No abstract

The absence of a pupillary light reflex and the lack of any clinical response to visual stimulation are generally considered reliable signs of poor visual function in patients with abnormal mental status. Two case reports are presented, one with no pupillary light reflex and no response to visual stimuli; and another with no clinical response to visual stimulation. After several months with no signs of vision, both patients regained significant visual function. It is important to recognize that all signs of visual function can be absent despite the potential for good vision. This should be considered before concluding that visual loss will be permanent.

Gatifloxacin is a new fluoroquinolone with different properties, such as excellent activity against otitis media pathogens, less potential for selection of antimicrobial resistance, good middle ear penetration and a prolonged half life. Fluoroquinolone use in children has been limited owing to some concerns of arthrotoxicity based on observations made on juvenile animals. Nevertheless, multiple studies have been published showing that this observation, found only in certain animals, does not necessarily correlate to findings in humans. Results from four clinical (two Phase II and two Phase III) studies involving 1176 children have been published to evaluate the safety and efficacy of gatifloxacin (10 mg/kg once daily for 10 days) in children with complicated to treat otitis media. Three studies included a baseline tympanocentesis and one study included a mandatory, during therapy, tympanocentesis in those children with a positive baseline culture. In the double tympanocentesis study, the bacterial eradication rate was 90% (103/114). Among all clinically evaluated children treated with gatifloxacin, 90% (605/682) were considered to be a clinical success at the end of therapy and 90% by the end of the study. The overall incidence of gatifloxacin-related adverse events observed in the Phase III trials was 2% for both gatifloxacin and the comparator agent, amoxicillin-clavulanate. Among 453 gatifloxacin recipients, the incidence of adverse events was similar for children younger than 2 years old (16%) and older than 2 years (23%). Transitory arthralgia occurred in 1.4% (12/867) of gatifloxacin-treated children. At 1-year safety follow-up, data was collected among 77% of gatifloxacin-treated children and no evidence of arthropathy was reported.

No abstract

Data from Latin America describing the potential differences among children with unilateral or bilateral otitis media are scarce and needed in order to implement appropriate prevention actions and specific antimicrobial recommendations. The present study analyzed the demographic and microbiologic characteristics of 1,427 Costa Rican children with unilateral and bilateral otitis media in whom a tympanocentesis was performed between 1992 and 2006 (median age: 23 months; range two to 150 months). There were no significant differences in the demographics, microbiology and antimicrobial susceptibility among middle ear fluid isolates obtained from both populations. The only significant finding was observed in children with Moraxella catarrhalis otitis media that was observed more frequently than other bacterial pathogen in the middle ear fluid of children with unilateral acute otitis media that were < 24 months of age and during the rainy season.