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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In view of the significant and articulate minority view among pediatricians that breast feeding is not "worth the bother" in developed countries, this review of the literature delves into the evidence from both developed and developing countries for the advantages of breastfeeding, both in infants and for long-term health. Infants in developed settings experience twice the hospitalization rate and more severe illness from lower respiratory tract infection, primarily respiratory syncytial virus. In developing countries the mortality risk is 4-fold. for otitis media, the relative risks were 3.3-4.3 for Finnish infants. Bacterial meningitis and/or bacteremia had a 4-fold risk for hospitalization in a Connecticut study, and a 3-fold relative risk in 2 developing country studies. Human milk was the best preventative for bacteremia and necrotizing enterocolitis in prematures in British neonatal units. A 20-fold reduction in neonatal deaths occurred in Philippine study of breastfeeding, especially in low birth weight babies. Diarrhea causes the most infant mortality in developing nations, where bottle-feeding raises rates 14-fold. In the U.S. estimated relative risks is 3.7 for diarrheal mortality. Sudden infant death is about 1/5 less common in U.S. breast fed babies than in bottle fed. There is evidence for better long-term health after breast feeding in disorders such as celiac disease, Crohn disease, ulcerative colitis, insulin-dependent diabetes mellitus, thyroid disease, malignant lymphoma, chronic liver disease, atopic dermatitis, and food allergies. The design of good studies of protection conferred by breast feeding, and the possible modes of action of breast milk are discussed.
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PMID:Breast-feeding and health in the 1980s: a global epidemiologic review. 194 1

The stress response in humans commonly includes elevations in plasma concentrations of glucocorticoids, catecholamines, glucagon, growth hormone, aldosterone, and renin, resulting in alterations in the metabolism of glucose and other energy substrates, and in increased sodium and water retention. In severe illness, triiodothyronine and sometimes thyroxine are decreased without evidence of clinical hypothyroidism. Antidiuretic hormone may be elevated in bacterial meningitis and other central nervous system disorders, as well as in acute asthma, chronic ventilator therapy, pneumothorax, atelectasis, and postoperatively. Increased ADH concentration can lead to significant hypoosmolality and hyponatremia with adverse effects on the patient. In the setting of severe intracerebral insults, ADH may be inappropriately low, resulting in diabetes insipidus. Insulin concentrations may be inappropriately low for serum glucose concentration, or insulin may have diminished receptor responsiveness in seriously stressed patients. Either situation leads to hyperglycemia. Disturbances in calcium, phosphorus, and magnesium homeostasis may occur relatively frequently in the critically ill patient in response to therapeutic interventions, or illness-induced altered metabolism. It is not always clear when an altered metabolic or hormonal state is an appropriate response to a stress, or represents decompensation of the body's mechanisms for coping with that stress. It is important, however to recognize the common responses of the organism to severe illness, and to monitor for treatable abnormalities which occur.
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PMID:Endocrine manifestations of critical illness in the child. 354 20

Insulin-like growth factors (IGFs) have 6 types of binding proteins (IGFBPs), and IGFBP-3 is the major IGFBP in human sera. A proteolytic enzyme for IGFBP-3 has recently been reported to be present in human and animal pregnant sera. Although the physiological significance of a pregnancy-associated IGFBP-3 protease remains to be established, the proteolysis could result in lowering the affinity for IGFs, thereby enhancing their delivery to target tissues by increasing free IGFs in the circulation. The methods for detection of IGFBP-3 protease which have been widely used so far are a method reported by Lamson et al. which used affinity crosslinking or western ligand blotting. These methods need radioactive materials (iodinated IGFs and IGFBP-3) and it takes at least a few days to get the results. We have now developed a simple assay for the proteolysis of IGFBP-3. The method is western immunoblotting without radioactive materials. The results can be obtained in a day. With this method, we proved the absence of significant proteolytic activity in sera from rapidly growing children (early stage of puberty or precocious puberty), and sera from a severe type of growth hormone deficiency. Significant proteolytic activity, as in pregnant women, was detected in 6 out of 11 patients with acute disorders such as measles, Kawasaki disease, bacterial meningitis and mycoplasma pneumonia, some of whom were probably in a catabolic condition. These data suggests that the proteolysis of IGFBP-3 might also be important in modulating IGF action in some acute diseases during childhood. The increased bioavailability of IGFs by IGFBP-3 proteolysis may play a role in overcoming catabolic conditions.
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PMID:Proteolytic activity of IGFBP-3 in various clinical conditions during childhood studied by means of western immunoblotting. 855 66

Seven recent studies in intensive care found that: *The need for intravenous sedation should continually be reassessed * Low-dose dopamine does not offer significant renal protection * Higher doses of continuous venovenous hemofiltration may improve survival * Subclavian central venous catheterization is associated with fewer complications than the femoral route * We have little evidence to support the use of ranitidine and sucralfate as prophylaxis for stress ulcers * Many young patients with suspected bacterial meningitis can undergo lumbar puncture without a CT scan if they have no abnormalities on a quick history and physical examination * Intensive insulin therapy to control blood glucose lowers the mortality rate.
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PMID:Intensive care update: seven studies that should change your practice. 1206 66

Chryseobacterium meningosepticum is an uncommon pathogen causing adult bacterial meningitis. Herein, we report the case history of one 21-year-old woman with this uncommon central nervous system infection. A diagnosis of adult C. meningosepticum meningitis can only be confirmed by a positive cerebrospinal fluid (CSF) culture. The patient had insulin-dependent diabetes mellitus as the underlying condition associated with this infection. The clinical presentations were fever, headache, consciousness disturbance, and seizure. CSF analysis revealed a purulent inflammatory reaction. After a 21-day course of intravenous cefepime (6 g/day) treatment, this patient was discharged in a state of complete recovery.
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PMID:An adult case of Chryseobacterium meningosepticum meningitis. 1550 80

Pseudomonas aeruginosa is a rare cause of infective endocarditis. The case of community-acquired P. aeruginosa infective endocarditis reported here is the first described in the literature to present as bacterial meningitis. Furthermore, new risk factors for P. aeruginosa infective endocarditis, including mitral annular calcification and re-use of insulin syringes, are proposed. Treatment of P. aeruginosa infective endocarditis complicated by bacterial meningitis is discussed.
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PMID:Pseudomonas aeruginosa infective endocarditis presenting as bacterial meningitis. 1629 Dec 69