Norovirus as the cause of medically attended gastroenteritis: a hospital-based experience.

Gastroenteritis remains an important cause of morbidity and mortality worldwide. With the introduction of vaccines against rotavirus, interest has shifted to understanding the epidemiology of norovirus (NoV). While the importance of NoV in gastroenteritis outbreaks is well established, its role in sporadic gastroenteritis is less known.

Experience with pandemic 2009 H1N1 influenza in a large pediatric hospital.

Objective: In 2009, a new strain of influenza A, H1N1, was detected in two children in the United States. It spread quickly and became pandemic (pH1N1), disproportionately affecting children. The aim of the present study was to describe our experience with pH1N1 in a large pediatric hospital.

Acute gastroenteritis.

Acute gastroenteritis represents a frequent cause of morbidity and mortality among children in the developing world as well as morbidity in the developed world. Despite the large number of potential etiologic agents, management of gastroenteritis is uniform and aimed to prevent the two major complications, dehydration and malnutrition. Current guidelines emphasize the use of oral rehydration and the early reintroduction of age-appropriate foods.

Protein requirements of infants and children: growth during recovery from malnutrition.

Objective: To evaluate the adequacy of protein intakes now recommended as safe for infants and toddlers.

Methods: Subjects were recovering malnourished infants, age 5.3 to 17.

Compensatory growth in broiler chicks fed on Lemna gibba.

The growth of broiler chickens on diets containing various levels of Lemna gibba was evaluated. Groups of broiler chicks were fed on diets containing 0-400 g Lemna gibba/kg for 3 weeks. These chickens were then changed to standard diets for a further 2 weeks.

Clinical trial of modified whole milk, lactose-hydrolyzed whole milk, or cereal-milk mixtures for the dietary management of acute childhood diarrhea.

A randomized, double-masked clinical trial was completed to compare the effects of four dietary regimens for the nutritional management of 116 Peruvian children between 3 and 24 months of age with acute diarrhea. Diets consisted of a modified whole milk formula (group M), a lactose-hydrolyzed milk formula (HM), wheat noodles and whole milk (N-M), or wheat noodles and lactose-hydrolyzed whole milk (N-HM), all offered in amounts up to 55 kcal/kg body weight/day for the first 2 days of treatment and up to 110 kcal/kg/day for 4 days thereafter. The clinical characteristics of the patients in each group were similar initially.

Acceptability, tolerance, and nutritional value of a rice-based infant formula.

An infant formula based on high protein rice flour, with added lysine and threonine, was evaluated in recovering malnourished infants. Acceptability, tolerance, and the digestibility of most major nutrients (energy 93.9 +/- 0.

Prediction of total daily fecal excretion during acute childhood diarrhea.

Clinical data from 133 male patients between 3 and 36 months of age were reviewed to identify factors that could predict high rates of fecal excretion during acute diarrhea. Diarrheal severity after hospitalization was measured by separate 4-h quantitative collections of feces during 6 days: the number of these 4-h collection periods with any stool output was used as an estimate of the number of bowel movements each day. The number of 4-h periods with any stool output was highly correlated with total fecal excretion expressed as grams per kilogram of body weight per day (p less than 0.

Effect of continued oral feeding on clinical and nutritional outcomes of acute diarrhea in children.

One hundred twenty-eight nonmalnourished male patients between 3 and 36 months of age were randomly assigned to receive one of four lactose-free dietary treatments to determine the effect of dietary therapy on the severity and nutritional outcome of diarrheal illness. Group 1 received a formula diet composed of casein, sucrose, dextrin with maltose (Dextri-Maltose), and vegetable oil to provide 110 kcal/kg body weight/d (CSO-110). Group 2 received CSO to provide 55 kcal/kg/d (CSO-55) for 2 days and then CSO-110.

The effect of decortication and extrusion on the digestibility of sorghum by preschool children.

The effect of decortication and extrusion on the apparent protein quality and digestibility of sorghum (S. vulgare) was evaluated in comparative balance studies in nine children 7-24 months of age. Sorghum provided (as kilocalories) 8% protein and 62% carbohydrate in the study diet.

The role of the carrier in treatment failures after antibiotic for group A streptococci in the upper respiratory tract.

During a prospective study of endemic group A streptococcal upper respiratory tract infection and the streptococcal carrier state, we investigated persistence of group A streptococci after treatment with recommended doses of antibiotics. We evaluated clinical findings, culture results, and streptococcal antibody responses at the acute-stage clinic visit and at convalescent-stage visits 3 and 8 weeks later. Data from 280 children ill with pharyngitis and their family contacts were analyzed (mean age 13.

Risk of bacteremia after endotracheal intubation for general anesthesia.

Blood cultures were obtained before and after endotracheal intubation to assess the risk of bacteremia associated with this procedure and to evaluate the need for prophylactic antibiotics to prevent bacterial endocarditis in patients with structural heart disease requiring general anesthesia. Blood cultures were obtained immediately before intubation and two and ten minutes after intubation in 50 individuals without evidence of structural heart disease who required general anesthesia for elective surgery. Of 32 who had orotracheal intubation, only one demonstrated postintubation bacteremia; of 18 individuals who had nasotracheal intubation, none had evidence of bacteremia.

Failure of penicillin to eradicate group A streptococci during an outbreak of pharyngitis.

In an outbreak of group A streptococcal pharyngitis in a semi-closed community, 42 (25%) of 169 courses of antibiotic therapy failed to eradicate the organism. 16 (19%) of 85 individuals treated with intramuscular benzathine penicillin G and 9 (19%) of 47 patients treated with an oral antibiotic (penicillin V or erythromycin) continued to harbour the same serotype of group A streptococcus. 12 (48%) of 25 persons remained treatment failures after re-treatment; even after a third course of treatment 5 of 12 (42%) still harboured the organism.

The immunologic response to group A streptococcal upper respiratory tract infections in very young children.

The immunologic responses to streptolysin O and streptococcal deoxyribonuclease B were evaluated in children with group A streptococci recovered from the upper respiratory tract to re-examine the hypothesis that a limited capacity to respond to group A streptococcal infection may explain the rare occurrence of acute rheumatic fever in very young children. ASO and anti-DNase B titers were determined on serial bleedings from a total of 301 individuals (52 less than or equal to 3 years; 249 older than 3 years). Very young children with group A streptococcal upper respiratory tract infections had an immunologic response to SO greater than the response in older children as reflected by the magnitude of the antibody rise, and comparable to the ASO response in older children as measured by the percentage showing a significant titer rise.