AMERICAN ACADEMY OF PEDIATRICS, INC. PROCEEDINGS AND REPORTS

PEDIATRICS ◽  
1955 ◽  
Vol 15 (2) ◽  
pp. 221-230
Author(s):  
C. Henry Kempe
Keyword(s):  
American Academy ◽  
Daily Practice ◽  
Polymyxin B ◽  
Sulfa Drugs ◽  
Antimicrobial Drugs ◽  
Gram Negative ◽  
American Academy Of Pediatrics ◽  
The Difference ◽  
Related Compounds ◽  
Antibacterial Spectrum

THE SCOPE of the topic is such that one must present many simplifications in a positive manner. As an aid to memory in classifying the ever-increasing number of antibiotics and their antibacterial spectra and dosages, 2 charts have been prepared which are self-explanatory (Tables I and II). In all types of oversimplification one may quarrel with 1 or more points, but the material presented can be of practical value in daily practice. CHOICE AND DOSAGE OF COMMON ANTIBIOTICS Antimicrobial drugs are classified as bacteriocidal (those which kill bacterial organisms) or bacteriostatic (those which primarily inhibit bacterial multiplication which, however, resumes upon the removal of the bacteriostatic drug). Bacteriocidal agents actually differ from bacteriostatic agents only in the fact that their action is irreversible. The difference between bacteriostatic and bacteriocidal action appears to be a quantitative rather than qualitative one. Agents may be bacteriostatic at a given concentration and for a given exposure, while increasing concentration or exposure may cause a progressive shift toward bacteriocidal action. Primarily bacteriocidal agents in current use are penicillin, streptomycin, polymyxin B, bacitracin, and neomycin. Primarily bacteriostatic agents are tetracycline and all related compounds, chloramphenicol, erythromycin, and all sulfa drugs. The dosages of these drugs are given in Table I. A simple way to recall the antibacterial spectrum of antibiotics: pathogens are divided into rods (most of which are gram negative) and cocci (most of which are gram positive). Bacteriocidal agents which kill rods only are streptomycin and polymyxin B; bacteriocidal agents killing cocci only are penicillin and bacitracin; neomycin is bacteriocidal for a wide variety of rods and cocci.

scholarly journals Antimicrobial Activities of Mefloquine and a Series of Related Compounds

2000 ◽  
Vol 44 (4) ◽  
pp. 848-852 ◽  
Author(s):  
C. M. Kunin ◽  
W. Y. Ellis
Keyword(s):  
Staphylococcus Epidermidis ◽  
Antimicrobial Activities ◽  
Walter Reed Army Institute ◽  
Gram Negative Bacteria ◽  
Antimicrobial Drugs ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Resistant Strains ◽  
Vancomycin Resistant ◽  
Related Compounds

ABSTRACT Mefloquine was found to have bactericidal activity against methicillin- and fluoroquinolone-susceptible and -resistant strains ofStaphylococcus aureus and Staphylococcus epidermidis and gentamicin- and vancomycin-resistant strains ofEnterococcus faecalis and Enterococcus faecium. The MICs were 16 μg/ml, and the minimal bactericidal concentrations (MBCs) were 16 to 32 μg/ml. These concentrations cannot be achieved in serum. Mefloquine was active at a more achievable concentration against penicillin-susceptible and -resistant Streptococcus pneumoniae, with MICs of 0.2 to 1.5 μg/ml. Mefloquine was not active against gram-negative bacteria and yeasts. In an attempt to find more active derivatives, 400 mefloquine-related compounds were selected from the chemical inventory of The Walter Reed Army Institute of Research. We identified a series of compounds containing a piperidine methanol group attached to pyridine, quinoline, and benzylquinoline ring systems. These had activities similar to that of mefloquine against S. pneumoniae but were far more active against other gram-positive bacteria (MICs for staphylococci, 0.8 to 6.3 μg/ml). They had activities similar to that of amphotericin B againstCandida spp. and Cryptococcus neoformans. Combinations of the compounds with gentamicin and vancomycin were additive against staphylococci and pneumococci. The MIC and MBC of gentamicin were decreased by four- to eightfold when this drug was combined with limiting dilutions of the compounds. There was no antagonism with other antimicrobial drugs. The compounds were rapidly bactericidal. They appear to act by disrupting cell membranes. Combinations of the compounds with aminoglycoside antibiotics may have potential for therapeutic use.

Tuberculin Testing in the Pediatric Office and Clinic

PEDIATRICS ◽  
1979 ◽  
Vol 64 (6) ◽  
pp. 965-966
Author(s):  
Edwin L. Kendig
Keyword(s):  
American Academy ◽  
Disease Control ◽  
School Children ◽  
Tuberculin Test ◽  
Pediatric Clinic ◽  
American Academy Of Pediatrics ◽  
Tuberculin Testing ◽  
The Difference ◽  
Low Rate

Another article in this issue of Pediatrics, "Assessment of Tuberculin Screening in an Urban Pediatric Clinic," (p 856) again focuses attention on a weighty question: Is routine use of the tuberculin test important? The authors have pointed out the difference in philosophy of the Center for Disease Control, and the American Academy of Pediatrics. The Center for Disease Control recommends that routine tuberculin testing for school children and other similar programs be abandoned if the yield of positive tuberculin reactions is less than 1%1; this recommendation is based on the assumption that discovery of cases at this low rate will not have epidemiologic impact (italics added).

scholarly journals Impact of the 2017 American Academy of Pediatrics Guideline on Hypertension Prevalence Compared With the Fourth Report in an International Cohort

Hypertension ◽  
2019 ◽  
Vol 74 (6) ◽  
pp. 1343-1348 ◽  
Author(s):  
Liu Yang ◽  
Roya Kelishadi ◽  
Young Mi Hong ◽  
Anuradha Khadilkar ◽  
Tadeusz Nawarycz ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
American Academy ◽  
Pediatric Population ◽  
Fasting Blood Glucose ◽  
Laboratory Data ◽  
American Academy Of Pediatrics ◽  
Fourth Report ◽  
The Difference ◽  
Stage 1 ◽  
Control Study

In 2017, the American Academy of Pediatrics (AAP) updated the clinical practice guideline for high blood pressure (BP) in the pediatric population. In this study, we compared the difference in prevalence of elevated and hypertensive BP values defined by the 2017 AAP guideline and the 2004 Fourth Report and estimated the cardiovascular risk associated with the reclassification of BP status defined by the AAP guideline. A total of 47 200 children and adolescents aged 6 to 17 years from 6 countries (China, India, Iran, Korea, Poland, and Tunisia) were included in this study. Elevated BP and hypertension were defined according to 2 guidelines. In addition, 1606 children from China, Iran, and Korea who were reclassified upward by the AAP guideline compared with the Fourth Report and for whom laboratory data were available were 1:1 matched with children from the same countries who were normotensive by both guidelines. Compared with the Fourth Report, the prevalence of elevated BP defined by the AAP guideline was lower (14.9% versus 8.6%), whereas the prevalence of stages 1 and 2 hypertension was higher (stage 1, 6.6% versus 14.5%; stage 2, 0.4% versus 1.7%). Additionally, comparison of laboratory data in the case-control study showed that children who were reclassified upward were more likely to have adverse lipid profiles and high fasting blood glucose compared with normotensive children. In conclusion, the prevalence of elevated BP and hypertension varied significantly between both guidelines. Applying the new AAP guideline could identify more children with hypertension who are at increased cardiovascular risk.

Genetic testing for autistic spectrum disorders

2020 ◽  
pp. 78-79
Author(s):  
Е.А. Померанцева ◽  
А.А. Исаев ◽  
А.П. Есакова ◽  
И.В. Поволоцкая ◽  
Е.В. Денисенкова ◽  
...  
Keyword(s):  
Genetic Testing ◽  
American Academy ◽  
Autistic Spectrum Disorder ◽  
Genetic Factors ◽  
Molecular Genetic ◽  
Autistic Spectrum Disorders ◽  
Autistic Spectrum ◽  
American Academy Of Pediatrics ◽  
Spectrum Disorders ◽  
Testing Algorithm

Согласно рекомендациям Американской академии педиатрии при постановке диагноза аутизм, следует направить семью на консультацию генетика и генетическое обследование. Однако оптимальный подход к алгоритму генетического обследования при выявлении расстройства аутистического спектра еще предстоит разработать. В рамках исследования было проведено сравнение выявляемости генетических факторов аутизма различными молекулярно-генетическими тестами. According to American Academy of Pediatrics recent guidelines, each family with a child diagnosed with autistic spectrum disorder should be reffered to a medical geneticist and offered genetic tests. However, an optimal genetic testing algorithm has yet to be developed. This study was conducted to compare abilities of different molecular-genetic methods to detect genetic factors of autistic spectrum disorders.

scholarly journals The Lipid Lysyl-Phosphatidylglycerol Is Present in Membranes of Rhizobium tropici CIAT899 and Confers Increased Resistance to Polymyxin B Under Acidic Growth Conditions

2007 ◽  
Vol 20 (11) ◽  
pp. 1421-1430 ◽  
Author(s):  
Christian Sohlenkamp ◽  
Kanaan A. Galindo-Lagunas ◽  
Ziqiang Guan ◽  
Pablo Vinuesa ◽  
Sally Robinson ◽  
...  
Keyword(s):  
Sinorhizobium Meliloti ◽  
Minimal Medium ◽  
Polymyxin B ◽  
Growth Conditions ◽  
Membrane Lipid ◽  
Low Ph ◽  
Wild Type ◽  
Rhizobium Tropici ◽  
Gram Negative ◽  
Inducible Genes

Lysyl-phosphatidylglycerol (LPG) is a well-known membrane lipid in several gram-positive bacteria but is almost unheard of in gram-negative bacteria. In Staphylococcus aureus, the gene product of mprF is responsible for LPG formation. Low pH-inducible genes, termed lpiA, have been identified in the gram-negative α-proteobacteria Rhizobium tropici and Sinorhizobium medicae in screens for acid-sensitive mutants and they encode homologs of MprF. An analysis of the sequenced bacterial genomes reveals that genes coding for homologs of MprF from S. aureus are present in several classes of organisms throughout the bacterial kingdom. In this study, we show that the expression of lpiA from R. tropici in the heterologous hosts Escherichia coli and Sinorhizobium meliloti causes formation of LPG. A wild-type strain of R. tropici forms LPG (about 1% of the total lipids) when the cells are grown in minimal medium at pH 4.5 but not when grown in minimal medium at neutral pH or in complex tryptone yeast (TY) medium at either pH. LPG biosynthesis does not occur when lpiA is deleted and is restored upon complementation of lpiA-deficient mutants with a functional copy of the lpiA gene. When grown in the low-pH medium, lpiA-deficient rhizobial mutants are over four times more susceptible to the cationic peptide polymyxin B than the wild type.

scholarly journals Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Aryatara Shilpakar ◽  
Mehraj Ansari ◽  
Kul Raj Rai ◽  
Ganesh Rai ◽  
Shiba Kumar Rai
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Confirmatory Test ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Extended Spectrum ◽  
Esbl Producers

Abstract Background The existence of multidrug-resistant organisms, including extended-spectrum beta-lactamases (ESBLs), is on rise across the globe and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile. Methods A cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the standardized Kirby-Bauer disk diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test. Results Out of the 92 isolates, 84 (91.3%) were multidrug-resistant, and 47 (51.1%) were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers. Conclusion Multidrug resistance was very high; however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.

568 Sleep Evaluation in Down Syndrome: What is the Adherence to American Academy of Pediatrics DS Guidelines?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A224-A224
Author(s):  
Anne Marie Morse
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
American Academy ◽  
Phenotypic Variability ◽  
Sleep Diary ◽  
Poor Correlation ◽  
Sleep Habits ◽  
American Academy Of Pediatrics ◽  
Obstructive Sleep

Abstract Introduction Specialized health care guidelines for children with Down Syndrome (DS) published by the American Academy of Pediatrics (AAP) provided specific recommendations based on the higher risk needs of individuals with DS. Obstructive sleep apnea (OSA) is reported to be present in 50–79% of individuals with DS. According to the AAP guideline, all individuals with DS should have a polysomnography (PSG) evaluating for OSA by 4 years old and then screened by history and physical exam annually thereafter. An interim analysis of an ongoing Down Syndrome Research study was evaluated to determine rate of adherence to these guidelines. Methods The Dimensional, Sleep, and Genomic Analyses of Down Syndrome to Elucidate Phenotypic Variability study enrolled down syndrome patients 30 months and older, as well as first degree relatives to participate. Patients completed a standardized clinical sleep interview, childhood sleep habits questionnaire and was asked to complete 2 week sleep diary, actigraphy and polysomnography. We aimed to characterize the rate of PSG completion by 4 years of age, number of research PSGs completed and rate of OSA identified on research PSG. Results A total of 31 patients were consented. The median patient age was 10 years old with a slight female predominance (15F:12M). 27 patients completed the sleep interview and 19 successfully completed a scorable polysomnography. Only 7 patients had completed a PSG previously by age of 4 years. 11 of 19 studies demonstrated obstructive sleep apnea ranging from mild to severe severity (1.7–42.5/hr). REM AHI (range 1.2–58.2/hr, mean 19/hr and median 12.3/hr) demonstrated increased severity. Conclusion Despite AAP guidelines recommending universal PSG evaluation by the age of 4 years of age, only 26% of patients interviewed has a PSG successfully completed previously. Additional recommendations by AAP include yearly surveillance of symptoms although there is poor correlation between parent report and polysomnogram results. Of the 19 research completed PSGs, 58% demonstrated OSA with the mean and median results consistent with moderate to severe OSA and worsening during REM sleep. Improved effort to successfully obtain PSG in this population is needed. Further study is ongoing to evaluate the relationship to other health and cognitive outcomes. Support (if any) NIMH

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