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Target Concepts:
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Query: UMLS:C0032285 (
pneumonia
)
54,520
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
An earlier report on the Nigerian expanded programme on immunization (EPI), covering 1974-1988, failed to demonstrate a clear-cut impact of the programme. This report attempts to determine the effectiveness of EPI in Borno State, Nigeria. We analysed trends in routine notifications for diphtheria, pertussis, tetanus, tuberculosis,
measles
, and
pneumonia
, from 1985 to 1991; data on poliomyelitis were excluded because of poor documentation, while we included data on
pneumonia
for comparison. We also performed a before (1983-1987) after (1988-1991) comparison in terms of the intensifications of EPI by age-specific strata amongst paediatric hospitalization for all EPI diseases at the University of Maiduguri Teaching Hospital, the sole referral hospital for childhood infectious diseases. Our results show an apparent reduction in morbidity from diphtheria, pertussis, tetanus,
measles
and
pneumonia
, and this was particularly prominent following intense vaccinations between 1988 and 1991. The reduction in these EPI diseases and
pneumonia
occurred despite the prevailing adverse socioeconomic conditions, and the absence of a specific control strategy for
pneumonia
in Nigeria. On the other hand, in spite of national BCG coverage of about 90% there has been a recent (1989-1991) increase in the registered cases of tuberculosis in infants and older children in Borno State. There is a need to intensify other intervention measures alongside EPI activities.
...
PMID:The EPI in Borno State, Nigeria: impact on routine disease notifications and hospital admissions. 146 Jun 96
This study reports the course of
measles
and results of
measles
immunization in a cohort of human immunodeficiency virus-infected children. Six cases of
measles
were identified. All had typical clinical manifestations, 5 of 6 developed
pneumonia
and 3 of 6 died. A
measles
intervention program consisting of serologic screening and active immunization (
measles
-mumps-rubella (MMR)) was instituted in 1990. Among 127 children with data available for analysis (mean age, 6.7 years), only 35% had documentation of prior immunization with MMR. Among 80 children who had preimmunization
measles
serology reported, 56% were
measles
antibody-negative and 40% were antibody-positive; following intervention 36% remained
measles
antibody-negative. Six children lost
measles
antibody over time. MMR nonresponders had lower CD4 lymphocyte counts (303 +/- 394) compared with responders (865 +/- 677; P = 0.0058).
Measles
is a potentially fatal illness in human immunodeficiency virus-infected children. Prevention strategies are limited by low rates of age-appropriate MMR immunization, poor antibody responses to MMR in older human immunodeficiency virus-infected children and seroreversion.
...
PMID:Population-based study of measles and measles immunization in human immunodeficiency virus-infected children. 146 90
The Expanded Programme on Immunization (EPI) dramatically increased coverage. In 1990, approximately 80% of the world's children younger than 1 year received
measles
vaccine, and it was estimated that around 2 million deaths were prevented. Still in 1990 an estimated 45 million cases and around 1 million deaths occurred in developing countries. In one community study in Kenya in 1985
measles
accounted for 35% of reported deaths in infants 1-12 months old and for 40% of deaths in children 1-4 years old. The Schwarz vaccine was introduced in the 1960s; under most field conditions its efficacy is about 85% for children receiving the vaccine at 9 months or older. The urban poor, who usually have less access to immunization services, are usually the most at risk. Other high-risk groups include specific age groups (school children who represent cohorts from previous years when coverage was lower and who may not have been exposed to
measles
infection), ethnic minorities (who may have been underserved or may have rejected immunization for cultural reasons), hospitalized children who are at high risk of nosocomial transmission, and children in refugee camps. Vitamin A administered to children acutely ill with
measles
reduces mortality. Results from a trial in South Africa showed children treated with vitamin A had reduced risk of dying, recovered more quickly from
pneumonia
and diarrhea, and had less croup. In addition, symptomatic treatment for cases requires antibiotics to combat bacterial complications, and oral rehydration salts for dehydration following diarrhea. Case fatality rates can be lowered if cases reach health care facilities where appropriate care is offered early. For uncomplicated cases, supportive fluids, antipyretics, and nutritional therapy may be required. Many children need increased food intake for 4-8 weeks to recover their premeasles nutritional status.
...
PMID:The epidemiology of measles. 146 63
Swaziland is a kingdom with 800,000 inhabitants bordering on Mozambique and South Africa with about 50% of the population under 15 years of age. The experience of a nurse in a small clinic in the course of several years is recounted. Swaziland ranks 3rd in the world in alcohol abuse which often leads to wounds requiring suturing. Penicillin is given prophylactically with a paracetamol preparation for analgesia. As a rule, every injured person will get a .5 ml tetanus injection for prophylaxis. The most serious conditions of polyclinic patients are hepatitis, bilharzia, diarrhea, pellagra,
pneumonia
, and malnutrition. A great number of patients have sexually transmitted diseases, and the rate of AIDS infection is not known. According to 1 study 60-80% of the population in reproductive age will die of AIDS in the course of a 5-year period. The majority of people are impervious to counseling about their sexual behavior in spite of educational programs on the radio, in schools, and in work places. Condoms are not popular, since they are not considered manly. Pregnant women receive iron and multivitamin tablets in the course of pregnancy. Many pregnant women are anemic, and 70% give birth at home, the rest in a hospital or clinic. During delivery they get no analgesia, and there are few complications. The average weight of the newborn is 3.5 kg, although none of the women are under 150 cm. A little after birth all children are vaccinated with bacillus Calmette-Guerin (BCG) and polio, later with diphtheria-pertussis-tetanus (DPT) and
measles
.
...
PMID:[Nursing under a different sky. Swaziland]. 146 29
The clinical features, microbiology, treatment, and outcome in 24 children diagnosed with lung abscess at Harare Central Hospital during 1979-88 were reviewed retrospectively. This condition is rare in children, and the present study is the first to address lung abscess in Zimbabweans. 17 (71%) of the 24 patients were male and their mean age was 4.9 years. The most common presenting symptoms were fever, cough, and breathlessness. Abnormal chest signs (e.g., localized dull percussion note, with amphoric or bronchial breathing) were detected in 18 cases. Foremost among the predisposing factors were
measles
(25%), empyema thoraxis (17%), and unconsciousness (13%). Bacteria were isolated from 18 children, with Staphylococcus aureus (8 cases), group A beta hemolytic streptococci (4 cases), and Pseudomonas aeruginosa (3 cases) the most common. Treatment consisted of bronchoscopy to aspirate pus from the bronchus and exclude foreign bodies as well as antibiotic administration. There were 6 deaths (25% case fatality rate). The prevention or prompt treatment of
measles
is urged to reduce further the incidence of this rare health condition. However, the spread of human immunodeficiency virus infection among children in sub-Saharan Africa is likely to be accompanied by pediatric lung abscess cases secondary to
pneumonia
.
...
PMID:Lung abscess in children in Harare, Zimbabwe. 147 6
Physicians analyzed December 1982-November 1989 data on 48 2-60 month old children with empyema thoracis at the University of Calabar Teaching Hospital in southeastern Nigeria to determine the incidence and etiology of empyema thoracis in this region. The incidence rate stood at 2/1000 pediatric admissions. 3 children died (6.3%), all of heart failure. 47 children suffered from fever, cough, and breathlessness, the symptoms for
pneumonia
. Even though bronchopneumonia is a common complication of
measles
which occurs frequently in Calabar, only 3 children (6.25%) also had
measles
. The most frequent complication of this accumulation of pus in the thoracic cavity was congestive heart failure (16 cases). 47 patients suffered from anemia (hemoglobin levels 11 gm/dl). Hemoglobin levels of 54% of all patients decreased over time to 8 gm/dl. In fact, 2 children had hemoglobin levels of 4.4 gm/dl and they experienced cardiac failure. Laboratory personnel were only able to examine pleural aspirates from 37 patients. They did not detect any organisms in 27% of these aspirates. This may have been due to parent's widespread practice of giving medication to all the children before coming to the hospital. 45.9% of the aspirates only grew Staphylococcus aureus while another 8.1% grew it and other pathogens. About 90% of the pathogens were resistant to ampicillin and penicillin and almost 90% were sensitive to cloxacillin, gentamicin, and erythromycin. Cloxacillin was very expensive and parenteral erythromycin was unavailable. Nevertheless the pediatricians used parenteral gentamicin and cloxacillin. The parents were responsible for buying the antibiotics which tended to be costly. All the patients required emergency closed tube thoracostomy drainage within 24 hours of admission. 83.3% remained in the hospital for 2 weeks and 33.3% for 1 month. Despite the rarity of empyema, long hospitalization and expensive drugs make it an important disease in Calabar.
...
PMID:Clinical and bacteriological study on childhood empyema in south eastern Nigeria. 150 92
Seventy-two children with early
measles
(1st-3rd day of rash), presenting at two centres in Santiago, Chile, were classified as having mild ('ordinary
measles
', n = 50), or moderate to severe
measles
('primarily severe
measles
', n = 22). The level of serum C-reactive protein (CRP) was determined by nephelometry from a finger prick sample. The mean CRP value in ordinary
measles
, 19 mg/l, was significantly lower (P less than 0.001) than in primarily severe
measles
where the mean CRP was 65 mg/l. During late
measles
(5th-8th day of rash), the mean CRP was 19 mg/l if the child recovered uneventfully (n = 35), whereas the mean level of 123 mg/l (P less than 0.001) was encountered when the child suffered from complicating
pneumonia
(n = 22). We conclude that the simple quantitative CRP determination is a useful alarm signal during the course of
measles
: elevated levels point to severity or complications in recovery.
...
PMID:C-reactive protein in measles. 152 7
Hundreds of striped dolphins (Stenella coeruleoalba) died along the Spanish Mediterranean coast during the second half of 1990. We necropsied 58 dolphins. Partial collapse of the lungs with patchy atelectasis, subcutaneous edema, icterus, and stomatitis were the most prominent gross morphologic changes. Histologically, a bronchiolo-interstitial pneumonia was the most frequent lesion (72% of the animals). It was characterized by hyperplasia of alveolar epithelial type II cells and formation of multinucleate syncytia in alveolar and bronchiolar lumina. Other prominent lesions were encephalitis (69%), lymphoid depletion, and formation of multinucleate syncytia in the cortex of lymph nodes. The distribution of morbillivirus antigen was investigated in 23 well-preserved dolphins using a monoclonal antibody against the hemagglutinin glycoprotein of phocine distemper virus. Positive immunostaining was found in brain (77%), in lung (70%), and in mesenteric (61%), mediastinal (47%), and prescapular (45%) lymph nodes. Phocine distemper virus antigen was demonstrated less frequently in trachea, stomach, biliary epithelium, intestine, kidney, and mammary gland. Necrotizing-hemorrhagic
pneumonia
and encephalitis due to Aspergillus fumigatus were seen in three dolphins, whereas two animals had lesions of toxoplasmosis. Changes in our dolphins were similar to those caused by distemper in seals and porpoises. The origin of the dolphin virus and the relationships among dolphin, seal, and porpoise
morbilli
viruses are unknown.
...
PMID:Pathologic and immunocytochemical studies of morbillivirus infection in striped dolphins (Stenella coeruleoalba). 155 61
A 16-year-old female was admitted for the treatment of bronchial asthma. She had a history of
measles
pneumonia
at four years of age. Her chest radiograph revealed right unilateral hyperlucency. She was diagnosed as having Swyer-James syndrome from the results of computed tomography, pulmonary angiography, bronchoscopy, and perfusion-ventilation scintigrams, which revealed unsuspected bilateral involvement, and irregularity of severity and distribution. In addition, she had a hypoplastic right upper bronchus, pulmonary hypertension, pneumothorax, and bronchial asthma. The findings of bilateral involvement, irregular distribution, and bronchial lesions strongly suggest that the etiology in this case was damage to the airways caused by
measles
infection in childhood.
...
PMID:[A case of Swyer-James syndrome with bilateral lesions]. 156 31
Twelve pregnant women and one woman who had just given birth were hospitalized with
measles
in Houston between 1988 and 1990. The most common and serious maternal complication was
pneumonitis
(seven patients). Other maternal complications included hepatitis (seven patients), premature labor (four patients), spontaneous abortion (one patient), and death (one patient). For four of 13 patients, all of whom had severe
measles
and
pneumonitis
due to
measles
virus, an adverse fetal outcome such as abortion or prematurity was associated with their conditions. Historical accounts describing maternal sequelae of
measles
have suggested more severe disease in pregnant women, although this observation has not always been confirmed by more recent reports in developed countries. The clinical course in our patients suggests that
measles
during pregnancy may be associated with serious complications.
...
PMID:Complications of measles during pregnancy. 162 85
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