ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

As soon as a new but still unproved method of treatment is adopted by even a minority of the medical profession, it becomes virtually impossible to conduct the controlled trial that alone can furnish truly reliable evaluation of its effectiveness and its hazards.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In 1982 and 1983 practicing pediatricians in a Lyme disease-endemic county, reported 90 cases of Lyme disease among children 19 years of age and younger (median age, 9 years). Three-fourths of the children had initial symptom onset in the summer months, with peak incidence in July. Infection occurred twice as often in boys than in girls, and tick bites were recalled by less than half (49%) of the children or parents. Erythema chronicum migrans was present in two-thirds (67%) of the cases with median onset 7 days after a definite tick bite. Arthritis or arthralgia occurred in 59% and neurologic symptoms, especially seventh nerve palsy, occurred in 14%. Asymmetric involvement of a few large joints, especially the knee, was most commonly reported for those with joint involvement. Antibiotics were prescribed for 79% of the children, three-fourths of whom were treated with oral penicillin. Initial diagnosis of Lyme disease is usually made on clinical grounds alone because serologic tests are often negative. Serologic tests for antibody toBorre-lia burgdorferiwere more often positive in cases with neurological or joint involvement, in addition to erythema chronicums migrans (80%), than in cases presenting with erythema chronicums migrans only.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A day care center for the short term care of mildly ill children opened in Minneapolis in October, 1985. We conducted a prospective study to evaluate the risk for study participants of acquiring subsequent infections as a result of possible exposure to other infectious agents while at the center. Between June, 1986, and August, 1987, we determined the rates of subsequent infections for 118 children attending the day care center (center-based children) and compared them with rates of subsequent infections for children participating in a home-based sick child care program (home-based children). Of 105 center-based children potentially exposed to respiratory illness while at the center, 24 (23%) developed subsequent respiratory illness compared with 17 (16%) of the matched home-based children (odds ratio, 1.5; 95% confidence interval, 0.7, 3.1). Of 17 center-based children potentially exposed to gastrointestinal illness, 1 (6%) developed subsequent gastrointestinal illness compared with one (6%) of the matched home-based children (odds ratio, 1.0; 95% confidence interval, 0.06, 16.0). Of 12 pairs of children, where the center-based child was potentially exposed to chickenpox while at the center and both were susceptible to chickenpox, 1 center-based child (8%) developed chickenpox compared with 2 home-based children (17%) (odds ratio, 0.5; 95% confidence interval, 0.04, 5.5). We were not able to demonstrate that children who attended the sick child day care center were at significantly increased risk of developing subsequent infections when compared with a matched group of children who did not attend the center.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Neutralizing antibodies to pertussis toxin (antitoxin) were determined in 201 blood samples from 4-year-old children. They had received primary immunization at 6 to 8 months of age with an acellular (n= 149) or a whole cell (n= 52) pertussis vaccine and 195 of them had received a booster dose of the acellular vaccine 9 to 16 months later. Data on exposure to pertussis and occurrence of pertussis were also collected. There was a rapid decrease of antitoxin between immediate postbooster titers and those measured 24 months later. This decrease per month was significantly greater than that after the primary immunization series (P< 0.001). Neither the number nor the spacing of acellular vaccine doses given for primary series influenced the titers found 24 months after the booster. An antitoxin response was still measurable in 86% of the 196 four-year-old children. None of 19 exposed children developed whooping cough, which suggested that the antibody concentrations during the follow-up period were sufficient for protection. The results indicate a need for long term follow-up studies in the evaluation of new vaccines and immunization schedules.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In children born to mothers infected with human immunodeficiency virus 1 (HIV-1), a diagnosis of HIV infection cannot be based on a positive antibody result until at least 18 months of age. There is therefore an urgent need for simple and reliable methods of diagnosing HIV infection in these infants. The sensitivity and specificity of a test using the invitroantibody production of HIV-specific IgG was assessed in children whose infection status was known and compared with virus and antigen detection.In vitroantibody production sensitivity was 90 to 95%, at least as sensitive as virus culture in antibody-positive infected children. In the first 2 months there is a relatively high proportion of false positive results, possibly a result of contamination by maternal cells. However, after this periodin vitroantibody production is a simple, inexpensive and reliable tool for early diagnosis.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Human parainfluenza type 3 is the most common cause of bronchiolitis and pneumonia after respiratory syncytial virus. In a recent outbreak of nosocomial respiratory illness in a neonatal intensive care unit, parainfluenza type 3 virus was isolated in 6 of 17 neonates cultured (5 symptomatic patients and 1 asymptomatic patient). Eighteen of 52 nursing personnel had been ill during the previous week and concomitantly, with cough and nasal congestion. These personnel and all patient care givers were asked to submit nasopharyngeal cultures. Parainfluenza type 3 virus was recovered from 2. Glove and gown barriers and cohorting of infant patients limited further spread of the disease.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A randomized, controlled clinical trial was conducted in 76 children to evaluate the efficacy of trimethoprim-sulfamethoxazole for 4 weeks, prednisone for 2 weeks and aluminum ibuprofen suspension for 2 weeks in resolving chronic otitis media with effusion which had persisted for more than 8 weeks. After 2 weeks of treatment resolution rates of chronic otitis media with effusion in the prednisone and trimethoprim-sulfamethoxazole groups were significantly greater than those in the control (no treatment) and ibuprofen groups. After 4 weeks the differences in resolution rates between the control, trimethoprim-sulfamethoxazole and prednisone groups became smaller. After 12 months of follow-up, differences in hearing sensitivity among study groups were not statistically significant, although 83% of patients had a 15-dB or greater hearing loss. Therefore short term antimicrobial and antiinflammatory treatment did not appear to have a long lasting effect on chronic middle ear inflammation.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A retrospective analysis of data from 18 clinical studies was performed to examine the effectiveness and safety of cefaclor in the treatment of upper and lower respiratory tract infections caused byMoraxella catarrhalis(previously calledBranhamella catarrhalis)Eighty-six percent of 56 evaluable patients had improvement in their symptoms of infections following therapy with cefaclor. There were no serious or life-threatening adverse drug experiences reported by any patient. Cefaclor appears to be an appropriate antibiotic for the safe and effective treatment of respiratory tract infections caused byM. catarrhalis.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We compared aztreonam with chloramphenicol in a randomized trial involving the treatment of 36 children with typhoid fever. Eighteen children were randomized to receive aztreonam, 150 mg/kg/day intravenously, and 18 to receive chloramphenicol, 100 mg/kg/day orally. On entry in the study the clinical characteristics of the two treatment groups were comparable. The duration of therapy was 14.9 ± 3.6 days for the aztreonam group and 12.8 ± 2.6 days for the chloramphenicol group. The mean duration of fever was 5.9 ± 3.1 days and 4.05 ± 2.1 days for aztreonam and chloramphenicol groups respectively (P> 0.05). Clinical cure

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID