RESUMO
BACKGROUND: While the Northern Hemisphere experiences the effects of the 2009 pandemic influenza A (H1N1) virus, data from the recent influenza season in the Southern Hemisphere can provide important information on the burden of disease in children. METHODS: We conducted a retrospective case series involving children with acute infection of the lower respiratory tract or fever in whom 2009 H1N1 influenza was diagnosed on reverse-transcriptase polymerase-chain-reaction assay and who were admitted to one of six pediatric hospitals serving a catchment area of 1.2 million children. We compared rates of admission and death with those among age-matched children who had been infected with seasonal influenza strains in previous years. RESULTS: Between May and July 2009, a total of 251 children were hospitalized with 2009 H1N1 influenza. Rates of hospitalization were double those for seasonal influenza in 2008. Of the children who were hospitalized, 47 (19%) were admitted to an intensive care unit, 42 (17%) required mechanical ventilation, and 13 (5%) died. The overall rate of death was 1.1 per 100,000 children, as compared with 0.1 per 100,000 children for seasonal influenza in 2007. (No pediatric deaths associated with seasonal influenza were reported in 2008.) Most deaths were caused by refractory hypoxemia in infants under 1 year of age (death rate, 7.6 per 100,000). CONCLUSIONS: Pandemic 2009 H1N1 influenza was associated with pediatric death rates that were 10 times the rates for seasonal influenza in previous years.
Assuntos
Surtos de Doenças , Hospitalização/estatística & dados numéricos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Adolescente , Distribuição por Idade , Argentina/epidemiologia , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Hipóxia/etiologia , Hipóxia/mortalidade , Lactente , Recém-Nascido , Influenza Humana/classificação , Influenza Humana/complicações , Influenza Humana/mortalidade , Masculino , Pneumonia Bacteriana/epidemiologia , Pneumonia Bacteriana/etiologia , Índice de Gravidade de Doença , Staphylococcus/isolamento & purificação , Streptococcus pneumoniae/isolamento & purificaçãoRESUMO
From the beginning of medicine, the reproduction of patients' images, initially as drawings, either for didactic purposes or to share experiences, were common in medical practice. Photography greatly facilitated and generalized this practice within health teams. The images of the affected patients need the same consents and guarantees of confidentiality as any other parts of the medical record, so the importance of obtaining informed consent is highlighted. Beyond ethical aspects, professionals have to take into account the legal responsibility involved in carrying out this act.
Desde los inicios de la medicina, la reproducción de imágenes de pacientes, ya sea con fines didácticos o de compartir experiencias, fue considerada una práctica habitual en el quehacer médico. La aparición de la fotografía facilitó y generalizó enormemente esta práctica dentro de los equipos de salud. Las imágenes de los pacientes requieren el mismo consentimiento y garantías de confidencialidad que otras partes del registro médico. Se remarca la importancia del consentimiento informado. Se considera la responsabilidad legal de estos actos.
Assuntos
Confidencialidade/ética , Consentimento Livre e Esclarecido/ética , Pediatria/ética , Fotografação/ética , Argentina , Criança , Confidencialidade/legislação & jurisprudência , Humanos , Consentimento Livre e Esclarecido/legislação & jurisprudência , Fotografação/legislação & jurisprudênciaRESUMO
Desde los inicios de la medicina, la reproducción de imágenes de pacientes, ya sea con fines didácticos o de compartir experiencias, fue considerada una práctica habitual en el quehacer médico. La aparición de la fotografía facilitó y generalizó enormemente esta práctica dentro de los equipos de salud. Las imágenes de los pacientes requieren el mismo consentimiento y garantías de confidencialidad que otras partes del registro médico. Se remarca la importancia del consentimiento informado. Se considera la responsabilidad legal de estos actos.
From the beginning of medicine, the reproduction of patients' images, initially as drawings, either for didactic purposes or to share experiences, were common in medical practice. Photography greatly facilitated and generalized this practice within health teams. The images of the affected patients need the same consents and guarantees of confidentiality as any other parts of the medical record, so the importance of obtaining informed consent is highlighted. Beyond ethical aspects, professionals have to take into account the legal responsibility involved in carrying out this act.
Assuntos
Humanos , Fotografia , Consentimento Livre e Esclarecido/ética , Bioética , Confidencialidade/ética , JurisprudênciaRESUMO
El síndrome urémico hemolítico es una enfermedad multiorgánica y con pronóstico variable según sea la forma clásica con diarrea o sin ella. Se lo reconoce por su alta morbilidad (insuficiencia renal crónica). En el período agudo se describen casos fatales. Reportamos el caso de un niño de 23 meses de vida quien ingresó a UCIP con diagnóstico de SUH para diálisis peritoneal. Durante el séptimo baño de diálisis el paciente experimentó inquietud, desasosiego y paro cardiorespiratorio casi inmediatamente. El hallazgo necrópsico reveló necrosis isquémica subendocárdica