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Biomedical subjects

Basim I Asmar

Publications and source records attributed to Basim I Asmar.

12 recordsLinked to original sources

Antibiotic susceptibilities of Yersinia enterocolitica recovered from children over a 12-year period.

Antibiotic susceptibility testing by the microdilution technique was performed on 184 Yersinia enterocolitica isolates recovered from children with gastroenteritis in the Detroit area during a 12-year period. The majority of isolates were resistant to ampicillin, ticarcillin and cefazolin. The most active agents were cefotaxime, ceftriaxone, cefepime, gentamicin, tobramycin, sulphamethoxazole/trimethoprim, imipenem and ciprofloxacin. Cefotaxime and ceftriaxone were effective in the treatment of bacteraemia in 12 patients.

Adolescent↗

Effect of using 2 throat swabs vs 1 throat swab on detection of group A streptococcus by a rapid antigen detection test.

OBJECTIVE: To assess the effect of using 2 throat swabs vs 1 on rapid detection of group A streptococcus by the STREP A OIA MAX (hereafter, OIA MAX) test. METHODS: Children aged 5 to 18 years with acute pharyngitis were randomized to 1 of 2 study groups. In group 1, one throat swab was obtained, streaked first on sheep blood agar, and then used for OIA MAX testing. In group 2, two throat swabs were obtained simultaneously. One swab was streaked first on sheep blood agar and then joined with the other swab for OIA MAX testing. In both groups, the pledgets in the collection-transport tube were incubated in Todd-Hewitt broth. A positive group A streptococcus culture either by sheep blood agar or Todd-Hewitt broth was confirmed by a latex agglutination test. RESULTS: Three hundred sixty-three patients were enrolled, 177 in group 1 and 186 in group 2. Cultures were positive for group A streptococcus in 154 (42.4%) of 363 patients. The sensitivity and specificity of OIA MAX testing were 94.7% and 100.0%, respectively, in group 1, and 92.4% and 96.3%, respectively, in group 2. There was no statistical difference between the sensitivity, the specificity, and the predictive values of the OIA MAX test performed with 1 swab compared with those performed with 2 swabs (P>.10). There was no association between OIA MAX test sensitivity and the severity of pharyngitis as measured by the modified Centor criterion (history of fever, absence of cough, presence of pharyngeal or tonsillar exudates, and presence of cervical lymphadenopathy) scores. CONCLUSIONS: The OIA MAX test yielded comparable sensitivity and specificity in both study groups. The use of 2 throat swabs instead of 1 swab did not increase the sensitivity of the OIA MAX test. The performance of the OIA MAX test did not depend on the severity of pharyngitis.

Adolescent↗

Use of complementary and alternative medicine by parents of children with HIV infection and asthma and well children.

OBJECTIVE: Although the use of complementary and alternative medicine (CAM) in children is increasing, little is known about its use in children with human immunodeficiency virus (HIV) infection. This study investigated the use of CAM by parents of children with HIV infection (H), children with asthma (A), and well children (W). Our hypothesis was that parents of the H group are more likely to use CAM than parents of the W or A group because of the nature and severity of the illness. MATERIALS AND METHODS: Parents of 152 subjects [H (n = 46), A (n = 53), and W (n = 53)] were interviewed on the use of CAM for their children, types of CAM, reasons for use/nonuse, methods of payment, and perceived benefits for their children. RESULTS: Compared with parents of the W and A groups, parents of the H group were less likely to be employed, were less likely to have private insurance, were less likely to have a high school or college education, and were more likely to be black. Interestingly, 38% of the W parents used CAM in their children compared with 22% in the H group and 25% in the A group. More than 80% of all three groups paid out of pocket for their use of CAM in their children. Within these groups, H parents were more likely to want CAM as part of their child's medical care (H = 91% vs W = 75% and A = 67%, P = 0.02) and were more likely to believe that CAM was expensive (H = 78% vs W = 57% and A = 60%, P < 0.01). CONCLUSIONS: Our study revealed a relatively high rate of CAM usage by parents of all three study groups. Although parents of children with HIV infection were more likely to want CAM as part of their children's medical care, their rate of CAM usage was not higher than that in well children. This may be related to their socioeconomic factors. A larger and more diverse study population may provide more information on factors contributing to CAM usage in chronically ill and well children.

Asthma↗

Antibacterial resistance.

Resistance to antimicrobial agents, which was recognized more than 50 years, continues to be a major cause of increased morbidity, mortality and health care cost. Overuse of antibiotics is considered the major contributing factor; however, poor implementation of infection control measures, prolonged hospitalization, admission to intensive care units and the use of invasive procedures are other contributing factors. The authors review the epidemiology, mechanism of resistance, treatment options and prevention measures of infections caused multi-drug resistant S. pneumoniae, methicillin-resistant S. aureus (MRSA), macrolide-resistant S. pyogenes and vancomycin-resistant enterococci (VRE) in pediatric patients. Antibacterial resistance among Gram-negative organisms, including extended spectrum beta-lactamase (ESBL) producing enteric bacteria, and the management and prevention of infections caused by these organisms are also discussed.

Child↗

Advances in prevention of mother-to-child HIV transmission.

Advances have been made in the understanding of the pathogenesis of mother-to-child transmission of human immunodeficiency virus (HIV). Most transmission occurs during delivery and after birth throught breastfeeding. For this reason, efforts to interrupt transmission have focused on peripartum period and infant feeding. This includes the use of antiretroviral therapy, elective cesarean section and avoidance of breastfeeding. This review summarizes recent major studies and new development on the prevention of mother-to-child HIV transmission. The application and the impact of such interventions in developing world is discussed. Prevention of mother-to-child transmission of HIV should now be integrated as part of basic maternal and child health services in developing countries.

Adolescent↗

Human herpesvirus 6 (HHV6) infection.

Human herpes virus-6 was first reported in 1986 and is the sixth member of the herpes virus family. HHV-6 consists of two closely related variants HHV-6A and HHV-6B. The majority of infections occur in healthy infants with most infections caused by HHV-6B. The virus preferentially infects CD4+T-lymphocytes and the surface marker CD46 acts as a co-receptor. Infection is followed by persistence and latency in different cells and organs including monocytes/macrophages, salivary glands, the brain and the kidneys. In this article we will discuss the clinical manifestations of HHV-6 infection in healthy children and the syndromes associated with HHV-6 reactivation in immunocompromised patients. Evidence of association between HHV-6 infection and different clinical entities such as multiple sclerosis, malignancy, infectious momononucleosis, drug hypersensitivity syndromes and skin eruptions is discussed. Published data on the use and efficacy of antiviral agents in complicated infections and infections in immunocompromised patients is presented.

Adolescent↗

Severe cytomegalovirus enterocolitis in an immunocompetent infant.

Gastrointestinal cytomegalovirus infection is a common opportunistic infection in immunocompromised patients. It is a rare cause of enterocolitis in immunocompetent hosts. We present a case of severe cytomegalovirus enterocolitis causing intractable diarrhea in a previously healthy infant. The child was successfully treated with intravenous ganciclovir.

Cytomegalovirus↗

Vancomycin-resistant Enterococcus faecium endocarditis in a premature infant successfully treated with linezolid.

A 4 1/2-month-old, 26-week premature infant with multiple complications of prematurity required a central venous catheter for venous access and antibiotic treatment of bacterial nosocomial infections. He developed tricuspid valve endocarditis with vegetation caused by Enterococcus faecium resistant to ampicillin, vancomycin and quinupristin-dalfopristin but susceptible to linezolid. He was successfully treated with linezolid intravenously (7 weeks) and then orally (2 weeks).

Acetamides↗

Staphylococcal acalculous cholecystitis in a child.

Acute acalculous cholecystitis is inflammation of the gallbladder in the absence of gallstones. It usually occurs in critically ill patients and is rare in the pediatric age group. We describe a 12-year-old boy who presented with fever, jaundice, and abdominal pain and was found to have acute acalculous cholecystitis, sacroiliitis, and pelvic osteomyelitis associated with bacteremia as a result of Staphylococcus aureus. Antibiotic therapy without surgical intervention was effective. A high index of suspicion is required to make an early diagnosis and institute appropriate treatment for children with this condition. Although cholecystectomy has been considered the standard therapy, medical treatment alone can be successful.

Acute Disease↗

Increased prevalence of G1P[4] genotype among children with rotavirus-associated gastroenteritis in metropolitan Detroit.

The G and P genotypes of rotavirus stool isolates from 100 children were determined by reverse transcription-PCR and nucleotide sequencing. G1P[4] was the most prevalent genotype(41%), followed by G1P[8] (16%) and G4P[4] (14%). The G genoypes detected were G1 (73%), G4 (17.4%), G9 (6.3%), and G2 (2.8%). The P genotypes were P[4] (71%) and P[8] (29%). Coinfection with more than one G genotype occurred in 12 patients, and coinfection with more than one P genotype occurred in 11 patients.

Child↗

Severe hepatitis associated with oxacillin therapy.

A 6-year-old girl had fever, abdominal pain, and severe anicteric hepatitis during intravenous oxacillin therapy for staphylococcal osteomyelitis. She had greatly elevated liver enzymes, prolonged prothrombin time, leukopenia, and eosinophilia. Clinical symptoms resolved and laboratory data returned to normal after withdrawing oxacillin and substituting cefazolin. This hepatotoxicity appears to be specific to oxacillin and not to other beta-lactams. Monitoring liver function tests during oxacillin therapy, especially in patients receiving prolonged treatment, may be warranted.

Chemical and Drug Induced Liver Injury↗