However, in the Israeli study, fungal infections also occurred, most of which were bloodstream infections. Therefore, among pediatric selleck bio patients with neoplastic diseases who suffer from a low white blood cell count for a long period of time, care should be taken to guard against fungal infections as well. Concerning procedures that can make patients vulnerable to NIs, we found that endotracheal intubation, nasogastric tube insertion, urinary catheterization and central venous catheterization significantly increased the incidence of NIs (P-value < .001). Patients who were exposed to more invasive procedures such as endotracheal intubation (mean duration: 4.9 days) and central venous catheterization (mean duration: 1.7 days) also more quickly developed NIs than patients who were exposed to less invasive procedures such as nasogastric tube insertion (mean duration: 10.

2 days). We therefore recommend that the more invasive procedures should be carried out only when necessary in order to reduce the incidence of NIs. The strengths of our study are twofold. First, it is a prospective study in which NI episodes were carefully monitored and the data collection carried out according to a given research plan. Second, according to our best knowledge, it is the first study of NI episodes among pediatric patients with neoplastic diseases in Thailand. However, our study also has the following limitations. First, the period of data collection was relatively short. A longer period of data collection would be able to provide a clearer picture of NI episodes among this group.

Second, care should be taken when comparing the incidence rates of NIs of our study with those of other institutions and countries, since we have excluded patients who had fever of unknown origin and viral related illnesses. These entities are computed in most studies as NIs per CDC criteria. Third, we also have not recorded the types of chemotherapy regimens these patients received as well as their cancer stages, which may have some impact on episodes of NIs. Further studies could address these shortcomings. Fourth, our study also did not investigate the relationship between the incidence of NIs and other intrinsic factors, including the presence of other underlying diseases as well as level of anemia and white blood cell counts.

Acknowledgments The authors would like to thank all nurses from the Pediatric Ward of the Chiang Mai University Hospital Anacetrapib for helping collecting data and Albert L. Oberdorfer from the English Department of the Chiang Mai University for editorial help.
Collecting routine functional outcomes in children with spinal cord injury (SCI) has significant practical implications, as health care providers, social agencies, and school systems have a need to know if children are progressing, regressing, or maintaining their functional levels.