ISSN:1040-8703    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This year the Advisory Committee on Immunization Practices of the United States Centers for Disease Control and Prevention has updated recommendations for use of influenza vaccine. Previously, use of influenza vaccine focused primarily on the elderly as well as younger persons with underlying conditions that place them at high risk for severe disease and complications from influenza infection. The new recommendations also emphasize the benefits of influenza vaccination for young, healthy children who are at high risk for hospitalization with influenza infection. These changes are the result of recent reports demonstrating that otherwise healthy young children aged 6 to 24 months are hospitalized for influenza and its complications at rates comparable to those for whom influenza vaccination is already recommended, including the elderly.

ISSN:1040-8703    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

In recent years, seven rapid tests for influenza have become commercially available. These tests offer the promise of making rapid influenza diagnosis much more widely available than in the past, when rapid diagnosis could be made only by fluorescent antibody staining, a demanding technique available only in advanced laboratories. Two of the rapid tests have waived status under the Clinical Laboratory Improvements Amendments of 1988. This article describes each of the seven tests and reviews English-language publications that have evaluated the performance of these tests on specimens from children. A discussion of the implications of the tests for clinical decision-making is included.

ISSN:1040-8703    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Human herpesvirus 8, also known as Kaposi sarcoma-associated herpesvirus, is etiologically associated with Kaposi sarcoma and other rare malignancies. Human herpesvirus 8 infection is common in certain areas of Africa and Italy, but occurs in only 0% to 15% of adult populations in North America and Europe. Reports of human herpesvirus 8 prevalence of 3% to over 50% among children in Central Africa, Brazil, and South Texas suggest that horizontal transmission of human herpesvirus 8 occurs among children. Primary human herpesvirus 8 infection in immunocompetent children is associated with a fever and maculopapular rash.

ISSN:1040-8703    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Sepsis with organ failure (severe sepsis) remains an important cause of morbidity and mortality among children. The clinical pathophysiology of severe sepsis reflects a coordinated activation of the innate immune response, including elaboration of proinflammatory cytokines and the induction of the extrinsic pathway of coagulation (sepsis-induced coagulopathy). These proinflammatory and procoagulant pathways are linked, and are similarly coregulated by a number of proteins and factors, including protein C. However, at least 80% of children and adults with severe sepsis develop acquired deficiency of protein C because of factor consumption. This deficiency is associated with poor outcomes, including multiple organ failure and mortality. Recently, recombinant activated protein C was shown to reduce the mortality of adults with severe sepsis, and is now approved for such use in the United States and Europe. The rationale for pediatric applications of protein C and ongoing clinical trials in children are reviewed.

ISSN:1040-8703    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Candidainfections have become an increasingly frequent problem in neonatal intensive care units, particularly among extremely low birth weight infants. Transmission occurs both vertically and horizontally, withCandida albicansandC. parapsilosisas the predominant species. Multiple risk factors have been identified with prior antibiotic exposure, presence of a central line, endotracheal intubation, and prior fungal colonization reported most frequently. The primary site of infection can involve the bloodstream, meninges, or urinary tract, but disease is frequently disseminated to multiple organ systems. Amphotericin is the most commonly used antifungal agent, although fluconazole is being used more frequently. The potential role of antifungal prophylaxis is not yet clearly defined, but has been the topic of recent investigative efforts. The crude mortality rate among neonates with systemic candidiasis remains approximately 30%.

ISSN:1040-8703    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Stachybotrysis a toxin-producing fungus that grows indoors when both water and cellulose are available. Epidemiologic evidence has demonstrated an association between acute pulmonary hemorrhage in infants and exposure toStachybotrysand other fungi in water-damaged home environments. In recent years, advances in understanding of this association have occurred in six major areas: animal models, biologic mechanism of lung injury, dose-response relationship, isolation from diseased patients, detection methods, and intervention. The association demonstrates strength, consistency, coherence, and specificity. While additional data are gathered, a preventive approach to reducing the exposure of infants with pulmonary hemorrhage is suggested.

ISSN:1040-8703    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This section focuses on issues in infectious disease that are commonly encountered in pediatric office practices. Dr. McCarthy discusses recent literature regarding the evaluation and management of acute fevers without apparent source on clinical examination in infants and children and the evaluation of children with prolonged fevers of unknown origin. Drs. Klig and Chen (pp 121–126) review recent literature about lower respiratory infection in children. This section focuses on febrile children in whom a source of fever is not readily apparent on clinical examination. This issue is discussed in several contexts: recent developments concerning the epidemiology, pathophysiology, diagnostic approach, and therapy of febrile illnesses; children from 3 to 36 months of age with fever; infants younger than 90 days of age with fever; and children of any age with prolonged fever, usually lasting more than 7 to 10 days, for whom a diagnosis has not been established.

ISSN:1040-8703    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Lower respiratory infections (LRIs) continue to threaten the health of children worldwide and are exacerbated by global environmental problems such as air pollution [1]. In the developing world where nutrition remains poor and access to healthcare is scarce, LRIs are the most common cause of illness and death in children. Outcomes of LRI illness are far better in developed countries, but the overall morbidity of LRI is still high and may exceed that of other age groups [2••]. The environmental “health” of our planet remains an issue closely linked to the health of children—particularly in terms of LRI disease. It is also clear that further progress in preventing, diagnosing, and treating LRI disease will have a significant impact on the health of children. The recent literature details both progress and clinical dilemmas of LRI-related illnesses in children. Lower respiratory infection disease is considered to include the following entities: acute lower respiratory infections, pneumonia, atypical pneumonia, bronchitis, and bronchiolitis. This update will review current reports on the evaluation of children with LRIs, bacterial and viral LRIs, and sequelae of LRIs.

ISSN:1040-8703    

出版商:OVID    

年代:2003

数据来源: OVID