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Baquero-Artigao F, Mellado Peña MJ, Del Rosal Rabes T, Noguera Julián A, Goncé Mellgren A, de la Calle Fernández-Miranda M, Navarro Gómez ML. [Spanish Society for Pediatric Infectious Diseases guidelines on tuberculosis in pregnant women and neonates (i): Epidemiology and diagnosis. Congenital tuberculosis]. An Pediatr (Barc) 2015; 83:285.e1-8. [PMID: 25754313 DOI: 10.1016/j.anpedi.2015.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/13/2015] [Accepted: 01/15/2015] [Indexed: 12/18/2022] Open
Abstract
Tuberculosis (TB) screening in pregnancy using tuberculin skin test (TST) is recommended in case of symptoms of TB disease, close contact with a patient with infectious TB, or high risk of developing active disease. The new interferon gamma release assay (IGRA) tests are recommended in BCG-vaccinated pregnant women with positive TST and no known risk factors for TB, and in those immunocompromised, with clinical suspicion of TB but negative TST. TB diagnosis is difficult due to the non-specific symptoms, the increased frequency of extrapulmonary disease, the delay in radiological examinations, and the high rate of tuberculin anergy. Neonatal TB can be acquired in utero (congenital TB), or through airborne transmission after delivery (postnatal TB). Congenital TB is extremely rare and does not cause fetal malformations. It may be evident at birth, although it usually presents after the second week of life. In newborns with no family history of TB, the disease should be considered in cases of miliary pneumonia, hepatosplenomegaly with focal lesions, or lymphocytic meningitis with hypoglycorrhachia, especially in those born to immigrants from high TB-burden countries. TST is usually negative, and IGRAs have lower sensitivity than in older children. However, the yield of acid-fast smear and culture is higher, mostly in congenital TB. Molecular diagnosis techniques enable early diagnosis and detection of drug resistance mutations. There is a substantial risk of disseminated disease and death.
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Affiliation(s)
- F Baquero-Artigao
- Grupo de Infección Congénita y Perinatal de la SEIP, Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital Infantil La Paz, Madrid, España.
| | - M J Mellado Peña
- Grupo de Tuberculosis de la SEIP, Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital Infantil La Paz, Madrid, España
| | - T Del Rosal Rabes
- Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital Infantil La Paz, Madrid, España
| | - A Noguera Julián
- Unidad de Infecciones, Servicio de Pediatría, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España
| | - A Goncé Mellgren
- Servicio de Medicina Maternofetal, Institut Clínic de Ginecología, Obstetricia i Neonatologia, Hospital Clínic, Barcelona, España
| | | | - M L Navarro Gómez
- Sección de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Gregorio Marañón, Madrid, España
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García López Hortelano M, Mellado Peña MJ. [International adoption in Spain: Current situation]. An Pediatr (Barc) 2015; 82:291-2. [PMID: 25704273 DOI: 10.1016/j.anpedi.2015.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 01/22/2015] [Indexed: 10/24/2022] Open
Affiliation(s)
- M García López Hortelano
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas, Patología Tropical, Adopción Internacional y Consulta del Niño Viajero, Hospital Universitario Infantil La Paz, Madrid, España.
| | - M J Mellado Peña
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas, Patología Tropical, Adopción Internacional y Consulta del Niño Viajero, Hospital Universitario Infantil La Paz - Hospital Carlos III, Madrid, España
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Piñeiro Pérez R, Martínez Fernández-Llamazares C, Calvo Rey C, Piñeiro Pérez AP, Criado Vega EA, Bravo Acuña J, Cabrera García L, Mellado Peña MJ. [Pediamécum: one year of experience]. An Pediatr (Barc) 2014; 81:257.e1-6. [PMID: 24857432 DOI: 10.1016/j.anpedi.2014.02.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 02/13/2014] [Accepted: 02/14/2014] [Indexed: 10/25/2022] Open
Abstract
In 2011, the Spanish Association of Pediatrics decided to support the most ambitious project of its newly created Committee for Medicinal Products: Pediamécum. This is the first free on-line database with information on medicinal products for pediatric use in Spain. The web page http://pediamecum.es/ started on December 17 December 2012. One year later, Pediamécum includes 580 registered drugs. The website achieved more than one million page views by the end of 2013. Because of the first anniversary of Pediamécum, a survey was performed to request the feeling of users. Four hundred eighty-three responses were obtained. Ninety-five percent believed that it is easy to navigate through the web, and 74% said that their doubts about the use of medicines in children were always resolved. The overall rating of Pediamécum is 7.5/10. The aims of Pediamécum are being accomplished; which is reflected essentially due to it becoming a useful tool for all professionals who care for children in their daily clinical practice.
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Affiliation(s)
- R Piñeiro Pérez
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP).
| | | | - C Calvo Rey
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP)
| | | | - E A Criado Vega
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP)
| | - J Bravo Acuña
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP)
| | - L Cabrera García
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP)
| | - M J Mellado Peña
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP)
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Morales Senosiáin D, Mellado Peña MJ, Gutiérrez Angulo M, Trevisi Lannoó P, García Hortelano M. [Experience in the diagnosis of hepatitis E in a tropical infectious diseases unit]. An Pediatr (Barc) 2011; 76:214-7. [PMID: 22100778 DOI: 10.1016/j.anpedi.2011.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 09/15/2011] [Accepted: 09/16/2011] [Indexed: 10/15/2022] Open
Abstract
The hepatitis E virus (HEV) is endemic in some developing countries. It produces acute hepatitis in sporadic cases or epidemics. The main transmission route is faecal-oral by contaminated waters. In developed countries the cases described are more and more frequent, mainly due to population movement (travellers, immigrants, international adoptions), although there have also been increases in the local population. We currently have serological and molecular techniques for the diagnosis of this infection. We describe the experience in the diagnosis of the infection by HEV in a Paediatric Tropical Infectious Diseases Unit in Madrid.
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Affiliation(s)
- D Morales Senosiáin
- Unidad de Enfermedades Infecciosas y Tropicales, Adopción Internacional y Niño Viajero, Servicio de Pediatría, Hospital Carlos III, Madrid, España.
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González Martínez F, Mellado Peña MJ, Angulo González de Lara R, García López Hortelano M, Villota Arrieta J, Subirats Fernández M. [Larva Currens as a differential diagnosis of skin lesions in immigrant children]. An Pediatr (Barc) 2010; 73:102-4. [PMID: 20591754 DOI: 10.1016/j.anpedi.2010.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 05/01/2010] [Accepted: 05/06/2010] [Indexed: 11/26/2022] Open
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Moreno-Pérez D, Andrés Martín A, Altet Gómez N, Baquero-Artigao F, Escribano Montaner A, Gómez-Pastrana Durán D, González Montero R, Mellado Peña MJ, Rodrigo-Gonzalo-de-Liria C, Ruiz Serrano MJ. [Diagnosis of tuberculosis in pediatrics. Consensus document of the Spanish Society of Pediatric Infectology (SEIP) and the Spanish Society of Pediatric Pneumology (SENP)]. An Pediatr (Barc) 2010; 73:143.e1-143.14. [PMID: 20335081 DOI: 10.1016/j.anpedi.2009.12.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 12/14/2009] [Indexed: 11/19/2022] Open
Abstract
Tuberculosis is one of the most important health problems worldwide. There are an increased number of cases, including children, due to different reasons in developed countries. The most likely determining cause is immigration coming from high endemic areas. Measures to optimize early and appropriate diagnosis of the different forms of tuberculosis in children are a real priority. Two Societies of the Spanish Pediatric Association (Spanish Society of Pediatric Infectology and Spanish Society of Pediatric Pneumology) have agreed this Consensus Document in order to homogenize diagnostic criteria in pediatric patients.
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Affiliation(s)
- D Moreno-Pérez
- Hospital Materno-Infantil Carlos Haya, Universidad de Málaga, España.
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Cuello MR, Cuadros EN, Claros AM, Hortelano MG, Fontelos PM, Peña MJM. [Filarial infestation in patients emanating from endemic area. 14 cases series presentation]. An Pediatr (Barc) 2009; 71:189-95. [PMID: 19640814 DOI: 10.1016/j.anpedi.2009.04.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Revised: 04/28/2009] [Accepted: 04/29/2009] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The migration causes the emergence of new diseases in our environment. One of them is the filariosis which, due to the biologic cycle peculiarity, it's weird its appearance in pediatrics. This studio accomplishes a review of all the filariosis cases diagnosed the last years in an Unit specialized in Tropical Pediatrics Diseases. MATERIAL AND METHODS Retrospective analysis comprising 14 patients than were diagnosed with filariosis from 1995 to 2007 in the Pediatrics Unit of Carlos III Hospital (Madrid). They have been analyzed several variables to cope with clinic-epidemiological, therapeutics and evolutional characteristics. RESULTS All patients in the study came from Equatorial Guinea, their ages were between 3 and 15 years old. The isolated species were: 6 cases with O. volvulus, 8 with M. perstans and 2 with Loa-loa. The pruritus was the main symptom in the 71% of the cases. The eosinophilia was detected in the 78% of the patients, and the Loa-loa was the specie with higher figures. The 85% of the patients showed co-parasitation, being the intestinal the most frequent. The diagnostics was established by epidermic biopsy, microfilaremia detection, direct visualization and serology. The utilized drugs were: Mebendazole for the cases with M. perstans and Ivermectin or Dietylcarbamazine for the rest of the species. One child showed mixed filariosis. The cure was successful in the 8 cases that could be followed up. CONCLUSIONS We consider essential to execute a filariosis screening to every patient emanating from endemic area, especially to those with eosinophilia. The diagnostic in the childhood, even though it's difficult, it allows the prevention of the disease development, serious complications as blindness and break the parasite life cycle.
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Affiliation(s)
- M Rivera Cuello
- Unidad de Pediatría Tropical, Servicio de Pediatría, Hospital Carlos III, Madrid, España.
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Piñeiro Pérez R, Mellado Peña MJ, Holguín A, Cilleruelo MJ, García Hortelano M, Villota J, Martín Fontelos P. [HIV-1 genetic variability in non Spaniard infected children]. An Pediatr (Barc) 2009; 70:20-6. [PMID: 19174115 DOI: 10.1016/j.anpedi.2008.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2008] [Revised: 07/22/2008] [Accepted: 08/01/2008] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION The prevalence of HIV-1 non-B subtypes (HIV-NBS) is increasing in Europe, because of emigration from countries where genetic variants are endemic. Although HIV-NBS could have a different clinical evolution and could respond differently to antiretrovirals (AR) than B-subtypes, these variant's response remain undocumented. AIMS To identify HIV-1 genetic variants and to determine clinical evolution in a non-Spaniard children infected with HIV-1. PATIENTS AND METHOD Children with HIV-1 infection from endemic countries were tested for HIV-1 subtypes between 1-1-1988 and 31-12-2006. Twelve children less than 18 years old and born abroad were selected. RESULTS HIV-NBS were isolated in 5 children (42%): CRF2_AG recombinant in 3 cases (Equatorial Guinea), Subtype C in one (Equatorial Guinea) and CRF13_cpx in last one (India). DISCUSSION Because of the increasing frequency of patients with HIV-NBS and their unknown long-term evolution, all children from endemic countries should be tested for HIV subtypes. We believe new studies with more patients during longer times could reveal differences in these patient's clinical, immunological and virological evolution.
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Piñeiro Pérez R, Mellado Peña MJ, Méndez Echevarría A, Cilleruelo Ortega MJ, García Hortelano M, Villota Arrieta J, Martín Fontelos P. [Exposure to multiresisant tuberculosis: study and follow-up of nine children]. An Pediatr (Barc) 2008; 68:490-5. [PMID: 18447995 DOI: 10.1157/13120048] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A world increase in multidrug-resistant tuberculosis (MDR-TB) has been reported over the last few years. A larger number of diagnoses are being seen in Spain, due to the increase of immigration from high endemic TB countries. Articles published on this are anecdotal in children, and there is no clear directives for treatment of MDR-TB, or latent tuberculosis infection (ITBL) or on prophylaxis after exposure to active pulmonary MDR-TB. We present the initial management and progression of nine children after close contact exposure to an Ecuadorian woman diagnosed with active pulmonary TB, resistant to Isoniazid, Rifampicin and Pyrazinamide.
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Núñez Cuadros E, Mellado Peña MJ, Rivera Cuello M, Penim Fernández M, Piñeiro Pérez R, García-Hortelano M, Cilleruelo Ortega MJ, Villota Arrieta J, Martín-Fontelos P. [Antiretroviral drug toxicity in human immunodeficiency virus infected children]. An Pediatr (Barc) 2008; 68:425-31. [PMID: 18447985 DOI: 10.1157/13120038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Paediatric Human Immunodeficiency Virus infection (HIV) nowadays is a chronic disease with an excellent long term prognosis, but lifelong combined antiretroviral treatment is required. However, an improved quality of life in this population is limited by adverse drug effects. The highest risk of treatment toxicity is developing a complete metabolic syndrome including: Hyperlipemia, lipodystrophy, insulin resistance, lactic acidosis, osteopenia, hypertension, and specific system and organ toxicity, such as the kidney, liver, CNS or bone marrow. The risk of cardiovascular disease adult life and also definitive bone mass damage are the most significant metabolic costs that have to paid for increased survival. Most of these toxicities were able to be adequately treated but, pharmacological interferences, patient intolerance and the high number of drugs are the problems that limit the adherence to treatment, which is essential for a good therapeutical efficacy. In this article, we present four HIV paediatric patients who presented with almost the whole range of metabolic toxicities, and a practical overview of therapeutical management.
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Abstract
In recent years, major advances have been made in the care of HIV-infected children, particularly in antiretroviral treatment, which have dramatically improved survival and quality of life. The goal of highly active antiretroviral therapy (HAART), which includes at least three potent drugs, is the maximal and most durable suppression of viral replication possible, which is often not achieved despite clear immunologic and clinical improvement. There are still major barriers to achieving this goal, mainly the difficulty of permanent adherence to complex regimens and treatment-related toxicities. Adverse events are frequent, including a high prevalence of metabolic complications with unknown consequences in the future. These drawbacks of antiretroviral treatment are leading to a more conservative initial approach, as well as to research into simpler and less toxic therapeutic options. New strategies should continue to be developed to overcome the still important limitations of current antiretroviral treatment.
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Affiliation(s)
- J T Ramos Amador
- Unidad de Inmunodeficiencias, Departamento de Pediatría, Hospital 12 de Octubre, Madrid, España.
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12
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Villota Arrieta J, de la Loma Danilova A, García López M, de Ory Manchón F, Mellado Peña MJ, Pérez Jurado ML, Tenorio A, Martín Fontelos P. [Acute parotitis caused by Epstein-Barr virus]. An Esp Pediatr 2000; 52:65-6. [PMID: 11003864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Mellado Peña MJ, Cilleruelo Ortega MJ, Villota Arrieta J, García López M, Pérez Jurado ML, Barreiro Casal G, Veiga de Cabo J, Martín Fontelos P. [Human immunodeficiency virus infection in children. Clinical and immunological markers of disease progression]. An Esp Pediatr 1997; 47:363-8. [PMID: 9499302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to analyze the prognostic value of the clinical manifestations and of the lymphocyte CD4 count in a cohort of HIV infected children. PATIENTS AND METHODS We performed a prospective study in 37 HIV infected children during a 6 year period. We studied the statistical association between mortality and clinical and immunological parameters according to Fisher's test (p < 0.05). We performed a survival analysis according to Kaplan-Meier curves (p < 0.05). RESULTS We have found that a high risk of mortality is associated with recurrent and severe bacterial infections (p = 0.0001), failure to thrive (p = 0.0057), opportunistic infections (p = 0.0008) and AIDS (p < 0.0001). The survival analysis has shown a low probability of survival in HIV-encephalopathy (p = 0.000053) and high in one case of lymphocytic interstitial pneumonia (p = 0.07). An age-related CD4 count less than 2 SD was associated significantly with a bad prognosis (p = 0 .0017). CONCLUSIONS The clinical manifestations and age-matched CD4 count continue being good surrogate markers for the indication of prophylaxis, antiretroviral treatment and as prognostic values of the disease in HIV infected children until new techniques, especially plasma viremia, can be widely available.
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Mellado Peña MJ, Villota Arrieta J, Bernal Zamora A, Cilleruelo Ortega MJ, García López M, Barreiro Casal G, Pérez Jurado ML, Martín Fontelos P. [Syncitia inducing phenotype, zidovudine++ resistance and fast clinical progression in a child infected by HIV]. An Esp Pediatr 1997; 46:65-8. [PMID: 9082891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M J Mellado Peña
- Servicio de Pediatría, Instituto de Salud Carlos III, Majadahonda, Madrid
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Martín Fontelos P, Barreiro Casal G, Villota Arrieta J, Pérez Jurado ML, García López M, Mellado Peña MJ, Cilleruelo Ortega MJ. [Meningitis due to cefotaxime-resistant Streptococcus pneumoniae]. An Esp Pediatr 1996; 44:395-6. [PMID: 8796948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Villota Arrieta J, Barreiro Casal G, García López M, Cilleruelo Ortega MJ, Mellado Peña MJ, Pérez Jurado ML, Martín Fontelos P. [The halofantrine treatment of Plasmodium falciparum malaria. Clinical experience]. An Esp Pediatr 1996; 44:117-20. [PMID: 8830568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
UNLABELLED The objective of this study was to evaluate the efficacy of halofantrine in the treatment of malaria caused by Plasmodium falciparum since the resistance of these plasmodium to chloroquine is increasing in countries of Western Africa. MATERIAL AND METHOD Between January 1991 and June 1994 we studied 50 children from Equatorial Guinea. All of them were black and between the ages of 8 months and 13 years. They were treated with 3 doses of halofantrine (8 mg/kg every 6 hours). The definitive diagnosis was made by the demonstration of the parasites on thick and thin blood smears, stained by standard methods, repeated every 24-72 yours after therapy. We considered the disappearance of fever and the clearance of plasmodium from the red blood cells as signs of response to the treatment. We also monitored the tolerance and the adverse side effects of the drug. RESULTS All of the patients responded favorably with the disappearance of the fever after 24 hours and after 72 hours no parasites were seen in red blood cells. Only one patient had a recurrence, which occurred on the 10th day. All patient satisfactorily tolerated the drug and only 3 children showed an increase of aminotransferases that was spontaneously cured. CONCLUSIONS We conclude that halofantrine is a safe and efficient drug for the treatment of children diagnosed with malaria caused by Plasmodium falciparum.
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de José Gómez MI, González de Dios J, Mellado Peña MJ, García Miguel MJ, García Rodríguez MC, Cilleruelo Ortega MJ, Martínez Zapico R, Fernández Calle P, Martín Fontelo P. [Long-term follow-up study of 35 children with ADS treated with zidovudine (AZT)]. An Esp Pediatr 1992; 36:98-108. [PMID: 1575412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Thirty-five children diagnosed of AIDS were studied in order to evaluate toxicity and efficacy of oral Zidovudine treatment (AZT), as well as to analyze the clinical, biochemical, immunological and virological evolution of HIV infection throughout the treatment. Patients (19 males and 16 females) were studied from April 1988 to May 1990 with a mean follow-up time of 13.5 months (SD = 6.7 months). The mean age of the group was 4.68 years. The means of acquisition of this disease was 71.45 vertical and 28.6% via hemo-derivatives. Tolerance has been good with the main toxicity being hematological (28.5% anemia and/or neutropenia), 23% of which required blood supplements. The presence of neurological involvement and thrombopenia were observed in the incidence of greater toxicity. No influence on weight during AXT treatment was observed and hepatosplenomegalia and adenopathies were not modified. Bacterial and opportunistic infections were observed in 97.1% and 20% of patients, respectively. Neurological evolution was irregular and the improvement observed in some patients was mild and transitory. Three patients died during the follow-up from intercurrent infectious process. A progressive increase in MCV and a tendency towards leucopenia and lymphopenia (mainly in hemo-derivative infected patients) was observed. Neither significant immunological nor virological changes were observed during the treatment (except the tendency to diminish basal hypergammaglobulinemia). The results of this study were compared to other pediatric series treated with AZT.
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Pérez Alvarez T, Cilleruelo Ortega MJ, Ortiz Fuillerat C, Mellado Peña MJ, Babín Vich F, Pérez Alvarez L, Merodio Cuadra O. [Program of coordination between primary and tertiary care in the follow up of children with HIV infection]. An Esp Pediatr 1990; 33:365-8. [PMID: 2278441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Barreiro Casal G, García López M, Villota Arrieta J, Mellado Peña MJ, Baquero Mochales M, Revilla Lorenzo T. [Disseminated gonococcal infection]. An Esp Pediatr 1989; 31:391-2. [PMID: 2516713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- G Barreiro Casal
- Instituto Nacional de Salud Carlos III, Hospital del Rey, Servicio de Pediatría, Madrid
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20
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Mellado Peña MJ, Cilleruelo Ortega MJ, Pérez Jurado ML, Barreiro Casal G, Villota Arrieta J, Martín Fontelos P. [Hepatitis A with a biphasic course. Apropos of 2 cases]. An Esp Pediatr 1988; 28:255-7. [PMID: 3377346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- M J Mellado Peña
- Servicio de Pediatría, Instituto Nacional de Salud Carlos III, Hospital del Rey, Madrid
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