Repercusión de la pandemia COVID-19 en la actividad pediátrica en Atención Primaria / Impact of the COVID-19 pandemic on the pediatric activity in Primary Care

Introducción. La pandemia por COVID-19 ha supuesto un cambio en nuestras vidas y deseamos conocer su influencia en las consultas de pediatría en Atención Primaria. Pacientes y métodos. Estudio observacional retrospectivo de la actividad en un Centro de Salud urbano entre enero 2019 y marzo 2021. Se realiza aleatorización estratificada para elegir semana y día y se incluyen todos los pacientes. La información se extrae del programa Medora. Se recogen las variables: fecha de consulta, fecha de nacimiento, profesional, sexo, patología crónica, tipo y motivo de consulta, hospitalización reciente y afectación por COVID-19. Se realiza un análisis de regresión logística binaria y análisis de regresión de joinpoint. Resultados. La muestra es de 1.802 consultas. La tendencia de las tasas de consultas es estable de forma global y en la atención de enfermería, pero hay cambios estacionales en la atención de los pediatras. Durante la pandemia el tipo de consulta a la demanda/urgencia ha sido inferior que la programada (Odds Ratio = 0,19, IC al 95%: 0,1 a 0,3) y la atención telefónica/no presencial superior a la programada (Odds Ratio = 4,01: IC95% 2,3 a 6,95). El comportamiento de las consultas por tipo de patologías, consulta de revisión, vacunaciones o aspectos administrativos ha sido similar antes y durante la pandemia. Conclusión. El volumen de atenciones en nuestro Centro de Salud ha sido similar durante el periodo estudiado. La atención telefónica/no presencial ha sido cuatro veces superior a la consulta programada. Existen diferencias estacionales con descenso estival (AU)

Introduction. Our aim is to know the impact of the pandemic on pediatric activity in Primary Care.Patients and methods. Retrospective observational study of pediatric activity in an urban Health Center between January 2019 and March 2021. Stratified randomization is performed to choose the week and day. All patients are included. The information collected is extracted from the Medora program. Date of consultation, date of birth, professional, sex, chronic pathology, type and reason for consultation, recent hospitalization and involvement by COVID-19 are collected. Binary logistic regression analysis and regression analysis of joinpoint are performed.Results. The sample is made up of 1802 consultations. Trend in consultation rates is stable globally and in nursing care, but there are seasonal changes in pediatric care. During the pandemic, the demand/urgent consultation was lower than scheduled (Odds Ratio = 0.19, 95% CI 0.1 to 0.3) and telephone/non-face-to-face consultations were higher than scheduled (Odds Ratio = 4.01: 95% CI 2.3 to 6.95). The behavior of consultations by type of pathology, review consultation, vaccinations or administrative aspects has been similar before and during the pandemic.Conclusion. The number of consultations in our Health Center has been similar along the studied period. Telephone/non-face-to-face assistance has been four times higher thanscheduled consultation. There are seasonal differences in pediatric care with a summer decline (AU)

Percepción de los pediatras de Atención Primaria de su relación con la Pediatría Hospitalaria / Perception of the Primary Care pediatricians of their relationship with Hospital Pediatrics

Objetivo. El objetivo de este trabajo es conocer la percepción que tienen los pediatras de Atención Primaria (PAP) de Castilla y León de su relación con la Pediatría Hospitalaria. Población y métodos. Se realizó una encuesta entre los pediatras de Atención Primaria para conocer la relación entre niveles asistenciales en las 11 áreas sanitarias de la Comunidad. El cuestionario es anónimo y consta de 16 preguntas en dos bloques: 9 sobre “cómo es/cómo percibimos la relación entre los PAP y el hospital” (bloque 1) y 7 sobre “qué cosas son importantes para los PAP/qué se pide al hospital” (bloque 2). Se puntúa con una escala Likert de 1 (nada) a 5 (máximo). Resultados. Respondieron 134 pediatras (84% mujeres). El 64% tiene 15 años de experiencia en PAP. El 77% trabajan como pediatras de equipo, y el 64% en centros urbanos. El 43% tiene cupos de 800-999 pacientes. El 24% son tutores de apoyo MIR y el 24% colabora en la formación de estudiantes de Medicina. En el primer bloque de preguntas se observan medianas entre 2 y 4 de puntuación Likert, y en el segundo bloque los valores son más elevados (mediana 4). Encontramos diferencias significativas al comparar las respuestas por áreas sanitarias, en todas las preguntas del primer bloque y en la mayoría del segundo. Conclusión. La relación entre niveles es aceptable en su conjunto, con importantes diferencias entre áreas sanitarias (AU)

Objective. To know the perception that Primary Care pediatricians (PCP) of Castilla y Leon have about their relationship with hospital pediatricians. Population and methods. A survey was conducted among PCP to find out the relationship between healthcare levels in the 11 health areas of the Community. The questionnaire is anonymous and consists of 16 questions (two blocks): 9 about “how is/how we perceive the relationship between the PCP and the hospital” (first block) and 7 about “what is important for the PCP/what is asked to the hospital” (second block). It is scored on a Likert scale from 1 (not at all) to 5 (maximum). Results. 134 pediatricians answer (84% women). 64% have 15 years of experience as PCP. 77% work as team pediatrician, and 64% in urban settings. 43% attends 800-999 patients. 24% are support tutors and 24% are trainers of medical students. Medians between 2 and 4 of Likert scores are observed in the first block of questions, and values are higher (4) in the second one. We find significant differences when making comparisons by Health Areas in all the questions in the first block and in most of them in the second. Conclusión. The relationship between healthcare levels is acceptable as a whole with important differences among health areas (AU)

[Bronchiolitis: revision of 153 cases and comparative study of ribavirin treatment]. / Bronquiolitis. Revisión de 153 casos y estudio comparativo del tratamiento con ribavirina.

OBJECTIVE: We try in this paper to improve the knowledge of the main epidemiological, clinic, evolutive and therapeutic data in cases of children suffering from bronchiolitis in our medium; we analyze particularly the possible usefulness of ribavirin as a causal treatment. MATERIAL AND METHODS: Firstly we have accomplished backward studies about the children suffering from bronchiolitis, who has been hospitalized in our Unit from January 1987 to May 1994. Then we have carried out a comparative study of the evolution in both groups of patients with and without RBV treatment. We have identified the Respiratory Sincityal Virus (RSV) by direct immunofluorescence. RESULTS: We have found that the bronchiolitis impact is much higher during the winter, as well as city areas. The more affected patients are significantly younger than those with less severe injuries (p < 0.0005), and then, often show personal antecedent of prematurity and neonatal respiratory pathology. We have identified the RSV in 90.8% of the patients. The group treated with RBV showed a significative improvement of respiratory distress. The final cost of treatment was very similar in both groups (with and without RBV), since the hospital stay was shorten in the ribavirin group. CONCLUSION: RBV treatment was very usefull in moderate as well as severe cases in wich we found in average, a significative improvement of the clinic sign of respiratory distress.