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Biomedical subjects

E Mohs

Publications and source records attributed to E Mohs.

At least 37 records · Page 2Linked to original sources
PubMed1984

Adverse reactions to vancomycin used as prophylaxis for CSF shunt procedures.

From January to May 1982, 37 children undergoing CSF shunt procedures in two different countries were enrolled in a randomized, double-blind, controlled study to receive vancomycin hydrochloride (15 mg/kg/dose) or placebo (saline) one hour before surgery and again six hours later. Twenty patients received vancomycin, and 17 received placebo. In the 35 cases that could be evaluated, shunt-associated infections developed in three (17%) of 18 patients who received vancomycin and in four (23%) of the 17 placebo recipients. All infections were caused by Staphylococcus species susceptible to vancomycin. A histaminelike rash developed in seven (35%) of 20 patients during vancomycin infusion. It recurred with readministration in one patient and was accompanied by hypotension in another patient. The reactions were not related to too rapid infusion of vancomycin. Because of the adverse reactions to vancomycin, the study was discontinued.

Adolescent↗
PubMed1983

Oral rehydration in hypernatremic and hyponatremic diarrheal dehydration.

Ninety-four well-nourished, bottle-fed infants with hypernatremic (N = 61) or hyponatremic (N = 33) diarrheal dehydration were treated with oral rehydration. In 61 hypernatremic and 25 hyponatremic infants, two thirds of the fluid volume were given as glucose/electrolyte solution containing 90 mmole of sodium per liter and one third as plain water; the other eight hyponatremic infants were given glucose/electrolyte solution alone. Fluid deficits were successfully and rapidly replaced with oral therapy alone in all 61 hypernatremic infants (mean +/- SEM, 8.5 +/- 0.6 hours) and in 31 of those with hyponatremia (mean +/- SEM, 10 +/- 1.2 hours). Two hypernatremic infants required some intravenous (IV) fluids. The mean serum sodium levels fell in the hypernatremic infants to normal and rose in those with hyponatremia. Only five (8%) of the 61 hypernatremic infants manifested convulsions during oral rehydration; this compared favorably with the 14% rate of convulsions encountered previously when we used IV rehydration.

Administration, Oral↗
PubMed1983

Diarrhea associated with rotaviruses, enterotoxigenic Escherichia coli, Campylobacter, and other agents in Costa Rican children, 1976-1981.

Rotaviruses, enterotoxigenic Escherichia coli, Salmonella, Shigella, and parasites were investigated in outpatient diarrheic children, and in hospitalized diarrheic and non-diarrheic children, between January 1976 and June 1979. In outpatient cases studied within 4 days of onset of symptoms, rotaviruses were the most common agents (45.3%); E. coli heat-stable enterotoxin ranked second (13.4%); Shigella was third (8.1%); Salmonella was fourth (7.3%). In 63.2%, one or more enteric agents were detected. In hospitalized non-diarrheic children, asymptomatic shedding of pathogens was rarely observed. A later survey of outpatient diarrheic children revealed Campylobacter fetus jejuni in 8%. In 5.5 years of observation rotaviruses were endemic with excess frequency in the dry and cooler months of December and January. The excess occurrence of bacterial pathogens did not coincide with that of rotaviruses.

Campylobacter Infections↗
PubMed1981

Comparative toxicities of methicillin and nafcillin.

In a prospective, randomized study, 75 infants and children were treated with methicillin sodium and 74 were treated with nafcillin sodium. The two groups were comparable with regard to age, sex, duration of therapy, types off illnesses, etiologic bacteria, and bacteremia. Clinical responses were also comparable. The frequencies of fever, rash, eosinophilia, neutropenia, anemia, and abnormal hepatic enzymes were the same in the two groups. Two patients in each group had transient hematuria early in their course that resolved despite continued antibiotic therapy. Definite urologic toxic effect did not occur in patients who received nafcillin, while four (5.3%) of the methicillin-treated patients were judged to have this complication. In addition, six patients (8%) who received methicillin had questionable evidence of urologic toxic effect. It is concluded that methicillin and nafcillin have comparable clinical efficacy and adverse effects, with the exception that definite urologic toxic effect has been observed with nafcillin therapy.

Adolescent↗
PubMed1980

Oral rehydration of infants with acute diarrhoeal dehydration: a practical method.

Previous studies demonstrated the efficacy of oral glucose/electrolytes solution (GES) in rehydration of moderately dehydrated infants; the importance of providing one volume (200 ml) of solute-free water for every two volumes (400 ml) of GES ingested was also stressed. In this study we investigated a variation of our previous method intended to make it simpler and more practical. The entire calculated volume of GES was administered as rapidly as possible followed by a volume of free water equal to one-half the volume of GES ingested. In total 50 children (25 girls), aged 10 days to 24 months, with diarrhoeal dehydration were studied; the mean degree of dehydration was 7.2% of body weight. Hypernatraemia present on admission was corrected within a few hours, as was severe metabolic acidosis. Vomiting rapidly diminished or disappeared following onset of therapy and the mean rate of ingestion of fluids was high, 28 ml/kg/h, allowing for rapid rehydration; the mean time required for rehydration was 7.9 h (range 2.3-17). The described method offers simplicity and practicality, while still providing free water to correct or prevent hypernatraemia.

Acute Disease↗
PubMed1979

Oral rehydration of neonates with dehydrating diarrhoeas.

Thirty-nine of forty neonates with mean dehydration equivalent to 6.7% of body-weight were orally rehydrated with a glucose/electrolyte solution. Only one patient required any intravenous fluids for rehydration. Hypernatraemia and acidosis present at admission were corrected within a few hours without complications. It seems that oral rehydration, is suitable for neonates as well as for children and adults.

Administration, Oral↗
PubMed1978

Comparison of sucrose with glucose in oral therapy of infant diarrhoea.

In a randomised double-blind trial, 51 5--10% dehydrated infants were rehydrated with oral electrolyte solutions containing sucrose or glucose. Most infants in both groups were successfully rehydrated, but the sucrose solution produced a slower correction of electrolyte abnormalities and a higher percentage of patients who needed more than 24 h of therapy. Where there is adequate knowledge of the oral therapy method sucrose can substitute for glucose in many cases; where there is a choice glucose is recommended.

Acute Disease↗
PubMed1978

Comparison of human rotavirus disease in tropical and temperate settings.

Human rotaviruses (HRV) are a common cause of acute nonbacterial gastroenteritis in pediatric patients. A prospective study of HRV disease in a temperate (Dallas) and a tropical (San Jose, Costa Rica) setting demonstrated differences in seasonal distribution. In both locales, HRV accounted for 50% to 60% of acute nonbacterial gastroenteritis episodes from December through February; this period corresponded to the cooler months of winter in Dallas and to the dry season in San Jose. During the rest of the observation year, the virus was not recovered from any Dallas patients, but was found in 30% to 40% of Costa Rican patients in every month but May. Signs, symptoms, and laboratory values suggest the small bowel as the major site of pathophysiology; mucosal disruption may occur in some cases.

Acute Disease↗
PubMed1978

[Admissions for protein-calorie malnutrition at the National Children's Hospital, Costa Rica, 1975].

The hospital records of 478 children with protein-calorie malnutrition (PCM) were reviewed. These represented all children diagnosed as malnourished during 1975 (3.6 per cent of all hospital admittances in the National Children's Hospital); 52% of the cases were infants less than 6 months of age; 28% had low birth weight, a rate much in excess of the prevalence of low birth weight in the general population of Costa Rica (7%). In general, malnourished children had been weaned early, 75% during the first month of life. A considerable number of children belonged to "malnourishing families" which have particular characteristics favorable to establishment of malnutrition in the family. Thus, 36% of their siblings had also been admitted with malnutrition at a previous date to that of this study.

Age Factors↗
PubMed1978

[Human fetal growth in Costa Rica, 1970-1975].

Costa Rica has experienced a marked reduction in infant mortality--both in the neonatal and post-neonatal components--in the last decade. The decline could be related to improvements in the pattern of fetal growth. The present report analyses the birth weight of newborns from a random sample of all births in the Republic of Costa Rica during 1970 and 1975. While the average birth weight in that period was 3100 grams, the prevalence of low birth weight neonates decreased from 9 to 7 per cent in five years. The provinces of Limon and San Jose exhibited the highest frequency of low birth weight. Women 20 to 29 years old had babies with better or optimal body weight. Age, marital status and occupation of the mother appeared correlated with birth weight. A relationship between changes in fetal growth and changes in maternal, perinatal and neonatal mortality is apparent. The present situation of birth weight places Costa Rica among the countries in transition with a clearer perspective to attain an even higher infant survival in the near future. In this regard, several measures oriented toward prevention of low birth weight are recommended.

Adolescent↗
PubMed1977

Viral infections during pregnancy and in early life.

There is evidence that fetal antigenic stimulation and intrauterine infection is much more frequent in developing rural populations than in industrialized societies. A similar contrast is observed for postnatal intestinal infection that is significantly greater in the less developed areas. The differences are explained by the divergence in environmental sanitation and personal hygiene. Intestinal infection is important in that diarrheal disease is one of the main factors leading to malnutrition. It is apparent that for developing nations to attain better nutrition, much of the present burden of intestinal infection needs to be controlled.

Feces↗
PubMed1976

Gonorrhea in preschool- and school-aged children. Report of the prepubertal gonorrhea cooperative study group.

Single-dose antibiotic therapy was evaluated in 108 episodes of culture-confirmed, uncomplicated gonorrhea in 100 prepubertal children. There were 15 boys and 85 girls between 14 months and 14 years of age. Penicillin G procaine, 100,000 units/kg intramuscularly, was compared with amoxicillin trihydrate, 50 mg/kg orally. Probenecid, 25 mg/kg, was given simultaneously. Both drugs provided prompt bacteriological and clinical response. Multiple episodes of gonorrhea, presumably caused by reexposure, occurred in six girls. Oral and anal cultures were negative in all of 47 Costa Rican cases but were commonly positive in US children. Anal cultures yielded gonococci in 52% of girls and 25% of boys, and oral cultures were positive in 18% and 13%, respectively. In three instances, rectal cultures confirmed the diagnosis when vaginal cultures were negative. Gonorrhea should be considered in every child with vaginal or urethral discharge. Single-dose penicillin-probenecid or amoxicillin-probenecid treatment is curative.

Administration, Oral↗
PubMed1976

Amikacin in newborn infants: comparative pharmacology with kanamycin and clinical efficacy in 45 neonates with bacterial diseases.

The pharmacokinetic properties of amikacin (BBK8) were similar to those of kanamycin in newborn infants. Peak serum concentrations of both drugs were in the range of 15 to 25 mug/ml with the exception of kanamycin in babies weighing greater than 2,000 g at birth where peak levels were 12.5 to 15 mug/ml. Volumes of distribution, plasma clearances, and serum half-life values were comparable for the two drugs. The clinical and bacteriological responses to amikacin therapy were assessed in 45 neonates with bacterial diseases. A case fatality rate of 26% was observed in infants with septicemia and/or meningitis, whereas no deaths occurred among 22 infants with urinary tract and mucocutaneous infections. Cultures from infected sites were sterile within 72 h of initiating amikacin therapy in 47% of the infants, continued positive for greater than 72 h in 31%, and were not reevaluated during therapy in 22%. The clinical response was judged to be satisfactory in 92% of the surviving infants. The efficacy of amikacin was comparable to that of kanamycin or gentamicin in neonatal bacterial diseases.

Amikacin↗