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 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the winter of 1998-1999, there was an outbreak of encephalitis/encephalopathy in Japan that appeared to be associated with influenza. We conducted a national survey of the prevalence and clinical features of disease and the associated outcomes and prognostic factors related to this outbreak. A total of 202 cases were analyzed, of which 148 were diagnosed as influenza-associated encephalitis/encephalopathy on the basis of virologic analysis. Of the 148 cases studied, 130 (87.8%) were type A influenza and 17 were type B. Encephalitis/encephalopathy developed mainly in children age <5 years, either on the day that influenza signs appeared or on the next day. The major signs included altered consciousness or loss of consciousness, convulsions, cough, and vomiting. In many patients, multiple-organ failure developed, and rates of mortality (31.8%) and disability (27.7%) were high. Thrombocytopenia and severely elevated transaminase levels were factors associated with a poor prognosis. Thus, influenza-associated encephalitis/encephalopathy progressed rapidly and was associated with poor outcomes.
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PMID:Encephalitis and encephalopathy associated with an influenza epidemic in Japan. 1217 23

Health workers should assess all children with a cough or difficult breathing for pneumonia. They should refer any child with severe pneumonia to a hospital for admission. At the hospital, a distinction is usually made between severe or very severe pneumonia among children 2 months to 5 years old. Signs or symptoms unique to very severe pneumonia are cyanosis and inability to drink. If a child has these signs and has convulsions, hospital personnel should consider a lumbar puncture to check for meningitis. Chest indrawing may also be present in very severe pneumonia cases. Chest indrawing in children with no cyanosis who are able to drink constitutes severe pneumonia. Health workers need to look for a variety of nonspecific signs of severe or very severe pneumonia in babies younger than 2 months: not feeding well, convulsions, abnormally sleepy, fever (38 degrees Celsius), fast breathing (=or+ 60 breast/minute), cyanosis, grunting, or apnea. These signs are also signs for meningitis or sepsis in young infants. Treatment for all 3 conditions is benzylpenicillin plus gentamicin for at least 14 days. Oxygen treatment is also indicated for these young infants. Treatment for both severe and very severe pneumonia cases includes oxygen and an antibiotic (benzylpenicillin and chloramphenicol, respectively). Hospitals should have in stock at all times essential antibiotics (benzylpenicillin, cloxacillin, chloramphenicol, and gentamicin) and an oxygen supply (oxygen cylinder or oxygen concentrator). When the oxygen supply is limited, children with very severe pneumonia should be the priority. Oxygen needs to be delivered at a flow rate of 1-2 liters/minute via nasal prongs or a nasal catheter. Admitted pneumonia cases with fever (39 degrees Celsius) should receive paracetamol to treat the fever. Hospital workers need to keep the airway of pneumonia cases clear and to encourage them to drink and/or breast feed.
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PMID:Managing pneumonia. 1229 68

The main causes of death in rural areas of the Faritany of Toamasina during 1986 are identified and classified by order of importance for the entire population as well as for vulnerable groups such as preschool children and reproductive-aged women. The 10 leading causes of death of infants and children under age 5 years are coughs and fevers, as well as thoracic pains; vomiting and diarrhea; age factors; high, intermittent fevers and chills; protein-calorie malnutrition; convulsions; other high fevers; cough of long duration; sudden death; and measles. Leading causes of death for women aged 15-49 years include coughs and fevers, as well as thoracic pains; high, intermittent fevers and chills; vomiting and diarrhea; other high fevers; delivery complications; cough of long duration; malnutrition; abortion or miscarriage; sudden death; and postpartum illnesses. Over 60% of deaths reported for children aged 0-5 years could have been prevented through a broader vaccination program, oral rehydration therapy, nutrition education and growth monitoring, and the preventive treatment of malaria. Priority focus should be given to respiratory infections.
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PMID:[Causes of mortality in a rural area in the Faritany of Toamasina in 1986]. 1229 43

African traditional practices can be both beneficial and harmful to the newly born. This article describes these practices from 4 perspectives: 1) the period following childbirth or "maternage;" 2) nutrition; 3) curative care; and 4) social customs. The beneficial practices include: 1) giving the baby water as soon as he is washed to prevent neonatal hypoglycemia; 2) breast feeding; 3) carrying the baby on the mother's back and 4) the traditional massage. The harmful practices during maternage include: 1) the baby is rolled in the dirt to protect him and "give birth to his race;" 2) after birth the baby is given lemon juice or gin to prevent the obstruction of the respiratory cords; 3) mother and baby are "put in the dark" or a separate room for the rest of the family and community for 6 days to protect them against evil influences. The harmful nutritional practices are based on superstitions that relate to all animal products because they might produce diseases. 1) Eggs are known to cause diarrhea and throughout Africa eggs are forbidden because of their effect on children's physical development. 2) Chicken and pigeon and "everything that flies" causes convulsions. 3) Palm oil, oranges and bananas cause coughing. 4) Sugar cane, manioc leaves and everything with natural sugar cause intestinal ailments. Traditional health cures are used during an illness and are aimed at reestablishing the balance between man and his environment. Examples described include treatment for measles and chicken pox; fevers; diarrhea, and vomiting and convulsions. The positive traditional African practices need to be combined with those of modern medicine while discouraging the harmful practices.
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PMID:[Children and traditional practices]. 1234 28

The WHO/UNICEF Sick Child Algorithm, applicable to children 2 months-5 years of age, provides health care professionals with a standardized assessment and classification tool. Children whose caretakers report are unable to drink, having convulsions, or abnormally sleepy or difficult to wake should be referred immediately to a hospital. Otherwise, caretakers should be queried as to whether the child is coughing, has diarrhea, fever, or ear pain/discharge. In cases where the answer is "yes," the algorithm lists further questions that should be asked, signs that should be checked, and clinical procedures followed. Also set forth are classification systems for cough, diarrhea, fever, measles, ear problems, and nutritional status. To check nutritional status, health workers are instructed to weigh the child, calculate weight-for-age, look for eyelid pallor and foamy patches on the white of the eye, identify severe wasting, and examine for edema of the hands and feet.
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PMID:Key assessment and classification elements of the WHO / UNICEF sick child algorithm. 1234 43

The care of children at the end of life is gradually improving. Nevertheless, more than half suffer from intractable symptoms before dying. Although pain has been the subject of clinical research, evidence-based data are almost completely lacking for other symptoms, highlighting the need for clinical research in palliative care. We review the available evidence on fatigue, anorexia, dyspnea, respiratory secretions, cough, constipation, mouth dryness, urinary obstruction, terminal convulsions and gasping. When evidence is lacking, we offer our empiric approach. Short duration benzodiazepines have become an important component of treatment that should remain simple, while providing the dying child the comfort needed to experience the highest quality relationships with those around him.
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PMID:[Treatment of non-painful symptoms in terminally ill children]. 1250 11

A 12 year old boy was admitted to emergency service with loss of consciousness, convulsions and anisocoria of the right eye along the history of upper respiratory tract infection for the last four days. Two months ago he was hospitalized at the intensive care unite due to motorcycle accident with frontal fracture and minimal frontal pneumocephalus. He was treated for ten days and discharged without any neurological impairment. The last computerized tomography showed right frontal air of 5x5x7 cm. multiple airs in the ventricular system and in the upper central canal of the cervical region. The air was removed immediately through a right frontal burr-hole with a bedside procedure. The patient's neurological status rapidly improved and ten days after computerized tomography showed clearly resolution of the air. The presented case is an interesting example of post traumatic pneumocephalus due to herniation and widespread intracranial air. The situation can be explained with acute penetration of huge amount of air into the cranium through the frontobasal fracture and torn dura by strong Valsalva 's maneuver resulting from coughing and sneezing in the course of upper respiratory tract infection. We suggest close follow up, frequent control computerized tomography scans, preventive and effective treatment respiratory tract infections along 3-6 months in similar cases.
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PMID:[Posttraumatic tension pneumocephalus causing herniation]. 1258 62

An 8-year-old boy suffered from persisting coughing fits for two weeks and subconjunctival haemorrhage since one week. In paired sera serological proof of infection with Bordetella pertussis was found.
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PMID:[Diagnostic image (136). A boy with coughing fits and subconjunctival hemorrhage. Subconjunctival hemorrhage secondary to whooping cough]. 1274 Nov 69

Cryptococcus neoformans affections during HIV-infection are frequent and serious. The aim of this study was to analyse the epidemiological, clinical, biological and therapeutic characteristics of cryptococcal meningitis in HIV-positive patients, admitted into the Center for Tropical Diseases Ho Chi Minh City (Vietnam), during a 5-month period (May-September 2001). Twenty-one patients (20 men and one woman) were included (identification of C. neoformans from the cerebrospinal fluid). The mean age was 28 years. The majority of patients had been living in Ho Chi Minh City (48%). The use of drugs and unprotected sexual relations were the principal risk factors of HIV-infection. The paucity and the confusion of clinical signs and symptoms, along with a high frequency of meningitis have been analysed. Clinical presentation features included: headache (95%), emaciation (90%), oro-pharyngeal candidiasis (90%), stiff neck (80%), nausea/vomiting (70%), fever (67%), coughing (38%), diarrhoea (33%), skin lesions (5%), convulsion (5%), photophobia (5%), and hemiparesis (5%). The severity of the prognosis was mainly linked to the delay before hospitalization, to the possible association with other opportunistic infections, and to the availability of appropriate treatment.
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PMID:[Cryptococosis and HIV/AIDS: a review of 21 cases reported in the Tropical Diseases Centre, Ho Chi Minh City (Vietnam)]. 1504 39

Perinatal tuberculosis is a rare disease with a high mortality rate and is difficult to diagnose. We report a case of perinatal tuberculosis diagnosed by postmortem study at the age of 3 months. An 83-day-old male infant presented with cough for 3 weeks and intermittent fever for 1 week. A focal tonic convulsion occurred on the day of admission. Physical examination revealed failure to thrive, tachypnea, and marked hepatosplenomegaly. Chest roentgenogram showed bilateral nodular alveolar-interstitial infiltrates. Abdominal computed tomography showed multiple nodules in the liver and spleen as well as lymphadenopathy in the hepatic portal hilum. Antituberculous therapies were prescribed on the second hospital day. The patient died from respiratory failure on the sixth hospital day. Mycobacterium tuberculosis was cultured from gastric aspirates and cerebrospinal fluid 4 weeks after inoculation. Postmortem examination revealed disseminated necrotizing granulomas in several organs and tissues, including the porta hepatis lymph nodes, a primary hepatic complex. M. tuberculosis infection was diagnosed in his mother based on positive findings of Mautoux test and chest roentgenogram. This case illustrates that tuberculosis, though rare, still should be considered in poor-weight-gain neonates with cough, fever, and/or hepatosplenomegaly. Careful maternal and other family contact history is essential to establishing the diagnosis.
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PMID:Perinatal tuberculosis in a three-month-old infant. 1508 46


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