Caustic substance injuries.

Caustic and corrosive substance ingestions are a significant cause of early and late morbidity and may cause esophageal carcinoma after a long latent period. Initial management should be directed at the assurance of adequate ventilation and cardiovascular stability as well as the prevention of vomiting. Early esophagoscopy (to the level of first lesion, if present) is useful to identify those patients who do not need hospitalization or treatment. Esophagoscopy and contrast esophagram are useful to define the full extent of esophageal injury, but should be withheld until after the acute phase. Glucocorticoids are probably useful in limiting the extent and severity of esophageal stricture, the most frequent and significant long-term sequela. Colon interposition is used in those situations in which dilation of a stricture has been unsuccessful, and may prevent the subsequent development of esophageal carcinoma.

Relation of concentrations of Haemophilus influenzae type b in cerebrospinal fluid to late sequelae of patients with meningitis.

Forty-four patients with Haemophilus influenzae type b meningitis had follow-up evaluations approximately one year after hospital discharge. Patients with greater than or equal to 10(7) colony-forming units of H. influenzae type b per milliliters CSF had significantly greater frequencies of speech impairment (P less than 0.001), hearing loss (P = 0.04), and moderate or severe neurologic sequelae (P less than 0.01). Patients with greater than or equal to 1 microgram H. influenzae b antigen/ml CSF had a greater incidence of hearing loss (P = 0.03) but not of speech abnormalities (P = 0.06) or other neurologic sequelae (P = 0.64). Glucose concentrations less than 10 mg/dl correlated with the incidence of hearing loss (P = 0.02) and speech impairment (P = 0.02). "Partial" antibiotic therapy, CSF protein concentrations, and number of CSF polymorphonuclear leukocytes did not correlate well with sequelae. These data indicate that pretreatment concentrations of H. influenzae b and glucose concentrations in CSF were the best predictors of late sequelae of patients with H. influenzae b meningitis.

Absorption of lindane (gamma benzene hexachloride) in infants and children.

Concentrations of lindane (gamma benzene hexachloride) were measured in blood from children who had received treatment with 1% lindane lotion. Lindane was present in the blood of all patients from two of 48 hours following application. Concentrations were inversely related to weight, surface area, and were independent of the quantity of lindane applied.

Concentrations of erythromycin in serum and tonsil: comparison of the estolate and ethyl succinate suspensions.

Concentrations of erythromycin were measured in serum and tonsil from children who had received either the estolate or ethyl succinate suspension before surgery. The in vitro assay measured total erythromycin activity against a group A beta hemolytic streptococcus. Levels of erythromycin in serum and tonsil after single and multiple doses of the estolate were significantly higher than those after administration of the ethyl succinate. The therapeutic implications of these findings are unknown.

Erythromycin: a review of its uses in pediatric practice.

Erythromycin continues to be a valuable and useful antimicrobial agent in children. Its low index of toxicity, freedom from sensitization, and reliable absorption and when administered orally contribute to make it an attractive agent in the treatment of a variety of minor respiratory and skin infections, especially in those situations where real or potential allergy to penicillin exists. Additional major uses are in the eradication of the carrier state in whooping cough and in diphtheria, especially in those instances when oral therapy can be tolerated. Dispite use over more than two decades, resistance developing in formerly susceptible organisms has not been a problem and thus seems unlikely to become so in the future.