ISSN:0951-7375    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Major advances in our knowledge of respiratory infections in childhood have been made this year in epidemiology, the microbiology of infecting agents, and in the management of two common infections. Epidemiologic studies have clarified the risk of acquiring a respiratory infection for a child attending a day care center. Young children in day care, particularly those without older siblings, have more respiratory infections in their early years than do children who do not attend day care. Attendance over a number of years reduces the risk. Respiratory infections acquired by children in day care centers tend to run a more prolonged course than infections in other children. Passive inhalation of cigarette smoke from a mother has again been shown to be a risk factor for lower respiratory infection in children. Interesting data from Gambia in West Africa have demonstrated the importance of respiratory syncytial virus as a primary pathogen for lower respiratory infection in younger children and as a pathogen initiating bacterial infection in older children. The measurement of transcutaneous Pco2was found to be helpful in monitoring the progress of acute laryngotracheobronchitis in children. Dilemmas in the management of acute viral bronchiolitis have again been demonstrated in two papers from major centers finding opposite effects for nebulized salbutamol on oxygen saturation in respiratory infections. In one study it improved and in the other it fell. There seems no obvious explanation for the difference in findings. The value of early thoracotomy in reducing the duration of ill health in children with severe empyema was demonstrated in a study from Nashville, Tennessee.

ISSN:0951-7375    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Pneumonia continues to be a common condition affecting the fit and healthy, as well as those with impaired host defenses against infection. We are starting to understand the epidemiology and importance of newly recognized pathogens such asChlamydia pneumoniaeandMoraxella catarrhalis. New rapid methods for making an etiologic diagnosis are beginning to be developed by making use of the recent advances in molecular biology. Despite these advances and the use of potent antimicrobial agents, the best known bacterial pathogen,Streptococcus pneumoniaeremains the commonest cause of morbidity and mortality.

ISSN:0951-7375    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The major developments in the area of infections of the airways include unraveling the complexities of the host response to infection, greater knowledge of host defense-bacterium interactions, and greater realization of the interaction between bacterial and viral agents. The host inflammatory response to infection is the major cause of airways injury, and may come to act against the interests of the host. In chronic infection it is clear that bacterial mechanisms of great subtlety act to neutralize and exploit host defense processes to enhance the maintenance of infection. Greater understanding of such mechanisms may lead to newer approaches of managing and preventing such infections.

ISSN:0951-7375    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Tuberculosis continues to be on the upswing in the United States as well as in the developing world. There have been many recent instances of patients with acquired immunodeficiency syndrome dying from nosocomially acquired, drug-resistant tuberculosis. This transmission occurs because of inadequate isolation precautions, delayed diagnosis of tuberculosis, and ineffective control of environmental factors. In an effort to reduce the transmission risk, the Centers for Disease Control recommended adoption of a series of source-and facility-oriented infection control methods. These methods, and administration of preemptive isoniazid in anergic human immunodeficiency virus-1-infected patients at risk for tuberculosis, may help to prevent overt clinical disease in high prevalence areas. A significant advance has been made in the early diagnosis of tuberculosis. The polymerase chain reaction technique appears to be sensitive, specific, and reliable in detecting mycobacteria directly in clinical specimens. Tuberculosis that occurs in patients with human immunodeficiency virus-1 infection remains responsive to antituberculous drugs even when administered for a duration as short as 6 months. In other patients, short-course chemotherapy continues to be highly effective provided that organisms are susceptible and the patients are compliant. Short-course therapy fails in silicotuberculosis and if the organisms are resistant to two or more drugs included in the regimen.

ISSN:0951-7375    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Respiratory viral infections remain important causes of morbidity and mortality worldwide, and progress in further controlling these infections continues to develop slowly. Recent research documents the impact of these illnesses on young children in developed and developing countries, adults with compromising conditions, and the elderly. Live influenza vaccines that have been developed in recent years are immunogenic in seronegative young children but appear to offer no advantage over inactivated vaccines for adults at high risk for influenza virus infections.

ISSN:0951-7375    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Human immunodeficiency virus infection continues to spread into selected populations at an unprecedented rate. Over 10 million individuals are already infected worldwide, and by the year 2000 as many as 30 million individuals may become infected. As a consequence, acquired immunodeficiency syndrome has become one of the leading causes of mortality in many urban centers worldwide. The predominant mode of transmission continues to be sexual contact, with increasing evidence of heterosexual transmission in the United State, western Europe, Latin America, and the Caribbean. In most cases heterosexual transmission is associated either with intravenous drug use or sexually transmitted diseases. With over 3 million infected women, perinatal transmission to infants has increased dramatically, and up to 5 million acquired immunodeficiency syndrome orphans now exist in Africa alone. In order to control further spread of this disease, educational campaigns encouraging behavioral change are underway. Although these programs have had initial successes, there is now increasing evidence of recidivism in selected high-risk groups, emphasizing the need for repeated intensive counseling in order to sustain behavioral changes.

ISSN:0951-7375    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

An estimated 1 million individuals in the United States are infected with the human immunodeficiency virus. Over 200,000 acquired immunodeficiency syndrome cases have been reported to the Centers for Disease Control as of January 1992. While only 10% of reported cases have been in women, this proportion is steadily growing. Among women with acquired immunodeficiency syndrome, over 80% are of reproductive age. Thus, great concern has been raised over perinatal transmission of human immunodeficiency virus, which is the major cause of pediatric acquired immunodeficiency syndrome.

ISSN:0951-7375    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A fundamental difficulty in understanding the pathogenesis of human immunodeficiency virus (HIV) infection has been the prediction, based on early studies, that very few target cells in infected individuals harbor and express HIV. However, the recent application of more sensitive methods of viral detection indicates that the viral burden and magnitude of expression may be significantly higher than previously believed. The level of HIV replicationin vivoappears to represent a balance between the complex viral mechanisms regulating HIV gene expression and the ability of the host immune system to recognize and eliminate infected cells. The activation and attenuation of HIV production also appears to intimately depend on important cellular factors involved in the normal host response to immunologic or inflammatory stimuli. Emerging data are illuminating a preliminary, but increasingly coherent, framework for understanding the pathogenesis of HIV-associated disease. Improved understanding of the natural history of HIV infection may facilitate the derivation and improved application of therapeutic interventions for treatment of the acquired immunodeficiency syndrome.

ISSN:0951-7375    

出版商:OVID    

年代:1992

数据来源: OVID