摘要:

We conducted a blinded taste test evaluating 12 antimicrobial suspensions by smell, texture, taste, aftertaste and overall acceptance. Drugs received cumulative scores in each category as well as a total score ranking. Overall Lorabid® scored highest but not significantly higher than Keflex®, Suprax® and Ceclor®, all of which scored higher than the other test drugs. Cefzil® and Augmentin® scored just below this group of drugs and higher than all other test drugs. Vantin® was inferior to these drugs primarily because of its low score in aftertaste. It was ranked along with V-Cillin-K®, Veetids®, Sulfatrim® and Pediazole®, the lowest scoring group of drugs other than Dynapen® which scored lower than all other test drugs. No difference overall was detected between the two penicillin VK suspensions evaluated, V-Cillin-K® and Veetids®.

ISSN:0891-3668    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The infection status of 91 infants born to mothers with human immunodeficiency virus (HIV) infection was determined. Twenty-eight (31%) infants had confirmed HIV infection and 63 (69%) had seroreverted to HIV and lack evidence of infection. During the first 6 months of life HIV culture had a sensitivity and specificity for diagnosis of HIV infection of 80 and 100%, respectively. False negative HIV cultures were observed in only 7 of 35 specimens, 6 from among the 12 infected infants tested at birth. The sensitivity and specificity of polymerase chain reaction (PCR) detection of HIV were 95 and 93%, respectively. A single false negative PCR test result was observed among the 19 tests performed on specimens from HIV-infected infants. False positive PCR test results were observed occasionally throughout the first 6 months of life. Detection of HIV-specific IgA antibody lacked diagnostic sensitivity; positive test results were observed in only 53% of specimens obtained from infected infants. Culture and PCR detection offer excellent sensitivity and specificity for diagnosis of HIV infection during the first 6 months of life; however, false-negative HIV cultures sometimes are observed, particularly during the newborn period, and either false negative or false positive PCR test results may be noted occasionally. For purposes of clinical decision-making, any positive test result should be confirmed with a second HIV culture or PCR test performed on a separate blood specimen.

ISSN:0891-3668    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A prospective cohort study of 318 human immunodeficiency virus 1 (HIV-1)-infected and 309 seronegative pregnant women was carried out in Butare, Rwanda. Birth weight was significantly lower among singleton infants born alive to HIV-1-infected mothers compared with those born alive to seronegative mothers (2706 gvs.2825 g;P= 0.002). Crown-to-heel length, head circumference, chest circumference and placental weight were also reduced. Maternal HIV-1 infection was significantly associated with intrauterine growth retardation but not with preterm birth. Differences in the body mass index and weight/head ratio suggest that the adverse impact on live born infants may have been most severe towards the end of pregnancy, resulting in a lean infant with a relatively large head. The higher frequency of intrauterine growth retardation could not be explained by potential confounding factors such as maternal cigarette smoking, history of sexually transmitted diseases or sociodemographic characteristics. The neonatal physical examination did not reveal any differences in clinical signs or symptoms within 48 hours of birth except for the presence of conjunctivitis which was more common among infants of HIV-1-infected mothers. The perinatal and neonatal mortality rates were not significantly affected by maternal HIV-1 status.

ISSN:0891-3668    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Aerosolized pentamidine is widely used in adult patients with human immunodeficiency virus as both prophylaxis and therapy forPneumocystis cariniipneumonia. The aim of this study was to evaluate the safety of a monthly regimen of aerosolized pentamidine in human immunodeficiency virus-infected infants. Seven human immunodeficiency virus-infected infants, ages 3.5 to 11 months, were given a total of 45 monthly treatments of aerosolized pentamidine. The infant's dose of pentamidine was based on an adult dosage of 300 to 600 mg/month, adjusted for minute ventilation and weight. There were no discernible clinical side effects in 62% (28 of 45) of the treatments. Observed toxicity included mild to moderate coughing, mild wheeze and transient arterial desaturation as measured by pulse oximetry. Pulmonary function data revealed an increased tidal volume (P< 0.005) and an increased pulmonary resistance (P< 0.02) post-pentamidine treatment. Urinary pentamidine concentrations were obtained and pentamidine was detected in all tested samples suggesting pulmonary deposition and systemic absorption. In conclusion aerosolized pentamidine appears to be a relatively safe, well-tolerated treatment in infants, with side effects similar to those seen in adults.

ISSN:0891-3668    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Malassezia pachydermatis, a lipophilic yeast, has been described to cause sporadic nosocomial bloodstream infections (BSI). Nosocomial outbreaks ofM. pachydermatisBSI have never been described. A cluster ofM. pachydermatisBSIs in the neonatal intensive care unit at Louisiana State University Medical Center, University Hospital provided the opportunity to investigate the epidemiology of this organism and apply molecular epidemiologic typing techniques. A case-patient was defined as any neonatal intensive care unit patient in University Hospital with a blood culture positive forM. pachydermatisfrom January 1, 1989, through August 15, 1991. Five patients met the case definition. Case-patients were premature as estimated by gestational age and required prolonged hospitalization. Case-patients received parenteral nutrition and intravenous lipids for twice as many days as randomly selected controls. No environmental source ofM. pachydermatiswas identified; however, infants on each side of a previously identifiedM. pachydermatis-colonized infant became colonized withM. pachydermatisduring a 20-day period. Chromosomal analysis of fiveM. pachydermatisblood isolates from two case-patients had identical banding patterns. These data show thatM. pachydermatiscan cause nosocomial BSI outbreaks, that premature infants receiving parenteral nutrition and/or lipids may be at greatest risk and that transmission is most likely from person to person, probably via the hands of medical personnel.

ISSN:0891-3668    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Several trials of high titer measles vaccine (>104.7plaque-forming unit) have found female recipients of Edmonston-Zagreb (EZ) vaccine to have lower survival than female recipients of standard measles vaccine. Two trials with medium and high titer EZ vaccine from the age of 4 months were conducted in Guinea-Bissau. To test for possible long term impact on the immune system, an investigation of T cell subsets was conducted among all children still residing in the community at 3 to 5 years of age. No differences were found between recipients of medium titer vaccine and controls. In the second trial, however, recipients of high titer had lower CD4:CD8 ratios than controls and had significantly higher CD8 percentages and lower CD4:CD8 ratios than recipients of medium titer EZ. When analyzed by sex, differences were found only among the girls. However, these differences were small and seemed unlikely to explain the reduced survival which has been associated with high titer EZ measles vaccination. In the 2 years after the investigation of T cell subsets, there was no increased mortality for recipients of EZ vaccine. Hence it is unlikely that high titer vaccine has an persistent adverse effect on survival after 3 years of age.

ISSN:0891-3668    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Newborns in Finland have been vaccinated withBacillus Calmette-Guérin(BCG) since the 1950s. Until the end of 1970 the vaccine was made from BCG strain Gothenburg by the Swedish BCG laboratory in Gothenburg and from 1971 on from the same strain in Copenhagen, Denmark. It was replaced by the Glaxo vaccine in 1978. Complications caused by BCG vaccination have been under follow-up, and the data have been collected from nationwide registers. In this study we analyzed the incidence rates of BCG osteitis between the years 1960 and 1988. From 1960 to 1970 the incidence rate was from 2.7 to 13.0/100 000 BCG-vaccinated infants (mean, 7.3; median, 6.9). The incidence increased during the years 1971 to 1978 when it varied between 15.3 and 72.9/100 000 BCG-vaccinated infants (mean, 36.9; median, 30.4). Since 1978 the incidence has varied between 1.7 and 10.1/100 000 BCG-vaccinated infants (mean, 6.4; median, 7.2). In Britain no reports of BCG osteitis have been published despite the use of the same Glaxo vaccine. Our results indicate that the incidence of BCG osteitis in a given population depends on the BCG vaccine used. The follow-up of BCG complications is an essential part of BCG vaccination program.

ISSN:0891-3668    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Epidemiologic patterns of acute diarrheal diseases in a high standard of living communal settlement, situated in a region endemic for enteric diseases, were evaluated by a historical prospective study of 284 children (12 064 child months) from August, 1988, through July, 1992. Three hundred eighty-three episodes of acute diarrhea were identified, yielding a rate of 0.38 episode per 12 child months. One hundred and children (35.6%) were reported to have 1 to 4 diarrheal episodes and 29 (10.2%) children had 5 or more diarrheal episodes during the follow-up period. The mean number of episodes of acute diarrhea per 12 child months in children ages 0 to 2 years was 2.28, in 2− to 6-year-olds 0.44, in 6− to 13-year-olds 0.12 and in 13− to 18-year-olds 0.03 (P< 0.001). Children less than 12 months of age had a lower incidence of acute diarrheal diseases during the months they were being breast-fed than children that were fed with formula during the same period (1.22 vs. 3.06 episodes per 12 child months, respectively;P< 0.001). Enteropathogens were isolated in 40% of diarrheal episodes in which stool cultures were obtained. The identification rates of the various enteropathogens were: diarrheagenicEscherichia coli, 11%;Shigellaspp., 10%;Giardia lamblia, 10%;Salmonellaspp., 4%;Staphylococcus aureus, 3%;Campyiobacter jejuni, 1%. Potential interventions against acute diarrhea in this set up of a high standard of living rural community are education of caretakers and parents on hygienic practices that can prevent transmission of pathogens among the young children and encouraging mothers to breast-feed their children.

ISSN:0891-3668    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Two thousand eight hundred ninety-eight children younger than 5 years old were investigated during a 2-year period in a rural area of The Gambia for possible pneumonia, meningitis or septicemia. After clinical examination and appropriate investigations, 1014 children were diagnosed as having pneumonia, 31 as having meningitis and 100 as having septicemia. Nine hundred seven children had a final diagnosis of malaria including 702 who satisfied the World Health Organization criteria for a diagnosis of pneumonia. A bacterial etiology was established in 115 (11%) patients with a final diagnosis of pneumonia, in 25 (81%) with meningitis and in 29 (29%) with suspected septicemia. Overall the

ISSN:0891-3668    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We reviewed the isolation of fungi from cerebrospinal fluid (CSF) cultures at Texas Children's Hospital during the past 6 years to evaluate the significance of a positive culture and to identify potential risk factors. Thirty-seven fungal isolates were recovered from 23 patients representing 2% of all 1498 positive CSF cultures for the study period.Candidaspecies accounted for 94.5% of all fungal isolates. Nine of the 23 patients were newborns and 8 of these were very low birth weight premature neonates.C. albicanswas recovered from the CSF of all newborns. Eleven patients were children 4 months to 14 years old. Three patients had positive cultures of CSF obtained on postmortem examination. Leading potential risk factors for positive CSF cultures from neonates included antimicrobial therapy, prematurity, very low birth weight, umbilical catheterization, total parenteral nutrition, intubation and respiratory distress syndrome. For children beyond the newborn period, potential risk factors were

ISSN:0891-3668    

出版商:OVID    

年代:1994

数据来源: OVID