F A I Riordan

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BACKGROUND Procalcitonin (PCT), a precursor of calcitonin, is a recognised marker of bacterial sepsis, and high concentrations correlate with the severity of sepsis. PCT has been proposed as an earlier and better diagnostic marker than C reactive protein (CRP) and white cell count (WCC). This comparison has never been reported in the differentiation of(More)
Interleukin-10 (IL-10), an anti-inflammatory cytokine, was measured in 131 children with meningococcal disease. IL-10 concentrations were significantly higher in children who died and correlated positively with proinflammatory cytokines. Children who die from meningococcal disease have high IL-10 concentrations, which do not suppress proinflammatory(More)
OBJECTIVE To measure admission cortisol and adrenocorticotrophic hormone (ACTH) levels in children with meningococcal disease to try and determine the prevalence of adrenal insufficiency. DESIGN Prospective observational study. SETTING Pediatric departments of four hospitals in Merseyside, United Kingdom. PATIENTS Ninety-six children with(More)
OBJECTIVES To determine, for the last 5 years in children on Merseyside with clinical meningococcal disease (MCD), the impact on diagnostic yield of newer bacteriologic methods; bacterial antigen detection (AD) and polymerase chain reaction (PCR). METHODS Prospective data collection at Royal Liverpool Children's Hospital over two epochs: 1 September 1992(More)
BACKGROUND Endothelial damage is important in meningococcal disease. Cell adhesion molecules, including P selectin, E selectin, and intercellular cell adhesion molecule 1 (ICAM-1), are expressed by activated endothelium and then subsequently shed. METHODS ICAM-1, P selectin, and E selectin were measured on admission to hospital in children with(More)
OBJECTIVE To measure the promptness of antibiotic treatment in children with meningococcal disease. METHODS "Door to needle time" for parenteral antibiotics in children with meningococcal disease was recorded prospectively as part of a larger study. The time from arrival at hospital until the first dose of parenteral antibiotics was recorded in 100(More)
Meningococcal disease remains a major cause of death in young children. A decrease in mortality requires recognition and treatment of the disease at a number of stages in the illness. Life-threatening meningococcal disease usually presents as septicaemia rather than meningitis. The cardinal feature of meningococcal septicaemia is the purpuric rash. Many(More)