Kathryn Maitland

..We hypothesize that boluses may cause excess deaths from neurological or respiratory events relating to fluid overload...

..The role of fluid resuscitation in the treatment of children with shock and life-threatening infections who live in resource-limited settings is not established...

..Human albumin solution is expensive and not readily available in Africa. We examined the safety and efficacy of the fluid resuscitation with two synthetic colloids, Dextran 70 and hydroxyethyl starch, to inform future trial design...

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..We examined the clinical and laboratory features on admission and outcome of children with SAM and diarrhoea at a Kenyan district hospital...

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..In Africa, the increasing cost of treating resistant infections supports economic arguments for prevention through conjugate H. influenzae type b immunization...

..However, it is unclear whether their cooccurrence with falciparum parasitization and severe disease happens by chance or by association among children in areas where malaria is endemic...

..We conclude that the HP2-2 polymorphism and deletions in alpha-globin gene are not risk factors for acute seizures in children. Future studies should examine other susceptibility genes...

..To determine the diagnostic value of visible severe wasting in identifying severe acute malnutrition at two public hospitals in Kenya...

..Few studies have reported outcome and haematological recovery of children with severe malaria where transfusion practice complies with WHO recommendations...

..CONCLUSIONS: Gentamicin or chloramphenicol alone was suboptimal therapy for Gram-negative sepsis, although in this retrospective study, there was no association between resistance and mortality...

..We determined the incidence, aetiological factors and the immediate outcome of seizures in a rural malaria endemic area in coastal Kenya...

..Plasmodium falciparum appears to have a particular propensity to involve the brain but the burden, risk factors, and full extent of neurological involvement have not been systematically described...

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..This study aimed to investigate whether this trend affected clinical burden, clinical severity of anaemia and requirements for paediatric transfusion...

..To date, information about the frequency of electrolyte disturbances among children with severe falciparum malaria is limited...

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..To systemically review the evidence from clinical trials comparing the use of crystalloids and colloids for fluid resuscitation in children with severe infection...

..Before clinical trials, evidence is needed that cord blood donations, which vary greatly in volume, can be collected and stored into a fixed volume of anticoagulant-preservative solution obviating the need for prestorage processing...

..We evaluated the safety and efficacy of this guideline compared to resuscitation with a standard isotonic solution...

..Hypothermia was a rare marker of severity in our setting. We recommend that other observations be highlighted to identify high risk groups and that routine temperature observations be reduced wherever staff are few...

..Several markers of cardiovascular compromise and metabolic acidosis correlate with mortality. The role of cardiac dysfunction in the pathogenesis of severe childhood malaria remains unknown...

..The risk from bacterial contamination of blood for transfusion in sub-Saharan Africa is not known. This study assessed the frequency of bacterial contamination of pediatric whole blood transfusions at a referral hospital in Kenya...

..Oral ciprofloxacin is a potential alternative to the standard parenteral ampicillin/gentamicin combination, but its pharmacokinetics in malnourished children is unknown...

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..Mid upper arm circumference (MUAC) and the clinical sign "visible severe wasting" are simple and inexpensive methods but have not been evaluated in this setting...

..In an open-label, randomized, controlled trial, we compared the safety of resuscitation with albumin to saline in Kenyan children with severe malaria...

..On correction of acidosis, plasma potassium decreases precipitously, and thus careful, serial monitoring of serum potassium is suggested in patients with severe malaria complicated by acidosis...

..Early recognition and prompt treatment may lead to improvements in outcome. We discuss the new evidence supporting the role of hypovolaemia in severe malaria and potential treatment options whilst awaiting the results of clinical trials...

..The study objective was to accurately define the incidence and severity of group A rotavirus disease in a resource-poor setting necessary to make informed decisions on the need for vaccine prevention...

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..This presented us with the opportunity to examine whether there was any dose relationship of quinine and hypoglycaemia occurrence...

..UTIs are common in SAM and can lead to secondary invasive bacterial sepsis. Very few studies have examined the usefulness of dipstick screening of urine specimens in SAM and none has explored its prognostic value...

..To determine how well antibiotic treatment is targeted by simple clinical syndromes and to what extent drug resistance threatens affordable antibiotics...

..Current therapeutic challenges are discussed and research priorities are highlighted...

..We then review some recent literature regarding the pathological processes involved in the aetiology of severe malaria that may lead to improvements in the management of children with severe disease...

..This method was successfully applied to measure plasma ciprofloxacin concentrations in a population pharmacokinetics study of ciprofloxacin in malnourished children...

..There are conflicting reports on whether iron deficiency changes susceptibility to seizures. We examined the hypothesis that iron deficiency is associated with an increased risk of acute seizures in children in a malaria endemic area...

..Volume expansion corrects the hemodynamic abnormalities and is associated with improved organ function and reduction in acidosis. Formal trials of volume expansion are needed to determine whether volume expansion will reduce mortality...

..The present paper focuses on the identification of children with sepsis and on fluid management strategies...

..Our study supports the conclusion that both heterozygotes and homozygotes enjoy a selective advantage against death from Plasmodium falciparum malaria...

..5 mg/kg) in children with severe malnutrition and to evaluate clinical factors affecting pharmacokinetic parameters...

..We summarize the results of recent clinical trials examining the safety and efficacy of volume expansion in children with 'cerebral malaria' complicated by acidosis...

..This review addresses recent developments that relate to the pathogenesis of severe malaria and its treatment, and also highlights the increase in the global burden of malaria and provides a summary of clinical trials of malaria vaccines...

..We studied every acute pediatric admission to a rural district hospital in Kenya to examine the prevalence, incidence, types, and outcome of community-acquired bacteremia...