Background: Among hospital-acquired infections (HAIs) in children, ventilator-associated pneumonia (VAP) is the most common after blood stream infection (BSI). VAP can prolong length of ventilation and hospitalization, increase mortality rate, and directly change a patient’s outcome in Pediatric Intensive Care Units (PICU). Objectives: The research on VAP in children is limited, especially in Iran; therefore, the identification of VAP incidence and mortality rate will be important for both clinical and epidemiological implications. Materials and Methods: Mechanically ventilated pediatric patients were assessed for development of VAP during hospital course on the basis of clinical, laboratory and imaging criteria. We matched VAP group with control group for assessment of VAP related mortality in the critically ill ventilated children. Results: VAP developed in 22.9% of critically ill children undergoing mechanical ventilation. Early VAP and late VAP were found in 19.3% and 8.4% of VAP cases, respectively. Among the known VAP risk factors that were investigated, immunodeficiency was significantly greater in the VAP group (p = 0.014). No significant differences were found between the two groups regarding use of corticosteroids, antibiotics, PH (potential of hydrogen) modifying agents (such as ranitidine or pantoprazole), presence of nasogastric tube and total or partial parenteral nutrition administration. A substantial number of patients in the VAP group had more than four risk factors for development of VAP, compared to those without VAP (p = 0.087). Mortality rate was not statistically different between the VAP and control groups (p = 0.477). Conclusion: VAP is still one of the major causes of mortality in PICUs. It is found that altered immune status is a significant risk factor for acquiring VAP. Also, occurrence of VAP was high in the first week after admission in PICU.
Introduction:The present study was connected in order to evaluate the relationship between biological, cognitive and psychosocial characteristics of mothers and the weight of infant at the time of birth.Materials and Methods:In order to conduct this research a sample of 910 women among recently delivered mothers of Isfahan province in 2009 were selected. From stratified sampling and cluster sampling according to the percentage of population in each of the cities of Isfahan Province was used. The data was gathered with a questionnaire prepared by the researcher in order to evaluate the biological cognitive and psychosocial characteristics of mothers, in addition to the Enrich marital satisfaction test. After collecting data, the analysis of the data was done with SPSS software in two categories of descriptive and inferential statistics by using logistic regression model.Results:The results showed that the prevalence of low weight infants was 9.5 percent and 38.7 percent of pregnancies was unwanted. Twenty-nine percent of mothers had marital dissatisfaction. 15/6 percent of pregnancies were below 20 years old and 22 percent was above of 35 years old. 38.9 percent of mothers were exposed to cigarette smoke. The average of weight gain during pregnancies was 9 kilograms. Thirty three percent of mothers had high blood pressure during pregnancy, 26.7 percent had history of abortion and 31.9 percent had history of bleeding. 23/1percent of women was employed during pregnancy, 19.8 percent gave twin birth and 21/1 percent of parents were relative of each other, 29.7 percent of deliveries were done in cesarean way.Conclusion:The results of this study showed that severe marital dissatisfaction, abnormal blood pressure during pregnancy, being employed during pregnancy, weight gain less than 5 Kg during pregnancy, pregnancy below the age of 20 can meaning fully increase the possibility of low birth weight in infant (α=0.05). The results were consisting with the previous findings and indicated that some of the applicable benefits of this research can be recording of information about each delivery in the whole country with holding training workshops of before and during pregnancy skills by welfare organization.
Background: Critically ill children at the intensive care unit frequently develop hospital-acquired pneumonia (HAP). Human herpes viruses (HHVs), primarily or by reactivation may cause bronchopneumonitis in mechanically ventilated patients. The exact prevalence and role of HHVs in morbidity and mortality of pediatric patients undergoing mechanical ventilation is unclear. The current study was conducted to evaluate the prevalence of 5 Herpes viruses by polymerase chain reaction (PCR) method in bronchoalveolar lavage (BAL) samples in critically ill children at a pediatric intensive care unit (PICU). Methods: Overall, 140 bronchoalveolar lavage samples from 83 mechanically ventilated cases were studied. Samples were taken via the mini-BAL technique. Samples were analyzed by qualitative PCR for detection of herpes simplex virus type 1 and 2 (HSV1/HSV2), human herpes virus type 6 and 7 (HHV6/HHV7), Ebstein-Barr virus (EBV), and cytomegalovirus (CMV).
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