ABSTRACT
INTRODUCTION: Rotavirus is the main etiologic agent of acute infectious diarrhea in children worldwide. Considering that a rotavirus vaccine (G1P8, strain RIX4414) was added to the Brazilian vaccination schedule in 2006, we aimed to study its effectiveness and safety regarding intestinal intussusception. METHODS: A quasi-experimental trial was performed in which the primary outcome was the number of hospitalizations that were presumably due to acute infectious diarrhea per 100,000 children at risk (0-4 years old). The secondary outcomes included mortality due to acute infectious diarrhea and the intestinal intussusception rates in children in the same age range. We analyzed three scenarios: Health Division XIII of the State of São Paulo (DRS XIII) from 2002 to 2008, the State of São Paulo, and Brazil from 2002 to 2012. RESULTS: The averages of the hospitalization rates for 100,000 children in the pre- and post-vaccination periods were 1,413 and 959, respectively, for DRS XIII (RR=0.67), 312 and 249, respectively, for the State of São Paulo (RR=0.79), and 718 and 576, respectively, for Brazil (RR=0.8). The mortality rate per 100,000 children in the pre- and post-vaccination periods was 2.0 and 1.3, respectively, for DRS XIII (RR=0.66), 5.5 and 2.5, respectively, for the State of São Paulo (RR=0.47), and 15.0 and 8.0, respectively, for Brazil (RR=0.53). The average annual rates of intussusception for 100,000 children in DRS XIII were 28.0 and 22.0 (RR=0.77) in the pre- and post-vaccination periods, respectively. CONCLUSIONS: A monovalent rotavirus vaccine was demonstrated to be effective in preventing the hospitalizations and deaths of children that were presumably due to acute infectious diarrhea, without increasing the risk of intestinal intussusception. .
Subject(s)
Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Diarrhea/prevention & control , Intussusception/prevention & control , Rotavirus Infections/prevention & control , Rotavirus Vaccines/administration & dosage , Acute Disease , Brazil/epidemiology , Diarrhea/mortality , Diarrhea/virology , Hospitalization/statistics & numerical data , Intussusception/mortality , Intussusception/virology , Rotavirus Infections/mortalityABSTRACT
Se analizan las historias clínicas de dos pacientes adultos con cuadro clínico de obstrucción intestinal que fueron intervenidos quirúrgicamente, encontrándose intususcepción intestinal como causa de la sintomatología en uno de ellos. En el otro el cuadro clínico era originado por la presencia de bridas interasas, sinembargo, se encontró como hallazgo incidental invaginación ileoileal. Debido a la baja frecuencia de esta patología en este grupo de edad se hace su presentación y se revisa la literatura
Subject(s)
Humans , Male , Adolescent , Adult , Intussusception/surgery , Intussusception/diagnosis , Intussusception/physiopathology , Intussusception/mortality , Intussusception/rehabilitation , Intestinal Obstruction/surgery , Intestinal Obstruction/complications , Intestinal Obstruction/diagnosis , Intestinal Obstruction/rehabilitationABSTRACT
This is a retrospective analysis of 82 patients of intussusception in infancy and childhood. Males were more than females in the ratio 2.4 : 1, the ages varied from 2 months to 12 years. Majority (73%) were less than 1 year old. Commonest presentations were pain, vomiting, distension, palpable lump and blood and mucus in stools. The management of these patients varied from barium enema reduction (3 cases), reduction by surgery and manipulation (59 cases) and resection with primary anastomosis (20 cases). We analysed our patients by giving scores based on clinical criteria. We concluded that the patients in our circumstances do not show any correlation of the scoring pattern with morbidity or mortality, chances of reduction by barium enema or manually. Resection, however, did correlate with a high incidence of death (75%). Resections were required slightly more in ileo-ileal intussusceptions than in those having a colonic involvement, morbidity in the form of wound dehiscence, and sepsis was higher in those patients who had undergone resections.
Subject(s)
Child , Child, Preschool , Evaluation Studies as Topic , Female , Humans , Ileal Diseases/mortality , Infant , Intussusception/mortality , Male , Prognosis , Retrospective Studies , Sex FactorsABSTRACT
Se estudian los casos de invaginación intestinal en niños; en el Servicio de Cirugía Pediátrica del Area Hospitalaria No. 6 Callao; en el período de 1972 a julio de 1982. Para el trabajo se revisa la bibliografía sobre esta patología, causa más frecuente de obstrucción intestinal en niños, entre los 0 a 18 meses de edad. Al analizar las historias clínicas de los casos presentados se obtienen datos que son sintetizados en 6 tablas que ponen en evidencia los hallazgos desde el punto de vista clínico, etiológico y tratamiento efectuado, así como los resultados obtenidos. Se discute y establece un estudio comparativo con lo señalado por los autores consultados y se ofrecen las recomendaciones y conclusiones que constituyen nuestro aporte