Hospitalizations and deaths due to pertussis in children from 1996 to 2013.

OBJECTIVES: To assess temporal trends of hospitalizations and deaths from pertussis in Brazilian children in the period of 1996-2013. METHODS: This was a descriptive ecological study of temporal trends, based on the DATASUS database. The number of hospitalizations and deaths from pertussis in children up to 19 years of age from January 1996 to December 2013 was obtained. Descriptive statistics were applied for data analysis. RESULTS: During the study period, a total of 19,047 hospital admissions from pertussis were recorded, of which 88.2% occurred in infants younger than 1 year. In the period 1996-2010, the mean annual number of admissions was 755, ranging from a maximum of 1179 in 2004 to a minimum of 400 in 2010. There was an increase of admissions in the last three consecutive years (2011, 2012, and 2013) with 1177, 2954 and 3589 hospitalizations, respectively. There were 498 deaths from pertussis throughout the study period, of which 96.8% occurred in children younger than one year. There was an increase in the number of deaths from pertussis in children in the years 2011, 2012, and 2013, with 40, 93, and 87 recorded deaths, respectively. The increase in hospitalizations and deaths from pertussis in children occurred in all regions of the country, with the highest increase observed in the Southeast, North and Northeast regions. CONCLUSIONS: There was a substantial increase in hospitalizations and deaths from pertussis in children for three consecutive years (2011, 2012, and 2013) in all Brazilian regions. The most affected age group was that of children younger than one year.

Aumento de internações pediátricas por queimaduras durante o período de isolamento social pela pandemia Covid-19 / Increase in pediatric hospitalization for burns during the period of social isolation by Covid-19

A pandemia de COVID-19 pode ter agravado o risco de acidentes domésticos, pois foram necessárias medidas de isolamento social e menor tempo de permanência das crianças e adolescentes fora de casa. O objetivo desta pesquisa foi comparar as queimaduras em crianças e adolescentes no período do isolamento social da pandemia da COVID-19, com as queimaduras ocorridas nos anos anteriores. Estudo transversal, retrospectivo, com análise dos prontuários de vítimas de queimaduras. O grupo de pacientes de 2020 (período do isolamento social) foi comparado com o dos anos de 2017-2019. Foram internadas 449 crianças no período estudado. Em conclusão, o isolamento social gerou aumento de internamentos pediátricos por queimadura e durante a fase de isolamento social em 2020 houve aumento significativo de queimaduras mais graves.

The COVID-19 pandemic may have increased the risk of domestic accidents, as social isolation measures were necessary and children and adolescents spent less time outside the home. The objective of this research was to compare burns in children and adolescents during the period of social isolation of the COVID-19 pandemic, with burns that occurred in previous years. Cross-sectional, retrospective study, with analysis of the medical records of burn victims. The group of patients from 2020 (period of social isolation) was compared with that of the years 2017-2019. A total of 449 children were hospitalized during the study period. In conclusion, social isolation generated an increase in pediatric hospitalizations for burns and during the social isolation phase in 2020 there was a significant increase in more serious burns.

Hemofilia B grave em lactente ­ um relato de caso / Serious hemophyllia B in infant - a case report

OBJETIVO: Relatar o caso de um lactente de 5 meses com aparecimento espontâneo de equimoses cutâneas, com suspeita inicial de maus tratos e que revelou na evolução o diagnóstico de hemofilia B. RELATO DO CASO: aparecimento espontâneo de duas nodulações circundadas por porções arroxeadas da pele, uma em braço esquerdo e outra em dorso. O coagulograma mostrou um TAP de 13,4, um RNI de 1,26, um KPTT incoagulável e plaquetas de 643.000. Evoluiu com choque hipovolêmico por sangramento em partes moles, necessitando de transfusão de concentrado de hemácias. CONSIDERAÇÕES: As hemofilias são doenças relativamente raras, mas potencialmente graves e de alta morbidade devido suas complicações crônicas. O diagnóstico diferencial com maus tratos deve ser sempre investigado se houver suspeita clínica

OBJECTIVE: To report the case of a 5-month-old infant with spontaneous appearance of cutaneous ecchymosis, with initial suspicion of mistreatment and who revealed the diagnosis of hemophilia B in the evolution. CASE REPORT: spontaneous appearance of two nodulations surrounded by purple portions of the skin, one on the left arm and one on the back. The coagulogram showed a prothrombin time of 13.4, an INR of 1.26, an incoagulable APTT and platelets of 643,000. He evolved with hypovolemic shock due to soft tissue bleeding, requiring transfusion of red blood cell concentrate. CONSIDERATIONS: Hemophilia is a relatively rare disease, but potentially serious and of high morbidity due to its chronic complications. The differential diagnosis with maltreatment should always be investigated if there is clinical suspicion

Síndrome hemofagocítica pós vacinal: um relato de caso / Post vacinal hemofagocytic syndrome: a case report

Introdução: síndrome hemofagocítica (HLH) é uma condição agressiva e potencialmente fatal que acomete principalmente crianças pequenas. Relato: menino, 2 meses, apresentou quadro catarral após realização de vacinas, evoluindo com anemia hemolítica e posterior coagulação intravascular disseminada, com necessidade de uso de drogas vasoativas e ventilação mecânica. Realizado tratamento com pulsoterapia de dexametasona, evoluindo com melhora completa do quadro. Discussão: a HLH corresponde a um distúrbio na homeostase do sistema imune que atinge principalmente crianças. O tratamento deve ser feito através de corticoterapia e, em alguns casos, drogas imunomoduladoras, imunossupressoras ou transplante alogênico de células hematopoiéticas. Conclusão: a HLH é uma patologia pouco comum, e sua ocorrência após a administração de vacinas é pouco relatada. Apresenta sintomas que mimetizam infecções comuns e deve ser aventada sua hipótese em casos de febre sem sinais de localização. Em geral, a evolução da doença é rápida e cursa com alta morbimortalidade.

Introduction: Hemophagocytic syndrome (HLH) is an aggressive and potentially fatal condition that affects mainly young children. Report: A 2-month-old boy presented with catarrhal symptoms after vaccinations, evolving with hemolytic anemia and later disseminated intravascular coagulation, requiring the use of vasoactive drugs and mechanical ventilation. Treatment with dexamethasone pulse therapy was performed, progressing with complete improvement of the condition. Discussion: HLH is a disorder in the homeostasis of the immune system that affects mainly children. Treatment should be done through corticotherapy and, in some cases, immunomodulatory, immunosuppressive drugs or allogeneic hematopoietic cell transplantation. Conclusion: HLH is an uncommon pathology, and its occurrence after vaccine administration is rarely reported. It presents symptoms that simulates common infections and its hypothesis should be considered in cases of fever without signs of localization. In general, the evolution of the disease is fast and progresses with high morbidity and mortality.

Úlcera de Curling fatal em paciente pediátrico ­ um relato de caso / Fatal curling ulcer in a pediatric patient - a case report

OBJETIVO: Relatar um caso de um paciente grande queimado que evoluiu com úlcera gástrica perfurada, com evolução fatal. RELATO DO CASO: Menino de dois anos, grande queimado por combustão. Apresentou no sétimo dia de queimadura dois episódios de vômitos, precedidos por náuseas, sendo o segundo com grande quantidade de sangue. Evoluiu com taquicardia, taquipneia e perfusão lentificada. Realizou endoscopia que evidenciou coágulo em estômago. Foi medicado e realizada nova endoscopia dois dias após, com observação de escape de ar de dentro da luz gástrica. Evoluiu com abafamento de bulhas cardíacas, frequência cardíaca de 80, edema generalizado e abdome tenso, e em seguida parada cardiorrespiratória. CONSIDERAÇÕES: Essa patologia ocorre de forma súbita, muitas vezes sem pródromos, e pode levar ao óbito rapidamente, especialmente se tratando de crianças menores

OBJECTIVE: To report a case of a large burned patient who developed a perforated gastric ulcer, with a fatal outcome. CASE REPORT: Two-year-old boy, heavily burned by combustion. On the seventh day of the burn, he presented two episodes of vomiting, preceded by nausea, the second of which had a large amount of blood. He developed tachycardia, tachypnea and slow perfusion. An endoscopy was performed that showed a clot in the stomach. He was medicated and a new endoscopy was performed two days later, with observation of air leakage from the gastric lumen. He evolved with muffled heart sounds, a heart rate of 80, generalized edema and tense abdomen, and then cardiorespiratory arrest. CONSIDERATIONS: This pathology occurs suddenly, often without prodromes, and can lead to death quickly, especially for younger children

Hospitalizations and deaths due to pertussis in children from 1996 to 2013☆ / Internações e óbitos por coqueluche em crianças no período entre 1996 e 2013

ABSTRACT OBJECTIVES: To assess temporal trends of hospitalizations and deaths from pertussis in Brazilian children in the period of 1996-2013. METHODS: This was a descriptive ecological study of temporal trends, based on the DATASUS database. The number of hospitalizations and deaths from pertussis in children up to 19 years of age from January 1996 to December 2013 was obtained. Descriptive statistics were applied for data analysis. RESULTS: During the study period, a total of 19,047 hospital admissions from pertussis were recorded, of which 88.2% occurred in infants younger than 1 year. In the period 1996-2010, the mean annual number of admissions was 755, ranging from a maximum of 1179 in 2004 to a minimum of 400 in 2010. There was an increase of admissions in the last three consecutive years (2011, 2012, and 2013) with 1177, 2954 and 3589 hospitalizations, respectively. There were 498 deaths from pertussis throughout the study period, of which 96.8% occurred in children younger than one year. There was an increase in the number of deaths from pertussis in children in the years 2011, 2012, and 2013, with 40, 93, and 87 recorded deaths, respectively. The increase in hospitalizations and deaths from pertussis in children occurred in all regions of the country, with the highest increase observed in the Southeast, North and Northeast regions. CONCLUSIONS: There was a substantial increase in hospitalizations and deaths from pertussis in children for three consecutive years (2011, 2012, and 2013) in all Brazilian regions. The most affected age group was that of children younger than one year.

RESUMO OBJETIVOS: Avaliar a tendência temporal de internações e óbitos por coqueluche em crianças brasileiras de 1996 a 2013. MÉTODOS: Trata-se de um estudo ecológico descritivo de tendência temporal, baseado no banco de dados Datasus. Foram extraídos os números de internações e de óbitos por coqueluche em crianças até 19 anos de janeiro de 1996 a dezembro de 2013. A estatística descritiva foi aplicada para análise de dados. RESULTADOS: No período estudado foram registradas 19.047 internações por coqueluche, das quais 88,2% foram de lactentes menores de um ano. De 1996 a 2010, o número médio anual de internações foi de 755 e oscilou entre o máximo de 1.179 em 2004 e o mínimo de 400 em 2010. Houve um acréscimo de internações nos últimos três anos consecutivos (2011, 2012 e 2013), com 1.177, 2.954 e 3.589 registros, respectivamente. Ocorreram 498 óbitos por coqueluche em todo o período estudado, dos quais 96,8% eram menores de um ano. Houve acréscimo no número de óbitos por coqueluche em crianças em 2011, 2012 e 2013, com 40, 93 e 87 registrados, respectivamente. O aumento de internações e óbitos por coqueluche em crianças ocorreu em todas as regiões do país e houve maior acréscimo nas regiões Sudeste e Norte-Nordeste. CONCLUSÕES: Houve um aumento substancial de internações e de óbitos por coqueluche em crianças por três anos consecutivos (2011, 2012 e 2013) em todas as regiões brasileiras. A faixa etária mais atingida foi a de menores de um ano.