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Biomedical subjects

A M Lake

Publications and source records attributed to A M Lake.

14 recordsLinked to original sources
PubMed1992

Dose-response to acellular pertussis vaccine and comparison with whole cell pertussis vaccine at 15-24 months and 4-6 years of age. Acellular Pertussis Vaccine Study Team.

In a randomized double-blind trial 55 children of 15-24 months and 56 children of 4-6 years of age previously immunized with whole-cell DTP (WC-DTP) received acellular pertussis DTP vaccines containing 12.5 micrograms (AC-12.5) or 25 micrograms (AC-25) each of pertussis toxoid (PT) and filamentous haemagglutinin (FHA) per dose of WC-DTP. No differences in antibody responses or adverse events were noted for children who received AC-25 as compared with AC-12.5. All three groups had significant increases in pertussis agglutinins, but the geometric mean titre (GMT) for 4-6-year-old children who received WC-DTP was higher than the GMT for children who received acellular vaccine. No significant differences were noted in the GMT of antibodies to FHA or PT between children who received WC-DTP and recipients of acellular vaccine. The rates of several adverse reactions were significantly (p less than or equal to 0.05) higher for recipients of WC-DTP, and children given WC-DTP were significantly (p less than or equal to 0.00001) more likely to have received acetaminophen. These acellular vaccines are safe and as immunogenic for FHA and PT as WC-DTP when administered as the fourth or fifth dose to children who received three doses of WC-DTP in infancy. The lower (12.5 micrograms) dose of acellular vaccine was as effective as the higher (25 micrograms) dose in inducing antibodies to FHA and PT in children 15-24 months and 4-6 years of age.

Antibodies↗
PubMed1990

Cholestatic jaundice in the newborn.

Neonatal cholestasis or direct hyperbilirubinemia in the first 3 months of life is nearly always more pathologic than physiologic. This article reviews the extensive differential diagnosis of cholestatic jaundice and the approach to diagnosis. A sense of urgency is underscored by the value of early recognition and intervention in metabolic, iatrogenic, and anatomic disorders. The long-term management goals are reviewed, including indications for hepatic transplantation.

Humans↗
PubMed1989

Nutritional support for pediatric patients with inflammatory bowel disease.

Pediatric patients with ulcerative colitis and Crohn's disease often suffer from malnutrition and growth failure. This is particularly true in pubertal children. Chronic insufficient nutrient intake is most often the cause of growth failure. Both parenteral nutrition and defined enteral formulas are available to rehabilitate patients with malnutrition and growth failure. Assessment of nutritional status and growth and the use of parenteral nutrition and defined enteral formulas to reverse malnutrition, growth failure, and inflammation in pediatric patients with inflammatory bowel disease are discussed.

Adolescent↗
PubMed1979

Acute abdominal pain in childhood. Finding the cause.

The child with acute abdominal pain poses a problem of differential diagnosis. Selection of diagnostic studies and initial management depends on the unique characteristics of history or physical examination that narrow the range of possible underlying causes.

Abdomen, Acute↗
PubMed1979

Complement alterations in inflammatory bowel disease.

A prospective evaluation of the activity of the complement system was undertaken in 32 patients at the time of diagnosis of inflammatory bowel disease, before the onset of therapy. Serum classical pathway components and function were normal, while significant abnormalities of the alternative pathway were found. Depressions of serum properdin and properdin convertase were noted in association with diminished consumption of C3--C9 after reaction with cobra venom. These abnormalities of alternative pathway integrity were most significant in regional enteritis and in ulcerative colitis with extraintestinal complications. Sequential studies extending into clinical remission revealed resolution of all significant abnormalities.

Adolescent↗
PubMed1979

Intestinal goblet cell mucus release. II. In vivo stimulation by antigen in the immunized rat.

We previously reported that the infusion of certain soluble immune complexes stimulated mucus release from the rat small intestine in vivo. The present studies sought to evaluate the response of the intestine of normal and immunized rats to the infusion of antigen alone. One hour after the intraduodenal infusion of antigen, small intestinal washings were obtained and analyzed for the presence of 35S-labeled, high m.w. glycoprotein of goblet cell origin. The amount of goblet cell glycoprotein released was estimated from the radioactivity present in the void volume of a Sepharose 4B gel filtration column. The release of goblet cell mucus was enhanced by antigen stimulation in orally immunized animals. The discharge of goblet cell mucus was not increased after antigen infusion in animals immunized by the i.p. route despite the induction of high levels of serum antibody. The inability to demonstrate release of mucus after antigen challenge in systemically immunized rats suggests that the amount or the type(s) of antibody required at the mucosal surface is produced only after oral immunization.

Animals↗
PubMed1978

Peripheral lymphadenopathy in childhood. Ten-year experience with excisional biopsy.

We reviewed our experience with excisional lymph node biopsy over a ten-year period in an attempt to determine which clinical features, if any, were predictive of histologic diagnosis. A total of 75 patients, aged 8 months to 17 years, were available for review. Of these patients, 41 (55%) had nodes with nondiagnostic hyperplasia, 16 (21%) had noncaseating granulomatous lymphadenitis, 5 (7%) showed the caseating lesion of tuberculosis, while 13 (17%) showed a lymphoreticular malignant neoplasm. While patients with lymphoma more frequently had a history of weight loss or arthralgia, no one clinical feature, by either its presence or absence, could predict the biopsy diagnosis. All five patients with supraclavicular lymhadenopathy were found to have mediastinal disease. Of the 41 patients initially found to have nondiagnostic reactive hyperplasia, seven (17%) ultimately proved to have a specific pathologic process.

Adolescent↗
PubMed1978

Hemostatic alterations in inflammatory bowel disease: response to therapy.

Twelve patients with acute, untreated inflammatory bowel disease (IBD) were followed prospectively for coagulation and platelet function. With no symptomatic coagulopathy, abnormalities were found in all patients. With acute diseases, elevations of fibrinogen (9/12), factor V (8/12), and factor VIII (6/12) were common. Depressions of antithrombin III levels were also observed acutely (8/12). Abnormalities of platelets were both quantitative and qualitative. Thrombocytosis was present (11/12), and abnormalities in the rate and percent platelet aggregation were seen (9/10). During therapy, factors V and VIII, antithrombin III levels, and the quantitative and qualitative platelet abnormalities returned towards normal in direct correlation with sedimentation rate and clinical disease activity.

Adolescent↗
PubMed1977

Vitamin E deficiency and enhanced platelet function: reversal following E supplementation.

Marked platelet hyperaggregability to adenosine diphosphate, epinephrine, and collagen was demonstrated in two children with vitamin E deficiency, with complete reversal following E supplementation. No clinical thrombotic tendency was observed during the E-deficient state. The action of vitamin E in the schema of platelet arachidonate peroxidation appears to be at the step of phosphilpase A activation, or the conversion of arachidonic acid into the cyclic endoperoxides, since the peroxidation product malonaldehyde was increased during the E-deficient state with normalization following E sufficiency.

Adenosine Diphosphate↗
PubMed1976

Enterovirus infections in neonates.

Twenty-seven ill neonates with enterovirus infections were studied to learn if enterovirus infection can be distinguished from neonatal sepsis. Enterovirus infection was associated with the summer-fall season (93%), recent maternal illness (59%), absence of other perinatal problems (81%), and findings of fever (93%), viral meningitis (62%), diarrhea (81%), and rash (41%). Four children developed thrombocytopenia and three necrotizing enterocolitis. Three children died, all with Coxsackie B virus infections that likely were acquired in utero. Although no single feature is pathognomonic, this constellation of epidemiologic and clinical findings, coupled with negative bacterial cultures, should suggest the possibility of neonatal enterovirus infection.

Bacterial Infections↗