RESUMO
Bacteremia was documented in 14 of 156 previously healthy children with temperatures of at least 40.0 degrees C but without focal signs, seen in an emergency department; 116 children had malaria, and no infections were identified in 26. Concurrent malaria infection was frequent in children with bacteremia. The highly febrile child without focal signs in the tropics requires evaluation for bacteremia even when a diagnosis of malaria has been confirmed.
Assuntos
Bacteriemia/complicações , Febre de Causa Desconhecida/etiologia , Malária Falciparum/complicações , Doença Aguda , Fatores Etários , Ampicilina/administração & dosagem , Ampicilina/uso terapêutico , Anemia/etiologia , Pré-Escolar , Cloxacilina/administração & dosagem , Cloxacilina/uso terapêutico , Diagnóstico Diferencial , Infecções por Enterobacteriaceae/complicações , Feminino , Febre de Causa Desconhecida/microbiologia , Febre de Causa Desconhecida/parasitologia , Gentamicinas/administração & dosagem , Gentamicinas/uso terapêutico , Humanos , Lactente , Masculino , Nigéria , Prevalência , Estudos Prospectivos , Convulsões/etiologia , Infecções Estafilocócicas/complicaçõesRESUMO
The fatty acid composition of human milk is often used as a model for artificial feeding, but it may vary with maternal diet. We reviewed 14 studies from 9 European countries and 10 studies from 7 African countries on fatty acids in mature human milk. Considering the marked differences in methods and dietary composition in different parts of Europe and Africa, average milk fatty acid composition data are surprisingly consistent. The diet of lactating women apparently influences, to a certain extent, the milk content of saturated and monounsaturated fatty acids and linoleic acid (18:2n-6). However, different self-selected diets in different geographic locations seem to have little effect on the milk content of 20 and 22 carbon long-chain polyunsaturated fatty acids (LCP), with the exception of relatively high n-3 fatty acids in the milk of African women consuming a large proportion of dietary fat from sea fish. Even then, docosahexaenoic acid (22:6n-3), and not eicosapentaenoic acid (20:5n-3), remains the predominant n-3 LCP in milk. Rural African women consuming little animal fat tend to have high milk contents of n-6 LCP. Thus the milk secretion of n-6 LCP does not appear to depend on maternal dietary intake of preformed LCP. Metabolic processes appear to be important in regulating human milk LCP.