Comparison of itraconazole, voriconazole, and posaconazole as oral antifungal prophylaxis in pediatric patients following allogeneic hematopoietic stem cell transplantation.

Oral antifungal prophylaxis with extended-spectra azoles is widely used in pediatric patients after allogeneic hematopoietic stem cell transplantation (HSCT), while controlled studies for oral antifungal prophylaxis after bone marrow transplantation in children are not available. This survey analyzed patients who had received either itraconazole, voriconazole, or posaconazole. We focused on the safety, feasibility, and initial data of efficacy in a cohort of pediatric patients and adolescents after high-dose chemotherapy and HSCT. Fifty consecutive pediatric patients received itraconazole, 50 received voriconazole, and 50 pediatric patients received posaconazole after HSCT as oral antifungal prophylaxis. The observation period lasted from the start of oral prophylactic treatment with itraconazole, voriconazole, or posaconazole until two weeks after terminating the oral antifungal prophylaxis. No incidences of proven or probable invasive mycosis were observed during itraconazole, voriconazole, or posaconazole treatment. A total of five possible invasive fungal infections occurred, two in the itraconazole group (4%) and three in the voriconazole group (6%). The percentage of patients with adverse events potentially related to clinical drugs were 14% in the voriconazole group, 12% in the itraconazole group, and 8% in the posaconazole group. Itraconazole, voriconazole, and posaconazole showed comparable efficacy as antifungal prophylaxis in pediatric patients after allogeneic HSCT.

[Experimental and clinical study of the stability of an osteosynthesis plate for the atrophic mandible]. / Experimentelle und klinische Studie zur Stabilität einer Osteosyntheseplatte für den atrophen Unterkiefer.

BACKGROUND: The high rate of complications led us to develop a new osteosynthesis plate for the treatment of the fractured atrophied mandible. The development of the new so-called pencil-bone plate is based on the 2.0 mini-plate system manufactured by the Medartis Company. MATERIAL AND METHODS: Finite elements (FE) analysis of the new plate as well as flexibility experiments were undertaken, and 14 patients with 16 fractures of the atrophied mandible were treated with the pencil-bone plate between October 2000 and November 2001. RESULTS: The results clearly show that the pencil-bone plate reacted in both the FE model and the static flexibility experiment in a more stable way than a standard 2.0 plate. In 13 patients, healing proceeded without serious complications; all of the patients showed subjective, nearly unchanged chewing, speaking, and swallowing abilities and no complications occurred when wearing dentures. One patient underwent surgical intervention after a new trauma. CONCLUSION: The clinical outcome of the treated fractures confirmed the experimental results, which proved the high stability of the plate in the area of the fracture site. Due to the mini-plate format the intraoral application of the plate is possible without problems. The intraoral access allows rapid operation followed by a minimum of morbidity. A great advantage of the small dimension system is the unrestricted wearing of dentures after the application.

Microspectrometer with slab-waveguide transmission gratings.

An integrated transmission diffraction grating in a planar optical waveguide is presented for broadband spectroscopic analysis of liquids and gases. Silicon oxynitride slab waveguides on silicon substrates with low optical loss in the visible range are combined with a phase transmission grating exhibiting a blaze effect at 500 nm to achieve high-efficiency diffraction and high spectral dispersion. Collimated white light propagates through the waveguide and couples into air at a stepped formed planar grating. The beams of each adjacent step interfere constructively at the focal line of a cylindrical lens, its focal line positioned perpendicular to the waveguide plane. We used a common silicon photodiode array to detect the spectral data. Our approach is to develop a compact and economic spectrometer without moving parts that can be applied for UV-visible analysis and near-infrared industrial process control as well.