Frank A. Disney

Childhood antecedents of adult obesity Do chubby infants become obese adults

We investigated whether obese infants tend to become obese adults. Records of subjects born between 1945 and 1955 were reviewed to select three cohorts based on weight in the first six months of age, which exceeded the 90th percentile at least once, ranged between 25th and 75th percentiles or was below 10th percentile at least once. Three hundred and sixty-six subjects, now between 20 and 30 years of age, were located and their present height and weight determined. Thirty-six per cent of those exceeding the 90th percentile as infants were overweight adults, as compared to 14 per cent of the average age and light-weight infants. A significant increase (chi square = 17.2, p less than 0.001) in adult obesity was evident when the infant exceeded the 75th percentile that was independent of his height. Social class, educational level, and parental weight all correlated with adult weight (p less than 0.001). Sex and ordinal position of birth did not. The data suggest that infant weight correlates strongly with adult weight independently of other factors considered.

The accuracy of diagnosis of beta streptococcal infections on clinical grounds

Summary In a group of 1,199 cases of illness in children suspected of having streptococcal infection a diagnosis on clinical grounds was correct in approximately 75 per cent of patients. Certain symptoms and signs were suggestive of streptococcal infection but none were diagnostic. Throat cultures materially increase the accuracy of diagnosis.

Adverse and beneficial effects of immediate treatment of Group A beta-hemolytic streptococcal pharyngitis with penicillin.

One hundred forty-two children with presumed Group A beta-hemolytic streptococcal (GABHS) pharyngitis were enrolled in a randomized double blind prospective study comparing the consequences of immediate penicillin treatment with treatment delayed for 48 to 56 hours. One hundred fourteen of the enrolled patients were culture-positive. An adverse impact of early antibiotic therapy was noted; the incidence of subsequent infections with GABHS was significantly greater in those treated at the initial office visit with penicillin. In the month following documented evaluation of GABHS, a recurrence occurred 2 times more frequently in those treated with penicillin immediately compared with those for whom treatment was delayed 48 to 56 hours. Late recurrences (beyond 1 month but in the same streptococcal season) occurred 8 times more frequently (P less than 0.035). Delay in penicillin treatment did not increase GABHS intrafamilial spread. Symptoms of both groups were assessed for 2 days following the initiation of treatment. Both placebo-treated and penicillin-treated groups used aspirin or acetaminophen ad libitum. Penicillin was shown to reduce fever and relieve sore throat, dysphagia, headache, abdominal pain, lethargy and anorexia significantly beyond that achieved with aspirin or acetaminophen alone. Penicillin had no effect on culture-negative cases.

The child-health nurse (pediatric nurse practitioner) in private practice. A controlled trial.

Abstract Four registered nurses who had been inactive in nursing were recruited for half-time work and were trained in a four-month program to provide well-child care and telephone-call management of general pediatric problems. During 1969, 1220 newborn infants were assigned in alternate fashion either to team care (pediatrician with trained nurse) or to pediatricians care alone. For team patients, the nurse alone conducted alternate well-child visits. Data accumulated over two years indicated (1) care by a child-health nurse and pediatrician team was of a quality equal to care by the pediatrician alone; (2) team care was acceptable to parents as well as health professionals; and (3) physicians received fewer telephone calls from team patients. On the other hand, the physicians were involved in somewhat more than the expected half of the well-child visits made by the experimental group.

A multicenter, randomized, single-blind evaluation of cefuroxime axetil and phenoxymethyl penicillin in the treatment of streptococcal pharyngitis

Ninety-three children from four pediatric practices, with clinical and bacteriologic evidence of acute Group A beta-hemolytic streptococcal pharyngitis (GABHS) randomly received cefuroxime axetil (60 cases) or phenoxymethyl penicillin (33 cases). Cefuroxime axetil was given twice daily (125 mg). Phenoxymethyl penicillin was given three times daily (250 mg). The treatment groups were similar. Throat cultures were routine 2 to 7 days after the start of therapy and 2 days and 14 days after the end of therapy. The bacterial cure rates were 85 percent (51/60) for cefuroxime axetil, and 88 percent (29/33) for phenoxymethyl penicillin treated patients. Clinical results were comparable in both treatment groups. It was concluded that cefuroxime axetil given twice daily is as effective as phenoxymethyl penicillin given three times daily in producing bacteriologic eradication and clinical symptomatic improvement in children with GABHS.

A comparison of intramuscular and oral benzathine penicillin G in the treatment of streptococcal infections in children

T HIS study was planned to determine whether the oral or the parenteral use of penicillin is superior in the treatment of beta hemolytic streptococcal infections in children. We also hoped to rind the best practical dosage schedule for oral penicillin. Because previous experience had convinced us that a single intramuscular dose of 600,000 units of benzathine penicillin G was a highly effective and practical method of therapy in these infections, ~ we compared it with the same penicillin salt in oral form.

A comparative evaluation of the safety and immunogenicity of a single dose of unbuffered oral rhesus rotavirus serotype 3, rhesus/human reassortant serotypes 1, 2 and 4 and combined (tetravalent) vaccines in healthy infants

To assess safety and immunogenicity, 213 healthy infants aged 6 weeks to 4 months were randomized to receive a single dose of placebo, a 10(4) or 10(5) p.f.u. dose of rhesus rotavirus (RRV) serotype 3, human-RRV reassortant (VP-7 serotypes 1, 2 or 4) or a 10(4) or 10(5) p.f.u. dose of tetravalent rotavirus vaccine (containing equal parts of serotype 1, 2, 3 and 4 strains). The infants were fed ad libitum before and after vaccination; no buffer was used. For 7 days after vaccination, potential vaccine side effects were monitored, and no significant differences were noted for any symptom evaluated among the single serotype, tetravalent or placebo groups. Sera, obtained before and 28 days after vaccination, were measured for antibody to rotavirus by IgG, IgA and IgM enzyme-linked immunosorbent assay in all subjects, and by neutralizing antibody to the individual serotypes by plaque reduction in placebo and tetravalent vaccinees. The serological response rates for serotypes 1, 2, 3, 4 and the tetravalent vaccine were 25, 12, 19, 11 and 22%, respectively, at 10(4) p.f.u.; 47, 50, 35, 29 and 61%, respectively, at 10(5) p.f.u.; and 37% for placebo. The tetravalent vaccine was more immunogenic at 10(5) than at 10(4) p.f.u. (p = 0.04). Grouped together, the vaccines at 10(5) p.f.u. (single serotype and tetravalent) were more immunogenic than the vaccines at 10(4) p.f.u. (38 of 85 versus 17 of 94 seroresponders; p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

THE COMPARATIVE INEFFECTIVENESS OF NAFCILLIN (A NEW ANTISTAPHYLOCOCCAL DRUG) AGAINST BETA HEMOLYTIC STREPTOCOCCAL INFECTIONS IN CHILDREN.

Nafcillin, one of the newer penicillins designed for use against penicillin‐resistant staphylococci, was compared with buffered penicillin G in the oral treatment of beta hemolytic streptococcal infections in children. Although usually effective, occasionally it was not, nor was it as reliable as buffered penicillin G for this purpose.