Anales Espanoles De Pediatria最新文献

Background The prone sleeping position for sleeping has been identified as the principal risk factor for sudden infant death syndrome (SIDS).ObjectiveThe aim of this study was to determine the prevalence of different sleeping positions and other risk factors for SIDS and to identify the advice given to parents in several maternity units in Latin America and the Caribbean through a specially-designed questionnaire.MethodsDescriptive cross-sectional study based in hospitals. All the countries in Latin America and the Caribbean were contacted through the Pan American Health Organization and responses were obtained from 16 countries.ResultsTwo hundred thirteen hospitals answered the survey. The preferred sleeping position for healthy infants was prone in 8.5 % of the hospitals, side in 48.8 %, and supine in 25.2 %. In 17.5 % of the hospitals no position was preferred or the answers were inconsistent.Concerning the recommendations given to parents on the best position for their infants at home, 25.7 % recommended the supine position, 7.6 % the prone position, 59.0 % the side position while 7.6 % made no recommendations.ConclusionsThe results of this study show that in the hospitals surveyed there is a policy of not placing healthy neonates in the prone position. However, the most frequent position was the side, which is not advisable as it increases the risk of SIDS. To reduce in the incidence of SIDS, campaigns to increase the use of the supine position should be carried out in hospitals and among the general public.

Objectives To describe the causes of neonatal mortality in the Community of Valencia (VC) and to compare two registration systems for causes of death: that of the Spanish Society of Neonatology and that of the Word Health Organization's "Statistical Bulletin of Deaths (SBD)".MethodsData related to death from the SSN's mortality form, which orders all the diagnoses according to their severity, and data from the SBD, which uses sequential criteria (basic, intermediate or immediate cause of death) were obtained. Both systems were joined in a single form. Data from 19 hospitals in the Community of Valencia (1998-99) were collected. Two features were compared: a) "single cause of death" meaning the first diagnosis of the SSN system versus the "basic cause" of the SBD; and b) "multidiagnosis", which compares all the diagnoses mentioned anywhere in either of the two systems.ResultsA total of 206 neonatal deaths were included. When using the "basic cause" criterion the most common causes of death were malformations (31 %), respiratory distress syndrome (20 %) and extreme prematurity (10 %). However, when applying the "first diagnosis" criterion, the most common causes were respiratory distress syndrome (34 %), malformations (33 %) and asphyxia (9 %). These differences were statistically significant. When the causes of death were compared using the "multidiagnosis" criterion the differences were greater.ConclusionsThe two systems differ qualitatively and quantitatively. The SSN form is useful for studying prevalent morbidity among deaths as well as other parameters, but it may fail to identify the causes of death. The SBD uses more explicit criteria for the causes of death. Thus, both systems should be complementary.

Objectives: To assess the epidemiological characteristics of invasive pneumococcal disease (IPD) in children in Gipuzkoa (Spain) as well as the serotype distribution among these episodes and to analyze the potential impact of new conjugate vaccines.

Methods: We performed a retrospective study of cases of IPD in the pediatric population (< 15 years) between 1981 and 2001. Patients were included if blood, cerebrospinal, joint or peritoneal fluid isolates were culture-positive for Streptococcus pneumoniae.

Results: One hundred twenty-nine episodes (30 meningitis, 39 bacteremic pneumonia, 7 peritonitis, 1 arthritis and 52 bacteremia without focus) were identified. The incidence of IPD in children increased throughout the study period and from 1999-2001 was 12.6 cases per 100,000/ year in children aged < 15 years, 34.5 in those < 5 years, 48.4 in those < 2 years and 40.8 in infants < 2 months. The incidence of pneumococcal meningitis was similar throughout the study period (1981-2001): 1.3 in children aged < 15 years, 3.5 in those < 5 years, 8.1 in those < 2 years and 10.2 in infants < 2 months. From 1989 to 2001 mortality was 1 % (1/98 cases). The pneumococcal serotypes and serogroups present in the 7-valent vaccine accounted for 60.5 % and 70.9 % of the cases (9-valent vaccine: 70.2 % and 80.6 %; 11-valent vaccine: 76.6 % and 87.2 %). From 1999-2001, penicillin resistance was 35.4 % and erythromycin resistance was 38.7 %.

Conclusions: The incidence of IPD in children in Gipuzkoa has increased in the last few years, with rates similar to those in other European countries. Continued surveillance is required to assess the impact of the new conjugate vaccines on this infection.