Swiss medical weekly
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Swiss medical weekly · Apr 1999
[Prevalence of Helicobacter pylori infection in asymptomatic 5-7-year-old children of St. Gallen canton].
The prevalence of Helicobacter pylori infection in asymptomatic Swiss children is not known. The aim of this study was to determine the rate of Helicobacter pylori infection in preschool children of the Canton of St. Gallen, eastern Switzerland. ⋯ In 20/21 brother and sister pairs, the status of Helicobacter pylori infection was concordant. The amount of living space per person and the educational level of parents were comparable for all Helicobacter pylori positive children (Swiss and immigrants). In conclusion, total prevalence of Helicobacter pylori infection in preschool children aged 5 to 7 is low in the eastern part of Switzerland, with a significantly higher rate in children of immigrant parents.
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Swiss medical weekly · Apr 1999
Case Reports[Rhabdomyolysis and cholestatic hepatitis under treatment with simvastatin and chlorzoxazone].
Acute rhabdomyolysis under treatment with HMG-CoA reductase inhibitors ("statins") is a group-specific if rare side effect. Muscle toxicity of statins can be potentiated by medication influencing their metabolism. Here drug interactions on the level of the microsomal cytochrome P450 enzymes play an important role. ⋯ Withdrawal of the causal medication and conservative therapy with volume substitution and forced diuresis was followed by almost complete resolution of the symptoms with normalisation of the blood tests. Possible mechanisms involved in the drug interactions are discussed. Thorough knowledge of the enzyme systems involved in drug metabolism helps to predict possible adverse drug interactions and prevent toxic effects.
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Swiss medical weekly · Dec 1998
Case Reports[Chronic meningococcemia--a rare, but characteristic disease picture].
Chronic meningococcaemia is a rare clinical manifestation of invasive infection by Neisseria meningitidis. The clinical signs and symptoms are recurrent fever, skin rash, arthralgias and headache. This constellation is rather typical and may enable the clinician to establish the diagnosis. ⋯ Positive cultures may be obtained by needle aspiration or skin biopsy. There are a few reports on patients with deficiency of late complement components or immunoglobulin deficiency. We report on two patients with the typical findings of chronic meningococcaemia.
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As a rule the indication for sedation should be broad. Any child who is, or could be, frightened by an intervention should have the benefit of sedation. Correspondingly, an analgesic should be chosen if the intervention is painful. ⋯ Despite all efforts a small proportion of patients show an inadequate response to the chosen medication. In young children and in sick children the specific physiological and anatomical features will overtax the therapist. In such cases the help and advice of a specialist trained in paediatric anaesthesia can and should be sought.