Evolución de la función pulmonar en niños con asma grave en tratamiento con omalizumab / Lung function evolution in children with severe asthma treated with omalizumab

Introducción: Omalizumab es un anticuerpo monoclonal frente a la inmunoglobulina E utilizado en el tratamiento del asma alérgica grave. El objetivo de este estudio fue describir el efecto de omalizumab sobre los valores de la función pulmonar y la fracción exhalada de óxido nítrico (FeNO) en pacientes pediátricos. Material y métodos: Análisis estadístico de la función pulmonar y de la FeNO en los 13 niños tratados con omalizumab en el servicio de pediatría de un hospital terciario entre los años 2010 y 2016. Resultados: Se observa una mejoría estadísticamente significativa a los 3 meses de tratamiento que se mantiene estable en el tiempo, tanto en valores de función pulmonar (pretratamiento: capacidad vital forzada [FVC] 84,1% y volumen espiratorio forzado en el primer segundo [FEV1] 72%; postratamiento: FVC 101% [p= 0,02] y FEV1 92% (p= 0,01) como en la FeNO (pretratamiento: 82 ppb; postratamiento: 36 ppb). Conclusiones: En nuestros pacientes pediátricos con asma grave, omalizumab es capaz de mejorar y mantener estable en el tiempo la función pulmonar y disminuir el valor de la FeNO

Introduction: Omalizumab is a monoclonal antibody against immunoglobulin E used in the treatment of severe allergic asthma. The aim of this study was to describe, in pediatric patients, the effects of omalizumab in pulmonary function values and in the nitric oxide concentration levels in exhaled breath (FeNO). Material and methods: We performed a statistical analysis of lung function and FeNO evolution in 13 children treated with omalizumab in a pediatric service, between year 2010 and 2016. Results: A statistically significant improvement was observed after 3 months of treatment, which remained stable over time, in lung function values (pre-treatment: forced vital capacity [FVC] 84.1% and forced expiratory volume in the first second [FEV1] 72%; after treatment: FVC 101% [p= 0.02] and FEV1 92% [p= 0.01]). A significant improvement was also detected in the FeNO levels (pre-treatment: 82 ppb; after treatment: 36 ppb). Conclusions: In our pediatric patients with severe asthma, omalizumab was able to improve and maintain stable in time both pulmonary function and FeNO values

[Comparison of clinical features and diagnosis between the A and B subgroups of respiratory syncytial virus.] / Comparación de las características clínicas y diagnósticas de los subgrupos A y B del virus respiratorio sincitial.

BACKGROUND: Lower respiratory tract infection by respiratory syncytial virus (RSV) is the most frequent cause of admission in children under 2 years old. The RSV subgroups A and B may circulate simultaneously. We aimed to determine whether clinical differences exist between RSV subgroups A and B. Additionally, we tested the sensitivity of the rapid antigen detection test (RADT) based on immunochromatography in diagnosing subgroups A and B, taking the polymerase chain reaction assay (RT-PCR) as reference. METHODS: A retrospective observational study was performed in a tertiary hospital from October 2013 to March 2014. Clinical records and analytical variables of all children under 5 admitted with lower respiratory tract infection and RT-PCR positive for RSV in nasal lavage were consulted. Previously, the RADT for RSV had been performed from the same sample. RESULTS: A total of 198 children under 5 were diagnosed with RSV by RT-PCR: 55 (28%) were RSV-A, 132 (67%) RSV-B and 11 (5%) were positive for both subgroups. No differences were observed between subgroups in medical history, symptoms, radiological and analytical findings, and severity. The sensitivity of RADT for RSV was 52%, higher for RSV-A (69%) than for RSV-B (44%, p=0.001). CONCLUSIONS: The two RSV subgroups were indistinguishable in symptoms and prognosis. The sensitivity of RADT compared to RT-PCR was low and limits its usefulness for clinical decision-making. Key words. Respiratory syncytial virus. RSV subgroups. Rapid antigen detection test. Reverse transcription polymerase chain reaction.

Neumonía cavitada versus hernia diafragmática congénita / Cavitary pneumonia versus congenital diaphragmatic hernia

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Fístula traqueoesofágica en H en periodo neonatal: diferentes abordajes terapéuticos / H-type tracheoesophageal fistula in neonates: Different therapeutic approaches

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[Activity of a short-stay observation unit in an emergency department of a tertiary hospital. A two-year experience]. / Actividad de una unidad de observación en un servicio de urgencias de un hospital terciario: dos años de experiencia.

OBJECTIVES: To describe the characteristics of the activity of a short stay observation unit (SSOU) in a tertiary hospital, and to analyze its influence on the hospitalization rate. MATERIAL AND METHODS: The activity of the SSOU during the first 2 years after opening is described. Descriptive variables were registered. Hospitalization activity during the first 5 months after opening the unit was compared with the activity during the same period in the previous year. RESULTS: From June 1, 2001 to May 31, 2003, 74,989 patients were admitted to the emergency department (ED) and 2,438 (3.25 %) were transferred to the SSOU. The mean age of the patients was 64.55 months. The mean length of stay was 5 hours and 50 minutes. The main discharge diagnoses were gastrointestinal disease (30.2 %), accidents (15 %), respiratory illness (12.5 %) and febrile syndrome (9.8 %). The hospitalization rate in patients admitted to the ED was 5.8 % from June 1, 2000 to October 1, 2000 and was 4.28 % in the same period in 2001. The mean diagnosis-related group (DRG)-weight was 0.8648 in 2000 and was 0.9078 in 2001. Total weight was 680.66 in 2000 and 495.69 in 2001, allowing an approximate saving of 329,162 Euros. CONCLUSIONS: The opening of the SSOU has been useful in the assessment and treatment of common childhood diseases and has helped reduce the hospitalization rate, increase the complexity of inpatients and lower costs.

Actividad de una unidad de observación en un servicio de urgencias de un hospital terciario: dos años de experiencia / Activity of a short-stay observation unit in an emergency department of a tertiary hospital. A two-year experience

Objetivos: Exponer las características de la actividad de la unidad de observación de un hospital terciario y analizar los cambios derivados de ello en la hospitalización. Material y métodos: Se describe la actividad de dicha unidad en los primeros 2 años, recogiendo diferentes variables descriptivas. Posteriormente, se compara la actividad hospitalaria en la planta durante los primeros 5 meses tras su instauración, con el mismo período del año anterior, cuando no existía esa unidad. Resultados: En el período comprendido entre el 1 de junio de 2001 y el 31 de mayo de 2003 se atendieron 74.989 urgencias, de las cuales 2.438 (3,25 %) se valoraron en la unidad de observación. La edad media de los pacientes fue de 64,55 meses. La estancia media se sitúa en las 5 h y 50 min. Los diagnósticos al alta fueron asignados a patología digestiva (30,2 %), accidentes (15 %), patología respiratoria (12,5 %) y síndrome febril (9,8 %). En el período de junio a octubre de 2000 ingresaron en el servicio de pediatría el 5,8 % de pacientes atendidos en urgencias, por un 4,28 % del mismo período del año 2001. El peso medio de los ingresos en el año 2000 fue 0,8648, y en 2001 fue 0,9078. El peso total de los ingresos del año 2000 fue 680,66 y del 2001 de 495,69, lo que se traduce en un ahorro aproximado de 329.162 d. Conclusiones: La instauración de una unidad de observación ha sido útil en el manejo de patología frecuente en la infancia y ha contribuido, en nuestro hospital, a una disminución en el número de ingresos, una mayor complejidad de los pacientes ingresados y una disminución del gasto

Objectives: To describe the characteristics of the activity of a short stay observation unit (SSOU) in a tertiary hospital, and to analyze its influence on the hospitalization rate. Material and methods: The activity of the SSOU during the first 2 years after opening is described. Descriptive variables were registered. Hospitalization activity during the first 5 months after opening the unit was compared with the activity during the same period in the previous year. Results: From June 1, 2001 to May 31, 2003, 74,989 patients were admitted to the emergency department (ED) and 2,438 (3.25 %) were transferred to the SSOU. The mean age of the patients was 64.55 months. The mean length of stay was 5 hours and 50 minutes. The main discharge diagnoses were gastrointestinal disease (30.2 %), accidents (15 %), respiratory illness (12.5 %) and febrile syndrome (9.8 %). The hospitalization rate in patients admitted to the ED was 5.8 % from June 1, 2000 to October 1, 2000 and was 4.28 % in the same period in 2001. The mean diagnosis-related group (DRG)-weight was 0.8648 in 2000 and was 0.9078 in 2001. Total weight was 680.66 in 2000 and 495.69 in 2001, allowing an approximate saving of 329,162 d. Conclusions: The opening of the SSOU has been useful in the assessment and treatment of common childhood diseases and has helped reduce the hospitalization rate, increase the complexity of inpatients and lower costs

Infección por Streptococcus pneumoniae en el Área de Salud de Pamplona (1999-2001) / Streptococcus pneumoniae infection in a health district of Pamplona (Spain)

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