Human metapneumovirus (HMPV) has an important etiological role in acute lower respiratory infections in children under five years. Our objectives were to estimate the relative contribution of HMPV to ...hospitalization in children with acute respiratory infection, to define the clinical and epidemiological features of HMPV single and multiple infections, and to compare HMPV infections with respiratory syncytial virus (HRSV), rhinovirus (HRV), adenovirus and human bocavirus infections in the same population.
A prospective study performed on all children less than 14 years of age with a respiratory tract disease admitted to a secondary hospital between September 2005- June 2014. Clinical characteristics of patients were analyzed. Nasopharyngeal aspirate was taken at admission for viral study with polymerase chain reaction for 16 respiratory viruses. A total of 3,906 children were included. At least one respiratory virus was detected in 75.2% of them. The most common identified virus was HRSV, followed by HRV. HMPV was detected in 214 cases (5.5%); 133 (62%) were single infections and the remaining were detected in coinfection with other viruses. 90.7% cases were detected between February and May. Children's mean age was 13.83 ± 18 months. Fever was frequent (69%), and bronchiolitis (27%), and recurrent wheezing (63%) were the main clinical diagnosis. Hypoxia was present in 65% of the patients and 47% of them had an infiltrate in X-ray. Only 6 (2.8%) children were admitted to the intensive care unit. Only the duration of the hospitalization was different, being longer in the coinfections group (p <0.05). There were many differences in seasonality and clinical characteristics between HMPV and other respiratory viruses being more similar to HRSV.
HMPV infections accounted for 5.5% of total viral infections in hospitalized children. The clinical characteristics were similar to HRSV infections, but seasonality and clinical data were different from other viral infections.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objective To demonstrate that heated humidified high-flow nasal cannula (HHHFNC) is superior to inhaled hypertonic saline solution (HSS) in improving respiratory distress in moderate bronchiolitis. ...In addition, it could improve comfort and reduce length of hospital stay (LOS) and admission to Paediatric Intensive Care Unit (PICU). Design Randomised Clinical Trial from 1 October 2010 to 31 December 2012. Setting Two urban secondary (no PICU available) paediatric hospitalisation units. Patients Hospitalised children aged up to 6 months with moderate acute bronchiolitis (Respiratory Distress Assessment Instrument, RDAI ≥4). Intervention Patients were randomised to HHHFNC or HSS. All of them received epinephrine as bronchodilator. Main outcomes Primary outcome was difference in mean Respiratory Assessment Change Score (RACS) between both groups measured in six previously defined consecutive moments. Secondary outcomes were difference in mean comfort scores in this period, LOS and rate of PICU admission. Results Seventy-five previously healthy patients were enrolled. Mean age was 2.4 months (95% CI 2.04 to 2.76). 43 were allocated to HSS group and 32 in HHHFNC. Data of 1 patient were lost, and 8 changed group over the study period. Intention-to-treat principle was applied. There were no significant differences in mean RACS and mean comfort scores between groups at the evaluation points. Median LOS or PICU admission rate were similar in both groups. No adverse events were observed. Conclusions HHHFNC was not superior to HSS in treatment of moderate acute bronchiolitis with respect to severity and comfort scores, LOS or PICU admission rate. Clinical Trial Registration ClinicalTrials.gov Identifier NCT01873144.
Children with medical complexity. What is the way? Monroy Tapiador, Miguel Ángel; Climent Alcalá, Francisco José; Rodríguez Alonso, Aroa ...
Anales de Pediatría,
10/2021, Letnik:
95, Številka:
4
Journal Article
El niño con patología crónica y complejidad: ¿cuál es el camino? Monroy Tapiador, Miguel Ángel; Climent Alcalá, Francisco José; Rodríguez Alonso, Aroa ...
Anales de pediatría (Barcelona, Spain : 2003),
October 2021, 2021-10-00, 2021-10-01, Letnik:
95, Številka:
4
Journal Article
COVID-19 ocular findings in children: a case series Fernández Alcalde, Celia; Granados Fernández, Maria; Nieves Moreno, Maria ...
World journal of pediatrics : WJP,
06/2021, Letnik:
17, Številka:
3
Journal Article
Analizar la valoración de la atención a los niños con patología crónica compleja (NPCC) en atención primaria (AP), desde el punto de vista de sus médicos y de sus familias.
Estudio observacional, ...descriptivo y transversal.
Pediatría de AP y unidad de patología crónica compleja (UPCC) del Hospital Universitario La Paz (HULP).
Pacientes y familiares de la UPCC y sus médicos de AP de la Comunidad de Madrid (CAM).
Realización de encuestas validadas presenciales y online.
Grado de satisfacción en la formación, capacitación y manejo específico del NPCC según escalas tipo Likert.
Se encuestaron 53 familias y 170 médicos de AP (96,5% pediatras). Los resultados de la encuesta a familiares revelan descoordinación entre niveles asistenciales (73,6%), escasa confianza en el primer nivel asistencial e impresión de poca capacidad de resolución de problemas por parte de pediatría de AP (50%).
Entre los médicos de AP destaca la poca formación para el seguimiento de los NPCC (96,5%), escasa experiencia en su manejo (93%) e insuficiente comunicación con el hospital (80,5%).
La falta de tiempo en las consultas es un problema común, percibido por pediatras y pacientes.
La falta de coordinación entre AP y atención hospitalaria (AH) se detecta como un problema importante en la continuidad asistencial de NPCC. Son necesarias intervenciones que mejoren esta coordinación. La AP es cercana a la familia, pero precisa mejorar la formación y capacitación de los profesionales en problemas de salud y soporte tecnificado de NPCC, así como incrementar el tiempo necesario para su atención.
To analyze the assessment of the care of children with medical complexity (CMC) in Primary Care (PC), from the point of view of their doctors and their families.
Observational, descriptive and transversal study.
PC Pediatrics and Complex Chronic Pathology Unit (UPCC) of Hospital Universitario La Paz (HULP).
Patients and relatives of the UPCC and their PC physicians of the Community of Madrid (CAM).
Face-to-face and online validated surveys were conducted.
Degree of satisfaction in the training, education and specific management of the CMC according to Likert-type scales.
Fifty-three families and 170 PC physicians (96.5% pediatricians) were surveyed. The results of the family survey reveal lack of coordination between levels of care (73.6%), little confidence in the first level of care, and an impression of poor problem-solving capacity by PC pediatricians (50%).
Among PC physicians, there is little training in the follow-up of CMC (96.5%), little experience in their management (93%) and insufficient communication with the hospital (80.5%).
Lack of time in consultations is a common problem, perceived by pediatricians and patients.
The lack of coordination between PC and Hospital Care is detected as an important problem in the continuity of care at CMC. Interventions are needed to improve this coordination. The PC is close to the family but needs to improve the education and training of professionals in health problems and technical support from CMC, as well as increase the time necessary for their care.
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