Although therapeutic first-line approaches have been established in severely immunosuppressed patients with a high risk of invasive fungal infections, treatment modalities for cases with unsatisfactory outcome have not been well defined, especially for the pediatric age gap. Therapy with coadministration of two or three antifungals has been applied by clinicians in difficult-to-treat infections, which still have no support from randomized, controlled clinical trials. The most prevailing reason for a combination regimen is to broaden the antimycotic spectrum, which may even result in antagonistic interaction. The experience and recommendations of combinational antifungal therapy for cryptococcal infections, systemic candidiasis, invasive aspergillosis and other rare mold infections have been presented in this review, giving some information on mechanism of action and principles in combined use of mycotic anti-infectives. Most experience of combination therapy approaches are in adult patients; but in fact, there is no conclusive data documenting definite benefits of this approach, either in adults or children.
Objective: Asthma is the most common chronic disease of childhood, and magnesium is one of the most frequently found minerals in human body and it is used in the treatment of asthma. Although there are studies on magnesium levels in adult patients with asthma, there is yet no data on the levels of magnesium in children. The present study compared the levels of serum magnesium between the children with asthma and healthy children.
Methods:Children aged between 5 and 17 years with mild-moderate persistent asthma, who were admitted to our hospital between January 2009 and August 2010, were included in the study. Serum magnesium levels were measured in 50 patients with acute asthma attack, in 50 patients receiving treatment for stable asthma, and in 50 children admitted to the hospital for any reason and matched with asthma patients except for the diagnosis of asthma. The test was performed by photometric method using Roche-Hitachi Modular P biochemistry analyzer. The normal range of serum Mg was considered to be 1.59-to-2.10 mg/dL and p<0.05 was considered statistically significant.
Results:All three groups were similar in terms of mean age and gender distribution. Although mean serum magnesium levels were within the normal range in healthy children and in children treated for stable asthma (1.89±0.32 and 1.93±0.34 mg/dL respectively), it was 1.62±0.26 mg/dL in children having an asthma attack, which was within the normal range but close to the lower limit (p<0.001).
Conclusion:Although its efficacy has not been definitely proven, magnesium is used either via intravenous route or as inhaler in acute asthma attack. Knowledge about the changes in body magnesium levels of asthma patients would be a guide for revealing the role of magnesium in the treatment of asthma. As was shown in the present study, magnesium levels tend to decrease in the body during acute attack.
Kızamık sıklıkla çocukluk döneminin bulaşıcı, yaygın bir hastalığıdır. Ciddi sayılabilecek komplikasyonlara yol açabilir. Bunların en önemlisi hastalıktan yıllar sonra ortaya çıkan, dönüşümsüz beyin hasarı yapan panensefalit tablosudur. Etkili bir tedavisi bulunmadığından hastalığın önlenmesinde aşılama önemlidir. Dünya genelinde olduğu gibi Türkiye'de de kızamık eliminasyonu için büyük çaba gösterilmektedir.
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