Fever in neutropenia in children and adolescents: Evolution over time of main characteristics in a single center, 1993-2001

Goals of work: To assess the evolution over time of main characteristics of episodes of fever in severe chemotherapy-induced neutropenia (FN) in children and adolescents with cancer treated for FN following nonmyeloablative chemotherapy, to compare the results with the experiences of other centers, and to assess the impact of the changes found on management of FN and on risk prediction rules. Patients and methods: Retrospective cohort study of all children and adolescents up to 18 years presenting with FN in a single pediatric oncology unit between 1993 and 2001. Main results: In 132 patients, 364 episodes of FN were reported. The relative incidence of FN increased significantly over time in patients with precursor B-cell acute lymphoblastic leukemia (PBC-ALL), reflecting the increased intensity of chemotherapy. At presentation with FN, the proportions of patients (1) with PBC-ALL versus other malignancies, (2) with other malignancies being in complete remission, (3) with a central venous catheter, and (4) with shaking chills all significantly increased over time (overall proportions, 64%, 60%, 50%, and 5%, respectively; p <0.001 for all). In 337 (93%) episodes, ceftriaxone plus amikacin was used as empirical broad spectrum antimicrobial therapy. Conclusions: This study demonstrates that some characteristics of FN, though not necessarily its management, change over time, implying regular update of risk prediction rules. In contrast to other centers, the first-line antimicrobial therapy did not need modification because of changing resistance pattern

David Gorlaeus (1591-1612)

When David Gorlaeus (1591-1612) passed away at 21 years of age, he left behind two highly innovative manuscripts. Once they were published, his work had a remarkable impact on the evolution of seventeenth-century thought. However, as his identity was unknown, divergent interpretations of their meaning quickly sprang up. Seventeenth-century readers understood him as an anti-Aristotelian thinker and as a precursor of Descartes. Twentieth-century historians depicted him as an atomist, natural scientist and even as a chemist. And yet, when Gorlaeus died, he was a beginning student in theology. His thought must in fact be placed at the intersection between philosophy, the nascent natural sciences, and theology. The aim of this book is to shed light on Gorlaeus’ family circumstances, his education at Franeker and Leiden, and on the virulent Arminian crisis which provided the context within which his work was written. It also attempts to define Gorlaeus’ place in the history of Dutch philosophy and to assess the influence that it exercised in the evolution of philosophy and science, and notably in early Cartesian circles. Christoph Lüthy is professor of the history of philosophy and science at Radboud University Nijmegen, the Netherlands.Toen David Gorlaeus (1591-1612) op 21-jarige leeftijd overleed, liet hij twee baanbrekende manuscripten na. De postuum gepubliceerde werken hadden een grote invloed op het wetenschappelijk denken in de zeventiende eeuw. Doordat Gorlaeus’ identiteit onbekend was, ontstonden al snel zeer uiteenlopende interpretaties van de publicaties. Lezers uit de zeventiende eeuw dachten met een anti-aristotelische denker en een voorloper van Descartes van doen te hebben. Twintigste-eeuwse historici schilderden hem af als een atomist, natuurwetenschapper en zelfs als chemicus. Gorlaeus was echter 'slechts' beginnend theologiestudent en zijn werk bevindt zich op het kruispunt van filosofie, de ontluikende natuurwetenschappen en theologie. Christoph Lüthy beoogt met dit boek inzicht te geven in de familieomstandigheden van Gorlaeus, zijn opleiding aan de universiteit van Franeker en Leiden en de historische context waarin hij zijn werk schreef. Ten slotte probeert Lüthy te bepalen welke plaats Gorlaeus’ werken innemen in de geschiedenis van de Nederlandse filosofie en wat hun invloed was op de ontwikkelingen in filosofie en wetenschap