinoma, 1 tubular adenoma, and 4 cases of atypical tubular hyperplasia were observed in 5 females and 3 males from both control and treated groups from 6 studies with unrelated test compounds. In treated rats, the lesions were considered spontaneous in nature, rather than related to treatment, because of: (1) their sporadic incidence, (2) the short duration of the studies, and (3) the absence of similar lesions in other rats given the same test compound. These lesions are considered a recently occurring spontaneous finding, and the similarities with the familial renal cancer models, namely the Eker and the Nihon models, strongly suggest genetic factors as responsible for the lesions.     

Osteochondroma of the mandibular condyle: literature review and report of a case

AIM: The intent of this report is to present a brief review of the literature on osteochondroma and to present a case involving the surgical removal and replacement of a major portion of the condyle and angle of the mandible using free autogenous mandibular bone. BACKGROUND: While osteochondroma is the most common tumor of skeletal bones, it is relatively uncommon in the jaws occurring at the condyle or the tip of the coronoid process. This benign cartilage-capped growth is usually discovered incidentally on radiographic examination or on palpation of a protruding mass in the affected area. Malocclusion and progressive facial asymmetry are common findings in most cases of condylar osteochondroma. REPORT: A case of a 29-year-old woman with an osteochondroma of the mandibular condyle is presented. Surgical treatment was tumor resection, grafting, and reshaping of the mandibular angle and ramus. As this lesion is usually asymptomatic and discovered incidentally on radiographic examination, the general practitioner usually is the first professional to make the diagnosis. SUMMARY: Condylectomy cannot be recommended as routine in all cases.37 Common surgical treatments include condylectomy and reconstruction.24 If the tumor involves only a limited area of the condylar surface, then preservation of the remaining portion of the condyle and reshaping should be done. Reasons for not taking such a conservative approach are the possibilities of malignancy and the risk of recurrence. In this case report the extraoral vertical ramus osteotomy, associated with free autogenous mandibular bone, presented several advantages.