Aseptic Meningoencephalitis Complicated by Retrobulbar Neuritis

A 25-year-old man was admitted to our hospital for testing and follow-up of aseptic meningoencephalitis. After admission to our hospital, the patient suddenly complained of visual field disorder and a decrease of visual acuity in the right eye. We diagnosed aseptic meningitis complicated by retrobulbar neuritis using MRI. We immediately initiated weekly steroid pulse therapy, and eventually, marked improvement in visual acuity and the visual field disorder was observed without any late effects

Continuous versus intermittent antibiotics for bronchiectasis

Background Bronchiectasis is a chronic airway disease characterised by a destructive cycle of recurrent airway infection, inflammation and tissue damage. Antibiotics are a main treatment for bronchiectasis. The aim of continuous therapy with prophylactic antibiotics is to suppress bacterial load, but bacteria may become resistant to the antibiotic, leading to a loss of effectiveness. On the other hand, intermittent prophylactic antibiotics, given over a predefined duration and interval, may reduce antibiotic selection pressure and reduce or prevent the development of resistance. This systematic review aimed to evaluate the current evidence for studies comparing continuous versus intermittent administration of antibiotic treatment in bronchiectasis in terms of clinical efficacy, the emergence of resistance and serious adverse events. Objectives To evaluate the effectiveness of continuous versus intermittent antibiotics in the treatment of adults and children with bronchiectasis, using the primary outcomes of exacerbations, antibiotic resistance and serious adverse events. Search methods On 1 August 2017 and 4 May 2018 we searched the Cochrane Airways Review Group Specialised Register (CAGR), CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, and AMED. On 25 September 2017 and 4 May 2018 we also searched www.clinicaltrials.gov, the World Health Organization (WHO) trials portal, conference proceedings and the reference lists of existing systematic reviews. Selection criteria We planned to include randomised controlled trials (RCTs) of adults or children with bronchiectasis that compared continuous versus intermittent administration of long-term prophylactic antibiotics of at least three months' duration. We considered eligible studies reported as full-text articles, as abstracts only and unpublished data. Data collection and analysis Two review authors independently screened the search results and full-text reports. Main results We identified 268 unique records. Of these we retrieved and examined 126 full-text reports, representing 114 studies, but none of these studies met our inclusion criteria. Authors' conclusions No randomised controlled trials have compared the effectiveness and risks of continuous antibiotic therapy versus intermittent antibiotic therapy for bronchiectasis. High-quality clinical trials are needed to establish which of these interventions is more effective for reducing the frequency and duration of exacerbations, antibiotic resistance and the occurrence of serious adverse events. Plain language summary Are antibiotics more effective when given continuously or intermittently to people with bronchiectasis? Background Bronchiectasis is an incurable lung disease characterised by repeated chest infections. Antibiotics are a main form of treatment and can be taken long term to prevent chest infections from developing. This could be continuously or intermittently for a fixed period of time. However, we do not currently know which approach is the most effective for reducing the frequency and duration of exacerbations, managing antibiotic resistance and minimising side effects. Study Characteristics On 1 August 2017 we searched a wide range of sources to find clinical trials for our review. We found 268 potentially relevant results but on closer examination none of the studies met our review criteria and none could be included. Authors' conclusions There is no high-quality evidence about whether continuously administered or intermittently administered antibiotics are safer and more helpful for people with bronchiectasis. More research is needed to evaluate which one of these methods is better for reducing chest infections, limiting resistance to antibiotic therapy and reducing serious side effects

知能検査の基礎的研究(1) : WPPSI知能診断検査と田中・びねー式知能検査の比較

"1.同一の幼児に二種類の,田中びねー式及びWPPSIという現在広く使われている個別知能テストを実施し,その成績を比較すること,そして二種の知能検査そのものの特色を比較することを目的とした.2.田中びねー式とWPPSIとの間にかなりのIQの差がみられたが,特に言語性検査との間に有意差がみられた.WPPSIの言語性と動作性の問にも,IQの有意差がみられた.田中びねー式はWPPSIの言語性との間に高い相関を示し,動作性とは相関関係がみとめられなかった.これらの結果から,一つには田中びねー式とWPPSI言語性検査は,知能の同じような側面を測定しているのに対して,動作性だけは,やや異った側面を測定しているということが考えられる.もう一つには,田中びねー式とWPPSIは,IQの基準となっている母集団に時代的制約からくる差異があるのではないかということが考えられる.3.個々の幼児における二種のテストのIQの差は,前述の一般的傾向からずれている場合も多くみられ,この原因として,検査者の側の問題,幼児の側の問題などが考えられる.4.田中びね一式の各問題の合格率の検討がなされ,このテストの妥当性に対する疑問が示された.