Investigation of responsible foods for food-induced anaphylaxis in children / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : This study aimed to investigate the age-specific and cause-specific clinical presentations of food-induced anaphylaxis.<br><b>Methods</b> : We retrospectively analyzed the medical records of 49 patients aged ≤15 years who visited our emergency department between January 2008 and December 2012 for food-induced anaphylaxis.<br><b>Results</b> : Roe (9 cases), egg (8 cases), and buckwheat (8 cases) were the three major foods responsible. In patients aged <1 years, egg was the major culprit, in those aged 1-6 years, roe was the major culprit, and in those aged ≥7 years, buckwheat was the major culprit. Twelve cases were treated by intramuscular administration of epinephrine.<br><b>Conclusion</b> : The trend of responsible foods for food-induced anaphylaxis in children is different depending on age. It is therefore necessary to enlighten the public about this age difference. The frequency for roe responsible for anaphylaxis was higher than that found in other reports. We suggest that local eating habits had an effect on this result.

Clinical study on antimicrobial susceptibilities of <i>Streptococcus pneumoniae</i> isolated from respiratory specimens between 2005 and 2011 / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : The purpose of this study was to investigate the changes in antimicrobial susceptibilities of <i>Streptococcus pneumoniae</i> (<i>S. pneumoniae</i>) to penicillin G (PCG), cefotaxime (CTX), and meropenem (MEPM) in specimens isolated from pediatric patients in comparison to those isolated from adults.<br><b>Methods</b> : We retrospectively investigated laboratory records of 1062 strains of <i>S. pneumoniae</i> isolated between 2005 and 2011 at our hospital.<br><b>Results</b> : In the strains isolated from children, there was no significant change in the percentage of penicillin-sensitive <i>S. pneumoniae</i> (PSSP). The rate of susceptibility to MEPM was significantly increased, and the rate of susceptibility to CTX was significantly reduced. The percentage of PSSP strains isolated from children was significantly lower than that in the stains isolated from adults.<br><b>Conclusion</b> : In <i>S. pneumoniae</i> isolated from children, resistance to cephalosporins is increasing compared with resistance to penicillin and carbapenems. Even in the same region, strains isolated from children have a higher rate of resistance than those isolated from adults.

Changes in the recommended age for rubella-containing vaccine and rubella seroprevalence among pregnant women / 日本プライマリ・ケア連合学会誌

<b>Objectives</b> : To investigate the prevalence of rubella HI antibody among pregnant women in relation to changes in the recommended age for rubella-containing vaccination.<br><b>Methods</b> : A total of 659 primiparous women were included in this study. All subjects were ≥20 years old at the time of delivery in our hospital during the 5-year period from January 2008 to December 2012. Rubella HI antibody titers were measured. Subjects were divided into four groups according to their date of birth and retrospectively analyzed : i) single-dose mass vaccination in junior high school generation ; ii) “interim measures generation” ; iii) single-dose vaccination in infancy generation ; and iv) infancy plus catch-up MR two-dose vaccination generation. HI antibody titers ≤1 : 16 was defined as a low antibody titer.<br><b>Results</b> : The percentage of cases with low antibody titers in the total study population was 20.2%. The percentages of cases with low antibody titers in each group were : i) 20.4%, ii) 18.2%, iii) 30.6%, and iv) 31.6%.<br><b>Conclusion</b> : The percentage of low antibody titers among all cases was comparable to other reports. The results suggested that rubella seroprevalence was low among those in the generation including and subsequent to the single-dose vaccination in infancy generation.

A Study of Clinical Manifestations and Diagnostic Methods for Group A β-hemolytic Streptococcus Infections in Children / 日本プライマリ・ケア連合学会誌

<b><i>Abstract</i></b><br><b>Introduction</b> : It is recommended that all negative rapid antigen tests for Group A streptococcus infection be conducted as back-up cultures.<br><b>Purpose</b> : This study is intended to make a comparison of clinical manifestations and physical findings between patient and non-patient groups ; and to determine the effects on rapid strep test results if the same swab is used for both the culture and the rapid strep test.<br><b>Methods</b> : We retrospectively studied the medical records of 480 cases where the rapid strep test was conducted in the outpatient pediatric department. The patient group consisted of those with positive laboratory cultures.<br><b>Results</b> : The patient group was 124 cases. The patient group showed significantly high incidences of sore, or reddened throats, with a significantly small amount of tonsillar exudate.<br> The sensitivity of the strep tests was 87.9% and their specificity was 100% on a culture test.<br><b>Conclusion</b> : It is difficult to rule in or rule out the Group A streptococcus infection on the basis of the clinical manifestations and physical findings. By using the same swab for both culture and rapid strep test, the results of the latter were less affected, and so this was considered as a simple and effective diagnostic method.