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The benefits and risks of bacille Calmette-Guérin vaccination among infants at high risk for both tuberculosis and severe combined immunodeficiency: assessment by Markov model.

https://arctichealth.org/en/permalink/ahliterature170405
Source
BMC Pediatr. 2006;6:5
Publication Type
Article
Date
2006
Author
Michael Clark
D William Cameron
Author Affiliation
Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8L6, Canada. mclar018@uottawa.ca
Source
BMC Pediatr. 2006;6:5
Date
2006
Language
English
Publication Type
Article
Keywords
BCG Vaccine - adverse effects
Blindness - etiology - psychology
Brain Damage, Chronic - etiology - psychology
Canada - epidemiology
Choice Behavior
Cohort Studies
Consumer Satisfaction - statistics & numerical data
Humans
Incidence
Indians, North American
Infant, Newborn
Markov Chains
Models, Theoretical
Monte Carlo Method
Quality-Adjusted Life Years
Risk
Risk assessment
Severe Combined Immunodeficiency - epidemiology
Tuberculosis - epidemiology - prevention & control
Tuberculosis, Meningeal - complications - psychology
Vaccination - adverse effects - mortality - psychology
Vision, Monocular
Abstract
Bacille Calmette-Guérin (BCG) vaccine is given to Canadian Aboriginal neonates in selected communities. Severe reactions and deaths associated with BCG have been reported among infants born with immunodeficiency syndromes. The main objective of this study was to estimate threshold values for severe combined immunodeficiency (SCID) incidence, above which BCG is associated with greater risk than benefit.
A Markov model was developed to simulate the natural histories of tuberculosis (TB) and SCID in children from birth to 14 years. The annual risk of tuberculous infection (ARI) and SCID incidence were varied in analyses. The model compared a scenario of no vaccination to intervention with BCG. Appropriate variability and uncertainty analyses were conducted. Outcomes included TB incidence and quality-adjusted life years (QALYs).
In sensitivity analyses, QALYs were lower among vaccinated infants if the ARI was 0.1% and the rate of SCID was higher than 4.2 per 100,000. Assuming an ARI of 1%, this threshold increased to 41 per 100,000. In uncertainty analyses (Monte Carlo simulations) which assumed an ARI of 0.1%, QALYs were not significantly increased by BCG unless SCID incidence is 0. With this ARI, QALYs were significantly decreased among vaccinated children if SCID incidence exceeds 23 per 100,000. BCG is associated with a significant increase in QALYs if the ARI is 1%, and SCID incidence is below 5 per 100,000.
The possibility that Canadian Aboriginal children are at increased risk for SCID has serious implications for continued BCG use in this population. In this context, enhanced TB Control--including early detection and treatment of infection--may be a safer, more effective alternative.
Notes
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PubMed ID
16515694 View in PubMed
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[Caseous pneumonia in nursing and young infants (based on pathomorphological study data)]

https://arctichealth.org/en/permalink/ahliterature34971
Source
Probl Tuberk. 1996;(4):37-8
Publication Type
Article
Date
1996
Author
L I Mykolyshin
Source
Probl Tuberk. 1996;(4):37-8
Date
1996
Language
Russian
Publication Type
Article
Keywords
Autopsy - statistics & numerical data
Child, Preschool
English Abstract
Female
Humans
Infant
Infant, Newborn
Lung - pathology
Male
Pneumonia, Bacterial - etiology - pathology
Tuberculosis, Meningeal - complications - pathology
Tuberculosis, Pulmonary - complications - pathology
Ukraine
Abstract
Fifty-six autopsy protocols showing the presence of caseous pneumonia in babies and infants who died in 1947-1994 were examined. In the age group of children who died from caseous pneumonia (n = 88), babies and infants made up 63.6%. In 1947-1962, caseous pneumonia was found to frequently complicate a primary tuberculosis process both in babies (28.3%) and in 1-3-year-old infants (22.2%). At the same time lifetime tuberculosis was not recognized in 21.4% of cases and 26.8% died within the first 3 days of their hospital stay.
PubMed ID
9026802 View in PubMed
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Childhood acute bacterial meningitis in the Sudan: an epidemiological, clinical and laboratory study.

https://arctichealth.org/en/permalink/ahliterature37905
Source
Scand J Infect Dis Suppl. 1990;66:1-103
Publication Type
Article
Date
1990
Author
M A Salih
Author Affiliation
Department of Pediatrics, University Hospital, Uppsala, Sweden.
Source
Scand J Infect Dis Suppl. 1990;66:1-103
Date
1990
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Child
Child, Preschool
Disease Outbreaks
Female
Hearing Loss, Sensorineural - etiology
Humans
Immunoenzyme Techniques
Infant
Male
Meningitis - complications - diagnosis - epidemiology
Meningitis, Haemophilus - complications - diagnosis - epidemiology
Meningitis, Meningococcal - complications - diagnosis - epidemiology
Meningitis, Pneumococcal - complications - diagnosis - epidemiology
Neisseria meningitidis - classification
Prospective Studies
Research Support, Non-U.S. Gov't
Sudan - epidemiology
Sweden
Abstract
The aims of the present study were to document the epidemiology, clinical features and complications of childhood acute bacterial meningitis (ABM) in The Sudan during both an inter-epidemic (endemic) period (1985-1986), and the 1988 serogroup A epidemic; and to examine the phenotypic and genetic similarities and differences of Neisseria meningitidis strains isolated in The Sudan and Sweden. A new enzyme immunoassay test (Pharmacia Meningitis EIA-Test) was evaluated as a potential rapid diagnostic method for the detection of Haemophilus influenzae (HI) type b, Neisseria meningitidis (MC) and Streptococcus pneumoniae (PNC). The test was found to have good sensitivity (0.86) and specificity (0.95) in the inter-epidemic period; and to be adaptable to the field work in The Sudan during the 1988 MC epidemic. During inter-epidemic (endemic) situations in The Sudan, greater than 90% of childhood ABM was caused by one of the three organisms, HI type b, MC and PNC. HI accounted for 57% of the cases. The peak incidence (76%) of HI cases was in infants (less than 12 months) similar to the situation in other African countries. The overall case fatality ratio was 18.6%. Prospective follow-up of survivors for 3-4 years revealed that an additional 43% either died or had permanent neurological complications, the most prevalent and persistent of which was sensorineural hearing loss recorded in 22% of long term survivors. Post-meningitic children were found to have significantly lower intelligence quotients (92.3 +/- 13.9) than their sibling controls (100.7 +/- 10.2, P = 0.029). Features of the large serogroup A sulphonamide resistant MC epidemic (February-August 1988) in Khartoum are described. An estimated annual incidence of 1,679/100,000 was recorded at the peak of the epidemic. The highest attack rate was in young children less than 5 years, as in many other African countries; nevertheless, a high morbidity was observed in adults (31% of the cases greater than or equal to 20 years). The clinical features, mortality (6.3%) and short term sequelae in Sudanese children were generally within the framework described for MC disease elsewhere. Detailed analysis of MC isolates from Sudan and Sweden by characterizing their electrophoretic enzyme types, DNA restriction endonuclease pattern and outer membrane proteins, revealed that serogroup A MC clone III-1 was responsible of The Sudan epidemic in 1988 and has been the dominant serogroup A organism in Sweden since 1973. The Sudanese strains isolated prior to the epidemic (1985) were clone IV-1.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
2115207 View in PubMed
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Employment and disability pension after central nervous system infections in adults.

https://arctichealth.org/en/permalink/ahliterature264569
Source
Am J Epidemiol. 2015 May 15;181(10):789-98
Publication Type
Article
Date
May-15-2015
Author
Casper Roed
Henrik Toft Sørensen
Kenneth J Rothman
Peter Skinhøj
Niels Obel
Source
Am J Epidemiol. 2015 May 15;181(10):789-98
Date
May-15-2015
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Denmark
Disabled persons - statistics & numerical data
Employment - statistics & numerical data
Encephalitis, Herpes Simplex - complications
Female
Humans
Insurance, Disability
Male
Meningitis - complications
Middle Aged
Pensions
Registries
Abstract
In this nationwide population-based cohort study using national Danish registries, in the period 1980-2008, our aim was to study employment and receipt of disability pension after central nervous system infections. All patients diagnosed between 20 and 55 years of age with meningococcal (n = 451), pneumococcal (n = 553), or viral (n = 1,433) meningitis or with herpes simplex encephalitis (n = 115), who were alive 1 year after diagnosis, were identified. Comparison cohorts were drawn from the general population, and their members were individually matched on age and sex to patients. Five years after diagnosis, the differences in probability of being employed as a former patient with pneumococcal meningitis or herpes simplex encephalitis versus being a member of the comparison cohorts were -19.9% (95% confidence interval (CI): -24.7, -15.1) and -21.1% (95% CI: -33.0, -9.3), respectively, and the corresponding differences in probability of receiving disability pension were 20.2% (95% CI: 13.7, 26.7) and 16.2% (95% CI: 6.2, 26.3). The differences in probability of being employed or receiving disability pension in former meningococcal or viral meningitis patients versus members of the comparison cohorts were small. In conclusion, pneumococcal meningitis and herpes simplex encephalitis were associated with substantially decreased employment and increased need for disability pension. These associations did not seem to apply to meningococcal meningitis or viral meningitis.
PubMed ID
25852076 View in PubMed
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Etiology of deafness in Robarts School for the Deaf.

https://arctichealth.org/en/permalink/ahliterature240850
Source
J Otolaryngol. 1984 Feb;13(1):47-8
Publication Type
Article
Date
Feb-1984
Author
V D Janzen
D. Schaefer
Source
J Otolaryngol. 1984 Feb;13(1):47-8
Date
Feb-1984
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Child
Child, Preschool
Deafness - etiology - genetics - psychology
Ear Diseases - physiopathology
Ear, Middle - physiopathology
Female
Humans
Intelligence Tests
Male
Meningitis - complications
Ontario
Rubella - complications
Schools
Abstract
A survey of the children at the Robarts School for the Deaf was performed in order to determine the etiology of hearing loss, the reading ability as related to the degree of hearing loss, and the incidence of middle ear disease. The largest category for etiology was idiopathic at 31%, followed by hereditary at 22.5%, and maternal rubella at 19%. The incidence of serous otitis media was found to be 11%.
PubMed ID
6716551 View in PubMed
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Experiences from Auditory Brainstem Implantation (ABIs) in four paediatric patients.

https://arctichealth.org/en/permalink/ahliterature279419
Source
Cochlear Implants Int. 2016;17(2):109-15
Publication Type
Article
Date
2016
Author
Karin Lundin
Fredrik Stillesjö
Gunnar Nyberg
Helge Rask-Andersen
Source
Cochlear Implants Int. 2016;17(2):109-15
Date
2016
Language
English
Publication Type
Article
Keywords
Auditory Brain Stem Implantation - methods
CHARGE Syndrome - surgery
Child, Preschool
Cochlear Diseases - surgery
Female
Goldenhar Syndrome - surgery
Humans
Infant
Male
Meningitis - complications
Otosclerosis - etiology - surgery
Sweden
Treatment Outcome
Abstract
Indications for auditory brainstem implants (ABIs) have been widened from patients with neurofibromatosis type 2 (NF2) to paediatric patients with congenital cochlear malformations, cochlear nerve hypoplasia/aplasia, or cochlear ossification after meningitis. We present four ABI surgeries performed in children at Uppsala University Hospital in Sweden since 2009.
Three children were implanted with implants from Cochlear Ltd. (Lane Cove, Australia) and one child with an implant from MedEl GMBH (Innsbruck, Austria). A boy with Goldenhar syndrome was implanted with a Cochlear Nucleus ABI24M at age 2 years (patient 1). Another boy with CHARGE syndrome was implanted with a Cochlear Nucleus ABI541 at age 2.5 years (patient 2). Another boy with post-ossification meningitis was implanted with a Cochlear Nucleus ABI24M at age 4 years (patient 3). A girl with cochlear aplasia was implanted with a MedEl Synchrony ABI at age 3 years (patient 4). In patients 1, 2, and 3, the trans-labyrinthine approach was used, and in patient 4 the retro-sigmoid approach was used.
Three of the four children benefited from their ABIs and use it full time. Two of the full time users had categories of auditory performance (CAP) score of 4 at their last follow up visit (6 and 2.5 years postoperative) which means they can discriminate consistently any combination of two of Ling's sounds. One child has not been fully evaluated yet, but is a full time user and had CAP 2 (responds to speech sounds) after 3 months of ABI use. No severe side or unpleasant stimulation effects have been observed so far. There was one case of immediate electrode migration and one case of implant device failure after 6.5 years.
ABI should be considered as an option in the rehabilitation of children with similar diagnoses.
PubMed ID
26841821 View in PubMed
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Incidence and etiology of neonatal septicaemia and meningitis in western Sweden 1975-1986.

https://arctichealth.org/en/permalink/ahliterature59810
Source
Acta Paediatr Scand. 1990 Nov;79(11):1023-30
Publication Type
Article
Date
Nov-1990
Author
I. Tessin
B. Trollfors
K. Thiringer
Author Affiliation
Department of Paediatrics, Mölndal Hospital, University of Gothenburg, Sweden.
Source
Acta Paediatr Scand. 1990 Nov;79(11):1023-30
Date
Nov-1990
Language
English
Publication Type
Article
Keywords
Female
Gram-Negative Aerobic Bacteria - isolation & purification
Humans
Incidence
Infant mortality
Infant, Low Birth Weight - microbiology
Infant, Newborn
Infant, Premature - microbiology
Male
Meningitis - complications - epidemiology - microbiology
Prognosis
Research Support, Non-U.S. Gov't
Retrospective Studies
Septicemia - complications - epidemiology - microbiology
Staphylococcus aureus - isolation & purification
Streptococcus agalactiae - isolation & purification
Sweden - epidemiology
Abstract
In a retrospective study of neonatal septicaemia and meningitis in a defined region of western Sweden 1975-1986, 231 cases were identified. The incidence was 2.8/1000 live births. The case-fatality rate was 15%. thirty-three patients had meningitis. Only 55 patients (24%) had no known risk factors. Preterm delivery was a most important risk factor for both morbidity and mortality. The most common causative organisms were group B streptococci, Staphylococcus aureus and aerobic Gram-negative rods, together isolated from 82% of the patients. The cases were approximately equally divided between very early, early and late onset infections. Group B streptococci were over-represented in very early onset infections in all birthweight groups and aerobic Gram-negative rods were the most common isolates from low birthweight infants with late onset infections. However, group B streptococci, Staphylococcus aureus and Gram-negative rods were found in all birthweight and gestational age groups. Thus, initial antimicrobial therapy must be equally broad in all neonates with suspected septicaemia.
PubMed ID
2267918 View in PubMed
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Incidence and prognosis of central nervous system infections in a birth cohort of 12,000 children.

https://arctichealth.org/en/permalink/ahliterature237653
Source
Scand J Infect Dis. 1986;18(4):287-94
Publication Type
Article
Date
1986
Author
P. Rantakallio
M. Leskinen
L. von Wendt
Source
Scand J Infect Dis. 1986;18(4):287-94
Date
1986
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Bacterial Infections - complications - epidemiology - mortality
Brain Abscess - complications - epidemiology
Cerebral Palsy - etiology
Child
Child, Preschool
Encephalitis - complications - epidemiology - mortality
Epilepsy - etiology
Female
Finland
Follow-Up Studies
Hearing Disorders - etiology
Humans
Infant
Infant, Newborn
Intellectual Disability - etiology
Male
Meningitis - complications - epidemiology - mortality
Meningitis, Viral - complications - epidemiology - mortality
Meningoencephalitis - complications - epidemiology
Mumps - complications - epidemiology
Sex Factors
Virus Diseases - complications - epidemiology - mortality
Abstract
All types of central nervous system (CNS) infections were investigated in a 1966 birth cohort of 12,000 children from Northern Finland followed up from birth to the age of 14. 174 CNS infections occurred in 167 children, 110 boys and 64 girls. The annual incidence of bacterial CNS infections was 36.3/100,000 and that of viral infections 688.0/100 000. It is concluded that bacterial CNS infections were recorded very fully but only 2/3 of the viral infections could be traced, even though the more severe cases were quite well documented. 8/55 children (14.5%) with bacterial meningitis died; the corresponding figure for viral encephalitis and meningitis (excluding mumps) was 3/67 (4.5%). 17/55 (30.9%) developed mental retardation, epilepsy, cerebral palsy or hearing defect or some combination of these after bacterial CNS infection, and 9 (8.1%) after viral infection. The difference with respect to the children who had not experienced CNS infection was statistically significant only for the bacterial infection cases. CNS infections explained 7.6% of all deaths from 28 days to 14 years, 3% of the handicapping cases of cerebral palsy, mental retardation and epilepsy or some combination of these, and 6.6% of the hearing defects.
PubMed ID
3764348 View in PubMed
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21 records – page 1 of 3.