La expresión clínica y epidemiológica actual por tos ferina en un hospital terciario / The clinical expression and current epidemiology of whooping cough in a tertiary hospital

Objetivo: Describir el patrón clínico y epidemiológico de la expresión de tos ferina. Material y métodos: Estudio retrospectivo observacional de pacientes entre 0 y 15 años de edad diagnosticados de infección por Bordetella pertussis entre enero de 2009 y diciembre de 2011 en un hospital terciario de Madrid. Resultados: Se confirmaron microbiológicamente 65 casos, un 46,1% de ellos en menores de 1 año; un 20% de los niños no había recibido ninguna vacuna de B. pertussis, un 77% de ellos debido a que eran menores de 2 meses. El síntoma principal fue la tos paroxística (61,5%), con una media de 11 días de evolución. La radiografía de tórax y el hemograma no ayudaron a esclarecer el diagnóstico. Conclusión: La tos ferina es una enfermedad que cabe considerar en lactantes y adolescentes. Es necesario adoptar determinadas medidas preventivas para disminuir la incidencia de esta patología (AU)

Title: The clinical expression and current epidemiology of whooping cough in a tertiary hospital Objective: To describe the clinical and epidemiological pattern of expression of pertussis. Methods: Retrospective observational study of patients between 0 and 15 years of age diagnosed with infection by Bordetella pertussis between January 2009 and December 2011 in a tertiary hospital in Madrid. Results: 65 cases were confirmed microbiologically, 46.1% of them in children under 1 year; 20% of children had received no vaccine for B. pertussis, 77% of them were under 2 months old. The main symptom was ther paroxistical cough (61.5%), with 11 days of average evolution. Chest X ray and blood test didn’t help to find out the diagnosis. Conclusion: Pertussis is a disease to be considered in infants and adolescents. It is necessary to perform certain preventive attitudes to reduce the incidence of this disease (AU)

Presencia de los familiares durante la realización de procedimientos invasivos / Presence of family members while performing invasive procedures. A prospective study

Introducción: En nuestro medio tradicionalmente no se ha permitido a los familiares de los pacientes permanecer junto al niño cuando se realizaban procedimientos invasivos. Objetivo: Evaluar el grado de satisfacción de los familiares, el personal sanitario y del propio paciente con la presencia de los familiares durante la realización de los procedimientos dolorosos en un servicio de urgencias pediátricas. Material y métodos: Se realizó un estudio observacional prospectivo. Se diseñó un protocolo de actuación y se instruyó al personal sanitario. Se diseñó una encuesta con datos demográficos, datos del procedimiento y grado de satisfacción tanto del paciente y su familiar como del profesional sanitario. Resultados: Se obtuvieron datos de 75 procedimientos. En 5 de ellos los familiares rechazaron la opción de estar presentes. Los más frecuentes fueron punciones lumbares (44%), sutura/cura de heridas (22,7%) y venopunciones (17,3%). El 100% de los niños quisieron que sus familiares estuvieran presentes. El 90% de los familiares y el 57% de los profesionales opinaron que la presencia de los familiares había facilitado el procedimiento. El 90% de los familiares y el 76% de los profesionales opinaron que había sido beneficioso para el niño. El 95% de los familiares y el 71% de los profesionales opinaron que se debería dar la opción a los familiares de estar presentes. El 73% de los profesionales quedaron satisfechos. En una escala del 1 al 10 la satisfacción global de los familiares fue de un 9,5. Conclusiones: En nuestra experiencia la presencia familiar es una práctica posible que facilita la realización de los procedimientos dolorosos y resulta beneficiosa para el niño. Encontramos una alta satisfacción familiar y al mismo tiempo una amplia aceptación por parte del personal sanitario(AU)

Introduction: Family members of child patients have traditionally not been allowed to be present during invasive procedures. Objectives: To evaluate the level of satisfaction of family members, healthcare professionals, and the patients themselves, when family members are present during invasive procedures carried out in the pediatric emergency department. Materials and methods: A prospective observational study was carried out, which included a questionnaire containing demographic information, the details of the procedure, and the level of satisfaction of the patient, their family members, and the healthcare professionals present. Results: Data was obtained from 75 procedures. In 5 of these, family members chose not to be present during the procedure. The most frequent procedures were lumbar punctures (44%), laceration repairs (22,7%) and venopunctures (17,3%). All (100%) the children who were asked wanted their family members to be present. 90% of family members and 57% of healthcare professionals were of the opinion that the presence of family members facilitated the procedure. Furthermore, 90% of family members and 76% of healthcare professionals thought that family presence was beneficial to the patient. 95% of family members and 71% of healthcare professionals thought that the option to be present during invasive procedures should be given to family members. 73% of healthcare professionals were satisfied with the presence of family members. On a scale of one to ten, overall satisfaction of family members was 9.5.Conclusions: In our experience, family presence during invasive procedures is possible, and we have found this to be beneficial to the child. We also found that both family members and healthcare professionals were accepting and also satisfied with this new practice policy(AU)

[Presence of family members while performing invasive procedures. A prospective study]. / Presencia de los familiares durante la realización de procedimientos invasivos.

INTRODUCTION: Family members of child patients have traditionally not been allowed to be present during invasive procedures. OBJECTIVES: To evaluate the level of satisfaction of family members, healthcare professionals, and the patients themselves, when family members are present during invasive procedures carried out in the pediatric emergency department. MATERIALS AND METHODS: A prospective observational study was carried out, which included a questionnaire containing demographic information, the details of the procedure, and the level of satisfaction of the patient, their family members, and the healthcare professionals present. RESULTS: Data was obtained from 75 procedures. In 5 of these, family members chose not to be present during the procedure. The most frequent procedures were lumbar punctures (44%), laceration repairs (22,7%) and venopunctures (17,3%). All (100%) the children who were asked wanted their family members to be present. 90% of family members and 57% of healthcare professionals were of the opinion that the presence of family members facilitated the procedure. Furthermore, 90% of family members and 76% of healthcare professionals thought that family presence was beneficial to the patient. 95% of family members and 71% of healthcare professionals thought that the option to be present during invasive procedures should be given to family members. 73% of healthcare professionals were satisfied with the presence of family members. On a scale of one to ten, overall satisfaction of family members was 9.5. CONCLUSIONS: In our experience, family presence during invasive procedures is possible, and we have found this to be beneficial to the child. We also found that both family members and healthcare professionals were accepting and also satisfied with this new practice policy.

Hemorragia digestiva masiva por fistulización al esófago de una colateral aortopulmonar / Massive digestive system haemorrhage due to the formation of oesophageal fistulas of the aortopulmonary collateral arter

No disponible

Déficit del cofactor molibdeno como causa de encefalopatía epiléptica precoz / Molybdenum cofactor deficiency as a cause of early epileptic encephalopathy

No disponible

Lesiones equimóticas en miembro superior / Ecchymotic injuries in u pper extremity

El maltrato infantil es un problema que en muchos casos no llega a ser identificado. El papel del pediatra en la detección de una posible situación de abuso a través de la anamnesis, la exploración física, las pruebas complementarias y los datos sociales es fundamental. El maltrato físico debe formar parte del diagnóstico diferencial de cualquier lesión hallada en un niño. Las contusiones y los hematomas constituyen las manifestaciones más comunes, y existen hallazgos en la exploración que pueden orientar sobre su origen. Toda sospecha de maltrato debe comunicarse a las autoridades competentes. Se presenta un caso de maltrato físico detectado en el servicio de urgencias de un hospital terciario a partir de datos incongruentes en la anamnesis y lesiones sospechosas en la exploración(AU)

Child abuse is an important health problem which is often misdiagnosed. Paediatricians play a vital role in the detection of child maltreatment where, interviewing of parents and child, physical examination, diagnostic testing and investigation of any possible social risk factors is crucial when there is a suspicion. Maltreatment should be considered as part of the differential diagnosis when we face injuries in children. Haematomas and bruises are the most common clinical manifestation of physical abuse, and there are certain patterns which may be suggestive or even diagnostic of its probable origin. Suspected cases of child abuse should be always reported to the appropriate public agency. We present the case of a 12 year old boy, victim of physical abuse, diagnosed in the emergency department of a tertiary hospital based on a suspicion after vague explanation, inconsistent with the injury’s characteristics(AU)