ABSTRACT
Introducción: En Europa occidental el 20-40% de los niños con fiebre solicitan asistencia sanitaria. La mayoría presentan infecciones virales banales, sin embargo, es esencial en pediatría distinguir los pacientes que presentan una infección severa. Este proceso se inicia con el reconocimiento de la gravedad y la posterior búsqueda de atención médica por parte de los padres. Metodología: Estudio observacional analítico y transversal. Se seleccionaron 100 pacientes en 2 centros de salud. Se recogieron los datos sociodemográficos, junto con las respuestas de un checklist que contenía los signos y los síntomas ante los que solicitar asistencia sanitaria en caso de fiebre. Posteriormente se rellenó el checklist por parte del pediatra. Resultados: La edad media de los pacientes fue de 5,41 años. El 50% consultó en las primeras 48h de evolución de la fiebre. En el 42% la respuesta a todos los ítems del checklist fue exactamente la misma entre acompañante y pediatra. No existieron diferencias significativas según variables: primer episodio de fiebre (p=0,262), edad del paciente (p=0,859), tener hermano/as (p=0,880), parentesco familiar del acompañante (p=0,648) o grado de estudios del acompañante (p=0,828). Conclusiones: Las consultas médicas por fiebre en pediatría se realizan muy precozmente. Un alto porcentaje no presentan signos de alarma cuando consultan. Se plantea la necesidad ampliar la formación sobre los signos de alarma de la fiebre en todos los padres, independientemente del número de hijos, de la edad o del nivel educacional. El checklist como herramienta para la valoración en el domicilio de la fiebre ha recibido una alta puntuación en su utilidad.(AU)
Introduction: In Western Europe, 20%-40% of children with fever request health care. Most of them present trivial viral infections, however, it is essential in pediatrics to distinguish patients who present a severe infection. This process begins with the recognition of the seriousness and the subsequent search for medical attention by the parents. Methodology: Analytical and cross-sectional observational study. One hundred patients were selected in two health centers. Sociodemographic data were collected, together with the responses to a checklist containing the signs and symptoms to request health care in case of fever. Subsequently, the checklist was filled out by the pediatrician. Results: The mean age of the patients was 5.41 years. 50% consulted in the first 48h of fever evolution. In 42%, the response to all the items on the checklist was exactly the same between the companion and the pediatrician. There were no significant differences according to variables: first episode of fever (P=.262), age of the patient (P=.859), having a sibling (P=.880), family relationship of the companion (P=.648) or educational level of the companion (P=.828). Conclusions: Medical consultations for fever in pediatrics are carried out very early. A high percentage do not present alarm signs when they consult. There is a need to expand training on the alarm signs of fever in all parents, regardless of the number of children, age or educational level. The checklist as a tool for home assessment of fever has received high marks for its usefulness.(AU)
Subject(s)
Humans , Male , Female , Cultural Characteristics , Fever/drug therapy , Parents , Mothers , Health Education , Cross-Sectional Studies , Pediatrics , Family PracticeABSTRACT
INTRODUCTION: In Western Europe, 20%-40% of children with fever request health care. Most of them present trivial viral infections, however, it is essential in pediatrics to distinguish patients who present a severe infection. This process begins with the recognition of the seriousness and the subsequent search for medical attention by the parents. METHODOLOGY: Analytical and cross-sectional observational study. One hundred patients were selected in two health centers. Sociodemographic data were collected, together with the responses to a checklist containing the signs and symptoms to request health care in case of fever. Subsequently, the checklist was filled out by the pediatrician. RESULTS: The mean age of the patients was 5.41 years. 50% consulted in the first 48h of fever evolution. In 42%, the response to all the items on the checklist was exactly the same between the companion and the pediatrician. There were no significant differences according to variables: first episode of fever (P=.262), age of the patient (P=.859), having a sibling (P=.880), family relationship of the companion (P=.648) or educational level of the companion (P=.828). CONCLUSIONS: Medical consultations for fever in pediatrics are carried out very early. A high percentage do not present alarm signs when they consult. There is a need to expand training on the alarm signs of fever in all parents, regardless of the number of children, age or educational level. The checklist as a tool for home assessment of fever has received high marks for its usefulness.
Subject(s)
Checklist , Parents , Child , Humans , Child, Preschool , Cross-Sectional Studies , Fever/diagnosis , Fever/etiology , Educational StatusABSTRACT
A study was performed in 2007 to isolate and characterize infectious bursal disease viruses (IBDVs) in commercial broilers grown in the Delmarva (DMV) Peninsula region of the United States. Bursae of Fabricius were collected weekly from 1 to 4 wk of age from broilers on 10 farms with a history of poor performance. Microscopic pathology was used to determine the infectious bursal disease (IBD) status of the broilers. Bursae from 1- and 2-wk-old broilers did not show IBD microscopic lesions. Moreover, broilers on 1 of the 10 farms were IBD lesion free at 3 and 4 wk of age. However, 3 of 9 and 9 of 9 farms yielded broilers with IBD-affected bursae from 3- and 4-wk-old commercial broilers, respectively. Ten IBDV isolates were recovered from 3 of 3 lesion-positive bursal pools at 3 wk of age and 7 of 9 lesion-positive bursal pools at 4 wk of age. Analysis of the viral protein (VP) 2 genes identified all isolates as serotype 1 Delaware (Del) variant viruses. Five field isolates, each representing different molecular clades of the Delaware variant viruses, were selected for further study. Experimental infection of specific-pathogen-free white leghorn chickens with isolates DMV/4813/07, DMV/4947/07, DMV/4955/07, DMV/5038/07, and DMV/5041/07 produced gross and microscopic pathology of the bursa consistent with Delaware variant infection. Monoclonal antibody testing showed DMV/4813/07, DMV/4947/07, DMV/ 4955/07, and DMV/5041/07 to be similar to previous recognized variant viruses. However, DMV/5038/07 was found to be unreactive with the monoclonal antibodies that typically recognize reference strains STC, Del E, GLS, RS593, and AL2. In a challenge of immunity study, 10-day-old progeny from breeders immunized with a commercially available inactivated IBDV vaccine containing the Del E and classic strains were protected to a lesser degree against isolate DMV/5038/07 compared to Del E challenge based on microscopic lesion scores (P < 0.01) of the bursa. This result suggests the virus is antigenically different from the Del E strain contained in the vaccine. Collectively, the monoclonal antibody and progeny challenge of immunity findings suggest DMV/5038/07 is antigenically different from the Del E strain contained in the vaccine.
