The Journal of pediatrics
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The Journal of pediatrics · Jan 1998
Diagnosis of penicillin, amoxicillin, and cephalosporin allergy: reliability of examination assessed by skin testing and oral challenge.
The specificity of pediatrician-diagnosed allergy reactions to penicillin, amoxicillin, and oral cephalosporins, which was based on contemporaneous examination of the patient, was evaluated by an elective skin testing program. Children and adolescents (n = 247) experiencing an adverse reaction to penicillin, amoxicillin, and/or an oral cephalosporin sufficient to lead to the recommendation to avoid further use were enrolled. Skin testing with penicillin G, commercial benzylpenicilloyl phosphate, penicillin minor determinate mixture, ampicillin, cefazolin, cefuroxime, and ceftriaxone was performed according to the suspected drug allergy followed by an oral challenge, repeat testing, and prospective follow-up if no reactions were observed. ⋯ One hundred sixty-three patients received multiple treatment courses with beta-lactam antibiotics after a negative skin testing procedure and three (1.8%) had adverse IgE reactions, all of which were mild. Physician-diagnosed allergic reactions to beta-lactam antibiotics based on patient examination at the time of the reaction is more accurate than patient history alone but still overestimates the rate of possible true allergy in 66% of patients. Elective penicillin, amoxicillin, and cephalosporin skin testing and oral challenge protocols are necessary to identify patients not at risk.
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The Journal of pediatrics · Dec 1997
Case ReportsEndoscopic hemostasis of bleeding duodenal ulcer in a child with Henoch-Schönlein purpura.
A 9-year-old boy with Henoch-Schönlein purpura had a duodenal ulcer. Endoscopic injection with pure ethanol was performed on a pulsating visible vessel in the third part of the duodenum, resulting in complete hemostasis. A bleeding ulcer, although rare, may be a serious gastrointestinal complication of Henoch-Schönlein purpura and may require aggressive intervention.
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The Journal of pediatrics · Dec 1997
Meta Analysis Comparative StudyA meta-analytic review of the preventive treatment of recurrences of febrile seizures.
To assess the efficacy of various medications in the prevention of recurrent febrile seizures. ⋯ Because both agents found to be effective in prevention of recurrent febrile seizures have known adverse effects, prophylaxis of febrile seizures cannot be recommended.
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The Journal of pediatrics · Dec 1997
Multicenter StudyIncidence of premature birth and neonatal respiratory disease in infants of HIV-positive mothers. The Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted Human Immunodeficiency Virus Infection Study Group.
We sought to determine the prematurity rate in infants of HIV-positive mothers and to characterize the incidence and severity of neonatal respiratory disease in this population. ⋯ Infants born to HIV-positive mothers exhibited high prematurity and low birth weight rates, and the odds of prematurity were higher in infants who were infected with HIV. Despite the high incidence of prematurity and perinatal risk of this population, incidence and severity of neonatal respiratory disease were not higher than would be expected from available neonatal data in populations not exposed to HIV.
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The Journal of pediatrics · Dec 1997
If a first antiepileptic drug fails to control a child's epilepsy, what are the chances of success with the next drug?
This study was carried out to determine how often a child's epilepsy is controlled and remits if a first antiepileptic drug (AED) fails to control seizures. ⋯ If the first AED is not efficacious, the outcome is less favorable, although many children will have remission of their epilepsy. Invasive or complex treatments for epilepsy with partial and generalized tonic-clonic seizures should not be used until at least two AEDs have failed to control seizures.