Background: Previous studies consistently found remarkable prevalence rates of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorders (PTSD) in pediatric patients and their parents. Findings suggest a significant association between child and parent PTSS. The present study examined, in a sample of pediatric patients with different conditions, incidence rates and determinants of PTSS and PTSD in the patients, and their mothers and fathers. Also, associations of maternal, paternal and child PTSS and PTSD were analyzed. Method: Two hundred and nine children (aged 6.5–14.5 years) were interviewed 5–6 weeks after an accident or a new diagnosis of cancer or diabetes mellitus type 1 by means of the Child PTSD Reaction Index. Their mothers ( n = 180) and fathers ( n = 175) were assessed with the Posttraumatic Diagnostic Scale. Results: Children reported PTSS levels in the mild range. Sixteen percent of the fathers and 23.9% of the mothers met full DSM‐IV diagnostic criteria for current PTSD. Type of trauma impacted differently on parents and children. In children, accident‐related injury was associated with higher PTSS scores. Conversely, in parents, diagnosis of cancer in their child was associated with more symptoms. Functional status of the child was also found to be an important predictor of PTSS in children and parents. PTSS scores of mothers and fathers were significantly correlated with each other. However, child PTSS were not significantly related to PTSS of mothers and fathers. This was true for total scores as well as for DSM‐IV symptom clusters. Conclusions: There is a need for careful evaluation of PTSS and PTSD in pediatric patients with accidental injuries or sudden onset of severe chronic diseases and in their respective parents. Importantly, children, their mothers, and their fathers should be assessed separately, because a significant association between child and parental PTSS may not exist.
Abstract Objective: To acquire data on pediatric nosocomial infections (NIs), which are associated with substantial morbidity and mortality and for which data are scarce. Design: Prevalence survey and evaluation of a new comorbidity index. Setting: Seven Swiss pediatric hospitals. Patients: Those hospitalized for at least 24 hours in a medical, surgical, intensive care, or intermediate care ward. Results: Thirty-five NIs were observed among 520 patients (6.7%; range per hospital, 1.4% to 11.8%). Bacteremia was most frequent (2.5 per 100 patients), followed by urinary tract infection (1.3 per 100 patients) and surgical-site infection (1.1 per 100 patients; 3.2 per 100 patients undergoing surgery). The median duration until the onset of infection was 19 days. Independent risk factors for NI were age between 1 and 12 months, a comorbidity score of 2 or greater, and a urinary catheter. Among surgical patients, an American Society of Anesthesiologists (ASA) score of 2 or greater was associated with any type of NI ( P = .03). Enterobacteriaceae were the most frequent cause of NI, followed by coagulase-negative staphylococci; viruses were rarely the cause. Conclusions: This national prevalence survey yielded valuable information about the rate and risk factors of pediatric NI. A new comorbidity score showed promising performance. ASA score may be a predictor of NI. The season in which a prevalence survey is conducted must be considered, as this determines whether seasonal viral infections are observed. Periodic prevalence surveys are a simple and cost-effective method for assessing NI and comparing rates among pediatric hospitals.
Due to the wide spectrum of clinical manifestations of Lyme neuroborreliosis laboratory investigations are necessary to confirm the diagnosis. Serum and CSF antibodies against Borrelia burgdorferi (Bb) as well as mononuclear CSF pleocytosis are usually present in patients with suspected neuroborreliosis. In some cases, however, the results may be conflicting, causing difficulty for the clinician in making a therapeutic decision. We therefore analysed the value of clinical symptoms, the presence of intrathecal antibody production against Bb with a modified IFA and a capture ELISA test, and the presence of Bb in the CSF with PCR testing in eleven children with suspected neuroborreliosis. In six of eight children with probable neuroborreliosis we could demonstrate intrathecal antibody production against Bb. In only one of these cases could Bb be detected in the CSF with the PCR assay. In two children the clinical manifestations consisting of erythema chronicum migrans and facial palsy, the presence of mononuclear CSF pleocytosis, and the presence of Bb specific antibodies in serum supported the diagnosis of neuroborreliosis, despite the absence of intrathecal specific antibodies. Three additional children with possible neuroborreliosis based on the occurrence of nonspecific clinical symptoms along with high serum antibody titers to Bb were included in the study. Intrathecal antibodies against Bb could not be detected and the PCR result was negative; therefore the diagnosis of neuroborreliosis was not substantiated in these three patients. We conclude that in addition to clinical symptoms, serological evidence and CSF findings suggestive of neuroborreliosis, the demonstration of intrathecal specific antibody synthesis against Bb may be helpful in establishing a definitive diagnosis of neuroborreliosis. The absence of CSF antibodies, however, does not necessarily indicate a lack of CNS involvement, especially if the examination is performed early in the course of disease. PCR testing in CSF is not suitable for routine application in the diagnosis of Lyme neuroborreliosis.
Background Since it is possible to identify the subgroups of RSV, A-subtype and B-subtype, there are findings indicating that the subtype may influence severity of RSV infection. Our study was designed to assess the hypothesis that A-subtype infections were more severe than Bsubtype infections among hospitalized children.
Journal Article Modification of Otitis Media in Chinchillas Rechallenged with Nontypable Haemophilus influenzae and Serological Response to Outer Membrane Antigens Get access Raymond B. Karasic, Raymond B. Karasic Maxwell Finland Laboratory for Infectious Diseases and Departments of Pediatrics and Medicine, Boston University School of Medicine and Boston City Hospital, Boston, Massachusetts Search for other works by this author on: Oxford Academic PubMed Google Scholar Cynthia E. Trumpp, Cynthia E. Trumpp Maxwell Finland Laboratory for Infectious Diseases and Departments of Pediatrics and Medicine, Boston University School of Medicine and Boston City Hospital, Boston, Massachusetts Search for other works by this author on: Oxford Academic PubMed Google Scholar Hanspeter E. Gnehm, Hanspeter E. Gnehm Maxwell Finland Laboratory for Infectious Diseases and Departments of Pediatrics and Medicine, Boston University School of Medicine and Boston City Hospital, Boston, Massachusetts Search for other works by this author on: Oxford Academic PubMed Google Scholar Peter A. Rice, Peter A. Rice Maxwell Finland Laboratory for Infectious Diseases and Departments of Pediatrics and Medicine, Boston University School of Medicine and Boston City Hospital, Boston, Massachusetts Search for other works by this author on: Oxford Academic PubMed Google Scholar Stephen I. Pelton Stephen I. Pelton Maxwell Finland Laboratory for Infectious Diseases and Departments of Pediatrics and Medicine, Boston University School of Medicine and Boston City Hospital, Boston, Massachusetts Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 151, Issue 2, February 1985, Pages 273–279, https://doi.org/10.1093/infdis/151.2.273 Published: 01 February 1985 Article history Received: 03 July 1984 Published: 01 February 1985
