"Induced sputum versus gastric lavage for the diagnosis of pulmonary tuberculosis in children".

BACKGROUND: Diagnosis of pulmonary tuberculosis (PTB) is difficult in infants and young children. For microbiological confirmation of PTB children, sequential gastric lavage (GL) is recommended. Induced sputum (IS) may be an alternative or complementary tool, but the information is limited in children in developed countries. The aim of this study is to assess the safety and diagnostic yield from IS combined with GL for PTB diagnosis in non-HIV infected children. METHODS: The study involved 22 children with suspected PTB admitted to the Getafe Hospital from January 2007 to May 2011. IS and GL were performed on three consecutive days, according to a standardized protocol. In all samples, BK staining, culture and PCR were carried out, including Genotype MTBDR plus for resistance to INH-RIF (Isoniazid-Rifampin) since 2008. A preliminary analysis of an ongoing prospective study is presented. RESULTS: Median age was 72 months (range 1 month to 14 years of age). Seven (33%) were ≤ 5 years of age. Seventeen were clinically diagnosed of PTB based on positive PPD and radiological criteria. Microbiological confirmation was achieved in 10 (58.8%) by either GL or IS. M. tuberculosis was identified by GL in 8 children (47.1%) and by IS in 7 (41.2%). One infant (2 IS samples) had transient oxygen desaturation recovered spontaneously. CONCLUSIONS: IS appears to be safe and well tolerated by children for diagnosis of PTB and is more convenient. Increasing the diagnostic yield of PTB in children with PTB may be a complementary technique. Largest studies are necessary to define the role of IS in paediatric PTB.

[PFAPA syndrome: study of 10 cases]. / Síndrome PFAPA: Estudio de 10 casos.

BACKGROUND AND OBJECTIVES: «PFAPA syndrome¼ is an autoinflammatory entity consisting of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis. Its etiology is unknown although a dysregulation in the control of the autoinflammatory response seems to play a role. Although a genetic origin is suspected, no specific mutation has been determined yet. Corticosteroids are the mainstay of the treatment during the acute attacks. However, in long-term follow-up the role of tonsillectomy is controversial. PATIENTS AND METHODS: A retrospective study of the pediatric cases diagnosed with the PFAPA syndrome was performed in our center during the last 4 years. RESULTS: Ten patients were diagnosed with the syndrome who received corticosteroids as the only treatment with improvement and favourable prognosis. CONCLUSION: PFAPA syndrome is the most common periodic fever disorder described in childhood whose genetic background has not been yet clarified. Our contribution with 10 patients further supports the common existence of this entity and the need to keep it in mind when having recurrent fevers.

Embarazo en la adolescencia, su repercusión familiar y en la sociedad / Pregnancy in adolescence, its familiar repercussion and in the society

El embarazo en edades tempranas se ha convertido en un problema social y de salud pública de alcance mundial, que afecta a la familia en gran medida como célula fundamental de la sociedad; lo que constituye un reto de gran envergadura. En la actualidad es de gran importancia abordar el periodo de la adolescencia, dada la trascendencia de este grupo etario para el desarrollo y su impacto en la población mundial, particular, en América Latina, el Caribe y Cuba. La maternidad temprana afecta directo a los indicadores perinatales maternos y la salud familiar, propicia una disfuncionalidad en la misma. Describir la repercusión que tiene sobre la familia y la sociedad el embarazo en la adolescencia, fue el objetivo de la investigación. Mediante el resultado del análisis crítico de la información disponible sobre el tema en la bibliografía consultada, se demuestra cómo las consecuencias de este problema repercuten en la calidad de vida de la joven madre y de su familia; determina un riesgo importante para su descendencia. Es por ello que se hace necesario comenzar las acciones relacionadas con estos aspectos a partir de la célula básica de la sociedad, que es la familia, pues constituye el primer grupo al cual pertenece el ser humano. Se necesita imprescindible el papel de los profesionales de la enfermería a nivel de los consultorios del médico de familia, como un elemento clave para la prevención del embarazo precoz, mediante la labor educativa y otras acciones que contribuyan a la prevención. Fueron consultadas las bases de datos LILACS, EBSCO e HINARI.

The pregnancy at an early agehas become a social and public health problem of worldwide reach, greatly affecting the family as the fundamental unit of society which constitutes a far-reaching challenge.At the present, it is vital to discuss the teen-age period, due tothis age group transcendence for developmental and its impact in the world population, individual, in Latin America, The Caribbean, and Cuba. Early maternity have a direct effect on the perinatal maternal indicators and the family health, it propitiatesfamily malfunctioning.Describing the repercussion that the pregnancy in adolescence has on the family and the society was the objective of this study. Data bases such as LILACS, EBSCO and HINARI were consulted. By means of the result of critical analysis of the available topical information in the consulted bibliography,it is provided evidence of how the consequences of this problem have influence upon the quality of life of the young mother and of her family; it determine an important risk for her descendants.Consequently, it becomes necessary to begin the actions related with these aspects from the basic cell of the society, which it is the family, because it is the first group a human being belongs to.The role of nurse professionals at family doctor offices proves to be itself indispensable for preventing early pregnancy, by means of the educational work and other actions than go towards prevention.

Maternidad temprana: repercusión en la salud familiar y en la sociedad / Early Pregnancy: Impact on Family Health and Society

Introducción: el embarazo en la adolescencia se considera en la actualidad una preocupación para el Sistema Nacional de Salud, afectando en gran medida a la familia como célula fundamental de la sociedad, así como a la salud propiamente dicha. Este fenómeno se manifiesta a nivel global y Cuba no está exenta. Se considera la maternidad temprana un problema culturalmente complejo que actúa desfavorablemente sobre la salud reproductiva de las adolescentes y la familiar, propiciando una disfuncionalidad en la misma, y en la dirección del desarrollo de un país, al afectar los índices de mortalidad materna y del recién nacido. Objetivo: profundizar en el embarazo de la adolescencia y de su inseparable unión entre la familia y la sociedad. Métodos: se realizó una revisión bibliográfica donde se consultaron las bases de datos incluidas en los servicios LILACS, EBSCO e HINARI, y se alcanzó muy buena cobertura, tanto en Cuba como en Latinoamérica, el Caribe y en el resto del mundo. Conclusiones: el embarazo en la adolescencia representa un impacto negativo sobre la condición física, emocional y económica de los adolescentes, que a su vez involucra a la familia y a la sociedad y constituye un problema social y médico(AU)

Introduction: Teenage pregnancy is considered today a concern for the National Health System, greatly affecting the family as the fundamental unit of society, and health itself. This is a global phenomenon and Cuba is not exempt. Early motherhood is considered a culturally complex problem that acts unfavorably on the reproductive health of adolescents and family, prompting a dysfunction, and the direction of development of a country, by affecting the rates of maternal and newborn mortality. Objective: Deepen on teenage pregnancy and inseparable union between family and society. Methods: A literature review was conducted to consult LILACS, EBSCO, and HINARI databases reaching a very good coverage, both in Cuba, Latin America, the Caribbean and elsewhere. Conclusion: pregnancy in adolescence represents a negative impact on the physical, emotional and economic status of adolescents, involving in turn family and society and it constitutes a social and health problem(AU)

Síndrome PFAPA: Estudio de 10 casos / PFAPA syndrome: Study of 10 cases

Fundamento y objetivo: El síndrome de PFAPA es una entidad autoinflamatoria que incluye fiebre periódica, estomatitis aftosa, faringitis y adenitis cervical. Su etiología es desconocida, pero una desregulación en el control de la respuesta inflamatoria parece tener un papel importante en la fisiopatología. Aunque se sospecha la existencia de un origen genético, no se ha determinado ninguna mutación hasta la fecha. Los corticoides son la base del tratamiento agudo, mientras que el papel de la amigdalectomía en el seguimiento a largo plazo es controvertido. Pacientes y método:Se realizó un estudio retrospectivo de los casos pediátricos diagnosticados de síndrome de PFAPA en nuestro centro en los últimos 4 años. Resultados: Se encontró un total de 10 pacientes diagnosticados de este síndrome que recibieron corticoides como único tratamiento eficaz con adecuada respuesta y pronóstico favorable. Conclusiones: El síndrome PFAPA constituye el tipo de fiebre periódica más frecuente en la edad pediátrica, cuyo origen genético no ha sido elucidado todavía. Nuestra contribución con 10 pacientes afectos resalta la frecuencia común de esta entidad y la necesidad de tenerla presente ante toda fiebre recurrente (AU)

Background and objectives: «PFAPA syndrome» is an autoinflammatory entity consisting of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis. Its etiology is unknown although a dysregulation in the control of the autoinflammatory response seems to play a role. Although a genetic origin is suspected, no specific mutation has been determined yet. Corticosteroids are the mainstay of the treatment during the acute attacks. However, in long-term follow-up the role of tonsillectomy is controversial. Patients and methods: A retrospective study of the pediatric cases diagnosed with the PFAPA syndrome was performed in our center during the last 4 years.Results: Ten patients were diagnosed with the syndrome who received corticosteroids as the only treatment with improvement and favourable prognosis. Conclusion: PFAPA syndrome is the most common periodic fever disorder described in childhood whose genetic background has not been yet clarified. Our contribution with 10 patients further supports the common existence of this entity and the need to keep it in mind when having recurrent fevers (AU)