Clinical progression of incidental tomographic findings in paranasal sinuses of asymptomatic individuals: cohort study

Objective: To determine whether the presence of opacification in the paranasal sinuses of children and adolescents without rhinosinusitis implies an increased risk of later development of upper respiratory tract symptoms. Methods: This was a prospective study of a cohort of patients aged 0 to 18 years who underwent computerized tomography (CT) scans for indications unrelated to rhinosinusitis. Sinus opacification was evaluated using an opacification/development ratio score. The patients' clinical progression was followed up using a questionnaire for 1 month after the scans. Results: Fifty-six percent (56%) of the 106 patients enrolled in the study had opacity, the majority due to mucosal thickening. Intense opacification was defined as "suspected" (score >= 15) and patients in this subset had a greater risk of developing symptoms during follow-up (odds ratio = 2.74; 95% CI 1.10-6.83) compared to those with no findings or discrete findings. Conclusions: Intense incidental sinus opacity on CT indicates a risk of future development of a clinical respiratory condition.87543343

Genotypes and Clinical Data of Respiratory Syncytial Virus and Metapneumovirus in Brazilian Infants: A New Perspective

The aim of this study was to determine if there was a correlation between respiratory syncytial virus (RSV) and metapneumovirus (MPV) genotypes and clinical data of Brazilian infants hospitalized for acute lower respiratory infection. The viruses in the patients' nasopharyngeal secretions were studied using the polymerase chain reaction and phylogenetic analysis. The study assessed 144 infants; 31.9% were RSV positive and 5.6% were MPV positive. Statistical analysis was performed using the chi-squared test, Fisher's test, Odds ratio, univariate logistic regression, non-conditional multivariate logistic regression and the forward - stepwise method. Multivariate analysis confirmed a significant relationship between a positive PCR test for RSV and hospitalization during the month of May and with pulse oximetry less than 90%. The phylogenetic analysis indicated the genotypes GA2, GA5, SAA1 (Group A), SAB1, SAB3 and BA (Group B) for RSV and Group B, subgroup B1, for MPV.131353

Variant isolates of human metapneumovirus subgroup B genotype 1 in Campinas, Brazil

Background: Human metapneumovirus (HMPV) is a paramyxovirus associated with respiratory illness. The genotypes of HMPV isolates in Brazil have not been well characterized. Objectives: To investigate the presence of HMPV in clinical samples collected from pediatric patients of two university hospitals in the region of Campinas (Sao Paulo, Brazil) and to genotype them by partial sequencing of the HMPV F gene. Study design: Nasopharyngeal aspirates were collected from children hospitalized between April and September, 2004 because of acute respiratory infections (ARI). Results: We identified HMPV in 8 of 142 (5.6%) clinical samples. We determined through phylogenetic analysis that HMPV isolates in Campinas during the study were clustered within subgroup B genotype 1. Two of the isolates analyzed showed significant differences from previously isolated B I viruses, when compared to HMPV isolated in South Africa and,Canada, and clustered in a separate branch within this genotype. Conclusions: In 2004 in our geographic region all HMPV isolates from pediatric patients were in the B I HMPV genetic group, with two variant isolates. (c) 2007 Elsevier B.V. All rights reserved.421788

Clinical Features and Outcome of Children and Adolescents Hospitalized with Influenza A (H1N1) Virus Infection Compared with Flu-Like Symptoms and Negative Rapid Tests for Influenza A (H1N1) Admitted in the Same Period of Time

This report describes the clinical features and outcome of 61 pediatric hospitalized patients with influenza-like infection. Fever, cough and respiratory distress were the most common symptoms of the infection. Fifteen patients presented positive RT-PCR results for influenza A (H1N1). The group with positive results was compared with the negative one. The main significant difference was antibiotic usage and the need of mechanical ventilation in the patients with H1N1-virus infection. Among the 11 patients who required intensive care due to respiratory failure, 3 from the positive group died and none from the negative group.57648148

Children and adolescents deaths from trauma-related causes in a Brazilian City

Introduction: Injury is the first cause of death worldwide in the population aged 1 to 44. In developed countries, the most common trauma-related injuries resulting in death during childhood are traffic accidents, followed by drowning. Methods: This retrospective study based on autopsy examinations describes the epidemiology profile of deaths by trauma-related causes in individuals younger than 18 years from 2001 to 2008 in the city of Campinas. The aim is to identify epidemiology changes throughout the years in order to develop strategies of prevention. Results: There were 2,170 deaths from all causes in children < 18 years old, 530 of which were due to trauma-related causes, with a male predominance of 3.4:1. The age distribution revealed that 76% of deaths occurred in the 10-17 age group. The most predominant trauma cause was firearm injury (47%). Other frequent causes were transport-related injuries (138 cases-26%; pedestrians were struck in 57.2% of these cases) and drowning (55 cases-10.4%). Asphyxia/suffocation was the cause of death in 72% of cases in children < 1 year old; drowning (30.8%) was predominant in the 1-4 age group; transport-related deaths were frequent in the 5-9 age group (56%) and the 10-14 age group (40.4%). Gun-related deaths were predominant (68%) in the 14-17 age group. 51% of deaths occurred at the scene. Conclusions: There was a predominance of deaths in children and adolescents males, between 15-17 years old, mainly from gun-related homicides, and the frequency has decreased since 2004 after the disarmament statute and the combating of violence.