Epidemiology of hemolytic-uremic syndrome in Canadian children from 1986 to 1988, †
The Journal of PediatricsPublished 1 August 1991
Paul Rowe, Elaine Orrbine, George A. Wells, Peter N. McLaine, MEMBERSOFTHECANADIANPEDIATRIC
Citations170
SJR quartileQ1
SJR score1.01
SNIP1.11
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TL;DR
HUS is relatively common in Canadian children younger than 5 years, and is strongly associated with E. coli O157:H7 infection, and reasons for the striking regional variation in the incidence are unexplained.
Abstract
HUS is relatively common in Canadian children younger than 5 years, and is strongly associated with E. coli O157:H7 infection. Reasons for the striking regional variation in the incidence of HUS and for the increased rate of dialysis in female patients are unexplained and deserve further investigation.
Keywords
Immunology and MicrobiologyMedicineBiochemistry, Genetics and Molecular Biology
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The association of VTEC, and particularly strains of O157:H7, with haemolytic uraemic syndrome is confirmed, although over 94% of VT EC produced VT2 alone or together with VT1.
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P E. coli 0157:H7 can cause hemolytic uremic syndrome and both nonbloody and bloody diarrhea, and can spread within families and through modes other than foodborne transmission.
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127 Citations1988Kristine L. MacDonald
The E coli 0157:H7 organism is a more common pathogen in the United States than is generally recognized, and the diagnosis should be considered for patients with suspected enteric infection.
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123 Citations1980James F. Bale
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109 Citations1986W. R. Gransden, M A Damm +3 more
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100 Citations1990Susan Read, Carlton Gyles +3 more
The majority of VTEC isolates were susceptible to commonly used antimicrobial agents and a number of the serotypes of the VTEC isolate recovered have been associated with human disease; however, no VTEC of serotype O 157.H7 were isolated.
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In the authors' editorial in the Journal in 1978, Kaplan and I discussed the observations of Koster et al.2 on shigella-associated hemolytic uremic syndrome, which suggested that endotoxin damaged vascular endothelium and set in motion events leading to the full-blown syndrome.
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It is postulate that strong expression of P1 antigen may promote the binding of VT to red cells and thus reduce the dose to vulnerable nucleated cleated endothelial cells, and P1 negativity a risk factor in HUS.
Journal of the Royal Statistical Society Series B (Statistical Methodology)Numerical Results on Approximate Confidence Limits for the Odds Ratio
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American Journal of EpidemiologyTHE INCREASING INCIDENCE OF THE HEMOLYTIC-UREMIC SYNDROME IN KING COUNTY, WASHINGTON: LACK OF EVIDENCE FOR ASCERTAINMENT BIAS
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The results indicate that the increased incidence of hemolytic-uremic syndrome in childhood has been sustained in King County, Washington, and that this increase is not due to ascertainment bias caused by the diagnosis of less severely ill cases.
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In a logistic regression model, female gender emerged as the only statistically significant risk factor for haemolytic anaemia (odds ratio 3·85; 95% confidence interval 1·24–12), consistent with recent reports of a moderate increase in the risk of HUS for females.
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To develop a guide to the prognosis of children with hemolytic-uremic syndrome, the medical records of 78 patients seen at The Children's Hospital, Boston, from 1976 through 1986 were reviewed.
