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Zapatero L.,Hospital Materno Infantil Gregorio Maranon | Martinez-Canavate A.,Hospital Materno Infantil | Lucas J.M.,Hospital Universitario Virgen Of La Arrixaca | Guallar I.,H. Infantil C. S. Miguel Servet | And 4 more authors.
Allergologia et Immunopathologia | Year: 2011

Introduction: Sensitisation to Alternaria is a cause of respiratory disease in Spain, particularly in childhood, but it is also a significant marker of the severity of this disease. Therefore, the use of an aetiological treatment (allergen specific immunotherapy) is essential, and both subjective and objective clinical parameters should be used to follow up this treatment. Objective: This open-label, uncontrolled, observational, prospective study was designed in order to study the evolution of these patients on allergen specific immunotherapy therapy in daily clinical practice and to assess the use of different monitoring tools. Material and Methods: A total of 99 patients were included. They were monosensitised to this perennial allergen and treated with subcutaneous allergen specific immunotherapy. After one year of follow-up, these patients were assessed for the presence of symptoms, use of medication, clinical incidents, quality of life and asthma control. Results: After one year of treatment a significant fall was observed in the use of concomitant medication (β2-agonists: p = 0.0278, inhaled corticosteroids: p = 0.0007, anti-leukotrienes: p = 0.0495), nasal symptoms (p = 0.0081), quality of life (PAQLQ, p < 0.0001) and asthma control (ACQ, p < 0.0001). Twenty-one patients had to attend emergency department due to exacerbation of their allergic disease, and only one of them had to be admitted to hospital. Conclusion: respiratory allergic disease due to Alternaria alternata is a disease which is hard to control, and in our daily practice, the use of specific subcutaneous immunotherapy can be of significant benefit in our paediatric patients. © 2009 SEICAP.


Corona C.,Hospital Materno Infantil Gregorio Maranon
Cirugía pediátrica : organo oficial de la Sociedad Española de Cirugía Pediátrica | Year: 2010

Percutaneus gastrostomy placement is a procedure widely performed in children with failure to thrive or intolerance to oral feeding. At the moment of making the indication, the need of an antir-reflux surgery in the same procedure comes to question. The aim of this study was to analyse which preoperative factors are associated with a higher risk of a posterior fundoplication. We realized a retrospective review of 67 patients divided in 2 groups (cases and controls) in which a percutaneus gastrostomy (PEG) had been made by our service in the period of 1997 to 2008. We compared these two groups: Group A (n=11) - patients with severe gastroesophageal reflux who required a Nissen procedure afterwards; Group B (n=56) - patients who kept without reflux after PEG. We analyzed the different preoperative factors that could have been in association to severe reflux after gastrostomy. Mean age at the moment of undergoing PEG was 15 months. Mean time of follow up was 3,5 years. Only neurological impairment and documented reflux pregastrostomy were associated with the need of an antirreflux surgery after PEG. Neurological impairment and documented pregastrosotmy GER could be an indication of concurrent antirreflux surgery at the time of gastrostomy.


Cervantes Guijarro C.M.,CS General Ricardos | Sanchez Luna M.,Hospital Materno Infantil Gregorio Maranon | Bazan Fernandez P.,Enfermera Pediatria
Pediatria de Atencion Primaria | Year: 2014

Background: new technologies like websites, social networks and telemedicine are increasingly being used by the community to improve and promote health. The aim of this study was to demonstrate the impact of the e-Health in primary care medicine of healthy infants during their first 6 months of age. Methods: pilot intervention prospective, controlled, non randomised study, of follow up of healthy newborns until they’re 6 months old, developed in a primary care medical centre. A website was developed and also an e-Health already established website was used, in between of the health child visits at 1-2, 2-4 and 4-6 months of age; also telemedicine discussions group of vaccines, breastfeeding and introduction of solid food. The control group received usual care. Results: the use of new technologies, demonstrated a decreased in face to face pediatrics and nursing consultations (p<0.05) and also an increase in exclusive breastfeeding until six months old (controls 18,5%, group of intervention 36%). Follow up: website 72.5%, social networks 58.8%, telemedicine 88.3% and telemedicine patients groups 78.4%. Survey: change in the attitudes about going to the emergency department by questions about the newborn care, before 58.62% after 0%, p<0.05. Safe sleeping position: sleeping on his back, before 73.68% after 100% p<0.05. Conclusions: telemedicine is effective and efficient in improving child health in pediatric primary care. Website, social networks and telemedicine, resolve questions of breastfeeding, introducing of solid foods and vaccines. Telemedicine benefits the continuous improvement in health care and decreases the face-to-face pediatrics and nursery consultations. © 2014, Spanish Association of Primary Care Pediatrics. All rights reserved.


Rodriguez R.,Hospital Materno Infantil Gregorio Maranon | Ramilo O.,Ohio State University
Journal of Infection | Year: 2013

Bronchiolitis is the leading cause of hospitalization of infants and young children worldwide. Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis in infants. Studies conducted using molecular diagnostic assays confirmed that RSV accounts for over 50% of bronchiolitis in young children requiring hospitalization. Those studies demonstrate that it is common to identify RSV in association with a second viral agent but it is yet unclear whether the simultaneous detection of two or even three viruses is associated with increased disease severity. Despite extensive efforts, a vaccine for prevention of RSV infection is not yet available. Palivizumab a humanized monoclonal antibody directed against the F protein of RSV is the only agent licensed to prevent severe RSV disease in high-risk children. Among the new antivirals being developed for treatment of RSV infections, an RNA-interference based agent has demonstrated promising results for treatment of lung transplant recipients with acute RSV infection. © 2013.


Ibanez R.,Hospital Universitario Nino Jesus | Solar A.,Hospital Materno Infantii Teresa Herrera | Maldonado J.,Hospital Materno Infantil Virgen de Las Nieves | Nevot S.,Hospital Sant Joan de Deu | And 13 more authors.
Acta Pediatrica Espanola | Year: 2016

Objectives: The main objective of this study was to evaluate the tolerance of a new casein hydrolyzate formula, and its efficacy during a 3 months consumption period by infants with IgE-mediated cow's milk protein allergy (CMPA). Methods: This study was part of randomized, double blind study performed in 15 Spanish hospitals. In the present paper the results of the arm that received an extensively hydrolyzed casein formula are reported. Full term infants aged up to 9 months were included to check that 97% of them tolerate the formula at introduction. The CMPA was confirmed by a specific lgE dosage before inclusion. An oral food challenge was made with the formula. Over 3 months, the evolution of the clinical symptoms and the growth were evaluated. Results: The 25 boys and 22 girls included tolerated the formula at introduction without any adverse reaction during the first day of formula intake, meaning that 97% of the infants tolerated the treatment at introduction (p= 0.0112). Three adverse events were reported 4, 6 and 10 days later and were considered possibly or probably related to the study formula indicating an effective delayed tolerance of more than 93% of infants. At 1 month of follow-up, the condition of the infants was greatly improved as indicated by the dramatic decrease of the digestive symptoms from 40.4% to 13%, and the total regression of all the other symptoms. The growth of the infants over 3 months showed a normal pattern, in agreement with the World Health Organization (WHO) growth references. Conclusion: This new casein hydrolyzate formula shows a rate of tolerance >97%, it is efficient to rapidly improve clinical symptoms and allows a normal growth pattern in infants with CMPA. © 2016 Ediciones Mayo, S.A. All rights reserved.

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