Heikki Peltola

..As most methicillin-resistant staphylococci remain clindamycin-sensitive, clindamycin remains an option instead of costly alternatives...

..Although vaccination has been proved to be a safe, efficacious, and cost-effective intervention, immunisation rates remain suboptimal in many European countries, resulting in poor control of many vaccine-preventable diseases...

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..Despite favorable meta-analyses, no study involving third-generation cephalosporins for the treatment of childhood bacterial meningitis has documented a benefit of adjuvant dexamethasone therapy if the outcomes are examined individually...

..We tested the potential of real-time polymerase chain reaction to identify Streptococcus pneumoniae (Pnc) and Haemophilus influenzae type b (Hib) from cerebrospinal fluid impregnated on filter paper strips...

..We compared dexamethasone and/or glycerol recipients with placebo recipients, and measured hearing at 3 threshold levels...

..Important new information was revealed by a large double-blind, prospective study from Latin America in which the effects of oral glycerol (GLY) were compared with those of DXM...

..No sufficiently powered study has examined the true need for these treatments...

..To maintain the absence of these diseases, the adopted policy should continue, but the country should also be prepared for prompt supplementary vaccinations in the case of epidemic outbreaks...

..The only realistic way to combat these severe infections efficaciously would be through widespread vaccination, starting with Hib conjugates...

..Streptococcus pneumoniae is an agent of special interest now that Hib conjugates have been used widely for more than 2 decades...

..Epidemiological data are pivotal in mumps, because serological testing is subject to many interpretation problems...

..The use of conjugates, preferably with a reduced number of doses and in combination with other vaccines or perhaps in fractional doses, should be extended to less privileged countries, where most Hib disease occurs...

..Despite the ongoing possibility of imported disease, major outbreaks probably can be avoided by maintaining high vaccination coverage and the 2-dose policy. JAMA. 2000;284:2643-2647...

..Often they are administered for 1 to 2 months, the first 1 to 2 weeks intravenously, and decompressive surgery is usually added. No prospective, randomized, sufficiently powered comparative trial has been available...

..To explore whether 4-day parenteral beta-lactam therapy is as effective as 7-day therapy for children hospitalized for parenteral antimicrobials...

..Acute hematogenous osteomyelitis, septic arthritis, and their combination are considered to warrant especially aggressive treatment if caused by Staphylococcus aureus...

..CRP normalizes faster than ESR, providing a clear advantage in monitoring recovery. LEVEL OF EVIDENCE: Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence...

..Here we present an overview of MMR vaccinations and the Finnish experience of the MMR disease elimination process, and we describe surveillance activities in the era following elimination in Finland...

..However, the overall high frequency and severity of the findings among the HIV-positive children require regular inclusion of the ORL area in these children's clinical evaluation...

..We studied the potential of modern microbiological assays to improve this poor situation...

..The persistence of antibodies against measles, mumps, and rubella induced by the measles-mumps-rubella (MMR) vaccine and the kinetics of antibody decline after the second MMR vaccine dose were studied in the same cohort for 20 years...

..Clindamycin, vancomycin and expensive linezolid are options against methicillin-resistant Staphylococcus aureus. Extensive surgery beyond a diagnostic sample by aspiration is rarely needed in uncomplicated cases...

..All patients recovered completely. Routine arthrotomy in nonneonatal hip arthritis warrants reconsideration...

..Paracetamol seems to have beneficial effects in bacteraemic adults and some experts recommend initial slow β-lactam infusion. We investigated whether these treatments had benefits in children with bacterial meningitis...

..Aspiration's advantages are high microbiological yield and a relatively low risk of a clinically significant adverse event. Aspiration should be used if identification of the causative agent outweighs the modest risk of the procedure...

..However, the pneumococcal conjugate vaccine is a highly functional weapon against deadly pneumococcal infections, and strenuous efforts are needed to maximise its accessibility to children most at risk...

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..A mathematical model, including memory, predicted accurately the Hib-ab concentrations, which are maintained through anamnestic responses to intervening stimuli (Hib or cross-reacting bacteria)...

..Several disorders have been attributed to measles-mumps-rubella (MMR) vaccination during the past decade. The aim of this prospective follow-up study was to identify serious adverse events causally related to MMR vaccination...

..The issue will be fully elucidated only by prospective epidemiological and clinical studies, but awaiting them should not delay large-scale vaccinations against Hib throughout Asia...

..Other allergenic vaccine components have been sought, and gelatin has been suggested as one cause of allergic adverse events. The aim of this study was to further characterize the actual allergenic vaccine components...

..Evaluation of clinical characteristics, bacteriology and hearing in paediatric patients with and without chronic suppurative otitis media (CSOM) in Luanda, Angola...

..In recent decades the treatment of childhood acute bone and joint infections has shifted towards shorter antibiotic courses and rapid transition to oral therapy...

..Mixed infections of the CNS with picornaviruses and bacteria are rare. Detection of an enterovirus does not affect the clinical picture and outcome of bacterial meningitis...

..The available evidence concerning several of the postulated complications is controversial. The aim of this study was to assess whether an association prevails between MMR vaccination and encephalitis, aseptic meningitis, and autism...

..We thus investigated associations between acute infections, infection pressure (i.e. number of daily child contacts) and atopy in one of the largest population-based medical surveys ever published in the medical literature...

..The last CRS case was recorded in 1986. As a result of the high coverage two dose MMR vaccination programme, rubella was successfully eliminated from Finland. How long the acquired protection will last remains to be seen...

..Each suspected vaccine failure requires laboratory confirmation to maintain reliable surveillance and control and to establish the specific etiology of the disease...

..Respiratory or gastrointestinal tract infection predated the onset of GBS by 3 to 30 days in 20 (83%) of the 24 patients. CONCLUSIONS: No causal association seems to prevail between MMR vaccination and GBS...

..Many recent cross-sectional studies have suggested that lack of early exposure to communicable diseases, including measles, in affluent countries may have increased rates of atopic disease...

..A careful surveillance including serological follow-up is therefore very important...

..No adverse event was attributable to either drug. CONCLUSION: Procaine penicillin is as effective and safe as cefuroxime for common community-acquired infections in immunocompetent children...

..We conducted a prospective, randomized, double-blind study in which the effects of glycerol and intravenous dexamethasone were compared with placebo recipients in an intensive care setting in India...

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..This finding emphasizes the need of including a measurement of the presenting status in all studies examining treatment efficacy...

..Annual influenza vaccination should be recommended to all children from 6 months to 3 years of age...

..The system as well as the schedule used would then be of minor importance...

..The results may have wide implications on global measles eradication efforts. The potential of IgG avidity measurement in complex postvaccination measles epidemiology is discussed...