ISSN:0891-3668    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In a prospective controlled study of the efficacy and sequelae of ventilating tubes, 44 children with bilateral recurrent acute otitis media (>6 episodes/year) and 13 children with bilateral persistent middle ear effusion (>3 months) received unilateral ventilating tube insertion in a randomly selected ear. The contralateral ears were randomized to receive either myringotomy alone or no surgery. Clinical, otoscopic, tympanometric and audiologic examinations were performed before the study and 2 to 4 weeks later, then at 3-month intervals for up to 2 years and at 36 months after surgical randomization. Medical therapy and antibiotic prophylaxis were used whenever indicated. While the ventilating tubes remained functional (mean duration, 10 months) the ears with a tube had significantly fewer episodes of otitis media than their contralateral ear (P< 0.001; 95% confidence intervals −0.7, −1.7) and had more hearing improvement (P= 0.005; 95% confidence intervals, −5.9, −1.2). After tube extrusion there was a tendency for surgically treated ears to have more otitis and worse hearing, but not at a significant level. Tympanosclerosis, retraction and atrophy were more common in ears that received tubes. The majority of ears treated medically also improved. There is need for a more cautious and selective use of ventilating tubes.

ISSN:0891-3668    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Medical records of 18 pediatric acquired immunodeficiency syndrome patients with 24 central venous catheters (CVCs) were reviewed to determine the rates and types of CVC complications and to evaluate the influence of selected social factors, absolute granulocyte counts and CD4+ T cell counts on the rate of CVC infections. CVCs were in place for a total of 4233 days. CVCs were used for blood sampling, administration of blood products and infusions of intravenous immune globulin, parenteral nutrition and medications. Complications included catheter-related infections (8 episodes; with a rate of 1.9/1000 CVC days), occlusions (15 episodes) and unplanned catheter removals (9 episodes). Reduced CD4+ T cell counts were not

ISSN:0891-3668    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The frequency ofEscherichia coliwith Galαl–4Galβ-specific adhesins is reduced among children who develop renal scars. The adhesion-negative phenotype may be due to the absence ofthe papDNA sequences which encode these adhesins or to a phase variation event induced byin vitroculture. In the present study the frequency ofpap and pilhomologous DNA was determined by dot blot analysis with probes specific for the respective sequence usingE. colistrains from children with recurrent pyelonephritis with and without renal scarring. The frequency ofpapwas 79% in the strains isolated from the nonscarring group compared with 39% in the strains from the scarring group (P< 0.001). The Galαl-4Galβ phenotype was expressed by 89% of the pap-positive strains from the nonscarring group compared with 71% in the scarring group (P< 0.05). In addition 13 of 77 of the pap-positiveE. coli strains agglutinated sheep erythrocytes but not the Galαl-4Galβ latex beads; a reaction attributed to reactivity with the Forssman glycolipid. DNA sequences homologous withpilwere found in 95% of all strains and there was no significant difference between the nonscarring and the scarring groups. The low frequency of Galαl-4Galβ specific strains in the scarring group was therefore due to the absence ofpap-homologous DNA sequences and to a reduced rate of phenotypic expression among pap-positive scarring strains. There was no support for a relationship between type 1 fimbriae and renal scarring.

ISSN:0891-3668    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We conducted a prospective study in 87 household contacts of 51 children with hemolytic uremic syndrome to determine the frequency of infection with Shiga-like toxin-producing bacteria. Gastrointestinal tract symptoms occurred in only 1 of 87 contacts. Free fecal toxin was detected in 25 of 64 (39%) of the household members. Neutralization with specific antisera to Shiga-like toxins I and II (SLT-I, SLT-II) revealed that in 6 of these household contacts only SLT-I was present in stool, in 10 only SLT-II was present and in 9 both toxins were found. Thirty-three percent of the hemolytic uremic syndrome families in which 2 or more members were studied had more than 1 household member with free fecal toxin in stool. None of the household contacts was found to haveE. coli0157:H7 in feces. Serum samples were available in 77 household contacts; 75% (58 of 77) had serum neutralizing liters of ≥ 1:4 to 1 or both toxins. In those contacts for whom paired sera were available, seroconversion was found in 10 of 24 (42%). These data show that household contacts of children with hemolytic uremic syndrome are commonly colonized with Shiga-like toxin-producingE. coliand seroconversion to Shiga-like toxins occurs frequently in family members of children with hemolytic uremic syndrome.

ISSN:0891-3668    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We measured serum interferon concentrations in 42 patients with Kawasaki syndrome. The children ranged in age from 7 months to 6 years. All acute sera were obtained within 12 days of the onset of fever. Convalescent sera (illness day 19 to 56) were available from 25 of 42 patients. Sera were also obtained from 40 controls ranging in age from 2 months to 12 years. Control sera included healthy children (n = 14), children with bacterial infection (n = 10) and children with viral infection (n = 16). Sera were coded and interferon concentrations were measured blindly using human diploid fibroblast cell monolayerschallenged with 104plaque-forming units of vesicular stomatitis virus. Specimens from 10 of 16 patients with viral infection were positive for interferon. Three of 10 patients with bacterial infection had detectable serum interferon. No interferon was detected in specimens from the 14 healthy control children or the 42 children with Kawasaki syndrome. Despite the use of a sensitive assay we were unable to detect interferon in the sera of patients with Kawasaki syndrome.

ISSN:0891-3668    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Children of preschool age most often receive medications in liquid form, and smell and taste are major determinants in achieving compliance. We compared smell, taste and other characteristics of 14 commonly prescribed antimicrobial suspensions in a blind test in 30 adult volunteers to determine whether there was a difference in their acceptability. A significant difference was observed with cephalosporins ranking highest and penicillins ranking lowest. Our findings support anecdotal observations and claims often made by parents that cephalosporin antimicrobial suspensions taste good and are readily accepted by children and that penicillin suspensions have an unpleasant taste and aftertaste and are poorly accepted. Other drugs had intermediate scores. Of the two erythromycin suspensions evaluated, IlosoneKtested superior to Erythromycin ESH.

ISSN:0891-3668    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Ninety infants less than 1 year of age with pneumonia and 43 control infants were investigated for viral and chlamydial infection with the use of culture and serology and for bacterial infection with the use of blood cultures, lung aspirates, antibody assays and antigen detection procedures. One or more potential pathogens were identified in 62 (69%) cases with pneumonia and in 12 (28%) controls. Infection by respiratory viruses was identified in 42 (49%) cases and in 8 (19%) controls. Respiratory syncytial virus was the commonest pathogen identified and was found in 32 cases (37%). Bacterial infections were also common, being found in 27 (30%) cases and 3 (7%) controls, and predominantly involvedStreptococcus pneumonias(20%) orHaemophilus influenzae(11%). Bacterial infections were associated with raised white blood cell counts and were identified more often by antigen detection procedures (68%) than by culture of blood or lung aspirates (34%) or by serology (33%). Mixed viral-bacterial infections were identified in 13 cases (15%). Infection withChlamydia trachomatiswas diagnosed in 2 infants with acute lower respiratory tract infection and in 1 control infant.

ISSN:0891-3668    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Seventy-four children ages 1 to 9 years hospitalized because of severe pneumonia were investigated using blood cultures, lung aspirates, nasopharyngeal aspirates, serology and antigen detection procedures. A bacterial infection was identified in 57 (77%), a viral infection was seen in 25 (34%) and 18 (24%) had mixed viralbacterial infections. The bacterial pathogens most frequently identified wereStreptococcus pneumoniaeandHaemophilus influenzaefound in 61 and 15% of patients, respectively. The viral pathogen most frequently recovered was respiratory syncytial virus (12%). Evidence ofChlamydia pneumoniaestrain TWAR andMycoplasma pneumoniaeinfection was found in 12 and 4% of cases, respectively. Overall a potential pathogen was identified in 60 (81%) children, with evidence of polymicrobial infection in 30 cases (40.5%). The study provides information on the relative role of different infectious agents in the etiology of severe pneumonia in children in a developing country.

ISSN:0891-3668    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1991

数据来源: OVID