ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Tuberculosis in children is a growing problem, both globally and in many industrialized countries. With a rising incidence, clinicians will again face the challenge of the myriad presentations of tuberculous disease. Multidrug resistance and HIV coinfection present additional complications. Renewed interest in tuberculosis among scientists has led to progress in our understanding of antimycobacterial effector mechanisms, the regulation of Th1 and Th2 immune responses, virulence factors, and the potential for immunotherapeutic agents to reduce the duration of antituberculous therapy.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Group B streptococci remain a leading cause of life-threatening neonatal infection worldwide. The current estimate of incidence in the United States is 1.8 cases per 1000 live births, with a case-fatality ratio of 10% to 20%. Advances in understanding of the pathogenesis of septic shock and meningitis are yielding new approaches to the treatment of these serious infections. Selective intrapartum chemoprophylaxis with ampicillin has been shown to be both effective and cost effective and is gaining more widespread acceptance as a preventive measure. Conjugate vaccines consisting of type-specific group B streptococci capsular polysaccharides coupled to tetanus toxoid or protein membrane antigens of group B streptococci have been shown to prevent neonatal infection in a mouse model of maternal immunization. Such vaccines are now in trials of safety and immunogenicity in humans.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This paper focuses on the advances that have been made in our understanding of the pathogenesis, diagnosis, treatment, and prevention of herpes simplex virus (HSV) infections. Insights have been gained into the immune defense mechanisms that may be active in protecting the fetus from HSV infection. An animal model that closely mimics human neonatal HSV disease may permit exploration of novel interventional strategies. Brain biopsy for the diagnosis of HSV encephalitis has been supplanted by polymerase chain reaction detection of HSV DNA in the cerebrospinal fluid and, to a lesser extent, by detection of intrathecal HSV-specific antibodies. Prolonged immune activation within the nervous system following HSV encephalitis has been demonstrated and may implicate immune activation in the pathogenesis of HSV-induced neurologic damage. The continuing emergence of antiviral drug resistance further underscores the need for new strategies for treatment and prevention of HSV infections.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

International cooperation and widespread use of trivalent oral poliovaccine has almost eliminated paralytic poliomyelitis from developed countries and is now dramatically decreasing the disease in developing countries. The remarkable results are based on the strategies recommended by the World Health Organization, which include national mass campaigns for administering oral polio vaccine to all children younger than 5 years of age, enhanced surveillance to find patients with acute flaccid paralysis, creating a network of laboratories for viral diagnosis, and targeted immunization to populations in endemic areas. Another remarkable advance in clinical and research fields of enterovirus infections is the development of molecular genetic technologies such as polymerase chain reaction and in situ hybridization assays. A cloned enterovirus complementary DNA prepared from the highly conserved 5′ region of the enterovirus genome can be used for rapid and sensitive group-specific diagnosis of enterovirus infections. This complementary DNA is currently being used to study the molecular mechanisms in the pathogenesis of enteroviral heart disease; lesions in acute and chronic myocarditis and even in end-stage dilated cardiomyopathy may be associated with replication of enteroviruses.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The spleen contributes importantly to the normal and pathologic removal of blood cells from the circulation and to defense against infection with encapsulated bacteria. Surgical splenectomy provides efficacious treatment for a number of pediatric disorders but is associated with perioperative morbidity and a life-long risk of overwhelming infection. Alternatives to conventional splenectomy include laparoscopic splenectomy, partial splenectomy, partial splenic embolization, and autologous splenic transplantation. Sickle cell disease is the most common cause of functional asplenia in children. Asplenia develops during infancy in many infants with sickle cell anemia, and prophylactic penicillin markedly reduces mortality from pneumococcal infection. In contrast, recent evidence suggests that children with sickle-hemoglobin C disease do not develop functional asplenia before 3 to 4 years of age and thus may not benefit from penicillin prophylaxis. Recommendations for the treatment of asplenic patients include pneumococcal,Haemophilus influenzaetype b, and meningococcal immunizations, antimicrobial prophylaxis for selected patients, and prompt evaluation and aggressive treatment of acute febrile illness.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Despite improved pretransfusion donor evaluation and testing, there is still residual risk of transfusion-associated viral infectious disease. Moreover, other important infectious pathogens, including bacteria, protozoa, and nonenveloped viruses, are not detected in current testing programs. Recent investigations from several laboratories have stimulated interest in decontamination of blood products as an additional means to further enhance the safety of blood transfusion. Furthermore, because testing is a retrospective strategy, a robust decontamination process could provide prospective protection against new pathogens that may enter the blood donor population. Recent advances in decontamination of fresh frozen plasma, plasma derivatives, platelet concentrates, and erythrocytes are reviewed. The introduction of solvent-detergent-treated plasma fractions marks an important advance in transfusion safety. Other technologies for cellular components are emerging to address transfusion-associated infectious disease transmission.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Blood collected from the umbilical cord and placenta at the birth of a child is a rich source of immature blood cell elements and has been used clinically as an alternative source of transplantable stem and progenitor cells. Studies on the proliferative and replating capacities of cord blood stem and progenitor cells have documented their extensive capacity for division and self renewal. Studies on the immune cells in cord blood have shown them to be less immunologically reactive in a number of situations. These characteristics are consistent with the experience in children receiving HLA-matched sibling cord blood cells, in which these cells have been transplantable in a large number of clinical disorders with low or absent graft-versus-host disease. Stem and progenitor cells from cord blood are efficiently transduced with new genetic material by retroviral and adeno-associated viral vectors and may be of efficacy in the future for autologous gene therapy approaches to treat disease. Efforts in banking of cryopreserved cord blood cells have been undertaken, and a number of such stored samples have been used for fully and partially HLA-matched unrelated transplantation. Efforts to better understand the cells in cord blood and their clinical utility are continuing.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID