@article {3556, title = {Association between orofacial granulomatosis and Crohn{\textquoteright}s disease in children: systematic review.}, journal = {World J Gastroenterol}, volume = {20}, year = {2014}, month = {2014 Jun 21}, pages = {7497-504}, abstract = {

AIM: To review pediatric cases of orofacial granulomatosis (OFG), report disease characteristics, and explore the association between OFG and Crohn{\textquoteright}s disease.

METHODS: We conducted a systematic review according to the PRISMA guidelines. We searched Medline, LILACS, Virtual Health Library, and Web of Knowledge in September 2013 for cases of OFG in the pediatric age range (< 18 years), with no language limitations. All relevant articles were accessed in full text. The manual search included references of retrieved articles. We extracted data on patients{\textquoteright} characteristics, disease characteristics, association with other diseases, and treatment. We analyzed the data and reported the results in tables and text.

RESULTS: We retrieved 173 reports of OFG in children. Mean age at onset was 11.1 {\textpm} 3.8 years (range: 2.0-18 years). Prevalence in males was significant higher than in females (P < 0.001), with a male:female ratio of 2:1. Gastrointestinal signs or symptoms were present in 26.0\% of children at the time of OFG diagnosis. Overall, 70/173 (40.4\%) children received a concomitant diagnosis of Crohn{\textquoteright}s disease. In about half (51.4\%) of the cases the onset of OFG anticipated the diagnosis of Crohn{\textquoteright}s disease, with a mean time between the two diagnoses of 13.1 {\textpm} 11.6 mo (range: 3-36 mo). Overall, 21/173 (12.1\%) of the children with OFG had perianal disease, while 11/173 (6.4\%) had a family history of Crohn{\textquoteright}s disease. Both perianal disease and a family history of Crohn{\textquoteright}s disease were significantly associated with a higher risk of Crohn{\textquoteright}s disease diagnosis in children with OFG [relative risk (RR) = 3.10, 95\% confidence interval (CI): 2.46-3.90; RR = 2.74, 95\%CI: 2.24-3.36, P < 0.0001 for both). Treatment of OFG included steroids (70.8\% of children) and other immunosuppressive drugs (42.7\%), such as azathioprine, thalidomide and infliximab.

CONCLUSION: High prevalence of Crohn{\textquoteright}s disease in children with OFG suggests that OFG may be a subtype of Crohn{\textquoteright}s disease.

}, keywords = {Adolescent, Age of Onset, Child, Child, Preschool, Crohn Disease, Female, Granulomatosis, Orofacial, Humans, Immunosuppressive Agents, Male, Prevalence, Risk Factors, Steroids, Treatment Outcome}, issn = {2219-2840}, doi = {10.3748/wjg.v20.i23.7497}, author = {Lazzerini, Marzia and Bramuzzo, Matteo and Ventura, Alessandro} } @article {1796, title = {Amenorrhea in women treated with thalidomide: report of two cases and literature review.}, journal = {Inflamm Bowel Dis}, volume = {19}, year = {2013}, month = {2013 Jan}, pages = {E10-1}, keywords = {Adolescent, Amenorrhea, Colitis, Ulcerative, Crohn Disease, Female, Humans, Review Literature as Topic, Thalidomide}, issn = {1536-4844}, doi = {10.1002/ibd.22845}, author = {Lazzerini, Marzia and Bramuzzo, Matteo and Martelossi, Stefano and Magazz{\`u}, Giuseppe and Pellegrino, Salvatore and Ventura, Alessandro} } @article {1771, title = {Antibiotics in severely malnourished children: systematic review of efficacy, safety and pharmacokinetics.}, journal = {Bull World Health Organ}, volume = {89}, year = {2011}, month = {2011 Aug 1}, pages = {594-607}, abstract = {

OBJECTIVE: To systemically review the evidence in support of World Health Organization guidelines recommending broad-spectrum antibiotics for children with severe acute malnutrition (SAM).

METHODS: CENTRAL, MEDLINE, EMBASE, LILACS, POPLINE, CAB Abstracts and ongoing trials registers were searched. Experts were contacted. Conference proceedings and reference lists were manually searched. All study types, except single case reports, were included.

FINDINGS: Two randomized controlled trials (RCTs), one before-and-after study and two retrospective reports on clinical efficacy and safety were retrieved, together with 18 pharmacokinetic studies. Trial quality was generally poor and results could not be pooled due to heterogeneity. Oral amoxicillin for 5~days was as effective as intramuscular ceftriaxone for 2~days (1 RCT). For uncomplicated SAM, amoxicillin showed no benefit over placebo (1 retrospective study). The introduction of a standardized regimen using ampicillin and gentamicin significantly reduced mortality in hospitalized children (odds ratio, OR: 4.0; 95\% confidence interval, CI: 1.7-9.8; 1~before-and-after study). Oral chloramphenicol was as effective as trimethoprim-sulfamethoxazole in children with pneumonia (1 RCT). Pharmacokinetic data suggest that normal doses of penicillins, cotrimoxazole and gentamicin are safe in malnourished children, while the dose or frequency of chloramphenicol requires adjustment. Existing evidence is not strong enough to further clarify recommendations for antibiotic treatment in children with SAM.

CONCLUSION: Large RCTs are needed to define optimal antibiotic treatment in children with SAM with and without complications. Further research into gentamicin and chloramphenicol toxicity and into the pharmacokinetics of ceftriaxone and ciprofloxacin is also required.

}, keywords = {Anti-Bacterial Agents, Child, Child Nutrition Disorders, Child, Preschool, Humans, Severity of Illness Index, Treatment Outcome}, issn = {1564-0604}, doi = {10.2471/BLT.10.084715}, author = {Lazzerini, Marzia and Tickell, David} }