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Acute Respiratory Infections (acute + respiratory_infections)
Selected AbstractsIncidence of acute respiratory infections and the relationship with some factors in infancy in Antalya, TurkeyPEDIATRICS INTERNATIONAL, Issue 1 2002Nilay Etiler Abstract Background: Acute respiratory infections (ARI) are one of the major problems of childhood in developing countries. The objective of the study was to obtain the incidence of ARI and its risk factors in Antalya, Turkey. Methods:,We carried out a prospective cohort study on 204 infants who were born between 1 November and 31 December 1997, in the area of two primary health-care units in the Antalya city center. The research group was followed periodically every 2 months by home visits and the infants were investigated to determine their symptoms of ARI. The weight and length of children were measured in every home visit. Additional questions about socioeconomic status, some environmental characteristics, and nutrition practice were asked. Data were entered into the computer and the Z -scores were calculated by the Epi Info 5 package program. The incidence rates, relative risks and confidence intervals were calculated by Microsoft Excel version 5.0 program. Results:,The incidence of ARI was 6.53 episodes per child per year among the children in the research group. The factors that influenced the incidence of ARI were lack of mother's and father's education, heating by wood stove, being a low-birthweight infant, not being completely breast-fed in the first 4 months of life and being stunted. There were no associations between the number of persons per room or smoking status of family members with ARI incidence. Conclusion:,Our results demonstrated that ARI were also associated with some socioeconomic, environmental and nutritional status characteristics such as paternal education, house ownership, breast-feeding, stunting, prematurity and burning of biomass fuels in Turkey. [source] Setting up an early warning system for epidemic-prone diseases in Darfur: a participative approachDISASTERS, Issue 4 2005Augusto Pinto Abstract In April,May 2004, the World Health Organization (WHO) implemented, with local authorities, United Nations (UN) agencies and non-governmental organisations (NGOs), an early warning system (EWS) in Darfur, West Sudan, for internally displaced persons (IDPs). The number of consultations and deaths per week for 12 health events is recorded for two age groups (less than five years and five years and above). Thresholds are used to detect potential outbreaks. Ten weeks after the introduction of the system, NGOs were covering 54 camps, and 924,281 people (IDPs and the host population). Of these 54 camps, 41 (76%) were reporting regularly under the EWS. Between 22 May and 30 July, 179,795 consultations were reported: 18.7% for acute respiratory infections; 15% for malaria; 8.4% for bloody diarrhoea; and 1% for severe acute malnutrition. The EWS is useful for detecting outbreaks and monitoring the number of consultations required to trigger actions, but not for estimating mortality. [source] Human metapneumovirus in hospitalized children in Amman, JordanJOURNAL OF MEDICAL VIROLOGY, Issue 6 2010Syed Asad Ali Abstract Human metapneumovirus (HMPV) has recently been identified as an important cause of acute respiratory infections (ARI) in children worldwide. However, there is little systematic data on its frequency and importance as a cause of ARI in the Middle East. We conducted a viral surveillance study in children <5 years of age admitted with respiratory symptoms and/or fever at two major tertiary care hospitals in Amman, Jordan from 1/18-3/29/07. Nose and throat swabs were collected and tested for HMPV and other respiratory viruses by real-time RT-PCR. A total of 743 subjects were enrolled. Forty-four (6%) subjects were positive for HMPV, 467 (64%) were positive for RSV and 13 (1.3%) had co-infection with both HMPV and RSV. The frequency of HMPV in January, February, and March was 4.1%, 3.0%, and 11.9% respectively. Clinical features associated with HMPV infection were similar to those of other respiratory viruses, except children with HMPV were more likely to present with fever than children not infected with HMPV. Children with HMPV and RSV co-infection were administered supplemental oxygen and were admitted to the ICU more frequently than children infected with HMPV alone or RSV alone, though these differences did not reach statistical significance. We conclude that HMPV is an important cause of acute respiratory infections in children in Amman, Jordan. Longer surveillance studies are needed to better understand the seasonal epidemiology of HMPV and to assess if co-infection with HMPV and RSV leads to more severe illness. J. Med. Virol. 82:1012,1016, 2010. © 2010 Wiley-Liss, Inc. [source] Home care for chronic respiratory failure in children: 15 years experiencePEDIATRIC ANESTHESIA, Issue 4 2002L. APPIERTO MD Background:,Advances in paediatric intensive care have reduced mortality but, unfortunately, one of the consequences is an increase in the number of patients with chronic diseases. It is generally agreed that home care of children requiring ventilatory support improves their outcomes and results in cost saving for the National Health Service. Methods:,Since 1985, the Children's Hospital Bambino Gesù of Rome has developed a program of paediatric home care. The program is performed by a committed Home Health Care Team (HHCT) which selects the eligible patients for home care and trains the families to treat their child. During the period January 1985 to January 2001, 53 children with chronic respiratory failure were included in the home care program. Of these, seven patients were successively excluded and six died in our intensive care unit (ICU), while one still lives in our ICU since 1997. The results obtained in the remaining 46 children are reported. Results:,The pathologies consisted of disorders of respiratory control related to brain damage (26%), upper airways obstructive disease (26%), spinal muscular atrophy (22%), myopathies and muscular dystrophies (6.5%), bronchopulmonary dysplasia (6.5%), tracheomalacia (6.5%), central hypoventilation syndrome (4.3%) and progressive congenital scoliosis (2.2%). Of these 46 patients, 34 children are mechanically ventilated and the median of their ICU stay was 109.5 days (range 54,214 days), while the remaining 12 children were breathing spontaneously and the median of their ICU stay was 90.5 days (range 61,134 days). We temporarily readmitted six patients to our ICU to perform scheduled otolaryngological surgery, eight patients for acute respiratory infections and two patients for deterioration of their neurological status due to high pressure hydrocephalus for placement of a ventriculoperitoneal shunt; these 16 patients were discharged back home again. Two other patients were readmitted for deterioration of their chronic disease and died in our ICU, while seven patients died at home. Conclusions:,Thirty-seven children are still alive at home and four of them improved their respiratory condition so that it was possible to remove the tracheostomy tube. Our oldest patient has now achieved 15 years of mechanical ventilation at home. [source] Use of intrapulmonary percussive ventilation (IPV) in the management of pulmonary complications of an infant with osteogenesis imperfectaPEDIATRIC PULMONOLOGY, Issue 11 2009Gustavo Nino MD Abstract Osteogenesis imperfecta (OI) is a genetic disorder characterized by abnormal collagen formation and short stature. These patients present with frequent vertebral, rib, and long bone fractures. There are many respiratory complications associated with OI including pneumonia, the most common cause of mortality in the severe forms of the disease. We present a case of an infant with OI (type III/IV) and significant tracheobronchomalacia who had required multiple hospitalizations for recurrent atelectasis and respiratory failure in the setting of acute respiratory infections. External chest percussion and vibration were avoided because of the risk of rib fractures. intrapulmonary percussive ventilation (IPV) was initiated during an acute illness with good effect, and continued successfully after discharge from hospital. We conclude that IPV represents a safe and effective alternative to airway clearance in infants with OI. Pediatr Pulmonol. 2009; 44:1151,1154. ©2009 Wiley-Liss, Inc. [source] Adenovirus infections within a family cohort in Iran,PEDIATRIC PULMONOLOGY, Issue 8 2009Mohammadreza Naghipour PhD Abstract Background Adenovirus is one of the most frequent viruses associated with acute respiratory infections (ARI). There is limited information of its transmission within the community. Methods Cohorts of 50 families with ,two children were visited weekly for 2 months to ascertain the presence ARI in Rasht, Iran. Nasopharyngeal swabs were obtained from symptomatic participants and at 3,4-day intervals to assess the duration of adenovirus shedding. Adenoviruses were identified by PCR and adenovirus positive amplicons were subjected to DNA sequencing. Results Thirty-three (35%) of 94 ARI episodes in children and 8 (27%) of 30 episodes in adults were due to adenovirus (not significant, NS). 25/50 (50%) families had adenovirus infections. Children had more infections than adults, were more likely to develop symptoms if there was a symptomatic case within the household and episodes had a longer duration (P,<,0.05). Adenoviruses were recovered for a median of 11 (interquartile range 5,26) days of follow up in children and 7 (2,20) days in adults (NS). Adenovirus-7 was the most frequent serotype (12 families), followed by adenovirus-6 (5 families), adenovirus-1 and 2 (4 families each), and adenovirus-5 (3 families). Both adenovirus-5 and 7 amplicons fell into two clusters. No mutations were observed during transmission within a family. Conclusion A substantial proportion of ARI in the community are due to adenovirus with further transmission within the family. Children ,2 years experienced a higher proportion of infections than younger children and adults. Viral shedding was more prolonged in children and adenovirus-7 and 5 predominated with several clusters co-circulating in the same season. Pediatr Pulmonol. 2009; 44:749,753. © 2009 Wiley-Liss, Inc. [source] Incidence of acute respiratory infections and the relationship with some factors in infancy in Antalya, TurkeyPEDIATRICS INTERNATIONAL, Issue 1 2002Nilay Etiler Abstract Background: Acute respiratory infections (ARI) are one of the major problems of childhood in developing countries. The objective of the study was to obtain the incidence of ARI and its risk factors in Antalya, Turkey. Methods:,We carried out a prospective cohort study on 204 infants who were born between 1 November and 31 December 1997, in the area of two primary health-care units in the Antalya city center. The research group was followed periodically every 2 months by home visits and the infants were investigated to determine their symptoms of ARI. The weight and length of children were measured in every home visit. Additional questions about socioeconomic status, some environmental characteristics, and nutrition practice were asked. Data were entered into the computer and the Z -scores were calculated by the Epi Info 5 package program. The incidence rates, relative risks and confidence intervals were calculated by Microsoft Excel version 5.0 program. Results:,The incidence of ARI was 6.53 episodes per child per year among the children in the research group. The factors that influenced the incidence of ARI were lack of mother's and father's education, heating by wood stove, being a low-birthweight infant, not being completely breast-fed in the first 4 months of life and being stunted. There were no associations between the number of persons per room or smoking status of family members with ARI incidence. Conclusion:,Our results demonstrated that ARI were also associated with some socioeconomic, environmental and nutritional status characteristics such as paternal education, house ownership, breast-feeding, stunting, prematurity and burning of biomass fuels in Turkey. [source] Antibiotic Prescriptions Are Associated with Increased Patient Satisfaction With Emergency Department Visits for Acute Respiratory Tract InfectionsACADEMIC EMERGENCY MEDICINE, Issue 10 2009Cordelia R. Stearns Abstract Objectives:, Health care providers cite patient satisfaction as a common reason for prescribing antibiotics for viral acute upper respiratory infections (URIs), even though quality performance measures emphasize nonantibiotic treatment for these conditions. In a secondary analysis of a cluster-randomized trial to test a combined patient and physician educational intervention to reduce antibiotic prescribing for URIs, the authors examined whether satisfaction is greater among patients diagnosed with URIs who are prescribed antibiotics in emergency department (ED) settings. Methods:, This was a follow-up telephone survey of 959 patients who received care for acute respiratory infections at any of eight Veterans Administration (VA) hospital EDs or eight location-matched non-VA hospital EDs around the United States. Patients reported their satisfaction with the amount of time spent in the ED, the explanation of treatment, the provider treatment, and overall satisfaction on a five-point Likert scale. The primary measure of effect was the association between antibiotic prescription and visit satisfaction, adjusted for patient and visit characteristics. Results:, Antibiotic treatment was significantly associated with increased overall visit satisfaction in non-VA EDs (adjusted odds ratio [OR] = 1.97, 95% confidence interval [CI] = 1.23 to 3.17), but not VA EDs (adjusted OR = 1.13, 95% CI = 0.81 to 1.58). Patients managed in non-VA EDs who received antibiotics were also significantly more likely to be satisfied with the explanation of treatment and the manner in which they were treated by the provider. Conclusions:, Antibiotic prescriptions are associated with increased overall patient satisfaction in non-VA, but not VA, ED visits for URIs. Continued efforts to reduce unnecessary prescriptions in these settings must address ways to maintain patient satisfaction and still reduce antibiotic prescriptions. [source] | ||||||||||