Antimicrobial solutions are widely used in the nursing care of chemotherapy induced oral mucositis (OM). There is little evidence, however, supporting their use for reducing mucosal damage. In our study, 132 patients were randomized to use normal saline (n=65) or povidone-iodine diluted 1:100 (n=67) mouthwashes for OM prophylaxis and treatment after high-dose chemotherapy comprising BEAM or HD-L-PAM followed by autologous peripheral stem cell transplantation. The study groups were well balanced in respect of age, sex, chemotherapy and the number of CD34+ cells in the graft. No significant difference was found between the groups in respect of OM characteristics, fever of unknown origin (FUO) and other infections. The antimicrobial solution was less tolerable for patients. OM occurred significantly more often in females than in males (86% vs 60%, P=0.0016) and was worse and of longer duration. The mechanical effect of mouthwashes might have a certain importance in FUO prevention. When indicating oral rinses, the patient's individual preference and tolerance of solutions offered should be considered.

ABSTRACT. Objective. The hospitalization rate for bronchiolitis of any cause among US children younger than 1 year is estimated at 31.2 per 1000. No data exist on respiratory syncytial virus (RSV)-specific hospitalization rates among high-risk Native Americans other than Alaska Natives, for whom the incidence of RSV hospitalization was estimated at 150 per 1000 among infants younger than 1 year. We aimed to estimate RSV hospitalization rates among Navajo and White Mountain Apache children younger than 2 years.Methods. We conducted prospective population-level hospital-based surveillance to determine RSV hospitalization rates among Navajo and White Mountain Apache children younger than 2 years. From 1997 to 2000, all children who were admitted for acute lower respiratory tract infection between October 1 and March 31 had a nasopharyngeal aspirate obtained and tested for RSV by commercial enzyme immunoassay kits. We reviewed charts of children who tested positive for RSV antigen to determine disease severity.Results. During 3 RSV seasons (1997-2000), 51.3% of 1837 admissions for acute lower respiratory tract infection among children younger than 2 years were attributed to RSV infection. The overall seasonal RSV hospitalization rate among children younger than 2 years was 63.6 per 1000 and 91.3 per 1000 among children younger than 1 year. In a univariate analysis, predictors of severity included age <6 months (relative risk: 6.8; 95% confidence interval: 3.1-17.0).Conclusions. Navajo and White Mountain Apache children are at high risk for RSV disease requiring hospitalization. A lower threshold for hospitalization or underlying chronic conditions that predispose to severe RSV disease do not seem to explain high RSV hospitalization rates in this population. Pediatrics 2002;110(2). URL: http://www.pediatrics.org/cgi/content/full/110/2/ e20; respiratory syncytial virus, American Indian, hospitalization, lower respiratory tract infection, bronchiolitis, surveillance.ABBREVIATIONS. RSV, respiratory syncytial virus; CHD, congenital heart disease; CLD, chronic lung disease; ALRI, acute lower respiratory tract infection; IHS, Indian Health Service; NP, nasopharyngeal aspirate; JHH, Johns Hopkins Hospital; OR, odds ratio. R espiratory syncytial virus (RSV) is a leading cause of lower respiratory tract disease and hospitalization among young children throughout the world. 1,2 The rates of hospitalization for bronchiolitis of any cause among US children younger than 1 year are estimated to be between 31 and 41 per 1000 children by studies of International Classification of Diseases, Ninth Revision discharge codes. 3,4 During the past 2 decades, RSV attributable hospitalization rates among young US children have increased from 12.9 per 1000 to 31.2 per 1000. 3 Known risk factors for serious RSV infection include congenital heart disease (CHD), chronic lung disease of prematurity (CLD), prematurity, immunodeficiency, male gender, crowding, passive smoke exposure, lack of breastfeeding, 4,5-14 and low titers of passively acquire...

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