Helvetica paediatrica acta
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A very unusual case of Wilms tumor in a child with Wiedemann-Beckwith syndrome is presented. The patient had his first metastasis after a disease-free interval longer than three years. ⋯ Both data emphasize the oncogenic potential of Wiedemann-Beckwith syndrome in children and support the contention that Wiedemann-Beckwith syndrome worsens the prognosis of Wilms tumor. Patients with Wilms tumor associated to Wiedemann-Beckwith syndrome should receive intensive therapy as well as close and prolonged follow-up in spite of apparent tumor remission.
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The authors describe a case of fulminant hepatitis in a 12-week-old infant whose mother was an asymptomatic carrier of the hepatitis B virus surface antigen and "e" antibody, the infection being unknown at the time of birth. They emphasize the importance of hepatitis B prophylaxis in all newborn children of surface antigen carrier mothers, irrespective of the situation concerning the hepatitis B virus e antigen.
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Ceftazidime, a new cephalosporin antibiotic, was used as monotherapy to treat 75 term neonates with suspected perinatal bacterial infection. Septicemia was documented in ten patients (13%). ⋯ The overall clinical, bacteriological and laboratory response to ceftazidime was satisfactory and the drug was well tolerated. However, reservations with regard to study design, limited gram-positive drug activity and potential emergence of drug resistance require further well-controlled clinical evaluations of ceftazidime in neonatal intensive care units, before definite recommendations for the use of this antibiotic in perinatal infection can be formulated.
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We report the data of 878 selected children between 1 month and 6 years, presenting a first episode of seizure with fever. Two-hundred-fifty-five children underwent lumbar puncture. In 7 cases the CSF findings showed a bacterial meningitis, in 14 cases a viral meningitis. ⋯ The data show that the probability of finding a bacterial or viral meningitis is high in children under 6 months of age even if no significant neurological signs are found on examination performed shortly after the seizure. In our study, older children affected by bacterial meningitis were clinically identifiable. In children aged 6 months to 3 years without important neurological signs, a complex seizure has been found to be a significant discriminating factor between patients with and without viral meningitis.
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The article discusses the present therapy of acute meningococcal septicemia. Besides adequate antibiotic treatment, the importance of early and aggressive shock and respiratory therapy, i.e. endotracheal intubation and mechanical ventilation, is stressed. The role of corticosteroids is discussed. The use of anticoagulants, fibrinolytic agents and inhibitors of fibrinolysis is discouraged.