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Biomedical subjects

D Beste

Publications and source records attributed to D Beste.

6 recordsLinked to original sources
PubMed2000

Evaluation of serotype prediction by cpsA-cpsB gene polymorphism in Streptococcus pneumoniae.

New pneumococcal conjugate vaccines covering a limited number of serotypes are likely to come into widespread use over the next few years. It is unknown what effect this will have on the relative importance of different serotypes as causes of pneumococcal infection. Hence, it will be important to monitor serotype prevalence before, during, and after the introduction of new vaccines. We have investigated the ability of a PCR method based on polymorphisms in two genes common to the different capsule loci to predict the serotype of 93 clinical isolates of Streptococcus pneumoniae submitted to the Central Public Health Laboratory in 1997. Of 70 isolates with vaccine serotypes, 65 were predicted to belong to the correct serotype; this number was improved to 69 with the inclusion of two additional patterns to the database. Of 23 isolates with other serotypes, 19 were correctly predicted as non-vaccine serotypes, the discrepancy lying with four isolates of 6A (non-vaccine serotype) that were indistinguishable from isolates of 6B (vaccine serotype). In situations in which culture of the organism is not feasible, this method could potentially be applicable directly to clinical specimens and could be a valuable aid to the surveillance of pneumococcal serotypes.

Bacterial Capsules↗
PubMed1997

Pediatric aerodigestive foreign body injuries are complications related to timeliness of diagnosis.

Foreign body (FB) injury from aspiration or ingestion is a common pediatric health problem. Diagnosis relies on clinical judgment plus medical history, physical examination, and radiographic evaluation. A multi-institutional review of 1269 FB events revealed that 85% were correctly diagnosed following a single physician encounter. However, 15% of the children had an elusive diagnosis (>1 week), despite previous evaluation. Delays in diagnosis were seven times more likely to occur in aspirations than in ingestions. Secondary injuries (e.g., pneumonia and atelectasis) occurred in 13% of airway FBs but in only 1.7% of esophageal FBs. Plain radiographs were used in 82% of children, and special studies (e.g., fluoroscopy) in only 7%. We conclude that diagnosis of FB injury in children is frequently achieved at the initial evaluation but that continued surveillance by follow-up visits to health care facilities from parents and other caretakers is important, to reduce pulmonary injuries.

Adolescent↗
PubMed1995

Diagnosis and management of pediatric laryngeal stenosis.

Pediatric laryngeal stenosis presents diagnostic and management challenges. A team approach involving multiple pediatric subspecialties is desirable. Management includes conservative endoscopic and aggressive open surgical intervention. Deciding which approach is appropriate presents a diagnostic dilemma. The long-term prognosis for most children is very good, and the successes are emotionally rewarding.

Endoscopy↗
PubMed1989

Subacute sinusitis in children.

The bacteriologic characteristics of subacute maxillary sinusitis have not been delineated in the pediatric age group. Forty children between the ages of 2 and 12 years with respiratory symptoms for at least 30 but less than 120 days were evaluated. Nasal discharge and cough were the most prominent symptoms. Common radiographic findings were diffuse opacification and mucosal thickenings. Sinus aspiration was performed on 52 sinuses of 40 children. Bacterial colony counts greater than or equal to 10(4) colony-forming units per milliliter were found in 30 (58%) of 52 sinus aspirates obtained from 26 (65%) children. The bacterial species most commonly recovered were Streptococcus pneumoniae, Haemophilus influenzae, and Branhamella catarrhalis. Twenty-five percent of the maxillary sinus isolates were beta-lactamase producing; however, many of these were recovered from patients who had recently received antimicrobial therapy. Subacute and acute maxillary sinusitis are similar in regard to causative organism, clinical presentation, and radiographic findings.

Child↗
PubMed1987

An assessment of preoperative coagulation screening for tonsillectomy and adenoidectomy.

Preoperative coagulation studies are commonly employed in order to try to identify the 2-4% of all patients undergoing tonsillectomy/adenoidectomy surgery who experience hemorrhagic complications. In an atmosphere of increasing cost consciousness, evaluation of the efficacy of screening tests is warranted. The records of 994 out of 1050 patients consecutively scheduled for tonsillectomy, adenoidectomy or T&A over a 2.5-year period were retrospectively reviewed in order to determine the usefulness of partial thromboplastin (PTT) and prothrombin time (PT) screening in predicting surgical and postsurgical bleeding. For patients with no history or clinical signs indicating possible bleeding disorder, preoperative PT and PTT failed to predict bleeding as an outcome. Also no patients were identified in this series to have previously undiagnosed coagulopathies on the basis of screening PT/PTT. The purpose of any screening test is to identify disease early enough for therapeutic intervention to be effective. Although preoperative PT/PTT will occasionally identify an unsuspected von Willebrand's or other coagulopathy, the prevalence of bleeding disorders in patients with negative history and examination is low enough that PT/PTT has essentially a zero predictive value for surgical bleeding. Screening PT/PTT should therefore be reserved for patients with known or suspected coagulopathies.

Adenoidectomy↗