Risk factors for severe bronchiolitis caused by respiratory virus infections among Mexican children in an emergency department.

Severe bronchiolitis is the most common reason for hospitalization among children younger than 2 years. This study analyzed the prevalence of community-acquired respiratory virus infection and the risk factors for hospitalization of Mexican children with severe bronchiolitis treated in an Emergency department.This retrospective study included 134 children 2 years or younger with severe viral bronchiolitis, and 134 healthy age-matched controls. The study period was September 2012 to January 2015. We determined the viral etiology and coinfections with multiple viruses and compared the risk factors detected in children with severe viral bronchiolitis with those in the control group.A total of 153 respiratory viruses in these 134 patients, single or mixed infections, were identified: respiratory syncytial virus (RSV) type A or B was the most frequently detected (23.6% and 17.6%, respectively), followed by rhinovirus (RV; 16.3%) and parainfluenza virus (PIV) type 3 (12.4%). Coinfections of 2 respiratory viruses were found in 14.2% of cases; all cases had either RSV type A or B with another virus, the most common being parainfluenza virus or rhinovirus. Exposure to cigarette smoking was independently associated with hospitalization for severe bronchiolitis (OR, 3.5; 95% CI, 1.99-6.18; P = .0001), and having completed the vaccination schedule for their age was a protective factor against adverse outcome (OR, 0.55; 95% CI, 0.35-0.87; P = .010).RSV is a common infection among young children with severe bronchiolitis; thus, developing a vaccine against RSV is essential. Campaigns to reinforce the importance of avoiding childhood exposure to cigarette smoke are also needed.

[Prevalence of vitamin D insufficiency and deficiency in Mexican adults with allergic asthma]. / Prevalencia de insuficiencia y deficiencia de vitamina D en adultos mexicanos con asma alérgica.

BACKGROUND: Hypovitaminosis D has been associated with various chronic diseases such as infections, autoimmune diseases, chronic obstructive pulmonary disease, cancer and asthma Objective: The objective at hand is to determine the prevalence of vitamin D (VD) insufficiency and deficiency in adults with allergic asthma. OBJECTIVE: Objective: The objective at hand is to determine the prevalence of vitamin D (VD) insufficiency and deficiency in adults with allergic asthma. METHODS: Through a cross-sectional study, we analyzed corresponding data amongst 135 patients. VD concentration was categorized as sufficient (≥ 30 ng/mL), insufficient (21-29 ng/mL), and deficient (≤ 20 ng/mL). The level of VD deficiency was measured through chemo-luminescence. We estimated the prevalence of VD alterations and their respective confidence intervals at 95 % (CI 95 %). RESULTS: Within the analyzed population, there were 99/135 women (73.3 %); the mean age was 34.5 ± 10.3 years. The mean concentration of VD was 17.9 ± 6.9 ng/mL and the median was 17 ng/mL. The prevalence of VD insufficiency and deficiency was 25.2 % (CI 95 %, 18.6-33.2 %) and 71.1 % (CI 95 %, 62.9-78.1 %), respectively; VD concentrations ≤ 10 ng/mL had 13.3 % (CI 95 %, 8.5-20.2 %) and ≥ 30 ng/mL at 3.7 % (CI 95 %: 1.4-8.6 %). When we contrasted the men to the women, the median concentration of VD did not differ significantly (16 ng/mL vs. 18 ng/mL, p = 0.71). CONCLUSION: In this study, patients with allergic asthma had distinctively reduced VD concentration levels; future research will determine if and how VD affects the severity of asthma.

Antecedentes: La hipovitaminosis D ha sido asociada con diversas enfermedades crónicas como infecciones, enfermedades autoinmunes, enfermedad pulmonar obstructiva crónica, cáncer y asma. Objetivo: Determinar la prevalencia de insuficiencia y deficiencia de vitamina (VD) en adultos con asma alérgica. Métodos: Estudio transversal en el que se analizaron los datos de 135 pacientes. La concentración de VD fue categorizada en suficiente (≥ 30 ng/mL), insuficiente (21-29 ng/mL) y deficiente (≤ 20 ng/mL). La concentración de VD se midió por quimioluminiscencia. Se estimaron las prevalencias de las alteraciones de la VD y sus respectivos intervalos de confianza a 95 % (IC 95 %). Resultados: En la población analizada, 99 fueron mujeres (73.3 %), con edad media de 34.5 ± 10.3 años. La concentración media de VD fue 17.9 ± 6.9 ng/mL (mediana de 17 ng/mL). La prevalencia de insuficiencia y deficiencia de VD fue de 25.2 % (IC 95 %, 18.6-33.2 %) y 71.1 % (IC 95 %, 62.9-78.1 %), respectivamente; las concentraciones de VD ≤ 10 ng/mL representaron 13.3 % (IC 95 %, 8.5-20.2 %) y ≥ 30 ng/mL, 3.7 % (IC 95 %, 1.4-8.6 %). Al contrastar hombres y mujeres, la concentración mediana de VD no difirió significativamente (16 ng/mL versus 18 ng/mL, p = 0.71). Conclusiones: En este estudio, los pacientes con asma alérgica tuvieron concentraciones de VD notoriamente disminuidas. Con futuras investigaciones se podrá evaluar el papel de la VD en la gravedad del asma.

Descriptive study of the complete blood count in newborn infants with Down syndrome.

The usefulness of the complete blood count (CBC) during the first week of life in infants with Down syndrome (DS) has been recognized; however, studies are limited and have evaluated only some of the parameters of the CBC. Here, we report a prospective study of 135 infants with cytogenetically confirmed DS and a reference group of 226 infants without birth defects all born during the period 2009-2015 at the Dr. Juan I. Menchaca Civil Hospital of Guadalajara (Guadalajara, Mexico). The goal was to evaluate hematological findings in the CBC during the first 7 days of life, interpreted according to gestational and postnatal age. Data were analyzed using multivariate logistic regression analysis expressed as adjusted odds ratio (aORs) with 95% confidence intervals (95% CIs). Infants with DS had a significantly higher risk for polycythemia (aOR = 12.4, 95% CI: 4.6-33.3), macrocytosis (aOR = 15.9, 95% CI: 1.8-143.4), high values of mean corpuscular hemoglobin (aOR = 36.4, 95% CI: 4.5-294.9), anisocytosis (red blood cells of unequal size) (aOR = 3.9, 95% CI: 2.1-7.6), thrombocytopenia (aOR = 32.4, 95% CI: 15.2-68.9), white blood cell (WBC) count ≥30 × 103 /µl (aOR = 19.4, 95% CI: 4.1-91.5), lymphocytosis (aOR = 73.3, 95% CI: 9.5-565.4), and basophilia (aOR = 16.8, 95% CI: 1.9-151.5). Overall, 74% of infants with DS in our study had polycythemia, thrombocytopenia, WBC count >30 × 103 /µl, or lymphocytosis (aOR = 35.6, 95% CI: 18.8-79.2). Compared with those in other studies, our infants with DS had distinctive hematological findings including a lower frequency of thrombocytopenia, infrequent neutrophilia, and frequent lymphocytosis and neutropenia. This suggests ethnic, socioeconomic, or nutritional differences. © 2017 Wiley Periodicals, Inc.

Extracutaneous sporotrichosis in a patient with liver cirrhosis.

We report an unusual case of disseminated cutaneous sporotrichosis with oral mucous and tracheal involvement in a forty-year-old male with a history of heavy drinking and liver cirrhosis. We also review the literature and other similar published cases.

Extracutaneous sporotrichosis in a patient with liver cirrhosis

Se presenta el caso clínico de un paciente de 40 años de edad conantecedente de alcoholismo intenso y cirrosis hepática que desarrolloesporotricosis cutánea diseminada con afectación a mucosa oral y tráquea.Se comenta la literatura correspondiente(AU)

We report an unusual case of disseminated cutaneous sporotrichosis with oralmucous and tracheal involvement in a forty-year-old male with a history ofheavy drinking and liver cirrhosis. We also review the literature and othersimilar published cases(AU)