PubMed Health⌕ Search

Biomedical subjects

K P O'Neill

Publications and source records attributed to K P O'Neill.

12 recordsLinked to original sources
PubMed1992

Etiology of acute lower respiratory tract infections in children in a rural community in The Gambia.

Approximately 500 children younger than 5 years old resident in 7 villages in a rural area of The Gambia were monitored closely for 1 year for episodes of acute lower respiratory tract infection (ALRI). Each episode was investigated with antigen detection techniques and antibody assays as well as culture for bacteria and viruses. A pathogen was identified in 76 (34.2%) of 222 cases with clinical signs of ALRI and in 34 (42%) of the 81 cases who, in addition, had radiologic evidence of ALRI. Evidence of infection with a bacterial pathogen, most commonly Streptococcus pneumoniae or Haemophilus influenzae, was obtained in 32 (14.4%) cases with clinical signs of ALRI (23.5% of those with radiologically proved pneumonia). Viral agents were cultured from 42 (19%) of 221 cases but also from 14 (14.6%) of 96 controls some of whom had minor symptoms of upper respiratory tract infection. In the absence of an outbreak of respiratory syncytial virus the viral agents recovered most often were influenza A and adenoviruses.

Bacterial Infections↗
PubMed1992

Endothelin does not affect experimentally induced corneal neovascularization.

Endothelin, a potent vasoconstrictor, was found to be ineffective in the treatment of experimentally induced corneal neovascularization. Endothelin was administered topically, subconjunctivally, and intraluminally in serial concentrations ranging from 0.0005 to 5.0 micrograms/mL in New Zealand white rabbits without effect. Electron microscopy of the neovascular cornea revealed the vessels consisted only of endothelin and pericytes. Hence, the vessels were not responsive to endothelin because they lacked contractile smooth muscle.

Animals↗
PubMed1991

Etiology of acute lower respiratory tract infections in Gambian children: I. Acute lower respiratory tract infections in infants presenting at the hospital.

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 involved Streptococcus pneumoniae (20%) or Haemophilus 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 with Chlamydia trachomatis was diagnosed in 2 infants with acute lower respiratory tract infection and in 1 control infant.

Acute Disease↗
PubMed1991

Etiology of acute lower respiratory tract infections in Gambian children: II. Acute lower respiratory tract infection in children ages one to nine years presenting at the hospital.

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 viral-bacterial infections. The bacterial pathogens most frequently identified were Streptococcus pneumoniae and Haemophilus influenzae found in 61 and 15% of patients, respectively. The viral pathogen most frequently recovered was respiratory syncytial virus (12%). Evidence of Chlamydia pneumoniae strain TWAR and Mycoplasma pneumoniae infection 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.

Acute Disease↗
PubMed1991

Methicillin-resistant Staphylococcus aureus corneal ulcers.

Three patients with corneal ulcers had gram-positive cocci isolated on initial scrapings. There was no response to topical fortified aminoglycosides or cephalosporins. Cultures revealed methicillin-resistant Staphylococcus aureus that was sensitive only to topical vancomycin eye drops. Because the microbiologic spectrum is similar, vancomycin should be considered instead of a cephalosporin in the treatment of corneal ulcers to cover methicillin-resistant S. aureus and S. epidermidis.

Aged↗
PubMed1989

Latex agglutination test for diagnosing pneumococcal pneumonia in children in developing countries.

OBJECTIVE: To prepare and assess the sensitivity and specificity of a latex agglutination test specific for the serotype of antigen in diagnosing pneumococcal pneumonia in Gambian children. DESIGN: Comparison of agglutination test specific for serotype with culture of blood and lung aspirates, countercurrent immunoelectrophoresis, and commercial latex agglutination tests in diagnosing pneumococcal pneumonia. Cross reaction studies and investigation of 102 control children to determine specificity of agglutination test specific for serotype. SETTING: General medical ward of Medical Research Council laboratories, The Gambia. PATIENTS: 101 Gambian children aged between 2 months and 10 years admitted with severe pneumonia. INTERVENTIONS: Serum samples were boiled and treated with edetic acid, and urine samples were boiled and concentrated 25 times before testing. END POINT: A latex agglutination test specific for the serotype of pneumococcal antigen that is sensitive and highly specific for detecting pneumococcus in the urine of patients with pneumococcal pneumonia. MEASUREMENTS AND MAIN RESULTS: Concentrated urine samples from 16 of the 21 children (76%) with pneumococcal pneumonia established by results of culture of blood or lung aspirates gave a positive result with the agglutination test specific for serotype, whereas only four of the 102 urine samples obtained from control children without pneumonia gave positive results. The serotypes of antigens detected in the urine of children with pneumococcal pneumonia and the serotypes of pneumococci isolated from cultures of blood or lung aspirates were the same in all cases. CONCLUSIONS: When performed on urine samples the agglutination test specific for serotype has a high specificity and is more sensitive than culture of blood or lung aspirates, commercial agglutination tests, or countercurrent immunoelectrophoresis in identifying pneumococcal pneumonia. It is easy to use and should be especially useful in communities with limited laboratory facilities.

Antigens, Bacterial↗
PubMed1989

Assessment of clinical criteria for identification of severe acute lower respiratory tract infections in children.

222 acute lower respiratory tract infections (LRI), as defined by the World Health Organisation, were identified during one year's surveillance of a cohort of 500 Gambian children aged 0 to 4 years. Symptoms and signs at presentation were related to radiological evidence of lobar consolidation, indicating severe LRI. In infants, a fever of greater than 38.5 degrees C, refusal to breast-feed, or the presence of vomiting were the best predictors of severe LRI. In children aged 1 to 4 years, a fever of greater than 38.5 degrees C or a respiratory rate greater than 60/min were the most accurate clinical signs for severe LRI. Chest indrawing did not discriminate severe LRI. These community-based findings differ from results of hospital-based studies.

Acute Disease↗
PubMed1989

Follow-up of Gambian children for a 1-year period after rotavirus infection.

To investigate the hypothesis that rotavirus infection in young children can trigger chronic diarrhoeal disease, a group of cases from a documented epidemic of rotavirus and a group of matched controls were followed for a 1-year period after infection. No evidence of excess chronic diarrhoea or vomiting in the group known to have been infected with rotavirus was found.

Diarrhea, Infantile↗
PubMed1988

Trial of co-trimoxazole versus procaine penicillin with ampicillin in treatment of community-acquired pneumonia in young Gambian children.

134 Gambian children under 5 years of age with severe pneumonia (as defined by the World Health Organisation classification of acute respiratory infections) were given either oral co-trimoxazole for 5 days, or a single intramuscular dose of fortified procaine penicillin and 5 days of oral ampicillin. At 2 weeks, there was no significant difference in outcome between the two groups. Co-trimoxazole is much less expensive than ampicillin or procaine penicillin, requires only twice-daily administration, and can be given by health-care staff with little training. The results support the use of co-trimoxazole as the antibiotic of first choice in outpatient management of young children with pneumonia in developing countries.

Ambulatory Care↗
PubMedDate not supplied

Conjunctival mass formation with unexpected foreign body.

Two 4-year-old females with inferior fornix conjunctival lesions are described. Both cases proved to be cotton-material-induced granulomas. These cases are reported to emphasize that recognition of foreign body conjunctival granuloma remains as a challenge to ophthalmologists.

Child, Preschool↗
PubMedDate not supplied

Excimer laser photorefractive keratectomy for myopia: six-month results.

Six eyes of six patients with myopia between -4.00 and -8.00 diopters underwent 193 nm Argon/fluoride excimer laser photorefractive keratectomy as part of a Phase II-A FDA Study. Six months after surgery, four of the six eyes had a spherical equivalent refraction within +/- 1.00 D; five eyes saw 22/30 or better without correction. All corneas demonstrated a faint reticulated subepithelial haze most visible by sclerotic scatter illumination. There were no episodes of delayed epithelial healing or recurrent erosions, and patients had no loss of contrast sensitivity, visual acuity under glare testing, or corneal sensation at the 3-month or 6-month visit. In this limited clinical trial, the excimer laser was capable of changing the refractive power of the cornea for correction of myopia. Long-term follow up of these patients will be necessary to determine the safety and efficacy of the procedure.

Adult↗