Análisis de las bronquiolitis por virus respiratorio sincitial hospitalizadas en un servicio de Pediatría durante dos temporadas separadas por 5 años y su relación con el broncoespasmo recurrente tras el alta / No disponible

Introducción: la bronquiolitis (BQL) es la infección de las vías respiratorias inferiores másfrecuente en lactantes menores de 1 año y una causa importante de hospitalización. El virus respiratoriosincitial (VRS) es el agente causal en el 70%-80% de los casos. Nos hemos preguntadosi, en nuestro medio, la variación en las diferentes tendencias terapéuticas a lo largo deltiempo se ha traducido en variaciones en los resultados clínicos.Material y métodos: se incluyeron en el estudio todos los lactantes menores de 2 años(< 24 meses) hospitalizados en nuestro servicio de Pediatría, por un primer episodio de BQLcausado por el VRS, durante dos temporadas con un intervalo de 5 años (2000-2001 y2005-2006). Se analizaron las diferencias epidemiológicas, clínicas y de tratamiento existentesentre estas dos temporadas.Posteriormente, las familias de los pacientes ingresados durante la segunda temporada,fueron entrevistadas mediante encuesta telefónica para obtener información clínico-epidemiológicasobre la evolución de la enfermedad tras el alta.Resultados: se incluyeron 110 pacientes, 56 de la primera temporada (2000-2001) y 54de la segunda (2005-2006). La BQL por VRS en nuestra muestra afectó fundamentalmentea lactantes menores de 1 año con una edad media al ingreso de 4,8 meses, sobre todo varones(65,5%) y con una época epidémica invernal (noviembre-febrero). En cuanto al tratamiento,destacó el menor uso de oxígeno adicional y de β2-agonistas, y el mayor uso de fluidoterapiaintravenosa y de adrenalina nebulizada durante la segunda temporada respecto ala primera En el estudio de seguimiento, mediante encuesta telefónica, el 56,6% de los pacientes entrevistadospresentó algún nuevo episodio de broncoespasmo tras el alta hospitalaria, precisandoasistencia en urgencias el 58,8%, siendo estos porcentajes mayores en aquellos pacientescon antecedentes familiares de broncoespasmo...(AU)

Introduction: bronchiolitis is the most frequent infection of the lower respiratory tractamong infants under 1 year and a significant cause of hospitalization. Respiratory syncytialvirus is the causal agent in 70%-80% of the cases. Our main goal was to check if differenttherapeutic tendencies over time have caused variations in clinical results.Patients and methodology: the study includes infants under 2 years of age admitted toour Pediatrics Department after a first episode of respiratory syncytial virus bronchiolitis,during two periods separated by 5 years (2000-2001 and 2005-2006). Epidemiological, clinicaland treatment differences between these two periods were analyzed.Subsequently, the families of patients admitted to hospital during the second periodwere interviewed by phone in order to obtain clinical and epidemiological informationabout the evolution of the disease after hospital discharge.Results: one hundred and ten patients were included; 56 from the first period (2000-2001) and 54 from the second (2005-2006). The respiratory syncytial virus bronchiolitis,in our sample, affected mainly to infants under 1 year, with an average age of 4.8 monthswhen admitted, most of them were male (65.5%) and during the winter season (November-February). Regarding treatment, during the second period additional oxygen and ‚2agonists were used less, while the use of intravenous fluid-therapy and nebulized adrenalineincreased.During the follow-up study made by phone interviews, 56.6% of the patients presentedwith a new wheezing episode after hospital discharge, 58.8% of them requiring healthcareassistance; these patients had a higher family history of asthma.Conclusions: even though the treatment of bronchiolitis has changed during these 5 years,main variations such as average hospital stay (5.2 days) and complications (intubations,referral to the ICU) did not have any significant modifications...(AU)

[Tuberculosis outbreak in a school]. / Brote de tuberculosis en una escuela.

OBJECTIVE: To demonstrate the importance of preventive measures when a case of tuberculosis is detected, identify the causes that favored a tuberculosis outbreak in a school and determine the efficiency of obtaining induced sputum samples. DESIGN: Descriptive, study. SETTING: The Santa Maria de la Providencia school, located in the municipality of Alcala de Henares in Spain. INTERVENTIONS: On April 11, 2005, a case of bacilliform pulmonary tuberculosis was notified in a teacher. Study of contacts in the collective was performed as a programmed intervention. Mantoux skin test and, if positive, chest radiograph were performed in contacts. Treatment of latent or active tuberculosis was recommended according to the result. RESULTS: School exposures were identified and underwent the Mantoux skin test (142 students in years 1, 2, 3, and 4 of compulsory secondary education and 22 teachers). The Mantoux test was positive in 68 students (48 %) and seven teachers (32 %). In seven students with results compatible with active tuberculosis disease, sputum induction was performed and treatment was started. A further two students, identified as contacts, were studied in another center and also started treatment for active tuberculosis disease. Due to the high risk of contagion, study of contacts was extended to the remaining students in compulsory secondary education. In this second phase, 134 students received the Mantoux skin test and seven were Mantoux positive (5.2 %). In all these students, active tuberculosis disease was ruled out. Latent tuberculosis treatment was recommended in all Mantoux-positive contacts.

Brote de tuberculosis en una escuela / Tuberculosis outbreak in a school

Objetivo. Demostrar la importancia de la actuación preventiva ante un caso de tuberculosis. Identificar las causas que favorecieron dicho brote. Comprobar la rentabilidad de la obtención de muestras mediante la inducción del esputo. Diseño. Estudio descriptivo. Emplazamiento. Colegio Santa María de la Providencia, ubicado en el municipio de Alcalá de Henares. Intervenciones. El 11 de abril de 2005 se notificó un caso de tuberculosis pulmonar bacilífera en un profesor de escuela. Como intervención programada se realizó el estudio de contactos del colectivo. Se realizó la prueba de tuberculina y radiografía de tórax (si tenían tuberculina positiva) a los contactos, recomendando tratamiento de la infección tuberculosa latente o de la enfermedad tuberculosa según el resultado. Resultados. Inicialmente se identificó el círculo de expuestos al caso, realizándose la prueba de tuberculina. En total la prueba se llevó a cabo en 142 alumnos de los grupos 1.º, 2.º, 3.º y 4.º de ESO y 22 profesores del claustro. Los resultados de la lectura de la prueba de tuberculina suponen un total de 68 alumnos con prueba (+) (48 %) y 7 profesores con prueba (+) (32 %). Los pacientes con hallazgos compatibles con enfermedad tuberculosa (7 alumnos) fueron citados para recoger muestras respiratorias, mediante la técnica del esputo inducido, e inicio de tratamiento. Otros 2 alumnos del centro escolar, identificados como expuestos, fueron estudiados en otro centro, iniciando ambos igualmente tratamiento de la enfermedad tuberculosa. Debido al elevado riesgo de contagio, se decide ampliar el estudio de contactos al resto de alumnos de ESO. En esta segunda fase se realizó la prueba a un total de 134 alumnos, de los cuales 7 tuvieron la prueba de tuberculina (+) (5,2 %). Se descartó mediante radiología, la presencia de enfermedad tuberculosa en todos ellos. A todos los contactos con prueba de tuberculina (+) se recomendó tratamiento de la infección tuberculosa latente

Objective. To demonstrate the importance of preventive measures when a case of tuberculosis is detected, identify the causes that favored a tuberculosis outbreak in a school and determine the efficiency of obtaining induced sputum samples. Design. Descriptive, study. Setting. The Santa Maria de la Providencia school, located in the municipality of Alcala de Henares in Spain. Interventions. On April 11, 2005, a case of bacilliform pulmonary tuberculosis was notified in a teacher. Study of contacts in the collective was performed as a programmed intervention. Mantoux skin test and, if positive, chest radiograph were performed in contacts. Treatment of latent or active tuberculosis was recommended according to the result. Results. School exposures were identified and underwent the Mantoux skin test (142 students in years 1, 2, 3, and 4 of compulsory secondary education and 22 teachers). The Mantoux test was positive in 68 students (48 %) and seven teachers (32 %). In seven students with results compatible with active tuberculosis disease, sputum induction was performed and treatment was started. A further two students, identified as contacts, were studied in another center and also started treatment for active tuberculosis disease. Due to the high risk of contagion, study of contacts was extended to the remaining students in compulsory secondary education. In this second phase, 134 students received the Mantoux skin test and seven were Mantoux positive (5.2 %). In all these students, active tuberculosis disease was ruled out. Latent tuberculosis treatment was recommended in all Mantoux-positive contacts

[Adverse reaction of pseudoephedrine]. / Reacción adversa por seudoefedrina.

We present a case of a 7 years old girl who developed an episode of myoclonic movements and tremors after being medicated with a not well quantified amount of a pseudoephedrine/antihistamine combination. We want to highlight the potential toxicity of pseudoephedrine, usually administered as part of cold-syrup preparations which are used for symptomatic treatment of upper respiratory tract cough and congestion associated with the common cold and allergic rhinitis. Although these products are generally considered to be safe either by physicians and parents, we can't underestimate the potential adverse events and toxic effects that can occur when administering these medications.

Reacción adversa por seudoefedrina / Adverse reaction of pseudoephedrine

Aportamos el caso de una niña de 7 años de edad que presentó un episodio de mioclonías y temblores de pocas horas de duración tras haber ingerido una cantidad no bien determinada de un preparado que contenía antihistamínico y seudoefedrina. Queremos destacar la potencial toxicidad de la seudoefedrina, comercializada en asociación con antihistamínicos y que se vende como fármaco para aliviar el resfriado común y la obstrucción nasal. Dichos productos se consideran medicamentos para tratar síntomas a menudo banales, por lo que pensamos que la población y, con menos frecuencia, los profesionales, pueden infravalorar la potencial toxicidad de los fármacos que los componen (AU)

We present a case of a 7 years old girl who developed an episode of myoclonic movements and tremors after being medicated with a not well cuantified amount of a pseudoephedrine/antihistamine combination. We want to highlight the potencial toxicity of pseudoephedrine, usually administered as part of cold-syrup preparations which are used for symptomatic treatment of upper respiratory tract cough and congestion associated with the common cold and allergic rhinitis. Although these products are generally considered to be safe either by physicians and parents, we can’t underestimate the potencial adverse events and toxic effects that can occur when administering these medications We present a case of a 7 years old girl who developed an episode of myoclonic movements and tremors after being medicated with a not well cuantified amount of a pseudoephedrine/antihistamine combination. We want to highlight the potencial toxicity of pseudoephedrine, usually administered as part of cold-syrup preparations which are used for symptomatic treatment of upper respiratory tract cough and congestion associated with the common cold and allergic rhinitis. Although these products are generally considered to be safe either by physicians and parents, we can’t underestimate the potencial adverse events and toxic effects that can occur when administering these medications (AU)