Safety of ciprofloxacin in children: Worldwide clinical experience based on compassionate use. Emphasis on joint evaluation

Summary Six hundred and thirty four adolescents and children aged three days to 17 years treated with ciprofloxacin on a compassionate basis were analysed for drug safety. 62% of the ciprofloxacin courses were given to patients with respiratory tract infection, primarily those with acute pulmonary exacerbation of cystic fibrosis. The mean daily oral dose was 25.2 mg/kg body weight. The duration of treatment ranged from one to 880 days (mean 22.8 days). Because of the arthropathogenic potential of quinolones in juvenile animals special emphasis was placed on the evaluation of musculoskeletal adverse events. Arthralgia considered by the treating physicians to be related to ciprofloxacin was reported in eight children, all of whom were females. Arthralgia resolved in all children. Some of these children were given subsequent courses of ciprofloxacin with no complaints of arthralgia. Overall, the safety profile of ciprofloxacin in children is not substantially different from that of adults.

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Verträglichkeit von Ciprofloxacin bei Kindern unter besonderer Beachtung der Gelenke. Auswertung weltweit dokumentierter Problemfälle

Zusammenfassung Die Verträglichkeit des Ciprofloxacin nach Anwendung bei 634 Jugendlichen und Kindern im Alter von drei Tagen bis 17 Jahren wurde analysiert. 62% der Behandlungen mit Ciprofloxacin erhielten Patienten mit Atemwegsinfektionen, insbesondere mit akuter pulmonaler Exazerbation der Mukoviszidose. Der Mittelwert der oralen Tagesdosis war 25,2 mg/kg Körpergewicht. Die Therapiedauer variierte zwischen 1 und 880 Tagen (Mittelwert 22,8 Tage). Wegen der gelenkknorpelschädigenden Wirkung der Chinolone bei juvenilen Versuchstieren wurde besondere Aufmerksamkeit der Beurteilung der mit Gelenken verbundenen Nebenerscheinungen gewidmet. Arthralgie, die von den behandelnden Ärzten als Folge der Ciprofloxacin-Behandlung beurteilt wurde, ist bei acht Kindern berichtet worden. Alle waren weiblich. Die Arthralgie verschwand bei allen Kindern. Einige dieser Kinder erhielten nachträgliche Behandlungen mit Ciprofloxacin ohne Auftreten arthralgischer Beschwerden. Generell unterschied sich das Verträglichkeitsprofil bei Kindern nicht wesentlich von dem der Erwachsenen.

     

A leg ulcer as manifestation of metastatic squamous cell vaginal carcinoma

Cutaneous metastasis of vaginal carcinoma is extremely rare. So far, the total number of reported skin metastasis of vaginal carcinoma is only one. We present another case with an unusual manifestation of vagina carcinoma metastasis: skin metastasis presenting as a leg ulcer on the lower leg.     

Localization of a gene for otosclerosis to chromosome 15q25-q26

Among white adults otosclerosis is the single most common cause of hearing impairment. Although the genetics of this disease are controversial, the majority of studies indicate autosomal dominant inheritance with reduced penetrance. We studied a large multi- generational family in which otosclerosis has been inherited in an autosomal dominant pattern. Five of16 affected persons have surgically confirmed otosclerosis; the remaining nine have a conductive hearing loss but have not undergone corrective surgery. To locate the disease- causing gene we completed genetic linkage analysis using short tandem repeat polymorphisms (STRPs) distributed over the entire genome. Multipoint linkage analysis showed that only one genomic region, on chromosome 15q, generated a lod score >2.0. Additional STRPs were typed in this area, resulting in a lod score of 3.4. STRPs FES (centromeric) and D15S657 (telomeric) flank the 14. 5 cM region that contains an otosclerosis gene.      

Peritoneal fluid concentrations of interleukin-8 in women with endometriosis: relationship to stage of disease

There is increasing evidence that immunological mechanisms play a role in the pathogenesis and pathophysiology of endometriosis. It was therefore of interest to study interleukin-8 (IL-8), a chemokine, in the peritoneal fluid and peripheral blood of women undergoing laparoscopic procedures. The presence and concentrations of IL-8 in relation to endometriosis, infertility and abdominal pain were evaluated. Samples of peritoneal fluid (n = 49) and peripheral blood (n = 50) were obtained from 50 consecutive patients undergoing laparoscopic surgery for various gynaecological indications (abdominal pain, infertility, sterilization). IL-8 was present in the peritoneal fluid of most women (87%). The concentration of IL-8 in the peritoneal fluid was higher in women with endometriosis compared to women without (P = 0.02). This difference was more pronounced in early (stage 1) endometriosis (P = 0.001). IL-8 concentrations in the peritoneal fluid were also higher in women with early endometriosis compared to women with later stages of the disease (P = 0.003). Peripheral blood concentrations did not correlate with peritoneal fluid concentrations of IL-8 and/or the presence of endometriosis. We conclude that IL-8 is an important factor that may contribute to the pathogenesis of endometriosis possibly by promoting neovascularization. This information can be a guide in the development of new therapeutic approaches for the treatment of endometriosis.