RESUMEN
Background: Bronchiolitis of infancy is a clinically diagnosed respiratory condition presenting with breathing difficulties, cough, poor feeding, and irritability and, in the very young, apnea. Objective: To determine the effect of cesarean section and UTI on bronchiolitis in children aged 2 months to 2 years. Design: Retrospective population-based data linkage cohort study of 202 cases in Rafic Hariri University Hospital (RHUH) and Makassed University Hospital (MUH). Methods: We reviewed retrospectively and studied prospectively the charts of the bronchiolitis hospitalized children between one month and two years in RHUH and MUH between 2011 and 2012 and continued prospectively until 2013. We studied: age, date of admission, type of delivery, gestational age, presence of UTI, screening and investigations done, related congenital diseases. The UTI is considered only when urine culture is positive. The type of delivery also mentioned. Results: Our study showed that 48% of bronchiolitis patients were born by cesarean section delivery compared with spontaneous vaginal delivery, these children had increased risk of admissions for bronchiolitis with (OR 2.71; CI 95%) and 10.16% of all patients had UTI. Conclusion: Physicians and expectant parents need to be made aware of this additional risk of elective cesarean sections and associated infant morbidity to aid in deciding the most appropriate mode of delivery. In infants and children with bronchiolitis continue to have a clinically important rate of UTIs.
RESUMEN
Objective. To study the nutritional status of children with Respiratory Syncitial virus infection. Methods. One hundred and twenty six children with acute respiratory infection, between the age of 4-24 months, were investigated for RSV infection with bronchiolitis, pneumonia and upper respiratory tract infection. Nasopharyngeal aspirates were collected and cytokine responses were determined by ELISA. Upper respiratory tract infections were detected in 16.66%, bronchiolitis in 30.15% and Pneumonia in 53.17% children. Results. Of the 126 patients, 46.66% children were positive for RSV while 58.33% were negative for RSV. Children with bronchiolitis were more commonly positive for RSV compared to URTI and pneumonia. RSV was almost equally distributed among boys (42.5%) and girls (48.7%). More children were RSV positive when the mean age lesser (8.4 mo) was compared to RSV negative (9.93 mo). Well nourished children and children with normal birth weight had more RSV positives, though not statistically significant. In a sub sample analysis of cytokines done (n=25), Interleukin-2 and Interleukin-8 levels were higher in the RSV positive children and these levels declined after 5 days of illness. Conclusions. RSV is more commonly associated with bronchiolitis in younger infants with normal birth weight or more weight for age (WFA). Proinflammatory cytokine IL-8 was secreted at high concentrations in the nasopharyngeal aspirate in all the children.