ECAD study: Evaluating agreement degree among paediatricians in hip dysplasia assessment by the Graf ultrasound method.

Developmental dysplasia of the hip (DDH) is the most common musculoskeletal anomaly of childhood. This study analyses paediatrician's concordance performing hip ultrasound according to Graf's method. An analytical cross-sectional study is designed. Patients' hips are evaluated by Graf's ultrasound method at 4-6 and 12-16 weeks of age. Demographic characteristics, pregnancy history, factors related to DDH, hip type, and α and ß angles are collected. To assess the agreement degree of hip diagnosis and hip types Kappa index (I. kappa) is used. Intraclass correlation coefficient (ICC) evaluates the concordance of α and ß angles. A p value < 0.05 is considered statistically significant. All results are represented with their 95% confidence interval (95% CI). Four hundred sixty-seven neonates are recruited and meet the inclusion criteria. A total of 3182 images were analysed. Agreement between paediatricians according to hip diagnosis and different types ranges from moderate to almost perfect I. kappa 0.6-1.0 (95% CI 0.5-0.7; 95% CI 1.0-1.0). α angle ICC for paediatricians is between 0.75 and 0.88 (95% CI 0.61-0.86; 95% CI 0.80-0.92). ß angle value agreement degree among paediatricians at both visits is moderate. The Graf method is the most popular ultrasound technique for hip assessment. In our setting, paediatricians carry out children follow-up; therefore, they should perform universal screening. In this study agreement degree between paediatricians varies between substantial and almost perfect. Conclusion: The Graf ultrasound procedure performed by paediatricians is a reliable test and can be used for DDH screening. What is Known • Developmental dysplasia of the hip (DDH) is the most common congenital musculoskeletal anomaly of childhood. Early diagnosis and treatment improve DDH prognosis. Lack of detection can cause complications such as lameness, early osteoarthritis and need for hip replacement at an early age. What is New • Today, the best screening method is still subject of debate. But it seems that with selective screening many pathological hips go unnoticed. Universal screening implementation may be a challenge in some countries. But the question is if this could be carried out by paediatricians as part of healthy child follow-up.

Haemoglobinopathies and other rare anemias in Spain: ten years of a nationwide registry (REHem-AR).

REHem-AR was created in 2013. The progressive implementation of neonatal screening for haemoglobinopathies in Spanish autonomous communities where the registry had not been implemented, as well as the addition of new centres during this period, has considerably increased the sample of patients covered. In this study, we update our previous publication in this area, after a follow-up of more than 5 years. An observational, descriptive, multicentre and ambispective study of adult and paediatric patients with haemoglobinopathies and rare anaemias registered in REHem was performed. The data are from a cross-sectional analysis performed on 1 June, 2023. The study population comprised 1,756 patients, of whom 1,317 had SCD, 214 had thalassaemia and 224 were diagnosed with another condition. Slightly more than one third of SCD patients (37%) were diagnosed based on neonatal bloodspot screening, and the mean age at diagnosis was 2.5 years; 71% of thalassaemia patients were diagnosed based on the presence of anaemia. Vaso-occlusive crisis and acute chest syndrome continue to be the most frequent complications in SCD. HSCT was performed in 83 patients with SCD and in 50 patients with thalassaemia. Since the previous publication, REHem-AR has grown in size by more than 500 cases. SCD and TM are less frequent in Spain than in other European countries, although the data show that rare anaemias are frequent within rare diseases. REHem-AR constitutes an important structure for following the natural history of rare anaemias and enables us to calculate investment needs for current and future treatments.

Flu and VRS 2018-19 Season and vaccine effectiveness against the need for hospital flu treatment in Guadalajara province, Spain. / Temporada de gripe y VRS 2018-19 y efectividad vacunal frente a la necesidad de atención hospitalaria por gripe en la provincia de Guadalajara.

INTRODUCTION: The objective was to estimate the effectiveness of inactivated trivalent vaccine (VE) in preventing hospital flu care (HFC) in Guadalajara, Castile-La Mancha (CLM), Spain, 2018-19 season. MATERIAL AND METHODS: Retrospective cohort study (40/2018 to 13/2019 weeks). SOURCES: Microbiology programme; electronic medical history; population census (INE, 1/7/2018). CASES: Population requiring HFC (hospital emergencies and/or emergency observation unit and/or hospital admissions), confirmed by antigenic test and/or PCR. Preventive fractions [PFv(vaccinated) and PFp(population)] and Necessary number of patients to be vaccinated (NNV) were calculated. RESULTS: 228 HFT occurred [cumulative incidence rate (IR)=8.9/104; ≥65 years=65%; vaccination coverage=13% (≥65 years=58%); mortality=9%); maximum incidence in the 6th week (IR=1.7/104) (in CLM, in 4th)]. Highest peak of RSV occurred in the 3rd (in CLM, in the 52th). PFv (14-65 years) was 96% (PFp=58%) and in ≥65, 32% (PFp=21%). NNV=414. As in Spain, influenza virus A predominated, with A(H3N2) being 13% more prevalent (strain not included in the vaccine). CONCLUSIONS: The season was delayed by sustained VRS circulation. The VE was lower than the national one. It is be essential to promote future campaigns to improve vaccination coverage.