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Two hundred and thirty-one patients were questioned the day following their cataract surgery to ascertain the incidence of postoperative morbidity. One hundred and nineteen patients received local anaesthesia (LA) and 112 received general anaesthesia (GA). There was a significant difference in the incidence of nausea (21% in GA group, 3% in LA group, p < 0.01), sore throat (41% GA group, 3% LA group, p < 0.01), and bruising of the eye (15% GA group, 39% LA group, p < 0.01). There was no significant difference in the incidence of vomiting, headache, double vision, the severity of postoperative pain, or the need for analgesia. The time before the patients drank and ate postoperatively was significantly shorter in the local anaesthetic group (1.3 h and 1.8 h LA group, 4.1 h and 6.7 h GA group respectively, p < 0.01).
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PMID:Postoperative morbidity following cataract surgery. A comparison of local and general anaesthesia. 903 83

We present the results of the investigation of an epidemic outbreak of Mycoplasma pneumoniae infection which affected 95 schoolchildren from certain village in Catalonia. The investigation took an epidemiological, clinical and microbiological approach, detecting by capture enzyme-immunoassay technique the presence of IgM antibodies against M. pneumoniae. All cases occurred over a 9 week period. The attack rate in children under five was 18% and 8.2% in those from 5-14 years. The age mean and standard deviation of the cases was 5.2 +/- 3.5 years, the range being from 9 months to 14 years. Cough was the most common clinical manifestation (87.4%), followed by fever (67.4%), asthenia (21.1%), abdominal pain (18.9%), vomiting (13.7%), earache (8.4%) and sore throat (6.3%). There was no significant difference in the distribution of symptoms according to age groups. IgM anti M. pneumoniae was positive in 36 (37.9%) of the samples analysed. Treatment chosen in most cases (90) was eritromicin and there was a correct evolution in all cases except for two clinical and radiological recurrences. Hospitalization was only necessary in 5 cases. The present findings are important to emphasize the high incidence of M. pneumoniae respiratory disease in children under 5, and suggests that with respiratory processes affecting very young children, a possible Mycoplasma pneumoniae infection should also be considered and the necessary action taken in the form of early and appropriate treatment.
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PMID:Community outbreak of acute respiratory infection by Mycoplasma pneumoniae. 881 90

A survey was performed to estimate the incidence of the minor sequelae of anaesthesia in children. During an eight-month period 266 children, aged five years and over, were personally interviewed by an anaesthetist following recovery from anaesthesia. At interview the child was questioned to ascertain any morbidity suffered and record was made of the operation performed and the anaesthetic administered. Data were then evaluated, using multivariate analysis, to identify risk factors for the more common sequelae. This study revealed a higher incidence of the minor sequelae of anaesthesia in children than had previously been reported. The three most common sequelae recorded were nausea (48.1%), vomiting (35.0%), and sore throat (31.4%).
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PMID:The incidence of minor sequelae following anaesthesia in children. 882 45

Edema contributes substantially to the postoperative discomfort and morbidity of adenotonsillectomy. In a double-blind study, 58 children undergoing adenotonsillectomy were given a single intraoperative dose of either dexamethasone or saline. The steroid markedly affected the postoperative course in the first day after surgery. According to parental reports, the percentage of patients vomiting was reduced from 48 to 4%. Severe throat pain was reported in 57% of controls and only 20% of dexamethasone patients. Twice as many steroid patients as controls tolerated some soft food on the first postoperative day. It appears that dexamethasone can greatly improve patient diet and comfort after adenotonsillectomy.
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PMID:Dexamethasone in adenotonsillectomy. 889 9

A 4-year-old Indonesian girl was seen with streaky haematomas on back and chest. Because of fever, throat pain, cough and vomiting, her parents had rubbed her with balm and a coin. Coin rubbing is a harmless, traditional treatment for various illnesses which is regularly used in Southeast Asia. The cutaneous manifestations can be mistaken for battering or a bleeding disorder.
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PMID:[Rubbing with a coin is not abuse]. 905 47

During the months of September 1993 through February 1994, an outbreak of hemorrhagic fever occurred in the city of Jayapura, the provincial capital of Irian Jaya, Indonesia. Seventy-two patients (age range = 1-41 years) with suspected dengue hemorrhagic fever (DHF) were enrolled into the outbreak investigation conducted during October-November 1993. The pediatric patient population consisted of 36 individuals ages 1-12 years of age with a similar male to female ratio. From clinical histories obtained from the children diagnosed with DHF (n = 23), the predominant complaints were fever (100%), headache (96.7%), vomiting (47.8%), abdominal pain (39.1%), back/bone pain (39.1%), cough (39.1%), sore throat (21.7%), convulsions (17.4%), and eye pain (13.0%). Clinical findings of the same pediatric patients included a positive tourniquet test result (100%), thrombocytopenia (100%), hemoconcentration (100%), skin petechiae (43.5%), epistaxis (39.1%), and maculopapular rash (26%). All four of the children diagnosed with DHF grade IV had hepatomegaly, pleural effusion, ascites, cold perspiration, and confusion. Serologic data demonstrated that a majority (46 of 70, 68.7%) of the individuals assessed did not have significant levels of IgM specific for dengue viruses at the time of their admission. However, the nine successful dengue virus isolations were only from these serononreactive cases (19.6%). From the other patients assessed, 11.4% had a primary (or first exposure) serologic response to dengue virus antigen (predominantly IgM); 17.1% had a secondary (or subsequent exposure) serologic response to the same dengue antigens (predominantly IgG response) and 5.7% (four adults) had indeterminate serologic data that could not differentiate between reactivity to dengue or Japanese encephalitis virus antigen preparations. Virus culture of blood samples produced nine dengue virus isolates: DEN- 1 (2), DEN-2 (1), and DEN-3 (6). Japanese encephalitis and influenza viruses were not isolated from blood and pharyngeal specimens, respectively, from any of the patients. Thus, this first reported outbreak of DHF in Irian Jaya, Indonesia was found to be attributed to dengue viruses types 1, 2, and 3.
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PMID:The first reported outbreak of dengue hemorrhagic fever in Irian Jaya, Indonesia. 924 17

The federal country of Carinthia is known for its lakes and ponds, which are extensively used for bathing. The water quality is monitored regularly in accordance to the EC-Directive 76/160/EC and especially to the more rigorous Austrian Standard M6230. Since redevelopment measures of the lakes have been nearly finished the water quality found has improved essentially. In spite of these monitored data no effective correlation to data from the concerning ambulant sector of medical care could be established. The Carinthian Sentinel Practice Network started in summer 1994 to retrieve informations about occurrence and frequency of bathing related illness of children up to 16 years old. The 26 participating primary health care and pediatric physicians, having their own independent practices spread all over the country, reported the specific doctor-patient-contracts to the coordinating base. Criteria for inclusion in the medical report were headache, sore throat, otalgia, stomach-ache, nausea, emesis, diarrhoea, fever, rhinitis, cough, cold, moreover conjunctivitis, skin rash and specific dermatitis. In addition physicians reported where, how long and how often the children had been bathing and how long they had been free of symptoms afterwards. Each case was reported to the coordinating base including a presumed diagnosis. Statistic evaluation showed that bathing related illness may be divided into three main groups according to symptom frequency. The frequency of otalgia (32.4%) was significantly higher than any other symptom asked for. Two groups of symptoms correlate with each other: on one hand rhinitis, conjunctivitis, cough and sore throat (36.5%) and on the other hand nausea, emesis, diarrhoea and fever (41.9%). These data underline conclusions drawn by other authors but are not representative enough to correlate to data from water monitoring. First results suggest that conclusions for public health authorities can be drawn from this additional information about the state of the lakes and ponds-providing a sufficient number of data is reported.
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PMID:[Bathing water related diseases: the Carinthian Sentinel Project as the source of epidemiological data]. 937 46

Crimean-Congo haemorrhagic fever (C-CHF) re-emerged recently in the United Arab Emirates. The clinical outcome of 11 cases of viral haemorrhagic fever patients admitted to hospital between June 1994 and January 1995 is described. Four cases were laboratory confirmed retrospectively as C-CHF, the other patients were diagnosed likely to have the same disease on epidemiological and clinical grounds. In 72.7% of the patients, infection was fatal. Symptoms started 3.5 days before hospitalization. On admission, 81.8% of patients had high fever, 45.5% were vomiting, 63.6% had diarrhoea, 45.5% had haemorrhagic signs, and 18.2% had throat pain. Fatalities occurred 6.8 days after admission. Survivors were hospitalized for 9.3 days. Nosocomial transmission was not observed.
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PMID:Clinical features of Crimean-Congo haemorrhagic fever in the United Arab Emirates. 942 56

Several children have day surgery under general anaesthesia and depend on adult relatives for support and postoperative care at home. This prospective review examines the post operative problems encountered by 62 such children from the time of discharge from hospital to the first outpatient visit. The children were in the age range 3 months to 12 years. The commonest complications reported were:- Pain (18.9%), Cough/Sore throat (18.9%), Fever (16.2%), Restlessness (13.5%), Vomiting (12.2%), and Sleeplessness (6.7%). Eight patients reported more than three complications each. Day case surgery should not be regarded as "Minor Surgery" under Minor Anaesthesia", rather, the concerns for safety and comfort of the patients should extend beyond the recovery room to the ward and home.
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PMID:Complications following day case paediatric surgery. 947 57

Epidemiological and clinical data are presented on 165 cases of Venezuelan hemorrhagic fever (VHF), a newly emerging viral zoonosis caused by Guanarito virus (of the family Arenaviridae). The disease is endemic in a relatively circumscribed area of central Venezuela. Since its first recognition in 1989, the incidence of VHF has peaked each year between November and January, during the period of major agricultural activity in the region of endemicity. The majority of cases have involved male agricultural workers. Principal symptoms among the patients with VHF included fever, malaise, headache, arthralgia, sore throat, vomiting, abdominal pain, diarrhea, convulsions, and a variety of hemorrhagic manifestations. The majority of patients also had leukopenia and thrombocytopenia. The overall fatality rate among the 165 cases was 33.3%, despite hospitalization and vigorous supportive care.
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PMID:Venezuelan hemorrhagic fever: clinical and epidemiological studies of 165 cases. 950 47


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