Biomedical subjects

N J Apostolopoulos

Publications and source records attributed to N J Apostolopoulos.

5 recordsLinked to original sources

PubMed1997

Auditory function in young patients with chronic renal failure.

Debate on the relationship between renal insufficiency and hearing loss continues mainly due to the advanced age and the possible accelerated presbycusis of the patients that have been studied in surveys. Hearing acuity was studied in 46 children and adolescents suffering from renal insufficiency. Sensorineural hearing loss (mainly high-frequency) of unknown cause was found in 14 patients (30.4%). Hearing loss was not influenced by the various haematological, biochemical and clinical parameter (type of renal disease, blood pressure, history of ototoxic drugs administration). However, hearing loss seemed to be affected by the method of management of the renal insufficiency (more in the haemodialysis group than in the peritoneal dialysis group). There were no significant changes in audiometric findings before and after haemodialysis.

Adolescent↗

PubMed1996

Concentrations of cefpodoxime in plasma, adenoid, and tonsillar tissue after repeated administrations of cefpodoxime proxetil in children.

Cefpodoxime proxetil was administered to 36 children undergoing tonsillectomy, adenoidectomy or both. It was very well tolerated. The detectable tissue concentrations of cefpodoxime were moderate but remained constant (approximately 0.05 mg/kg) 3, 6, and 12 h after the last dose of the drug, while the respective plasma concentrations were declining. This suggests the possibility of twice-daily administration. However, 30% of children did not have quantifiable concentrations in the tonsil and more than half the adenoids did not have quantifiable levels. Whether a higher dosage would lead to higher and more satisfactory tissue concentrations is a matter for further investigation.

Adenoids↗

PubMed1995

Peritonsillar abscess in children. Is incision and drainage an effective management?

Debate continues concerning proper management of peritonsillar abscess (PA). We studied 189 children (mean age, 9 years) admitted in our department during the last 7 years with the diagnosis of PA. Management consisted of incision and drainage (performed in 92.5% of the children without general anaesthesia) and antibiotic therapy intravenously. There was resolution without complications in the overwhelming majority of the cases. After the initial episode, we further followed up 101 children. The recurrence rate was 15.8%. Forty-seven percent of the recurrences occurred 1 month after the children had been discharged. Probably some of these second PA should be considered as persistent and not as recurrent. Therefore, we propose that after their discharge, the children must take oral antibiotics (resistant to beta-lactamase) for more than 10 days. Cultures were taken from 58 cases. The predominant bacterial isolates were Streptococcus spp. (55%), anaerobes spp. (12%) and Staphylococcus aureus (6%). To our knowledge, this is the first survey that addresses exclusively a pediatric population and suggests that incision and drainage without general anaesthesia is an applicable and effective management in children with PA. Moreover, we believe that peritonsillar abscess is no longer a strong indication for tonsillectomy due to the relatively low rate of recurrence. We recommend close follow-up, mainly for the first months after the initial episode.

Adolescent↗

PubMed1993

Evaluation of acoustic reflectometry in detecting otitis media in children.

Accurate detection of middle-ear effusion in children is not only useful but also necessary for diagnosis, management and follow-up of otitis media. A relatively new device, the Acoustic Otoscope (model 101, ENT Medical Devices) has been introduced for detecting middle-ear fluid in children. We tested 158 ears and the diagnosis was confirmed by acoustic admittance, acoustic reflex and pneumatic otoscopy. We propose 4.5 as a better breakpoint (the number on the vertical scale of the instrument which is the lower limit indicating middle-ear effusion) than 4.0 which is proposed by the manufacturer. In our results the 4.5 breakpoint maximizes both positive and negative predictive values (83 and 82% respectively) with satisfactory sensitivity and specificity (86 and 79% respectively) in detection of otitis media. Our clinical experience with this instrument, during the past 2 years, has led us to conclude that it is simple, non-invasive and objective. Unlike tympanometry, it requires no hermetic seal and is effective even if the child is crying. However, it is not sensitive enough when there are bubbles or negative pressure in the middle ear. When the user is aware of the flexibility of the instrument's breakpoints (in our opinion this is an advantage of the device) for different uses and different populations, the reflectometer often reduces the need for tympanometry and confirms the otoscopic examination.

Acoustic Impedance Tests↗

PubMedDate not supplied

AIDS-related behaviour in adolescents: intervention programme with international application.

Adolescents and young adults compromise one of the fastest-growing categories of AIDS cases. The results of an opinion survey taken of 3242 adolescents raise serious doubts about the prevalent view that high-risk behaviour is attributable to insufficient information and education on AIDS: female adolescents are found to be at risk despite having the proper knowledge. Five chief factors affected the knowledge and behaviour of adolescents: age, gender, origin, family profession, and parental education. Each of the subpopulations (females, younger adolescents, children in rural areas) has its own characteristics and needs. We describe a permanent and long-term intervention programme, which might be applied in any country.

Acquired Immunodeficiency Syndrome↗