miércoles, 23 de septiembre de 2009
Protocolos Diagnósticos y Terapéuticos de la Sociedad Española de Errores Innatos del Metabolismo.
Protocolo de actuación
Diagnóstico y tratamiento de los trastornos del ciclo de la urea
Diagnóstico y tratamiento de las acidemias propiónica, metilmalónica e isovalérica
Diagnóstico y tratamiento de las deficiencias de la β-oxidación mitocondrial de los ácidos grasos
Diagnóstico, tratamiento y seguimiento de las hiperfenilalaninemias
Diagnóstico y tratamiento de la enfermedad de Jarabe de arce
Diagnóstico, tratamiento y seguimiento de Adrenoleucodistrofia ligada al cromosoma X
Diagnóstico y tratamiento de los errores congénitos del metabolismo de la galactosa
Diagnóstico y tratamiento de Tirosinemia tipo I o hepato-renal
Diagnóstico y tratamiento de dislipemias primarias en la infancia
Diagnóstico y seguimiento de pacientes con glucogenosis de afectación fundamentalmente hepática
Diagnóstico y tratamiento de distonías de origen metabólico
Diagnóstico y tratamiento de homocistinuria
Diagnóstico y tratamiento de las enfermedades mitocondriales
Farmacología Pediátrica en Atención Pediátrica
http://www.fisterra.com/material/medicamentos/080118FarmacologiaPediatricaAP_GruposTerapeuticos.pdf
jueves, 13 de agosto de 2009
Protocolos de Infectología Pediátrica AEPED
Disponibles en http://www.aeped.es/protocolos/infectologia/index.htm Presentación de los Protocolos Prof Alfonso Delgado. Ex-Presidente de la AEP | |
1. Adenitis cervical Fernando Baquero-Artigao, Teresa del Rosal Rabes, Maria Jesús García Miguel | |
2. Discitis o Espondilodiscitis Daniel Blázquez Gamero, María Isabel González- Tomé, Pablo Rojo Conejo, Ignacio González Granado, Vanesa López, Jesús Ruiz Contreras | |
3. Encefalitis Maria Luisa Navarro, Felipe González, Mar Santos, Jesús Saavedra, T Hernández-Sampelayo | |
4. Faringoamigdalitis aguda Fernando Álvez González, Juan M. Sánchez Lastres | |
5. Fiebre sin foco Carlos Rodrigo Gonzalo de Liria, Maria Méndez Hernández | |
6. Meningitis bacteriana Fernando Baquero Artigao, Raquel Vecino López, Fernando del Castillo Martín | |
7. Neumonia adquirida en la comunidad Ana Méndez Echevarría, Mª Jesús García Miguel, Fernando Baquero Artigao, Fernando del Castillo Martín | |
8. Otitis media aguda Fernando del Castillo Martín, Fernando Baquero Artigao, Mª Jesús García Miguel, Ana Méndez Echevarría | |
9. Parasitosis intestinales Antonio F Medina Claros, María José Mellado Peña, Milagros García Hortelano, Roi Piñeiro Pérez y Pablo Martín Fontelos | |
10. Sinusitis aguda. Celulitis periorbitaria Maria Méndez Hernández, Carlos Rodrigo Gonzalo de Liria | |
11. Tos ferina David Moreno Pérez , Fernando Baquero Artigao, Carlos Rodrigo Gonzalo de Liria, María José Cilleruelo Ortega | |
12. Tuberculosis Ana Méndez Echevarría, MJ Mellado Peña , Fernando Baquero Artigao, Mª Jesús García Miguel | |
13. Gastroenteritis aguda César Gavilán Martín, Belén García Avilés, Raúl González Montero | |
14. Infección urinaria Carlos Rodrigo Gonzalo de Liria, Maria Méndez Hernández y Marta Azuara Robles | |
15. Infección fúngica invasiva (IFI): actualización C. Figueras, C. Diaz de Heredia, ML Navarro E. Roselló, y F. Alvez | |
16. Manejo de niños con asplenia/hipoesplenia Manuel J. Vicente Martín, David Moreno-Pérez, Esmeralda Núñez Cuadros, Mercedes Rivera Cuello, Andrés Hagerman Sánchez, Francisco Jesús García Martín | |
17. Infecciones bacterianas de la piel y tejidos blandos Jesús Saavedra Lozano, Mar Santos Sebastián, Felipe González , Teresa Hernández-Sampelayo, Maria Luisa Navarro Gómez | |
18. Infecciones por mordeduras y heridas punzantes Fernando Álvez González | |
19. Infecciones respiratorias virales Cristina Calvo, Mª Luz García García, Inmaculada Casas, Pilar Pérez-Breña | |
20. Osteomielitis y artritis séptica T. Hernández-Sampelayo Matos, S. Zarzoso Fernández, M. L. Navarro Goméz. M. M. Santos Sebastián, F. González Martínez, J. Saavedra Lozano | |
21. Patología infecciosa importada I: Malaria Milagros García López Hortelano, Marta Taida García Ascaso, María José Mellado Peña, Julián Villota Arrieta | |
22.Patología infecciosa importada II Marta Taida García Ascaso, Milagros García López Hortelano, Antonio F. Medina Claros |
Severe Respiratory Disease Concurrent with the Circulation of H1N1 Influenza
ABSTRACT
Background In the spring of 2009, an outbreak of severe pneumonia was reported in conjunction with the concurrent isolation of a novel swine-origin influenza A (H1N1) virus (S-OIV), widely known as swine flu, in Mexico. Influenza A (H1N1) subtype viruses have rarely predominated since the 1957 pandemic. The analysis of epidemic pneumonia in the absence of routine diagnostic tests can provide information about risk factors for severe disease from this virus and prospects for its control.
Methods From March 24 to April 29, 2009, a total of 2155 cases of severe pneumonia, involving 821 hospitalizations and 100 deaths, were reported to the Mexican Ministry of Health. During this period, of the 8817 nasopharyngeal specimens that were submitted to the National Epidemiological Reference Laboratory, 2582 were positive for S-OIV. We compared the age distribution of patients who were reported to have severe pneumonia with that during recent influenza epidemics to document an age shift in rates of death and illness.
Results During the study period, 87% of deaths and 71% of cases of severe pneumonia involved patients between the ages of 5 and 59 years, as compared with average rates of 17% and 32%, respectively, in that age group during the referent periods. Features of this epidemic were similar to those of past influenza pandemics in that circulation of the new influenza virus was associated with an off-season wave of disease affecting a younger population.
Conclusions During the early phase of this influenza pandemic, there was a sudden increase in the rate of severe pneumonia and a shift in the age distribution of patients with such illness, which was reminiscent of past pandemics and suggested relative protection for persons who were exposed to H1N1 strains during childhood before the 1957 pandemic. If resources or vaccine supplies are limited, these findings suggest a rationale for focusing prevention efforts on younger populations.
In early April 2009, a sharp increase in reports of patients requiring hospitalization for pneumonia and an unusual series of deaths were reported to the Mexican Ministry of Health. The National Epidemiological Surveillance System (SINAVE), a nationwide interagency system led by the Directorate General of Epidemiology,1 noted a particular increase among adults between the ages of 20 and 40 years and an increase in cases of laboratory-confirmed influenza. Typically, in Mexico, seasonal influenza is observed from October through March,2 with an appreciable increase in the rate of death among the elderly,3 similar to the pattern observed in other temperate climates, such as the United States.4,5 The concurrent finding of a swine-origin influenza A (H1N1) virus (S-OIV)6 from infected children in the United States7 prompted a rapid response from the Mexican public health emergency system.
From March 24 through April 29, 2009, there were reports of 2155 cases of severe pneumonia, including 100 deaths, to the SINAVE system in response to requests for data on patients who had required hospitalization for severe pneumonia. During this period, of the 8817 nasopharyngeal specimens that were submitted to the National Epidemiological Reference Laboratory, 3664 (42%) tested positive for influenza subtype A; of these specimens, 2582 (70%) were confirmed as S-OIV by reverse-transcriptase–polymerase-chain-reaction (PCR) assay.
In this article, we evaluate the reported case series of severe pneumonia and compare the age patterns with respect to morbidity and mortality with patterns from recent influenza epidemics in Mexico. Crucial epidemiologic factors, such as the age pattern of morbidity and mortality during the 2009 epidemic, are inferred because of the limited availability of diagnostic tests and data. Given the relatively rapid global spread of this newly described pathogen,8 early identification of groups at risk for severe pneumonia can aid in prioritizing the use of vaccines and antiviral drugs in the face of limited supplies.
domingo, 9 de agosto de 2009
Gripe H1N1
Protocolos de Nefrología Pediátrica AEPED
viernes, 7 de agosto de 2009
jueves, 6 de agosto de 2009
Bronquiolitis
Tratamiento de la bronquiolitis. BMJ