RESUMO
AIM: The rapid spread of a novel human coronavirus SARS-CoV-2 led to drastic measures world-wide. Most countries were forced to declare a national lockdown. We studied the effect of lockdown measures on the level of asthma control and maintenance treatment in children with recurrent wheezing and asthma during the first wave of COVID-19 in Spain. METHODS: We analysed children with recurrent wheezing or asthma before and after the implementation of the lockdown, by using a questionnaire aimed to examine pre-existing respiratory disorders, step treatment and level of asthma control before/after lockdown, COVID history and laboratory testing including IgG SARS-CoV-2. RESULTS: We enrolled 475 asthmatic and pre-school wheezers (60.6% males), mean age 5.6 years. There were no differences in asthma treatment comparing both periods: 81.7% maintained the same treatment (P = 0.103). According to child asthma-control questionnaire, 87.7% remained well controlled during confinement. Nearly, a third of children (34.9%) needed reliever treatment, mainly in older children. Determination of IgG SARS-CoV-2 was performed in 233 children (49.1%) of whom 17 (7.3%) tested positive. Seven patients positive to IgG SARS-CoV-2 were assisted in the emergency department and two required hospital admission. CONCLUSIONS: During COVID-19 lockdown in Spain, most children with recurrent wheezing and asthma remained well controlled from their underlying disease and did not modify greatly their maintenance treatments. Unexpectedly, we also observed that those children who tested positive to SARS-CoV-2 IgG showed a significant increase in paediatric hospital admissions and attendances to urgent care settings.
Assuntos
Asma , COVID-19 , Asma/epidemiologia , COVID-19/epidemiologia , Criança , Pré-Escolar , Controle de Doenças Transmissíveis , Feminino , Humanos , Imunoglobulina G , Masculino , Sons Respiratórios , SARS-CoV-2 , Espanha/epidemiologiaRESUMO
BACKGROUND: Chagas disease, caused by Trypanosoma cruzi (T. cruzi), is endemic in Latin-America and is emerging in Spain due to immigration. The vertical transmission rate is around 5%. A routine prenatal screening with serology of all pregnant women from endemic areas is recommended to identify infected newborns, allowing early treatment and cure. OBJECTIVE: The aim of this study was to estimate the prevalence of positive Chagas serology in a cohort of pregnant women from Latin-America and its vertical transmission. PATIENTS AND METHODS: An observational, prospective, follow-up study was conducted on women with positive serology to T. cruzi, as well as their newborns, from January 2013 to April 2015. Congenital Chagas was ruled out using a PCR technique at birth and at 1 month, and with serology at 9-12 months old. A child was considered infected when PCR was positive, and uninfected when PCR was negative, and/or it had a negative serology. RESULTS: Screening was performed on 1244 pregnant women from Latin-America, and there were positive results in 40 (prevalence 3.2%, 95% CI: 2.4-4.4%), with 85% of them from Bolivia. There was only one infected newborn (rate of vertical transmission 2.8% (95% CI: 0-15%)), who had a positive PCR at birth. Relative studies enabled an 8-year-old sister with an asymptomatic disease to be diagnosed and treated. Both were treated successfully with benznidazole (later the PCR and serology were negative). CONCLUSION: Screening during pregnancy in Latin-American women helped to detect those with Chagas disease. The rate of vertical transmission was 2.8%, in keeping with literature. Screening led to the detection and treatment of previously unidentified familial cases.
Assuntos
Doença de Chagas/epidemiologia , Doença de Chagas/transmissão , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/epidemiologia , Anticorpos Antiprotozoários/sangue , Doença de Chagas/sangue , Feminino , Humanos , Recém-Nascido , América Latina/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/sangue , Prevalência , Estudos Prospectivos , Estudos Soroepidemiológicos , Espanha/epidemiologia , Centros de Atenção Terciária , Trypanosoma cruzi/imunologia , Saúde da População UrbanaRESUMO
Parainfluenza 3 virus is a frequent cause of respiratory infections in the pediatric population although it is uncommonly diagnosed in neonates, being usually reported as neonatal intensive care unit microepidemics. We report a case of parainfluenza 3 respiratory infection associated with pericardial effusion in a very low birthweight infant.
RESUMO
El niño con una masa cervical representa un desafío para el pediatra. Lo más frecuente en niños son los procesos benignos de origen infeccioso. Presentamos un niño con tumoración laterocervical posterior con diagnóstico de pilomatricoma, tumor benigno poco conocido en Pediatría . No presenta características específicas, por lo que su diagnóstico se base en el estudio de anatomía patológica. El único tratamiento posible es la exéresis completa. El pilomatricoma se debe incluir en el diagnóstico diferencial de adenitis cervical en niños para evitar intervenciones y tratamientos innecesarios.
Children with neck masses are an everyday challenge for pediatricians. Infectious diseases are the most common etiology in childhood. We report a child with a neck mass who was diagnosed with pilomatrixoma. It is a quite unknown benign skin tumor in pediatrics. It cannot be easily differentiated from other skin tumors, and biopsy is necessary to make the definitive diagnosis. Treatment of pilomatrixoma consists of total surgical excision. Pilomatrixoma should be considered in the differential diagnosis of cervical lymphadenitis in children to avoid unnecessary interventions and antibiotic treatment.