ABSTRACT
OBJECTIVES: To determine the viruses and risk factors associated with hospital and intensive care unit (ICU) admissions in infants with acute bronchiolitis. INTRODUCTION: Bronchiolitis is a major cause of morbidity in infants. Widespread use of molecular-based methods has yielded new insights about its etiology, but the impact of viral etiologies on early outcomes is still unclear. METHODS: Seventy-seven infants with bronchiolitis who were under two years of age and visited an emergency unit were included. Using molecular-based methods, samples were tested for 12 different respiratory viruses. Logistic regression models were used to identify clinical and virological variables associated with the main endpoints: hospital admission and ICU admission. RESULTS: We identified at least one virus in 93.5 percent of patients, and coinfections were found in nearly 40 percent of patients. RSV was the most common pathogen (63.6 percent), followed by rhinovirus (39 percent). Identification of RSV was only associated with an increased risk of hospital admission in the univariate model. Younger age and enterovirus infection were associated with an increased risk of hospital admission, while atopy of a first-degree relative showed a protective effect. Prematurity was associated with an increased risk of admission to the ICU. Coinfections were not associated with worse outcomes. CONCLUSIONS: Molecular-based methods resulted in high rates of viral identification but did not change the significant role of RSV in acute bronchiolitis. Younger age and enterovirus infection were risk factors for hospital admission, while prematurity appeared to be a significant risk factor for admission to the ICU in acute viral bronchiolitis.
Subject(s)
Female , Humans , Infant , Male , Bronchiolitis, Viral/virology , Acute Disease , Brazil , Bronchiolitis, Viral/complications , Cohort Studies , Enterovirus/isolation & purification , Hospitalization , Intensive Care Units, Pediatric , Logistic Models , Polymerase Chain Reaction , Prospective Studies , Picornaviridae Infections/complications , Picornaviridae Infections/virology , Risk Factors , Respiratory Syncytial Viruses/isolation & purification , Rhinovirus/isolation & purificationABSTRACT
Objetivo: avaliar os mecanismos fisiopatológicos e evidências da associação entre doenças pulmonares e doença do refluxo gastroesofágico (DRGE), além de analisar criticamente os métodos diagnósticos e as opções terapêuticas para a DRGE / Objective: to evaluate pathophysiologic mechanism and evidences of the relationship between gastroesophageal reflux disease (GERD) and pulmonary diseases, as well as critically analyze diagnostic methods and therapeutic options for GERD. Data source: related articles published up to now were selected by searching MEDLINE, LILACS and COCHRANE databases reviews...
Subject(s)
Male , Female , Humans , Asthma/complications , Pulmonary Disease, Chronic Obstructive/complications , Gastroesophageal Reflux/etiology , Child , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/diagnosisABSTRACT
Cystic fibrosis is a genetic disease usually diagnosed by abnormal sweat testing. We report a case of an 18-year-old female with bronchiectasis, chronic P. aeruginosa infection, and normal sweat chloride concentrations who experienced rapid decrease of lung function and clinical deterioration despite treatment. Given the high suspicion ofcystic fibrosis, broad genotyping testing was performed, showing a compound heterozygous with deltaF508 and 3849+10kb C->T mutations, therefore confirming cystic fibrosis diagnosis. Although the sweat chloride test remains the gold standard for the diagnosis of cystic fibrosis, alternative diagnostic tests such as genotyping and electrophysiologic measurements must be performed if there is suspicion of cystic fibrosis, despite normal or borderline sweat chloride levels