ABSTRACT
OBJECTIVE: To examine the effects of animal-source foods on toddler growth. DESIGN: A 5-month comparison feeding intervention study with one of three millet-based porridges randomized to eighteen feeding stations serving 303 children aged 11-40 months. Feeding stations served plain millet porridge (Plain group), porridge with milk (Milk group) or porridge with beef (Meat group). Anthropometry, morbidity and food intake were measured at baseline and regular intervals. Longitudinal mixed models were used to analyse growth. SETTING: Embu, Kenya. SUBJECTS: Two hundred and seventy-four children were included in final analyses. RESULTS: Linear growth was significantly greater for the Milk group than the Meat group (P = 0·0025). Slope of growth of mid-arm muscle area of the Plain group was significantly greater than in the Meat group (P = 0·0046), while the Milk group's mid-upper arm circumference growth rate was significantly greater than the Meat group's (P = 0·0418). The Milk and Plain groups' measures did not differ. CONCLUSIONS: Milk and meat porridges did not have a significantly greater effect on growth than plain porridge in this undernourished population. Linear growth was influenced by more than energy intakes, as the Plain group's total body weight-adjusted energy intakes were significantly greater than the Meat group's, although linear growth did not differ. Energy intakes may be more important for growth in arm muscle. The diverse age distribution in the study makes interpretation difficult. A longer study period, larger sample size and more focused age group would improve clarity of the results.
Subject(s)
Diet , Energy Intake , Growth Disorders/prevention & control , Growth , Malnutrition/diet therapy , Meat , Milk , Animals , Arm/anatomy & histology , Arm/growth & development , Body Size , Child, Preschool , Female , Humans , Kenya , Longitudinal Studies , Male , Muscle, Skeletal/anatomy & histology , Muscle, Skeletal/growth & development , PanicumABSTRACT
Four newer antibiotics are available to treat gram-positive bacterial infections that are resistant to traditional antibiotics and to vancomycin. They should preferably be used with the help of an infectious-disease consultant: specific therapy should be chosen on the basis of the bacteria involved, the site of infection, whether the patient has kidney or liver disease, other medications the patient is taking, and side effects that develop.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Gram-Positive Bacterial Infections/drug therapy , Acute Disease , Adolescent , Anti-Bacterial Agents/classification , Daptomycin/therapeutic use , Drug Resistance, Bacterial , Female , Humans , Middle Aged , Vancomycin/therapeutic use , Virginiamycin/analogs & derivatives , Virginiamycin/therapeutic useABSTRACT
Daptomycin is a lipopeptide antimicrobial used for the treatment of aerobic gram-positive skin and soft tissue infections. We describe a patient with acute myeloid leukemia whose febrile neutropenia was treated with daptomycin and who later developed daptomycin-resistant Enterococcus faecium infection. Defervescence and negative blood cultures ensued after treatment with linezolid. Guidelines for testing daptomycin susceptibillities of enterococci include breakpoints only for vancomycin-susceptible Enterococcus faecalis, making interpretation of minimum inhibitory concentrations for common clinical infections difficult. No enterococcal cross-resistance has been reported among daptomycin, linezolid, or quinupristin-dalfopristin, and these agents may be viable alternatives.
Subject(s)
Anti-Bacterial Agents , Daptomycin , Drug Resistance, Bacterial , Enterococcus faecium , Gram-Positive Bacterial Infections/etiology , Leukemia, Myeloid/complications , Acute Disease , Adult , Antineoplastic Agents/therapeutic use , Female , Gram-Positive Bacterial Infections/diagnosis , Humans , Leukemia, Myeloid/drug therapyABSTRACT
Several newer agents with activity against multidrug- resistant gram-positive pathogens are available. These agents have in vitro and clinical data supporting their utility in the treatment of infections caused by pathogens such as methicillin-resistant staphylococci and vancomycin-resistant enterococci. Daptomycin appears to be rapidly bactericidal, and linezolid and quinupristin/dalfopristin also are cidal against staphylococci. Although the agents have several properties that are attractive for use in endocarditis, clinical data are limited. Further investigation with each agent and combination therapy are warranted before definitive recommendations can be made.
