ISSN:0891-3668    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

To ensure compliance and to reduce costs it is important, especially in less developed countries, that programs of child immunization should require as few clinic attendances and as few injections as possible. Therefore we have investigated whether aHaemophilus influenzaetype b conjugate vaccine could be given safely and effectively with diphtheria-tetanus-pertussis vaccine (DTP). One hundred twenty-six Gambian infants were given both polyribosylribitol phosphate (PRP)-outer membrane protein complex (PedvaxHIB®) and DTP on the same day at 8, 12 and 16 weeks of age; 60 were given the vaccines mixed in the syringe and 66 were given the vaccines separately. To minimize the injection volume the dose of PRP-OMPC used in both groups was 7.5 μg, which is half the usual dose. There were no significant differences in anti-PRP antibody titers between the groups after 1, 2 or 3 doses. The geometric mean titers of antibody for the two groups combined were 0.29 μg/ml 1 month after the first dose, 1.03 μg/ml after the second dose and 1.11 μg/ml after the third dose. Concentrations of antibodies to diphtheria, tetanus and pertussis 1 month after the third dose were not significantly different between the two groups. Systemic side effects were reported with equal frequency in the two groups and were similar to those reported elsewhere for DTP. Tenderness at the injection site was more common where the combined injection (0.75 ml) had been given than where DTP alone (0.5 ml) had been given. The main drawback to the use of these 2 vaccines together is the complexity of the mixing procedure used in this clinical trial.

ISSN:0891-3668    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The safety and immunogenicity of a vaccine againstHaemophilus influenzaetype b consisting of purified polyribosylribitol phosphate conjugated to tetanus toxoid (PRP-T) were evaluated in 277 Chilean infants who were randomly assigned to one of three treatment groups: Group A, PRP-T mixed with diphtheria-tetanus-pertussis (DTP) vaccine in a single syringe and given as a single inoculation in one arm and placebo in the other arm; Group B, PRP-T given in one arm and DTP in the other arm; Group C, DTP given in one arm and placebo in the other. Infants were immunized at 2, 4 and 6 months of age and examined daily for 4 days after each immunization. Serum PRP antibodies; tetanus, diphtheria and pertussis antitoxin; pertussis agglutinins; and antibodies toBordetella pertussisfilamentous hemagglutinin were measured at baseline and 2 months after each dose. PRP-T was well-tolerated. After three doses of PRP-T vaccine 100% of infants attained PRP antibody concentrations ≥ 0.15 μg/ml and 96 to 99% achieved high anti-PRP concentrations (≥ 1.0 μg/ml). The post-third dose anti-PRP geometric mean titer was high (6.94 μg/ml) in infants who were given PRP-T combined with DTP, although it was somewhat lower than the geometric mean titer of the group who received PRP-T in a separate arm (9.93 μg/ml) (Pnot significant). No differences were detected among the groups in tetanus antitoxin response, whereas after two or three doses the geometric mean titer of diphtheria antitoxin was significantly higher in the group who received PRP-T combined with DTP than in the group who received PRP-T as a separate inoculation (P< 0.016). Pertussis agglutinin, antitoxin and anti-filamentous hemagglutinin responses did not differ among the groups. These results encourage coadministration of PRP-T and DTP in a single inoculation, in view of the practical advantages of such combined immunization.

ISSN:0891-3668    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Dapsone (4, 4'-diaminodiphenylsulfone) is recommended as an alternative agent for prophylaxis againstPneumocystis cariniiin children with human immunodeficiency virus infection. We reviewed our experience over the past 100 months with 20 children (age range, 2 months to 13 years) who received dapsone and examined the safety and efficacy of this regimen. Dapsone was taken for an average of 7.33 months/patient or a total of 4410 days by those children in whom safety could be assessed. Three of the 20 patients had an adverse reaction to dapsone. One had mild elevation of blood methemoglobin values (5.6%) and transient elevation of serum transaminases that resolved without discontinuing drug. The other two developed allergic skin rashes which necessitated discontinuation. Efficacy of dapsone in preventingP. cariniipneumonia (PCP) was assessed in 16 children at high risk for developing PCP (defined by CD4 counts or prior PCP infection). These 16 children took dapsone for an average of 6.88 months and a total of 3300 days. Two of the 16 high risk children, one who had had a previousP. cariniipneumonia, developed PCP while taking dapsone. Both had CD4 counts ≤ 200 cells/mm3and were taking dapsone for ≥ 12 months before developing PCP. Dapsone is well-tolerated in children and appears to be as effective in preventing PCP in children with human immunodeficiency virus infection as it is in adults.

ISSN:0891-3668    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A randomized, double blind, placebo-controlled clinical trial was performed in 423 children attending day-care centers to assess whether stimulating nonspecific immunity would reduce the incidence of recurrent infections. The drug used for the trial (Imocur®) is an extract obtained from eight different species of bacteria. At the end of the total follow-up period (3 months with treatment and 4.5 months without), the risk for ≥ 4 episodes of upper respiratory infections was not significantly lower in the treated group than in the placebo group (26.7%vs.33.8%, relative risk, 0.79; 95% confidence interval, 0.59 to 1.06). In an exploratory analysis limited to the 3-month treatment period, however, we observed a 48% reduction in the risk of presenting ≥ 3 episodes of upper respiratory infections: 9.5%vs.18.3%, respectively, in the treatment group and the placebo group (relative risk, 0.52; 95% confidence interval, 0.31 to 0.86). Similar results were found for the risk of ≥ 1 episode of gastroenteritis. We also observed a strong correlation between the drug efficacy and age; this observation is coherent with the underlying pathophysiologic model in which the immune system matures with age.

ISSN:0891-3668    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Alpha-2a-interferon (IFN) has been shown to provide important local defense against some viral infections.In vitro, IFN inhibits the growth of respiratory syncytial virus in bovine monolayer cultures, but respiratory syncytial virus is known to be a poor inducer of IFN in infected infants. When IFN was administered by daily intramuscular injection in a double blind, placebo-controlled study of 22 infants with bronchiolitis caused by respiratory syncytial virus, there was no statistically significant difference in clinical course, duration of oxygen requirement or physical assessment between the treatment and control groups. Likewise viral isolation showed no difference between the groups. Further studies are needed to determine whether higher dosing or aerosol or other alternative route of delivery of IFN might lead to therapeutic benefit.

ISSN:0891-3668    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Respiratory syncytial virus (RSV) is the most frequent cause of hospitalization for respiratory tract infection during the first 2 years of life. The optimal approach to management remains controversial. During the 1991 to 1992 RSV season RSV-infected children admitted to eight Canadian tertiary care pediatric centers were followed to: (1) assess the morbidity and mortality attributable to RSV infection among hospitalized patients with and without known risk factors for severe disease; and (2) assess regional variation in the management of RSV infection. Of 529 RSV-infected patients 69% (363) had one or more of the risk factors for severe disease and the remaining 31% (166) had none. There were significant differences (P≤ 0.01) between the high and low risk groups, respectively, for: intensive care unit admission (27%, 2%), assisted ventilation (14%, 0.6%), ribavirin therapy (20%, 2%), supplemental oxygen (75%, 34%), antibiotic therapy (69%, 58%) and length of hospital stay ≥ 7 days (39%, 6%). Among low risk patients, centers varied significantly (P≤ 0.01) in the use of systemic corticosteroids (from 3 to 69% of patients), supplemental oxygen (13 to 74%), bronchodilators (68 to 93%) and ribavirin (0 to 10%). The observed regional variation in management of hospitalized children with RSV infection has implications for both the costs of hospital care and the conduct of multicenter trials of ribavirin and other therapies for RSV infection.

ISSN:0891-3668    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1993

数据来源: OVID