Articles: adult.
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Comparative Study
The impact of HIV on Streptococcus pneumoniae bacteraemia in a South African population.
To determine the impact of HIV infection on Streptococcus pneumoniae bacteraemia in adults and children by analysing the prevalence and clinical features of such diseases and determining the prevalent serotypes/serogroups and susceptibility patterns of isolates. ⋯ The burden of bacteraemia due to S. pneumoniae in HIV-seropositive individuals admitted to our hospital is considerable. Differences in the S. pneumoniae serotypes/serogroups in HIV-infected patients have been demonstrated with resultant differences in antibiotic susceptibility patterns. Excellent potential for vaccine coverage was demonstrated for both HIV-seronegative and HIV-seropositive individuals. Further studies are necessary to test the clinical efficacy of pneumococcal vaccination of HIV-seropositive adults and children as a potential preventative measure against this prevalent disease.
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A number of studies have shown that glucose tolerance falls with decreasing birth weight and that people with low birth weight and high body mass index (BMI) as adults are those at greatest risk of developing Type II (non-insulin-dependent) diabetes mellitus. No such studies have been carried out in African populations. Therefore we investigated the relation between glucose tolerance and birth weight in a group of 7-year-old black South Africans for whom longitudinal anthropometric data were available. ⋯ Children born with low birth weights but who had high weights at 7 years had higher insulin concentrations and indices of obesity compared with those with low birth weights and low weights at 7 years. There were also positive correlations between weight velocity and BMI (r = 0.24, p = 0.02) and weight velocity and insulin resistance (r = 0.18, p = 0.04) as measured using homeostasis model assessment (HOMA). Thus, low birth weight in conjunction with rapid childhood gains in weight especially as subcutaneous fat, produces poor glucose tolerance in 7-year-old children and can make them susceptible to the development of Type II diabetes later in life.
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Blood pressure monitoring · Apr 1998
Age-based differences between mercury sphygmomanometer and pulse dynamic blood pressure measurements.
Both the mercury sphygmomanometer and oscillometric measurement methods are widely in use for pediatric, adult, and geriatric patients. However, inherent differences between the methods of measurement may create varying degrees of sensitivity to age and potentially result in differences between measurements for these two techniques. DESIGN: Measurements of systolic and diastolic blood pressures in 154 subjects were obtained using the mercury sphygmomanometer and pulse dynamic oscillometric methods in accordance with the 1987 Association for the Advancement of Medical Instrumentation guidelines. Subjects were separated into three age groups and their data analyzed for differences between measurements for these two techniques. ⋯ The variation in the agreement of systolic blood pressure measurements can be attributed to the differing effects of age-dependent arterial changes on the measurement methods. The findings indicate that, although the pulse dynamic oscillometric method and mercury sphygmomanometer correlate well when patients of all ages were evaluated as a group, agreement between measurements of systolic blood pressure is dependent on age and the method of measurement employed.
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Blood pressure monitoring · Apr 1998
Relationship between ambulatory blood pressure monitoring and response of blood pressure in male hypertensive adolescents to exercise.
High blood pressure in the young has been related to the development of hypertension in adults; hence the importance of identifying adolescents with the risk of developing it. ⋯ Systolic blood pressure measured by ambulatory blood pressure monitoring is related to response of systolic blood pressure to exercise and ambulatory blood pressure monitoring can identify groups of subjects at greater than normal risk through their higher blood pressure during sleep. Greater than normal blood pressure variability in adolescents is an indicator of the risk of reaching abnormal exercise values of systolic blood pressure. Higher casual blood pressure than ambulatory blood pressure monitoring values for adolescents should be considered abnormal.
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The transdermal therapeutic system (TTS) for fentanyl is a drug-delivery system for use in patients with chronic pain who require an opioid analgesic. A multicentre, randomized, double-blind, placebo-controlled study was performed to evaluate the efficacy and safety of TTS-fentanyl as an analgesic for chronic cancer pain. One hundred and thirty-eight patients entered a 15-day dose-titration period, followed by a 9-day double-blind period (95 patients) with TTS-fentanyl or placebo. ⋯ Due to an unexpectedly high placebo response it was not possible to demonstrate fentanyl to be statistically superior to placebo. This may reflect the practical difficulties of performing clinical trials in cancer patients with great inter-individual variability. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.