ABSTRACT
Introducción: La pandemia por el virus de la gripe A (H1N1) 2009 ha supuesto un gran reto para el sistema sanitario a nivel mundial. Material y métodos: Se analizaron prospectivamente los pacientes con sospecha clínica de gripe A (H1N1) 2009 que cumplían criterios de estudio microbiológico de julio a diciembre de 2009 atendidos en un servicio de urgencias pediátricas. La confirmación microbiológica se realizó mediante reacción de la cadena de polimerasa en transcripción reversa. Se analizaron el número de consultas e ingresos desde urgencias. Se compararon los casos confirmados de gripe A (H1N1) 2009 con los negativos. Resultados: Se atendió a 1.144 pacientes con criterios de estudio microbiológico. Ingresaron 513 (44,8%) pacientes, 12 de ellos (1%) en UCIP y 3 fallecieron (0,3%). En 824 pacientes (72%) se detectaron factores de riesgo para complicaciones. 412 (36%) pacientes fueron positivos para gripe A (H1N1) 2009 y 732 (64%) fueron negativos. Al comparar ambos grupos, los pacientes positivos fueron de mayor edad (edad media: 7,4 vs 4,1 años, p < 0,001), tuvieron más factores de riesgo (OR: 2,21 [1,65-2,96]), menos neumonía (OR: 0,33 [0,23-0,49]) e ingresaron menos (OR: 0,19 [0,14-0,24]). Hubo un incremento del 12% de urgencias y del 5,7% de ingresos respecto al año 2008. Conclusiones: El virus de la gripe A (H1N1) 2009 ha presentado una elevada morbilidad con baja incidencia de casos graves y baja mortalidad incluso en población con factores de riesgo (AU)
Background: The 2009 H1N1 influenza A virus infection pandemic was an important challenge for public health systems worldwide. Material and methods: A prospective study including all patients with an influenza-like illness, with microbiological criteria for 2009 H1N1 virus, from July to December 2009 seen in the paediatric emergency department. Viral testing was performed using multiplex real-time reverse transcription polymerase chain reaction (RT-PCR). We analysed the number of visits to, and hospital admissions from, our emergency department. We compared patients with laboratoryconfirmed2009 H1N1 virus with non-confirmed ones. Results: A total of 1144 patients with microbiological criteria were identified. Of these, 513 (44.8%) were admitted to hospital, 12 of them (1%) to the PICU and 3 (0.3%) died. The majority of the patients (824; 72%) had some underlying medical condition. Of the 1144 patients, 412 (36%) had RT-PCR confirmed 2009 H1N1 infection, and 732 (64%) were not confirmed. The mean age of patients with 2009 H1N1 infection was higher than those not infected (median age: 7.4vs 4.1 years; p < .001). Laboratory-confirmed 2009 pandemic H1N1 influenza patients had more underlying high-risk conditions (OR: 2.21 [1.65-2.96]), suffered from pneumonia in less cases (OR: 0.33 [0.23-0.49]) and were admitted to hospital in less cases (OR: 0.19 [0.14-0.24]). In our emergency department, we identified an important increase in the number of visits (12%) and admissions (5.7%) compared to the previous year, 2008. Conclusions: The 2009 pandemic H1N1 influenza caused significant morbidity but the mortality was not significant. The majority of children with laboratory-confirmed 2009 H1N1 virus had uncomplicated illnesses despite the increased presence of high-risk conditions (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Influenza A Virus, H1N1 Subtype/immunology , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/diagnosis , Influenza, Human/microbiology , Influenza, Human/prevention & control , Pandemics/prevention & control , Emergencies/epidemiology , Risk Factors , Influenza A Virus, H1N1 Subtype/growth & development , Influenza, Human/pathology , Influenza, Human/transmission , Prospective Studies , Morbidity/trendsABSTRACT
BACKGROUND: The 2009 H1N1 influenza A virus infection pandemic was an important challenge for public health systems worldwide. MATERIAL AND METHODS: A prospective study including all patients with an influenza-like illness, with microbiological criteria for 2009 H1N1 virus, from July to December 2009 seen in the paediatric emergency department. Viral testing was performed using multiplex real-time reverse transcription polymerase chain reaction (RT-PCR). We analysed the number of visits to, and hospital admissions from, our emergency department. We compared patients with laboratory-confirmed 2009 H1N1 virus with non-confirmed ones. RESULTS: A total of 1144 patients with microbiological criteria were identified. Of these, 513 (44.8%) were admitted to hospital, 12 of them (1%) to the PICU and 3 (0.3%) died. The majority of the patients (824; 72%) had some underlying medical condition. Of the 1144 patients, 412 (36%) had RT-PCR confirmed 2009 H1N1 infection, and 732 (64%) were not confirmed. The mean age of patients with 2009 H1N1 infection was higher than those not infected (median age: 7.4 vs 4.1 years; p<.001). Laboratory-confirmed 2009 pandemic H1N1 influenza patients had more underlying high-risk conditions (OR: 2.21 [1.65-2.96]), suffered from pneumonia in less cases (OR: 0.33 [0.23-0.49]) and were admitted to hospital in less cases (OR: 0.19 [0.14-0.24]). In our emergency department, we identified an important increase in the number of visits (12%) and admissions (5.7%) compared to the previous year, 2008. CONCLUSIONS: The 2009 pandemic H1N1 influenza caused significant morbidity but the mortality was not significant. The majority of children with laboratory-confirmed 2009 H1N1 virus had uncomplicated illnesses despite the increased presence of high-risk conditions.
Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Pandemics , Child , Child, Preschool , Emergency Service, Hospital , Female , Hospitals , Humans , Male , Prospective StudiesABSTRACT
Objetivo: Describir la epidemiología del maltrato infantil en el servicio de urgencias de un hospital pediátrico de tercer nivel. Metodología: Estudio descriptivo retrospectivo, desde enero de 2008 a enero de 2006. Se incluyeron pacientes menores de 16 años atendidos en urgencias en los que se sospechó maltrato. Resultados: De un total de 96.419 urgencias, 71 casos (0,07%) fueron por un potencial maltrato (el 45% físico, el 35% sexual y el 20% por negligencia y abandono). La edad media fue de 6 años, sin diferencias entre sexos. El 86% de los casos consultó por sospecha de maltrato. En un 67% de los casos, el posible maltratador convivía en el domicilio con el menor. Se activó la vía sociojurídica en todos los casos. Ingresaron 24 pacientes, 14 por criterio médico y el resto para protección del menor. Dos pacientes quedaron con secuelas neurológicas graves y uno falleció. Se derivó a 8 pacientes a un centro de acogida. Conclusiones: Son necesarias tanto la sensibilización y la formación del personal sanitario para la detección del maltrato como la creación de unidades especializadas para el tratamiento y el seguimiento (AU)
Objective: To describe the epidemiology of child abuse in an emergency department of a tertiary paediatric hospital. Methods: Descriptive and retrospective study from January 2008 to January 2006 including patients less than sixteen years of age who were suspected of being abused during the examination in the emergency department. Results: Child maltreatment was 0.07% of all paediatric emergencies (45% physical abuse, 35% sexual abuse and 20% neglect). Mean age of 6 years old, with no gender differences. 86% were suspected of maltreatment. An adult living with the child was suspected in 67% of cases. Social and judicial procedures were activated. A total of 24 children were admitted, 14 under medical criteria and the rest in order to protect the child; 2 had serious neurological consequences and one died. Eight patients were discharged to social service care centres (AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Child Abuse/statistics & numerical data , Mandatory Reporting/ethics , Child Abuse, Sexual , Health Personnel , Inservice Training , Epidemiology, Descriptive , Retrospective StudiesABSTRACT
OBJECTIVE: To describe the epidemiology of child abuse in an emergency department of a tertiary paediatric hospital. METHODS: Descriptive and retrospective study from January 2008 to January 2006 including patients less than sixteen years of age who were suspected of being abused during the examination in the emergency department. RESULTS: Child maltreatment was 0.07% of all paediatric emergencies (45% physical abuse, 35% sexual abuse and 20% neglect). Mean age of 6 years old, with no gender differences. 86% were suspected of maltreatment. An adult living with the child was suspected in 67% of cases. Social and judicial procedures were activated. A total of 24 children were admitted, 14 under medical criteria and the rest in order to protect the child; 2 had serious neurological consequences and one died. Eight patients were discharged to social service care centres. CONCLUSIONS: We believe it is necessary to improve the pediatrician's knowledge of child abuse and to create specialized units.
