Children symptoms before and after knowing about an indoor fungal contamination.

To describe children symptoms before and after an indoor fungal problem was publicized. Children attending one of two elementary schools (one with indoor fungal problems and one without) were included in this study. The study included an analysis of symptoms reported by the nurses before and after the indoor fungal problem was publicized and a questionnaire responded to by the parents. Several symptoms related to exposure to mold were found to be statistically significant in the school with an indoor fungal problem before the problem was detected: the symptoms included coughing/wheezing, headaches and joint pains. After the problem was publicized the perception of symptoms increased.

Mother-to-child transmission of the human immunodeficiency virus in Texas.

BACKGROUND: The Pediatric Spectrum of HIV Diseases (PSD) project has been collecting data on HIV-exposed children in Texas since 1989. These data have now been analyzed to describe mother-to-child transmission in Texas and to provide much needed information on the magnitude of the pediatric HIV epidemic in the state. METHODS: We examined trends in the numbers of perinatally exposed children and perinatally acquired cases of HIV in the Texas PSD cohort. We calculated transmission rates and relative risks for 656 children born from January, 1995, to July, 1998, that received all or part of the ACTG 076 regimen. RESULTS: Only a small proportion (38%) of pairs of an HIV-infected mother and her HIV-exposed child received the full AIDS Clinical Trial Group 076 (ACTG 076) regimen; only 73% of the mothers received at least some prenatal care. In recent years, however, the numbers of perinatally exposed children and perinatally acquired cases of HIV have decreased in Texas. Univariate analyses showed that a reduction in the vertical transmission of HIV was associated with receipt of a full ACTG 076 regimen, receipt of a partial ACTG 076 regimen and residence in Dallas County. CONCLUSIONS: Findings identify a gap in meeting the health care needs of pregnant HIV-infected women and suggest missed opportunities to prevent mother-to-child transmission of HIV. At the same time this study confirms progress in prevention efforts to reduce mother-to-child transmission of HIV in Texas.

Adolescent immunization.

The dramatic improvements achieved in the control of vaccine-preventable diseases in children have only been shared partially by adolescents and young adults, as today several million adolescents are not receiving the full complement of vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). This article discusses the reasons for this problem and the tools to bridge this gap. In particular, medical societies and the Centers for Disease Control and Prevention (CDC) recommend a close assessment of the adolescentís immunization status between 11 and 12 years of age, inclusion of school immunization, and providing missing immunizations at any opportunity. The article also addresses other vaccines recommended for groups of adolescents with special needs, reporting information, and provides an update on the vaccines of the future.

Prophylaxis against respiratory syncytial virus in high-risk infants: administration of immune globulin and epidemiological surveillance of infection.

Hospitalizations secondary to respiratory syncytial virus (RSV) infection in children were monitored before and after the administration of RSV immune globulin. Monitored also was the effectiveness of prophylaxis in preventing the disease among at-risk children along the Texas-Mexico border. Small premature infants were at the greatest risk of hospitalization; preterm infants and then term infants followed. Prophylaxis does not necessarily prevent RSV bronchiolitis but may reduce the severity of the pulmonary disease.

American Academy of Pediatrics. Committee on Child Abuse and Neglect and Committee on Community Health Services. Investigation and review of unexpected infant and child deaths.

Although there is a continuing need for timely review of child deaths, no uniform system exists for investigation in the United States. Investigation of a death that is traumatic, unexpected, obscure, suspicious, or otherwise unexplained in a child younger than 18 years requires a scene investigation and an autopsy. Review of these deaths requires the participation of pediatricians and other professionals, usually as a child death review team. An appropriately constituted team should evaluate the death investigation process, review difficult cases, and compile child death statistics.

[Increased importance of teaching qualifications? Reality or only empty words?]. / Oket vektlegging av pedagogiske kvalifikasjoner? Virkelighet eller bare fagre ord?

Educational qualifications are important for all teachers of medicine. At University of Oslo, Norway, yearly personnel development courses are held for newly appointed teaching faculty members. To find out what priority the Medical School gives to this course, and how it is evaluated by the participants in the medical course, we conducted a questionnaire survey among the participants. The course was very well received by the participants, but the results indicate that personnel development is given low priority by the Medical School.

Brucellosis: a treatable cause of monoarthritis.

A 16-year-old Mexican-American boy presented with acute brucella sacroileitis. The diagnosis was based on a significantly elevated agglutination titer and confirmed by the growth of B. melitensis after four weeks incubation in blood culture. The patient recovered completely after six weeks of Tetracycline therapy. Because Brucella infection responds to treatment well, this infection is important in the differential diagnosis of arthritis, especially in an area endemic for Brucella. The readily available serologic techniques should be used to support the diagnosis, while recognizing that because of the slow growth rate of B. melitensis, the appropriate laboratory procedure is essential.