Análisis de una serie de 134 niños atropellados por vehículos a motor procedente de un servicio de urgencias pediátrico / Pediatric emergency department care of children injured by motor vehicles: report of a series

Se describe el perfil y el patrón lesional del niño atropellado atendido en un servicio de urgencias pediátrico (SUP), su morbimortalidad y la utilidad de la información obtenida en el SUP. El estudio retrospectivo-descriptivo se centró en menores de 18 años y serealizó entre febrero de 2005 y junio de 2006. Se recogieron 134 pacientes (H:M:1,6:1 - mediana de edad: 8,8 años), el 94,1% fueron atropellados en ciudad, por automóviles,el 32,1% en verano y el 45,8% de 17-20 h. El 97% resultó lesionado y el 91%fue leve. Las lesiones localizadas en extremidades (70,1%) y cráneo (37%); se produjeron por contusiones (67,2%) y traumatismo craneoencefálico (TCE) (34,3%). Ingresaron el 23,9% y la mortalidad fue del 1,5%. La información obtenida en el SUP ayuda adefinir el perfil y el patrón lesional esperable. La afectación de áreas vitales es frecuente.Parece razonable reforzar la prevención en verano y al final de las jornadas escolar y laboral (AU)

We describe the type of injuries our hospital’s pediatric emergency department treats in children run over by motorvehicles, estimate morbidity and mortality, and to assess the utility of information recorded in the department. This was a retrospective descriptive study of patients under the age of 18 years who were treated between February 2005 and June2006. Of the 134 patients (ratio of boys to girls, 1.6:1; median age, 8.8 years), 94.1% were run over by cars in the city ;32.1% of the accidents occurred in summer and 45.8% occurred between the hours of 5:00 and 8:00 P.M. Ninety-seven percent of the children sustained injuries; 91% of the injuries were not serious. The injuries were located on the extremities(70.1%) and head (37%); 67.2% were contusions and 34.3% were brain injuries. The department admitted 23.9% of thechildren; mortality was 1.5%. Information recorded by the emergency department helped define the profile of injuries ofthis type that can be expected. Injuries are often near vital structures. We conclude that it would be justifiable to reinforce prevention in the summertime as well as after school and working hours (AU)

Características clínicas de la gripe A H1N1 2009: estudio multicéntrico / Clinical features of influenza A H1N1 2009: a multicentre study

Objetivo: Describir las características clínico-epidemiológicas de los niños diagnosticados de gripe A H1N1 2009 en urgencias de 4 hospitales. Material y métodos: Estudio prospectivo multicéntrico de julio a diciembre 2009. Se incluyó a los pacientes diagnosticados de gripe A H1N1 2009 por PCR en tiempo real en urgencias. La solicitud de la prueba se hizo según los protocolos establecidos en cada momento de la epidemia. Se recogieron datos epidemiológicos, clínicos, de laboratorio y evolutivos. Resultados: Se incluyeron 456 casos con una mediana de edad de 6,5 años (PC25-75 3-10,6).Presentaron factores de riesgo para complicaciones de la gripe 266 pacientes (59,4%); principalmente complicaciones pulmonares (47%), cardiovasculares (17%), neurológicos (14%) e inmunodeficiencias (11%). La clínica más frecuente fue fiebre (96%), tos (88%), rinorrea (72%), mialgias o astenia y dificultad respiratoria y, menos frecuentes, síntomas digestivos y neurológicos. Se solicitó radiografía de tórax a 224 pacientes (49%), presentando un 31% infiltrados lobares y un 15% intersticiales. Ciento cuarenta pacientes fueron hospitalizados (31%), necesitando el apoyo de la unidad de cuidados intensivos (mediana de estancia 4 y 3,5 días, respectivamente).Las complicaciones más frecuentes fueron neumonías y crisis de broncospasmo. Fallecieron3 pacientes (un paciente previamente sano por miocarditis y 2 con encefalopatía por fallo respiratorio). Otro caso de miocarditis se recuperó con secuelas. Conclusiones: El perfil del paciente con gripe A H1N1 2009 diagnosticada en urgencias fue el de un escolar, con factores de riesgo de complicaciones, que presentaba sintomatología respiratoria febril de corta evolución al que pudo darse de alta. Además de las complicaciones respiratorias habituales de la gripe, destacaron los casos de afectación miocárdica (AU)

Objective: To describe clinical and epidemiological features of influenza A H1N1 2009 diagnosed patients in the Emergency Department of 4 hospitals. Material and methods: Prospective multicentre study conducted from july to december 2009. The patients diagnosed by Real-Time PCR of influenza A H1N1 2009 in the emergency department were included. The test was requested according to the protocols established throughout the epidemic. Epidemiological, clinical, laboratory variables and outcomes were evaluated. Results: A total of 456 cases were included, with a median age of 6.5 years (PC25-75 3-10.6). There were risk factors of complications In 266 patients (59.4%) due to the influenza, mainly: respiratory (47%), cardiovascular (17%), neurological (14%) and immunosuppression (11%). The most frequent symptoms were fever (96%), (88%) cough, (72%) rhinorrhoea, muscle aches orasthenia and breathing difficulties and, less common, gastrointestinal and neurological symptoms. Chest X-ray was performed on 224 cases (49%), with lobar (31%) and interstitial (15%) infiltrates. One hundred and forty patients (31%) were hospitalised and 3.2% required Intensive Care Unit (median stay 4 and 3.5 days, respectively). The most frequent complications were pneumonias and bronchospasms. Three patients died (a previously healthy patient with myocarditis and 2 patients with encephalopathy due to respiratory failure). Another case of myocarditis recovered with sequelae. Conclusions: The profile of patient with influenza A 2009 diagnosed in the emergency department was a school child, with risk factors of complications, presenting with respiratory symptoms and fever over a short time, and who can be discharged. It is important to emphasise myocarditis, as well as the usual respiratory complications of influenza virus (AU)

[Clinical features of influenza A H1N1 2009: a multicentre study]. / Características clínicas de la gripe A H1N1 2009: estudio multicéntrico.

OBJECTIVE: To describe clinical and epidemiological features of influenza A H1N1 2009 diagnosed patients in the Emergency Department of 4 hospitals. MATERIAL AND METHODS: Prospective multicentre study conducted from july to december 2009. The patients diagnosed by Real-Time PCR of influenza A H1N1 2009 in the emergency department were included. The test was requested according to the protocols established throughout the epidemic. Epidemiological, clinical, laboratory variables and outcomes were evaluated. RESULTS: A total of 456 cases were included, with a median age of 6.5years (PC(25-75) 3-10.6). There were risk factors of complications In 266 patients (59.4%) due to the influenza, mainly: respiratory (47%), cardiovascular (17%), neurological (14%) and immunosuppression (11%). The most frequent symptoms were fever (96%), (88%) cough, (72%) rhinorrhoea, muscle aches or asthenia and breathing difficulties and, less common, gastrointestinal and neurological symptoms. Chest X-ray was performed on 224 cases (49%), with lobar (31%) and interstitial (15%) infiltrates. One hundred and forty patients (31%) were hospitalised and 3.2% required Intensive Care Unit (median stay 4 and 3.5days, respectively). The most frequent complications were pneumonias and bronchospasms. Three patients died (a previously healthy patient with myocarditis and 2 patients with encephalopathy due to respiratory failure). Another case of myocarditis recovered with sequelae. CONCLUSIONS: The profile of patient with influenza A 2009 diagnosed in the emergency department was a school child, with risk factors of complications, presenting with respiratory symptoms and fever over a short time, and who can be discharged. It is important to emphasise myocarditis, as well as the usual respiratory complications of influenza virus.