Randomised trial of oral versus sequential intravenous/oral cephalosporins in children with pyelonephritis

The hypothesis was tested that oral antibiotic treatment in children with acute pyelonephritis and scintigraphy-documented lesions is equally as efficacious as sequential intravenous/oral therapy with respect to the incidence of renal scarring. A randomised multi-centre trial was conducted in 365 children aged 6 months to 16years with bacterial growth in cultures from urine collected by catheter. The children were assigned to receive either oral ceftibuten (9mg/kg once daily) for 14days or intravenous ceftriaxone (50mg/kg once daily) for 3days followed by oral ceftibuten for 11days. Only patients with lesions detected on acute-phase dimercaptosuccinic acid (DMSA) scintigraphy underwent follow-up scintigraphy. Efficacy was evaluated by the rate of renal scarring after 6 months on follow-up scintigraphy. Of 219 children with lesions on acute-phase scintigraphy, 152 completed the study; 80 (72 females, median age 2.2 years) were given ceftibuten and 72 (62 females, median age 1.6years) were given ceftriaxone/ceftibuten. Patients in the intravenous/oral group had significantly higher C-reactive protein (CRP) concentrations at baseline and larger lesion(s) on acute-phase scintigraphy. Follow-up scintigraphy showed renal scarring in 21/80 children treated with ceftibuten and 33/72 with ceftriaxone/ceftibuten (p = 0.01). However, after adjustment for the confounding variables (CRP and size of acute-phase lesion), no significant difference was observed for renal scarring between the two groups (p = 0.2). Renal scarring correlated with the extent of the acute-phase lesion (r = 0.60, p < 0.0001) and the grade of vesico-ureteric reflux (r = 0.31, p = 0.03), and was more frequent in refluxing renal units (p = 0.04). The majority of patients, i.e. 44 in the oral group and 47 in the intravenous/oral group, were managed as out-patients. Side effects were not observed. From this study, we can conclude that once-daily oral ceftibuten for 14days yielded comparable results to sequential ceftriaxone/ceftibuten treatment in children aged 6months to 16years with DMSA-documented acute pyelonephritis and it allowed out-patient management in the majority of these childre

Philosophy from the outside in: Rosenzweig’s critical project

This paper examines Rosenzweig’s philosophic project in the context of his time as a critical intervention in the discussion of the place of Jewish thought in the university and in society. If Hermann Cohen represented the first generation of Jewish philosophers claiming that participation in the university is constitutive for the institution’s claim to universalism, the second generation-represented by Martin Buber - was more diffident about the university and its openness. For Buber, literary modernism offered what the university would refuse. Disappointed about the failure of the recognition of the efforts of the previous two generations, Rosenzweig represents the third generation. He turns the situation into a creative response anchoring philosophy as a project that calls for a resolute move outside the university

Aspects de la réception de Spinoza chez Moses Mendelssohn et Salomon Maimon

Au regard de la réception de Spinoza, on peut considérer certains aspects centraux de la pensée critique chez Mendelssohn et Maimon comme des moments d’une constellation de projets, certes distincts, mais en définitive reliés l’un à l’autre. L’impulsion théorique précise de leurs approches respectives peut ainsi être replacée dans sa signification philosophique plus large dès lors qu’on considère ces différents desseins philosophiques comme autant d’articulations d’un programme commun : faire de la différence et de l’altérité juive un problème d’ordre philosophique plutôt qu’existentiel. Les pensées de Spinoza, Mendelssohn et Maimon résistent ainsi aux récits paradigmatiques habituels qui caractérisent la plupart des histoires de la philosophie. La doctrine critique que ces trois auteurs ont en commun rend en effet problématique toute tentative d’assimiler et de faire rentrer leurs œuvres dans les schèmes dominants de ces histoires. En reconsidérant la généalogie de la réception de Spinoza et en analysant la façon d’aborder des questions qui, sinon, demeureraient occultées, voire totalement exclues, le souci d’élaborer une philosophie critique est ainsi mis en évidence avec, pour principal support, la question de la tâche, de la fonction et de la nature de la philosophie en tant que telle. Il en ressort qu’une analyse plus serrée de la réception de Spinoza, est donc non seulement nécessaire pour une compréhension critique de Mendelssohn et de Maimon, mais ménage une position avantageuse pour poser des questions philosophiques plus vastes.Mit Blick auf Spinoza werden zentrale Motive kritischen Denkens bei Mendelssohn und Maimon erkenn- und lesbar als Momente einer Konstellation hintergründig miteinander verbundener Projekte. Der genauere theoretische Impuls dieser Ansätze wird dadurch in seiner philosophischen Relevanz deutlich, dass diese nicht als isolierte Positionen betrachtet werden, sondern als Artikulationen des gemeinsamen Anliegens jüdischer Philosophen, jüdische Differenz und Alterität als philosophisches Problem vorstellig zu machen. Anstatt die philosophischen Ansätze Spinozas, Mendelssohns und Maimons gemäß der landläufigen Paradigmen philosophiehistorischer Geschichtsschreibung einzuordnen und zu interpretieren, ist vielmehr die kritische Signifikanz dieser Philosophen in ihrer Eigenständigkeit zu begreifen, die solche Versuche der Zu- und Einordnung gerade als philosophisch suspekt erweist. Indem das Denken dieser jüdischen Philosophen daraufhin betrachtet wird, wie sie Fragestellungen in die Philosophie einbringen, welche vom dominanten Philosophiediskurs marginalisiert, wenn nicht gänzlich ausgeschlossen werden, kommt ein Anliegen kritischen philosophischen Denkens in den Blick, das sich für die Frage von Aufgabe, Funktion und Wesen von Philosophie als von grundlegender Bedeutung erweist. So zeigt sich die Spinoza-Rezeption nicht nur als für das kritische Verständnis von Mendelssohn und Maimon unabdingbar, sondern erschließt auch ihre genauere philosophiekritische Bedeutung.Attention to the trajectory of Spinoza reception permits central aspects of critical thought in Mendelssohn and Maimon to be read as moments within a constellation of different but ultimately interconnected projects. The precise theoretical impetus of their approaches can thus be recognized in its larger philosophical significance, while the respective philosophical projects come into view as articulations of a shared objective: to address Jewish difference and alterity as a philosophical problem rather than one of particular forms of existence. Spinoza s, Mendelssohn s, and Maimon s thought resist reduction to the common narrative paradigms that define most accounts of the history of philosophy. The critical tenet these philosophers share renders problematic such popular attempts at assimilation and integration into dominant schemes of histories of philosophy. Examination of this line of Spinoza reception in terms of how its participants managed to address issues which remained otherwise marginalized, if not altogether excluded, brings to the fore the concern for a philosophical critique with its principal bearing on the question of the task, function, and nature of philosophy as such. A closer examination of Spinoza reception, it turns out, is thus not only necessary for a critical understanding of Mendelssohn and Maimon, it provides a critical vantage point for the larger questions of philosophy

The Hyphen in the Theological-Political: Spinoza to Mendelssohn, Heine, and Derrida

Spinoza&rsquo;s Theological-Political Treatise introduced the unique catchphrase of the theological-political. While commanding popular currency, the full implications of the phrase is rarely considered in terms of modern Jewish thought. This paper examines how paying close attention to the hyphen helps us better understand the critical role of the hyphen in Spinoza and its significance for Mendelssohn, Heine, and Derrida&rsquo;s critical agenda of rethinking the theological-political

THE MESSIANIC: JEWISH TRADITION AND PHILOSOPHY

The working group Bamidbar holds an annual workshop on themes and issues in current critical theory and philosophy. Founded by the editors of the journal Bamidbar: Journal for Jewish Thought and Philosophy, the workshop is designed as open forum for critical learning and discussion of themes and issues at the interface of Jewish tradition and current philosophy. This year’s subject is the question of the many meanings of the Messianic, their diverse forms of articulations and appropriations and their role for philosophy in rethinking the Messianic