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

The importance of effectively protecting infants against measles is substantial because of the number of lives that can be saved and the morbidity that can be prevented. (i) Infants contract measles before the recommended age of immunization. (ii) Circulating maternal antibodies render measles vaccination ineffective in many infants. These problems have led to clinical trials of immunizing infants using routes other than the usual subcutaneous one. One promising approach is the inhalation of aerosolized vaccine. This study was undertaken to try to immunize very young infants using easily accessible vaccine and ordinary equipment. Infants aged 4-6 months were selected for measles immunization by inhalation. They were clinically well, with no history of tuberculosis or asthma. From each child, 0.2 ml of blood was obtained by finger-prick. The blood was kept on ice, then centrifuged and the serum stored in a freezer at -20 degrees C. Each child was weighed and clinically assessed and his rectal temperature recorded. Using a plastic nebulizer to hold reconstituted vaccine by SCLAVO of Italy and an ordinary foot pump, the vaccine was aerosolized. One thousand TCID50 of the vaccine was administered to each child with a vinyl face mask for a period of at least 30 s, to allow him to retain 250 TCID50. The child was then clinically followed up three times a week for 4 weeks with particular reference to (i) fever, (ii) conjunctivitis, (iii) cough, and (iv) skin rash. None of the infants developed any of the above signs during the interval.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Immunization by inhalation of aerosolized measles vaccine. 169 77

Sixty-two black children were prospectively followed up for 1-7 years after pneumonia contracted at a median age of 17 months. In 55% of cases the pneumonia was measles-associated and 27% had serological evidence of infection with other respiratory viruses. Recurrence of cough or wheeze for more than 6 months occurred in 85% with just over 50% having recovered during the follow-up period. While the highest incidence of persistent symptoms occurred in children after measles superinfected with another virus, this was not significant. Abnormal radiographic features persisted in 53% of children and consisted of peribronchial and/or parenchymal lesions. Abnormal large and small airway calibre and/or bronchial hyperreactivity were found in one-third of children, and were significantly more common in those children whose main symptom was recurrent wheezing. Clinical and lung function abnormalities years after lower respiratory tract infection in this group of disadvantaged children compare with reports from more privileged groups. Recognition that long-term sequelae occur may prevent inappropriate subsequent management of symptomatic children.
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PMID:Prolonged after-effects of pneumonia in children. 198 91

Ten goats were inoculated with peste des petits ruminants virus, a paramyxovirus closely related to rinderpest virus. All goats developed severe clinical disease, 8/10 having coughing or dyspnea as prominent clinical signs. In addition, all of the goats had stomatitis and diarrhea. Histopathologic and immunohistochemical studies were done only on the respiratory tracts. Pathologic changes ranged from mild multifocal bronchiolitis and bronchitis to severe bronchointerstitial pneumonia. Lesions were more severe in anteroventral than caudal lobes. The histologic nature of the viral process in the goat lungs had many features in common with the processes of pneumonia in dogs, due to canine distemper, or pneumonia in human beings, due to measles virus. Immunohistochemical staining of formalin-fixed, paraffin-embedded respiratory tract tissue was performed using an indirect system with rabbit anti-rinderpest virus serum, biotinylated anti-rabbit antibody, streptavidin-alkaline phosphatase, and nitroblue tetrazolium chromogen. Staining was sensitive, highlighting the presence of viral antigen in both lung and trachea of all goats. Viral antigen was found in both cytoplasm and nucleus of tracheal, bronchial, and bronchiolar epithelial cells, type II pneumocytes, syncytial cells, and alveolar macrophages. In general, the amount of staining correlated directly with the severity of the inflammatory process.
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PMID:An immunohistochemical study of the pneumonia caused by peste des petits ruminants virus. 206 17

This is a three case study report of children with measles which later progressed to bronchopneumonia and subcutaneous emphysema. All three children were from farming families, and none had been previously vaccinate against measles. For a period of six months, 183 cases of measles were treated at our hospital of which only three worsened to subcutaneous emphysema, demonstrating an incidence rate of 1.6%; they also showed to have bronchopneumonia, with severe coughing episodes; which made us recall the possible physiopathology principle of the pressure gradient theory behind this complication proposed by Bloch in 1968. The factors related to our patients suggested a more severe and aggresive type of measles with a greater probability of having complications. The prognostic value of the severity of this type of measles in the presence of subcutaneous emphysema is limited and its management should be primarly focused on treating the added bronchial problem.
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PMID:[Measles and subcutaneous emphysema. Presentation of 3 cases]. 206 47

The diagnosis of childhood illness by maternal health interview surveys is widely used to estimate the prevalence of childhood morbidity in developing countries. To determine the validity of interview-based diagnoses, and to define simple, sensitive and specific diagnostic algorithms, we compared symptoms and signs reported by mothers during structured interviews with physicians' diagnoses for 271 children on the Philippine island of Cebu. The 271 children had 318 physician diagnosed illnesses: 105 acute lower respiratory infections (ALRI), 121 diarrhoeas, 36 measles, 50 upper respiratory infections (URTI), 5 roseola infantums and one milaria rubria. An algorithm for measles (age greater than or equal to 120 days, rash and fever greater than or equal to 3 days and fading of rash) had a sensitivity and specificity of 94%. For ALRI an algorithm of cough, dysponea and fever had a sensitivity of 82%, but specificity was lower in comparison with URTI (58%) than with children who had no respiratory illness (79%). Inclusion of signs of respiratory distress (flaring of nostrils, intercostal retraction) raised the specificity to 83-84%, but reduced sensitivity to 68%. Diagnosis of diarrhoea based on frequent loose or liquid stools had a sensitivity of 95-97% and specificity of 80% in children with or without concomitant non-diarrhoeal illnesses. Addition of questions on numbers of stools (greater than or equal to 6 per day), and no signs of dehydration increased specificity to 95% but reduced the sensitivity to 84-86%. However, specific signs of dehydration were not well reported by the mothers.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Validation of the diagnosis of childhood morbidity using maternal health interviews. 206 19

Eighty cases of miliary tuberculosis admitted to our hospital between January 1981 and December 1984 were reviewed. The age of the patients ranged from 3 months to 12 years, with an average of 2 years 2 months (26.5 months). Nine cases (11.25%) died during hospitalization due to the severe condition at the time of admission. Only 8 patients (10%) were in good nutritional condition. Seventy-two patients (90%) had been visiting the primary health care clinic for several times since 2-3 months but were never diagnosed as suffering from tuberculosis. Fever or recurrent fever were found in 78 cases (97.5%), anorexia in 65 cases (81.3%), chronic and/or recurrent cough in 72 cases (90%) and malaise in 43 (53.8%). Forty-one (51.3%) denied the presence of a close contact with source of infection. Hepatomegaly was found in 44 cases (55%), 19 (23.8%) of which were associated with splenomegaly. Choroidal tubercle was found in 4 cases; 1 case with coxitis, 1 with brain tuberculoma, 1 with ascites, 1 with endobronchitis and 1 with hepatitis. Forty-three (53.8%) were tuberculin negatives, 24 of which become positives after treatment. Fourteen cases had BCG scar. History of measles was found in 21 cases. Children with longterm and recurrent fever, anorexia, decrease of body weight and recurrent cough should be suspected of having TB thus enabling to get an early diagnosis.
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PMID:Miliary tuberculosis in children. A clinical review. 207 67

Maternal beliefs regarding diet during common childhood illnesses--diarrhea, fever, measles, cough and marasmus were determined in 143 rural mothers by using the interview technique. Some foods were preferred while others were restricted during episode of each illness, depending upon their 'hot' and 'cold', 'light' and 'heavy' and other characteristics, as determined by locally prevalent traditional dietary beliefs. 'Cold' foods like curd, butter milk were restricted during an episode of cough while 'hot' foods like tea, ginger with honey, were preferred. During diarrhea, 'light' foods like khichri, diluted milk and 'easy to digest' were preferred while 'heavy' foods like undiluted milk, roti and 'difficult to digest' were restricted. The study revealed that for a successful health education, it is important to identify local cultural practices and beliefs. The useful practices should be encouraged and reinforced while the harmful ones should be discouraged.
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PMID:Maternal beliefs regarding diet during common childhood illnesses. 225 96

In developing countries, diagnoses of diseases associated with deaths in children are frequently derived from retrospective maternal interviews. To determine the validity of this methodology, and to define sensitive and specific diagnostic algorithms, we compared symptoms and signs reported by mothers using structured questionnaires, with selected physician diagnoses for 164 deaths among hospitalized children on the Philippine island of Cebu. The 164 decreased children had 256 physician diagnoses of acute lower respiratory infections (ALRI) (100), diarrhoeas (92), measles (48), and neonatal tetanus cases (16). Forty-three per cent of children had multiple illnesses. An algorithm for tetanus (age at death less than or equal to 30 days with convulsion or spasm) was 100% sensitive, but specificity could not be estimated due to the small number of comparison neonatal deaths. An algorithm for measles (age greater than or equal to 120 days, with rash and fever for at least three days) had 98% sensitivity and 90% specificity. Diagnosis of ALRI was more difficult, cough and dyspnoea alone yielding 86% sensitivity but low specificity, whereas prolonged cough and dyspnoea provided 93% specificity but low sensitivity (41%). Diarrhoea diagnoses based on frequent loose or liquid stools had high sensitivity (78-84%) and specificity (79%), irrespective of whether the child died with diarrhoea alone or in combination with other illnesses. However, maternal reports of moderate/severe dehydration had low specificity. We conclude that, in this setting, verbal autopsies can diagnose major illnesses contributing to death in children with acceptable sensitivity and specificity.
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PMID:Validation of postmortem interviews to ascertain selected causes of death in children. 237 51

A 18-year-old man was admitted with fever, dry cough, erythema, conjunctivitis, and dyspnea. The case was diagnosed as measles because of the typical clinical course and the increase of measles viral antibody titre. Electrocardiogram showed transient ST-T abnormalities and the laboratory data showed transient increase of CPK. Therefore myocarditis was considered. However chest roentgenogram showed no abnormal findings. Arterial oxygen was low. The Ga scintigram revealed diffused uptake in both lungs. Microscopic examination of the transbronchial lung biopsy revealed alveolitis. In view of he above, measles pneumonia was diagnosed in this case.
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PMID:[A case of measles in adolescents with myocarditis and pneumonia]. 250 6

Six children who survived severe acute bronchiolitis in infancy and early childhood continued to have persistent symptoms of breathlessness, cough and wheeze resistant to bronchodilator therapy. Hyperinflation of the chest, widespread crepitations and rhonchi were persistent clinical features. Failure to thrive was a problem in most. At presentation clinical measles was diagnosed in one child and adenovirus titres were raised in another; the aetiological agents in the others were not known. Lung biopsy from the child with measles showed features of severe bronchiolitis. The clinical and radiological features and course of the illness were consistent with those of bronchiolitis obliterans. Although illness was prolonged the long term prognosis was satisfactory with the majority of children showing improved chest signs, growth and general health after four to eight years of follow up.
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PMID:Bronchiolitis obliterans in children--a report of six cases. 262 35


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