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Query: UMLS:C0728731 (prematurity)
 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Respiratory syncytial virus (RSV) is a recognised cause of lower respiratory tract infection in infants and young children. It causes severe respiratory disease in preterm infants with or without chronic lung disease. This study, conducted at Waterford Regional Hospital, evaluates the incidence of RSV infection in hospitalised children, its seasonal variation, and effectiveness of its prevention. Thirty eight percent of admitted children with bronchiolitis were RSV positive in the year 1999 November to March is the peak season for this infection. A highly selected group of 7 preterm children with or without chronic lung disease received Palivizumab prophylaxis. Not one of them acquired RSV infection. The high cost of Palivizumab was the main factor for its restricted use. Palivizumab was found to be effective in preventing RSV infection in our study. Since we had a small number of patients, further studies are needed for its economic and judicious use. Respiratory syncytial virus (RSV) is virulent easily transmissible and the most common cause of lower respiratory tract disease in children of less than 2 years of age. Up to 98% of children attending day care will be infected in single RSV season. Between 0.5% and 3.2% of children with RSV infection require Hospitalisation. Approximately 90,000 hospital admissions and 4500 deaths per year were reported in United States. In Ireland 2807 patients were admitted with Bronchiolitis in 1998. Major risk factors for hospitalisation due to RSV are Prematurity, chronic lung disease, congenital heart disease, compromised immunity and age younger then 6 weeks in otherwise healthy children. No effective treatment of RSV positive bronchiolitis beside supportive care in the form of adequate nutrition and oxygen therapy is available. Antiviral therapies such as Ribavirin has not been proved to be effective in RSV infection. Bronchodilators show variable results. Corticosteroids were not found effective. There is no effective vaccine available as yet. There is no proven method for active immunity. Various immunoglobulins are available for acquiring passive immunity against RSV infection. PREVENT study group in Jan. 1997 showed intravenous immunoglobulin (RSV- IGIV) use in reducing 41% to 63% hospitalisation in RSV patients. But RSV-IGIV was not licensed outside the United States because of risk of transmission of blood borne products, difficulty in administration ie. intravenous access, large fluid volume (15 ml/kg), high protein load (750 mg/kg), shortage of supply and need to postpone live vaccine (eg. MMR, varicella). monoclonal antibody Palivizumab was developed for prophylaxis against RSV infection. Clinical safety and efficacy of Palivizumab were demonstrated in IMpact trial published in Sept. 1998. Reduction in hospitalisation up to 55% was noted in this study. It was a pivotal randomised, double blind, placebo controlled phase 3 study conducted in 139 centres throughout Canada, United States and United Kingdom. We looked at our experience in patients admitted with bronchiolitis in Waterford Regional Hospital. We described the outcome of carefully selected Seven children of high risk group for Palivizumab prophylaxis. Its clinical Implications and cost effectiveness was evaluated in this study.
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PMID:Prophylaxis in RSV infection (Palivizumab)--is it worthwhile? 1120 17

Autism spectrum disorders [ASD] are complex neurobehavioraL disorders defined by social and communication deficits and repetitive and stereotyped behaviors. The current estimated prevalence of ASD is approximately 1:100, which reflects a 15-fold increase from studies published a half-century ago. ASD is a highly heritable disorder, however, the exact cause of ASD is still unknown. ASD is associated with altered functional and structural connectivity patterns in the frontal and temporo-limbic brain regions that occur early in life. It is now believed that environmental factors may modulate phenotypical expression of ASD that are associated with the genetic predisposition. Several possible risk factors for ASD were investigated and included advanced parental age, birth complications, prematurity, Low birth weight and assisted conception. Numerous epidemioLogical reports have failed to confirm any association between immunizations and MMR specifically or thimerosaL exposure and risk for ASD. The diagnosis of ASD can be reLiably made in the second year of Life and appears to be relatively stable over time. However, diagnosis of very young children can be quite complex due to their clinical heterogeneity and varying patterns of onset that can differ from the typical autism symptoms of an older child. It is further challenging to distinguish between developmental and/or speech delay and ASD at this early age. Standardized tests for ASD diagnosis, developmental level and adaptive skiLls have been successfully used for accurate diagnosis of ASD. Research has recently focused on possible basic measures and/or biological markers that can assist with early diagnosis of ASD. Recent studies suggest that substantial gains can be achieved by intensive behavioral intervention initiated prior to 24 months, as neural plasticity is increased and chaLLenging behaviors are less prominent. Effective early intervention should begin soon after the diagnosis is made, and be individualized, intensive, and comprehensive and should include parent education, and behavioral intervention. It is highly important for pediatricians and experts in child neurology, development and child psychiatry to recognize the early signs of ASD, diagnostic tools and effective intervention methods.
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PMID:[Autism spectrum disorders--a syndrome on the rise: risk factors and advances in early detection and intervention]. 2251 65