The Pediatric infectious disease journal
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Pediatr. Infect. Dis. J. · Sep 2003
Randomized Controlled Trial Clinical TrialSurvival of previously measles-vaccinated and measles-unvaccinated children in an emergency situation: an unplanned study.
Previous studies have suggested that standard measles vaccine may reduce mortality by more than the number of deaths thought to be caused by measles infection in areas with high mortality. However, these observations have not been based on randomized trials. ⋯ Consistent with previous observational studies, measles vaccination was associated with a reduction in mortality that cannot be explained by the prevention of measles infection. This nonspecific beneficial effect was particularly strong for girls. Further studies are needed to examine the extent of nonspecific effects in settings with high mortality.
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Pediatr. Infect. Dis. J. · Sep 2003
Comparative StudyEffect of palivizumab prophylaxis in decreasing respiratory syncytial virus hospitalizations in premature infants.
Respiratory syncytial virus (RSV) is a major cause of hospitalization in preterm infants and infants with chronic lung disease (CLD). Palivizumab, a humanized monoclonal antibody, was approved in Europe in 1999 as prophylaxis against severe RSV-related respiratory illness. No multiple season data have been published on palivizumab effectiveness in European populations. Data collected during 4 years in Spain compared RSV hospitalization rates and risk factors in a cohort of palivizumab-prophylaxed and nonprophylaxed preterm infants. ⋯ Data from this study support the effectiveness of palivizumab in significantly modifying RSV-related hospitalizations in high risk preterm infants, with and without CLD, during two respiratory seasons.
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Pediatr. Infect. Dis. J. · Sep 2003
Comparative StudyHyperlactatemia in human immunodeficiency virus-infected children receiving antiretroviral treatment.
Hyperlactatemia and lactic acidosis occur in HIV-infected adults receiving antiretroviral treatment. Our objective was to determine the incidence, course and risk factors for hyperlactatemia in our HIV-infected pediatric patients. ⋯ Symptom-free hyperlactatemia was observed in HIV-infected children receiving nucleoside analog reverse transcriptase inhibitors. In our study, only a younger age at the beginning of antiretroviral treatment was a statistically significant risk factor for hyperlactatemia. Random measurements of blood lactate concentrations should be included in the clinical follow-up of those HIV-infected children <3 years of age who are treated with nucleoside analog reverse transcriptase inhibitors, symptomatic or not.
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Pediatr. Infect. Dis. J. · Sep 2003
Comparative StudyLactic acidemia in human immunodeficiency virus-uninfected infants exposed to perinatal antiretroviral therapy.
To investigate potential mitochondrial toxicity in HIV-uninfected infants exposed to highly active antiretroviral therapy (HAART) in utero and/or neonatal zidovudine. ⋯ Transient lactic acidemia was observed in the majority of HIV uninfected infants exposed to HAART in utero and/or zidovudine neonatally. We hypothesize that the hyperlactatemia is a consequence of persistent, primarily subclinical, mitochondrial toxicity from the transplacental and neonatal exposure to antiretrovirals and of impaired hepatic lactate clearance. Although the clinical relevance of our findings is unknown, we recommend lactate monitoring in these infants, considering discontinuation of neonatal zidovudine in symptomatic infants with lactate > or =5 mmol/l and careful long term follow up of these children.
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Pediatr. Infect. Dis. J. · Sep 2003
Analysis of the efficacy of urine culture as part of sepsis evaluation in the premature infant.
Premature infants have a higher incidence of urinary tract infection (UTI) than full term infants. UTI in premature infants can present with signs of sepsis: poor weight gain; temperature instability; metabolic acidosis; poor feeding; and abdominal distention. ⋯ There is minimal benefit in obtaining urine cultures from very low birth weight infants as part of a sepsis evaluation in the first 24 h of life. It is important to obtain urine cultures from older infants with signs of sepsis to identify patients with UTI with or without bacteremia.