ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Fully intermittent short course chemotherapy regimens have been used successfully in adults but not in children. We report the results on 76 children with tuberculosis, excluding central nervous system tuberculosis and primary pulmonary complex. Isoniazid, rifampin and pyrazinamide were used for treatment. They were randomly allocated to Regimen A (52 doses) and Regimen B (94 doses). Overall efficacy of both schedules was >95% in 27 children with lymphatic, 43 with pulmonary and 6 with disseminated tuberculosis.Compliance in 10 children after 2 to 4 months of therapy was poor because rapid improvement was mistaken by parents for cure. Two children died, probably of underlying lung disease.Follow-up for up to 2 years did not reveal any case of relapse or recurrence of the disease. Therapy for 6 months involving administration of only 52 or 94 doses of drugs was found to be economical, effective and safe for treating children with tuberculosis.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Serum concentrations of beta-2-microglobulin (B2-M) were correlated with disease outcome in 40 children infected by the human immunodeficiency virus. Serum B2-M serum concentrations below 3.0 mg/100 ml or decreasing concentrations were indicative of a stable disease course but were also noted preterminally in lymphopenic children. Of 20 patients with B2-M concentrations above 3.0 mg/liter, 12 had a progressive disease course and 8 remained stable. In the latter 8 patients the B2-M values decreased with time. Elevated B2-M concentrations were also noted in infants younger than 1 year of age and denoted active human immunodeficiency virus infection. B2-M serum concentrations are a useful prognostic marker in human immunodeficiency virus-infected children.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We reviewed cases of Gram-negative enteric bacillary meningitis in infants and children treated with cefotaxime at Texas Children's Hospital from January, 1984, through June, 1989. Seventeen of 20 children had an underlying condition predisposing to the development of meningitis. The etiologic organisms in these 20 children (2 days to 12 years old; median, 12 days old) wereKlebsiellasp, 9;Escherichia coli, 4;Enterobacter cloacae, 3;Citrobacter diversus, 2; other, 2. With the exception of one isolate ofAcinetobacter, all isolates were susceptible to cefotaxime. In addition to cefotaxime 17 children received an aminoglycoside intravenously. Children with meningitis caused byKlebsiellasp. or non-Kliebsiellaorganisms received cefotaxime for 31 ± 14 and 37 ± 17 days, respectively. Aminoglycosides were administered for 16 ± 10 days in both groups. Five children in each group also received intraventricular doses (1 to 25) of an aminoglycoside (9) or colistimethate (1). The mean durations of positive lumbar, ventricular cerebrospinal fluid or brain abscess cultures were 5.8 ± 4.7 and 7.2 ± 5.0 days after start of therapy in theKlebsiellaand non-Klebsiellameningitis patients, respectively. Only three children were normal at the time of discharge or follow-up. Gram-negative enteric meningitis remains difficult to treat despite the excellentin vitroactivity of cefotaxime against Gram-negative enterics, in part as a result of the predisposing conditions resulting in the development of this infection.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We prospectively examined the utility of obtaining blood cultures through newly inserted intravenous catheters in 99 children who required both a blood culture and placement of an intravenous catheter. Two blood cultures were collected from each patient, one through a freshly inserted intravenous catheter and another through a butterfly needle at a separate venipuncture site. A standardized technique of skin preparation with povidone-iodine was used. The rate of contamination was 1.0% (95% confidence intervals, 0 to 3.0%) for each method. Ten patients had blood cultures yielding true pathogens; in five of these bacteremic children, only one of two sets of blood cultures was positive. We conclude that blood cultures can be collected through freshly placed intravenous catheters without increasing the risk of contamination. These results also raise the possibility that obtaining two blood cultures instead of a single culture may improve the detection of bacteremia in children.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Records have been kept prospectively in our institution since 1928 of all positive blood cultures taken from neonates. Using a modification of objective Centers for Disease Control criteria to define sepsis, we reviewed the records of all neonates with positive blood cultures for the years 1979 to 1988 inclusive and found 270 cases of sepsis. The sepsis rate for infants ≤30 days of age was 2.7 cases/1000 live births, with a mortality rate from sepsis of 15.9%. There was an increase in sepsis due to commensal species (CS) over the period (P< 0.007). The number of infants in the nursery who developed sepsis when more than 30 days of age also increased (P< 0.002), as did the rate of sepsis from CS in this group (P< 0.001). Isolation of CS from the blood with fulfillment of the modified Centers for Disease Control criteria was associated with a 13.7% mortality rate, whereas isolation of CS without fulfillment was associated with a 4% rate (P< 0.01).

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The common cold is the most frequent acute respiratory illness of man. On the average adults have 2 to 4 and children have 6 to 10 colds each year.1 3These illnesses are associated with major socioeconomic costs in the form of missed school and work, physician visits and the purchase of over the counter medications. Although the morbidity of these infections is relatively minor, 2.9% of colds are complicated by otitis media or sinusitis and 0.7% are associated with an exacerbation of underlying reactive airway disease.1At least one-third of colds are caused by the rhino-viruses.3In spite of the importance of these viruses as a cause of illness, surprisingly little is known about the pathogenesis of rhinovirus infection. The purpose of this review is to summarize recent information about the pathogenesis of the common cold with particular attention to the potential role of polymorphonuclear leukocytes (PMNs).

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID