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Severe malaria in children in Papua New Guinea 总被引:1,自引:0,他引:1
Allen SJ; O'Donnell A; Alexander ND; Clegg JB 《QJM : monthly journal of the Association of Physicians》1996,89(10):779-788
The clinical features of severe falciparum malaria and risk factors for
mortality were studied in 489 children admitted with malaria to Madang
Hospital, Papua New Guinea. The most common severe manifestations of
malaria were severe anaemia (22%) and coma (16%). Children with severe
anaemia were younger than those with coma (median age 2.2 vs. 3.7 years)
and had been ill for longer before admission (median 7 vs. 4 days,
respectively). Although the clinical features of coma in Madang children
with malaria resembled closely those reported in African children,
mortality was lower (8% vs. 17-25%, respectively). Overall, 17 (3.5%)
children died, most within 12 h of admission. A high level of plasma
lactate (> or = 5 mmol/l) was common (20%) and was the major predictor
of death in multiple regression analysis. Raised plasma creatinine and
decreased plasma bicarbonate were also independent predictors of mortality.
Coma was not predictive of death, although a high proportion of children
with profound coma died. Investigation of the causes of acidosis in
children with malaria is a high research priority. In view of the short
time interval between admission and death in many children, emphasis must
be placed on the prevention or early recognition and treatment of acidosis
in the district health clinic as well as the central hospital.
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The impact of research education on student nurse attitude,skill and uptake of evidence‐based practice: a descriptive longitudinal survey 下载免费PDF全文
Matthew J Leach RN BN ND DipClinNutr PhD Anne Hofmeyer RN DipUnivTeach MPHC PhD Amanda Bobridge RN BN BHSc PhD 《Journal of clinical nursing》2016,25(1-2):194-203
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CJ Stewart ECL Marrs S Magorrian A Nelson C Lanyon JD Perry ND Embleton SP Cummings JE Berrington 《Acta paediatrica (Oslo, Norway : 1992)》2012,101(11):1121-1127
Aim: To describe gut colonization in preterm infants using standard culture and 16S gene rRNA profiling, exploring differences in healthy infants and those who developed NEC/late onset sepsis (LOS). Methods: Ninety‐nine stools from 38 infants of median 27‐week gestation were cultured; 44 stools from 27 infants had their microbial profiles determined by 16S. Ordination analyses explored effects of patient variables on gut communities. Results: Standard microbiological culture identified a mean of two organisms (range 0–7), DGGE 12 (range 3–18) per patient. Enterococcus faecalis and coagulase negative staphylococci (CONS) were most common by culture (40% and 39% of specimens). Meconium was not sterile. No fungi were cultured. Bacterial community structures in infants with NEC and LOS differed from healthy infants. Infants who developed NEC carried more CONS (45% vs 30%) and less Enterococcus faecalis (31% vs 57%). 16S identified Enterobacter and Staphylococcus presence associated with NEC/LOS, respectively. Conclusions: Important differences were found in the gut microbiota of preterm infants who develop NEC/LOS. The relationship of these changes to current practices in neonatal intensive care requires further exploration. 相似文献
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RJ Mascarenhas ND Hapangama PJ Mews A Burlakoti S Ranjitkar 《Australian dental journal》2019,64(1):106-110
Chronic orofacial pain of neuropathic origin can present diagnostic and management dilemmas to dental practitioners and also affects the patient's quality of life. Intracranial aneurysms are a potential cause of stroke (e.g. sub‐arachnoid haemorrhage) that is usually associated with, high rates of mortality and morbidity. A patient who had been previously managed for symptoms of temporomandibular joint disorder (TMD) presented with sharp, shooting pain of moderate intensity. It was precipitated by swallowing, and radiated to the right throat, posterior border of the mandible, ear and temporomandibular joint. Clinical and radiological investigations ruled out odontogenic pain, TMD and other more common types of facial pain. Magnetic resonance imaging revealed a 7 × 6 mm aneurysm in the right middle cerebral artery (MCA) which was subsequently surgically clipped. Interestingly, the facial pain resolved after this procedure. Compression of the insular region of the brain innervated by the trigeminal, glossopharyngeal and vagus nerves provides a plausible explanation for the pain reported. To our knowledge, this is the first case of facial neuralgia associated with an aneurysm in the MCA which emphasizes the importance of a multidisciplinary approach in the diagnosis and management of unusual cases of chronic orofacial pain. 相似文献