Association Between Serum Vitamin A Levels and Recurrent Respiratory Tract Infections in Children

To evaluate the association between serum vitamin A levels and the prevalence of recurrent respiratory tract infections (RRTIs) in children and adolescents and to provide evidence that would help decrease the prevalence of respiratory tract infections (RTIs) in children. This cross-sectional study included 8034 children and adolescents in Beijing aged 6 months to 17 years. RRTI and RTI symptoms were diagnosed according to the Clinical Concept and Management of Recurrent Respiratory Tract Infections in Children. Multivariate logistic regression models were used to evaluate the association between serum vitamin A levels and RRTIs after adjusting for potential confounders. Among the included children, 721 (8.97%) were diagnosed with vitamin A deficiency, whereas 3,073 (38.25%) were diagnosed with subclinical vitamin A deficiency. Only 28.8% (208/721) of children with vitamin A deficiency and 53.1% (1,631/3,073) of children with subclinical vitamin A deficiency had no RRTI and RTI symptoms, respectively. Compared with children with normal vitamin A levels, those with vitamin A deficiency and subclinical vitamin A deficiency had a greater risk for RRTIs, with an odds ratio (OR) of 6.924 [95% confidence interval (CI): 5.433–8.824] and 2.140 (95% CI: 1.825–2.510), respectively]. Vitamin A levels were also positively associated with RTI symptoms, with those having vitamin A deficiency and subclinical vitamin A deficiency showing an OR of 1.126 (95% CI: 0.773–1.640) and 1.216 (95% CI: 1.036–1.427), respectively. The present cross-sectional study found that low serum vitamin A levels were significantly associated with RRTI or RTI prevalence in children and adolescents.

Multifactorial aetiology of recurrent respiratory tract infections in children

Recurrent respiratory tract infections in children are a common health problem. Exposure to harmful environmental agents and coexistence of chronic diseases affect the severity and rate of infections. Ineffective outpatient treatment is an indication for a more comprehensive diagnostic workup. The aim of the study was to determine the cause of recurrent respiratory tract infections in children. The study group included 130 children aged 3–17 years who were referred for diagnostic investigation to determine the cause of recurrent respiratory tract infections. The eligibility criterion for the study group was the occurrence of 8 or more respiratory tract infections a year in children aged up to 6 years and 5 or more infections a year in children aged 7–17 years. The study group was subdivided into the following age groups: 3–5 years (n = 60), 6–9 years (n = 35), 10–13 years (n = 11) and 14–17 years (n = 24). The presence of potential risk factors for recurrent infection was analysed on the basis of questionnaires. Tests and examinations were also performed in order to exclude allergies, ear, nose and throat disorders and gastroesophageal reflux disease. Selected laboratory values (complete blood count, vitamin D concentration, immunoglobulin levels) were compared with those obtained from 86 healthy children from the control group. The majority of children had risk factors for recurrent respiratory tract infections. Adenoid hypertrophy was diagnosed in 44.6% of children, asthma in 36.9%, vitamin D deficiency in 30.7%, gastroesophageal reflux disease in 16.2% and immunodeficiency in 9.2% of children. Multimorbidity was found in 34.6% of the subjects. In the study group, there were higher vitamin D levels [study group: 25.6 ng/mL (25th percentile = 17; 75th percentile = 33.3), control group: 22.84 ng/mL (25th percentile = 16.3; 75th percentile = 28.7); p < 0.044] and higher leukocyte levels [study group: 7.5 × 103/μL (25th percentile = 5.9; 75th percentile = 9.1), control group: 6.4 × 103/μL (25th percentile = 5.3; 75th percentile = 7.7); p < 0.02]. The results indicate that children with recurrent respiratory tract infections are a heterogeneous group of patients. The youngest children were the largest group (n = 60). In the majority of children, the onset of symptoms was associated with the beginning of nursery/preschool or school attendance. In 1 in 3 children, a combined presence of a few diseases was found which increase susceptibility to recurrent respiratory tract infections.

Analysis of the Effect of Nursing Intervention on Children with Respiratory Tract Infection Based on Comprehensive Nursing

Recurrent respiratory tract infections in children are common. It means that children are repeatedly exposed to external pathogens within a certain time, and the clinical symptoms are reciprocating. This article carries out nursing intervention on children’s respiratory tract infection through comprehensive nursing methods and analyzes the intervention effect. Moreover, this paper uses a controlled trial to study the nursing methods of recurrent respiratory tract infections in children. In addition, this paper determines and screens test samples according to relevant standards, conducts different nursing methods on samples of different groups, and compares them with the same indicators. Finally, this paper combines mathematical statistics to make statistics of experimental results and draws tables and statistical graphs. By comparing multiple parameters, it can be seen that the comprehensive nursing intervention has a good effect on the nursing of children with respiratory tract infection compared with the traditional nursing intervention, so this nursing method can be expanded in the future.

The modified Nadeem’s technique for the treatment of H-type tracheoesophageal fistula

An H-type fistula is an unusual category of the tracheoesophageal fistula to occur constituting only 5 % of all cases. The continuity of the esophagus leads to a delayed and vague presentation with a complaint of choking on feed and respiratory issues unlike the inability to feed and frothing soon after birth in other variants of tracheoesophageal fistula. We received a referred case of a 3-months-old male having recurrent respiratory tract infections and episodes of choking. After a thorough evaluation, a suspicion of H-type fistula was encountered that led to refined radiological evaluation. Contrast given per oral also delineated fistula and CT scan with intravenous and oral contrast revealed fistulous communication between two channels. Operated for H-type fistula through the modified Nadeem’s technique via a left cervical approach and discharged after uneventful recovery. The modified Nadeem’s technique via a left-sided cervical approach facilitates access, vision, and intervention easily as compared to the conventional right-sided approach given in the literature.