ABSTRACT
Se valoran los gastos sanitarios producidos como consecuencia de una mala utilización de las urgencias pediátricas en un centro cuya cobertura supera los 350.000 habitantes. Se reflexiona sobre el detrimento que implica, tanto para el área primaria que asiste, como para estos servicios (AU)
Subject(s)
Humans , Hospitals, Pediatric/economics , Emergency Medical Services/economics , Health Expenditures/statistics & numerical data , Primary Health Care/economics , Cost-Benefit AnalysisABSTRACT
OBJECTIVES: A study was made of head injuries among children treated in hospital emergency services, along with an analysis of the corresponding health care pressures, type of treatment and possibilities of prevention. MATERIAL AND METHODS: A retrospective analysis was made of the last 152 pediatric head injuries seen in our center, with an evaluation of patient age, the cause and place of injury, and the individuals present at the time of the injury. When, where and what form of first aid was provided was also studied, along with the time elapsed before the arrival at the center, the reason for the consultation, severity of the injury and the treatment dispensed. The costs entailed are also evaluated. RESULTS: During the study period, pediatric head injuries accounted for 5.25% of healthcare demands. A large majority of the injuries took place at home, in parks or at school (95.39%), in the presence of relatives or tutors, and with a male predominance of 2:1. In terms of age and sex distribution, two well differentiated groups were established, corresponding to ranges of 0-7 and 7-14 years. On the average, 30-40 minutes elapsed between the injury and arrival at the Emergency Room with most cases (80.27%) corresponding to minor injuries. Moderate head trauma accounted for 19.73% of the cases. Evaluation in the form of anamnesis and clinical exploration, with a 24 hour guided observation period, proved to be the most effective approach. Only 1.97% of the patients required cranial CAT exploration, with head X-rays proving to be ineffective and to generate unnecessary costs in all cases. CONCLUSIONS: The management of pediatric head injuries should be returned to the charge of the primary healthcare areas. The adoption of such measure would improve prevention and treatment, while curbing costs. Cranial radiological exploration should be discarded as a complementary evaluation parameter. Within each particular healthcare area, common protocols should be established to facilitate the follow-up of these patients from the time of first arrival, including a 24 hour guided observation period even in the case of only slight head injuries.
Subject(s)
Brain Injuries , Adolescent , Age Distribution , Brain Injuries/diagnosis , Brain Injuries/epidemiology , Brain Injuries/therapy , Child , Child, Preschool , Emergency Service, Hospital , Female , Humans , Incidence , Infant , Male , Sex Distribution , Trauma Severity IndicesABSTRACT
After programme a inquiry-type this carry out itself amongst the families that adopted children with antibodies from the human immunodeficiency virus (AcVIH) in, they communicate the facts collected about the problematic that raise their adoption. They provide some conclusions.
Subject(s)
Acquired Immunodeficiency Syndrome , Adoption , HIV Seropositivity , Child , Humans , SpainABSTRACT
We study 37 children with mothers infected by human immunodeficiency virus type 1 (HIV-1) at birth and over the following three years. HIV-1 serology of these patients is reported, i.e., HIV-1 antigen p24 and antibodies using two commercially available enzymatic methods and Western blot. Throughout follow-up, IgG antibodies to HIV-1 showed a statistically significant tendency to decrease (p less than 0.001). After 12 months, 70% of the children lacked HIV-1 antibody banding by Western blot; this was taken to constitute a definitive criterion of lack of antibodies to HIV-1. Five children presented p24 antigenemia during the study, four persistently so. Of the patients over 18 months of age, 8 presented HIV-1 infection symptoms (30.7%), and three suffered AIDS (11.5%).
Subject(s)
Acquired Immunodeficiency Syndrome/transmission , HIV Seropositivity , HIV-1/immunology , Acquired Immunodeficiency Syndrome/immunology , Child, Preschool , Female , HIV Antibodies/immunology , Humans , Infant , Infant, Newborn , Male , Maternal-Fetal Exchange , PregnancyABSTRACT
A social study is made of 60 families with offspring presenting antibodies to HIV and monitored in our Service. Their data are compared with those obtained from an HIV antibody-negative control population randomly extracted from our Center.
Subject(s)
Acquired Immunodeficiency Syndrome/prevention & control , HIV Seropositivity/epidemiology , Acquired Immunodeficiency Syndrome/epidemiology , Child , Family Characteristics , Family Health , Female , Humans , Male , Socioeconomic Factors , Spain/epidemiologyABSTRACT
Authors present two cases of children with abnormal movements. One of them described slow and dystonic movements of neck and head due to an important gastroesophageal reflux. These movements were useful to decrease annoyances that reflux causes in the child. Appearance of these movements and reflux is what is named "Sandifer syndrome". The other case presented stereotyped movements of head, like a negation, continuous and produced by a long intake of neuroleptics, which had caused a blockade of central dopaminergic receivers. Suppression neuroleptics of cured the child.
