Varicella Vaccine: A Point of Decision

PEDIATRICS ◽  
1986 ◽  
Vol 78 (4) ◽  
pp. 705-707
Author(s):  
Stanley A. Plotkin
Keyword(s):  
Varicella Vaccine ◽  
Normal Children ◽  
Normal Adults

The governmental authorities on biologics soon will be asked to decide on the licensure of a live varicella vaccine. Pediatricians may then have to decide whether and how to use it. This commentary summarizes the data and provides a viewpoint in favor of licensure and use in normal children and adults. Additional articles are published in the accompanying supplement to this issue of Pediatrics. The goals of a varicella vaccine are three: (1) to protect normal children against the complications of varicella, (2) to protect normal adults against the complications of varicella, and (3) to protect immunosuppressed children (particularly those with leukemia) against disseminated varicella.

Risk of Herpes Zoster in Children With Leukemia: Varicella Vaccine Compared With History of Chickenpox

PEDIATRICS ◽  
1986 ◽  
Vol 77 (1) ◽  
pp. 53-56
Author(s):  
Philip A. Brunell ◽  
Jean Taylor-Wiedeman ◽  
Clementina F. Geiser ◽  
Lisa Frierson ◽  
Eva Lydick
Keyword(s):  
Herpes Zoster ◽  
Antibody Response ◽  
Acute Lymphocytic Leukemia ◽  
Varicella Vaccine ◽  
Lymphocytic Leukemia ◽  
Normal Children ◽  
History Of

A study was undertaken to determine whether children immunized with live varicella vaccine are at greater risk of acquiring herpes zoster than children who have had varicella. Children with acute lymphocytic leukemia who had had varicella were compared with those who received live varicella vaccine. During the period of observation, 15 of 73 children who had varicella acquired herpes zoster and none of the 34 children who had been vaccinated. If the time of observation was adjusted for and the vaccinees who failed to have a sustained antibody response or who acquired chickenpox were removed, the risk of herpes zoster was still less in vaccinees (P = .0075). Because herpes zoster is common in children with acute lymphocytic leukemia, differences in the two groups could be discerned more readily than if normal children were compared. There is no reason to suspect that recipients of live varicella vaccine would be more likely to acquire herpes zoster than children who get varicella.

Zoster in Normal Children After Varicella Vaccine

1989 ◽  
Vol 159 (5) ◽  
pp. 1000-1001 ◽  
Author(s):  
S. A. Plotkin ◽  
S. E. Starr ◽  
K. Connor ◽  
D. Morton
Keyword(s):  
Varicella Vaccine ◽  
Normal Children

Secretion of growth hormone-releasing hormone in patients with idiopathic pituitary dwarfism and acromegaly

1988 ◽  
Vol 117 (2) ◽  
pp. 273-281 ◽  
Author(s):  
Ryuichi Yamasaki ◽  
Haruhiko Saito ◽  
Kazuhito Kameyama ◽  
Eiji Hosoi ◽  
Shiro Saito
Keyword(s):  
Type I ◽  
Normal Children ◽  
Pituitary Dwarfism ◽  
Gh Secretion ◽  
Fasting Plasma ◽  
Pathophysiological Role ◽  
Plasma Gh ◽  
High Level ◽  
Normal Adults

Abstract. The plasma levels of immunoreactive-GHRH in patients with idiopathic pituitary dwarfism and acromegaly were studied in the basal state and during various tests by a sensitive and specific RIA. The fasting plasma GHRH level in 22 patients with idiopathic pituitary dwarfism was 6.3 ± 2.3 ng/l (mean ± sd), which was significantly lower than that in normal children (9.8 ± 2.8 ng/l, N = 21), and eight of them had undetectable concentrations (less than 4.0 ng/l). Little or no response of plasma GHRH to oral administration of L-dopa was observed in 7 of 10 pituitary dwarfs, and 3 of the 7 patients showed a response of plasma GH to iv administration of GHRH (1 μg/kg). These findings suggest that one of the causes of idiopathic pituitary dwarfism is insufficient GHRH release from the hypothalamus. The fasting plasma GHRH level in 14 patients with acromegaly and one patient with gigantism was 8.0 ± 3.9 ng/l, which was slightly lower than that in normal adults (10.4 ± 4.1 ng/l, N = 72). One acromegalic patient with multiple endocrine neoplasia type I had a high level of plasma GHRH (270 ng/l) with no change in response to L-dopa and TRH test. In 3 untreated patients with acromegaly L-dopa did not induce any response of plasma GHRH in spite of inconsistent GH release, and in 4 patients with acromegaly, TRH evoked no response of plasma GHRH in spite of a marked GH release, suggesting that the GH responses are not mediated by hypothalamic GHRH. These findings suggest that the measurement of plasma GHRH in response to L-dopa with a sensitive and specific RIA could be of use in clarifying the pathophysiological role of endogenous GHRH in patients with GH secretion disorders.

Developmental changes in upper airway dynamics

2004 ◽  
Vol 97 (1) ◽  
pp. 98-108 ◽  
Author(s):  
Carole L. Marcus ◽  
Lucila B. Fernandes Do Prado ◽  
Janita Lutz ◽  
Eliot S. Katz ◽  
Cheryl A. Black ◽  
...  
Keyword(s):  
Upper Airway ◽  
Older Children ◽  
Normal Children ◽  
Compensatory Response ◽  
Pharyngeal Airway ◽  
Ventilatory Drive ◽  
Airway Response ◽  
Airway Responses ◽  
Airway Dynamics ◽  
Normal Adults

Normal children have a less collapsible upper airway in response to subatmospheric pressure administration (PNEG) during sleep than normal adults do, and this upper airway response appears to be modulated by the central ventilatory drive. Children have a greater ventilatory drive than adults. We, therefore, hypothesized that children have increased neuromotor activation of their pharyngeal airway during sleep compared with adults. As infants have few obstructive apneas during sleep, we hypothesized that infants would have an upper airway that was resistant to collapse. We, therefore, compared the upper airway pressure-flow (V̇) relationship during sleep between normal infants, prepubertal children, and adults. We evaluated the upper airway response to 1) intermittent, acute PNEG (infants, children, and adults), and 2) hypercapnia (children and adults). We found that adults had a more collapsible upper airway during sleep than either infants or children. The children exhibited a vigorous response to both PNEG and hypercapnia during sleep ( P < 0.01), whereas adults had no significant change. Infants had an airway that was resistant to collapse and showed a very rapid response to PNEG. We conclude that the upper airway is resistant to collapse during sleep in infants and children. Normal children have preservation of upper airway responses to PNEG and hypercapnia during sleep, whereas responses are diminished in adults. Infants appear to have a different pattern of upper airway activation than older children. We speculate that the pharyngeal airway responses present in normal children are a compensatory response for a relatively narrow upper airway.

Varicella: Complications and Costs

PEDIATRICS ◽  
1986 ◽  
Vol 78 (4) ◽  
pp. 728-735 ◽  
Author(s):  
Stephen R. Preblud
Keyword(s):  
High Risk ◽  
Varicella Vaccine ◽  
Risk Groups ◽  
Vaccination Program ◽  
Varicella Vaccination ◽  
Effective Vaccine ◽  
Normal Children ◽  
Live Attenuated Vaccine ◽  
Increased Risk ◽  
The Cost

Vanicella (chickenpox) has long been considered a benign, inevitable disease of childhood. Complications are generally mild and rarely severe, and virtually every individual is infected by adulthood. Infection is associated, however, with a high risk of serious complications in certain high-risk groups, such as leukemic children. Concerns about the severity of varicella in this population have led to the development and testing of a live, attenuated vaccine. Because of the favorable results thus far available, the vaccine may soon be licensed for use in high-risk individuals. The fact that a vaccine may soon be available has led to an increased interest in the potential benefits of a childhood varicella vaccine program. The costs associated with varicella infection in normal persons without a varicella vaccination program have been estimated to be approximately $400 million, 95% of which is the cost of caring for a child at home. Vaccination of normal 15-month-old children with a safe and effective vaccine with long-lasting immunity could reduce the cost by 66% and result in a savings of $7 for every dollar spent on the vaccination program. This assumes that vaccine would be administered only once with measles, mumps, and rubella vaccine, that there would be no increase in the number of varicella cases in older persons who are at increased risk for complications, and that there would be no deleterious effect on the occurrence and severity of herpes zoster. If the assumptions cited above hold true, then it would appear that normal children would benefit from prevention of varicella by vaccination, not by virtue of the severity of the disease but rather because of the inevitability of the disease and its associated expense.

SUCROSURIA AND MENTAL DEFICIENCY: A COINCIDENCE

PEDIATRICS ◽  
1959 ◽  
Vol 24 (5) ◽  
pp. 774-779
Author(s):  
Thomas L. Perry ◽  
Richard W. Lippman ◽  
Dorothy Walker ◽  
Kenneth N. F. Shaw
Keyword(s):  
Hiatus Hernia ◽  
Mental Deficiency ◽  
Normal Subjects ◽  
Cane Sugar ◽  
Loading Test ◽  
Normal Children ◽  
Normal Individuals ◽  
Oral Sucrose ◽  
Sucrose Loading ◽  
Normal Adults

The results of an oral sucrose loading test carried out with 25 normal children, 37 normal adults, and 37 mentally defective subjects are presented. Sucrosuria occurred in most of these subjects, and was as common a finding in normal subjects as in mentally defective individuals. Sucrose was present in the urine of some infants fed a commonly-used formula containing cane sugar. The degree of sucrosuria produced in many normal individuals by the ingestion of 1.0 gm/kg of sucrose was of the same order as that reported previously for patients having mental defect, hiatus hernia and sucrosuria. It seems clear that the presence of sucrose in the urine after this sugar has been ingested is entirely physiologic and is unrelated causally to mental deficiency.

Bartter's Syndrome: Contrasting Patterns of Prostaglandin Excretion in Children and Adults

1978 ◽  
Vol 54 (1) ◽  
pp. 115-118 ◽  
Author(s):  
F. Dray
Keyword(s):  
Bartter’S Syndrome ◽  
Bartter's Syndrome ◽  
Urine Excretion ◽  
Normal Children ◽  
Daily Urine ◽  
Pg E2 ◽  
Normal Adults

1. The daily urine excretion has been studied of prostaglandins (PG) E2 and F2α, as measured by radioimmunoassay, in eight children and seven adults with Bartter's syndrome. 2. Excretion of both PGE2 and PGF2α was significantly higher in the patients with Bartter's syndrome than in 17 normal children. 3. Twelve normal adults excreted significantly more PGE2 and PGF2α than did the normal children. In contrast, adults with Bartter's syndrome did not show an increase in prostaglandin excretion.

scholarly journals Fluorometric Assay of Human Serum Carnosinase Activity in Normal Children, Adults and Patients with Myopathy

1984 ◽  
Vol 21 (6) ◽  
pp. 510-514 ◽  
Author(s):  
K Bando ◽  
T Shimotsuji ◽  
H Toyoshima ◽  
C Hayashi ◽  
K Miyai
Keyword(s):  
Muscular Dystrophy ◽  
Human Serum ◽  
Accurate Method ◽  
Mean Value ◽  
Adult Women ◽  
Normal Children ◽  
Adult Men ◽  
The Mean ◽  
Low Activity ◽  
Normal Adults

A sensitive, accurate method has been established for the assay of serum carnosinase by measuring the fluorescence emitted from the L-histidine liberated on treatment with o-phthaldialdehyde. Using this method the serum values for normal adults, infants and children were measured. The mean value was very low in infants of less than 1 year old but increased with age, being almost the same in children aged 6 years or more as in adults. In adult men, the mean activity was 1·85 μmol/mL/h and in adult women it was 2·07 μmol/mL/h. Low activity was observed in patients with muscular dystrophy.

Effects of Methylphenidate in Normal Adults with Reference to Drug Action in Hyperactivity

1984 ◽  
Vol 18 (1) ◽  
pp. 86-88 ◽  
Author(s):  
Michael G. Aman ◽  
Marina Vamos ◽  
John S. Werry
Keyword(s):  
Drug Effects ◽  
Drug Action ◽  
Stimulant Drug ◽  
Normal Children ◽  
Double Blind ◽  
Hyperactive Children ◽  
Reduced Physical Activity ◽  
Emotional Responsivity ◽  
Adult Volunteers ◽  
Normal Adults

Methylphenidate was administered to each of 12 adult volunteers in a double-blind, placebo-controlled, crossover study for purposes of comparison with previous studies in hyperactive children. Statistically significant changes occurred only on a minority of measures, but the results were generally in the direction of facilitated performance, reduced physical activity and increased emotional responsivity. As these results are similar to those in hyperactive and normal children, this appears to support the contention that stimulant drug effects in hyperactive children are not paradoxical or atypical.

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