Edelstein K, Cirino PT, Hasher L, Fletcher JM, Dennis M. (2012) Sleep problems, chronotype, and diurnal preferences in children and adults with spina bifida. J Biol Rhythms. 2012 Apr;27(2):172-5.
Spina bifida meningomyelocele (SBM) is a neural tube defect that involves dysraphism of the spinal
cord and extensive reorganization of the brain. The authors assessed
the relationship between chronotype, diurnal preferences, and sleep
problems in individuals with SBM and healthy controls. Although
individuals with SBM showed the characteristic decelerating quadratic
relationship between age and chronotype, the curve was displaced,
peaking at a younger age in controls compared with SBM (23.4 vs. 29.2
years). Groups did not differ in morningness-eveningness preferences.
Individuals with SBM endorsed more sleep problems than controls. Further
examination of the relationship between entrainment and sleep in SBM is
warranted.
doi: 10.1177/0748730411435209
Tuesday, April 10, 2012
Use of intravesicular amikacin irrigations for the treatment and prophylaxis of urinary tract infections in a patient with spina bifida and neurogenic bladder: a case report
Huynh D, Morgan JA. (2011) Use of intravesicular amikacin irrigations for the treatment and prophylaxis of urinary tract infections in a patient with spina bifida and neurogenic bladder: a case report. J Pediatr Pharmacol Ther. 2011 Apr;16(2):102-7.
This case report describes the use of intravesicular amikacin irrigations to treat and prevent urinary tract infections (UTIs) in a pediatric patient with spina bifida and neurogenic bladder. A 15 year old Hispanic female was admitted for a UTI caused by Enterobacter cloacae and multiple-drug resistant Pseudomonas aeruginosa. A 7 day course of daily intravenous amikacin and ceftazidime was initiated along with twice daily intravesicular amikacin irrigations (15 mg/30 mL) with a dwell time of 2 hours. The patient improved and was discharged on prophylactic Bactrim SS (sulfamethoxazole/trimethoprim) 1 tablet daily and intravesicular amikacin irrigations (15 mg/30 mL) once every other day. Approximately 2 months after discharge, the patient developed another UTI from multidrug resistant Escherichia coli and was treated with a 14 day course of daily intravenous ciprofloxacin accompanied by daily intravesicular amikacin irrigations. Adjunctive therapy with either once daily or twice daily intravesicular amikacin irrigations successfully treated the patient's UTI. However, prophylactic treatment with intravesicular amikacin failed to prevent future UTIs in this patient.
This case report describes the use of intravesicular amikacin irrigations to treat and prevent urinary tract infections (UTIs) in a pediatric patient with spina bifida and neurogenic bladder. A 15 year old Hispanic female was admitted for a UTI caused by Enterobacter cloacae and multiple-drug resistant Pseudomonas aeruginosa. A 7 day course of daily intravenous amikacin and ceftazidime was initiated along with twice daily intravesicular amikacin irrigations (15 mg/30 mL) with a dwell time of 2 hours. The patient improved and was discharged on prophylactic Bactrim SS (sulfamethoxazole/trimethoprim) 1 tablet daily and intravesicular amikacin irrigations (15 mg/30 mL) once every other day. Approximately 2 months after discharge, the patient developed another UTI from multidrug resistant Escherichia coli and was treated with a 14 day course of daily intravenous ciprofloxacin accompanied by daily intravesicular amikacin irrigations. Adjunctive therapy with either once daily or twice daily intravesicular amikacin irrigations successfully treated the patient's UTI. However, prophylactic treatment with intravesicular amikacin failed to prevent future UTIs in this patient.
- PMID: 22477833 [PubMed - in process] PMCID: PMC3208437
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