Epidemiología de la neumonía adquirida en la comunidad en menores de 5 años en la Comunidad Valenciana / Epidemiology of community-acquired pneumonia in children aged lessthan 5 years old in the Autonomous Community of Valencia (Spain)

Objetivo: Estimar la incidencia, tratamiento y complicaciones de la neumonía adquirida en la Comunidad Valenciana. Métodos: Cohorte retrospectiva de 654 niños nacidos en 1995 y 1996 en Valencia, y seguidos durante los primeros 5 años de vida por 9 pediatras. Se obtuvo el número de neumonías, tratamiento, complicaciones e intervenciones requeridas. Resultados: Se encontraron 99 episodios de neumonía adquirida en la comunidad (NAC) en 80 pacientes (1,24 casos/niño), 51 casos (51,1 %) antes del tercer año y 38 entre el tercer y quinto año (38,4 %): 51 casos (51,5 %) fueron diagnosticados en atención primaria y 46 (46,5 %) en urgencia hospitalaria. En atención primaria, la media de visitas fue de 2,44, con un rango de 1 a 6. Todos fueron tratados con antibiótico. Los más utilizados fueron amoxicilina-ácido clavulánico (43,4 %) y cefuroxima (26,3 %). Catorce casos requirieron cambio a un segundo antibiótico. El 23 % de los casos ingresó en el hospital para tratamiento. Conclusión: La incidencia de NAC en nuestro medio en 30,3 casos/1.000 niños menores de 5 años/año (intervalo de confianza [IC] 95 %: 18,7-46,8). La incidencia de ingreso corresponde a 7,03 casos/1.000 niños menores de 5 años/ año

Objective: To assess the incidence of community acquired pneumonia in the Autonomous Community of Valencia in Spain, and describe its treatment and complications. Methods: A retrospective cohort comprising 654 children born in 1995 and 1996 in Valencia and followed-up during the first 5 years of life by nine pediatricians was studied. The number of cases of pneumonia, treatment, complications and interventions was recorded. Results: Ninety-nine episodes of community-acquired pneumonia in 80 children were recorded (1.24 cases/child). Fifty-one cases (51.1 %) occurred before the child's third birthday and 38 (38.4 %) occurred between the third and the fourth. Of the 99 cases, 51 were diagnosed in primary care and 46 in the emergency room. There was a mean of 2.44 visits per process in primary care (range 1-6). All the children were treated with antibiotics. The most frequently used were amoxicillin-clavulanate (43.3 %) and cefuroxime (26.3 %). Fourteen patients required a change of antibiotic. Twenty-three percent of the children were hospitalized. Conclusion: The incidence of community-acquired pneumonia in Valencia was 30.3 cases/1000 children aged less than 5 years/ year (95 % CI: 18.7-46.8), and the incidence of hospitalization was 7.03 cases/1000 children aged less than 5 years/year

[Epidemiology of community-acquired pneumonia in children aged less than 5 years old in the Autonomous Community of Valencia (Spain)]. / Epidemiología de la neumonía adquirida en la comunidad en menores de 5 años en la Comunidad Valenciana.

OBJECTIVE: To assess the incidence of community acquired pneumonia in the Autonomous Community of Valencia in Spain, and describe its treatment and complications. METHODS: A retrospective cohort comprising 654 children born in 1995 and 1996 in Valencia and followed-up during the first 5 years of life by nine pediatricians was studied. The number of cases of pneumonia, treatment, complications and interventions was recorded. RESULTS: Ninety-nine episodes of community-acquired pneumonia in 80 children were recorded (1.24 cases/child). Fifty-one cases (51.1 %) occurred before the child's third birthday and 38 (38.4 %) occurred between the third and the fourth. Of the 99 cases, 51 were diagnosed in primary care and 46 in the emergency room. There was a mean of 2.44 visits per process in primary care (range 1-6). All the children were treated with antibiotics. The most frequently used were amoxicillin-clavulanate (43.3 %) and cefuroxime (26.3 %). Fourteen patients required a change of antibiotic. Twenty-three percent of the children were hospitalized. CONCLUSION: The incidence of community-acquired pneumonia in Valencia was 30.3 cases/1000 children aged less than 5 years/ year (95 % CI: 18.7-46.8), and the incidence of hospitalization was 7.03 cases/1000 children aged less than 5 years/year.

[Visceral leishmaniasis and AIDS. Report of 2 cases with cutaneous dissemination]. / Leishmaniasis visceral y SIDA. A propósito de dos casos con diseminación cutánea.

The cutaneous affection in visceral leishmaniasis (VL) or Kala-azar, is well known although poorly documented. The coinfection by the human immunodeficiency virus (HIV) has resulted in the development of frequent atypical forms of VL, increasing the descriptions of cutaneous affection in its evolution. We present two cases of VL-HIV, stressing the location of Leishmania in cutaneous lesions and in apparently normal skin. We suggest the cutaneous biopsy as diagnostic procedure and criteria for the definition of VL-HIV as indicative of AIDS.

[Chronic calcifying pancreatitis and chronic renal failure]. / Pancreatitis crónica calcificante e insuficiencia renal crónica.

We report a case of chronic calcifying pancreatitis and exocrine pancreatic deficiency in a patient with chronic renal failure under hemodialysis. We analyze the possible relationship between these two entities with special reference to the role of secondary hyperparathyroidism and extraosseous or metastatic calcification.