Retropharyngeal abscesses in infants

Ravindra, Chetna; Merchant, Rashid; Dalai, Siba Prasad; Parcksh, S.

doi:10.1007/bf02753389

Cited by 5 publications

(2 citation statements)

References 3 publications

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“…3 However, the elderly and newborns can develop retropharyngeal infection. [4][5][6][7][8] Knowledge of the retropharyngeal space and its relationship to the other compartments is important in understanding the presentation, treatment, and complications of deep neck infections. The retropharyngeal space extends from the base of the skull to the mediastinum at the level of the first or second thoracic vertebrae.…”

mentioning

confidence: 99%

Retropharyngeal Abscess in Children: 10-Year Study

Al-Sabah

Salleen²,

Hagr³

et al. 2004

J. Otolaryngol.

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Objective: Retrospective analysis of all patients treated for retropharyngeal infection in a tertiary care pediatric hospital. Methods: Charts were reviewed for demographic data, duration of symptoms, radiologic workup, antibiotic choice, microbiologic findings, surgical approach, complications, and duration of medical therapy. Surgical findings were correlated with computed tomographic (CT) scans. Results: Sixty-eight patients were included in the study. Empirical intravenous clindamycin was started for a trial of conservative medical therapy. Fifty-one patients (75%) responded to medical treatment, and only 17 patients (25%) required surgical intervention. The CT scan showed a sensitivity of 43% and a specificity of 63% in this series. None of the patients with retropharyngeal infection died, had a major complication, or had a recurrence. Conclusion: Based on the current study, we propose that all patients should be given a trial of medical treatment with intravenous clindamycin. Surgery should be reserved for those who do not respond. An extensive review of the literature is presented. Sommaire Objectif: Analyse rétrospective de tous les patients traités pour une infection rétropharyngée dans un hôpital de soins tertiaires pédiatriques. Méthode: Nous avons extrait des dossiers les informations suivantes : démographie, durée des symptômes, investigation radiologique, choix d'antibiotiques, constatations microbiologiques, approche chirurgicale, complications et durée du traitement médical. Les trouvailles chirurgicales ont aussi été corrélées avec la tomodensitométrie. Résultats: Nous avons revu 68 dossiers. La clindamycine a été essayée empiriquement dans tous les cas. Cinquante-et-un patients ont bien répondu à ce traitement et seulement 17 (25%) ont donc eu besoin d'une intervention chirurgicale. La tomodensitométrie a montré une sensibilité de 43% et une spécificité de 63%. Aucun de ces patients n'a présenté de complication significative (aucun n'est décédé) ni n'a présenté de récidive. Conclusion: Suite à ces résultats, nous recommandons un traitement médical de clindamycine intraveineuse pour tous. La chirurgie devrait être réservée pour ceux qui ne répondent pas. Nous présentons aussi une revue de la littérature.

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mentioning

confidence: 99%

Retropharyngeal Abscess in Children: 10-Year Study

Al-Sabah

Salleen²,

Hagr³

et al. 2004

J. Otolaryngol.

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“…Estradiol (compound 2), the major estrogenic hormone of human beings, also causes disturbances ofmitosis in cultured cells (1,4,5). These perturbations include aneuploidy, multinucleation, and mitotic arrest, and estradiol has been reported to inhibit the polymerization of rat brain tubulin (6). Seegers et al (5) found that 2-methoxyestradiol (2ME; compound 3), a metabolite of both estradiol (7) and the oral contraceptive agent 17-ethynylestradiol (compound 4), was more potent than estradiol in producing mitotic perturbations and proposed that it was 2ME rather than estradiol that caused the observed disturbances.…”

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confidence: 99%

2-Methoxyestradiol, an endogenous mammalian metabolite, inhibits tubulin polymerization by interacting at the colchicine site.

D’Amato

Lin

Flynn

et al. 1994

Proc. Natl. Acad. Sci. U.S.A.

382

313

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A metabolite of estradiol, 2-methoxyestradiol (2ME), inhibits angiogenesis In the chicken embryo chorioallantoic membrane assay. Since 2ME causes mitotic perturbalions, we ea ined Its interactions with tubulin. In our standard 1.0 M glutamate system (plus 1.0 mM MgCl2 at 3rC), superstoichiometric concentrations (relative to tubulin) of 2ME inhibited the nucleation and propagation phases of tubulin assembly but did not affect the reaction extent. Although polymer formed In the presence of 2ME was more cold-stable than control polymer, morphology was little changed. Under suboptimal reaction conditions (0.8 M glutamate/no MgCl2 at 26WC), substoichiometric 2ME totally inhibited polymerization. No other estrogenic compound was as effective as 2ME as an inhibitor of polymerization or of the binding of colchicine to tubulin. Inhibition ofcolchicine binding was competitive (KM,22 aM). Thus, a m an metabolite of estradiol binds to the colchicine site of tubulin and, depending on reaction conditions, either inhibits assembly or seems to be incorporated into a polymer with altered stability properties.There is growing evidence that estrogenic compounds affect cell division and act directly on microtubules by interacting with tubulin. The most extensively studied of these compounds is the synthetic analog diethylstilbestrol (DES; Fig. 1, compound 1) and related agents (1-3). These drugs cause disturbances in mitosis, inhibit microtubule assembly at relatively high concentrations, and inhibit the binding of colchicine to tubulin. Estradiol (compound 2), the major estrogenic hormone of human beings, also causes disturbances ofmitosis in cultured cells (1,4,5). These perturbations include aneuploidy, multinucleation, and mitotic arrest, and estradiol has been reported to inhibit the polymerization of rat brain tubulin (6). Seegers et al. (5) found that 2-methoxyestradiol (2ME; compound 3), a metabolite of both estradiol (7) and the oral contraceptive agent 17-ethynylestradiol (compound 4), was more potent than estradiol in producing mitotic perturbations and proposed that it was 2ME rather than estradiol that caused the observed disturbances. Although 2-methoxyestrogens are extremely weak in binding to cytosol estrogen receptors (8), 2ME is found in blood and urine after sequential hepatic hydroxylation and methylation ofestradiol (7).We recently found that 2ME inhibited angiogenesis in the chicken embryo chorioallantoic membrane assay of Crum et al. (9). Disks of2ME (100 Mg) produced large avascular zones 48 hr after implantation on a 6-day embryo, similar to in vitro results of others (10). In attempting to define the mechanistic basis, we observed that 2ME inhibited microtubule assembly. This finding led us to study the interactions of 2ME with purified tubulin.MATERIALS AND METHODS Materials. Purified bovine brain tubulin and H2-CSA4 were prepared as described (11,12). Monosodium glutamate (2.0 M) was adjusted to pH 6.6 with HCl. 2ME, 2-fluoroestradiol, 2-methoxy-17-ethynylestradiol, 2-methoxyestradiol 3-0-meth...

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Bacterial Infections of the Respiratory Tract

Barnett¹,

Klein²

2011

Infectious Diseases of the Fetus and Newborn

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Retropharyngeal abscesses in infants

Cited by 5 publications

References 3 publications

Retropharyngeal Abscess in Children: 10-Year Study

Retropharyngeal Abscess in Children: 10-Year Study

2-Methoxyestradiol, an endogenous mammalian metabolite, inhibits tubulin polymerization by interacting at the colchicine site.

Bacterial Infections of the Respiratory Tract

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