ABSTRACT
The emergence and spread of drug-resistant pneumococcal strains among infants and young children in the United States have complicated the management of infections such as community-acquired pneumonia, meningitis, bacteraemia and OM. The rapidly escalating prevalence of drug-resistant S. pneumoniae and the limited therapeutic options to successfully treat these resistant organisms accentuate the need for vaccine prevention. Successful trials with the pneumococcal 7-valent conjugate vaccine have demonstrated that it is highly effective against invasive disease, safe and immunogenic in infants, who are a high-risk population for pneumococcal disease. Trials evaluating the efficacy of this vaccine against OM and pneumonia are in progress. The pneumococcal 7-valent conjugate vaccine should provide physicians with an effective means of preventing pneumococcal infections.
Subject(s)
Pneumococcal Infections/epidemiology , Pneumococcal Infections/therapy , Bacteremia/epidemiology , Bacteremia/therapy , Child, Preschool , Humans , Incidence , Infant , Meningitis, Pneumococcal/epidemiology , Meningitis, Pneumococcal/therapy , Otitis Media/epidemiology , Otitis Media/therapy , Penicillin Resistance , Pneumococcal Vaccines/therapeutic use , Pneumonia, Pneumococcal/epidemiology , Pneumonia, Pneumococcal/therapy , Prevalence , Treatment Outcome , United States/epidemiology , Vaccines, ConjugateABSTRACT
Recent evidence suggests significant short-term neurocognitive deficits following mild traumatic brain injury (MTBI) in sports. However, sequelae of mild head injuries is complicated by many factors including a history of multiple head injuries and injury severity. Few studies have considered the influence these variables may have on proper classification of a MTBI and their meaning for return-to-play guidelines. This study presents the short-term neuropsychological and balance outcomes of four college athletes who sustained mild head injuries of different severity (grade I, grade II, grade III and multiple head injured with a grade II based on American Academy of Neurology guidelines). The results demonstrated that self-report symptoms of concussion were slow to resolve in the grade III and multiple concussed individuals. For neuropsychological testing, Trails A & B, Symbol Digit Modalities Test and Digits Span Backwards were the most sensitive in identifying differences between the injuries. For balance assessments using the Neurocom Smart Balance System, the Sensory Organization Test and Reaction Time were also important variables in detecting differences among the various injuries. When these data are used together, it can assist physicians in determining safe return-to-play for athletes who sustain MTBI. There are contradindications in the numerous grading systems and return-to-play guidelines for MTBI. The results from this study provides new evidence which can be assimilated into a valid grading scale for MTBI sustained in sport.
Subject(s)
Athletic Injuries/pathology , Brain Injuries/pathology , Cognition Disorders/etiology , Postural Balance , Sensation Disorders/etiology , Adult , Athletic Injuries/classification , Athletic Injuries/complications , Brain Injuries/classification , Brain Injuries/complications , Cognition Disorders/pathology , Humans , Male , Neuropsychological Tests , Prognosis , Severity of Illness IndexABSTRACT
Two siblings with congenital afibrinogenemia received prophylactic infusions of cryoprecipitate in order to prevent serious hemorrhage during early childhood. Three bags (units) of this fibrinogen-containing blood product were administered every 7-10 days for 15 months in one case and 24 months in the other. Hemorrhage was nearly completely prevented during the period of prophylaxis. Side effects from cryoprecipitate were not observed. Prophylactic infusion of cryoprecipitate, made practical by the relatively long half-life of fibrinogen, should be considered in other patients with this disorder.
