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Biomedical subjects

Michael W Simon

Publications and source records attributed to Michael W Simon.

6 recordsLinked to original sources
PubMed2004

Changes in newborn bathing practices may increase the risk for omphalitis.

Aseptic cord care, in conjunction with antibacterial skin care, has reduced the incidence of omphalitis specifically caused by Staphylococcus aureus. However, this practice has resulted in the emergence of resistant organisms that may pose a greater risk for newborn infections. Subsequently, many institutions have changed to dry cord care and nonantiseptic whole-body baths, a practice that has not been adequately studied to determine potential infectious risks. Three cases of omphalitis occurring after an institutional change to nonantiseptic whole-body baths are presented. Clinical diagnosis and treatment of omphalitis are reviewed. Recommendations for surveillance of omphalitis are offered.

Anti-Bacterial Agents↗
PubMed2003

Congenital absence of the 5th digital ray and its proximal segmental structures.

Limb reduction anomalies involving digits or parts of limbs are not uncommon. Most cases take the form of terminal transverse absence defects involving hypoplasia or aplasia of all structures distal to a particular level on a limb with relative preservation of the more proximal tissues. Longitudinal absence defects are a more rare form of limb reduction anomalies. Structures within one or more digital rays are typically involved. More proximal segmental tissues may also be affected with the most serious cases resulting in absence of the radius or ulna. We report a case of isolated, longitudinal absence of the 5th finger and its corresponding proximal segmental structures in a newborn infant. The embryology of limb development and possible etiologies for skeletal absence defects are summarized.

Adult↗
PubMed2003

Cutaneous larva migrans.

Cutaneous larva migrans is occasionally seen in pediatric emergency outpatient care settings. It results from infestation of hookworm larvae into the epidermis. The infestation is self-limited but may produce severe discomfort. The diagnosis relies entirely on clinical findings. Laboratory findings only support the clinical diagnosis but do not confirm it. Treatment is typically with topical thiabendazole, but oral thiabendazole may be indicated in severe cases.

Adolescent↗
PubMed2003

Occurrence of Epstein-Barr virus illness in children diagnosed with group A streptococcal pharyngitis.

Epstein-Barr virus mononucleosis and group A streptococcal pharyngitis are acute infectious processes similar in both their clinical manifestations. Coinfections may occur and be a direct result of a synergistic effect on inflamed pharyngeal and tonsillar tissue. It was our observation that a population of children diagnosed with group A streptococcal pharyngitis and not responding to appropriate antimicrobial therapy had Epstein-Barr virus illness.

Adolescent↗
PubMed2002

Pharmacokinetics and safety of valaciclovir in children with Epstein-Barr virus illness.

OBJECTIVE: Valaciclovir has in vitro activity against Epstein-Barr virus (EBV) and, because of improved absorption with higher achievable serum concentrations, may be more effective than aciclovir in the treatment of EBV. No studies to date have evaluated the efficacy, safety or proper dosing of valaciclovir in children for the treatment of EBV infection. The objectives of this study were to determine the pharmacokinetics and safety of valaciclovir tablets and suspension in children with EBV illness. METHODS: 24 children with EBV illness were randomised to receive valaciclovir suspension 10 mg/kg or 20 mg/kg; eight children subsequently were crossed over and also received valaciclovir 500 mg tablets. Doses of either suspension or tablets were administered every 8 hours for four doses, and pharmacokinetic studies were performed to determine aciclovir serum concentrations. Samples for drug assay were obtained at 0, 0.5, 1, 2, 4, 6, 8 and 24 hours. Samples were assayed by high performance liquid chromatography (HPLC) methods and aciclovir pharmacokinetics determined using non-compartmental analysis. RESULTS: Valaciclovir pharmacokinetic parameters (mean +/- SD) in children who received tablets and suspension (normalised to 500 mg dose) were: maximum serum concentration (C(max)) 3.16 +/- 1.30 and 2.42 +/- 0.74 mg/L, time to maximum serum concentration (t(max)) 1.88 +/- 0.99 and 1.31 +/- 0.53 hours, half-life (t 1/2) 1.72 +/- 0.41 and 1.94 +/- 0.60 hours, apparent total systemic clearance (CL/F) 20.01 +/- 6.61 and 15.58 +/- 3.34 ml/min/kg, volume of distribution/bioavailability (Vd/F) 3.04 +/- 1.26 and 2.58 +/- 0.81 L/kg, and area under the concentration-time curve (AUC) 10.13 +/- 3.47 and 8.59 +/- 2.52 mg x h/L, respectively. There were no statistically significant differences in the pharmacokinetics of valaciclovir tablets versus suspension. The relative bioavailability of the valaciclovir tablets compared with the suspension was 115 +/- 32%. Valaciclovir was well tolerated, with gastrointestinal disturbances and headache being the most common adverse effects in a small number of subjects. CONCLUSIONS: Valaciclovir is absorbed and achieves concentrations in children that appear to be effective for the treatment of herpes lesions. The pharmacokinetics of valaciclovir suspension and tablets are similar, and the pharmacokinetics of aciclovir after administration of valaciclovir to children are similar to historical observations of aciclovir pharmacokinetics in adults. Valaciclovir has a good safety profile and was well tolerated after oral administration in this group of children.

Acyclovir↗