RESUMEN
The toxicity of interferon (IFN) alfa-2b therapy was prospectively evaluated in 53 children treated from 1991 to 1996 in 2 successive studies of IFN alfa therapy for severe hemangiomas at Sainte-Justine Hospital. Toxicity was generally mild and transient, with grade 1 toxicity occurring in 100% of patients, grade 2 toxicity in 89%, grade 3 toxicity in 58%, and grade 4 toxicity in 17%. Ten of 43 patients available for evaluation had an abnormal neurologic examination. Severe neurotoxicity in the form of spastic diplegia occurred in one patient. In conclusion, IFN alfa therapy is generally well tolerated in children. However, it may rarely be associated with severe toxicity and must be used with caution.
Asunto(s)
Antineoplásicos/efectos adversos , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Hemangioma/tratamiento farmacológico , Interferón-alfa/efectos adversos , Antineoplásicos/uso terapéutico , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Interferón alfa-2 , Interferón-alfa/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Masculino , Perineo , Estudios Prospectivos , Proteínas RecombinantesRESUMEN
During a 15-year period, 29 children, under the age of 6 years, with acute Guillain-Barré syndrome were seen at our institution. A review of their charts revealed that pain was a symptom in all patients and was present on admission in 79% of cases. Pain was often the most important symptom and led to misdiagnosis in 20 patients (69%). In 11 of these children, symptoms were present for more than a week before the correct diagnosis was made. The most common pain syndrome was back and lower limb pain, present in 83% of patients. Pediatricians should consider Guillain-Barré syndrome in their differential diagnosis when faced with a child who has lower limb pain and areflexia.
Asunto(s)
Dolor/etiología , Polirradiculoneuropatía/fisiopatología , Preescolar , Diagnóstico Diferencial , Electrofisiología , Femenino , Humanos , Lactante , Pierna , Masculino , Polirradiculoneuropatía/líquido cefalorraquídeo , Reflejo Anormal , Estudios RetrospectivosRESUMEN
OBJECTIVE: The purpose of this study was to determine the optimal parenteral feeding regimen for infants with compromised respiratory function. METHODS: We studied the influence of varying the source of energy on respiratory gas exchange in 10 infants who were supported by mechanical ventilation and who received intravenous feedings. Two isoenergetic parenteral regimens were infused consecutively; the level of fat intake was varied inversely with that of glucose. Under similar ventilator settings, transcutaneous partial pressures of oxygen and carbon dioxide, as well as indirect calorimetry were measured during each regimen. RESULTS: Despite the higher carbon dioxide production during the glucose-rich regimen (8.9 +/- 0.7 vs 7.9 +/- 0.4 ml/kg per minute, p < 0.05 by analysis of variance), transcutaneous partial pressure of carbon dioxide remained unaffected, suggesting ventilatory compensation as documented by the increased (p < 0.002) alveolar ventilation. This was not associated with a detectable rise in oxygen consumption, but with a significant change in partial pressure of oxygen (77 +/- 5 vs 66 +/- 3 mm Hg, p < 0.05). CONCLUSIONS: Ventilator-dependent infants with early and mild bronchopulmonary dysplasia, who receive intravenous feedings of a moderate load of glucose-based energy, can compensate for enhanced carbon dioxide production by increasing their respiratory drive, with a beneficial effect on oxygenation compared with that observed when energy is derived from lipid-based solutions.