Infectious complications in children with acute lymphoblastic leukemia treated in low-middle-income countries.

Infections are the most important cause of morbidity and mortality in children treated for acute lymphoblastic leukemia (ALL). The rates of infection-associated mortality are up to 10-times higher in low- and middle-income countries (LMIC) than in high-income countries. The prevention, early recognition and management of infectious complications is especially challenging in LMIC because of disease and poverty-related factors, as well as the shortage of trained personnel, supplies, diagnostic tools and adequate organizational infrastructure.

Vaccine-preventable diseases and their impact on Latin American children.

A joint meeting of the Latin American Society of Pediatric Infectious Diseases, the Dominican Society of Pediatrics and the Dominican Society of Vaccinology was held in the Dominican Republic. This report highlights the most relevant issues that were presented and discussed about vaccine-preventable diseases, their epidemiology and impact in Latin American children, the need to move forward and expand national immunization programs and the economical and political obstacles to introduce 'new' vaccines. These include those against Streptococcus pneumoniae, rotavirus, hepatitis A, varicella, Neisseria meningitidis, Bordetella pertussis, influenza and human papillomavirus, among others.

A double-blind study of the efficacy and safety of multiple daily doses of amikacin versus one daily dose for children with perforated appendicitis in Costa Rica.

Background: There is evidence that aminoglycosides given in a single daily dose (once daily dose, ODD) are as effective and safe as multiple daily doses (MDD). However, the published pharmacokinetic and pharmacodynamic data are overly representative of pediatric populations in Europe and the USA, and not representative of low or middle-income countries such as Costa Rica, in which the patient population might differ from those in higher income settings.

Methods: A double-blind, randomized clinical trial of the efficacy and safety of ODD vs.

Caspofungin therapy of neonates with invasive candidiasis.

Background: Invasive candidiasis is an increasing problem in neonatal intensive care units worldwide and is an important cause of morbidity, mortality and prolongation of hospital stay. Despite administration of amphotericin B, invasive candidiasis in neonates is sometimes complicated by persistent fungemia and refractory invasive candidiasis. The problem has been augmented by the increasing prevalence of non-albicans species that often are resistant to fluconazole and to amphotericin B.

Double blind, randomized, placebo-controlled study of dexamethasone therapy for hematogenous septic arthritis in children.

Background: Septic arthritis is associated with residual dysfunction in 10 to 25% of affected children. Concentrations of cytokines detected in synovial fluid of children with bacterial arthritis correlate with the severity of inflammation. Treatment with dexamethasone decreased cartilage degradation in experimental Haemophilus influenzae b and Staphylococcus aureus arthritis.