The use of inhaled corticosteroids in wheezy pre-school age children : current practice and literature review

Preschool children and infants frequently suffer wheezy episodes, mostly associated with viral respiratory tract infections. There is no evidence to support the use of maintenance low dose inhaled corticosteroids to prevent or manage episodic mild wheeze caused by such viral infections. However, infants and young children with recurrent episodic wheeze and a positive asthma risk index (i.e. risk factors associated with a predisposition for the future development of asthma) should be considered for a short, three-month trial of an inhaled corticosteroid. Failure to respond to an inhaled corticosteroid should prompt its discontinuation and not an increase in the drug dose. Persistent wheezing should suggest a possibility of an alternate diagnosis and the child should be referred for further investigations. Some recurrently wheezy infants and children simply do not respond to inhaled corticosteroids and most symptoms remit spontaneously after the age of five years, especially among those who do not have an atopic predisposition. The use of large doses of inhaled corticosteroids in young children whose wheezing persists should be discouraged due to the significant risk of long-term effects.peer-reviewe

Acyclovir induced nephropathy : a case report

Acyclovir is frequently used in the management of suspected or proven serious viral infections in children. Despite its good safety profile serious side effects are known to occur. We describe a case of suspected viral encephalitis treated with intravenous acyclovir and complicated by acute, reversible, renal failure. To our knowledge this is the first such report in a Maltese Paediatric patient.peer-reviewe

Current trends in the management of childhood gastroenteritis in the community

Infection of the gastrointestinal tract are still amongst the most common infections of childhood. Despite improvements in the standard of living over the last fifty years, gastroenteritis still constitutes a sizeable amount of general practitioner consultations and hospital admissions, Although most infections’ are mild and self-limiting with the minimum of active treatment, a small proportion require more aggressive management and hospital admission. With the advent of oral rehydration solutions the management of gastroenteritis has become simpler and the complication of hypernatraemic dehydration rare.peer-reviewe

Isoparametric and Dupin Hypersurfaces

A hypersurface $M^{n-1}$ in a real space-form ${\bf R}^n$, $S^n$ or $H^n$ is isoparametric if it has constant principal curvatures. For ${\bf R}^n$ and $H^n$, the classification of isoparametric hypersurfaces is complete and relatively simple, but as Elie Cartan showed in a series of four papers in 1938-1940, the subject is much deeper and more complex for hypersurfaces in the sphere $S^n$. A hypersurface $M^{n-1}$ in a real space-form is proper Dupin if the number $g$ of distinct principal curvatures is constant on $M^{n-1}$, and each principal curvature function is constant along each leaf of its corresponding principal foliation. This is an important generalization of the isoparametric property that has its roots in nineteenth century differential geometry and has been studied effectively in the context of Lie sphere geometry. This paper is a survey of the known results in these fields with emphasis on results that have been obtained in more recent years and discussion of important open problems in the field.Comment: This is a contribution to the Special Issue "Elie Cartan and Differential Geometry", published in SIGMA (Symmetry, Integrability and Geometry: Methods and Applications) at http://www.emis.de/journals/SIGM