RESUMO
INTRODUCTION: Acute gastroenteritis (AGE) in infants has a significant impact on the quality of life of their parents. MATERIAL AND METHODS: Cross-sectional study on the sociological family impact related to rotavirus AGE in children under 2 years. The study was carried out in 25 hospitals and 5 primary care centres in Spain. Sociodemographic, epidemiological and clinical data were recorded, as well as the symptomatology of AGE and its severity measured by the Clark scale. Stool samples were tested to determine rotavirus positive (RV+) or negative (RV-). The parents were asked to complete a a family impact questionnaire. RESULTS: Stool specimens were tested in 1087 AGE cases (584 RV+ vs 503 RV-). The 99.5 % of parents whose children were RV+ reported more worries vs. the 97.7 % of RV-, and RV+ had a higher importance score (p < 0.05). A higher percentage of RV+ parents and those with a high importance score reported more time dedicated to dehydration treatment (p < 0.05). The 82.5 % vs. 73.9 % had disruption of their household tasks, with more importance scores (p < 0.05). RV+ had a higher percentage and importance score than RV- ones in all aspects of their child's AGE symptoms, except loss of appetite. CONCLUSION: AGE produces important dysfunctional experiences in daily family life. According to parental perceptions, RV+ produces greater worries and dysfunctions in child behaviour.
Assuntos
Saúde da Família , Gastroenterite/virologia , Infecções por Rotavirus , Estudos Transversais , Humanos , LactenteRESUMO
During the last few years, increasing antibiotic resistance amongst the major respiratory pathogens in the community has compromised the choice of empirical therapy for some respiratory tract infections. Of special interest has been the progressive increase in the resistance rates of Streptococcus pneumoniae to macrolides and penicillin, and of S. pyogenes to macrolides. Several studies have confirmed the association between community use of certain antibiotics and the development of resistance in S. pneumoniae and S. pyogenes. Nevertheless, not all the antibiotics have the same ability to select resistance and not all microorganisms are affected in the same way. The aim of antimicrobial therapy in respiratory tract infections is bacterial eradication. Pharmacokinetic and pharmacodynamics can be used to predict bacteriological eradication with antimicrobial therapy.
Assuntos
Farmacorresistência Bacteriana , Haemophilus influenzae/efeitos dos fármacos , Infecções Respiratórias/tratamento farmacológico , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pyogenes/efeitos dos fármacos , Antibacterianos/farmacocinética , Antibacterianos/uso terapêutico , Criança , Infecções por Haemophilus/tratamento farmacológico , Humanos , Infecções Respiratórias/microbiologia , Infecções Estreptocócicas/tratamento farmacológicoRESUMO
La tos ferina todavía es una enfermedad no bien controlada desde el punto de vista epidemiológico. En España su incidencia ha disminuido notablemente, en paralelo con el aumento de cobertura vacunal de la población infantil, pero en el año 2000 aún se declararon 906 casos. Aunque la cobertura vacunal de la primovacunación es muy buena, la administración de las dosis de refuerzo de los 18 meses y los 4-6 años ha sido poco frecuente en la mayoría de comunidades, por lo que el nivel de inmunidad de la población es deficiente. Esta falta de control de la tos ferina se debe a una subóptima cobertura vacunal, consecuente a la elevada frecuencia de efectos adversos de la vacuna de tos ferina de célula completa (Pw) y a la pérdida de inmunidad protectora en adolescentes y adultos, que constituyen la principal fuente de contagio de los niños pequeños. La solución a estos problemas pasa por la utilización de las nuevas vacunas acelulares de tos ferina (Pa), tanto en la primovacunación como en las dosis de refuerzo, para conseguir mantener una inmunidad prolongada. Las vacunas DTPa con Pa de tres o más componentes protegen mejor que las de uno o dos componentes, y con una eficacia similar a la de las vacunas DTPw. Los efectos adversos de las vacunas DTPa son menores que los de las vacunas DTPw. En los países desarrollados, como España, las ventajas de las vacunas combinadas con Pa justifican su uso en sustitución de las vacunas con Pw (AU)
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