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At least 73 records · Page 4Linked to original sources

Streptokinase treatment for femoral artery thrombosis after arterial cardiac catheterisation in infants and children.

Data on 205 children who underwent retrograde arterial catheterisation were studied to assess the frequency of femoral artery thrombosis and the safety and efficacy of systemic streptokinase treatment for this complication. In 29 (14%) a transarterial balloon dilatation was performed. In 15 (7.3%) patients impaired arterial perfusion due to vascular spasm with or without thrombus formation was seen in the cannulated leg after catheterisation. Despite heparinisation, signs of impaired arterial circulation persisted in nine patients (4.4% of the total). In these patients femoral artery thrombosis was strongly suspected. Six (53%) of these had undergone a balloon dilatation. Therefore in this study the risk of femoral artery thrombosis developing was 12 times greater after transarterial balloon dilatation than after arterial catheterisation without dilatation (20.6% v 1.7%). Systemic infusion of streptokinase was started in all patients with femoral artery thrombosis. Arterial perfusion became normal in all patients, though in one this was delayed. Haematological monitoring showed lengthening of the thrombin time and a decrease of the fibrinogen concentration during streptokinase treatment. There were no serious complications. Systemic infusion of streptokinase is a safe and useful treatment in children with persistent femoral artery thrombosis after arterial cardiac catheterisation.

Cardiac Catheterization↗

Clinical experience of managing empyema thoracic in children.

Data of 54 children with a diagnosis of thoracic empyema at a medical center in central Taiwan from January 1991 through April 2001 were analyzed. Their mean age was 4.4 years and the mean hospital stay was 13 days. Streptococcus pneumoniae was the most common pathogen, followed by Staphylococcus aureus and Haemophilus influenzae. These patients were divided into 2 groups according to the treatment method. Twenty-two patients were treated successfully with antibiotics and tube thoracostomy, whereas the other 32 children required further pleural decortication with antibiotic treatment. In patients with empyema, decortication allowed for more rapid defervescence than did closed tube thoracostomy (1.94 vs 5.04 days; p<0.001) and there were no complications in the group that underwent decortication treatment (p<0.03). In conclusion, the decortication of loculated empyema thoracis in children is a safe and effective management procedure.

Adolescent↗

3M/house cochlear implant in children.

Data on 265 children with the 3M/House single-channel cochlear implant have been collected and analyzed for presentation to FDA. Significant improvements from preimplant to postimplant in auditory detection, auditory discrimination/identification, and speech production have been demonstrated. Some children also demonstrate the ability to recognize words and sentences without the aid of speechreading.

Adolescent↗

[Etiology of brain abscesses in children].

Data on 67 children treated for abscess of the brain in 1966-1984 years are analysed. The work deals with study of the etiology of brain abscesses in children and the possibility of their prevention. Comparative analysis of the causes of brain abscesses in different age groups (from 10 weeks to 15 years) shows pyoinflammatory skin diseases to be the most common cause of brain abscesses in young children, in those under the age of 12 months in particular. In the next age groups the incidence of cerebral abscesses caused by pyogenic diseases of the skin reduces whereas that of abscesses of otorhinosinusogenic origin increases.

Adolescent↗

[Evaluation of the surgical treatment of retinal detachment in children. Personal data].

Twenty nine children aged 8-18 years with retinal detachment were treated in the period 1980-1987. The cause of detachment was in 27 cases injury and in 2 cases rupture of a congenital retinal cyst. In the majority of cases the detachment was connected with a dialysis at the ora serrata and comprised two quadrants of the fundus' periphery. The operation in 25 children consisted on implantation of a silicone sponge. A hard silicone implant situated intrasclerally with a band round the globe was used in 3 persons. A cerclage of the eye ball with a silicone sponge was performed only in one child. In 25 children the retina reattached after operation.

Adolescent↗

Annual fertility rates from Census data on own children: comparisons with vital statistics data for the United States.

This paper begins by describing the procedure and data requirements for calculating annual fertility rates from census data on own children. Then, using data from the United States Censuses of 1960 and 1970, fully adjusted estimates are presented and compared with recorded vital statistics rates. Total fertility estimates derived from own children data for whites average less than two percent lower than the recorded rates- a difference that can be attributed partially to the fact that the estimates are adjusted for net census undercount but the recorded rates are not. Even without adjustments for mortality, children not living with their mothers, and net census undercount, the own children data estimates accurately replicate recorded trends (even though the levels are misspecified). The utility of own children data for the study of differential fertility is discussed.

Adolescent↗

Use of antimicrobial agents for community-acquired lower respiratory tract infections in hospitalised children.

Data collected from 613 children aged 2-14 years who had been hospitalized for acute bronchitis, wheezing, or pneumonia were analysed to evaluate the prescribing practices of pediatricians treating community-acquired lower respiratory tract infection. Antibiotics were prescribed for 92.1% of the children: 85% had acute bronchitis, 72% had wheezing, and 97.9% had pneumonia. A high frequency of antibiotic overuse and inappropriate prescriptions was noted. In order to contain costs and limit the risk of resistant bacteria emerging, it is urgent that pediatricians and parents be educated in the proper use of antibiotics.

Adolescent↗

Reflex anal dilatation associated with severe chronic constipation in children.

Data were collected from children with severe chronic constipation, and the appearance of the anus at presentation was noted. A visibly relaxed sphincter (indicating a degree of reflex anal dilatation) was seen in 20 children out of the 129 in whom this sign was sought. The only differentiating characteristic in this group of children was the greater degree of faecal loading judged on palpation of the abdomen. This evidence supports the hypothesis that constipation of such severity that it was referred to a specialised clinic can produce signs that may lead to an erroneous diagnosis of sexual abuse by anal penetration.

Adolescent↗

Persistence of occurrence of injury: can injuries of preschool children predict injuries of school-aged children?

Data regarding 10,394 children from the 1970 British birth cohort were used to assess the consistency of injuries reported by parents as occurring between birth and 5 years of age and injuries reported between 5 and 10 years of age. Children with three or more separate injury events reported between birth and 5 years of age were 5.9 times more likely to have three or more injuries reported between 5 and 10 years of age than children without early injuries (95% confidence interval = 4.4 to 8.0). Children with one or more injuries resulting in hospitalization before 5 years of age were 2.5 times as likely to have one or more admissions to the hospital for injuries after 5 years of age than children with no early hospitalizations for injuries (95% confidence interval = 2.0 to 3.3). Stepwise regression was used to identify other predictors of injury. The number of injuries before 5 years of age were the best predictors of injuries reported between 5 and 10 years of age, followed by male sex, aggressive child behavior, young maternal age, many older, and few younger siblings. The findings of this study are consistent with two other large studies that relied on medical records rather than parental report and that focused on more severe injuries. Children with several of the identified risk factors can be predicted to have high rates of accidental injuries and may benefit from focused intervention.

Accidents↗

Stroke in young adults and children.

Data from studies of 337 children and 1606 young adults are summarized to identify the major causes of stroke in these age groups. In children under 15 years of age, stroke occurs in patients with congenital heart disease, nonatherosclerotic vasculopathies, infection, and hematologic defects like sickle cell disease. In patients 15 to 35 years of age, dissection, cardioembolism, nonatheroslerotic vasculopathies, and prothrombotic states cause a significant percentage of strokes. In adults over 35 years of age, traditional atherosclerotic risk factors predominate. Lifestyle choices (e.g., cigarette smoking, alcohol consumption, and illicit drug use) can significantly increase the rate of stroke among young adults in a community. Limited access to healthcare may increase the role of infectious disease and peripartum complications.

Adult↗

Somatosensory evoked potentials after posterior tibial nerve stimulation--normative data in children.

We report normative data of somatosensory evoked potentials to posterior tibial nerve stimulation from 47 children 4-15 years of age. We recorded near-field potentials from the peripheral nerve, the cauda equina, the lumbar spinal cord and the somatosensory cortex. Far-field potentials were recorded from the scalp electrodes with a reference at Erb's point and on the earlobe. The near-field potentials N8 (peripheral nerve) and P40 (cortex) were present in all children. N20 (near-field from the cauda equina) was recorded in 38 subjects. N22 (near-field from the lumbar spinal cord), P30 and N37 ( both far-field waveforms probably generated in the brainstem) were recorded in 46 subjects each. The latencies and the peripheral conduction time (N8-N22) increased with age, while the central conduction time (N22-P40) and the intracranial conduction time (P30-P40) both decreased with age (up to about 10 years of age). The spinal conduction time (N22-P30) was relatively independent of age. The interpeak latencies allow the assessment of specific portions of this pathway. The subcortical posterior tibial nerve-somatosensory evoked potentials are of particular interest in children when the cortical peaks are influenced by sedation and sleep, or by anaesthesia.

Adolescent↗

[A telemetric study of central rhythms in children].

Data concerning central (mu) rhythms in children are reported, these rhythms being studied by means of prolonged telemetric recording which makes it possible to study various experimental situations. Several different patterns of mu rhythm were observed in every subject, depending on the experimental situation. The level and the quality of attention on the one hand, immobility on the other, were found to be the two main factors which facilitated the occurrence or the maintenance of mu rhythms. The induction of movement, especially of the hand, was the major cause of blocking pre-existing mu rhythms, but attention alone was also able to provoke the same reaction. These data were compared with those obtained in animals by direct recording from the cortical somaesthetic areas. The respective roles of vigilance, attention and movement are discussed.

Attention↗

[Clinical and laboratory characteristics of bacterial meningitis in children].

Data from the records of 528 children under 15 years old with diagnosis of acute bacterial meningitis, admitted at the Hospital Couto Maia between 1990 and 1992 were analyzed. Bacterial meningitis was more frequent in children under the age of 1 year (37.8%). The most common etiologic agent was H. influenzae (42.2%). The global lethality was 20.9%. Individual predictors of poor outcome were: absence of the "classic triad", CSF cell count under 1000/mm3, age under 2 years, presence of seizures, depressed sensorium, and S. pneumoniae as causal agent.

Adolescent↗

Lymphocyte subsets in children younger than 2 years old: normal values in a population at risk for human immunodeficiency virus infection and diagnostic and prognostic application to infected children.

Data were collected prospectively from 116 children younger than 2 years old who were seen at the Duke Pediatric AIDS Clinical Trials Unit for known human immunodeficiency virus seropositivity. Forty-six (40%) of these children were human immunodeficiency virus-infected and 70 were not infected. Using 3-month blocks, 10th, 50th and 90th percentiles were calculated for the CD4+ and CD8+ cell counts, percentage of lymphocytes positive for CD4 and CD8 and T4:T8 ratios. Results from the infected and uninfected children were compared. By 3 to 6 months of age the infected patients had significantly lower CD4+ counts, percentage CD4+ cells and T4:T8 ratios, whereas the percentage of CD8+ lymphocytes was significantly higher. Absolute CD8+ counts were approximately the same in infected and uninfected children through age 2 years. Most infected children had one or more abnormal lymphocyte subset results (less than the 10th percentile for uninfected patients) by age 2: 83% had an abnormal CD4+ percentage; 78% had an abnormal T4:T8 ratio; and 67% had an abnormal CD4+ count. All 13 children who had an opportunistic infection (at any age) had an abnormal CD4+ percentage before age 2 years, and 12 of 13 had a low absolute CD4+ count or T4:T8 ratio. Among patients who died 10 of 11 had 1 or more low CD4+ count, 9 of 11 had an abnormal CD4+ percentage and 8 of 11 an abnormal T4/T8 ratio.

CD4-CD8 Ratio↗

Parents' beliefs about preventing gun injuries to children.

Data were collected from parents bringing children to selected pediatric practices in Maryland using questionnaires and focus group discussions. Gun ownership ranged from 27% in the suburban practice to 53% in the rural practice. Unrealistic perceptions of children's capabilities and behavioral tendencies with regard to guns were common among gun owners. Half of all gun-owning parents believed that active strategies (eg, education, supervision) were the best method of preventing gun injuries to children older than 12 years of age. Nearly all gun owners indicated a willingness to follow their pediatrician's advice about gun storage, but only 19% of the mothers and 10% of the fathers said they would follow advice to remove guns from the home. Among parents who did not have a gun in the home, 40% said they would consider obtaining one if they felt threatened; however, 73% of these parents indicated they would be dissuaded from doing so by a pediatrician's advice about the risks of keeping guns in the home. Results suggested that pediatricians will be most effective if they recommend passive strategies (eg, removing guns from the home or storing guns unloaded and locked) on the basis of children's developmental capabilities and behavioral tendencies and make their recommendations part of general counseling about child safety.

Adult↗

[Hemosorption and ultraviolet irradiation of blood in the complex treatment of suppurative and septic diseases in children].

Data on the observation of 120 children aged from one to seven years with ++pyo-septic diseases are described. The complex of intensive therapy included methods of extracorporal detoxication. Positive dynamics was noted after hemosorption and UV irradiation of blood. Preliminary UV irradiation of blood before sorption eliminated metabolic disorders. Less lethality was noted.

Blood↗