[Vaccination schedule of the Spanish association of pediatrics: recommendations 2009]. / Calendario vacunal de la Asociación Española de Pediatría: Recomendaciones 2009.

Based on the available evidence, we, the Vaccine Advisory Committee (CAV) of the Spanish Association of Pediatrics (Asociación Española de Pediatría, AEP), provide information about and comments on vaccine-related innovation during 2008. Modifications to the Vaccine Schedule for 2009 are also discussed. The importance of the recommendation of administration of a varicella booster at start of school (3-4 years of age) is highlighted according to the technical specifications of one of the vaccines. The importance of making the heptavalent pneumococcal conjugate vaccine universally available is reiterated in accordance with the unquestionable results of scientific tests, WHO recommendations, the posture adopted by the majority of neighboring European countries, and the decision taken in 2006 by the autonomous community of Madrid (Spain). New scientific reasons are provided, corroborating the recommendation made by this committee in 2008, for the implementation by Spanish pediatricians of the vaccine against rotavirus and human papilloma virus. With regard to the latter, vaccination should be from 11 to 16 years of age, and then extended, in accordance with the technical specifications of the available vaccine preparations, to 26 years of age. As part of the recommendations, we insist that children in risk groups should be given flu vaccine and hepatitis A vaccine. The committee considers that these two vaccines must also be given, when pediatricians consider it appropriate, to children other than those in risk groups. This recommendation can be regarded as the first step towards a future recommendation of universal vaccination. Finally, this year we include an appendix with recommendations and vaccination strategies to be followed in children who have not previously received vaccines or who have not been completely immunized.

Calendario vacunal de la Asociación Española de Pediatría: Recomendaciones 2009 / Vaccination Schedule of the Spanish Association of Pediatrics: Recommendations 2009

El Comité Asesor de Vacunas (CAV) de la Asociación Española de Pediatría (AEP), con base en la evidencia disponible, informa y comenta las novedades que sobre vacunas se han producido en el año 2008 y aconseja las modificaciones del Calendario Vacunal para el año 2009. Se insiste en recomendar la administración de la segunda dosis de recuerdo de vacuna de varicela al inicio de la escolarización (3-4 años) según las especificaciones de la ficha técnica de una de las vacunas. Se sigue reiterando la importancia de universalizar la vacunación antineumocócica conjugada heptavalente, en consonancia con las incuestionables pruebas científicas existentes, la recomendación de la Organización Mundial de la Salud, la postura adoptada en la mayoría de los países europeos de nuestro entorno y la decisión que tomó en 2006 la Comunidad Autónoma de Madrid en España. Se aportan nuevas razones científicas que corroboran la recomendación, realizada en 2008 por este Comité, de implementar la vacuna frente al rotavirus y el virus papiloma humano; se insiste respecto a esta última en la vacunación prioritaria desde los 11 años hasta los 16 años y se amplía, en consonancia con las fichas técnicas de los preparados vacunales disponibles, hasta los 26 años. En estas recomendaciones vacunales, se insiste en dos vacunas, gripe y hepatitis A, que deben aplicarse a los niños en riesgo. Este Comité considera que las vacunas frente a la gripe y la hepatitis A deben ser implementadas cuando los pediatras lo consideren oportuno, más allá de los grupos de riesgo, como primer paso para una futura recomendación universal. Por último, este año se incluye un anexo sobre las recomendaciones y estrategias vacunales a seguir en el caso de niños no vacunados o inmunizados de forma incompleta (AU)

Based on the available evidence, we, the Vaccine Advisory Committee (CAV) of the Spanish Association of Pediatrics (Asociación Española de Pediatría, AEP), provide information about and comments on vaccine-related innovation during 2008. Modifications to the Vaccine Schedule for 2009 are also discussed. The importance of the recommendation of administration of a varicella booster at start of school (3¿4 years of age) is highlighted according to the technical specifications of one of the vaccines. The importance of making the heptavalent pneumococcal conjugate vaccine universally available is reiterated in accordance with the unquestionable results of scientific tests, WHO recommendations, the posture adopted by the majority of neighboring European countries, and the decision taken in 2006 by the autonomous community of Madrid (Spain). New scientific reasons are provided, corroborating the recommendation made by this committee in 2008, for the implementation by Spanish pediatricians of the vaccine against rotavirus and human papilloma virus. With regard to the latter, vaccination should be from 11 to 16 years of age, and then extended, in accordance with the technical specifications of the available vaccine preparations, to 26 years of age. As part of the recommendations, we insist that children in risk groups should be given flu vaccine and hepatitis A vaccine. The committee considers that these two vaccines must also be given, when pediatricians consider it appropriate, to children other than those in risk groups. This recommendation can be regarded as the first step towards a future recommendation of universal vaccination. Finally, this year we include an appendix with recommendations and vaccination strategies to be followed in children who have not previously received vaccines or who have not been completely immunized (AU)

Vaginitis recurrente y peritonitis por Streptococcus pneumoniae en niña prepuberal / Streptococcus pneumoniae-induced recurrent vaginitis and peritonitis in a prepubertal child

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[Why are pediatric empyemas on the increase in Spain?]. / Por qué hay más empiemas pediátricos en España?

There is a widespread perception among Spanish pediatricians that the incidence of empyema has significantly increased in the last few years, even though the objective information available is limited, and there is no specific active epidemiological surveillance system for this condition. In the present article, we review the situation of empyema in Spain, and discuss the main hypotheses put forward in the international literature to explain this increase, as well as the limitations of the sources available. Despite the scarcity of information, we draw the following conclusions: 1) the incidence of pediatric empyema is increasing in Spain, both generally and when caused by pneumococcus in particular; 2) the reason for this increase remains unknown, and to date no firm link has been established between this phenomenon and the heptavalent conjugate pneumococcal vaccine; and 3) this situation justifies the establishment of prospective systems for the surveillance and control of empyema and, once again, highlights the importance of developing active surveillance systems for pneumococcal disease.

¿Por qué hay más empiemas pediátricos en España? / Why are pediatric empyemas on the increase in Spain?

Existe la percepción entre los pediatras españoles de que el número de casos de empiema pediátrico ha aumentado significativamente en los últimos años; sin embargo, la información objetiva disponible es limitada, y además es una patología de libre declaración para la que no existen sistemas específicos de vigilancia epidemiológica activa. En este trabajo se revisa la situación del empiema pediátrico en España, y se discute las principales hipótesis que se han planteado en la bibliografía internacional para explicar este incremento, así como las limitaciones de las fuentes disponibles. Se concluye que, aunque la información disponible es limitada: a) la incidencia de empiema pediátrico está aumentando en nuestro país, tanto globalmente como la específicamente ocasionada por neumococo; b) la causa de este incremento es desconocida, y hasta la fecha no existen datos que permitan vincularlo a la vacuna antineumocócica conjugada heptavalente, y c) esta situación justifica la puesta en marcha de sistemas prospectivos de vigilancia y control del empiema y, una vez más, pone de relieve la importancia de implantar y desarrollar sistemas de vigilancia activa de la enfermedad neumocócica (AU)

There is a widespread perception among Spanish pediatricians that the incidence of empyema has significantly increased in the last few years, even though the objective information available is limited, and there is no specific active epidemiological surveillance system for this condition. In the present article, we review the situation of empyema in Spain, and discuss the main hypotheses put forward in the international literature to explain this increase, as well as the limitations of the sources available. Despite the scarcity of information, we draw the following conclusions: 1) the incidence of pediatric empyema is increasing in Spain, both generally and when caused by pneumococcus in particular; 2) the reason for this increase remains unknown, and to date no firm link has been established between this phenomenon and the heptavalent conjugate pneumococcal vaccine; and 3) this situation justifies the establishment of prospective systems for the surveillance and control of empyema and, once again, highlights the importance of developing active surveillance systems for pneumococcal disease (AU)

Hipertensión pulmonar asociada al VIH en una adolescente con infección de transmisión vertical / Pulmonary hypertension associated with vertically transmitted HIV infection in an adolescent girl

No disponible

[Criteria for including vaccines in the immunization schedule of the Spanish Association of Pediatrics]. / Criterios de inclusión de vacunas en el calendario de la Asociación Española de Pediatría.

The Vaccine Advisory Committee of the Spanish Association of Pediatrics analyzes and discusses the criteria followed when preparing their yearly Recommended Immunization Schedule for children and adolescents. The relative importance of each criterion in the final recommendation is assessed. Following a review of the current state of affairs of childhood immunization in Spain and of the crucial role played by pediatricians, some reflections are presented on the problems derived from the vaccines recommended by this Committee but not covered by the national health system. Suggestions are made for individual pediatricians who may need to establish specific priorities in the recommendation of these vaccines.

[Immunization schedule of the Spanish Association of Pediatrics: recommendations 2008]. / Calendario vacunal de la Asociación Española de Pediatría: recomendaciones 2008.

The Vaccine Advisory Committee of the Spanish Association of Pediatrics provides information on the new developments in vaccines that have taken place in 2007, based on the available evidence, and discusses these developments. Certain modifications to the Immunization Schedule for 2008 are recommended. A second varicella vaccine booster dose, administered together with the booster dose of the measles-mumps-rubella (MMR) vaccine when children start school (3-4 years), is recommended to avoid vaccine failures against the varicella-zoster virus. Based on current scientific evidence, the importance of universal heptavalent conjugate pneumococcal vaccination, as carried out in most similar European countries and in the autonomous community of Madrid in Spain, is stressed. Human papilloma virus vaccine is included in the Immunization Schedule for girls from 11 years old, and initially, at least up to the age of 16 years. Vaccination against rotavirus in children starting at 6 weeks and completing the series before 6 months is recommended. Other recommendations included in this year's Immunization Schedule are vaccination against influenza and hepatitis A virus in risk groups and at the pediatrician's discretion, as a first step toward the future recommendation of universal immunization.

[Family impact of rotavirus gastroenteritis in children under two years]. / Impacto familiar de la gastroenteritis por rotavirus en menores de dos años.

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.

[Vaccination schedule of the Spanish Association of Pediatrics: recommendations 2007]. / Calendario de vacunación de la Asociación Española de Pediatría: recomendaciones 2007.

The Vaccine Advisory Committee of the Spanish Association of Pediatrics provides information on the new developments in vaccines that have taken place in 2006 and recommends certain modifications to the Immunization Schedule for 2007. To ensure early protection, the measles-mumps-rubella (MMR) vaccine booster dose should be administered when children start school (3-4 years). Based on existing scientific evidence, the importance of universal heptavalent conjugate pneumococcal vaccination, as occurs in most similar European countries and in the autonomous community of Madrid in Spain, is confirmed. The safety and efficacy of rotavirus and human papilloma virus vaccines, as well as their use in our environment, is discussed and the role of pediatricians in their implementation is stressed. The recommended immunization schedule for children and adolescents starting vaccination late is also discussed.

Dos vacunas frente a rotavirus seguras y eficaces / Two safe and effective rotavirus vaccines

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[Human papillomavirus vaccines: a new challenge for pediatricians]. / Vacuna frente al virus del papiloma humano: un nuevo reto para el pediatra.

Human papillomavirus (HPV) infections are the most common sexually transmitted infections in the world. This infection is a necessary cause of cervical cancer, has been related to other forms of anogenital, airway and digestive cancers, and also causes anogenital warts. The recent advances in HPV prophylactic vaccines and their imminent commercial availability will post a new challenge to pediatricians: the indication and administration of these vaccines for the prevention of HPV infection, and consequently, of cervical cancer and other HPV-related diseases. The present article reviews the essentials of HPV infection, its relationship with cervical cancer, the advances in prophylactic HPV vaccines, and the role of the pediatrician in this context.

Vacuna frente al virus del papiloma humano: un nuevo reto para el pediatra / Human papillomavirus vaccines: a new challenge for pediatricians

La infección por virus del papiloma humano (VPH) es la enfermedad de transmisión sexual más frecuente en el mundo. Esta infección constituye una causa necesaria del cáncer de cérvix, se ha relacionado con otras formas de cáncer anogenital, de vía aérea y digestivo, y es además el origen de las verrugas anogenitales. Los avances recientes en la vacunación profiláctica frente al VPH y la inminente disponibilidad comercial de estas vacunas, colocan al pediatra ante un nuevo reto: la indicación y administración de estas vacunas para la prevención de la infección por VPH, y como consecuencia, del cáncer de cérvix y otras patologías relacionadas con el VPH. En este artículo se revisan los aspectos esenciales de la infección por VPH, su relación con el cáncer de cérvix, los avances en las vacunas profilácticas frente al VPH y el papel del pediatra en este contexto

Human papillomavirus (HPV) infections are the most common sexually transmitted infections in the world. This infection is a necessary cause of cervical cancer, has been related to other forms of anogenital, airway and digestive cancers, and also causes anogenital warts. The recent advances in HPV prophylactic vaccines and their imminent commercial availability will post a new challenge to pediatricians: the indication and administration of these vaccines for the prevention of HPV infection, and consequently, of cervical cancer and other HPV-related diseases. The present article reviews the essentials of HPV infection, its relationship with cervical cancer, the advances in prophylactic HPV vaccines, and the role of the pediatrician in this context

[The role of the rotavirus vaccine in childhood vaccination schedules]. / El papel de la vacuna frente a rotavirus en los calendarios de vacunación infantil.

Rotavirus is the leading cause of diarrhea in infants. In developed countries, this infection leads to considerable morbidity with a high number of hospitalizations and medical interventions in the winter season, giving rise to substantial medical and social costs. In developing countries, rotavirus is a major cause of mortality in infants due to dehydration, with an estimated 600.000 deaths or more per year worldwide. A vaccine that is easy administrated, safe and with high efficacy would be the ideal means to reduce the burden of this disease and its high economic and social cost and to decrease the number of deaths in low-income countries. Recently, the results of two well-designed clinical trials with a large number of subjects have been reported. Both studies, which used different vaccines, reported high efficacy in the prevention of severe gastroenteritis and hospitalizations caused by rotavirus. When these vaccines become available in Europe, a reduction in hospitalizations, medical consultations, and days of work lost can be expected.

El papel de la vacuna frente a rotavirus en los calendarios de vacunación infantil / The role of the rotavirus vaccine in childhood vaccination schedules

Rotavirus es la principal causa de diarrea en lactantes. En países desarrollados, esta infección origina una enorme morbilidad con un número elevado de hospitalizaciones y actos médicos en la temporada de invierno, que suponen un elevado coste económico y social. En países en desarrollo, rotavirus es una causa importante de mortalidad en lactantes originada por la deshidratación, y se estima que existen 600.000 muertes por esta causa cada año en el mundo. Una vacuna de fácil administración, segura y con elevada eficacia sería la medida ideal para reducir la carga de la enfermedad y sus costes económicos y sociales y para reducir el número de muertes en los países más desfavorecidos. Recientemente, se han publicado los resultados de dos ensayos clínicos bien diseñados incluyendo un alto número de sujetos. Ambos estudios han demostrado elevada eficacia de estas vacunas en la prevención de la gastroenteritis grave y las hospitalizaciones producidas por rotavirus. Cuando estas vacunas estén disponibles en Europa es previsible que se produzca una reducción en el número de hospitalizaciones, visitas clínicas y pérdidas de días de trabajo de los padre

Rotavirus is the leading cause of diarrhea in infants. In developed countries, this infection leads to considerable morbidity with a high number of hospitalizations and medical interventions in the winter season, giving rise to substantial medical and social costs. In developing countries, rotavirus is a major cause of mortality in infants due to dehydration, with an estimated 600.000 deaths or more per year worldwide. A vaccine that is easy administrated, safe and with high efficacy would be the ideal means to reduce the burden of this disease and its high economic and social cost and to decrease the number of deaths in low-income countries. Recently, the results of two well-designed clinical trials with a large number of subjects have been reported. Both studies, which used different vaccines, reported high efficacy in the prevention of severe gastroenteritis and hospitalizations caused by rotavirus. When these vaccines become available in Europe, a reduction in hospitalizations, medical consultations, and days of work lost can be expected

Linfangioma abdominal infectado por Salmonella enteritidis / Abdominal lymphangioma infected by Salmonella enteritidis

No disponible