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Objective: To determine factors associated with mortality by sepsis syndrome in children. Methods: We performed an analytical study of cases and controls, which included patients between 31 days and 14 years of age, treated at Hospital Universitario del Valle in Cali, Colombia, with sepsis syndrome between 1999 and 2003. Information was gathered from medical records and books. The outcome variable was the status on discharge from hospital (alive or dead). All the dead children were verified in the hospital records and all the living children were confirmed alive four weeks after discharge. The exposure control variables were age, gender, origin, socioeconomic status, educational level of mothers, family order of the child, classification and origin of sepsis, nutritional status, underlying disease, presence and type of immunosuppression, invasive procedures, duration of surgery, broad-spectrum antibiotics, as well as preoperative, hospital and intensive care stay. Results: We evaluated 110 cases and 110 controls, 79 with diagnosis of sepsis and 31 with septic shock. The cases had more days of evolution of the disease, higher proportion of family order of the child between third and fifth offspring, malnutrition, acquired immunosuppression, respiratory origin of sepsis, and shorter hospital stay and in intensive care. The logistic regression model showed that more days of disease progression (OR 1.05 CI 95% 1.01-1.10), and family order of the child (1.39 CI 95% 1.11-1.74), meant greater risk of dying from sepsis syndrome. Conclusions: It must be insisted to the community of the importance of consultation and early diagnosis of any infectious process for rapid identification of the bacteria, allowing the introduction of specific treatment and referral according to severity level. [ABSTRACT FROM AUTHOR]

Introduction: Up to 40 weeks of postconceptional age, the kangaroo mother program at the Hospital Universitario del Valle has proved to be a safe alternative for premature babies' management with a low birth weight. Objectives: To evaluate the physical growth and morbidity in children followed since 40 weeks up to 1 year in the program. Material and methods: A cohort study was performed in newborn infants admitted to the kangaroo mother program in the newborn unit at the Hospital Universitario del Valle, Cali, Colombia, with birth weight lower than 2000 g, from 40 weeks postconceptional age up to one year age, between August 2002 and July 2006. Information was collected about maternal age and morbidity, prenatal control, type of birth, gender, birth weight, gestational age, breastfeeding, thick motor development, physical growth, morbidity, readmissions, mortality and tests results. Results: A total of 390 infants were admitted to the program, with a 61% of captation. 65% of theirs mothers did not have prenatal control. Before completing the 40 weeks, 5.3% were readmitted due to anaemia and apnoea. After 40 weeks, 13% were readmitted by bronchopneumonia and acute diarrhoea. Most of them were allocated in the reference percentiles for weight and size. Size had a better growth than weight. The cumulated low weight incidence for age at 13 months was 22%. Conclusions: To increase the coverage of prenatal control program and to watch that the children receive prescribed iron and formulated folic acid. [ABSTRACT FROM AUTHOR]

Copyright of Colombia Medica is the property of Universidad del Valle and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Colombia Medica is the property of Universidad del Valle and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To assess the putative association between 5 minutes Apgar score, neonatal seizures and neurodevelopmental delay (Infanib test) performed at 1 year of corrected age.Design: Historic cohort.Setting: A first level hospital in Cali, Colombia (1989 to 1997); Subjects came from a low socioeconomic stratum population.Study subjects: A total of 287 infants who completed the 1 year follow up program were included. Interventions: not applicableMain outcome measures: Incidence (cumulative and density) of neuromotor abnormalities (abnormal Infanib test) at 1 year of age.Results: Compliance with program visits was 80%. Thirty nine (13.6%) infants presented low 5 minutes Apgar score. Thirty six (12.5%) infants presented neonatal seizures, associated mainly with neonatal asphyxia and hypoglicemia. Forty seven infants had an abnormal Infanib test (cumulative incidence 16.4% and incidence density 1.3 new cases per 100 infants-year). A significant association between neonatal seizures and an abnormal Infanib was found (RR crude 2.39 IC 95% 1.37-4.16). Low 5 minutes Apgar score is not an effect modifier neither a confounder of the association between neonatal seizures and an abnormal Infanib. Exploring the presence or absence of effect modification only bacterial meningitis, demonstrated a role as confounder for the association between seizures and Infanib results.Conclusions: Both neonatal seizures and bacterial meningitis were independently associated with abnormal Infanib results. Neonatal seizures are not only an important risk factor (adjusted RR = 2.51 IC 95% 1.10-5.72), but an easily identifiable one that can help the physician taking the medical history to identify patients at high risk for neuromotor abnormalities during the first year of life. [ABSTRACT FROM AUTHOR]

Introduction: Afebrile pneumonia syndrome in infants, also called infant pneumonitis, pneumonia caused by atypical pathogens or whooping cough syndrome is a major cause of severe lower respiratory infection in young infants, both in developing countries and in developed countries., Objective: To describe children with afebrile pneumonia syndrome., Methods: Through a cross-sectional study, we reviewed the medical records of children diagnosed with afebrile pneumonia treated at Hospital Universitario del Valle, a reference center in southwestern Colombia, between June 2001 and December 2007. We obtained data on maternal age and origin, prenatal care, the childs birth, breastfeeding, vaccination status, symptoms, signs, diagnosis, treatment, and complications., Results: We evaluated 101 children with this entity, noting a stationary presentation: June-August and November- December. A total of 73% of the children were under 4 months of age; the most common symptoms were: cyanotic and spasmodic cough (100%), respiratory distress (70%), and unquantified fever (68%). The most common findings: rales (crackles) (50%), wheezing and expiratory stridor (37%); 66% were classified as mild and of the remaining 33%, half of them required attention in the intensive care unit. In all, there was clinical diagnosis of afebrile pneumonia syndrome in infants, but no etiologic diagnosis was made and despite this, 94% of the children received macrolides., Conclusions: These data support the hypothesis that most of these patients acquired the disease by airway, possibly caused by viral infection and did not require the indiscriminate use of macrolides.