Nocturnal Enuresis: Comparison of the Effect of Imipramine and Dietary Restriction on Bladder Capacity

Fifty children with nocturnal enuresis have been studied with a view to determining maximum bladder capacities and frequency of micturition, and the changes induced by dietary treatment and imipramine. Of 50 children treated with imipramine, 31 were symptomatically cured. Fifteen of the 48 children treated by dietary measures were also symptomatically cured, but as nine had already been cured by imipramine the correct cure rate for dietary treatment, for reasons indicated in the text, may have been no more than seven of the 48 cases. Treatment on the above lines, in those who responded, led to an increase in bladder capacity and a fall in diurnal frequency of micturition.Because the bladder can enlarge under the above conditions it is concluded that the bladder in the average enuretic is functionally but not structurally small, and that when dietary manipulation helps, it does so by eliminating factors from the diet to which the bladder is sensitive. Imipramine, by contrast, is effective because it blocks peripherally this effect.     

Effects of different methods of treatment of primary enuresis on psychologic functioning in children.

Sixty-two children with primary nocturnal enuresis were assigned randomly to one of two groups. Group 1 was treated with imipramine hydrochloride, and group 2 received a course of treatment with the Mozes Detector. Seventeen children from group 1 and 18 from group 2 were tested with the age-appropriate form of the Cattell personality questionnaire on three occasions: at the time of entry into the study, 2 months later and at follow-up, an average of 16 months later. The patients in group 2, who were older, had a higher rate of cure than did the patients in group 1. They also had significantly higher levels of extroversion and significantly lower levels of neuroticism at follow-up than did those in group 1. These findings indicate that better results are seen with the Mozes Detector than with imipramine in older children with primary nocturnal enuresis.     

Levamisole in the treatment of ascariasis in children

Levamisole (the laevorotatory isomer of tetramisole) is a new synthetic anthelmintic. A cure rate of 91% was obtained in a series of 111 ascariasis-infected children treated with a single oral dose of the drug. The failures, who were treated with the drug a second time one week later, were all cured. In a comparative study of levamisole and piperazine citrate in a series of 100 children with ascariasis a cure rate of 92% and 90% was obtained with a single dose of levamisole and piperazine respectively, indicating equal efficacy. Levamisole is better tolerated than piperazine citrate and is virtually free of toxic effects.     

Nephroblastoma in infants, 1969-75: variations in treatment and survival.

In a series of 79 infants aged under 1 year with nephroblastoma diagnosed during 1969-75 all the patients underwent nephrectomy, 33 (42%) received a course of radiotherapy, and 49 (62%) received chemotherapy. The overall three-year survival rate for patients who survived at least one week after diagnosis was 65%. The corresponding rate for infants with stage I tumours was 76%. The survival rate in children with early-stage tumours was significantly higher in those who were treated by nephrectomy and chemotherapy alone compared with those who also received radiotherapy. In a large proportion of cases nephrectomy and chemotherapy together constituted sufficient treatment for the cure of infants with nephroblastoma, and in some instances nephrectomy alone proved adequate. There was no general tendency for children under 1 year old to be unable to withstand chemotherapy.     

Plasmodium falciparum hyperparasitaemia in children. Risk factors, treatment outcomes, and gametocytaemia following treatment

The risk factors associated with hyperparasitemia at presentation and after treatment with different antimalarial drug regimens were evaluated in 1,048 children enrolled prospectively in seven antimalarial drug trials between July 1996 and September 2003 in a hyperendemic area of southwestern Nigeria. The outcomes of treatment of hyperparasitaemia, and gametocyte carriage following treatment were also evaluated. The children were assigned to one of seven treatment groups: chloroquine (CQ) only; pyrimethamine-sulfadoxine (PS) only; amodiaquine (AQ) only; CQ plus chlorpheniramine (CQCP); PS combined with CQ or AQ (COM); PS combined with probenecid (PPS); and halofantrine (HF). Hyperparasitaemia was found in 100 (9.5%) of the 1,048 children at enrolment (day 0). Following oral therapy, 1.2% of all patients (i.e. 13 patients) became hyperparasitaemic, which developed in all patients by day 1 of follow-up. In a multiple regression model, age < or = 5 years, and a core temperature (oral or rectal) > or = 39.5 degrees C were found to be independent risk factors for hyperparasitaemia at enrolment. Following therapy, the cure rate on day 14 was significantly lower in those treated with CQ compared to other treatment groups. Severe resistance (RIII) response to treatment occurred significantly more frequently in those with hyperparasitaemia at enrolment than in those without, and was seen in five and one child with hyperparasitaemia who were treated with CQ and CQCP, respectively. Gametocyte carriage was insignificantly lower at enrolment and at all times following treatment in children with hyperparasitaemia than in age- and gender-matched children without hyperparasitaemia who received the same treatment. The results are discussed in the light of management of uncomplicated hyperparasitaemia in children in endemic settings.     

CO_2激光联合胸腺五肽治疗尖锐湿疣的临床效果分析

目的：探讨CO2激光联合胸腺五肽治疗尖锐湿疣的临床疗效。方法：将我院2010年2月-2011年8月期间收治的82例尖锐湿疣患者随机分为两组,治疗组50例采用CO2激光器治疗联合胸腺五肽肌注;对照组32例单纯采用CO2激光器治疗;两组治疗疗程结束后观察临床疗效。结果：治疗组50例,一次治愈者46例,占92%;二次治愈者4例,占8%。对照组32例,一次治愈者19例,占59.4%;二次治愈者13例,占40.6%。两组一次治愈率比较差异明显,具有统计学意义（P〈0.05）。两组术后局部轻度水肿和疼痛,无需处理1~3天缓解或痊愈。结论：CO2激光联合胸腺五肽治疗尖锐湿疣临床疗效好,并具有治疗简便,术后不良反应少,治愈率高等特点。     

CO2 激光联合胸腺五肽治疗尖锐湿疣的临床效果分析

目的:探讨CO2激光联合胸腺五肽治疗尖锐湿疣的临床疗效。方法:将我院2010年2月-2011年8月期间收治的82例尖锐湿疣患者随机分为两组,治疗组50例采用CO2激光器治疗联合胸腺五肽肌注;对照组32例单纯采用CO2激光器治疗;两组治疗疗程结束后观察临床疗效。结果:治疗组50例,一次治愈者46例,占92%;二次治愈者4例,占8%。对照组32例,一次治愈者19例,占59.4%;二次治愈者13例,占40.6%。两组一次治愈率比较差异明显,具有统计学意义(P<0.05)。两组术后局部轻度水肿和疼痛,无需处理1~3天缓解或痊愈。结论:CO2激光联合胸腺五肽治疗尖锐湿疣临床疗效好,并具有治疗简便,术后不良反应少,治愈率高等特点。     

Four-day, twice daily, quadruple therapy with amoxicillin, clarithromycin, tinidazole and omeprazole to cure Helicobacter pylori infection: a pilot study

Background. The best regimen for the treatment of Helicobacter pylori infection has yet to be defined. Four-day quadruple therapy with tetracycline, metronidazole, bismuth, and a proton pump inhibitor has been shown to obtain a very high cure rate. However, the fact that it must be taken four times daily may interfere with compliance. The objective of the study was to test the efficacy and tolerability of a new 4-day therapy with 4 drugs taken every 12 hours to cure H. pylori infection.
Patients and Methods. Fifty-six consecutive patients with peptic ulcer disease and H. pylori infection were treated with an oral 4-day course with omeprazole (20 mg/12 hours), clarithromycin (500 mg/12 hours), amoxicillin (1 g/12 hours) and tinidazole (500 mg/12 hours). Efficacy of the treatment was determined at least 2 months after therapy either by biopsy (in the case of gastric ulcer) or by ¹³C-urea breath test. A second breath test was performed at least 6 months after therapy.
Results. Two patients were lost to follow-up. Forty-nine of the remaining 54 patients were cured at the first control [intention-to-treat cure rate: 87.5% (CI 95% 75–94%); per protocol cure rate: 90.7% (CI 95% 81–98%)]. Forty-three of these 49 cured patients returned for a second ¹³C urea breath-test at 6–12 months. Two of them were not cured, giving a long-term cure rate of 85.5% per protocol and 73.2% by intention-to-treat. Compliance was good, although 25 patients had mild side effects.
Conclusion. This particular four-day therapy is well tolerated, easy to follow, and achieves an acceptably high cure rate.     

Management of Ontario children with acute lymphoblastic leukemia by the Dana-Farber Cancer Institute protocols.

There is ample evidence of the value of intensive therapeutic strategies in the management of acute lymphoblastic leukemia (ALL), the commonest form of malignant disease in children. Such a program, devised at the Dana-Farber Cancer Institute (DFCI), Boston, and incorporating high-dose L-asparaginase, was adopted in 1984 by the Children''s Hospital at Chedoke-McMaster, Hamilton, Ont., and the Children''s Hospital of Western Ontario, London. We describe the experience of these institutions in the treatment of 82 children with ALL, 19 of whom were switched to the DFCI protocols while in continuing first remission with other treatment programs to complete a minimum of 2 years of maintenance therapy; the remaining 63 children, who had recently diagnosed disease, were consecutively enrolled in the DFCI protocols. Each child was assigned at diagnosis to a category of risk for relapse and treated accordingly. There were no remission induction failures or deaths due to induction therapy among the patients with newly diagnosed disease. There were no differences in total or event-free survival rates between the patients in Hamilton and those in London or between those whose protocols were switched and those who were treated from the beginning with the DFCI protocols. With a median follow-up interval of 144 weeks the total survival rate was 95% and the event-free survival rate 88%. For patients at standard risk of relapse the event-free survival rate was 100%, for those at high risk the rate was 82%, and for those at very high risk the rate was 67%. If infants (all of whom suffered a relapse) are excluded from the last category the rate was 89%. These results were achieved with moderate toxic effects (except for two deaths, one of which was due to a therapeutic misadventure) and suggest that the prospect for cure in children with ALL. may now approximate 80%, a degree of success that demands that consideration be given to reducing total therapy, at least for children with standard-risk disease. Further follow-up will determine whether these high event-free survival rates will stabilize and meet the criteria for cure.     

液氮喷雾治疗器的研制与临床应用

介绍了液氮雾化的原理,自行研制新型液氮喷雾治疗器经过,并用于临床治疗,冷冻治疗242例雀斑,疗效显著,经1年~3年追踪观察,治愈率为81.4%,有效率复发率为0.02%。结果显示新型液氮治疗器适用于治疗小的、表浅的和某些特殊部位的皮损,对色素性疾病有很好的疗效。     

综合治疗法对不同弱视儿童治疗效果观察

目的:探讨综合治疗法对不同程度、不同年龄、不同类型的弱视患儿的临床疗效。方法:选取2012年1月~2014年1月在我院接受治疗的弱视患儿393例(671眼),根据弱视程度分为轻度组(299眼)、中度组(293眼)和重度组(79眼),3组患者均采用遮盖、精细目力训练、仪器训练及压抑疗法进行治疗,均治疗6~12个月,比较不同程度、不同年龄、不同类型的弱视患儿治疗后临床疗效。结果:治疗后,轻度、中度和重度组患儿的治愈率分别为90.97%、72.35%和17.72%,总有效率分别为100.00%、96.93%和84.81%,组间比较差异具有统计学意义(P0.05)。3~5岁、6~8岁和9~11岁患儿的治愈率分别为77.08%、74.72%和71.03%,总有效率分别为99.48%、97.36%和93.93%,3~5岁患儿总有效率显著高于9~11岁患儿(P0.05),但三个年龄段患儿治愈率差异不显著(P0.05)。屈光不正性弱视患儿、斜视性弱视患儿、屈光参差性弱视患儿的治愈率分别为85.65%、45.75%和61.54%,总有效率分别为99.34%、90.20%和95.38%,其中,屈光不正性弱视患儿经治疗的总有效率和治愈率均显著高于其他两种类型(P0.05)。结论:综合治疗法对弱视患儿的临床疗效与弱视程度、弱视类型和年龄密切相关,结合儿童弱视类型提早治疗是提高预后的关键。     

Enuresis and the Electric Alarm—A Study of 200 Cases

Of 200 children with persistent enuresis 66% were cured after treatment with an electric alarm over a 30-week period. It is suggested that treatment may be discontinued after the child has been dry for four weeks, that if continued for longer than 16 weeks treatment is unlikely to produce a cure, and that a two-year follow-up period is necessary before a cure can be accepted.     

注射器针头划拨法治疗儿童拇指狭窄性腱鞘炎的临床疗效及与病程的关系

目的:探讨注射器针头划拨法治疗儿童拇指狭窄性腱鞘炎临床疗效,分析病程长短与治疗效果的相关性。方法:纳入2015年4月至2018年10月于我院治疗的拇指狭窄性腱鞘炎患儿59例,根据患儿发病时间分为短程组(发病时间≤6个月,n=28)和长程组(发病时间6个月,n=31),所有患儿采用7#注射器针头划拨法进行治疗,术后1个月及6个月门诊复查并评定临床疗效,观察记录是否残留屈曲挛缩,触发弹响感、主动屈伸拇指指间关节活动度改善情况及术后并发症情况,分析两组患儿病程与治疗效果相关性,记录术后随访结果。结果:短程组治疗有效率为96.43%,长程组治疗有效率为93.55%,两组有效率比较无统计学差异(P0.05)。术后1个月及6个月复查56例患儿均成功解除屈曲挛缩畸形,主动屈伸拇指指间关节活动度改善情况满意,触发激痛点消失,后续随访6～46个月未见复发,未愈的3例患儿经外科手术治疗后达到治愈效果。两组患儿病程长短与治疗效果不存在线性相关性(P0.05)。结论:注射器针头划拨法治疗儿童拇指狭窄性腱鞘炎临床疗效确切,治疗器械普通,创口小,简单易行,在治疗病程大于6个月的儿童拇指狭窄性腱鞘炎也能取得较满意的临床疗效。     

Randomized Single-Blinded Non-inferiority Trial Of 7 mg/kg Pentamidine Isethionate Versus 4 mg/kg Pentamidine Isethionate for Cutaneous Leishmaniaisis in Suriname

BackgroundStandard treatment of cutaneous leishmaniasis (CL) in Suriname entails three injections of pentamidine isethionate (PI) 4 mg/kg per injection in 7 days (7 day regimen). Compliance to treatment is low and may contribute to increasing therapy failure. A 3 day regimen, including 2 injections of 7 mg/kg in 3 days may increase compliance.MethodsIn a randomized, single-blinded non-inferiority trial conducted in Suriname, 84 CL patients received the 7 day regimen and 79 CL patients received the 3 day regimen. Primary objective was the proportion of patients clinically cured at 6 weeks follow-up. Secondary objectives were clinical cure at 12 weeks follow-up; parasitological cure at 6 and 12 weeks; adverse and drug related toxicity events recorded one week after the end of treatment and health related quality of life. The non-inferiority margin was set at 15%, 1 sided test, α = 0.1.ResultsAt 6 weeks follow-up 31 (39%) patients in the 3 day regimen and 41 (49%) patients in the 7 day regimen were clinically cured. Intention to treat (ITT) analyses showed that the difference in proportion clinically cured was -9.6% (90% Confidence Interval (CI): -22.3% to 3.2%). Per protocol (PP) analysis showed that the difference in proportion clinically cured was 0.2% (90% CI: -14.6% to 15.2%). ITT analysis showed that the difference in proportion parasitological cured at 6 weeks was -15.2% (90% CI:-28.0% to -2.5%). PP analyses showed similar results. Non-inferiority could not be concluded for all adverse and toxicological events.ConclusionWe cannot conclude that the 3 day regimen is non-inferior to the 7 day regimen regarding proportion clinically and parasitological cured. Therefore there is no evidence to change the current standard practice of the 7 day regimen for the treatment of CL in Suriname.     

Performance and Safety of Praziquantel for Treatment of Intestinal Schistosomiasis in Infants and Preschool Children

Background

In 2012 the WHO formally recognised that infants and preschool children are at significant risk of schistosomiasis and qualify for treatment with praziquantel (PZQ). Targeted surveys determining both the performance and safety of this drug are now needed in endemic areas. We have formally assessed parasitological cure and putative side-effects in a prospective cohort of Schistosoma mansoni-infected children (aged 5 months–7 years old) in lakeshore settings of Uganda.

Methodology/Principal Findings

From a total of 369 children found to be egg-patent for intestinal schistosomiasis, 305 were followed-up three to four weeks after PZQ treatment and infection status re-assessed. Separately, a previously tested side-effect questionnaire was employed before and 24 hours after PZQ treatment to assess incidence and amelioration of symptoms in young children and their mothers. While the overall observed parasitological cure was 56.4%, a significant difference was found between a sub-set of children who had a history of multiple PZQ treatments (between one and four in an 18 month period), where cure rate was 41.7%, and those who had never received treatment (cure rate was 77·6%). PZQ proved to be safe, with only mild reported side effects which cleared within a month after treatment. Prevalence of reported symptoms was significantly lower in children than in mothers, and fewer side-effects were reported upon subsequent rounds of PZQ treatment.

Conclusion/Significance

Our findings show that PZQ treatment of young children resulted in satisfactory cure rates, and marked reduction in egg-output, with only mild and transient reported side-effects. However, the cure rate is clearly lower in younger children and those with history of previous treatment. Cure rate, but not egg reduction rate, was also lower in children with heavier pre-intervention infection intensity. With chemotherapy now recommended as a long-term strategy for disease control in young children, research into optimising the periodicity of targeted treatment strategies is now crucial.     

Nephroblastoma: treatment during 1970-3 and the effect on survival of inclusion in the first MRC trial.

In 1970-3 313 children were diagnosed as having nephroblastoma in Great Britain. From the start of the first Medical Research Council nephroblastoma study in October 1970 until the end of 1973, 98 children (57% of all eligible children) were included in the trial. Of the 313 children, 288 (92%) had a nephrectomy, 248 (79%) received a course of radiotherapy, and 267 (85%) were given at least four days'' chemotherapy. The three-year survival rate was 58%; the rate among children in the trial (77%) was significantly better than that among children who were eligible for the trial but not included (58%). Children who had nephrectomies at specialised children''s and teaching hospitals had a higher survival rate than those treated elsewhere. All children with nephroblastoma should be treated according to well-defined protocols which take into account the age of the child and the stage of the tumour and include a full course of maintenance chemotherapy.     

Long term observation of children with Giardia intestinalis invasion treated with metronidazole and furazolidone]

The results of a long-term (3-year) follow-up of children infected with G. intestinalis treated with metronidazole and furazolidone are presented. Therapy was effective in 84-95% of cases, depending of the duration or the follow-up. Repetition of therapy with tinidazole was indicated in 5% of children after 6 months and in 15% of children after 1 and 2 years of observation because of persisting symptoms of the infection or recurrence. More frequent the treatment was necessary in children under 3 years of age. Some (14%) children required milk free diet and in a few cases (underlying disease--coeliac) gluten-free diet or a diet free of main allergens.     

A survey on head lice infestation in Korea (2001) and the therapeutic efficacy of oral trimethoprim/sulfamethoxazole adding to lindane shampoo

Total of 7,495 children including 3,908 boys and 3,587 girls from a kindergarten and 15 primary schools were examined for head lice infestation (HLI). The overall prevalence of HLI in this study was found to be 5.8%. Head lice were much more commonly detected in girls than in boys with prevalence of 11.2% and 0.9%, respectively. Sixty-nine children with HLI were treated with 1% lindane shampoo alone (group 1), and 45 children with HLI were treated with 1% lindane shampoo and oral trimethoprim/sulfamethoxazole (group 2), and follow-up visits were conducted 2 and 4 weeks later. The children who still had HLI 2 weeks after the primary treatment were treated again. At the 2-week follow-up visit, the treatment success rates of groups 1 and 2 were 76.8% and 86.7%, respectively, and at the 4-week follow-up visit, the rates were 91.3% and 97.8%, respectively. No statistically significant synergistic effect was observed for the combination of a 1% lindane shampoo and oral trimethoprim/sulfamethoxazole.     

Double-Blind, Multicenter Evaluation of Lansoprazole and Amoxicillin Dual Therapy for the Cure of Helicobacter pylori Infection

Background Treatment with amoxicillin plus omeprazole results in disappointing cure rates of Helicobacter pylori infection. The minimal inhibitory concentration of lansoprazole for H. pylori in vitro is lower than that for omeprazole, prompting interest in treatment with amoxicillin plus lansoprazole.
Materials and Methods. H. pylori -infected patients with endoscopically documented duodenal ulcer either currently or within the past year were randomized to 14 days of (1) lansoprazole, 30 mg bid, plus amoxicillin, 1 gm tid; (2) lansoprazole, 30 mg tid, plus amoxicillin, 1 gm tid; (3) lansoprazole, 30 mg tid alone; or (4) amoxicillin, 1 gm tid alone. Endoscopy was done at enrollment and at 4 to 6 weeks after completion of treatment or for recurrent symptoms. H. pylori status was assessed by culture and histology. Ulcer prevalence was evaluated at follow-up endoscopy.
Results. Two hundred sixty-two patients met enrollment criteria and were treated. By per-protocol analysis, H. pylori infection was cured in 57% of those treated with lansoprazole twice daily plus amoxicillin and in 67% of those treated with lansoprazole three times daily plus amoxicillin, compared with 0% treated with lansoprazole alone or amoxicillin alone ( p < .001 for dual therapy versus either monotherapy). Amoxicillin resistance was not observed. At follow-up endoscopy, ulcer prevalence was 17% in patients treated with lansoprazole twice daily plus amoxicillin, 23% in those treated with lansoprazole three times daily plus amoxicillin, 33% in those treated with lansoprazole alone, and 35% in those treated with amoxicillin alone ( p = .024; lansoprazole twice daily plus amoxicillin versus amoxicillin alone).
Conclusions. Treatment with amoxicillin plus lansoprazole, 30 mg tid, led to cure of H. pylori infection in 67% of patients with active or recently healed duodenal ulcer.