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Biomedical subjects

L W Herzog

Publications and source records attributed to L W Herzog.

6 recordsLinked to original sources

What is fever? Normal temperature in infants less than 3 months old.

To determine the normal temperature of healthy infants, we studied 691 infants less than 3 months of age being seen for regularly scheduled well-baby visits. All temperatures were taken rectally with an electronic thermometer. The mean temperature was 37.5 degrees C +/- 0.3 degrees C. Using a cutoff of 2 standard deviations (SD) above the mean, fever would be defined as a temperature > or = 38.1 degrees C. The 95th percentile was 38.0 degrees C, and > or = 38.1 degrees C would correspond to values above the 95th percentile. The most widely used definition of fever at present is a temperature > or = 38.0 degrees C; by this definition, 6.5% of these well infants would be considered to have a fever. A significant rise in temperature with age was noted. For infants from birth to 30 days old, 2 SD above the mean was 38.0 degrees C; for those 31 to 60 days old, it was 38.1 degrees C; and for those 61 to 91 days old, it was 38.2 degrees C. Similarly, the 95th percentile was 37.9 degrees C, 38.0 degrees C, and 38.1 degrees C, respectively. Temperature also varied significantly with the season of the year, being higher in the summer (2 SD above a mean = 38.3 degrees C) than in the winter (2 SD above a mean = 38.0 degrees C). Fever should be defined as a temperature > or = 38.0 degrees C in infants less than 30 days of age, > or = 38.1 degrees C in 1-month-olds, and > or = 38.2 degrees C in 2-month-olds.

Body Temperature↗

Urinary tract infections and circumcision. A case-control study.

It has been shown that uncircumcised infants have a higher rate of urinary tract infections in the first few months of life. To investigate further the association between noncircumcision and urinary tract infections, a case-control study was performed of infant boys who had a catheterized or suprapubic urine culture done as part of an acute illness visit. Cases (n = 36) were those infants who had a positive culture (greater than 105 organisms per milliliter); controls (n = 76) had a negative culture (less than 103 organisms per milliliter). There were no significant differences found in the two groups in age, ethnic group, and type of medical insurance. All of the cases were uncircumcised, vs 32% of controls. The data were analyzed separately by age, ethnic group, type of insurance, and method of culture, and in all groups the cases were significantly more likely to be uncircumcised. Of the 31 cases who underwent roentgenographic investigations, 8 had abnormal findings. Noncircumcision seems to be a highly significant risk factor for urinary tract infection in infants up to 12 months of age, affects infants regardless of race and socioeconomic status, and is associated with anatomic abnormalities in 26% of cases.

Black or African American↗

High sodium rehydration solutions in well-nourished outpatients.

We studied the safety and efficacy of high-sodium oral rehydration solution in the out-patient management of children with diarrhea, with or without dehydration. We studied 68 outpatients with acute diarrhea; 32% had mild-to-moderate dehydration; the rest were not dehydrated. They were treated at home for 24 h with either high-sodium (90 mmol/l) or low-sodium (30 mmol/l) solution. None of the patients given high-sodium solution became hypernatremic. Of those patients who were dehydrated, 55% did not take enough fluid at home to repair their dehydration. We conclude that patients must be closely supervised for the initial rehydration period, but that high-sodium rehydration solutions can be safely given to outpatients for up to 24 hours.

Acute Disease↗

The frequency of foreskin problems in uncircumcised children.

We performed a retrospective survey to determine the frequency of problems of the foreskin among uncircumcised children. Among 545 boys aged 4 months to 12 years, there were 272 uncircumcised boys and 273 control patients who were circumcised at birth. The total frequency of complications was significantly higher in the uncircumcised group (14% vs 6%). Both balanitis (6% vs 3%) and irritation (4% vs 1%) were more frequent among the uncircumcised children, but the difference was not statistically significant. Problems with adhesions were uncommon (1.5%) and equal in both groups. Symptomatic phimosis was seen in eight patients. The frequency of medical visits for penile problems was significantly higher in the uncircumcised group (10% vs 5%). Although the overall frequency of complications was higher among the uncircumcised children, most of the problems were minor.

Balanitis↗

Comparison of enzyme immunoassay with radioimmunoassay for the detection of hepatitis B surface antigen.

A direct solid-phase enzyme immunoassay (Auszyme I) and a direct solid-phase radioimmunoassay (Austria II) for detection of hepatitis B surface antigen (HBsAg) were compared in tests with a panel of 347 human sera. Compared with RIA, EIA showed a sensitivity of 98% with 153 HBsAg-positive sera and a specificity of 99% with 194 HBsAg-negative sera. Sera that gave false negative and false positive results by EIA were re-examined by both RIA and EIA to confirm the initial result. Use of less than the recommended volume of serum for EIA produced results inconsistent with RIA in four of 27 sera examined. Quantitative correlation between RIA and EIA was low (r = 0.691). Positive controls used for EIA showed considerable variation from day to day, although intra-assay variation was much less. The sensitivity of the EIA method examined compares favourably with previously published EIA studies and with the RIA used in this study. Auszyme I EIA is a sensitive and specific third generation test for HBsAg that offers several advantages over currently used RIA techniques.

Evaluation Studies as Topic↗

Prevalence of lymphadenopathy of the head and neck in infants and children.

This study demonstrates the widespread prevalence of "normal" adenopathy in children; i.e., not associated with infectious adenitis or serious system illness. The knowledge of this distribution is helpful in determining when adenopathy may be pathologic. Occipital and postauricular adenopathy is a common nonspecific finding in infancy; but, over the age of 2 years, it is sufficiently rare that it can be a useful diagnostic finding. Cervical and submandibular nodes are rare in infants under 12 months but are common in older children. Supraclavicular nodes are probably pathologic at any age.

Aging↗