ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Molecular biology techniques are now a vital part of hepatitis virology, with a central role in studies of diagnosis, epidemiology, virology, pathogenesis, and natural history of infection. Cloning of the genome of hepatitis E virus has allowed its tentative classification as a calici- or related virus, and is the first step toward the development of a vaccine. Long-term implications of hepatitis C for groups such as children with hemophilia, thalassemia, and even leukemia can be better understood by comparison of virus load measured by molecular amplification of the plasma viral RNA with the serologic and clinical status of the respective cohorts of children. A new vaccine for hepatitis A has been licensed in several European countries, and recent experience with severe hepatitis in infants after unexpected transmission of hepatitis B from anti-hepatitis B e positive mothers reemphasizes the value of universal hepatitis B immunization programs. Mother-to-infant transmission of hepatitis C virus has now been well documented, but there are still insufficient data on the dynamics of this, particularly in the absence of passive immunoprophylaxis or a vaccine, to permit recommendations regarding the management of individual pregnancies or deliveries. There is especially too little information to suggest whether breast feeding may be an important mechanism for transmission.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

It was proved in the 1980s that human herpesvirus-6 and human parvovirus B19 cause diseases in humans. Human herpesvirus-6, a newly recognized herpesvirus, is a causative agent of exanthem subitum. The virus produces broad clinical features; complications, including fatal outcome, are frequently activated in immuno-suppressed conditions such as organ transplantation. Parvovirus B19, a small-DNA virus, infects erythroid progenitor cells. Systemic infection with parvovirus B19 is responsible for several clinical entities, such as erythema infectiosum, arthropathy, aplastic crisis, fetal death, and other disease conditions, including those in immunosuppressed hosts. Reliable diagnostic technologies and carefully designed clinical, immunologic, and virologic studies will fully delineate the clinical significance of both viral infections.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Neonatal herpes, one of the most feared infections during infancy, continues to command the attention of many investigators. In the past year, important new findings were reported pertaining to epidemiology, diagnosis, prevention, and treatment of this disease. Unfortunately, practical solutions for many clinical problems remain elusive. This review describes recent advances in our understanding of neonatal herpes with particular emphasis on the dilemmas and controversies associated with management and prevention. Although elimination of neonatal herpes remains a distant goal, the review discusses reasons for hope, including improved prevention strategies based on recent epidemiologic data, development of new rapid diagnostic methods, and progress in the quest for an effective vaccine.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The cause of Kawasaki disease remains a mystery. Since its original description, many theories regarding the etiology of this serious childhood illness have been proposed, only to be refuted on closer scrutiny. The past year has seen important advances in our understanding of the pathophysiology of Kawasaki disease. Probably the most exciting advance has been the description of the mechanisms underlying the immunologic derangements seen in Kawasaki disease, together with evidence that this mysterious illness may be caused by a toxin that acts as a superantigen.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The number of preschool-aged children who attend day care has increased dramatically in recent years. Factors promoting spread of infections in this setting include crowding, lack of hygiene, high prevalence of early exploratory behaviors, and the likelihood of many susceptible children being in close contact. As a result, children attending day care experience a great number of episodes of respiratory and gastrointestinal illness than do other children. Moreover, the risk of a number of specific infections, including Haemophilus influenzae type b and hepatitis A, is increased by attendance in day care. Day-care staff are at increased risk of a number of infections, some of which, including cytomegalovirus and parvovirus B19, may have adverse consequences to a fetus. The presence of children in day care increases the risk of illness among staff and family members and may promote the circulation of infections in the community as a whole.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Sexually transmitted diseases pose a significant problem for children who have been sexually abused. The pattern of sexually transmitted diseases in this group reflects their changing pattern in the community at large. The prevalence of sexually transmitted diseases in sexual abuse victims is significant although it depends on a number of factors, including sexually transmitted disease prevalence in the community, the organism, and the type of abuse. The transmission route of most common sexually transmitted diseases beyond the neonatal period is accepted as sexual abuse, although the possibility of nonsexual transmission of some organisms, particularly those that can be transmitted at birth and have a long incubation and latency periods, is recognized. Mounting evidence for nonsexual transmission of human papillomavirus is generating continuing controversy. The significance of other organisms as indicators of abuse remains unclear. It is recommended that children suspected of being abused be screened for sexually transmitted diseases. There has been considerable discussion about the extent of screening. Screening should adhere to clear guidelines that address local epidemiologic issues. Screening for human immunodeficiency virus should be based on the extent of the virus in the community in which the child lives and on the nature of the abuse. Child sexual abuse must be recognized as an exposure category for human immunodeficiency virus. Test selection for evaluating sexually transmitted diseases in sexual abuse victims is a critical issue. Rapid screening methodologies should not be relied on, and if positive results are obtained, they should be confirmed using another method or even another laboratory. Prophylaxis is generally not seen as necessary and the more recent treatment guidelines recommended by the Centers for Disease Control are generally accepted as more appropriate for children. Future refinements in treatment may include moves to both oral and monotherapy.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Respiratory tract infections are a frequent problem for children, families, and pediatricians. Most such infections are trivial and do not warrant significant concern; however, for some children and some infections, aggressive and effective therapy is important. Much of the literature discussed in this article reflects attempts to clarify and improve appropriate use of antimicrobial therapy for those children in whom it is necessary.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Prevention of invasive infections caused by Haemophilus influenzae type b (Hib) bacteria has become possible with new vaccines. Covalent coupling to a protein carrier increases the immunogenicity of Hib capsular polysaccharide, and changes it to a T-cell dependent antigen. In clinical use, the conjugate vaccines are immunogenic in infancy, induce immunologic memory, and protect efficiently from invasive infections. They even seem to reduce oropharyngeal carriage of Hib bacteria. Wide-scale use of Hib conjugate vaccines has demonstrated their safety and low reactogenicity. Studies to combine them with other childhood vaccines are in progress. First signs of reduction of severe Hib infections can already be seen in countries where Hib conjugate vaccines are in wide use.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

In 1992, there was a setback in measles vaccination for developing countries as high-titre vaccines were withdrawn following reports of excess mortality in vaccine recipients. The importance of continuing polio vaccination in industrialized countries was emphasized by an outbreak of paralytic polio among an unimmunized community in the Netherlands. Immunization programs are now increasingly using the Jeryl Lynn strain of mumps vaccine following reports of meningoencephalitis associated with the Urabe strain. A hepatitis A vaccine has become generally available and hepatitis B vaccine is being introduced into more childhood programs in countries where the disease is highly prevalent. Trials of group B meningoccal meningitis vaccines have yielded disappointing estimates of efficacy, particularly in younger children. Earlier reports of invasive bacterial infections after pertussis immunization have not been confirmed.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID