Incremento en la incidencia de los derrames pleurales paraneumónicos

Obando, Ignacio; Tatay, D Sánchez; Wichmann, I; Santiago, R. Torronteras; Leal, JA León

doi:10.1157/13084183

Cited by 7 publications

(3 citation statements)

References 8 publications

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“…Diversos estudios han puesto de manifiesto que el aumento de los serotipos 1, 3 y 19A, no incluidos en la vacuna, serían responsables de dicho aumento [21][22] . El serotipo 1 es el más involucrado en el desarrollo de los derrames pleurales suponiendo en un estudio el 48% de los casos 23 .…”

Section: B Porcentaje De Cobertura De Los Serotipos Encontrados Conunclassified

“…El serotipo 1 es el más involucrado en el desarrollo de los derrames pleurales suponiendo en un estudio el 48% de los casos 23 . Según los datos de la región norteamericana de Intermountain West, el número de casos de empiema pleural pasó de 38 casos/año a 71,5 casos/año [21][22][23][24] . En un estudio realizado en España 25 los autores atribuyen el aumento de derrames al aumento global del número de neumonías bacterianas, manteniéndose constante la proporción de complicaciones (aunque repasando los datos del estudio donde se afirma esto, el número de neumonías aumenta ligeramente, de 36 a 41, mientras que el porcentaje de derrames pasa de 16% a 24% como puede verse en la tabla 1).…”

Section: B Porcentaje De Cobertura De Los Serotipos Encontrados Conunclassified

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Vacuna conjugada contra el neumococo: ¿Es una prevención universal adecuada de la enfermedad neumocócica?

Gorrotxategi

Mata²

2010

Rev Pediatr Aten Primaria

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Section: B Porcentaje De Cobertura De Los Serotipos Encontrados Conunclassified

Vacuna conjugada contra el neumococo: ¿Es una prevención universal adecuada de la enfermedad neumocócica?

Gorrotxategi

Mata²

2010

Rev Pediatr Aten Primaria

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“…Such effusions, commonly referred to as pleural empyema, lead to substantial morbidity, including respiratory distress, pain, and prolonged hospitalization, as well as child school loss, parental work loss, and stress on families. Over the past few decades, there has been a dramatic increase reported in the incidence of pediatric pleural empyema in multiple countries [3–11]. More recent data from Scotland suggests that since 2010, the incidence of empyema may have begun to fall, possibly due to the introduction of a 13-valent pneumococcal vaccine [12].…”

Section: Introductionmentioning

confidence: 99%

Intrapleural Dornase and Tissue Plasminogen Activator in pediatric empyema (DTPA): a study protocol for a randomized controlled trial

Livingston

Mahant

Ratjen

et al. 2017

Trials

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BackgroundA randomized controlled trial of adults with empyema recently demonstrated decreased length of stay in hospital in patients treated with intrapleurally administered dornase alfa and fibrinolytics compared to fibrinolytics alone. Whether this treatment strategy is safe and effective in children remains unknown.Methods/designThis study protocol is for a superiority, placebo-controlled, parallel-design, multicenter randomized controlled trial. The participants are previously well children admitted to a children’s hospital with a diagnosis of empyema requiring chest tube insertion and fibrinolytics administered intrapleurally. Children will be randomized after the treating physician has decided that pleural drainage is required but prior to chest tube insertion. After chest tube insertion, participants in the treatment group will receive intrapleurally administered tissue plasminogen activator (tPA) 4 mg followed by dornase alfa 5 mg. Participants in the placebo group will receive tPA 4 mg followed by normal saline. Study treatments will be administered once daily for 3 days. All participants, parents or caregivers, clinicians, and research personnel will remain blinded. The primary outcome is length of stay from chest tube insertion to discharge from hospital. Secondary outcomes include time to meeting discharge criteria, chest tube duration, fever duration, need for additional procedures, adverse events, hospital readmission, cost of hospitalization, and mortality.DiscussionThis multicenter randomized controlled trial will assess the safety, effectiveness, and cost-effectiveness of combined treatment with dornase alfa and fibrinolytics compared to fibrinolytics alone for the treatment of empyema in children.Trial registrationClinicalTrials.gov: NCT01717742. Registered on 8 October 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2026-0) contains supplementary material, which is available to authorized users.

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Has the number of cases of pediatric empyema increased in North-West Spain?

Martinón-Torres

Gallardo

Alvez

et al. 2015

J Pediatr Infect Dis

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Clinicians in Spain perceive an increase in the incidence of pediatric empyema. The available objective information is limited because it is a condition, for which there is no specific active epidemiological surveillance. This study aims to determine and evaluate the incidence of empyema of infectious origin, especially pneumococcal empyema, among children in Galicia (North-West of Spain). A retrospective search of all pediatrics cases of empyema from 1996 to present (May 2006) in Galicia (North-West of Spain) was performed using the official hospital admissions database. A total of 165 patients were identified, showing an increase in the incidence of empyema (1.02 cases/100,000 children in 1996 to 7.35 cases/100,000 children in 2005) and a decrease in the mean age of the patients affected [(7.25 (6.3) years in 1996 to 3.7 (3) in 2005]. This increase in the incidence of empyema started before the antipneumococcal vaccine became available and the reason for it remains unknown. This situation would justify the establishment of prospective systems for the surveillance and control of empyema.

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Incremento en la incidencia de los derrames pleurales paraneumónicos

Cited by 7 publications

References 8 publications

Vacuna conjugada contra el neumococo: ¿Es una prevención universal adecuada de la enfermedad neumocócica?

Vacuna conjugada contra el neumococo: ¿Es una prevención universal adecuada de la enfermedad neumocócica?

Intrapleural Dornase and Tissue Plasminogen Activator in pediatric empyema (DTPA): a study protocol for a randomized controlled trial

Has the number of cases of pediatric empyema increased in North-West Spain?

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