Brote de onicomadesis posvírica en Valladolid / Post viral onychomadesis outbreak in Valladolid

Introducción: En verano del 2008 se notificó un brote epidémico de onicomadesis en Valencia que afectó a más de 200 niños, y se relacionó con una virasis similar a la enfermedad boca-mano-pie (EBMP). Aunque ya se había descrito esta asociación en unos pocos casos, constituía la primera epidemia de este tipo en el mundo. Se comunica la observación de 16 casos de onicomadesis posvírica en Valladolid. Material y métodos: Se recogieron parámetros clinicoepidemiológicos de 15 niños y la madre de uno de ellos que se habían diagnosticado de onicomadesis a través de las consultas de Pediatría de 6 centros de salud, entre noviembre del 2008 y febrero del 2009.ResultadosEn un mes se diagnosticaron 11 casos de onicomadesis en alumnos de 2 guarderías de diferente barrio de Valladolid, y el resto en otros 4 centros escolares de la ciudad y de 2 poblaciones cercanas. Las edades oscilaron entre 18 meses y 3 años. Nueve de los 15 niños (60%) se habían diagnosticado de EBMP entre 3 y 12 semanas antes (media: 6 semanas), y al menos 6 presentaron fiebre. Los pacientes recuperaron ad integrum las uñas entre un mes y 4 meses. Conclusiones: Parece tratarse de otro brote epidémico de onicomadesis posvírica, según la similitud de las características clinicoepidemiológicas con el ocurrido en Valencia: edad, efecto clúster en guarderías, enfermedad vírica previa, a menudo con exantema acral, y recuperación de las uñas. El desconocimiento de esta nueva entidad clínica y el intervalo de tiempo que transcurre entre el proceso agudo vírico y la afectación ungueal probablemente estén originando un infradiagnóstico (AU)

Introduction: An onychomadesis outbreak associated with hand-foot-mouth disease (HFMD) was notified in winter 2008 in Valencia, Spain, with more than 200 people affected, the majority children. Even though this association has already described, this was the first outbreak known in the world. Sixteen cases of post-viral onychomadesis post viral in Valladolid are presented. Material and methods: Between November 2008 and February 2009, 15 children aged between 18 months and 3 years, and one mother, presented with onychomadesis in Primary Care Centres in Valladolid. Results: HFMD was diagnosed in a single month in 11 patients who attended two nurseries. The others attended others nurseries of Valladolid area. Nine children (60%) had the clinical diagnosis of HFMD 3 to 12 weeks before (mean: 6 weeks), six with fever. The nail changes were usually temporary with spontaneous normal re-growth in 1 to 4 months. Conclusions: The clinical and epidemiological characteristics of this report were similar to the Valencia outbreak: age, geographic clustering, acral eruption prior, etc. Perhaps the diagnosis is underestimated due to ignorance of the disease and the long interval between the acute viral process and nail shedding (AU)

[Post viral onychomadesis outbreak in Valladolid]. / Brote de onicomadesis posvírica en Valladolid.

INTRODUCTION: An onychomadesis outbreak associated with hand-foot-mouth disease (HFMD) was notified in winter 2008 in Valencia, Spain, with more than 200 people affected, the majority children. Even though this association has already described, this was the first outbreak known in the world. Sixteen cases of post-viral onychomadesis post viral in Valladolid are presented MATERIAL AND METHODS: Between November 2008 and February 2009, 15 children aged between 18 months and 3 years, and one mother, presented with onychomadesis in Primary Care Centres in Valladolid. RESULTS: HFMD was diagnosed in a single month in 11 patients who attended two nurseries. The others attended others nurseries of Valladolid area. Nine children (60%) had the clinical diagnosis of HFMD 3 to 12 weeks before (mean: 6 weeks), six with fever. The nail changes were usually temporary with spontaneous normal re-growth in 1 to 4 months. CONCLUSIONS: The clinical and epidemiological characteristics of this report were similar to the Valencia outbreak: age, geographic clustering, acral eruption prior, etc. Perhaps the diagnosis is underestimated due to ignorance of the disease and the long interval between the acute viral process and nail shedding.

[An epidemiological analysis of the sequence of bladder control and nocturnal enuresis prevalence in the children of the province of León]. / Análisis epidemiológico de la secuencia de control vesical y prevalencia de enuresis nocturna en niños de la provincia de León.

The objective of this study was to better understand the development of nocturnal bladder control in our population of children and to analyze the different factors that influence this process. A transversal epidemiological study in a randomly chosen sample of schoolchildren, between the ages of 6 and 10 years, in the province of Leon was performed. The study was carried out by means of an anonymous survey given to the children's parents through the school center. The survey was comprised of personal, environmental and sphincter control development questions. We define nocturnal enuresis as at least one wet night per month in children older than 6 years of age. Of the surveys distributed, 65.1% were answered. The prevalence of primary, secondary and total nocturnal enuresis was 10.18%, 2.91% and 13.09%, respectively, for children 6 years of age and 6.59%, 0.9% and 7.49%, respectively in 10 year old children. Among the children without nocturnal enuresis, in the event of family antecedents of nocturnal enuresis, in absence of toilet training, or when sphincter education was started later than 15 months of age, slower maturation of sphincter control was observed. We conclude, that the nocturnal enuresis prevalence is similar to that reported in other related countries and that bladder control maturation among children without bed-wetting tendencies is related to the educational attitude of the parents and family antecedents of nocturnal enuresis.

[Primary and secondary nocturnal enuresis. Are they different entities?]. / Enuresis nocturna primaria y secundaria. Son entidades diferentes?

The aim of this study was to know the prevalence and predominant factors of primary and secondary enuresis in schoolchildren. For this purpose, a randomized epidemiological study was performed on a representative sample of the general population of children, aged 6 and 10 years, living in the province of Leon. Their parents responded to a questionnaire that evaluated, in both forms of enuresis, what are the predominant factors, including: familiar, socioeconomic, personal, education and psychological factors. We found that in a selected population of 1,307 children, 171 presented nocturnal enuresis when they were 6 years old (13.09% +/- 0.93%). Of these, 133 had primary (10.18 +/- 0.84%) and 38 (2.91 +/- 0.46%) secondary enuresis. We found no significant differences between the two forms in regards to familiar, socioeconomic, personal education or psychological factors. The only differences were that in secondary enuresis, the parents were older (p < 0.05) and less education (p < 0.01) on the subject of bladder control, and a later onset of the same (p < 0.05), was given. We conclude that the prevalence of primary enuresis is 10.18% +/- 0.84% and that of secondary enuresis is 2.91% +/- 0.46%. We do not find clear differences that permit us to consider these two types of enuresis as different forms.