Leishmania antibodies in children’s serum samples in correlation with the disease in dogs

Sera of 489 children from Northern Greece aged between 6 months and 15 years of age and aflicted with different clinical entities, were tested for anti ? Leishmania infantum specific IgG and IgM antibodies, using an ELISA (enzyme linked immunosorbent assay) technique. In this survey, a remarkably high percentage (8.5%) of hospitalized children reacted positively to this method. Twenty three out of 489 children (4.7%) had IgG antibodies, seventeen (3.5%) IgM, while two (0.4%) had both IgG and IgM antibodies against soluble antigen of L. infantum promastigotes. Females had a higher seropositivity than males. The highest prevalence was observed in males aged between 6 months and 5 years old (10 out of 19), while the lowest was observed also in males aged between 11 and 15 years old (5 out of 11). Seropositivity rate was higher in children below 5 years of age. Some epidemiologic, as well as clinical data of canine Leishmaniosis from Northern Greece are discussed.     

住院儿童结核病79例治疗情况分析

目的对我所住院治疗的儿童结核病治疗情况进行临床分析,探讨其特点及疗效。方法对1997～2005年在我所住院治疗的79例0～14岁儿童结核病进行回顾性分析。结果 9年间在我所住院治疗患者2322例中0～14岁儿童结核病占3.4%,其中男、女各占49.45%和50.6%;婴幼儿占6.3%,学龄前儿童占21.5%,学龄期儿童占72.2%;原发性肺结核占7.6%,血型播散型肺结核占7.6%,继发性肺结核43例,占54.4%,其中菌阳12例,占27.9%;结核性胸膜炎31例（9例合并继发性肺结核）,占39.2%,结核性脑膜炎4例（2例合并肺结核）,占5.1%,79例中PPD试验强阳性者占87.3%,与肺结核患者密切接触者占49.4%。结论对PPD强阳性和肺结核密切接触的儿童要高度重视,要定期复查,早期发现,治疗管理是提高儿童结核的治愈率和降低死亡率的关键。     

Toxocarosis as zoonosis. A review of literature and the prevalence of Toxocara canis antibodies in 511 serum samples

A total of 511 serum samples from children aged between 6 months to 15 years old, with different clinical signs-living in the region of Northern Greece - were tested by ELISA (enzyme links immunosorbent assay) technique, for the detection of specific IgG and IgM antibodies against T. canis antigen. The reason IgM was detected was because IgM levels are elevated in the acute phase of toxocara infection, in spite of their notorious non-specificity. In this seroepidemiologic survey of children, a remarkably high percentage (12.5%) reacted positively to this method. Sixteen (3.1%) out of 511 sera showed IgG antibodies, 43 (8.4%) showed IgM, while 5 (1%) showed both IgG and IgM antibodies against T. canis E/S (excretory - secretory) antigen. Females were significantly more infected than males. Seropositivity rate was highest in children over the age of 10.     

Antipyretic effects of nimesulide in paediatric practice: a double-blind study

A double-blind, multi-centre study was carried out in 42 hospitalized children, aged 6 months to 8 years, suffering from acute respiratory tract infections with fever, to investigate the antipyretic activity of nimesulide. On entry, patients were allocated at random to receive either nimesulide oral suspension, 5 mg/kg/day divided into 3 daily doses, for 5 days or placebo. Both groups were treated simultaneously with antibiotics: children under 5 years of age received 100 mg amoxycillin/kg/day, those over 5 years received 40 to 50 mg erythromycin/kg/day. Measurements of rectal temperature before and during the 6 hours after the first dose of nimesulide showed a significant mean decrease from a baseline value of 38.89 +/- 0.74 degrees C to 37.28 +/- 0.76 degrees C at 6 hours. In the placebo group, no significant changes were observed between baseline (38.82 +/- 0.67 degrees C) and the 6-hour value (38.28 +/- 1 degree C). Morning temperatures remained within the normal range on the following days. Nimesulide was well tolerated. The results indicate that nimesulide has a prompt antipyretic effect which may well be clinically helpful before the correct antibiotic therapy is effectively established.     

417 例川崎病患儿单中心回顾性研究

目的:总结川崎病(KD)患儿的临床资料,分析其临床特点及变化趋势。方法:对2011-2016 年在荆州市中心医院确诊的417 例KD 住院患儿的临床资料进行回顾性分析,按照入院时间分为三组:A 组(2011-2012 年)70 例,B 组(2013-2014 年)139 例,C 组(2015-2016 年)208 例,比较三组KD 患儿的临床特点及变化情况。结果:KD 患儿的入院构成比从2011 年的3.18/10 000 上升至2016 年7.86/10 000, 呈逐年上升的趋势( P <0.05)。0 ~ 1 岁组49 例(11.8%), >1 ~ 2 组岁173 例(41.6%),>2 ~5 岁组170 例(40.7%),>5 ~14 岁组25 例(5.9%)。冠状动脉损害(CAL)发生率31.2%。不完全KD(IKD)早 期易诊断为急性化脓性淋巴结炎、脓毒症、呼吸道感染等导致KD 延迟诊断。IVIG 耐受组KD 应用糖皮质激素(GC) 治疗可较快退热,缓解病情。结论:2011-2016 年荆州市中心医院KD 患儿的入院构成比呈逐渐增高的趋势,1 ~5 岁为高发年龄,CAL 发生率明显增高,IKD 早期易误诊为其他疾病。GC 对IVIG 耐受KD 患儿治疗有效。     

Pharmacokinetics of mefloquine in children aged 6 to 24 months.

The study was carried out in 12 children aged 6 months to 2 years, with uncomplicated falciparum malaria admitted to the Hospital for Tropical Diseases, Bangkok. They were treated with mefloquine in the form of MSP (mefloquine 250 mg+sulfadoxine 500 mg+pyrimethamine 25 mg) at a single dose of 25 mg mefloquine base/kg body weight. All of them were cured (28 days follow-up) with minimal side effects. Pharmacokinetic parameter determination was carried out in 9 cases. The results revealed that MRT, t1/2 and tmax in this study (children 6-24 months old) are comparable to the values in children aged 5-12 years, but shorter than in adult patients. Cmax and AUC in children 6-24 months old are comparable to those in children of 5-12 years, but much higher than in adult patients. Vz/f values in this study are comparable to those in children 5-12 years old, but lower than in adult patients.     

Acceptability of orodispersible films for delivery of medicines to infants and preschool children

Orodispersible films (ODFs) possess potential to facilitate oral drug delivery to children; however, documentation of their acceptability in this age group is lacking. This study is the first to explore the initial perceptions, acceptability and ease of use of ODFs for infants and preschool children, and their caregivers through observed administration of the type of dosage form. Placebo ODFs were administered to children stratified into aged 6 to 12?months, 1?year, 2?years, 3?years, 4?years and 5?years old and into those with an acute illness or long-term stable condition in hospital setting. Acceptability of the dosage form and end-user views were assessed by (a) direct observation of administration, (b) questionnaires to caregivers and nurses, and (c) age-adapted questionnaires for children aged 3?years and over. The majority of children (78%) aged 3?years and over gave the ODF a positive rating both on verbal and non-verbal scales. Despite little prior experience, 78% of caregivers expressed positive opinion about ODFs before administration. After the ODFs were taken, 79% of infant caregivers and 86% caregivers of preschool children positively rated their child’s acceptance of the ODF. The intraclass correlation coefficient value was 0.92 showing good agreement between ratings of caregivers and nurses. ODFs showed a high degree of acceptability among young children and their caregivers. If drug loading permits, pharmaceutical companies should consider developing pediatric medicines in this format. The methodology described here is useful in assessing the acceptability of active ODF preparations and other dosage forms to children.     

Desloratadine dose selection in children aged 6 months to 2 years: comparison of population pharmacokinetics between children and adults

AIMS: The aim of this study was to identify the dose of desloratadine in children aged > or =6 months- < or =2 years that would yield a single-dose target exposure (AUC) comparable with that in adults taking 5 mg desloratadine as syrup. METHODS: In a phase 1, single-dose, open-label, pharmacokinetic study in 58 children aged > or =6 months- <1 year and > or =1 year- < or =2 years were randomly assigned to desloratadine syrup 0.625 mg (1.25 ml) and 1.25 mg (2.5 ml), respectively. Because the volume of blood that could be collected from individual subjects was limited, a population pharmacokinetic approach was used to estimate the pharmacokinetics of desloratadine. Safety was assessed based on results of screening and postdose physical examinations, laboratory safety tests, vital signs, and adverse events. RESULTS: The apparent clearance (CL/F) of desloratadine, population estimate (%CV), in children aged > or =6 months- <1 year was 27.8 l h(-1) (35) and corresponding values in children > or =1 year- < or =2 years was 35.5 l h(-1) (51), compared with 137 l h(-1) (58) for adults. The CL/F ratios (children to adults) indicated that doses of 1 mg for > or =6 months- <1 year and 1.25 mg for > or =1 year- < or =2 years would result in similar systemic exposure to that observed in adults receiving the recommended 5 mg dose. Desloratadine was well tolerated with no safety issues. CONCLUSIONS: Doses of 1.0 and 1.25 mg in children aged > or =6 months- < or =2 years should result in an exposure to desloratadine similar to that of adults receiving doses of 5 mg.     

Deprescribing opportunities for elderly inpatients in an academic,safety-net health system

BackgroundDeprescribing is one way to reduce inappropriate polypharmacy in older adult patients. Although algorithms have been published to guide practitioners in deprescribing, it is still unknown how applicable these algorithms are to the general older adult population.ObjectivesThe primary objective was to assess the applicability of published deprescribing protocols in hospitalized older adult patients.MethodsThis retrospective study included patients aged 65 years or greater who were discharged from an internal medicine team between January 1, 2017 and June 30, 2017. Along with age and admission to internal medicine wards, other eligibility criteria were extracted from published deprescribing protocols. The primary endpoint was the proportion of patients eligible for deprescribing based on published algorithms. Secondary endpoints included the proportion of patients receiving medications which were included in an algorithm, proportion of patients using medications included in the algorithms who were eligible for deprescribing, and proportion of patients with medications deprescribed during the hospital stay.ResultsTwo hundred sixty-seven patients were included and 124 (46.4%) used a medication with a published deprescribing algorithm. Thirty-four percent of all patients and 74% (92/124) of patients prescribed medications included in algorithms were eligible for deprescribing. Seven percent (6/92) of patients eligible for deprescribing had medications deprescribed during the hospital stay.ConclusionThe application of deprescribing algorithms in hospitalized older adults identified a significant opportunity to initiate deprescribing practices.     

注射用氨苄西林钠/舒巴坦钠在患儿中的药动学研究

目的:研究注射用氨苄西林钠/舒巴坦钠在患儿中的药动学。方法:非抗生素治疗腹腔内感染、皮肤和/或皮肤结构感染、眶周-眶隔前和面部蜂窝组织炎的住院患儿(<12岁)共计56例纳入本研究,注射剂量为37.5～72mg·kg-1的注射用氨苄西林钠/舒巴坦钠(2∶1)。采用带紫外检测器的高效液相色谱仪测定血清或血浆中氨苄西林和舒巴坦浓度,并计算药动学参数。结果:剂量或性别不影响氨苄西林或舒巴坦的药动学。3个年龄组的平均CL、Vss、t1/2相似(P>0.05)。氨苄西林或舒巴坦清除率与患儿年龄之间的关系无显著相关性。注射用氨苄西林钠/舒巴坦钠可通过静脉给药于≥1岁患儿,给药剂量为72mg·kg-1(2∶1),q6h。结论:注射用氨苄西林钠/舒巴坦钠的药动学与剂量和性别无关。     

Neonatal at risk factors, visual defects and the preschool child: A report from the Queen Mary Hospital multidisciplinary child development study.

An experimental group of 142 children aged four years who had experienced neonatal at risk factors and a control group of 112 children whose perinatal histories were optimal had vision screening tests to detect defective vision or strabismus. Five (3.5 percent) in the at risk group and 10 (8.9 percent) in the control group (total 15, 5.9 percent) were found to have a visual defect. Of those, six had already been identified because of a manifest squint. Nine children with defective vision were first identified through the study. The importance of the early identification and treatment of visual disorders, particularly amblyopia, is emphasised, and recommendations are made for more widespread vision screening of preschool children.     

云浮地区6880例住院患儿急性呼吸道感染病毒病原学分析

目的 回顾分析云浮市人民医院6880例儿科住院患儿急性呼吸道感染常见呼吸道病毒检测结果 ,了解其感染特点.方法 回顾性分析2015年1月 ～2019年12月云浮市人民医院儿科住院的6880例急性呼吸道感染患儿的临床资料,所有患儿入院后均需做咽拭子检查,采用直接免疫荧光法检测7种常见呼吸道病毒[呼吸道合胞病毒(RSV)、...     

分级心理护理干预体系改善儿童青少年住院患者焦虑抑郁情绪的应用效果分析

目的:检验分级心理护理干预体系在改善儿童青少年住院患者焦虑抑郁情绪的应用效果。方法:随机选取于2020年6月至2021年6月入住德阳市人民医院的80例儿童青少年住院患者为研究对象,采用随机数字表法将其分为试验组与对照组各40例,对照组进行常规护理干预,试验组进行分级心理护理干预,于出院时比较儿童抑郁障碍自评量表、儿童焦...     

布拉氏酵母菌治疗小儿急性腹泻病的临床研究

目的:评估布拉氏酵母茵散剂治疗小儿急性腹泻病的临床疗效.方法:以我院2008年3月～6月收治的92例小儿急性腹泻病惠儿为研究对象,随机分成两组各46例.两组均予补液、蒙脱石散剂口服、抗生素治疗,治疗组加服布拉氏酵母菌散剂连续治疗至出院,对92例惠儿资料进行数据分析.结果:两组总有效率比较差异有统计学意(X2=4.84,P＜0.05).腹泻平均持续时间对照组为(6.54±1.74)d,治疗组为(5.72±1.67)d(t=2.30,P＜0.05),两组比较差异有统计学意义;服药第4 d治疗组日平均大便次数(3.13±0.95)次,对照组(3.74±0.91)次(t=3.14,P＜0.01),服药第7 d治疗组日平均大便次数(1.74±0.93)次,对照组(2.24±0.95)次(t=2.55,P＜0.05),两组比较差异均有统计学意义;治疗组按给药治疗时机进行分层分析,比较第4 d和第7 d大便次数(t分别为3.90、3.71,P均＜0.01),差异有统计学意义.结论:布拉氏酵母茵可缩短小儿急性腹泻的持续时间,促进患儿恢复,患儿在腹泻发生48 h内早期给予布拉氏酵母茵治疗效果更佳.     

天津地区儿童急性呼吸道和消化道感染Saffold病毒的检出和临床流行特征

目的 调查天津地区儿童急性呼吸道和消化道感染中是否存在 Saffold 病毒（SAFV）感染及其流行病学特征。 方法 收集 360 份急性呼吸道感染患儿鼻咽抽吸物和 384 份消化道感染患儿粪便标本, 以针对 SAFV 5′-UTR 基因序列设计的特异性引物进行荧光定量 PCR 扩增, 随机取阳性扩增产物进行核苷酸序列测定, 并将所测序列在 GenBank 中进行比对。 计算呼吸道和消化道 SAFV 感染阳性者的阳性率, 不同年龄段及季节的 SAFV 阳性构成比和阳性检出率。 同时考察 SAFV 与其他病毒的混合感染情况。 结果 呼吸道和消化道检测 SAFV 阳性率分别为 11.9%（43/360）和 16.4%（63/384）。 不同性别的呼吸道 SAFV 阳性检出率差异无统计学意义［ 男 、女分别为 11.5% （28/243）和 12.8%（15/117）, χ2=0.13, P > 0.05］, 年龄 6 d～ 12 岁, ＜ 1 岁者占 79.0%（34/43）;消化道检测 SAFV 阳性患儿阳性检出率差异有统计学意义［ 男 、女分别为 13.4%（33/246）和 21.7%（30/138）, χ2=4.47, P＜ 0.05］, 年龄 5 h～ 11 岁。 不同年龄段的呼吸道和消化道 SAFV 阳性检出率差异均无统计学意义。 不同季节呼吸道 SAFV 阳性检出率差异有统计学意义, 以冬季和夏季为主（P＜ 0.01）, 而消化道 SAFV 阳性检出率差异无统计学意义。 呼吸道和消化道 SAFV 与其他病毒混合感染率分别为 7.0%（3/43）和 12.7%（8/63）。 结论 天津地区儿童存在 SAFV 感染, 在急性呼吸道和消化道感染患儿中具有较高的阳性检出率, 且在 1 岁以内患儿中的阳性检出率较高, 应该引起临床重视。     

Cefroxadine in the treatment of children affected by respiratory and ENT diseases. A multicentre study involving 1072 in-patients

In this multicentre trial, 1072 hospitalized children, 573 boys and 499 girls (847 of whom were aged less than 6 years), affected by respiratory tract (376 patients) or ENT (696 patients) infections were treated for 10 days with cefroxadine per os, at an average dose of 650 mg/day (325 mg every 12 h corresponding to 25 mg/kg b.w.). Most patients (1047; 97.7%) completed the trial, while 25 patients were withdrawn from the study (20 patients for viral diseases and 5 for side-effects). Of the patients affected by respiratory tract infections, 361 completed the trial and 342 of them (94.7%) were cured in 6.0 days on average. Of the patients affected by ENT infections, 686 completed the trial and 649 of them (94.6%) were also cured in an average of 6.0 days. In the two groups the signs and symptoms of the disease significantly (p less than 0.001) decreased by the end of the study. Some patients (80; 7.6%) complained of side-effects, mainly gastric discomfort (4.9%), skin rash (2.2%) and glossitis (0.5%). In conclusion, cefroxadine exerts a satisfactory antibacterial action with only a few days of treatment, and it appears to be very well tolerated.     

Gabapentin: new indication. Little impact on partial epilepsy in children between 3 and 12

(1) The standard treatment for partial epilepsy in children is carbamazepine. The efficacy of other antiepileptics has also been documented, either alone (phenobarbital, oxcarbazepine, valproate sodium, phenytoin), or in drug combinations (lamotrigine, topiramate). (2) A licence extension has been granted in France for gabapentin in partial epilepsy in children aged 3 to 12 years, in combination with other antiepileptics. (3) The clinical file contains no data from trials comparing gabapentin with other antiepileptics. (4) The main double-blind trial involved 247 children who were treated either with their usual treatment + gabapentin or usual treatment + placebo. Gabapentin was only moderately effective, and the overall number of responders did not differ significantly between the gabapentin and placebo groups. (5) In this trial the main adverse effects among the children on their usual treatment + gabapentin were behavioural disorders (hostility and mood swings). (6) In practice, the licensing of gabapentin for children with partial epilepsy aged between 3 and 12 years changes nothing in their practical management.     

Ganciclovir treatment in children: evidence of subtherapeutic levels

Ganciclovir (GCV) is used to treat babies and older children with cytomegalovirus-related disease. Treatment courses are generally derived from adult studies and there are few data relating to the pharmacokinetics of GCV in children. In adults, low trough GCV levels have been associated with treatment failure and virological resistance. Data regarding suitable drug levels for use in therapeutic drug monitoring (TDM) in the paediatric age group do not currently exist. In this study, anonymised data for all GCV levels sent to the UK Antibiotic Reference Laboratory from 1 November 1999 to 31 March 2007 were reviewed and analysed by age group. In total, 339 specimens were received from 129 patients; 192 specimens were from patients aged <18 years. There were significantly more trough GCV levels <0.5 mg/L in those aged <6 months and 6-12 months compared with adults (64.8% and 53.9%, respectively, vs. 15.9%; P<0.001). Those aged 5-18 years also had significantly more trough samples with levels <0.5 mg/L (80.0% vs. 15.9%; P<0.001). There was a significant difference between median peak GCV levels in those aged <6 months and adults (4.8 mg/L vs. 5.7 mg/L, respectively; P=0.047). In conclusion, GCV levels associated with treatment failure and considered subtherapeutic in adult patients were observed more often in specimens from paediatric patients. These lower levels may have implications for dosing in the paediatric age group, particularly during periods of rapid change in renal function such as the neonatal period. Clinicians should be aware of the relatively low drug exposure noted in this study and consider TDM and increasing drug dose where virological response is poor.     

血清肝细胞生长因子在肺炎支原体肺炎 儿童中的检测意义

摘要：目的 探讨血清肝细胞生长因子（HGF）在儿童肺炎支原体肺炎（MPP）中的作用及临床意义。方法 收集 2014年1月—2015年6月天津市中西医结合医院南开医院儿科住院的肺炎患儿107例,年龄3～14岁,分为MPP组 65例（重症MPP 27例,非重症MPP 38例）,细菌性肺炎组42例,同时选择30例健康儿童作为对照组,采用酶联免疫吸 附试验（ELISA）方法检测血清中HGF水平。全自动生化分析仪检测重症MPP组和非重症MPP组患儿血清C反应蛋 白（CRP）、乳酸脱氢酶（LDH）的差异。结果 健康对照组、MPP 组及细菌性肺炎组 HGF 水平呈逐渐升高趋势 ［（4 174.3±247.6）、（6 507.1±1 895.9）及（7 128.7±1 990.2）ng/L］（P＜0.05）,重症MPP组血清中HGF、CRP、LDH高于非 重症MPP组（P＜0.05）。结论 HGF参与了MPP的发生且与病情轻重有关,若结合患儿血清LDH及CRP均升高,提 示病情重,且耐药可能性大,应在给予大环内酯类药物的同时,给予糖皮质激素治疗。     

Influenza in the pediatric hospital unit at Antananarivo

62 rhinopharingeal samples from malagasy children, aged of 6 days to 14 years old, hospitalized because of acute respiratory infections, with doubtful viral etiology case, during June to August 1992, at the "H?pital des Enfants" in Antananarivo, were examined by two methods: inoculation by embryonned eggs and inoculation by MDCK cells. 24.1% of the samples were positive. The repartition of the cases by age and by sex were studied. The children aged of 1 to 12 months were the most affected with 65.7% of all cases (male: 60%, female: 40%). One subtype was detected: A(H3N2).