摘要:

Acute respiratory infections are primary causes of morbidity and mortality in children in developing countries. This project was designed to investigatc antimicrobial susceptibility of respiratory tract pathogens isolated from children in rural and city areas, and to contribute to the rational choice of antibiotics for respiratory tract infections in children in Ethiopia. Nasopharynx and throat cultures were taken from all children under five years of age in three study areas representing different levels of contact with health care and accessibility to modern drugs, such as antibiotics. In all, 1126 children were cultured.Huemophilus influenceandStreptococcus pneumonicie were both found in 85–90% of the children, and beta‐haemolytic streptococci group A in 12%. The level of antimicrobial resistance was low. None of the 954 strains ofH. irfluencewere beta‐lactamase producers. Pneumococci were susceptible to penicillin. The use of antibiotics was also low; 11 of 1126 children had antibiotics on the day of culture or the day before. The choice of antibiotics was not limited by resistance, and emphasis could be put on low cost, minimizing adverse drug reactions and ecological i

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12576.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The release of agents mediating inflammation in meningitis may bring about neuronal hypoxia, under which circumstances ATP concentrations decrease and its degradation products increase and are released into the cerebrospinal fluid. In this study of alterations in neuronal energy metabolism in meningitis, AMP, IMP, inosine, adenosine, guanosine, adenine, guanine, hypoxanthine, xanthine and urate were determined by high performance liquid chromatography in the cerebrospinal fluid of 54 children aged between 1 month and 13 years suffering from meningitis (25 viral, 24 bacterial and 5 tuberculous cases) and 63 controls. Compared to the controls, patients with viral meningitis exhibited high concentrations of IMP, adenosine, guanosine, adenine, guanine and xanthine; patients with bacterial meningitis exhibited high concentrations of IMP, inosine, guanosine, adenosine, hypoxanthine, xanthine and urate; and patients with tuberculous meningitis exhibited high concentrations of AMP, guanosine, xanthine and uratc. Viral and bacterial cases did not differ significantly for any of the metabolites studied. AMP and urate concentrations were significantly higher in patients with tuberculous cases compared with viral or bacterial meningitis cases.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12577.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Five children (four boys, one girl) with Noonan's syndrome were treated with growth hormone for a mean of 2.9 (range 1.8 to 4.6) years. Treatment was commenced at a mean age of 3.9 (range 2.5 to 6.0) years. After one year of treatment, height velocity SDS increased from a mean of ‐2.1 (range ‐4.1 to ‐ 0.3) to a mean of +3.1 (range +2.0 to +3.5). Subsequently, height SDS increased significantly from ‐3.3(range ‐4.2 to ‐2.2)to ‐2.4(range ‐3.3 to ‐ 1.6). Although in all patients a marked decrease in height velocity was observed in the following years of treatment, compared to the first year, height SDS continued to improve in comparison to pretreatment (mean height SDS in the third year for four patients was ‐2.1) (range ‐3.1 to ‐ 1.4). In the four patients who had completed their second year of treatment, height SDS for bone age had increased from ‐1.8 (range ‐ 2.8 to ‐ 09)

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12578.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12579.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Slightly elevated urinary albumin excretion rate (microalbuminuria) is a marker of early diabetic nephropathy, but it is unclear if the established definition of microalbuminuria (20–200 μg/min) is correct for children and adolescents. We investigated the albumin excretion rate, albumin/creatinine ratio and urinary albumin concentration in 150 healthy schoolchildren and adolescents to (a) obtain a reference value for albumin excretion rate, (b) relate albumin excretion to pubertal stages and (c) evaluate albumin/creatinine ratio and morning albumin concentration as screening methods for elevatcd albumin excretion rate. Albumin concentration was measured by immunoturbidimetry in timed overnight urine samples. The albumin excretion showed a skewed distribution (geometric mean 3.2 μg/min, 95 percentile 15.1 μg/min). In girls, a peak in the albumin excretion rate was found at the pubertal stage 4 (Tanner) and in boys at stage 5. Albumin/creatinine ratio of 2.5 mg/mmol as a scrccning level for elevatcd albumin cxcrction (15 μg/min) showed a high positivc (0.88) and negative (0.99) predictive

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12580.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Six 3 to 14‐year‐old boys with snoring and obstructive sleep apnea syndrome were monitored polygraphically during sleep with and without nasal continuous positive airway pressure with simultaneous recording of esophageal pressure (Pes) and M‐mode and two‐dimensional echocardio‐grams. Continuous non‐invasive blood pressure monitoring was performed in two older children. Three of the six children demonstrated a diastolic leftward shift of the interventricular septum related to the negativity of Pes. Progressively more negative Pescorrelated significantly with an increase in right ventricular internal end‐diastolic dimension and a decrease in left ventricular internal end‐diastolic dimension, with at times left ventricular “collapse”. One of the subjects with blood pressure monitoring demonstrated pulsus paradoxus with leftward shift of the interventricular septum. Nasal continuous positive airway pressure normalized all changes. Pulsus paradoxus and leftward shift of the interventricular septum are related to the mechanical changes associated with heavy snoring during sleep, regardless of the amount of

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12581.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12582.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Families which had experienced two or more unexpected infant deaths were the subject of detailed confidential enquiries, including necropsy examination. Cases were derived from two main sources: first, deaths occurring during a nationwide programme of support for families with a subsequent baby (8 families) plus 2 families from a scries of confidential enquiries in Sheffield, and second, direct referrals from paediatricians (17 families). Fifty‐seven deaths were studied. Twenty‐four families had experienced 2 and three had experienced 3 deaths: 11 deaths (19%) were found to be adequately explained by history or post‐mortem findings; 7 (12%) were probably accidental; 31 (55%) were most probably due to an action by one of the parents (filicide); only 5 (9%) were considered to be true or idiopathic sudden infant death syndrome; in 3 (5%) cases there was insufficient information to draw a conclusion. Five (18%) of the families lived in circumstances of serious social deprivation. A history of psychiatric illness was present in one or both parents in 18 (67%) of the fam

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12583.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

We report the details of an accidental overdosage of haloperidol in 24 children in one hospital in Kyushu, Japan. Evidence of acute toxicity included disturbances in consciousness (24/24), tremors in the extremities (16/24), an oculogyric or similar crisis (14/24), dysarthria (9/17), drooling (8/24), akathisia (6/20), hyperreflexia (6/24) and opisthotonos (3/24). Laboratory examinations revealed late‐onset transient thrombocytosis (5/24), elevated AST and GPT (1/24) and abnormal ECG with prolonged QT interval in 2 of 8 children. We detected haloperidol in 11 of 18 children whose blood was specifically examined within four days after the final haloperidol administration. The maximum serum haloperidol level was 28.9 ng/ml. The mean half‐life of haloperidol in the serum of five children (age range 2–10 years) was 18.6 ± 12.2 h (mean ± SD) (range 9.1

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12584.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12585.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY