Fluticasone in mild to moderate atopic dermatitis relapse: A randomized controlled trial.

BACKGROUND: The long-term efficacy of corticosteroids to prevent atopic dermatitis (AD) relapses has partially been addressed in children. This study compared an intermittent dosing regimen of fluticasone propionate (FP) cream 0.05% with its vehicle base in reducing the risk of relapse in children with stabilized AD. METHODS: A randomized controlled, multicentric, double-blind trial was conducted. Children (2-10 years) with mild/moderate AD (exclusion criteria: >30% affected body surface area and/or head) were enrolled into an Open-label Stabilization Phase (OSP) of up to 2 weeks on twice daily FP. Those who achieved treatment success entered the Double-blind Maintenance Phase (DMP). They were randomly allocated to receive FP or vehicle twice-weekly on consecutive days for 16 weeks. The primary study endpoint was relapse rate; time to relapse and severity of disease were also studied. Kaplan-Meier estimates were calculated. RESULTS: Fifty-four patients (29 girls) entered the OSP (23 mild AD) and 49 (26 girls) continued into the DMP. Mean age was 5.5 (SD: 2.8) and 5.1 (SD: 2.3) yrs for FP and vehicle groups, respectively. Four patients withdrew from the DMP (two in every group). Patients treated with FP twice weekly had a 2.7 fold lower risk of experiencing a relapse than patients treated with vehicle (relative risk 2.72, SD: 1.28; p=0.034). FP was also superior to vehicle for delaying time to relapse. Both treatment therapies were well tolerated. CONCLUSION: This long-term study shows that twice weekly FP provides an effective maintenance treatment to control the risk of relapse in children with AD.

[Perinatal cytomegalovirus infection in preterm infants]. / Infección perinatal por citomegalovirus en recién nacidos pretérmino.

OBJECTIVE: To study the incidence of perinatal cytomegalovirus infection in neonates admitted to our hospital in the last three years, as well as the mode of transmission, serologic and microbiologic data, and the clinical outcome of these infants. METHODS: We performed a retrospective study by reviewing the medical records of neonates with a diagnosis of cytomegalovirus infection. RESULTS: Twenty-four neonates received this diagnosis. Of these, 21 (85 %) were premature infants with a birthweight of less than 1500 gr, representing 6 % of all neonates with this birthweight hospitalized during the study period. The percentage of transfusion and breastfeeding was high (87 % and 91 %, respectively) and consequently the route of transmission could not be identified. Nine neonates (34 %) presented associated hepatic dysfunction and three (12 %) developed severe disease requiring antiviral treatment. CONCLUSIONS: Perinatal cytomegalovirus infection is frequent in preterm infants and may be serious. It is important to detect cytomegalovirus infections and to develop preventive methods.