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Biomedical subjects

F Navratil

Publications and source records attributed to F Navratil.

11 recordsLinked to original sources
PubMed2005

Mastitis in early infancy.

AIM: To evaluate the clinical features and microbiological findings in young infants with mastitis. METHODS: Retrospective review of medical records of 18 infants with breast inflammation during the first 3 mo of life seen in the paediatric emergency department between 1992 and 2002. RESULTS: All were full-term infants with female-male ratio of 3.5:1. The age ranged from 12 to 45 d, with a peak in the 4th and 5th weeks of life. Only five patients had systemic manifestations, and five were pretreated with oral antibiotics (amoxicillin-clavulanic acid). The latter as well as seven additional cases required incision and drainage due to abscess formation. Bacterial cultures grew Staphylococcus aureus in 10 cases including all pretreated infants. In four of these cases, Gram stain showed the pathogen. After antimicrobial treatment, no recurrence was observed in any of the patients. CONCLUSIONS: These findings suggest that mastitis in early infancy should be treated with parenteral antibiotics guided by Gram stain when available and informative. Otherwise, beta-lactamase-resistant antibiotics are a reasonable empirical initial treatment pending culture results. Optimizing the management of infants with mastitis is important especially since abscess formation requiring incision may be detrimental for later breast development.

Abscess↗
PubMed2004

Vaginal foreign bodies.

OBJECTIVE: To evaluate the clinical features and outcome in girls with a vaginal foreign body. METHODS: Retrospective review of medical records of 35 girls with a vaginal foreign body seen in an outpatient clinic for paediatric and adolescent gynaecology between 1980 and 2000. RESULTS: The ages ranged from 2.6 to 9.2 years. The most common symptom was blood-stained vaginal discharge/vaginal bleeding (49%). Duration of symptoms varied from 1 day to 2 years. Fifty-four percent of the patients recalled insertion of the foreign object, usually by the girl herself. All but three patients (91%) either recalled insertion of the foreign object and/or had vaginal bleeding or blood-stained or foul-smelling vaginal discharge, and/or visualization or palpation of the foreign body in physical examination. Symptoms resolved after removal of the foreign body followed by a single irrigation with Providon-Iod (Betadine). CONCLUSION: In the majority of patients a carefully obtained history and physical examination suggest the diagnosis of a vaginal foreign object. The leading symptoms are vaginal bleeding and blood-stained or foul smelling vaginal discharge. Removal of the foreign object followed by a single irrigation with Providon-Iod is the definitive treatment and does not require additional measures.

Child↗
PubMed2003

Vulvovaginitis in prepubertal girls.

This retrospective study evaluated the clinical features and findings in bacterial cultures and in microscopic examination of vaginal secretions in 80 prepubertal girls, aged 2-12 years, with vulvovaginitis. Vaginal secretions were obtained directly from the vagina with a sterile catheter carefully inserted into the vagina. Pathogenic bacteria were isolated in 36% of cases. In 59% of these cases the isolated pathogen was group A beta-haemolytic streptococcus. Candida was not found in any of the patients. The finding of leucocytes in vaginal secretions as an indicator for growth of pathogenic bacteria had a sensitivity of 83% and a specificity of 59%. Antimicrobial treatment should therefore be based on bacteriological findings of vaginal secretions and not on the presence of leucocytes alone.

Age Distribution↗
PubMed2002

[Genital infections in prepubertal girls].

Vulvitis and vulvovaginitis are the most common gynecologic complaint in prepubertal girls. The frequently observed therapeutic failures are due mainly to lack of knowledge of the characteristics of this age group, of age and development in appropriate diagnostic procedures and of therapeutic measures similar to those in the adult female patient. Prepubertal girls are anatomically, physiologically and behaviorally at relative risk for vulvovaginitis. Symptoms include pruritus, genital pain, "vulvar dysuria" and discharge. History taking and a general pediatric examination are mandatory, thereafter an age appropriate careful anogenital examination should follow. It requires time, patience and knowledge of the different non traumatizing examination techniques. The findings in girls with vulvovaginitis are variable and erythema, excoriations and discharge can be found. The genital inspection and the use of microscopy and microbiologic studies are helpful in planning an appropriate therapy. The majority of vulvovaginal infections in children are nonspecific but they can also be caused by specific organisms and are mostly bacterial. Yeast infections are not found in otherwise healthy prepubertal girls. The therapeutic approach consists of improved anogenital hygiene, sitz/tub baths and use of non irritating soaps. However if an abnormal population of bacteria is present antimicrobial therapy should be considered. Reassurance and a review of preventive methods are crucial in the management of girls with vulvovaginitis.

Bacterial Infections↗
PubMed1993

Pericardial effusion as a sign of acquired hypothyroidism in children with Down syndrome.

In three children with Down syndrome and acquired hypothyroidism echocardiography was performed before and after the start of L-thyroxine treatment. Initial studies revealed pericardial effusions which resolved during treatment suggesting that they were caused by hypothyroidism. The incidence of hypothyroidism in Down syndrome is high, but the diagnosis is often missed for lack of specific clinical criteria. The finding of pericardial effusion by echocardiography may be essential in discovering thyroid dysfunction. The cases illustrate that regular thyroid function tests are important in Down syndrome.

Child↗