Treatment safety and efficacy data are mainly derived from adult studies and there is a lack of specific paediatric data. There are small case series selleckchem on the efficacy of adult regimens

in paediatric patients.SummaryInternational multicentre studies are necessary for the evaluation of efficacy and safety of adult-derived treatment regimens in childhood ANCA-associated vasculitides. Specific childhood outcome measurements are recently developed for research purposes and enhance clinical care.”
“Objectives: The aims of this study were to review the clinical characteristics and management of submandibular space infections and to identify the predisposing factors of life-threatening complications.

Design and methods: This was a retrospective study at a tertiary academic center. We retrieved and evaluated the records of all patients admitted to the University of Padua Otolaryngology Clinic at Treviso Regional

Hospital with the diagnosis of submandibular space infection for the period 1998-2006. The following variables were reviewed: demographic data, pathogenesis, clinical AZD7762 cost presentation, associated systemic diseases, bacteriology, imaging studies, medical and surgical treatment, and complications. A multivariate logistic regression analysis was undertaken using a forward stepwise technique.

Results: Muttivariate analysis identified four risk factors for complications. Anterior visceral space involvement (odds ratio (OR) 54.44; 95% confidence interval (CI) 5.80-511.22) and diabetes mellitus (OR 17.46; 95% CI 2.10-145.29) were the most important predictive factors in the

model. Logistic regression analysis also confirmed other comorbidities (OR 11.66; 95% CI 1.35-100.10) and bilateral submandibular swelling (OR 10.67; 95% CI 2.73-41.75) as independent predictors for life-threatening complications.

Conclusions: Airway obstruction and spread of the infection to the mediastinum are the most troublesome Selleck Caspase inhibitor complications of submandibular space infections. Therefore, the maintenance of a secure airway is paramount. Patients with cellulitis and small abscesses can respond to antibiotics alone. Surgical drainage should be performed in patients with larger abscesses, Ludwig’s angina, anterior visceral space involvement, and in those who do not respond to antibiotic treatment. Moreover, the clinical assessment in patients with comorbidities, especially diabetes mellitus, requires a high level of suspicion for potential life-threatening complications. Early surgical drainage should always be considered in these patients, even in seemingly less critical cases. (C) 2008 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.