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Clinical Issues Surrounding Once-Daily Aminoglycoside Dosing In Children, Chad A. Knoderer, Julie A. Everett, William F. Buss

Scholarship and Professional Work – COPHS

Aminoglycoside antibiotics are first-line treatment for many infectious diseases in the pediatric population and are effective in adults. The traditional dosing interval in children is every 8–12 hours. Studies in adults reported equivalent efficacy and equal or less toxicity with once-daily regimens. Despite many studies in the adult population, this approach has yet to become standard practice in most pediatric hospitals. Reasons for lack of acceptance of this strategy in children include rapid aminoglycoside clearance, unknown duration of postantibiotic effect, safety concerns, and limited clinical and efficacy data.

Factors Influencing Immunization Status In Primary Care Clinics, David Page, Jan Meires, Amy B. Dailey

Health Sciences Faculty Publications

Background and Objectives: National standards and goals for childhood immunization rates are well established. Yet, despite clear standards and goals, physicians do not achieve the desired rate (90%) for immunization coverage. This study examined factors related to immunization status for 2-year-old children in pediatric and family practice settings.

Methods: Specially trained personnel used computer software to audit 2,552 records from 42 practices in Northeast Florida throughout 1997–1999. Immunization records were judged as either complete or incomplete, and factors related to immunization status were studied. Clinic type and 18 immunization practice standards were reviewed for effect on immunization status.

Results: The …

Prognostic Indicators Of Childhood Acute Viral Encephalitis, E Bhutto, M Naim, M Ehtesham, M Rehman, M A. Siddique, I Jehan

Community Health Sciences

Objective: To devise a set of clinical signs and laboratory parameters that would help clinicians assess prognosis in patients and plan appropriate management.Methods: Medical records of 147 paediatric cases (with a discharge diagnosis of acute viral encephalitis) admitted over a ten year period from 1987 to 1997 were reviewed and relevant information collected on a data extraction form.Results: Of 147 patients, 24 (16.3%) died and 48 (32.7%) were left with severe neurological deficits. A GCS (Glasgow Coma Scale) score between 6-10 had an association with poor outcome (OR = 2.62, Chi-square = 5.57, p-value = 0.018) and that a GCS …

A Call To Action: The Institute Of Medicine Report On Emergency Medical Services For Children., J F. Knapp

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Comparison Of Cytotoxic Properties Of Neonatal And Adult Neutrophils And Monocytes And Enhancement By Cytokines., E . R. Stiehm, R. L. Roberts, B. J. Ank, S. Plaeger-Marshall, N. Salman, L. Shen, M. W. Fanger

Dartmouth Scholarship

We studied cytotoxic capabilities of newborn polymorphonuclear leukocytes (PMNs) and monocytes and their enhancement by cytokines and antibodies. Umbilical cord PMNs were assessed for their ability to kill various target cells spontaneously, after activation with phorbol myristate acetate, in the presence of antiserum (antibody-dependent cellular cytotoxicity), and in the presence of dually specific antibody (heteroantibody-mediated cytotoxicity). Target cells included the K562 cell line (natural killer cell target), chicken erythrocytes (CRBCs), and herpes simplex virus-infected CEM cell lines. Newborn PMNs were equivalent to adult PMNs in their cytotoxic capacity in several cytotoxicity assays. Neither adult nor newborn PMNs lyse tumor cell …

Necrotizing Enterocolitis In Infants Weighing Less Than 2000 G, P Mufti, Z A. Bhutta

Department of Paediatrics and Child Health

Over a 4 year period, nine of 180 (5%) infants weighing less than 2000 G, admitted to the Aga Khan University Hospital (AKUH) developed necrotizing enterocolitis (NEC). An outbreak of NEC occurred in 1989, during which six infants developed the clinical illness. Overall incidence was 1.1%. Thirty-one birth weight and gestation matched controls were selected for comparison. Risk factors usually considered as predisposing factors, i.e., low 5 min Apgar score, rate of maternal complications, respiratory distress syndrome, mechanical ventilation, umbilical catheterisation, patient ductus arteriosus, use of antibiotics and feeding practices were found with equal frequency in both cases and controls. …

Germbuster Brainteaser: A Novel Education Tool, Andrew Sirotnak, Md, Joel D. Klein, Md, Stephen C. Eppes, Md

Department of Pediatrics Faculty Papers

As part of the Pediatric Infectious Diseases elective at the Alfred I. duPont Institute, pediatric residents from the Medical Center of Delaware and the Thomas Jefferson Medical College are encouraged to contribute original, educational material to our Germbusters newsletters. We thought readers of the Delaware Medical Journal would enjoy seeing one of the more innovative resident contributions.

The Health Of The School Child With Special Reference To Heart Cases, Annette G. West

Bachelors’ Theses

The first of the generally accepted objectives of education is health. The importance to the community of the health of its children can hardly be over-emphasized when it is fully realized that the children of to-day are the bread winners and the parents of to-morrow. The health of our children is the foundation upon which the welfare of the community depends. To conserve the health of the child is as much a function of the state as it is to conserve the natural resources. To investigate the evils that exist and to remedy all that may be remedied without transgressing …