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 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors undertook a retrospective study of the modes of prescription, the tolerance and efficacy of prostaglandin E1 in 62 consecutive neonates with congenital heart disease (average Age 1.6 days: 35 boys: weight: 3.1 +/- 0.6 Kg) admitted to the paediatric intensive care unit of Nancy University Hospital between 1998 and 2002. The infusion time and cumulative dosage were 134 +/- 112 (6-480) hours and 111 +/- 94 (4-396) microg/Kg respectively. The side effects that were observed were: Apnoea (19%), abdominal distension (16%), bradycardia (13%), enterocolitis (6.5%), hypotension (6.5%), vomiting (5%), fever (1.6%) and skin rash (1.6%). Gastrointestinal disturbances are associated with a low body weight (p<0.04), to prolonged treatment (p<0.02) with no influence of initial or cumulative dosages (P=NS), with respiratory assistance (p<0.03) and longer hospital stay (p<0.01). Hypotension was commoner in cases of poor neonatal adaptation. Mortality was correlated with severe initial acidosis (p<0.02), a low Apgar score, the initial prolonged use of high doses of prostaglandin (p<0.04), and the presence of severe valvular aortic stenosis or hypoplasia of the left heart (p<0.002). The authors conclude that treatment with prostaglandin is effective in the majority of cases despite the use of low maintenance doses (0.01 microg/Kg/min). Gastrointestinal disturbances favourised by the perinatal context, the cardiac disease, and prolonged treatment are significant factors for morbidity and mortality. The beneficial role of early neonatal enteral feeding was not demonstrated in this high risk population.
Arch Mal Coeur Vaiss 2005 May
PMID:[Complications of prostaglandin E1 treatment of congenital heart disease in paediatric medical intensive care]. 1596 3

The cerebral localization of the hydatid disease is rare, under 2%, and it primarily affects children. We report 4 cases of children presenting with a cerebral hydatid cyst (2 boys and 2 girls, mean age 9 years). Clinical symptoms were very progressive, the disease was frequently diagnosed several months (1-12 months) after onset of symptoms most often headaches and vomiting. One patient presented with a right tonic-clonic seizure 3 days before hospitalization. The diagnostic was confirmed in all cases by Cerebral CT scan. All the patients were screened for other localizations. One patient also presented with pulmonary and hepatic hydatid cysts. Hydatid blood tests were positive in only one case. The treatment was surgical for all the patients (using hydropulsion) without complications in 2 cases. One child presented with meningitis, and the other child with signs of secondary ICHT related to residual mass which required its puncture.
Med Mal Infect 2006 Aug
PMID:[Cerebral hydatid cysts in children: 4 cases]. 1689 Mar 92

Bacterial meningitis is a medical emergency requiring prompt recognition and evaluation and urgent initiation of appropriate antibacterial therapy. However, early recognition of severe bacterial infection including bacterial meningitis is a challenge in infants. Two clinical forms are basically observed in infants and young children: firstly, clinical meningitis which is characterized by fever, usually greater than 39 degrees C, and poorly specific gastrointestinal signs such as refusal of feeding and/or vomiting; irritability, abnormal crying, bulging fontanel, unusual generalized seizures occurring before six months of age and lasting more than 10 min should draw the clinician's attention and lead him/her to perform a lumbar puncture and initiate antibiotics; secondly, severe sepsis which is characterized by tachycardia, cold and/or mottled limbs and sometimes leg pain which should suggest a meningococcal disease; it is quite urgent to administer rapid fluid loading and antibiotic treatment while postponing lumbar puncture before the septic cascade evolves towards septic shock, extensive hemorrhagic rash, and ischemic limbs. Given the relative frequency of viral self-limiting diseases and rarity of serious bacterial infections, guidelines were published to guide the clinician's decision when dealing with a febrile infant. However, an alternative to these guidelines was recently suggested with a more clinically oriented decision-making attitude appearing as efficient while limiting hospitalizations.
Med Mal Infect
PMID:[Clinical signs suggestive of bacterial meningitis in infants]. 1940 42

Bordetella holmesii is a rare cause of bacteremia. It occurs mainly in hyposplenic patients, such as those affected by sickle cell anemia. The most frequent clinical signs are not very specific: fever, cephalalgia, cough, dyspnea, vomiting, etc. B. holmesii is frequently isolated from blood cultures. We describe the case of a 26-year-old sickle cell patient, presenting with dry cough and fever caused by a B. holmesii blood stream infection, identified by 16S rRNA gene sequencing. The outcome was favorable with amoxicillin. It is useful to know about B. holmesii, especially for physicians managing sickle cell or hyposplenic patients, because of its variable susceptibility to beta-lactams.
Med Mal Infect 2010 May
PMID:[Bordetella holmesii bacteremia in a 26-year-old patient with sickle cell disease]. 1958 32

Clinical diagnosis of acute bacterial meningitis may be delayed, either because off lack of sensitivity of clinical signs, or because of a poor vital prognosis; but over diagnosing is also frequent, leading to useless, expensive, and potentially dangerous hospitalizations. We conducted a comprehensive review of English and French literature from 1997 to 2007 by searching MEDLINE to review the accuracy of clinical examination for the diagnosis of meningitis. Additional references were identified by reviewing reference lists of articles back to 1993. We used the keywords "meningitis", "meningitis and clinical features", "cerebrospinal fluid (CSF) pleocytosis", "headache and fever", "Kernig sign", "Brudzinski sign", and "neck stiffness". We excluded nosocomial meningitis. Sensitivity for clinical signs such as headache, vomiting, or fever was low, generally less than 30%, neck stiffness could reach 45%, but the absence of two signs among fever, headache, neck stiffness, and altered mental status eliminated meningitis with a negative predictive value of 95%. Given the seriousness of bacterial meningitis, clinicians perform lumbar puncture (or brain imaging) too often, especially in high-risk patients. Further prospective clinical research is needed to improve the accuracy of bacterial meningitis clinical diagnosis.
Med Mal Infect
PMID:[Sensitivity and specificity of clinical signs in adults]. 1963 74

In Morocco, storage reservoirs are particular systems of water supply in rural areas. These reservoirs are fed with rainwater and/or directly from the river, which are very contaminated by several pathogenic bacteria. They are used without any treatment as a drinking water by the surrounding population. In this context, the aim of this study is to evaluate the impact of consuming contaminated water stored in reservoirs on health status for six rural communities located in Assif El Mal, Southern East of Marrakech. This was investigated using a classical methodology based on population survey and by molecular approach using PCR-DGGE technique to determine the intestinal bacterial diversity of consumers. The survey showed that, the residents of the studied area suffered from numerous health problems (diarrheal diseases, vomiting or hepatitis A) due to the lack of waste management infrastructures. The consumer's stool analysis by molecular approach revealed that numbers of Escherichia coli, Aeromonas hydrophila and Clostridia, were significantly higher in the diarrheal feces. In addition, PCR-DGGE study of the prevalence and distribution of bacteria causing human diseases, confirmed that, there is a relationship between water bacterial contaminations of storage reservoirs and microbial disease related health status. Therefore, water reservoir consumption is assumed to be the mean way of exposure for this population. It's clear that this approach gives a very helpful tool to confirm without any doubt the relationship between water bacterial contamination and health status.
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PMID:Sanitary impact evaluation of drinking water in storage reservoirs in Moroccan rural area. 2849 Sep 45


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