ABSTRACT
UNLABELLED: During 1992 1996 we observed 122 children with diphtheria, 49 with the toxic form, in the region of Nizhny Novgorod in Russia. Sixty-four patients suffered from diphtheric carditis, 9 died. The clinical picture was characterized by a rapid development of heart and circulatory failure. ECG showed QRS alterations with intraventricular conduction impairment, sinus node dysfunction, ectopic rhythm disturbances and repolarization disturbances in all patients with carditis. Infarction-like ECG changes were typical for the pseudocoronary form with the worst prognosis. Echocardiographically there was left ventricular (LV) dilatation and depressed LV function, whereas LV muscle mass was increased. Myoglobin, LDH and CPK levels were elevated in each patient demonstrating significant differences between the various courses of disease. CONCLUSION: In diphtheria, the extent of hypermyoglobinaemia (> 2000 ng/ml) and an increased LDH1/LDH2 (> 1) ratio are reliable markers for the development of carditis indicating a poor prognosis.
Subject(s)
Diphtheria/diagnosis , Myocarditis/diagnosis , Adolescent , Child , Child, Preschool , Creatine Kinase/blood , Diphtheria/mortality , Diphtheria/physiopathology , Echocardiography, Doppler , Electrocardiography , Female , Humans , Infant , L-Lactate Dehydrogenase/blood , Male , Myocarditis/microbiology , Myocarditis/mortality , Myoglobin/bloodABSTRACT
A total of 50 adolescents with different diseases of the joints were examined. Diagnostic errors were made in 42% of the cases. Hyperdiagnosis of juvenile rheumatoid arthritis was observed in 30% of the patients and hypodiagnosis in 12%. The studies showed that the knowledge of the initial manifestations of the disease, its further course, detailed acquaintance with the features of the articular syndrome, extra-articular signs, laboratory data and their dynamics during treatment in each specific case allowed one to avoid diagnostic errors.
Subject(s)
Arthritis, Juvenile/diagnosis , Adolescent , Diagnostic Errors , Female , Humans , MaleSubject(s)
Child Health Services/organization & administration , Hospitals, Pediatric/organization & administration , Hospitals, Special/organization & administration , Outpatient Clinics, Hospital/organization & administration , Preventive Health Services/organization & administration , Primary Prevention , Child, Preschool , Humans , Infant , RussiaABSTRACT
The results of the study on the pharmacokinetics peculiar properties of carbenicillin premature infants treated with the drug administered intravenously or intramuscularly are presented. The maximum antibiotic blood levels after intravenous administration exceeded the MIC for most of the causative agents isolated from the children. The schemes for the antibiotic use in treatment of purulent septic processes of children are recommended.
