Arch Pediat Adol Med
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Arch Pediat Adol Med · Jun 1999
Bacterial infections in infants 60 days and younger: epidemiology, resistance, and implications for treatment.
To establish what might be more optimal initial antibiotic therapy for suspected invasive bacterial infections in infants 60 days or younger who are evaluated in the emergency department (ED). ⋯ Our results reveal 2 important facts: (1) during a 4-year period, no isolates of Listeria were identified from any patients 60 days or younger; and (2) of the 96 GNRs isolated from patients in the ED, more than 60% were ampicillin resistant. These data suggest that in similar centers with a low incidence of infection with Listeria and high levels of ampicillin resistance among GNRs, empiric use of ampicillin as part of a combination for presumed bacterial infections in patients 60 days or younger initially evaluated in the ED may be neither necessary nor beneficial. Consideration should be given to empiric initial antibiotic therapy using a third-generation cephalosporin with or without gentamicin.
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Arch Pediat Adol Med · May 1999
Childhood passive smoking, race, and coronary artery disease risk: the MCV Twin Study. Medical College of Virginia.
Children with long-term exposure to passive cigarette smoke may be at elevated risk for the development of premature coronary artery disease (CAD). ⋯ Pubertal children with long-term passive cigarette smoke exposure have lower HDL-C levels. Racial differences in HDL-C levels are related to passive smoke exposure. In children with a family history of cardiovascular disease, interactions exist between passive smoking, HDL-C level, and blood pressure that differ by sex and race. White males exposed to passive smoking who have a family history of cardiovascular disease and higher weights and diastolic blood pressures may be at special risk for premature CAD.
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Arch Pediat Adol Med · May 1999
Unpredictability of serious bacterial illness in febrile infants from birth to 1 month of age.
A prior study (N Engl J Med. 1993; 329: 1437-1441) produced an effective screen to identify 1-to 2-month-old febrile infants (FIs) who are at low risk of having a serious bacterial illness (SBI). Because of anticipated differences in the epidemiological features of febrile illnesses, that Philadelphia protocol was not applied to FIs younger than 1 month. ⋯ The cause of febrile illnesses in neonates (infants younger than 1 month) approximates that of FIs 1 to 2 months of age. Unlike that for older 1- to 2-month-old FIs, however, the Philadelphia protocol lacks the sensitivity and negative predictive value to identify neonates at low risk for SBI.
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Arch Pediat Adol Med · May 1999
Randomized Controlled Trial Clinical TrialDorsal penile nerve block vs topical placebo for circumcision in low-birth-weight neonates.
To investigate the efficacy and safety of dorsal penile nerve block (DPNB) and eutectic mixture of lidocaine (EMLA) for palliation of pain associated with circumcision in low-birth-weight infants. ⋯ Dorsal penile nerve block is safe and effective in controlling pain associated with circumcision in low-birth-weight infants.
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Arch Pediat Adol Med · May 1999
Diagnostic testing for serious bacterial infections in infants aged 90 days or younger with bronchiolitis.
To describe the different laboratory tests that are performed on young infants aged 90 days or younger with bronchiolitis and to identify historical and clinical predictors of infants on whom laboratory tests are performed. ⋯ There is wide variability in the diagnostic testing of infants aged 90 days or younger with bronchiolitis. The risks of bacteremia, urinary tract infection, and meningitis in infants with bronchiolitis seems to be low. History or a documented temperature of 38.0 degrees C or more; oxygen saturation of less than 92%, and history of apnea were associated with laboratory testing for bacterial infections.