Clinical features, acute complications, and outcome of Salmonella meningitis in children under one year of age in Taiwan

<p>Abstract</p> <p>Background</p> <p><it>Salmonella </it>meningitis remains a threat to children below two years of age in both developing and developed countries. However, information on such infections has not been well characterized. We analyzed data related to twelve years of experience in order to clarify the comprehensive features of <it>Salmonella </it>meningitis in our patients, including admission characteristics, acute complications, and long-term outcome.</p> <p>Methods</p> <p>The records of patients with spontaneous <it>Salmonella </it>meningitis from 1982 to 1994 were retrospectively reviewed. The long-term outcome was prospectively determined for survivors at school age by the developmental milestones reported by their parents and detailed neurological evaluation along with intelligence, hearing, visual, speech and language assessments.</p> <p>Results</p> <p>Of the twenty-four patients, seizures were noted in fifteen (63%) before admission and thirteen (54%) during hospitalization. Acute complications mainly included hydrocephalus (50%), subdural collection (42%), cerebral infarction (33%), ventriculitis (25%), empyema (13%), intracranial abscess (8%), and cranial nerve palsy (8%). Three patients (13%) died during the acute phase of <it>Salmonella </it>meningitis. The twenty-one survivors, on whom we followed up at school age, have sequelae consisting of language disorder (52%), motor disability (48%), intelligence quotient < 80 (43%), epilepsy (33%), sensorineural hearing loss (17%), visual deficits (10%), abducens nerve palsy (5%), microcephaly (5%), and hydrocephalus (5%). Overall, good outcome was noted in six (28.6%) of twenty-one survivors, mild sequelae in three (14.2%), moderate in six (28.6%), and severe in six (28.6%).</p> <p>Conclusion</p> <p><it>Salmonella </it>meningitis in neonates and infants had a wide spectrum of morbidity and acute complications, leading to a complicated hospital course and subsequently a high prevalence of permanent adverse outcome. Thus, early recognition of acute complications of <it>Salmonella </it>meningitis and a follow-up plan for early developmental assessment of survivors are vital.</p

First Report from the Asian Rotavirus Surveillance Network

Rotavirus remains the most common cause of severe, dehydrating diarrhea among children worldwide. Several rotavirus vaccines are under development. Decisions about new vaccine introduction will require reliable data on disease impact. The Asian Rotavirus Surveillance Network, begun in 2000 to facilitate collection of these data, is a regional collaboration of 36 hospitals in nine countries or areas that conduct surveillance for rotavirus hospitalizations using a uniform World Health Organization protocol. We summarize the Network's organization and experience from August 2001 through July 2002. During this period, 45% of acute diarrheal hospitalizations among children 0–5 years were attributable to rotavirus, higher than previous estimates. Rotavirus was detected in all sites year-round. This network is a novel, regional approach to surveillance for vaccine-preventable diseases. Such a network should provide increased visibility and advocacy, enable more efficient data collection, facilitate training, and serve as the paradigm for rotavirus surveillance activities in other regions

Burden of community-acquired and nosocomial rotavirus gastroenteritis in the pediatric population of Western Europe: a scoping review

<p>Abstract</p> <p>Background</p> <p>Rotavirus affects 95% of children worldwide by age 5 years and is the leading cause of severe dehydrating diarrhea. The objective of this review was to estimate the burden of rotavirus gastroenteritis (RVGE) in the Western European pediatric population.</p> <p>Methods</p> <p>A comprehensive literature search (1999-2010) was conducted in PubMed and other sources (CDC; WHO, others). Data on the epidemiology and burden of RVGE among children < 5 years-old in Western Europe --including hospital-acquired disease--were extracted.</p> <p>Results</p> <p>76 studies from 16 countries were identified. The mean percentage of acute gastroenteritis (AGE) cases caused by rotavirus ranged from 25.3%-63.5% in children < 5 years of age, peaking during winter. Incidence rates of RVGE ranged from 1.33-4.96 cases/100 person- years. Hospitalization rates for RVGE ranged from 7% to 81% among infected children, depending on the country. Nosocomial RVGE accounted for 47%-69% of all hospital-acquired AGE and prolonged hospital stays by 4-12 days. Each year, RVGE incurred $0.54-$53.6 million in direct medical costs and $1.7-$22.4 million in indirect costs in the 16 countries studied. Full serotyping data was available for 8 countries. G1P[8], G2P[4], G9P[8], and G3P[8] were the most prevalent serotypes (cumulative frequency: 57.2%- 98.7%). Serotype distribution in nosocomial RVGE was similar.</p> <p>Conclusions</p> <p>This review confirms that RVGE is a common disease associated with significant morbidity and costs across Western Europe. A vaccine protecting against multiple serotypes may decrease the epidemiological and cost burden of RVGE in Western Europe.</p

Breastfeeding as a factor of psychomotor development and means of prevention of disability

Breast milk is the sole food of newborns usually for several months after birth. It is the first support of life of people newly created, during their multiple development. There has been, however, a tendency to argue that the standardized milk is identical to the parent. However, although similar to breast milk, it cannot emulate its properties, because it does not contain many nutrient inherent to the breast milk. Today there is a theoretically strong directive of the World Health Organization about exclusive breastfeeding for six months after birth, despite the effort made by some researchers to shrink the established intervals in the minds of women and doctors or other professionals for exclusive breastfeeding. This trend manifests when at the same time many other studies show the multifaceted contribution of breast milk to the spiritual, mental and physical development of infants, with results that last for many years after they are weaned. The current work aims to glean and evaluate these data and lead to a proposal for the position of breastfeeding in both the life of the young people individually and the relationship that develops between them and mothers, who exercise regularly mammal tasks.Το μητρικό γάλα, αποτελεί την αποκλειστική συνήθως τροφή των νεογνών, για αρκετούς μήνες μετά από τη γέννησή τους. Αποτελεί το πρώτο στήριγμα ζωής των νεοδημιουργηθέντων ανθρώπων, στη διάρκεια της πολύπλευρης ανάπτυξής τους. Έχει εκδηλωθεί ωστόσο η τάση να υποστηριχθεί ότι τα τυποποιημένα γάλακτα είναι όμοια με το μητρικό. Ωστόσο, αν και προσομοιάζουν με το μητρικό γάλα, δεν μπορούν να εξομοιώσουν τις ιδιότητές του, διότι δεν περιέχουν πολλές εγγενείς σε αυτό θρεπτικές ουσίες. Σήμερα επικρατεί θεωρητικά η οδηγία του Παγκόσμιου Οργανισμού Υγείας για εξάμηνο αποκλειστικό θηλασμό, παρά την προσπάθεια ορισμένων ερευνητών να συρρικνώσουν τα καθιερωμένα στη συνείδηση των γυναικών και των ιατρών αλλά και άλλων επαγγελματιών διαστήματα αποκλειστικού θηλασμού. Αυτή η τάση εκδηλώνεται όταν, στον αντίποδά της, πολλές άλλες μελέτες συνηγορούν υπέρ της πολύπλευρης συμβολής του μητρικού γάλακτος στην πνευματική, ψυχική και σωματική ανάπτυξη των βρεφών, με αποτελέσματα που διαρκούν για πολλά χρόνια μετά τον απογαλακτισμό τους. Η τρέχουσα εργασία έχει ως στόχο της να σταχυολογήσει και να αξιολογήσει τα δεδομένα αυτά και να οδηγηθεί σε μια πρόταση για τη θέση του μητρικού θηλασμού τόσο στη ζωή του νεαρού ανθρώπου μεμονωμένα, όσο και στη σχέση που αναπτύσσεται ανάμεσα σε αυτόν και τη μητέρα του, που ασκεί τακτικά τα θηλαστικά της καθήκοντα