In this issue of theJournal, an article by Asmar et al (see p 1100) shakes our confidence a bit i... more In this issue of theJournal, an article by Asmar et al (see p 1100) shakes our confidence a bit in using trimethoprim-sulfamethoxazole therapy. These authors demonstrate what has been already known but not well studied in children, namely, the hematologic toxic effects of this drug combination. Specifically, the trimethoprim-sulfamethoxazole combination is associated with a frequent occurrence of neutropenia and thrombocytopenia. The degree of neutropenia and thrombocytopenia is mild in most instances but, on occasion, may achieve levels that, even if not causing illness in the patient, will certainly add a few gray hairs to the prescribing physician. The combination of trimethoprim and sulfamethazole represents a marriage of two antimicrobial agents. Like some human unions, the joining of the two agents soon resulted in something unexpected—a new drug combination was found that, for many bacteria, was clearly more effective than either of its components. Of the two ingredients, the sulfonamide
Tienda online donde Comprar Year Book of Pediatrics,2007 al precio 97,11 € de James Stockman, tie... more Tienda online donde Comprar Year Book of Pediatrics,2007 al precio 97,11 € de James Stockman, tienda de Libros de Medicina, Libros de Pediatria - Pediatria general
... EM Carl, FT Nichols, R. Perry, K. Brock, K. McKie, R. Figueroa, M. Litaker, S. Weiner, D. Bra... more ... EM Carl, FT Nichols, R. Perry, K. Brock, K. McKie, R. Figueroa, M. Litaker, S. Weiner, D. Brambilla. (1997) Long-term stroke risk in children with sickle cell disease screened with transcranial doppler. Annals of Neurology 42:5, 699-704. 34. Anne Tuohy, Virgil McKie, Elizabeth ...
We performed sequential studies in 45 premature infants (birth weights less than 1500 g) from 7 t... more We performed sequential studies in 45 premature infants (birth weights less than 1500 g) from 7 to 120 days of age to determine factors governing the erythropoietin response to a declining hemoglobin concentration. The hemoglobin level and the plasma erythropoietin showed a significant inverse correlation (r = 0.50, P less than 0.001), as did, even more strikingly, the plasma erythropoietin response and the infants' oxygen-unloading capacity (r = 0.55, P less than 0.001). In infants with "right-shifted" oxygen-hemoglobin dissociation curves (hemoglobin F less than 30 per cent) hemoglobin levels fell 2 to 3 g per deciliter lower than those in infants with "left-shifted" curves (hemoglobin F greater than 60 per cent) before comparable erythropoietin responses occurred. It appears that premature infants respond appropriately to alterations in oxygen unloading capacity and that the position of the oxygen-hemoglobin dissociation curve and not the hemoglobin concentration alone has a major role in modulated erythropoiesis.
To determine the hemoglobin concentration at which iron absorption is minimal, five subjects with... more To determine the hemoglobin concentration at which iron absorption is minimal, five subjects with thalassemia major and one with thalassemia intermedia underwent a series of iron-absorption studies. The effect of tea as an inhibitor of non-heme iron absorption was also tested. Iron absorption increased as the hemoglobin concentration decreased, although iron absorption was much higher at any given hemoglobin level in the subject with thalassemia intermedia. In the subjects with thalassemia major, iron absorption averaged 10 per cent at hemoglobin concentrations between 9 and 10 and 2.7 per cent between 11 and 13 g per deciliter. The percentage of iron absorbed could be accurately predicted from the nucleated red-cell count (r = 0.91, P less than 0.001). Tea produced a 41 to 95 per cent inhibition of iron absorption. Since patients with thalassemia intermedia may absorb a large percentage of dietary iron, inhibitors of iron absorption, such as tea, may be useful in their management.
Evidence of disseminated intravascular coagulation was sought in 30 asymptomatic children with ve... more Evidence of disseminated intravascular coagulation was sought in 30 asymptomatic children with ventriculojugular shunts. In only three patients were elevated titers of fibrin split products present. In contrast to the paucity of abnormalities uncovered by routine coagulation ...
In this issue of theJournal, an article by Asmar et al (see p 1100) shakes our confidence a bit i... more In this issue of theJournal, an article by Asmar et al (see p 1100) shakes our confidence a bit in using trimethoprim-sulfamethoxazole therapy. These authors demonstrate what has been already known but not well studied in children, namely, the hematologic toxic effects of this drug combination. Specifically, the trimethoprim-sulfamethoxazole combination is associated with a frequent occurrence of neutropenia and thrombocytopenia. The degree of neutropenia and thrombocytopenia is mild in most instances but, on occasion, may achieve levels that, even if not causing illness in the patient, will certainly add a few gray hairs to the prescribing physician. The combination of trimethoprim and sulfamethazole represents a marriage of two antimicrobial agents. Like some human unions, the joining of the two agents soon resulted in something unexpected—a new drug combination was found that, for many bacteria, was clearly more effective than either of its components. Of the two ingredients, the sulfonamide
Tienda online donde Comprar Year Book of Pediatrics,2007 al precio 97,11 € de James Stockman, tie... more Tienda online donde Comprar Year Book of Pediatrics,2007 al precio 97,11 € de James Stockman, tienda de Libros de Medicina, Libros de Pediatria - Pediatria general
... EM Carl, FT Nichols, R. Perry, K. Brock, K. McKie, R. Figueroa, M. Litaker, S. Weiner, D. Bra... more ... EM Carl, FT Nichols, R. Perry, K. Brock, K. McKie, R. Figueroa, M. Litaker, S. Weiner, D. Brambilla. (1997) Long-term stroke risk in children with sickle cell disease screened with transcranial doppler. Annals of Neurology 42:5, 699-704. 34. Anne Tuohy, Virgil McKie, Elizabeth ...
We performed sequential studies in 45 premature infants (birth weights less than 1500 g) from 7 t... more We performed sequential studies in 45 premature infants (birth weights less than 1500 g) from 7 to 120 days of age to determine factors governing the erythropoietin response to a declining hemoglobin concentration. The hemoglobin level and the plasma erythropoietin showed a significant inverse correlation (r = 0.50, P less than 0.001), as did, even more strikingly, the plasma erythropoietin response and the infants' oxygen-unloading capacity (r = 0.55, P less than 0.001). In infants with "right-shifted" oxygen-hemoglobin dissociation curves (hemoglobin F less than 30 per cent) hemoglobin levels fell 2 to 3 g per deciliter lower than those in infants with "left-shifted" curves (hemoglobin F greater than 60 per cent) before comparable erythropoietin responses occurred. It appears that premature infants respond appropriately to alterations in oxygen unloading capacity and that the position of the oxygen-hemoglobin dissociation curve and not the hemoglobin concentration alone has a major role in modulated erythropoiesis.
To determine the hemoglobin concentration at which iron absorption is minimal, five subjects with... more To determine the hemoglobin concentration at which iron absorption is minimal, five subjects with thalassemia major and one with thalassemia intermedia underwent a series of iron-absorption studies. The effect of tea as an inhibitor of non-heme iron absorption was also tested. Iron absorption increased as the hemoglobin concentration decreased, although iron absorption was much higher at any given hemoglobin level in the subject with thalassemia intermedia. In the subjects with thalassemia major, iron absorption averaged 10 per cent at hemoglobin concentrations between 9 and 10 and 2.7 per cent between 11 and 13 g per deciliter. The percentage of iron absorbed could be accurately predicted from the nucleated red-cell count (r = 0.91, P less than 0.001). Tea produced a 41 to 95 per cent inhibition of iron absorption. Since patients with thalassemia intermedia may absorb a large percentage of dietary iron, inhibitors of iron absorption, such as tea, may be useful in their management.
Evidence of disseminated intravascular coagulation was sought in 30 asymptomatic children with ve... more Evidence of disseminated intravascular coagulation was sought in 30 asymptomatic children with ventriculojugular shunts. In only three patients were elevated titers of fibrin split products present. In contrast to the paucity of abnormalities uncovered by routine coagulation ...
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