Objective To evaluate the role of Doppler ultrasonography in the assessment of splanchnic circulation's hemodynamic changes in septic preterms at risk of necrotizing enterocolitis. Methods A total of 51 septic preterms were divided into two groups: 25 preterms with clinical signs of necrotizing enterocolitis (NEC) and 26 preterms with no clinical signs of NEC. Both groups were assessed with Doppler ultrasonography of the celiac and superior mesenteric arteries, and each septic preterm's peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI), and pulsatility index (PI) was calculated and recorded. Results These included a statistically significant lower PSV (p: 0.001) and a lower EDV (p: 0.001) in the superior mesenteric artery in the septic group with clinical signs of NEC in comparison with the septic group with no clinical signs of NEC. A statistically significant (p \ 0.001) higher PSV celiac (CA)/PSV superior mesenteric (SMA) ratio was found for the group of septic preterms with clinical signs of NEC when compared to the other group. Conclusion The study results showed that Doppler ultrasonography of the splanchnic circulation can be a tool for the early identification of NEC cases among septic preterms.Keywords Doppler ultrasonography Á Splanchnic circulation Á Sepsis Á Preterms Á NEC Sommario Obiettivo valutare il ruolo del Doppler nella valutazione dei cambiamenti emodinamici del circolo splancnico in pz pretermine settiche e a rischio di enterocolite necrotizzante. Metodi 51 pazienti pretermine settiche divise in due gruppi sia con segni clinici di enterocolite necrotizzante (NEC) o asintomatiche, entrambi valutati con Doppler a ultrasuoni delle arterie celiaca e mesenterica superiore, con velocità di picco sistolico (PSV), fine della velocità diastolica (EDV), indice di resistività (RI), indice di pulsatilità (PI) il calcolo e la registrazione. Risultati il più basso PSV è risultato statisticamente significativo (p: 0.001), il valore inferiore di EDV (p: 0.001) campionati a livello dell'arteria mesenterica superiore nel gruppo settico con segni clinici di NEC, a confronto con il gruppo delle settiche senza segni clinici di NEC. Statisticamente significativa (p \ 0.001) l'aumento del rapporto PSV celiaco (CA)/PSV a livello della mesenterica superiore (SMA) nel gruppo di sepsi con segni clinici di NEC in confronto con l'altro gruppo. Conclusione I risultati dello studio hanno mostrato che il Doppler del circolo splancnico può essere uno strumento di identificazione precoce dei casi NEC tra le pazienti pretermine settiche.

Background and aimRespiratory syncytial virus (RSV) is one of the most important causes of acute lower respiratory tract infections (ALRTI) in infants and young children. This study was conducted to describe the epidemiology of ALRTI associated with RSV among children ≤ 5 years old in Egypt.Patients and MethodsWe enrolled 427 children ≤ 5 years old diagnosed with ALRTI attending the outpatient clinic or Emergency Department (ED) of Children Hospital, Cairo University during a one- year period. Nasopharyngeal aspirates were obtained from the patients, kept on ice and processed within 2 hours of collection. Immunoflourescent assay (IFA) for RSV was performed.Results91 cases (21.3%) had viral etiology with RSV antigens detected in 70 cases (16.4%). The RSV positive cases were significantly younger than other non-RSV cases (mean age 8.2 months versus 14.2 months, p <0.001). RSV cases had significantly higher respiratory rate in the age group between 2-11 months (mean 58.4 versus 52.7/minute, p < 0.001) and no significant difference in the mean respiratory rate in the age group between 12-59 months. More RSV cases required supplemental oxygen (46% versus 23.5%, p < 0.001) with higher rate of hospitalization (37.1% versus 11.2%, p < 0.001) than the non-RSV cases. 97% of RSV cases occurred in winter season (p < 0.001).ConclusionRSV is the most common viral etiology of ALRTI in children below 5 years of age, especially in young infants below 6 months of age. It is more prevalent in winter and tends to cause severe infection.

Objectives: To evaluate the effectiveness of high-dose erythromycin to treat feeding intolerance in preterm infants predominantly fed milk formula. Design: This study is a prospective randomized controlled trial on 60 premature infants suffering from feeding intolerance. Thirty infants were given oral erythromycin ethylsuccinate at a dose of 50 mg/kg/day for 10 days or until they reached full enteral feeds. Randomization was stratified according to gestational age <32 weeks or ≧32 weeks gestation. The primary end point was the time taken to establish full enteral feeding since enrollment. Potential adverse effects associated with erythromycin were also monitored. Student’s t test was used for comparison of continuous variables and χ²for categorical data. Results: In infants <32 weeks, the use of erythromycin was associated with more daily weight gain (12.8 ± 2.6 g vs. 9.2 ± 5.3 g, p = 0.04) compared to the control group. Time to reach full feed did not differ between the erythromycin (13.8 ± 3.9 days) and the control (17.46 ± 4.9 days) groups (p = 0.07). In infants ≧32 weeks, there were no differences between the erythromycin and the control groups. Conclusion: High-dose erythromycin is associated with greater weight gain in preterm infants <32 weeks gestational age, who are predominantly fed cow’s milk-based protein formulas.

Introduction: Personal digital assistants (PDAs) used in electronic laboratory-based surveillance are a promising alternative to conventional surveillance to detect healthcare-associated infections (HAIs). The aim of the study was to monitor, detect, and analyze HAIs using PDAs in a neonatal intensive care unit (NICU). Methodology: In this descriptive study, 1,053 neonates admitted to the NICU in the obstetrics and gynecology ward at the Cairo University hospital were included and evaluated for HAIs by collecting data using PDAs programmed by Naval Medical Research Unit 3, Cairo, with the definitions for HAIs provided by the National Healthcare Safety Network of the Centers for Disease Control and Prevention. Case records were reviewed three times a week over 19 months, from March 2012 to September 2013. Results: Of 124 suspected episodes of infection recorded in PDAs, 89 confirmed episodes of infection were identified. HAI and NICU infection rates were 7.4 and 2.72/1,000 patient-days, respectively. Primary bloodstream infection was detected in 81 episodes and pneumonia in 8 episodes. The majority of infections (62%) were acquired in the ward before NICU admission. Klebsiella spp. was isolated most frequently (42%), followed by coagulase-negative Staphylococci (31%). Conclusions: This study is the first to report the use of PDAs in surveillance to detect HAIs in the NICU in our hospital. The majority of infections were acquired at the obstetric care department, indicating the importance of implementing rigorous prevention and control programs and a more detailed surveillance to identify other risk factors for infections.

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