Acute Bacterial Sinusitis in Children
ABSTRACT A 4-year-old girl who attends day care presents with rhinorrhea and a daytime cough that have been present for 12 days. She has not had fever, but her appetite is poor and her interest in activities is diminished. On physical examination, there is clear rhinorrhea present in the nasal passages. The remainder of the examination is unremarkable. Should she be treated with an antibiotic?
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ABSTRACT: Cough is one of the most common symptoms that patients bring to the attention of primary care clinicians. Cough can be designated as acute (<3 weeks in duration), prolonged acute cough (3 to 8 weeks in duration) or chronic (> 8 weeks in duration). The use of the term 'prolonged acute cough' in a cough guideline allows a period of natural resolution to occur before further investigations are warranted. The common causes are in children with post viral or pertussis like illnesses causing the cough. Persistent bacterial bronchitis typically occurs when an initial dry acute cough due to a viral infection becomes a prolonged wet cough remaining long after the febrile illness has resolved. This cough responds to a completed course of appropriate antibiotics.Cough 04/2013; 9(1):11. DOI:10.1186/1745-9974-9-11 · 1.26 Impact Factor
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ABSTRACT: Disorders of the respiratory system are commonly encountered in the primary care setting. The presentations are myriad and this review will discuss some of the more intriguing or vexing disorders that the clinician must evaluate and treat. Among these are dyspnea, chronic cough, chest pain, wheezing, and asthma. Dyspnea and chest pain have a spectrum ranging from benign to serious, and the ability to effectively form a differential diagnosis is critical for reassurance and treatment, along with decisions on when to refer for specialist evaluation. Chronic cough is one of the more common reasons for primary care office visits, and once again, a proper differential diagnosis is necessary to assist the clinician in formulating an appropriate treatment plan. Infant wheezing creates much anxiety for parents and accounts for a large number of office visits and hospital admissions. Common diagnoses and evaluation strategies of early childhood wheezing are reviewed. Asthma is one of the most common chronic diseases of children and adults. The epidemiology, diagnosis, evaluation, treatment, and the patient/parent education process will be reviewed. A relatively new topic for primary care clinicians is cystic fibrosis newborn screening. The rationale, methods, outcomes, and implications will be reviewed. This screening program may present some challenges for clinicians caring for newborns, and an understanding of the screening process will help the clinician communicate effectively with parents of the patient.Current problems in pediatric and adolescent health care 07/2013; 43(6):130-56. DOI:10.1016/j.cppeds.2013.05.001 · 1.56 Impact Factor
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ABSTRACT: We aimed to determine the variations in serum apolipoprotein E (ApoE) levels in pediatric patients with a variety of infectious diseases, and to investigate the potential mechanism of elevated ApoE serum levels during infection. A total of 279 pediatric patients with a variety of infections and 58 normal controls were enrolled in this study. Serum ApoE levels were detected using an immunoturbidimetric assay. A mouse sepsis model was established to evaluate the expression of ApoE and its receptors by real-time polymerase chain reaction (RT-PCR) and Western blotting. Serum ApoE was markedly increased in cases with bacterial infections including sepsis, bacterial meningitis, and bacterial pneumonia, compared to healthy controls. No significantly elevated serum ApoE levels were observed in aseptic meningitis patients or mycoplasma pneumonia patients. The mice sepsis models showed a similar pattern of increased serum ApoE levels in the early stage of infections. We found reduced expression of ApoE and its receptors in the liver tissues in these mice models. Serum ApoE may represent a novel indicator for diagnosis of bacterial infections, especially sepsis, in pediatric patients. The decreased expression of low-density lipoprotein receptor (LDLR), LDL receptor-related protein (LRP), and heparin sulfate proteoglycan (HSPG) syndecan-1 (SDC1) may contribute to reduced ApoE clearance and accumulation in the blood.Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 08/2013; 47(2). DOI:10.1016/j.jmii.2013.05.010 · 2.08 Impact Factor