Vacunación frente a la gripe estacional en la infancia y la adolescencia. Recomendaciones del Comité Asesor de Vacunas de la Asociación Española de Pediatría (CAV-AEP) para la campaña antigripal 2016-2017 / Seasonal influenza vaccination in children and adolescents. Recommendations of the Vaccine Advisory Committee of the Spanish Society of Paediatrics for the 2016-2017 campaign

El Comité Asesor de Vacunas de la Asociación Española de Pediatría (CAV-AEP) emite todos los años sus recomendaciones sobre la vacunación frente a este virus en la infancia y la adolescencia. La vacunación de la gripe es una actuación especialmente beneficiosa cuando va dirigida a personas (niños y adultos) que se incluyen en los grupos de población considerados de riesgo. Sin embargo, muchos niños y adolescentes pertenecientes a estos grupos de riesgo, y sus convivientes, continúan sin recibir, por distintas razones, dicha vacunación anual. Asimismo, se insiste en la recomendación de la vacunación de los profesionales sanitarios. En el presente documento se presentan las recomendaciones para la vacunación antigripal en la temporada 2016-2017, y se explican los fundamentos y limitaciones de las mismas. Es necesaria una mayor implicación de los profesionales, las autoridades sanitarias y todos los agentes sociales para transmitir cada año a la población, y de forma especial a los padres de niños y adolescentes pertenecientes a los grupos de riesgo, las recomendaciones de vacunación frente a la gripe estacional (AU)

The Advisory Committee on Immunization of the Spanish Association of Paediatrics issues its recommendations about vaccination against influenza virus in children and adolescents every year before the onset of the flu season. Influenza vaccination is particularly beneficial when aimed at individuals, both children and adults, who are included in the population groups considered at risk. However, for various reasons, many children and adolescents with underlying conditions and their contacts are still not given this vaccination annually. There is a need for a greater involvement of health professionals, health authorities and all social agents to inform the population, especially to the parents of children and adolescents in those risk groups, on the recommendations for seasonal influenza vaccination. In this document, current recommendations for influenza vaccination for the 2016-2017 season are presented, and reasons and limitations are explained. The recommendation for influenza vaccination is emphasized for health professionals (AU)

Calendario de vacunaciones de la Asociación Española de Pediatría (CAV-AEP): recomendaciones 2016 / Immunisation schedule of the Spanish Association of Paediatrics: 2016 recommendations

No disponible

[Immunisation schedule of the Spanish Association of Paediatrics: 2016 recommendations]. / Calendario de vacunaciones de la Asociación Española de Pediatría (CAV-AEP): recomendaciones 2016.

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) annually publishes the immunisation schedule which, in our opinion, estimates optimal for children resident in Spain, considering available evidence on current vaccines. We acknowledge the effort of the Ministry of Health during the last year in order to optimize the funded unified Spanish vaccination schedule, with the recent inclusion of pneumococcal and varicella vaccination in early infancy. Regarding the funded vaccines included in the official unified immunization schedule, taking into account available data, CAV-AEP recommends 2+1 strategy (2, 4 and 12 months) with hexavalent (DTPa-IPV-Hib-HB) vaccines and 13-valent pneumococcal conjugate vaccine. Administration of Tdap and poliomyelitis booster dose at the age of 6 is recommended, as well as Tdap vaccine for adolescents and pregnant women, between 27-36 weeks gestation. The two-dose scheme should be used for MMR (12 months and 2-4 years) and varicella (15 months and 2-4 years). Coverage of human papillomavirus vaccination in girls aged 11-12 with a two dose scheme (0, 6 months) should be improved. Information for male adolescents about potential beneficial effects of this immunisation should be provided as well. Regarding recommended unfunded immunisations, CAV-AEP recommends the administration of meningococcal B vaccine, due to the current availability in Spanish communitary pharmacies, with a 3+1 scheme (3, 5, 7 and 13-15 months). CAV-AEP requests the incorporation of this vaccine in the funded unified schedule. Vaccination against rotavirus is recommended in all infants. Annual influenza immunisation and vaccination against hepatitis A are indicated in population groups considered at risk.

Vacunación frente al meningococo B. Posicionamiento del Comité Asesor de Vacunas de la Asociación Española de Pediatría / Vaccination against meningococcal B disease. Public statement of the Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP)

La enfermedad meningocócica invasora, con sus 2 formas de presentación principales (sepsis y meningitis), es una patología grave y potencialmente mortal, causada por distintos serogrupos de Neisseria meningitidis, entre los cuales, actualmente, predomina el serogrupo B en Europa. La mayoría de los casos se producen en la edad pediátrica, con una mortalidad aproximada del 10% y un riesgo de secuelas permanentes del 20-30% entre los supervivientes. Presenta mayor incidencia y letalidad en niños sanos menores de 2-3 años, seguidos de los adolescentes, aunque puede ocurrir a cualquier edad. Hasta ahora no se contaba con ningún arma inmunopreventiva contra el meningococo B. Así, con la llegada a España de la única vacuna actualmente disponible, el Comité Asesor de Vacunas de la Asociación Española de Pediatría (CAV-AEP) ha analizado detalladamente tanto el potencial preventivo de dicha vacuna, como la situación peculiar administrativa de la misma en España. El objetivo de este documento es informar del posicionamiento del CAV-AEP en relación con la vacuna frente al meningococo B y el acceso a la misma por parte de la población infantil española, teniendo en cuenta que ha sido autorizada exclusivamente para el uso hospitalario en personas de riesgo. En Europa, la vacuna sí está disponible en farmacias, incluso incluida en calendarios oficiales de algunos países o regiones. Este comité considera que Bexsero(R) presenta un perfil de vacuna a incluir en todos los calendarios españoles y que debería estar disponible libremente en farmacias para su administración en todos los niños mayores de 2 meses

Meningococcal invasive disease, including the main clinical presentation forms (sepsis and meningitis), is a severe and potentially lethal infection caused by different serogroups of Neisseria meningitidis. Meningococcal serogroup B is the most prevalent in Europe. Most cases occur in children, with a mortality rate of 10% and a risk of permanent sequelae of 20-30% among survivors. The highest incidence and case fatality rates are observed in healthy children under 2-3 years old, followed by adolescents, although it can occur at any age. With the arrival in Spain of the only available vaccine against meningococcus B, the Advisory Committee on Vaccines of the Spanish Association of Paediatrics has analysed its preventive potential in detail, as well as its peculiar administrative situation in Spain. The purpose of this document is to publish the statement of the Committee as regards this vaccination and the access to it by the Spanish population, taking into account that it has been only authorized for people at risk. The vaccine is available free in the rest of Europe for those who want to acquire it, and in some countries and regions it has been introduced into the systematic immunisation schedules. The Committee considers that Bexsero(R) has a profile of a vaccine to be included in the official schedules of all the Spanish autonomous communities and insists on the need for it to be available in pharmacies for its administration in all children older than 2 months

[Immunisation schedule of the Spanish Association of Paediatrics: 2015 recommendations]. / Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2015.

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics updates the immunisation schedule every year, taking into account epidemiological data as well as evidence on the safety, effectiveness and efficiency of current vaccines, including levels of recommendation. In our opinion, this is the optimal vaccination calendar for all children resident in Spain. Regarding the vaccines included in the official unified immunization schedule, the Committee emphasizes the administration of the first dose of hepatitis B either at birth or at 2 months of life; the recommendation of the first dose of MMR and varicella vaccine at the age of 12 months, with the second dose at the age of 2-3 years; DTaP or Tdap vaccine at the age of 6 years, followed by another Tdap booster dose at 11-12 years old; Tdap strategies for pregnant women and household contacts of the newborn, and immunization against human papillomavirus in girls aged 11-12 years old with a 2 dose scheme (0, 6 months). The Committee reasserts its recommendation to include vaccination against pneumococcal disease in the routine immunisation schedule, the same as it is being conducted in Western European countries. The recently authorised meningococcal B vaccine, currently blocked in Spain, exhibits the profile of a universal vaccine. The Committe insists on the need of having the vaccine available in communitary pharmacies. It has also proposed the free availability of varicella vaccines. Their efectiveness and safety have been confirmed when they are administred from the second year of life. Vaccination against rotavirus is recommended in all infants. The Committee stresses the need to vaccinate population groups considered at risk against influenza and hepatitis A.

Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2015 / Immunisation schedule of the Spanish Association of Paediatrics: 2015 Recommendations

El Comité Asesor de Vacunas de la Asociación Española de Pediatría actualiza anualmente su calendario de vacunaciones, tras un análisis tanto epidemiológico como de la seguridad, efectividad y eficiencia de las vacunas actuales, incluyendo grados de recomendación. Es el calendario que se estima idóneo actualmente para los niños residentes en España. En cuanto a las vacunas oficiales incluidas en el calendario común, se recalca la posibilidad de vacunar indistintamente frente a hepatitis B desde el nacimiento o desde los 2 meses; la recomendación de la primera dosis de triple vírica y de varicela a los 12 meses y la segunda a los 2-3 años; la administración de la vacuna DTPa o Tdpa a los 6 años, con refuerzo en la adolescencia; estrategias con Tdpa en embarazadas y convivientes del recién nacido, y la inmunización frente al papilomavirus en niñas a los 11-12 años con pauta de 2 dosis (0, 6 meses). Este comité insiste en la vacunación antineumocócica universal, tal y como se está llevando a cabo en todos los países de Europa Occidental. La vacuna frente al meningococo B, autorizada pero bloqueada actualmente en España, presenta un perfil de vacuna sistemática y se reivindica que, al menos, esté disponible en las farmacias comunitarias. Se propone, igualmente, la disponibilidad pública de las vacunas frente a la varicela, ya que han demostrado ser efectivas y seguras a partir del segundo año de vida. La vacunación frente al rotavirus es recomendable en todos los lactantes. La vacunación antigripal anual y la inmunización frente a la hepatitis A están indicadas en grupos de riesgo

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics updates the immunisation schedule every year, taking into account epidemiological data as well as evidence on the safety, effectiveness and efficiency of current vaccines, including levels of recommendation. In our opinion, this is the optimal vaccination calendar for all children resident in Spain. Regarding the vaccines included in the official unified immunization schedule, the Committee emphasizes the administration of the first dose of hepatitis B either at birth or at 2 months of life; the recommendation of the first dose of MMR and varicella vaccine at the age of 12 months, with the second dose at the age of 2-3 years; DTaP or Tdap vaccine at the age of 6 years, followed by another Tdap booster dose at 11-12 years old; Tdap strategies for pregnant women and household contacts of the newborn, and immunization against human papillomavirus in girls aged 11-12 years old with a 2 dose scheme (0, 6 months). The Committee reasserts its recommendation to include vaccination against pneumococcal disease in the routine immunisation schedule, the same as it is being conducted in Western European countries. The recently authorised meningococcal B vaccine, currently blocked in Spain, exhibits the profile of a universal vaccine. The Committe insists on the need of having the vaccine available in communitary pharmacies. It has also proposed the free availability of varicella vaccines. Their efectiveness and safety have been confirmed when they are administred from the second year of life. Vaccination against rotavirus is recommended in all infants. The Committee stresses the need to vaccinate population groups considered at risk against influenza and hepatitis A

[Vaccination against meningococcal B disease. Public statement of the Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP)]. / Vacunación frente al meningococo B. Posicionamiento del Comité Asesor de Vacunas de la Asociación Española de Pediatría.

Meningococcal invasive disease, including the main clinical presentation forms (sepsis and meningitis), is a severe and potentially lethal infection caused by different serogroups of Neisseria meningitidis. Meningococcal serogroup B is the most prevalent in Europe. Most cases occur in children, with a mortality rate of 10% and a risk of permanent sequelae of 20-30% among survivors. The highest incidence and case fatality rates are observed in healthy children under 2-3 years old, followed by adolescents, although it can occur at any age. With the arrival in Spain of the only available vaccine against meningococcus B, the Advisory Committee on Vaccines of the Spanish Association of Paediatrics has analysed its preventive potential in detail, as well as its peculiar administrative situation in Spain. The purpose of this document is to publish the statement of the Committee as regards this vaccination and the access to it by the Spanish population, taking into account that it has been only authorized for people at risk. The vaccine is available free in the rest of Europe for those who want to acquire it, and in some countries and regions it has been introduced into the systematic immunisation schedules. The Committee considers that Bexsero® has a profile of a vaccine to be included in the official schedules of all the Spanish autonomous communities and insists on the need for it to be available in pharmacies for its administration in all children older than 2 months.

[Immunisation schedule of the Spanish Association of Paediatrics: 2014 recommendations]. / Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2014.

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) updates the immunisation schedule every year, taking into account epidemiological data as well as evidence on safety, effectiveness and efficiency of vaccines. The present schedule includes levels of recommendation. We have graded, as routine vaccinations, those that the CAV-AEP consider all children should receive; as recommended those that fit the profile for universal childhood immunisation and would ideally be given to all children, but that can be prioritised according to the resources available for their public funding; and as risk group vaccinations those that specifically target individuals in special situations. Immunisation schedules tend to be dynamic and adaptable to ongoing epidemiological changes. Based on the latest epidemiological trends, CAV-AEP recommends the administration of the first dose of MMR and varicella vaccines at age 12 months, with the second dose at age 2-3 years; the administration of DTaP or Tdap vaccine at age 4-6 years, always followed by another Tdap dose at 11-12 years; and the three meningococcal C scheme at 2 months, 12 months and 12 years of age. It reasserts its recommendation to include vaccination against pneumococcal disease in the routine immunisation schedule. The CAV-AEP believes that the coverage of vaccination against human papillomavirus in girls aged 11-12 years must be increased. Universal vaccination against varicella in the second year of life is an effective strategy, and the immediate public availability of the vaccine is requested in order to guarantee the right of healthy children to be vaccinated. Vaccination against rotavirus is recommended in all infants due to the morbidity and elevated healthcare burden of the virus. The Committee stresses the need to vaccinate population groups considered at risk against influenza and hepatitis A. The recently authorised meningococcal B vaccine has opened a chapter of hope in the prevention of this disease. In anticipation of upcoming national and international studies, the Committee recommends the vaccine for the control of disease outbreaks, and insists on the need to be available in pharmacies. Finally, it emphasises the need to bring incomplete vaccinations up to date following the catch-up immunisation schedule.

Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2014 / Immunisation schedule of the Spanish Association of Paediatrics: 2014 recommendations

El Comité Asesor de Vacunas de la Asociación Española de Pediatría (CAV-AEP) actualiza anualmente el calendario de vacunaciones teniendo en cuenta tanto aspectos epidemiológicos como de seguridad, efectividad y eficiencia de las vacunas. El presente calendario incluye grados de recomendación. Se consideran vacunas sistemáticas aquellas que el CAV-AEP estima que todos los niños deberían recibir; recomendadas, las que presentan un perfil de vacuna sistemática en la edad pediátrica y que es deseable que los niños reciban, pero que pueden ser priorizadas en función de los recursos para su financiación pública; y dirigidas a grupos de riesgo, aquellas con indicación preferente para personas en ciertas situaciones especiales. Los calendarios de vacunaciones tienen que ser dinámicos y adaptarse a los cambios epidemiológicos que vayan surgiendo. Teniendo en cuenta los últimos cambios en la epidemiología de las enfermedades, el CAV-AEP recomienda la administración de la 1.a dosis de las vacunas triple vírica y varicela a los 12 meses y la 2.a dosis a los 2-3 años; la administración de la vacuna DTPa o Tdpa a los 4-6 años, siempre acompañada de otra dosis de Tdpa a los 11-12 años; y el paso a un esquema 2 meses, 12 meses y 12 años de la vacunación frente al meningococo C. Se reafirma en la recomendación de incluir la vacunación frente al neumococo en el calendario de vacunación sistemático. El CAV-AEP estima que deben incrementarse las coberturas de vacunación frente al papiloma virus humano en las niñas a los 11-12 años. La vacunación universal frente a la varicela iniciada en el segundo año de vida es una estrategia efectiva, y se solicita la inmediata disponibilidad pública de la vacuna, reclamando el derecho a la prescripción y el derecho de los niños sanos a poder ser vacunados. La vacunación frente al rotavirus, dadas la morbilidad y la elevada carga sanitaria, es recomendable en todos los lactantes. Se insiste en la necesidad de vacunar frente a la gripe y a la hepatitis A a todos los que presenten factores de riesgo para dichas enfermedades. La vacuna frente al meningococo B, recientemente autorizada, abre un capítulo de esperanza en la prevención de esta enfermedad. En espera de próximos estudios nacionales e internacionales se recomienda, por el momento, para el control de brotes epidémicos y se insiste en el deseo de que sea comercializada libremente en las oficinas de farmacia. Por último, se insiste en la necesidad de actualizar las vacunaciones incompletas con las pautas de vacunación acelerada

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAVAEP) updates the immunisation schedule every year, taking into account epidemiological data as well as evidence on safety, effectiveness and efficiency of vaccines. The present schedule includes levels of recommendation. We have graded, as routine vaccinations, those that the CAV-AEP consider all children should receive; as recommended those that fit the profile for universal childhood immunisation and would ideally be given to all children, but that can be prioritised according to the resources available for their public funding; and as risk group vaccinations those that specifically target individuals in special situations. Immunisation schedules tend to be dynamic and adaptable to ongoing epidemiological changes. Based on the latest epidemiological trends, CAV-AEP recommends the administration of the first dose of MMR and varicella vaccines at age 12 months, with the second dose at age 2-3years; the administration of DTaP or Tdap vaccine at age 4-6 years, always followed by another Tdap dose at 11-12 years; and the three meningococcal C scheme at 2 months, 12 months and 12 years of age. It reasserts its recommendation to include vaccination against pneumococcal disease in the routine immunisation schedule. The CAV-AEP believes that the coverage of vaccination against human papilloma virus in girls aged 11-12 years must be increased. Universal vaccination against varicella in the second year of life is an effective strategy, and the immediate public availability of the vaccine is requested in order to guarantee the right of healthy children to be vaccinated. Vaccination against rotavirus is recommended in all infants due to the morbidity and elevated healthcare burden of the virus. The Committee stresses the need to vaccinate population groups considered at risk against influenza and hepatitis A. The recently authorised meningococcal B vaccine has opened a chapter of hope in the prevention of this disease. In anticipation of upcoming national and international studies, the Committee recommends the vaccine for the control of disease outbreaks, and insists on the need to be available in pharmacies. Finally, it emphasises the need to bring incomplete vaccinations up to date following the catch-up immunisation schedule

Incidence of anaphylaxis in the city of Alcorcon (Spain): a population-based study.

BACKGROUND: Relatively few studies have examined the incidence of anaphylaxis in the general population. OBJECTIVE: To report the incidence of anaphylaxis among the general population of the city of Alcorcon, Spain, using various public health care databases. METHODS: Episodes of anaphylaxis were recovered using validated alphanumeric strings in different fields of electronic clinical records used in the different public health settings in the city of Alcorcon (primary care, Emergency Department, hospitalized patients and Allergy Outpatient Clinic). Patients with anaphylaxis were tracked across the different clinical settings in Alcorcon. RESULTS: The incidence of anaphylaxis in Alcorcon was 103.37 episodes per 100 000 person-years (total standardized incidence rate of 112.2). There was a peak of 313.58 episodes in the 0-4 years age group and a different distribution of incidence rates (although non-significant) among different age groups between male patients and female patients. In most age groups, incidence tended to be higher for female patients aged over 10 years. Patients were attended at two or more levels in 76.78% of episodes, and a new evaluation was often made at a primary care centre (71.43%), Allergy Outpatient Clinic (75.6%), or both after the episode (58.93%). CONCLUSION AND CLINICAL RELEVANCE: This study revealed a higher rate of anaphylaxis than that in previous studies, although this incidence rate is probably lower than the real incidence rate. Studies exploring potential methodological, genetic and environmental factors accounting for these higher rates of anaphylaxis are required.

Nueva gripe [A(H1N1) 2009]: definición de caso sospechoso. Revisión de la concordancia en los criterios de definición de caso utilizados en las distintas comunidades autónomas españolas / No disponible

Introducción: la actual pandemia por un nuevo virus gripal y sus potenciales e inciertosefectos sobre la población han motivado un extraordinario despliegue de acciones a todos losniveles. Todos los preparativos se basan en los datos de situación de la pandemia. Este estudiopretende examinar la concordancia entre los criterios de definición de caso sospechoso de infecciónpor el nuevo virus de las distintas comunidades autónomas (CC. AA.) españolas y discutirsu posible impacto en la validez de la información acumulada.Material y métodos: se han recopilado, analizado y comparado los documentos y protocolosoficiales de las consejerías de sanidad de las CC. AA. en relación con la definición de casosospechoso de infección por el nuevo virus gripal, mientras ha estado vigente el sistema de registroe información basado en la recogida exhaustiva e individualizada de casos.Resultados: se han encontrado documentos referidos a 16 de las 17 CC. AA (todas menosCantabria y las ciudades autónomas de Ceuta y Melilla). Todas las variables que conformanla definición de caso muestran diferencias notables entre las CC. AA. estudiadas; en especiallos criterios de fiebre (con distintos umbrales) y las manifestaciones clínicas que caracterizanal síndrome gripal.Discusión: no hay dos formulaciones iguales de caso sospechoso entre todas las estudiadas,lo cual puede comprometer la validez final de los datos acumulados que son la base para losanálisis y preparativos realizados(AU)

Introduction: the present pandemia by a novel flu virus and its potential and uncertain effectson the population, have produced an extraordinary amount of actions at all levels. Allarrangements are based on data of the pandemia situation. This paper approaches the concordancein the suspected case definition criteria of infection by the new virus among the Spanish autonomous communities (AA. CC.) and to discuss its possible impact on the validity of the cumulatedinformation.Material and methods: documents and official protocols of the AA. CC. Health Departmentson novel flue suspected case definition have been compiled, while being in force therecording and information system based on the comprehensive and individualized record ofcases.Results: documents of 16 of the 17 AA. CC. (all but Cantabria and the autonomous townsof Ceuta and Melilla) have been found. All the variables that take part in the definition of caseshow outstanding differences among the AA. CC. studied; especially the criteria of fever (withvarious level thresholds) and the clinical manifestations of the flu-like syndrome.Discussion: there aren’t two equal formulations of suspected case among the studied ones,what compromises the final validity of the cumulated data which are the basis for the analysisand arrangements made(AU)

Vacunación frente al virus del papiloma humano para la prevención del cáncer de cérvix: ¿es el momento de su inclusión en los calendarios de vacunación infantil sistemática? / No disponible

Estamos asistiendo a un desarrollo espectacular de las vacunas en los últimos años. En estemomento nos encontramos ante una nueva vacuna, la vacuna frente a la infección por el virusdel papiloma humano (VPH) y el cáncer de cuello de útero (CCU); una vacuna destinada aprevenir enfermedades que padecerán los adultos, en particular las mujeres. Las autoridades sanitarias,los profesionales y la población tienen ante sí una intervención preventiva que ha despertadoexpectativas extraordinarias, y de la que se han de tomar decisiones nada fáciles. Estambién una actividad preventiva que para los pediatras constituye un novedoso reto por lasparticularidades de la enfermedad que se pretende evitar.Este suplemento de la Revista Pediatría de Atención Primaria se propone abordar el debatecientífico, las particularidades de la implementación de esta nueva vacuna y su posible incorporacióna los calendarios de vacunaciones sistemáticas en la población infantil. La mayoríade los interrogantes que se nos plantean necesitarán aún de nuevos estudios para poder tenerrespuestas definitivas. En esta presentación se pretende hacer una somera enumeración delo que ha de ser objeto de debate científico en el futuro próximo y que reconocidos expertosdesarrollan en los artículos siguientes

We are facing a great development of vaccines in the last few years. We are now infront o a new vaccine, the vaccine against infections caused by human papillomaviruses(HPV) and the cancer of uterine cervix-cervical cancer (CC); a vaccine bound to preventconditions that will be suffered in adulthood, particularilly the women. Sanitary authorities,health proffessionels and population in general have in front of them a preventive intervention that has raised extraordinary expectations, and about which there have to be takendecissions not easy at all. It is also a preventive intervention that represents a new challengeto the pediatricians because of the special features of the condition that is expected toprevent.This supplement of the journal “Pediatría de Atención Primaria” intends to approachthe scientific debate, the special feachures for the implementation of this new vaccineand its possible incorporation to the immunization schedules of children. Most of thedoubts we are facing will still need of new studies to have definite answers. This presentationtries to make a brief enumeration of what has to be the subject of scientific debatein the near future and that is outlined in the papers writen by well-known experts inthe topic

"Consenso en adopción internacional. Guía para pediatras y otros profesionales sanitarios". Resumen estructurado / No disponible

Se presenta un resumen estructurado del documento “Consenso en adopción internacional.Guía para pediatras y otros profesionales sanitarios” publicado en noviembre de 2005. Elresumen presentado trata de ser una muestra representativa del conjunto del documentooriginal y reflejar con fidelidad su contenido y propósitos.La adopción internacional ha aumentado en nuestro entorno de forma extraordinaria.En el período de tiempo de 1997 a 2004 han llegado a nuestro país 24.042 niños procedentesde 49 países. Los niños adoptados en el extranjero tienen mayor riesgo de presentar problemasde salud. El viaje y la estancia en el extranjero implican riesgos adicionales. Se describenel contenido de la consulta preadoptiva y las recomendaciones para llevar a cabo una evaluacióncompleta tras la llegada del niño desde su lugar de origen a su nueva familia. También sedestaca la necesidad de hacer un seguimiento longitudinal a largo plazo

We present a structured summary of the document “Consensus on international adoption.Guidelines for paediatricians and other health professionals” published on November2005. The summary presented tries to be a representative sample of the whole original documentand to reflect its contents and proposals with fidelity. International adoption hasincreased in an extraordinary way in our country. Between 1997 and 2004, 24042 childrenfrom 49 countries have arrived. Children adopted abroad have an increased risk of presentingwith health problems. The journey and stay abroad implies additional risks. We describethe contents of the preadoptive medical visit and recommendations for making acomplete evaluation after the arrival of the child from his/her country of origin to the newfamily. We also stress the need of undertaking a long follow up

El niño adoptado en el extranjero. Papel del pediatra de Atención Primaria / No disponible

Cada año más de 40.000 niños procedentes de más de 100 países son adoptados en elmundo. La adopción internacional ha experimentado un incremento extraordinario en losúltimos años de forma especial en nuestro país. España fue el primer país de la Unión Europeay el segundo en el mundo en número absoluto de adopciones anuales en 2004 (y primerodel mundo en tasa de adopciones por población). Según datos del Ministerio de Trabajoy Asuntos Sociales, en el período de 1997 a 2004 se adoptó en nuestro país a 24.042niños procedentes del extranjero. Europa del Este, Asia y América Latina son las principalesregiones de procedencia. El propósito de este texto es reflexionar sobre las necesidades sanitariasde estos niños y la participación de los pediatras de Atención Primaria en el procesode la adopción internacional. Los niños adoptados en el extranjero conforman un grupocon necesidades específicas, aunque heterogéneas, en el terreno de la salud. Presentan confrecuencia determinadas patologías, la mayoría de ellas detectables mediante cribado. Laacción concertada y sinérgica de los distintos niveles de la atención sanitaria ofrecerán lasmejores posibilidades de detección y resolución eficaces de los problemas. La participacióndel pediatra de Atención Primaria es fundamental y debe ser sistematizada, precisa y continuada.Es necesario promover la investigación para conocer el estado de salud real de losniños adoptados en el extranjero que llegan a nuestro país y proponer recomendacionesprácticas para satisfacer las necesidades reales de estos niños en el terreno de la salud

More of 40000 children coming from more than 100 countries are adopted in the worldevery year. International adoption has experienced an extraordinary increase recently, speciallyin our country. Spain has been the first country in the European Union and the secondin the world in absolute numbers of annual adoptions in 2004 (and the first of the world inthe rate of adoption per population). According to data from the Ministry of Work and SocialAffaires, between 1997 and 2004, 24042 foreign children were adopted in our country. EasternEurope, Asia and Latin America have been the most important regions of origin. The proposalof this paper is to think about the sanitary requirements of these children and the participationof Primary Care paediatricians in the international adoption process. Children adoptedabroad build up a group with special although heterogeneous health needs. Theyfrequently suffer from certain conditions, most of them detectable through screening tests.Specific and synergic actuation from different levels of sanitary care will offer the best opportunitiesof efficient detection and resolution of the problems. Primary Care paediatrician’s participationis fundamental and must be systematic, precise and continuous. It is necessary topromote research in this field in order to know the real health situation of the children adoptedabroad and to propose practical recommendations to satisfy their health necessities

Vacunas antipoliomielíticas: VPI frente a VPO / No disponible

Las dos vacunas frente a la poliomielitis, la vacuna parenteral de virus inactivados (VPI) y la vacuna oral de virus vivos atenuados (VPO), son extraordinariamente inmunógenas y efectivas. Ambas han logrado el control de la enfermedad en los países donde se han utilizado. En España, la VPO ha eliminado la poliomielitis por los poliovirus salvajes (último caso importado de Mauritania en 1989) y, en la actualidad, los únicos casos de poliomielitis que ocurren son los de parálisis asociada a la vacuna (PAV), que se producen con una frecuencia de 1 por cada 2,5 millones de dosis. El cambio de VPO por VPI eliminaría los casos de PAV sin comprometer las coberturas vacunales, si se utilizan las nuevas vacunas combinadas para no aumentar el número de inyecciones. Además, la VPI encaja en la estrategia final de erradicación de la poliomielitis en la que muchos autores recomiendan un período transitorio de VPI hasta que se elimine la circulación de los poliovirus derivados de la VPO, que de forma eventual pueden sufrir reversión al estado salvaje y producir enfermedad (AU)

No disponible

[Idiopathic arterial calcification in infancy. A literature review and presentation of one case (author's transl)]. / Enfermedad con calcificaciones arteriales idiopáticas en la infancia. Revisión de la literatura y presentación de un caso.

A 26 days old male newborn, developing cardiac insufficiency followed by death, is reported. Necropsy revealed broadly spread calcifications with severe affectation to the coronary arteries. No justifying cause to those calcifications was found. Literature is reviewed, and the current state of knowledge of this uncommon disease's etiology and pathogeny is questioned.