Familial and genetic data in reflux nephropathy.
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Biomedical subjects
Publications and source records attributed to G D Abbott.
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During a 120 day period, the charts of patients who had received antimicrobial agents were examined. This group numbered 255 and comprised 52% of children admitted with infections. Patients treated by family doctors and/or hospital staff predominantly had respiratory infections and the ampicillin/amoxycillin group of drugs was most commonly prescribed. Of the 203 antimicrobial agents prescribed by hospital staff, 64% were considered to be prescribed appropriately. The major errors related to dosage, the most potentially serious relating to the prescribing of aminoglycosides and chloramphenicol. Of the 203 antimicrobial agents prescribed for 171 children in the community, 11% were considered to be appropriately prescribed or without error. The major error was the prescribing of these drugs for syndromes of known viral aetiology. Errors were also frequent in relation to dosage, duration and choice of antimicrobial agents.
Whooping cough continues to be a major health problem in New Zealand. In a twelve month period, 64 cases were admitted to the paediatric wards of Christchurch Hospital. Of these 64 patients, 24 (37.5%) were fully immunised. The possible explanations for the large number of children contracting whooping cough, who have been immunised according to the schedule used in New Zealand, is discussed.
The spread of rotavirus infection was studied over four weeks in a sample of 28 families exposed to a child with rotavirus infection. The results showed a high incidence of intrafamilial infection, with 46% of members of these families developing rotavirus infections compared with none in another series of 18 families. Children in the families with an index case were more frequently affected than adults: 75% of the children developed rotavirus infection but only 33% of the adults. Children tended to suffer the infection in a more severe form. Intrafamily contact is clearly important in transmitting rotavirus infection, and preventive measures should aim at reducing the likelihood of such cross infection.
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A study of 100 children admitted to hospital with acute respiratory infection revealed that general practitioners remain the major referral source. Changing financial factors do not appear to have influenced this process. Sixty percent of children had a mild illness, requiring a short period hospital stay, but their referral was on a medical rather than a social basis.
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Prescribing practices for respiratory infection during the first three years were studied in a birth cohort of Christchurch children. Of the 5630 consultations studied 39 percent were treated with antimicrobial therapy only, 23 percent by antimicrobials supplemented by other medication, 22 percent by other medication only and 16 received no medication. There were only 27 return consultations because of the iatrogenic effects of medication prescribed for respiratory infection and all of these involved adverse reactions to antimicrobial treatment. However, in no case did these reactions require further treatment other than withdrawing or changing the child's medication. The implications of the high rate of antimicrobial prescribing present for this sample are discussed.
Five patients, three with severe aplasia and two with acute leukaemia have been treated by bone marrow transplantation (BMT). Four are alive and well with excellent graft function. One showed engraftment but died of acute graft-versus-host disease (GVH); this patient and his donor were hepatitis B antigen positive. Three show evidence of mild chronic GVH, two patients requiring control by immunosuppressive therapy. Bone marrow transplantation (BMT) has now become an established method of treatment in severe aplasia and in acute leukaemia and our results serve to emphasise this. The clinical and organisational problems associated with BMT are discussed.
Thirty-two Hickman central venous catheters were placed in patients suffering mainly from blood disorders. The catheters remained in situ for an average of 64 days. In 20 patients the catheters were removed either because they were no longer needed (14) or at death (6). In five patients they are still in position. Complications in seven patients led to the catheter being removed and these included four patients with catheter related sepsis. The use of these catheters allows safe long-term access to the venous circulation even in the neutropenic, immunosuppressed patient.
A newborn without any signs of Down's syndrome was found to have an acute proliferation that remitted without drug therapy. Chromosomal analysis of blood, bone marrow, and skin cells revealed that the child was a constitutional mosaic with normal cells and a low number of cells in which one no. 21 chromosome was replaced by a probably isochromosome for the no. 21 long arm: 46,XY/46,XY,i(21q). The abnormal cell line of the mosaic appeared to be selectively involved in this proliferation.
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An eight-year-old girl with severe acquired aplastic anaemia received a bone marrow transplant from her 11-year-old brother. The bone marrow graft is firmly established, but the patient has mild chronic graft versus host disease affecting liver and skin. The indications for bone marrow transplantation in aplastic anaemia are discussed.
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Explore the source record for details and available documents.