454 research outputs found
Trough concentrations of vancomycin: adult therapeutic targets are not appropriate for children
No full textDespite the need for effective vancomycin therapy, there are few data guiding vancomycin monitoring in children. We reviewed retrospectively vancomycin use in children 1 month to 12 years of age. Initial and adjusted target trough vancomycin concentrations in serum were infrequently achieved regardless of the dosing schedule. Currently recommended trough concentrations need to be re-examined with a more detailed pharmacokinetic study in children.Claire L. Gordon, Chantelle Thompson, Jonathan R. Carapetis, John Turnidge, Charles Kilburn and Bart J. Curri
Acute rheumatic fever and rheumatic heart disease in the Top End on Australia's Northern Territory. by Jonathan R. Carapetis, Don R. Wolff and Rart J. Currie
No full textTo describe the epidemiological and clinical features of acute rheumatic fever and rheumatic heart disease in the Top End of the Northern Territory
Privacy legislation and research
No full textTo the Editor: The Victorian Health Records Act 2001 became operational on 1 July 2002. This legislation provides important protection for the individual against misuse of health information through the establishment of Health Privacy Principles. We support the spirit of this legislation, but would like to draw attention to its potential effects on multicentre research and disease surveillance..
A Report on the Feasibility Study of the Proposed NT Pneumococcal Vaccine Trial
No full text*This report is free to read on the publisher's website
Prospective surveillance of invasive group a streptococcal disease, Fiji, 2005-2007.
No full textWe undertook a prospective active surveillance study of invasive group A streptococcal (GAS) disease in Fiji over a 23-month period, 2005-2007. We identified 64 cases of invasive GAS disease, which represents an average annualized all-ages incidence of 9.9 cases/100,000 population per year (95% confidence interval [CI] 7.6-12.6). Rates were highest in those >65 years of age and in those <5 years, particularly in infants, for whom the incidence was 44.9/100,000 (95% CI 18.1-92.5). The case-fatality rate was 32% and was associated with increasing age and underlying coexisting disease, including diabetes and renal disease. Fifty-five of the GAS isolates underwent emm sequence typing; the types were highly diverse, with 38 different emm subtypes and no particular dominant type. Our data support the view that invasive GAS disease is common in developing countries and deserves increased public health attention
High burden of impetigo and scabies in a tropical country.
No full textBACKGROUND: Impetigo and scabies are endemic diseases in many tropical countries; however the epidemiology of these diseases is poorly understood in many areas, particularly in the Pacific. METHODOLOGY/PRINCIPAL FINDINGS: We conducted three epidemiological studies in 2006 and 2007 to determine the burden of disease due to impetigo and scabies in children in Fiji using simple and easily reproducible methodology. Two studies were performed in primary school children (one study was a cross-sectional study and the other a prospective cohort study over ten months) and one study was performed in infants (cross-sectional). The prevalence of active impetigo was 25.6% (95% CI 24.1-27.1) in primary school children and 12.2% (95% CI 9.3-15.6) in infants. The prevalence of scabies was 18.5% (95% CI 17.2-19.8) in primary school children and 14.0% (95% CI 10.8-17.2) in infants. The incidence density of active impetigo, group A streptococcal (GAS) impetigo, Staphylococcus aureus impetigo and scabies was 122, 80, 64 and 51 cases per 100 child-years respectively. Impetigo was strongly associated with scabies infestation (odds ratio, OR, 2.4, 95% CI 1.6-3.7) and was more common in Indigenous Fijian children when compared with children of other ethnicities (OR 3.6, 95% CI 2.7-4.7). The majority of cases of active impetigo in the children in our study were caused by GAS. S. aureus was also a common cause (57.4% in school aged children and 69% in infants). CONCLUSIONS/SIGNIFICANCE: These data suggest that the impetigo and scabies disease burden in children in Fiji has been underestimated, and possibly other tropical developing countries in the Pacific. These diseases are more than benign nuisance diseases and consideration needs to be given to expanded public health initiatives to improve their control
Medical Management of Rheumatic Heart Disease
No full textBest practices guidelines for the long-term management of rheumatic heart disease (RHD) include secondary prevention with penicillin prophylaxis, clinical reviews by a specialist experienced in RHD management, serial echocardiographic assessment of left ventricular and valve function, timely referral for heart surgery, monitoring of anticoagulation for patients with atrial fibrillation and mechanical heart valves, and access to oral healthcare.There is an established evidence base for surgical or catheter-based intervention for severe or symptomatic RHD patients, whereas there is little evidence that pharmacological management of severe RHD changes outcomes. Unfortunately, the vast majority of the global burden of symptomatic RHD exists in regions of the world where there is limited or no access to surgical or catheter-based treatment. As a result, medical management is often the only option and may allow for symptomatic improvement.This chapter discusses the principles of medical management of RHD and the indications for surgical or catheter-based treatment.</p
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