RESUMO
Objetivos: Debido a la muy alta incidencia de otitis media aguda (OMA) referida en algunos trabajos y a la disponibilidad de una vacuna conjugada para su prevención, hemos estudiado la incidencia de OMA en nuestro medio en los últimos 9 años. Material y métodos: Se realiza el trabajo en el Centro de Salud de Manises, población de 26.000 habitantes (4.560 niños hasta 14 años), a 6 km de Valencia capital. Se obtienen los diagnósticos de otitis de 230.020 consultas entre 1993 y 2001. El criterio diagnóstico de OMA ha sido la presencia de otalgia más algún signo timpánico. Resultados: La OMA ha sido la causa del 4% de todas las consultas. Al cumplir 1 año de vida, el 35,4% de los niños ha tenido algún episodio de OMA, y al cumplir 4 años lo ha sufrido el 84,6%. Ha tenido tres o más cuadros de OMA el 5,7% de los niños al año de vida y el 31,8% al llegar a los 4. Se comprueba que cuanto antes tiene un niño la primera OMA, mayor número de episodios va a tener. La incidencia de mastoiditis es del 0,011%. Se comparan los resultados con los obtenidos por otros autores. Conclusiones: Encontramos una incidencia de OMA más baja que la referida por otros autores, probablemente porque es un trabajo retrospectivo donde sólo se han diagnosticado las OMA sintomáticas (AU)
Objective: In view of the very high incidence of acute otitis media (AOM) in children reported in some studies and the availability of a polysaccharide conjugate vaccine for its prevention, we studied the incidence of AOM in our population over the last nine years. Materials and methods: The research was carried out in the Health Center of Manises, a city 6 kilometers from Valencia, Spain, which has a population of 26,000 inhabitants (4,560 children of up to 14 years of age). The diagnosis was obtained from 230,020 consultations between 1993 and 2001. The diagnostic criteria were earache and any type of tympanic involvement. Results: AOM accounted for 4% of all consultations. Within the first year of life, 35.4% of children had had at least one AOM episode and 84.6% before the fourth year of life. 5.7% of children had had 3 or more AOM episodes within the first year and 31.8% before the fourth. There is a direct relationship between early age at the first episode and the number of episodes of AOM. The incidence of mastoiditis was 0.011%. These results were compared with those obtained by other authors. Conclusions: We found a lower incidence of AOM than that reported by other authors, probably because ours is a retrospective study involving only symptomatic AOM (AU)
Assuntos
Criança , Humanos , Otite Média/classificação , Otite Média/complicações , Otite Média/diagnóstico , Espanha , Atenção Primária à SaúdeRESUMO
OBJECTIVES: To determine the efficacy and immunogenicity achieved 6 years after the start of a massive vaccination campaign against hepatitis B in newborn infants and adolescents (12 years). The persistence of anti-hepatitis B virus surface antigen (HBS) levels and the need for a booster dose were also assessed. MATERIALS AND METHODS: From 1993 to 1997 the Engerix vaccine (10 micrograms) and since then the Recombivax vaccine (5 micrograms). The vaccination schedule was the standard of three doses (0, 1, 6). Blood analyses were used for determination of anti-HBs between October of 1998 and May of 2000. RESULTS: We studied 382 cases. Five years after the first dose, 96.1% (73/76) has anti-HBs and in 75% (57/76) levels were above 10UI/L. Six to seven years after vaccination anti-HBs were detected in 94,1 (32/34) of the children and in 70.6% (24/34) of these, levels were above 10UI/L. CONCLUSIONS: A high percentage of children were found to have good levels of anti-HBs 67 years after vaccination. Recent studies show that booster doses are not required because of the immunologic memory that produces the vaccine. The anti-HB protective level (> or = 10UI/l) should not be taken into consideration because this level is only valid when passive immunity with immunoglobulins is applied.
Assuntos
Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Programas de Imunização , Imunização Secundária , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-NascidoRESUMO
OBJETIVO: Tras haber pasado 6 años desde el inicio de la campaña de vacunación masiva de la hepatitis B en recién nacidos y adolescentes (12 años), se pretende conocer la eficacia e inmunogeneicidad de la misma, la persistencia de la misma, la persistencia de los valores de antihbs y la necesidad de realizar dosis de recuerdo. MATERIAL Y MÉTODOS: Se utilizó la vacuna engerix desde 1993 hasta 1987 (10 mg) y desde entonces la vacuna recombivax (5 mg). El calendario vacunal fue el estándar de 3 dosis (0, 1 y 6 años). Para realizar el estudio se aprovechó cualquier análisis de sangre para cuantificar el título de antihbs, entre octubre de 1998 y mayo de 2000. RESULTADOS: se obtuvieron 382 casos. A los 5 años de la primera dosis, el 96,1% (73/76) tenian antihbs y el 75% (57/76) por encima de 10U/L. A los 6-7 años de la vacunación, en el 94,1% (32/34) de los niños se detectaba antihbs y en el 70,6% (24/34) de éstos por encima de 10/Ul sólo en 5 niños fue negativo el anticuerpo. CONCLUSIÓN: en este estudio se ha encontrado un alto porcentaje de niños con buenos valores de antihbs, tras 6-7 años de la vacunación. La bibliografía reciente demuestra que, dada la memoria inmunológica que produce la vacuna, no es necesaria la revacunación. También debe olvidarse el denominado nivel protectivo de antihbs 10U/l, sólo válido cuando se aplica inmunidad pasiva con inmunoglobulinas (AU)
Assuntos
Criança , Pré-Escolar , Adolescente , Recém-Nascido , Lactente , Humanos , Programas de Imunização , Imunização Secundária , Vacinas contra Hepatite B , Anticorpos Anti-Hepatite BRESUMO
OBJECTIVE: To determine the pediatric demands in a primary health care center in order to better plan the work, as well as to up-date the health care and continuing education programs. PATIENTS AND METHODS: The total number of pediatric consultations to a health care center during two years were studied. RESULTS: A total number of 3,848 children, with a maximum age of 13 years, consulted this office a total of 48,936 times. The annual frequency index increases in accordance with a decrease in age, with an average of 6.2 consultations per child per year. The assistencial pressure was 24.15 consultations/ pediatrician/day in 1993 and 27.33 consultations/pediatrician/day in 1994. Consultations by children older than 7 years of age comprised 24.4% of the total. As for the distribution of these consultations, 74.19% were with a previous appointment, 18.06% without appointment, 7.16% due to health programs and 0.58% due to consultations done at home. For every 100 visits, 1.34 complementary tests, 1.8 x-rays and 6.5 referrals were done. Using Wonca's classifications, 42.23% belonged to group VIII, the next greatest number to group XVIII, followed by I, with the last being XVI. The most frequent reasons for consultations were: SRI in 24.3% of the cases, followed by the breast-feeding program, normality, tonsillitis and otitis. In addition, acute respiratory tract infection and acute childhood diarrhoea had weekly distributions throughout these two years. CONCLUSIONS: We comment on the necessity of adapting the continued education programs and the prevention and health promotion plans so that they better address the pathologies that are most frequently found in primary care.
