ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb00297.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb00298.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb00299.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb00300.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractVietnamese refugees arriving in Hong Kong since 1982 have been confined to restricted areas. In this study, 241 children in one of these areas were screened to identify their health status. Using NCHS standards, 48% were found to be below the fifth percentile for both weight‐for‐age and height‐for‐age. Anaemia was found in 8% and hepatitis B antigenaemia in 25%. Intestinal parasites were identified in 62% of faecal specimens and 26% of these contained more than one parasite. Although all children had received BCG, 41% had a negative PPD skin test. Chronic bacterial skin infections, lice and otitis media with perforation were identified as other common problems. Screening of this population revealed a high prevalence of health problems, some of which would respond to appropriate public health m

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb00301.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractT lymphocyte subsets in peripheral blood from 16 newly diagnosed type 1 diabetic children were studied prospectively at four time intervals: as soon as possible after diagnosis and 1, 4 and 12 months later. T lymphocyte subsets were analysed using monoclonal antibodies and counted by cytofluorimetry. The percentage of T lymphocytes (OKT3+cells) did not change at the four study times. The percentage of helper/inducer T cells (OKT4+cells) was high at the diagnosis (43.1 ± 2.1%), but decreased after 1 and 4 months with no difference in the control values. The percentage of suppressor/cytotoxic T lymphocytes (OKT8+cells) was low at the diagnosis, but increased after 1 and 4 months. The OKT4/OKT8ratio was 2.31 ± 0.22 at the diagnosis study, decreasing to 1.83 after 1 month, compared with 16 sex‐ and age‐matched control children. The high percentage of helper/inducer T lymphocytes and low number of suppressor/cytotoxic T cells at onset of diabetes favour immune reactions that lead to β‐cel

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb00302.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractSerum IgG, IgA and IgM antibody and salivary IgA antibody concentrations to non‐capsularHaemophilus influenzaeantigens were measured in 13 children withH. influenzaetype b meningitis and in 15 children with epiglottitis. Most had detectable serum IgG and IgM antibody at presentation but significantly fewer patients with meningitis had serum IgA antibody at presentation (P<0.05). Serum antibody concentrations had risen significantly by 3 weeks after presentation in patients with epiglottitis only. Convalescent serum IgG antibody concentrations against these antigens were higher in younger children with epiglottitis.Salivary IgA antibody toH. influenzaewas detectable at presentation in all children with epiglottitis and in 12 of 13 with meningitis. Salivary antibody concentrations did not differ significantly between the two patient groups at presentation, although patients with meningitis had higher salivary IgA antibody concentrations than 10 children of similar age with bronchiolitis (P<0.02). There was no association between the presence of salivary antibody and low concentrations of convalescent serum antibody.The rise in convalescent serum antibody concentrations to non‐capsularH. influenzaeantigens only in children with epiglottitis is similar to findings for antibody to capsular polysaccharide. However, this rise was greater for IgG in younger patients, and the low titre of convalescent serum antibody in patients with meningitis was not associated with higher titres of IgA antibody in secretions as described by others for polysaccharide antibody. These findings suggest that the poor serum antibody response to these antigens in patients with meningitis is independent of age and is not due to mucosal induction of systemic tolera

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb00303.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractThe selenium status of children with phenylketonuria on a synthetic low phenylalanine diet was assessed. Correlation between blood selenium and red cell glutathione peroxidase was unsatisfactory (r= 0.65) due to the poor discrimination of red cell glutathione peroxidase with a low selenium diet. No symptoms of deficiency were observed. Supplementation with 50 μg per week of selenium as brewers yeast tablets over a period of 6 months significantly increased the blood selenium of the phenylketonuric children. Plasma Vitamin E levels were within normal limits. The supplementation effectively doubled their selenium intake to 15–17 μg per day, which is probably sufficient for this group with an adequate Vitamin E status, though considerably lower than the recommended minimum intake of 50 μg per

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb00304.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractAn interview study investigating attitudinal and other factors influencing the selection of primary medical care (PMC) is described. It focuses on parents of sick children, excluding those with trauma or medical/surgical emergencies, and was conducted in part of the Western Region (WR) of Melbourne in late 1983, the period immediately prior to the introduction of Medicare. It is based on a cross‐sectional survey of in‐hours attenders of eight general practices (GP), the Western Region Community Health Centre (WRCHC), the general clinic of the casualty departments at the Western General Hospital (WGH), and the Royal Children's Hospital (RCH), a teaching hospital outside the region.The most commonly stated reasons for attendance at services generally were ‘closeness to home/work’, ‘recommendation’ and ‘good service’. ‘Cheap/economic reasons’ were given less frequently overall than the above reasons. There were however some differences in reasons given by attenders at different places of care. ‘Cheap/economic reasons’ was offered significantly more often and ‘recommendation’ significantly less often by WGH attenders compared with other attenders. ‘Specialists available’ and ‘dissatisfaction with other doctors’ was offered significantly more frequently and ‘close to home’ and ‘no other doctor’ significantly less frequently by RCH attenders than other attenders.Health insurance status did not differ significantly at the different places of care. Attenders of the RCH were significantly more knowledgeable about community health centres than GP or WGH attenders. Non‐GP attenders had more often used other than their current place of care for treatment in the recent past than GP attenders had.It is concluded that non‐economic as well as economic factors are important in the selection of PMC. A pluralist model recognizing the legitimacy of different PMC arrangements including multiple use of services best reflects community usage of PMC services. This is likely to be even more true under Medicare.The further development of specialist paediatric services at the WGH is necessary both for improved local service delivery and ongoing

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb00305.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractTwenty‐two preterm infants with systemic candidiasis are reported, of which seven cases were presumed to be antenatally acquired and 15 postnatally acquired. All except one were of very low birthweight. Fifteen infants had positive cultures of blood, cerebrospinal fluid or urine and seven had candida pneumonia only. Clinical features included general instability, respiratory deterioration and a necrotizing enterocolitis‐like presentation. The incidence of leukocytosis, shift to the left, eosinophilia and thrombocytopenia were not different from those with bacterial infection. The diagnosis was made after death in two infants. In the remaining 20 infants, treatment was initiated between 5 and 97 days of age, with a median delay of 4 days after the first positive cultures were taken. Complications of amphotericin and 5‐flucytosine therapy which developed in five infants resolved on cessation of treatment. The mortality rate was 18% and impairment rate among the 17 very low birthweight survivors was 18%. A high index of suspicion is required for systemic candidiasis, especially in infants of less than 1000 g birthweight. If recognized early, effective and safe antifungal therapy is possible with favourable short‐ and long‐ter

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb00306.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY