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Biomedical subjects

L K Pickering

Publications and source records attributed to L K Pickering.

At least 145 records · Page 8Linked to original sources
PubMed1984

The relationship of staff to the incidence of diarrhea in day-care centers.

Sixty randomly selected day-care centers in Houston, Texas, were surveyed for cases of diarrhea by weekly telephone calls during the period October 1980 to May 1981. Visits to each day-care center were made upon enrollment and again to collect self-administered questionnaires which had been mailed to the staff of each center. During the eight-month survey, 986 cases of diarrhea were reported, with an average day-care center incidence of 1.15 cases per 100 person-weeks of observation. A significant positive correlation (p less than 0.05 to p less than 0.01) was found between the incidence of diarrhea in a day-care center and each of the following variables reported by the day-care center staff: the average frequency of diapering, the average frequency of working with children less than two years of age, the average frequency of meal preparation, the average frequency of serving food to the children, and the percentage of staff who both diaper and either serve food or prepare meals daily. Day-care centers which accepted children less than two years of age had a 3.55-fold higher incidence of diarrhea compared with centers which did not accept children less than two years of age. Day-care centers in which one or more staff members prepared meals, served food, and diapered children on a daily basis had a 3.28-fold higher incidence of diarrhea compared with centers in which staff did not combine on a daily basis the duties of diapering children with either meal preparation or food service. The results suggest that staff members may play a role in the transmission of diarrhea in day-care centers through diapering, meal preparation, working with children less than two years of age, or a daily combination of diapering and either meal preparation or food service.

Adult↗
PubMed1984

Mezlocillin pharmacokinetics in pediatric oncology patients.

The pharmacokinetics of mezlocillin were studied in 31 children (age, 2 to 19 years) with malignancies and normal renal and hepatic functions. Mezlocillin was administered intravenously over 30 min every 4 h at doses ranging from 12.2 to 125 mg/kg. Blood samples were obtained over one dosage interval at steady state. For all patients, the mean clearance was 0.21 +/- 0.11 liter/h per kg, the mean distribution volume was 0.26 +/- 0.13 liter/kg, and the mean elimination half-life was 0.97 +/- 0.51 h. Trough concentrations were 23.0 +/- 29.9 mg/liter before the dose was administered and 20.4 +/- 27.5 mg/liter at the end of the dosing interval. Peak concentrations averaged 245 +/- 90.4 mg/liter, and average concentrations for the dosing interval were 83.7 +/- 40.4 mg/liter. There were no apparent effects of sex, malignancy, age, or dose on either the kinetic parameters or plasma concentrations. Overall, the disposition parameters for mezlocillin in this patient group were comparable to those reported in adults.

Adolescent↗
PubMed1984

The incidence of seizures after rehydration of hypernatremic rabbits with intravenous or ad libitum oral fluids.

Hypernatremic dehydration (mean plasma sodium, 184 mEq/L) was produced over a 3-5 d period in 71 rabbits. The dehydrated animals were divided into groups and rehydrated by intravenous (4, 6, and 8 h duration) or oral (4 and 24 h duration) solutions in amounts calculated to return plasma Na to 140 mEq/L. Plasma was obtained serially from each animal for electrolyte and osmolality determinations during dehydration and rehydration. Samples of brain hemisphere and cortex were obtained for chemical analysis from every animal immediately after death. The incidence of seizures was significantly less (P less than 0.025) in rabbits rehydrated orally when compared with rabbits rehydrated by the intravenous route. Brain water content was significantly greater in rabbits rehydrated intravenously when compared with normal rabbits and rabbits rehydrated orally. In addition, the amount of brain water was greater in rabbits with seizures when compared with those which did not have seizure manifestations. The mechanism underlying the significant reduction in seizures when the animals were rehydrated orally may relate to an integration of drinking behavior with rehydration status. Administration of oral fluids may provide an effective method of therapy for some patients with hypernatremic dehydration.

Administration, Oral↗
PubMed1984

Longitudinal study of occurrence of diarrheal disease in day care centers.

Sixty day care centers (DCC) randomly selected from 736 licensed child care facilities in Harris County (Houston), Texas were surveyed for the incidence of diarrhea by periodic visits and weekly telephone calls over two years. A total of 2,708 episodes of diarrhea were reported in 3,800 children under 6 years of age, and 84 cases occurred in center staff. Overall incidence was 0.44 episodes/person/year among children and 0.14 among staff. Attack rates among the 60 DCC ranged from none to 3.64 cases/year in each child. The incidence for children under 36 months of age was 17 times higher than for the older group. Characteristics of DCC associated with higher rates of disease among children were the presence of young, non-bowel trained children, staff who both diapered infants and prepared food on a regular basis, DCC for profit management, and DCC whose only guidelines were provided by the State. The socioeconomic burden associated with DCC disease, its transmission, and control is considerable and needs to be further addressed.

Age Factors↗
PubMed1984

Infectious diseases and child day care.

The number of day care centers and home care facilities has steadily increased in the United States. Recent interest has focused on the possible relationship between attendance at child day care facilities and the occurrence of certain infectious diseases. A variety of infectious agents have been reported as causes of illness among children and staff in day care programs. In general, however, concurrent risks for these infections among children attending and those not attending day care programs have not been established by prospective studies. A review is made of the pathogens that have been associated with infections in day care settings, patterns of occurrence of infectious diseases in day care facilities, aspects of control and prevention of these diseases, and controversies related to infectious diseases in child day care facilities. Aspects of this problem that warrant further research are outlined.

Child Day Care Centers↗
PubMed1983

Evaluation of a commercial enzyme immunoassay kit for rotavirus detection.

A commercial enzyme immunoassay kit (Rotazyme) was compared to electron microscopy for the detection of rotavirus in stool specimens collected during diarrhea outbreaks at day care centers in Houston. EIA was more sensitive than EM and detected SA-11 rotavirus which titered 2.0 X 10(3) PFU/ml.

Child↗
PubMed1983

Outbreaks of diarrhea associated with Clostridium difficile and its toxin in day-care centers: evidence of person-to-person spread.

Clostridium difficile was associated with five outbreaks of diarrhea occurring in three day-care centers caring for children less than 2 years of age during a three and one-half-month period; two centers had one outbreak of diarrhea, and one had three outbreaks. The frequency of isolation of C. difficile and its toxin was determined in stool specimens from 65 children attending the three day-care centers. Twelve of 21 (57%) children who had diarrhea excreted C. difficile and its toxin, whereas only four of 44 (9%) children who did not experience diarrhea yielded the organism and the toxin. Five of the 12 symptomatic children with C. difficile and its toxin had received prior antimicrobial therapy for upper respiratory tract infections. An eight-month prospective study was then carried out in one room of the center where the three outbreaks had occurred. Initially, one child had culture-positive stools for C. difficile. During the first 13-week study period six additional children of the 12 (50%) in the room under study became colonized with C. difficile. Six of the seven children who excreted C. difficile and its toxin experienced diarrhea with C. difficile toxin-positive stools by the end of the 13 weeks. Environmental contamination increased as more children became colonized and developed diarrhea. Electrophoretic evaluation of environmental and stool isolates obtained during one outbreak of diarrhea showed that the isolates had an identical protein pattern. Findings of this study indicate the importance of searching for C. difficile in children in day-care centers who develop diarrhea.

Bacterial Toxins↗
PubMed1983

Comparison of methods for identification of Giardia lamblia.

Stool specimens from children in daycare centers were screened for Giardia lamblia and intestinal amoebae by staining wet mounts with methylene blue and dilute Lugol's iodine. Merthiolate-iodine-formalin concentrations (MIFC) and permanent smears stained with Wheatley's trichrome method also were done. In addition, stools were preserved with polyvinyl alcohol (PVA) and 10% formalin and tested with trichrome and MIFC, respectively. The effectiveness of each method was based on a quantification scheme. Trichrome and MIFC were the best identification methods for cysts of G. lamblia. Trichrome was the superior method for identification of trophozoites. The other staining procedures were significantly less accurate. The use of preservatives did not improve recovery of G. lamblia compared with same morning processing of fresh stools. This study provides evidence that a permanent stain such as trichrome is an important tool for the diagnosis of G. lamblia and should be included in the processing of any diarrheal stool.

Child, Preschool↗