NUM-score: A clinical-analytical model for personalised imaging after urinary tract infections.

AIM: To identify predictive variables and construct a predictive model along with a decision algorithm to identify nephrourological malformations (NUM) in children with febrile urinary tract infections (fUTI), enhancing the efficiency of imaging diagnostics. METHODS: We performed a retrospective study of patients aged <16 years with fUTI at the Emergency Department with subsequent microbiological confirmation between 2014 and 2020. The follow-up period was at least 2 years. Patients were categorised into two groups: 'NUM' with previously known nephrourological anomalies or those diagnosed during the follow-up and 'Non-NUM' group. RESULTS: Out of 836 eligible patients, 26.8% had underlying NUMs. The study identified six key risk factors: recurrent UTIs, non-Escherichia coli infection, moderate acute kidney injury, procalcitonin levels >2 µg/L, age <3 months at the first UTI and fUTIs beyond 24 months. These risk factors were used to develop a predictive model with an 80.7% accuracy rate and elaborate a NUM-score classifying patients into low, moderate and high-risk groups, with a 10%, 35% and 93% prevalence of NUM. We propose an algorithm for approaching imaging tests following a fUTI. CONCLUSION: Our predictive score may help physicians decide about imaging tests. However, prospective validation of the model will be necessary before its application in daily clinical practice.

Sedoanalgesia With Ketamine in the Emergency Department: Factors Associated With Unsatisfactory Effectiveness.

OBJECTIVE: Ketamine is a safe and widely used sedative and analgesic in children. The purpose of this study is to evaluate the response to sedoanalgesia for painful procedures in the pediatric emergency department. METHODS: A retrospective study was conducted in children younger than 16 years who underwent painful procedures with intravenous/intranasal ketamine between January 2016 and December 2022. We collected demographic variables, effectiveness, route of administration, indication, dose, sedation strategy, duration of procedure, and associated adverse effects. RESULTS: A total of 671 ketamine sedation procedures (411 males/260 females) were included, with a mean age of 7.2 years. Closed reduction was the most common painful procedure (53.8%), followed by burn healing (24.6%). Ketamine was administered intravenously in 93.4% of procedures and intranasally in 6.6%. The result of sedoanalgesia was satisfactory in 84.9% and unsatisfactory in 15.1%. The percentage of cases with unsatisfactory analgesia was higher with intranasal administration (36.4%; P < 0.001). In the intravenous group, the percentage of cases with unsatisfactory effectiveness (28.7%) was higher for patients younger than 2 years of age (P < 0.001). Arthrocentesis procedures were associated with the highest percentage of unsatisfactory sedoanalgesia failures among patients receiving intravenous ketamine (39.3%; P < 0.001). Intranasal ketamine patients who received a dose between 3.6 and 4 mg/kg had a significantly higher percentage of unsatisfactory sedoanalgesia (66.7%; P = 0.048). Patients receiving intravenous ketamine had significantly higher rates of unsatisfactory sedoanalgesia when the initial dose interval was 1.6 to 2 mg/kg (11.8%; P = 0.002) and when the final total dose was also 1.6 to 2 mg/kg (17.6%; P = 0.002). CONCLUSIONS: This study concludes that intravenous/intranasal ketamine can provide safe and successful analgesia in pediatric patients in the ED. At intravenous doses of 1-1.5 mg/kg, good effectiveness was achieved in almost 90% of cases. Arthrocentesis had the highest percentage of unsatisfactory results. Repeat dosing should be considered for procedures longer than 20 minutes.

Hyponatremia and other potential markers of ultrasound abnormalities after a first febrile urinary tract infection in children.

Urinary tract infections are the initial manifestation in 30% of urinary tract malformations. Identifying these patients, who could benefit from a specific treatment, is still challenging. Hyponatremia during urinary tract infection has been proposed as a urinary tract malformation marker. We evaluate the prevalence of hyponatremia during febrile urinary tract infections and its association with subjacent urinary tract malformations. We performed a retrospective study of healthy patients under 16 years, diagnosed with a first episode of febrile urinary tract infection, who had undergone blood testing in the acute episode and at least one renal ultrasound during follow-up (January 2014-November 2020). Hyponatremia was defined as (serum sodium ≤ 130 mEq/L). According to imaging findings, we classified patients into three groups: normal kidney ultrasound, mild pelviectasis, and significant urinary tract malformation. We performed logistic regression models to identify independent risk factors for urinary tract malformation and mild pelviectasis. We included 492 patients and 2.8% presented hyponatremia. We identified normal ultrasound in 77%, mild pelviectasis in 10.8%, and urinary tract malformation in 12% of patients. We found an association between mild pelviectasis and hyponatremia [OR 6.6 (CI95% 1.6-26.6)]. However, we found no association between hyponatremia and urinary tract malformation. The parameters that were associated with malformations were presenting a non-E. coli infection, C-reactive-protein levels over 80 mg/L, and bacteremia. CONCLUSION: Hyponatremia during the first episode of febrile urinary tract infection is present in 2.8% of patients and is associated with mild pelviectasis in imaging. However, hyponatremia does not indicate a greater need for complementary tests to screen for urinary tract malformations. WHAT IS KNOWN: • Urinary tract infection is the first manifestation in 30% of children with urinary tract malformation. • Hyponatremia could be a marker to identify these children and guide the imaging approach. WHAT IS NEW: • Around 12% of children with a first episode of febrile urinary tract infection have a urinary tract malformation. • Non-E. coli infection, C-reactive protein levels over 80 mg/L, and bacteremia are markers for malformations to guide diagnostic imaging tests, but hyponatremia (Na ≤ 130 mEq/l) is not a reliable marker.

Blood analysis for screening of electrolyte and kidney function alterations in patients with febrile urinary tract infection.

AIM: To describe the prevalence, severity, risk factors, and clinical relevance of electrolyte disturbances and acute kidney injury (AKI) during febrile urinary tract infection (fUTI). METHODS: Retrospective observational study of well/fair-appearing patients between 2 months and 16 years, with no previous relevant medical history, diagnosed with fUTI in the paediatric emergency department (PED) with subsequent microbiological confirmation. Analytical alteration (AA) data were considered: AKI (creatinine elevation × 1.5 the median for age), plasma sodium alteration (≤130 or ≥150 mEq/L), and potassium alteration (≤3 or ≥6 mEq/L). RESULTS: We included 590 patients, 17.8% presented AA (13 hyponatremia, 7 hyperkalaemia, and 87 AKI). No patient presented severe analytic alterations or a higher frequency of symptoms potentially attributable to these alterations (seizures, irritability, or lethargy). Risk factors associated with these AA were clinical dehydration (OR = 3.5 95% CI: 1.04-11.7; p = 0.044) and presenting a temperature >39°C (OR = 1.9 95% CI: 1.14-3.1; p = 0.013). CONCLUSIONS: Electrolyte and renal function disturbances are infrequent in the previously healthy paediatric population with a fUTI. If present, they are asymptomatic and not severe. Based on our results, performing systematic blood analysis to rule out AA appears no longer justified, especially in the absence of risk factors.

Disruption of the Caenorhabditis elegans Integrator complex triggers a non-conventional transcriptional mechanism beyond snRNA genes.

Gene expression is generally regulated by recruitment of transcription factors and RNA polymerase II (RNAP II) to specific sequences in the gene promoter region. The Integrator complex mediates processing of small nuclear RNAs (snRNAs) as well as the initiation and release of paused RNAP II at specific genes in response to growth factors. Here we show that in C. elegans, disruption of the Integrator complex leads to transcription of genes located downstream of the snRNA loci via a non-conventional transcription mechanism based on the lack of processing of the snRNAs. RNAP II read-through generates long chimeric RNAs containing snRNA, the intergenic region and the mature mRNA of the downstream gene located in sense. These chimeric sn-mRNAs remain as untranslated long non-coding RNAs, in the case of U1- and U2-derived sn-mRNAs, but can be translated to proteins in the case of SL-derived sn-mRNAs. The transcriptional effect caused by disruption of the Integrator complex is not restricted to genes located downstream of the snRNA loci but also affects key regulators of signal transduction such as kinases and phosphatases. Our findings highlight that these transcriptional alterations may be behind the correlation between mutations in the Integrator complex and tumor transformation.

Handlebar Hernia: An Uncommon Traumatic Abdominal Hernia.

ABSTRACT: Handlebar hernia is a type of traumatic abdominal wall hernia caused by the impact of a bicycle handlebar against the abdominal wall. A good anamnesis and physical examination are important for the correct diagnosis, and ultrasonography is an accessible tool in the emergency department for imaging confirmation. We describe a case of an 11-year-old girl who presented to the emergency department after an abdominal trauma caused by a handlebar. Ultrasonography revealed an abdominal wall defect with herniation of omentum and bowel loops. Conservative management was initially established, followed by surgical treatment due to persistent symptoms.

Staphylococcal toxic shock syndrome in a child with interleukin-17 inhibitor treatment for psoriasis.

A 6-year-old girl presented with fever, skin rash, anuria, and conjunctivitis that rapidly progressed to toxic shock syndrome. Following hospital discharge, she developed a staphylococcal abscess on the lower extremity. She had recently received the first two doses of the interleukin-17 (IL-17) inhibitor secukinumab for resistant plaque psoriasis. IL-17 is known to be essential in host defense against Staphylococcus aureus. To our knowledge, this is the first reported case of staphylococcal toxic shock syndrome (STSS) associated with an IL-17 inhibitor.

Morphological and molecular data reveal a new species of Lueheia (Acanthocephala: Plagiorhynchidae) from Turdus migratorius (Turdidae) in central Mexico and its phylogenetic implications within the family.

Members of the genus Lueheia Travassos, 1919, are endoparasites of birds, particularly passerines, throughout the Americas. Adults of Lueheia sp., (Plagiorhynchidae Golvan, 1960; Porrorchinae Golvan, 1956) were recovered from the intestine of the American robin (Turdus migratorius phillipsi Bangs) in Mexico City, and two other species of acanthocephalans identified as Porrorchis nickoli, (Plagiorhynchidae: Porrorchinae) Salgado-Maldonado and Cruz-Reyes, 2002 and Centrorhynchus microcephalus (Bravo-Hollis, 1947) Golvan, 1956 (Centrorhynchidae Van Cleave, 1916), were recovered from the Virginia opossum (Didelphis virginiana Allen) and groove-billed ani (Crotophaga sulcirostris Swainson), respectively in southeastern Mexico. Specimens of three species were sequenced at two molecular markers, the small subunit (SSU) and large subunit (LSU) of the nuclear rDNA and compared with other sequences available in GenBank. Maximum likelihood and Bayesian inference analyses of the combined (LSU + SSU) dataset and each individual dataset revealed that the specimens of Lueheia sp. formed an independent lineage, which is recognized herein as a new species, Lueheia aztecae n. sp., representing the fifth species of the genus in the Americas, and the second in the Nearctic region. The new species can be morphologically distinguished from the other five species in the genus by having a cylindrical proboscis, armed with 24-26 longitudinal rows with 9-10 hooks each. Phylogenetic inference performed with the combined dataset consisting of two genes (LSU + SSU) revealed that Lueheia aztecae n. sp. and P. nickoli belonging to subfamily Porrorchinae, formed two independent lineages, indicating that the subfamily is paraphyletic. Porrorchis nickoli and C. microcephalus formed a clade with other species of the genus Centrorhynchus, suggesting that P. nickoli should be transferred to genus Centrorhynchus, to form C. nickoli n. comb. In addition, we briefly discuss the ecological associations between the members of the families Plagiorhynchidae and Centrorhynchidae.

Assessment of proadrenomedullin as diagnostic or prognostic biomarker of acute appendicitis in children with acute abdominal pain.

BACKGROUND: Acute appendicitis (AA) is one of the most frequent surgical pathologies in pediatrics. OBJECTIVES: To investigate the utility of proadrenomedullin (pro-ADM) for the diagnosis of AA. METHODS: Prospective, analytical, observational, and multicenter study conducted in 6 pediatric emergency departments. Children up to 18 years of age with suspected AA were included. Clinical, epidemiological, and analytical data were collected. RESULTS: We studied 285 children with an average age of 9.5 years (95% confidence interval [CI], 9.1-9.9). AA was diagnosed in 103 children (36.1%), with complications in 10 of them (9.7%). The mean concentration of pro-ADM (nmol/L) was higher in children with AA (0.51 nmol/L, SD 0.16) than in children with acute abdominal pain (AAP) of another etiology (0.44 nmol/L, SD 0.14; p < 0.001). This difference was greater in complicated cases compared with uncomplicated AA (0.64 nmol/L, SD 0.17 and 0.50 nmol/L, SD 0.15, respectively; p = 0.005). The areas under the receiver-operating characteristic curves were 0.66 (95% CI, 0.59-0.72) for pro-ADM, 0.70 (95% CI, 0.63-0.76) for C-reactive protein (CRP), 0.84 (95% CI, 0.79-0.89) for neutrophils, and 0.84 (95% CI, 0.79-0.89) for total leukocytes. The most reliable combination to rule out AA was CRP ≤1.25 mg/dL and pro-ADM ≤0.35 nmol/L with a sensitivity of 96% and a negative predictive value of 93%. CONCLUSION: Children with AA presented higher pro-ADM values than children with AAP of other etiologies, especially in cases of complicated AA. The combination of low values of pro-ADM and CRP can help to select children with low risk of AA.

Biocide Tolerance and Antibiotic Resistance in Salmonella Isolates from Hen Eggshells.

The aim of the present study was to determine biocide tolerance and antibiotic resistance in Salmonella isolates from hen eggshells. A total of 39 isolates from hen eggshells, identified as either Salmonella spp. or Salmonella enterica according to 16S rDNA sequencing, were selected for biocide tolerance. Isolates with minimum inhibitory concentrations (MICs) above the wild-type MICs were considered to be biocide tolerant: benzalkonium chloride (BC, 7.7%), cetrimide (CT, 7.7%), hexadecylpyridinium chloride (HDP, 10.3%), triclosan (TC, 17.9%), hexachlorophene (CF, 30.8%), and P3-oxonia (OX, 25.6%). The resulting 21 biocide-tolerant isolates were further characterized. Most isolates (95.2%) were resistant to ampicillin, but only 9.5% were resistant to cefotaxime as well as to ceftazidime. Resistance to chloramphenicol (61.9%), tetracycline (47.6%), streptomycin (19.0%), nalidixic acid (28.6%), ciprofloxacin (9.5%), netilmicin (14.3%), and trimethoprim-sulfamethoxazole (38.1%) was also detected. Considering only antibiotics, 66.7% of isolates were multiresistant; furthermore, 90.5% were multiresistant considering antibiotics and biocides combined. Efflux pump and biocide tolerance genetic determinants detected included acrB (95.2%), oqxA (14.3%), mdfA (9.5%), qacA/B (4.8%), and qacE (9.5%). Antibiotic resistance genes detected included blaTEM (14.3%), blaCTXM-2 (4.8%), blaPSE (4.8%), floR (19.05%), tet(A) (9.5%), tet(C) (4.8%), dfrA12 (0.05%), and dfrA15 (0.05%). Significant positive correlations were detected between phenotypic tolerance/resistance to biocides, biocides and antibiotics, and also between antibiotics, suggesting that a generalized use of biocides could co-select antibiotic resistance.

Application of bacteriophages in post-harvest control of human pathogenic and food spoiling bacteria.

Bacteriophages have attracted great attention for application in food biopreservation. Lytic bacteriophages specific for human pathogenic bacteria can be isolated from natural sources such as animal feces or industrial wastes where the target bacteria inhabit. Lytic bacteriophages have been tested in different food systems for inactivation of main food-borne pathogens including Listeria monocytogenes, Staphylococcus aureus, Escherichia coli O157:H7, Salmonella enterica, Shigella spp., Campylobacter jejuni and Cronobacter sakazkii, and also for control of spoilage bacteria. Application of lytic bacteriophages could selectively control host populations of concern without interfering with the remaining food microbiota. Bacteriophages could also be applied for inactivation of bacteria attached to food contact surfaces or grown as biofilms. Bacteriophages may receive a generally recognized as safe status based on their lack of toxicity and other detrimental effects to human health. Phage preparations specific for L. monocytogenes, E. coli O157:H7 and S. enterica serotypes have been commercialized and approved for application in foods or as part of surface decontamination protocols. Phage endolysins have a broader host specificity compared to lytic bacteriophages. Cloned endolysins could be used as natural preservatives, singly or in combination with other antimicrobials such as bacteriocins.

Multilocus sequence typing and antimicrobial resistance in Enterococcus faecium isolates from fresh produce.

The purpose of the present study was to determine the relatedness of Enterococcus faecium isolates from fresh produce to E. faecium strains from other sources by using multi-locus sequence typing (MLST) and to determine the antimicrobial resistance of the isolates. MLST analysis of 22 E. faecium isolates from fresh produce revealed 7 different sequence types (ST 22, ST 26, ST 43, ST 46, ST 55, ST 94 and ST 296). Most isolates belonged to ST 296 (40.9 %), followed by ST 94 (27.3 %). All isolates were sensitive to vancomycin and to imipenem, and only one was resistant to ampicillin (MIC 32 mg/l). However, all were resistant to cefotaxime and ceftazidine. E. faecium isolates from fresh produce were inhibited by quaternary compounds (benzalkonium chloride, cetrimide, hexadecylpyridinium chloride, didecyldimethylammonium bromide), biguanides (chlorhexidine), polyguanides [poly-(hexamethylene guanidinium) hydrochloride], bisphenols (triclosan, hexachlorophene) and biocidal solutions of P3 oxonia and P3 topax 66. Didecyldimethylammonium bromide and triclosan were the least effective biocides in growth inhibition, while hexadecylpyridinium chloride was the most effective. Results from MLST typing and antibiotic resistance suggest that the studied E. faecium isolates from fresh produce are not related to the clinically-relevant clonal complex CC17.

Smartphone-Based Rapid Quantitative Detection Platform with Imprinted Polymer for Pb (II) Detection in Real Samples.

This paper reports the successful development and application of an efficient method for quantifying Pb2+ in aqueous samples using a smartphone-based colorimetric device with an imprinted polymer (IIP). The IIP was synthesized by modifying the previous study; using rhodizonate, 2-acrylamido-2-methylpropane sulfonic acid (AMPS), N,N'-methylenebisacrylamide (MBA), and potassium persulfate (KPS). The polymers were then characterized. An absorption study was performed to determine the optimal conditions for the smartphone-based colorimetric device processing. The device consists of a black box (10 × 10 × 10 cm), which was designed to ensure repeatability of the image acquisition. The methodology involved the use of a smartphone camera to capture images of IIP previously exposed at Pb2+ solutions with various concentrations, and color channel values were calculated (RGB, YMK HSVI). PLS multivariate regression was performed, and the optimum working range (0-10 mg L-1) was determined using seven principal components with a detection limit (LOD) of 0.215 mg L-1 and R2 = 0.998. The applicability of a colorimetric sensor in real samples showed a coefficient of variation (% RSD) of less than 9%, and inductively coupled plasma mass spectrometry (ICP-MS) was applied as the reference method. These results confirmed that the quantitation smartphone-based colorimetric sensor is a suitable analytical tool for reliable on-site Pb2+ monitoring.

Preparation of a Molecularly Imprinted Polymer on Polyethylene Terephthalate Platform Using Reversible Addition-Fragmentation Chain Transfer Polymerization for Tartrazine Analysis via Smartphone.

This work describes the preparation of a molecularly imprinted polymer (MIP) platform on polyethylene terephthalate (MIP-PET) via RAFT polymerization for analyzing tartrazine using a smartphone. The MIP-PET platform was characterized using Fourier transform infrared (FTIR) techniques, Raman Spectroscopy, X-ray photoelectron spectroscopy (XPS), and confocal microscopy. The optimal pH and adsorption time conditions were determined. The adsorption capacity of the MIP-PET plates with RAFT treatment (0.057 mg cm-2) was higher than that of the untreated plates (0.028 mg cm-2). The kinetic study revealed a pseudo-first-order model with intraparticle diffusion, while the isotherm study indicated a fit for the Freundlich model. Additionally, the MIP-PET demonstrated durability by maintaining its adsorption capacity over five cycles of reuse without significant loss. To quantify tartrazine, images were captured using a smartphone, and the RGB values were obtained using the ImageJ® free program. A partial least squares regression (PLS) was performed, obtaining a linear range of 0 to 7 mg L-1 of tartrazine. The accuracy of the method was 99.4% (4.97 ± 0.74 mg L-1) for 10 samples of 5 mg L-1. The concentration of tartrazine was determined in two local soft drinks (14.1 mg L-1 and 16.5 mg L-1), with results comparable to the UV-visible spectrophotometric method.

Retrospective study of acute mastoiditis in children in Spain attended in a Pediatric Emergency department.

OBJECTIVE: To analyze the cases of acute mastoiditis, characteristics, management and complications in children attended in the emergency department. METHODS: Retrospective study of acute mastoiditis in a Spanish tertiary hospital over a 6-year period (2018-2023). RESULTS: One hundred two episodes of acute mastoiditis were analyzed (54% males, median age 1.8 years). Microorganisms were isolated in one third of cases, mainly Streptococcus pyogenes (64% of ear secretion cultures). Complications occurred in 27.5%, primarily subperiosteal abscess. A younger age, absence of vaccination schedule, previous history of otitis, cochlear implant carriers or white blood cell counts and C-reactive protein levels were not associated with complications. Complicated cases had longer hospitalizations. Treatment included antibiotics, corticosteroids, and surgery in 50% of cases. CONCLUSIONS: This study shows an increase of acute mastoiditis during 2023, with a relevant role of S. pyogenes. A younger age, absence of vaccination, personal history of otitis or cochlear implant, blood cell counts and C-reactive protein levels were not associated with complications.

Cross-Cultural Adaptation and Validation of the Perception of the Doctor-Patient Relationship (PREMEPA) Questionnaire in Chronic Multi-Pathological Patients.

OBJECTIVE: To conduct a cross-cultural adaptation and validation in Primary Care of the PREMEPA doctor-patient relationship perception questionnaire. DESIGN: Descriptive, cross-sectional study, using self-administered questionnaires. Qualitative validation: an adapted version of the original questionnaire, was adapted to our culture. The process consisted of the evaluation, cross-cultural adaptation and consensus of a group of experts. The questionnaire was piloted on a sample of 32 patients diagnosed with at least 2 chronic pathologies. MEASURES: Cognitive piloting, comprehensibility assessment, content validation and internal consistency analysis using Cronbach's alpha coefficient. Quantitative validation: the internal consistency, construct validity and validity of the questionnaire were studied by means of a confirmatory factor analysis developed in a multicenter study, randomly selecting 202 patients with at least 2 chronic pathologies. RESULTS: Content validity of the new Spanish version was confirmed to be adequate. Comprehensibility and internal consistency (Cronbach's α coefficient = 0.78) were adequate. The confirmatory factor analysis showed good dimensionality, factor relationship and internal consistency, as well as acceptable construct validity. The final result was a 13-item questionnaire consisting of 2 dimensions, which explain 58.5% of the variance: participation in decision-making (accounting for 45.2% of the variance) and person-centered communication (encompassing courtesy, empathy, humanity, and trust). CONCLUSIONS: This adapted version of the PREMEPA questionnaire can be considered valid for use in the Spanish population with a history of chronic pathology. This version of PREMEPA provides a new instrument to understand and improve chronic patient care, which can improve the doctor-patient relationship, encouraging adherence to treatment and enhancing health outcomes.

Electrochemical Analysis of Curcumin in Real Samples Using Intelligent Materials.

Curcumin is a compound of great importance in the food industry due to its biological and pharmacological properties, which include being an antioxidant, anti-inflammatory, antibacterial, antiviral, and anticarcinogenic. This paper proposes the synthesis of an electrochemical sensor based on molecularly imprinted polymers (MIPs) and MWCNT by drop casting deposited on a glassy carbon electrode (GCE) for the selective quantification of curcumin in food samples. The synthesized compounds are characterized by Fourier transform infrared (IR), Brunauer-Emmett-Teller (BET), and electrochemical techniques such as cyclic voltammetry (CV) and differential pulse voltammetry (DPV). The optimal conditions for further experiments were determined by selecting these parameters. We examined three food products, commercial capsules, turmeric rhizomes, and commercial turmeric powder, employing both electrochemical and HPLC methods for the analysis. The electrochemical method revealed a limit of detection (LOD) value of 0.1365 µmol L-1, compared with the HPLC analysis, which gave a value of 3.55 µmol L-1. Furthermore, the MIP material demonstrated superior selectivity for the analyte compared to potential interferents. The recovery percentage, determined using the HPLC method, fell within the range of 87.5% to 102.6.

Seizures in Children With Severe Acute Respiratory Syndrome Coronavirus 2 Infection.

BACKGROUND: Although respiratory symptoms are the most prominent manifestations of coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and especially the omicron variant, may cause neurological manifestations such as seizures. It remains unclear if specific variants of the virus increase the risk of seizures more than others. MATERIAL AND METHODS: This was a retrospective multicenter study of pediatric (zero to 16 years) patients with COVID-19 who attended five pediatric emergency departments in Madrid, Spain, between March 2020 and July 2022. An analysis of demographics, medical history, and seizure characteristics was conducted. The data obtained were correlated with the incidence of the different strains of SARS-CoV-2 in the Community of Madrid. RESULTS: A total of 2411 seizures (infectious and noninfectious) were recorded, and 35 of them (1.4%) were positive for SARS-CoV-2. Of those 35 patients, 18 (51.4%) reported a history of previous seizures. The highest percentage of cases occurred when the omicron variant was the most prevalent (28 [80%] vs 7 [20%] before omicron variant). Typical febrile seizures accounted for 52.9% of the cases. No treatment was required in more than half (57.1%) of the cases. CONCLUSION: during the emergence of the omicron variant, there has been an increase in the number of COVID-19-associated seizures. These findings highlight the need for SARS-CoV-2 screening in patients with febrile and afebrile seizures, in addition to other microbiological, biochemical, or neuroimaging tests, depending on the patient's age and clinical presentation.

Occupational diseases compensated in the Basque Country (Spain) from 1990 to 2008.

OBJECTIVE: Spain, and some of its regions in particular, report higher rates of occupational diseases than many other countries in Europe. We describe the distribution and temporal trend of compensated occupational diseases among the working population of the Basque Country, a heavy industrialized Spanish region, from 1990 to 2008. METHODS: Employment data and occupational disease data were obtained from the Spanish Institute of Statistics and the Basque and Spanish Social Security Departments, respectively. Annual incidence of occupational diseases and temporal trends were computed. RESULTS: Occupational diseases (33,547) were reported among workers in the Basque Country between 1990 and 2008. The occupational disease incidence increased sixfold during the study period, mainly due to less severe cases. The most frequent occupational diseases were caused by physical agents (85%), principally musculoskeletal disorders. The occupational disease incidence in Basque Country was two to six times higher than in most other regions of Spain and Europe. CONCLUSIONS: The rise in compensated occupational illnesses in the Basque Country is likely due to a mixture of better recognition of such illnesses and changes in laws, regulations, and administrative procedures. Chronic occupational diseases such as cancer and chronic respiratory diseases, however, remain under-reported, and care for people with such illnesses represents an undue financial burden on the public health care system and on their families.