Children represent a minority of total COVID-19 cases, but studies have reported severe disease and death in pediatric patients. Remdesivir (RDV) has recently demonstrated promising results in adults with COVID-19, but few data have been reported to date in children. A nationwide multicenter observational study was conducted on children with confirmed SARS-CoV-2 receiving compassionate treatment with RDV in Spain. Eight patients were included in the study, four infants and four older children [median age 5 years old; IQR 4 months–11.6 years old]. Half of them had complex underlying medical conditions, and the rest were mostly infants (3/4). Six out of eight children needed Pediatric Intensive Care Unit Admission. No RDV-related adverse outcomes were observed in our patients. Seven have reached successful clinical outcome, but one patient with serious clinical status died due to complications. However, she received RDV very late after the first COVID-19 symptom. Conclusions : In our cohort, most of the patients achieved successful clinical outcome, without observing adverse events. Clinical trials of RDV therapy for children with COVID-19 are urgently needed, to assess the safety, tolerability, efficacy, and pharmacokinetics of RDV in children, as this could be an effective treatment in severe cases. What is Known: • Remdesivir has not been approved to treat COVID-19 in children under 12 years old, although the drug is currently being prescribed in critically ill children. • Remdesivir has recently demonstrated promising results in adults with COVID-19, but few data have been reported to date in paediatric population. What is New: • We report a multicentre cohort of children with confirmed SARS-CoV-2 and severe COVID-19 disease receiving remdesivir during the first month of the pandemic in Spain. • No remdesivir-related adverse outcomes were observed in most of the cases. Seven patients reached successful clinical outcome, and one died due to complications (bacterial sepsis). Supplementary Information The online version contains supplementary material available at 10.1007/s00431-020-03876-1.
ResumenObjetivo. Determinar la seroprevalencia de hepatitis B en mujeres embarazadas de varias regiones de México e investigar factores de riesgo asociados. Material y métodos. Durante el periodo de mayo-agosto del año 2000 se realizó un estudio transversal en 9 992 mujeres embarazadas, con acceso a seguridad social (Instituto Mexicano del Seguro Social) en cinco ciudades de México: Tijuana, Ciudad Juárez, Acapulco, Cancún y Distrito Federal (zona noreste y sureste). Resultados. La prevalencia global para casos confirmados fue de 1.65% (165/9 992). Para las ciudades de estudio fue: 1.27% en Tijuana, 1.46% en Ciudad Juárez, 2.47% en Acapulco, 0.93% en Cancún, 1.2% en el noreste del Distrito Federal, y 2.52% en el sureste del Distrito Federal. Los factores de riesgo identificados fueron: edad, edad de inicio de vida sexual, ciudad (Acapulco y región sureste del Distrito Federal) y estado civil (solteras-divorciadas). Conclusiones. La prevalencia de antígeno de superficie del virus de la hepatitis B (HBsAg, por sus siglas en inglés) en embarazadas (1.65%) es mayor a la reportada en investigaciones previas y muestra diferencias geográficas. Esta prevalencia elevada indica un número considerable de casos de hepatitis B ocasionados por vía perinatal y de portadores en nuestra población. Se debe considerar la vacunación en recién nacidos de mujeres embarazadas con alto riesgo. El texto completo en inglés de este artículo también está disponible en: http://www.insp.mx/salud/index.html The overall prevalence for confirmed cases was 1.65% (165/ 9 992). The prevalences for individual cities were as follows: Tijuana, 1.27%; Ciudad Juarez, 1.46%; Acapulco, 2.47%; Cancun, 0.93%; northeastern Mexico City, 1.20%, and southeastern Mexico City, 2.52%. The risk factors found to be associated with HBsAg were: age, age at first sexual intercourse, city (Acapulco and southeastern Mexico City), and marital status (single or divorced). Conclusions. The prevalence of HBsAg in pregnant women (1.65%) was greater than that reported in previous studies and showed geographical differences. This high prevalence suggests that a considerable amount of cases of hepatitis B occurs perinatally and through contact with carriers in the general population. Vaccination of newborns of high-risk pregnant women should be considered. The English version of this paper is available too at:
Objective. Dengue hemorrhagic fever is a public health problem in Mexico since 1994. With four serotypes circulating the risk of epidemic dengue hemorrhagic fever is increasing. Material and Methods. We describe the clinical features of confirmed cases in the social security health system (IMSS) from 1995 to 2003. Clinical picture and epidemiological features were compared and a multivariate model was fitted to evaluate associations. Results. Cases were divided into two groups: 438 patients with dengue fever, including 109 cases with hemorrhagic manifestations without thrombocytopenia, and 977 cases with dengue hemorrhagic fever, including 79 deaths. The main risk factors associated with mortality were hematemesis (RR 2.6; CI 95% 1.4-4.6) and melena (RR 2.2; CI 95% 1.2-3.7). Conclusions. Our results characterize the clinical profile of dengue hemorrhagic fever cases in Mexico and identify prognostic factors to alert clinician for the prevention of a fatal evolution.
Violence in women with no social security is higher. Partner's alcohol intake pattern is an important risk factor. Detection of domestic violence in the clinical setting is necessary to recognize its real magnitude as a social problem.
Resumen Objetivo: Estimar la prevalencia de obesidad (OB) y sobrepeso (SP) en mujeres trabajadoras del IMSS en la Ciudad de México, aplicando dos criterios de clasificación y su asociación con algunos factores de riesgo. Material y métodos. Estudio transversal realizado entre julio de 1999 y septiembre de 2000 que incluyó a 588 mujeres trabajadoras en el IMSS entre 20 y 65 años. Los criterios utilizados para medir la prevalencia de OB y SP fueron los propuestos por la OMS y la Norma Oficial Mexicana para el manejo integral de la obesidad (NOM). Resultados. La frecuencia de OB fue 27.6% (26% ajustada) y de SP de 43.2% (40.2% ajustada) al aplicar los criterios de la OMS. Conforme a la NOM, los niveles de OB en el grupo de talla baja (<1.50 m) se elevaron a 75% y en el de talla mayor a 1.50 m a 52.2%. Sin embargo, al comparar el índice de masa corporal de talla baja y talla normal no se aprecian diferencias. El factor de riesgo para OB y SP fue la edad. En forma protectora resultaron la educación y el ejercicio. Conclusiones. Las altas prevalencias de OB y SP en la población estudiada constituyen un riesgo importante para la salud de este grupo de población, que se puede traducir en altos niveles de discapacidad y pensiones con un alto costo para la Institución. Estos resultados demandan la realización de intervenciones que permitan identificar precozmente a mujeres con índices de masa corporal de riesgo. Los rangos propuestos por la NOM pueden ser de utilidad para la identificación precoz de las mujeres en riesgo.
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