Duplicate publication.
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Duplicate Publications as Topic↗
Biomedical subjects
S Serlin
Publications and source records attributed to S Serlin.
Cyclacillin versus amoxicillin as treatment for acute otitis media.
A double-blind study of 240 pediatric outpatients with acute otitis media demonstrated that cyclacillin, administered three times a day for ten days, is as effective as and better tolerated than a similar regimen of amoxicillin. Clinical success was achieved in 96% of the children treated with each drug, and the bacteriologic cure rate was 98% in each treatment group. Only three of the 119 children (2.5%) treated with cyclacillin had drug-related diarrhea, in contrast to 17/121 children (14%) treated with amoxicillin (P less than .01). This greater tolerance for cyclacillin may be due to its more effective and rapid absorption in the upper gastrointestinal tract. The results are discussed in terms of the low incidence of resistant strains of Haemophilus influenzae and the advantages of cyclacillin as the first-line treatment for acute otitis media.
Acute Disease↗
Case of the month No. 60: laceration of the liver. Bile leakage into the laceration on hepatobiliary scan.
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Adolescent↗
Intraoperative hyperthermia associated with intraventricular hemorrhage.
A case is presented of a 34-month-old child who developed hyperthermia with a temperature of 40 degrees C while undergoing a suboccipital craniotomy for resection of a medulloblastoma. The presentation is followed by a discussion of the differential diagnosis of hyperthermia during anesthesia. Malignant hyperthermia, septicemia, thyroid storm, neuroleptic malignant syndrome, transfusion reaction, and exogenous causes of fever are discussed. The case serves as an illustration of the association between neurosurgical manipulation, intraventricular hemorrhage, and fever that may result from hypothalamic irritation.
Cerebral Hemorrhage↗
Single-dose caudal epidural morphine in children: safe, effective, and easy.
STUDY OBJECTIVE: To determine whether a single epidural dose of morphine sulfate is effective in providing 12- to 24-hour pain relief in children. DESIGN: A chart review of 113 consecutive pediatric patients having received a single dose of epidural morphine. SETTING: An inpatient anesthesia and surgical service at a regional children's hospital. PATIENTS: One hundred thirteen consecutive pediatric patients from 2 months to 15 years old who underwent major orthopedic, thoracic, genitourinary, or abdominal surgical procedures. INTERVENTIONS: 60 micrograms/kg of preservative-free morphine sulfate was administered epidurally after induction of anesthesia but before surgery began. The epidural space was accessed caudally, and a total volume of 1 ml/kg to a maximum of 20 ml was injected. No other intraoperative opioids were administered. MEASUREMENTS AND MAIN RESULTS: Forty-seven percent of the patients required no parenteral analgesic for 12 hours after receiving a single dose of epidural morphine, and only 10% required more than 0.1 mg/kg of parenteral morphine during this 12-hour period. For infants younger than 1 year of age, the supplemental intravenous (IV) morphine requirement was almost identical to that of the entire study population. There was no respiratory depression. All patients except those who had thoracotomies were followed on regular pediatric nursing floors. CONCLUSIONS: Single-dose caudal epidural morphine in children is safe and effective when administered intraoperatively prior to surgery as the only opioid and coupled with appropriate monitoring, nursing education, and follow-up by the anesthesiologist. These patients can be followed on regular nursing floors with proper monitoring.
Adolescent↗