Bacteremia: Occult or Nonoccult?

PEDIATRICS ◽  
1988 ◽  
Vol 81 (2) ◽  
pp. 332-332
Author(s):  
LORRY G. RUBIN
Keyword(s):  
High Risk ◽  
Young Children ◽  
Antibiotic Therapy ◽  
Small Proportion ◽  
Antigen Detection ◽  
Bacterial Antigen ◽  
Ambulatory Visit ◽  
Focus Of Infection

In Reply.— In our study we sought to evaluate the efficacy of bacterial antigen detection in highly febrile young children with occult or "unsuspected" bacteremia, ie, patients whose presentations did not necessarily mandate IV antibiotic therapy, but in whom parenteral a antibiotic therapy would be indicated if bacteremia could be reliably diagnosed at the initial ambulatory visit. The patients referred to by Dr Mauro, those with no focus of infection, constitute a small proportion of occult bacteremic patients (although a group at relatively high risk for bacteremia).

Risk and resilience in high-risk samples: How to promote positive outcomes for young children

2010 ◽  
Author(s):  
Margo Candelaria ◽  
Kathy Katz ◽  
Anna Quigg ◽  
Sarah Oberlander ◽  
Margo Candelaria
Keyword(s):  
High Risk ◽  
Young Children ◽  
Positive Outcomes ◽  
Risk And Resilience

scholarly journals Antibiotic-associated diarrhea in children: how to identify, what to do and how to treat?

2016 ◽  
Vol 1 (1) ◽  
pp. 78-89
Author(s):  
I. N. Zakharova ◽  
I. V. Berezhnaya ◽  
E. B. Mumladze
Keyword(s):  
High Risk ◽  
Antibiotic Therapy ◽  
Intestinal Microbiota ◽  
High Probability ◽  
Pseudomembranous Colitis ◽  
Inflammatory Diseases ◽  
Pediatric Practice ◽  
Antibiotic Associated Diarrhea ◽  
New Generation ◽  
Very High

Rational antibiotic therapy is one of the most important components in the treatment of children with various infectious and inflammatory diseases. However, wide and sometimes unjustified use of AB in pediatric practice often leads to the development of a variety of complications. Children receiveing AB, especially during the first 5 years of life, are at a very high risk of developing antibiotic-associated diarrhea (AAD) which manifests itself in three or more episodes of unformed stools for two or more consecutive days or for 8 weeks after withdrawal. The most relevant pathogen of AAD is C. difficile which, according to various data, causes from 10 to 25% of AAD cases and 90 to 100% of all cases of pseudomembranous colitis (PMC). Given the high probability of developing dangerous complications such as PMC, special attention should be paid to the prevention of the infection associated with C. difficile by reducing the frequency of uncontrolled and unjustified use of AB. A new generation of eco-antibiotics can be recommended which allow to maintain diversity of the intestinal microbiota and are less likely to cause complications.

scholarly journals Early Development of Locomotor Patterns and Motor Control in Very Young Children at High Risk of Cerebral Palsy, a Longitudinal Case Series

2021 ◽  
Vol 15 ◽  
Author(s):  
Annike Bekius ◽  
Margit M. Bach ◽  
Laura A. van de Pol ◽  
Jaap Harlaar ◽  
Andreas Daffertshofer ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
High Risk ◽  
Young Children ◽  
Early Development ◽  
Muscle Activation ◽  
Brain Lesions ◽  
Very Young Children ◽  
Gait Parameters ◽  
Locomotor Patterns ◽  
Over Time

The first years of life might be critical for encouraging independent walking in children with cerebral palsy (CP). We sought to identify mechanisms that may underlie the impaired development of walking in three young children with early brain lesions, at high risk of CP, via comprehensive instrumented longitudinal assessments of locomotor patterns and muscle activation during walking. We followed three children (P1–P3) with early brain lesions, at high risk of CP, during five consecutive gait analysis sessions covering a period of 1 to 2 years, starting before the onset of independent walking, and including the session during the first independent steps. In the course of the study, P1 did not develop CP, P2 was diagnosed with unilateral and P3 with bilateral CP. We monitored the early development of locomotor patterns over time via spatiotemporal gait parameters, intersegmental coordination (estimated via principal component analysis), electromyography activity, and muscle synergies (determined from 11 bilateral muscles via nonnegative matrix factorization). P1 and P2 started to walk independently at the corrected age of 14 and 22 months, respectively. In both of them, spatiotemporal gait parameters, intersegmental coordination, muscle activation patterns, and muscle synergy structure changed from supported to independent walking, although to a lesser extent when unilateral CP was diagnosed (P2), especially for the most affected leg. The child with bilateral CP (P3) did not develop independent walking, and all the parameters did not change over time. Our exploratory longitudinal study revealed differences in maturation of locomotor patterns between children with divergent developmental trajectories. We succeeded in identifying mechanisms that may underlie impaired walking development in very young children at high risk of CP. When verified in larger sample sizes, our approach may be considered a means to improve prognosis and to pinpoint possible targets for early intervention.

scholarly journals Resistance to temptation in toddlers at genetic risk for autism spectrum disorder

Autism ◽  
2018 ◽  
Vol 23 (4) ◽  
pp. 1018-1027
Author(s):  
Susan B Campbell ◽  
Jessie B Northrup ◽  
Amy B Tavares
Keyword(s):  
Autism Spectrum Disorder ◽  
High Risk ◽  
Young Children ◽  
Self Regulation ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Low Risk ◽  
Spectrum Disorder ◽  
Typically Developing ◽  
High Risk Children

Children with autism spectrum disorder often demonstrate difficulties with self-regulation, although studies of this construct in young children with autism spectrum disorder are limited. In this study, developmental changes were examined using a measure of self-regulation appropriate for young children, resistance to temptation. At 22, 28, and 34 months, toddlers with an older sibling with autism spectrum disorder (high risk) and toddlers with typically developing older siblings (low risk) were presented with an appealing toy and instructed not to touch it. Observers coded whether or not children touched the toy and the strategies they used to resist touching it. At 36 months, children were assessed for autism spectrum disorder, yielding three groups: high risk children with autism spectrum disorder, high risk children without autism spectrum disorder, and low risk children. At 22 months, most children, regardless of group, touched the forbidden toy; at 28 and 34 months, many high risk children without autism spectrum disorder and low risk children resisted the temptation to touch the toy, whereas most of the children with autism spectrum disorder did not. Differences in delay strategies were also evident. Some, but not all group differences, were accounted for by differences in language ability. Results highlight one early index of impulse control that differentiates children with emerging autism spectrum disorder from age-mates prior to the third birthday.

scholarly journals Impact of Social Distancing and Travel Restrictions on Non–Coronavirus Disease 2019 (Non–COVID-19) Respiratory Hospital Admissions in Young Children in Rural Alaska

2020 ◽  
Author(s):  
Leisha D Nolen ◽  
Sara Seeman ◽  
Dana Bruden ◽  
Joe Klejka ◽  
Chris Desnoyers ◽  
...  
Keyword(s):  
High Risk ◽  
Young Children ◽  
Hospital Admissions ◽  
High Risk Population ◽  
Respiratory Illnesses ◽  
Social Distancing ◽  
The Past ◽  
Secondary Benefits ◽  
Rural Alaska ◽  
Travel Restrictions

Abstract Hospitalizations due to non-coronavirus disease 2019 (non-COVID-19) respiratory illnesses decreased dramatically after social distancing was implemented in a high-risk population in rural Alaska; an unprecedented decline compared to the past 10 respiratory seasons. This demonstrates the potential secondary benefits of implementing social distancing and travel restrictions on respiratory illnesses.

scholarly journals The Impact of Culturing the Organ Preservation Fluid on Solid Organ Transplantation: A Prospective Multicenter Cohort Study

2019 ◽  
Vol 6 (6) ◽  
Author(s):  
I Oriol ◽  
N Sabe ◽  
J Càmara ◽  
D Berbel ◽  
M A Ballesteros ◽  
...  
Keyword(s):  
High Risk ◽  
Antibiotic Therapy ◽  
Graft Rejection ◽  
Graft Loss ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Preemptive Therapy ◽  
Solid Organ ◽  
Risk Culture ◽  
Culture Positive

Abstract Background We analyzed the prevalence, etiology, and risk factors of culture-positive preservation fluid and their impact on the management of solid organ transplant recipients. Methods From July 2015 to March 2017, 622 episodes of adult solid organ transplants at 7 university hospitals in Spain were prospectively included in the study. Results The prevalence of culture-positive preservation fluid was 62.5% (389/622). Nevertheless, in only 25.2% (98/389) of the cases were the isolates considered “high risk” for pathogenicity. After applying a multivariate regression analysis, advanced donor age was the main associated factor for having culture-positive preservation fluid for high-risk microorganisms. Preemptive antibiotic therapy was given to 19.8% (77/389) of the cases. The incidence rate of preservation fluid–related infection was 1.3% (5 recipients); none of these patients had received preemptive therapy. Solid organ transplant (SOT) recipients with high-risk culture-positive preservation fluid receiving preemptive antibiotic therapy presented both a lower cumulative incidence of infection and a lower rate of acute rejection and graft loss compared with those who did not have high-risk culture-positive preservation fluid. After adjusting for age, sex, type of transplant, and prior graft rejection, preemptive antibiotic therapy remained a significant protective factor for 90-day infection. Conclusions The routine culture of preservation fluid may be considered a tool that provides information about the contamination of the transplanted organ. Preemptive therapy for SOT recipients with high-risk culture-positive preservation fluid may be useful to avoid preservation fluid–related infections and improve the outcomes of infection, graft loss, and graft rejection in transplant patients.

scholarly journals Tuberculous abdominal aortic pseudoaneurysm with renal and vertebral tuberculosis: a case and literature review

2014 ◽  
Vol 8 (09) ◽  
pp. 1216-1221 ◽  
Author(s):  
Chao Zhang ◽  
Bing Chen ◽  
Yongquan Gu ◽  
Tao Luo ◽  
Shengjia Yang ◽  
...  
Keyword(s):  
High Risk ◽  
Literature Review ◽  
Antibiotic Therapy ◽  
Endovascular Repair ◽  
Postoperative Course ◽  
Aortic Pseudoaneurysm ◽  
Abdominal Aortic ◽  
Very High

Tuberculous pseudoaneurysm of the aorta is rare and exposes patients to a very high risk of unpredictable rupture. To our best knowledge, only 32 cases have been reported related to all arterial systems from 1993 to 2013 in the literature. We report a 44-year-old male who presented with an aortic pseudoaneurysm and tuberculosis of the kidney and vertebrae. He underwent endovascular repair and antibiotic therapy for tuberculosis, combined with a bare stent implanted to seal endoleaks after endograft stenting. The postoperative course was uneventful and the patient recovered and lived well afterwards. Epidemiology, pathogenesis, presentation, management, and mortality of this entity were reviewed and discussed.

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