ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

There are comparatively few data on the incidence and morbidity from pneumococcal disease, which is greatly under-estimated by case ascertainment from sterile site isolates alone. New diagnostic methods, such as serology and polymerase chain reaction, to detect components of the pneumococcal cell wall promise to significantly enhance detection of pneumococci causing childhood pneumonia. There is increasing evidence that excessive antibiotic use in children is a major factor promoting antibiotic resistance in pneumococci. Resistance is a problem worldwide and has focused attention on vaccine prevention. Fortunately, antibiotic-resistant pnemococci appear to belong to a limited range of serotypes, those commonly colonizing children, in all areas so far studied. If conjugate pnemococcal vaccines prove to eradicate carriage, immunization may be the major weapon against the spread of antibiotic-resistant pneumococcal infection. Conjugate pneumococcal vaccines are now being studied in large-scale efficacy trials with outcomes of bacteremia and otitis media, the results of which are eagerly awaited.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Pertussis continues to be a common cause of morbidity and mortality in unimmunized young children. In immunized populations, the disease remains endemic and epidemic. Reports of pertussis infection in older children and adults are increasing, and the data indicate that lifelong immunity from either pertussis immunization or childhood pertussis does not exist, which stresses the importance of continued booster immunization in this population. The less reactogenic acellular pertussis vaccines, which may provide protection equal to or even better than that provided by currently used whole-cell vaccines, seem to be suitable not only for primary immunization but also for boostering in all age groups. This review focuses on some recent developments in the epidemiology and prevention of pertussis infection.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The major advance in knowledge about rotavirus infection and prevention has been in vaccine development. Several large studies of tetravalent rhesis rotavirus vaccine have had encouraging results, and a first-generation vaccine is likely to be licensed by the 25th anniversary of the discovery of rotavirus (in 1973). Epidemiologic studies have highlighted a diversity of less common G types and non-group A strains, observations to be taken into account in further vaccine development. Disconcerting anecdotal reports of central nervous system involvement need to be cautiously interpreted. New information on pathophysiology raises the intriguing concept of viral toxin involvement. Oral immunoglobulin has been used for prophylaxis and also for treatment during active infection.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

For many years, acyclovir has been used to treat herpes simplex and varicella zoster infections in adults and children, although new drugs with improved bioavailability and dosage regimens (ie, famciclovir, valaciclovir) are replacing it for the outpatient management of these conditions in adults. Acyclovir remains the treatment of choice for severe herpes infections in both immunocompetent and immunosuppressed patients. Data on the newer antiherpes drugs in children are not available. Treatment of severe cytomegalovirus infections with ganciclovir and foscarnet is difficult because of toxicity; whether improved formulations of these drugs or newer agents prove clinically useful remains to be seen. For the most part, treatment of other herpesviruses is not indicated. The major advance in pediatric HIV treatment is the reduction in vertical transmission with peripartum zidovudine, although the optimal use of antiretrovirals in this situation remains to be determined. The nucleoside analogues zidovudine, zalcitabine, didanosine, and stavudine have been assessed in HIV-infected children; pediatric data about appropriate combinations (eg, with the protease inhibitors and the nonnucleoside reverse transcriptase inhibitors) and dosage regimens lag well behind the adult literature. The effectiveness of ribavirin in respiratory syncytial virus disease is uncertain. Preliminary data suggest that interferons may have a role in the management of chronic hepatitis B and C.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Immune thrombocytopenic purpura (ITP) is either a transient or a chronic bleeding disorder characterized by an unbalanced immune response due to inflammation (ie, infection, autoimmunity). There is new evidence arguing for an immune-mediated mechanism operative in ITP–increased HLA-DR expression, defects in cellular and humoral immunity, and specific autoantibody production. Moreover, different forms of ITP may be associated with specific alterations in the immune response. New immunosupportive modalities emphasize biologic interventions as a therapeutic strategy for autoimmune disorders. Practical guidelines for the diagnosis and treatment of ITP were recently established by the American Society of Hematology. These recommendations will substantially influence patient care and future research.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Until recently, transfusion was the only effective therapy for children with sickle cell disease (SCD). Although transfusion can be used to prevent or treat many of the complications of SCD, it has often been used indiscriminantly and with considerable risk to the patient. Recent studies attempted to define those clinical situations in which transfusion is effective as well as to optimize its delivery while minimizing complications. Other therapies are emerging, and in the future many will likely play an important role in the treatment of children with SCD. These therapies include pharmacologic interventions, such as hydroxyurea; bone marrow and cord blood transplantation; and improvements in supportive and preventive care. The future for new therapies looks promising, but the appropriate role for many of these therapeutic interventions remains to be determined.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID