Lyme Disease in Children.

Lyme disease is now the most frequently reported vector-borne disease in the United States. The highest incidence is in children aged 5 to 9 years with a male predominance. The most common manifestation, erythema migrans, is sometimes not recognized, leading to risk of complications.

Cardiac Manifestations of Lyme Disease.

Lyme carditis is an uncommon manifestation of Lyme disease. Most cases present with heart block of varying degrees, but the spectrum of disease includes other transient arrhythmias and structural manifestations, such as myopericarditis or cardiomyopathy. Antibiotics hasten the resolution of Lyme carditis, and cardiac pacing can be an adjunctive therapy.

Lyme Carditis in Hospitalized Children and Adults, a Case Series.

Background: Lyme carditis is an uncommon manifestation of Lyme disease. This report compares Lyme carditis presentation, management, and outcomes in pediatric and adult populations.

Methods: Charts of pediatric and adult patients with heart block (PR interval >300 ms) and positive Lyme serologies hospitalized in Portland, Maine, between January 2010 and December 2018 were analyzed.

Comparison of Drug Release and Adsorption under Supersaturating Conditions for Ordered Mesoporous Silica with Indomethacin or Indomethacin Methyl Ester.

Incomplete drug release from mesoporous silica systems has been observed in several studies. This work aims to increase the understanding of this phenomenon by investigating the mechanism of drug-silica interactions and adsorption behavior from supersaturated aqueous solutions of two similar drug molecules with different hydrogen bonding capabilities. Drug-silica interactions between indomethacin or its methyl ester and SBA-15 were investigated using spectroscopic techniques (infrared, fluorescence and X-ray photoelectron) and adsorption experiments.

Role of Drug Adsorption onto the Silica Surface in Drug Release from Mesoporous Silica Systems.

Factors contributing to incomplete drug release from a number of mesoporous silica formulations are not well understood. This study aims to address this gap in knowledge by exploring the role of drug adsorption onto silica substrates during the drug release process in dissolution media. Adsorption isotherms were generated to understand drug adsorption behavior onto the silica surface.

In vitro dissolution models for the prediction of in vivo performance of an oral mesoporous silica formulation.

Drug release from mesoporous silica systems has been widely investigated in vitro using USP Type II (paddle) dissolution apparatus. However, it is not clear if the observed enhanced in vitro dissolution can forecast drug bioavailability in vivo. In this study, the ability of different in vitro dissolution models to predict in vivo oral bioavailability in a pig model was examined.

Mesoporous silica formulation strategies for drug dissolution enhancement: a review.

Introduction: Silica materials, in particular mesoporous silicas, have demonstrated excellent properties to enhance the oral bioavailability of poorly water-soluble drugs. Current research in this area is focused on investigating the kinetic profile of drug release from these carriers and manufacturing approaches to scale-up production for commercial manufacture.

Areas Covered: This review provides an overview of different methods utilized to load drugs onto mesoporous silica carriers.

Human parechovirus-3 encephalitis in two neonates: acute and follow-up magnetic resonance imaging and evaluation of central nervous system markers of inflammation.

Background: Human parechovirus-3 has been known to cause neonatal sepsis and encephalitis for nearly a decade. However, information about magnetic resonance imaging and cerebrospinal fluid findings as well as outcomes has been limited.

Patients: Acute presentations and diagnostic testing of two neonates with Human parechovirus-3 encephalitis are described.

Lyme arthritis: a comparison of presentation, synovial fluid analysis, and treatment course in children and adults.

Objective: This case series examines differences in the presentation, management, and outcome of Lyme arthritis between the pediatric and adult population.

Methods: We reviewed charts of pediatric and adult patients evaluated for Lyme arthritis by rheumatologists and pediatric infectious disease specialists in Portland, Maine between January 2002 and July 2008. Patients included for analysis had documented joint swelling and positive Lyme serology.

Neonatal herpes disease following maternal antenatal antiviral suppressive therapy: a multicenter case series.

Objective: The goal was to describe herpes simplex virus (HSV) disease in neonates whose mothers received suppressive acyclovir therapy for HSV infection.

Study Design: A multicenter case series of 8 infants who developed neonatal HSV disease following maternal antiviral suppressive therapy during pregnancy.

Results: Eight infants were identified from New Jersey (5), Maine (1), New York (1), and Texas (1) between 2005 and 2009.

Oral acyclovir suppression and neurodevelopment after neonatal herpes.

Background: Poor neurodevelopmental outcomes and recurrences of cutaneous lesions remain unacceptably frequent among survivors of neonatal herpes simplex virus (HSV) disease.

Methods: We enrolled neonates with HSV disease in two parallel, identical, double-blind, placebo-controlled studies. Neonates with central nervous system (CNS) involvement were enrolled in one study, and neonates with skin, eye, and mouth involvement only were enrolled in the other.

Renal and miliary tuberculosis in an internationally adopted infant.

Renal tuberculosis is rare in children and particularly in infants. We present a case of miliary tuberculosis with focal renal involvement in a 5-month-old male infant recently adopted from Ethiopia, and review the literature on miliary and renal tuberculosis in infants and children. Salient points regarding tuberculosis screening in internationally adopted patients are also addressed.