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F Martinón-Torres

Publications and source records attributed to F Martinón-Torres.

At least 19 recordsLinked to original sources
PubMed2006

[Recommendations of the Vaccine Advisory Committee of the Spanish Association of Pediatrics: influenza vaccination campaign 2006-2007].

The recommendations of the Spanish Association of Pediatrics on influenza vaccination in the pediatric age group for the 2006-2007 season are presented. Influenza has special characteristics in children due to the high morbidity it carries. Moreover, children constitute the most frequent source of transmission. The risk factors supporting influenza vaccination in children and the need for immunization in persons living with high-risk children are discussed. The advisability of extending vaccination in health workers, and specifically to pediatricians and medical personnel in contact with sick children is stressed. The composition of the vaccine for the 2006-2007 seasons, the schedules and dosages in children depending on age, and the contraindications to vaccination are specified. Finally, the premises required to recommend universal vaccination in young children in Spain as a strategy to reduce morbidity due to this epidemic in children and adults are discussed.

Adolescent↗
PubMed2006

[Human papillomavirus vaccines: a new challenge for pediatricians].

Human papillomavirus (HPV) infections are the most common sexually transmitted infections in the world. This infection is a necessary cause of cervical cancer, has been related to other forms of anogenital, airway and digestive cancers, and also causes anogenital warts. The recent advances in HPV prophylactic vaccines and their imminent commercial availability will post a new challenge to pediatricians: the indication and administration of these vaccines for the prevention of HPV infection, and consequently, of cervical cancer and other HPV-related diseases. The present article reviews the essentials of HPV infection, its relationship with cervical cancer, the advances in prophylactic HPV vaccines, and the role of the pediatrician in this context.

Adolescent↗
PubMed2005

[Noninvasive ventilation with heliox in an infant with acute respiratory distress syndrome].

Noninvasive ventilation (NIV) combined with heliox therapy (Hx) constitutes a therapeutic option in the management of adult patients with acute exacerbations of chronic obstructive pulmonary disease. Either NIV or Hx alone can also be effective in pediatric patients, but there are no published reports on their combined use. We describe the case of a 4-month-old infant with acute respiratory insufficiency due to severe acute respiratory distress syndrome secondary to respiratory syncytial virus infection, successfully treated with nasal continuous positive airway pressure and heliox (Hx-nCPAP). A commercially available nCPAP ventilator adapted for heliox use was employed for Hx-nCPAP application. This is the first report of the use of Hx-nCPAP in an infant.

Equipment Design↗
PubMed2005

[Syncope in adolescents. Diagnostic and therapeutic approach].

Syncopal episodes are frequent in adolescence. Syncope is usually a benign, self-limiting condition but it may be a warning sign of serious disease that must be diagnosed and appropriately treated. The present article provides a review of the basic principles of the differential diagnosis of syncope in the adolescent patient and treatment recommendations.

Adolescent↗
PubMed2005

[Ingestion of foreign bodies containing lead].

Ingestion of a foreign body containing lead in children carries the additional risk of acute lead poisoning secondary to dissolution and absorption of the ingested lead in the acid environment of the stomach. We report the case of a 3-year-old girl who ingested a lead sinker. The patient was asymptomatic but therapy with a proton pump inhibitor (omeprazole) was empirically started on admission and the foreign body was removed from the stomach by emergency endoscopy within 6 hours of ingestion. Despite the quick removal, blood lead levels (drawn 3 hours after ingestion) exceeded 40 .g/dl. The patient completely recovered and continues to do well after 1 year of follow-up. This case reveals that acute elevations of blood lead concentrations may occur rapidly after ingestion of lead foreign bodies. Even in the absence of symptoms, lead foreign body ingestion in children should prompt lead screening and initiation of appropriate treatment.

Acute Disease↗
PubMed2004

[Recombinant human activated protein C in the treatment of children with meningococcal purpura fulminans].

Meningococcal purpura fulminans (MPF) produces high mortality and morbidity, despite appropriate standard therapy. Administration of recombinant human activated protein C (rhAPC) has been successfully applied in adults with MPF and pediatric studies are under way. We report three pediatric patients with MPF treated with rhAPC as compassionate therapy. In two of these patients, positive clinical and laboratory effects were observed and both children achieved full recovery. The remaining patient died after 36 hours from refractory multiorgan failure. No rhAPC-related adverse effects were detected. The reported cases highlight the usefulness of rhAPC in children with MPF at least as a rescue compassionate treatment. Further clinical trials are needed to better delineate its efficacy and administration schedule in children.

Adolescent↗
PubMed2003

[Mechanical ventilation in pediatrics (III). Weaning, complications and other types of ventilation. High-frequency ventilation].

In the era of lung-protective ventilation strategies, high frequency oscillatory ventilation (HFOV) has attracted renewed interest and its use has dramatically increased in neonatal and pediatric intensive care units. HFOV is able to reduce ventilator-induced lung injury by limiting the incidence of volutrauma, atelectrauma, barotrauma and biotrauma. During HFOV, adequate oxygenation and ventilation is achieved by using low tidal volumes and small pressure swings at supraphysiologic frequencies. Unlike other high-frequency ventilation modes, HFOV has an active expiration phase. HFOV constitutes a safe and successful ventilation mode for managing pediatric patients with respiratory insufficiency refractory to optimized conventional mechanical ventilation and provides better results when initiated early. However, the elective use of HFOV requires further studies to identify its benefits over conventional modes of mechanical ventilation and to support its routine use as a first line therapy. In the present article, the Respiratory Working Group of the Spanish Society Pediatric Critical Care reviews the main issues in the pediatric application of HFOV. In addition, a general practical protocol and specific management strategies, as well as the monitoring, patient care and other special features of the use of HFOV in the pediatric setting, are discussed.

Child↗
PubMed2003

[Convulsive syncope: characteristics and reproducibility using the tilt test].

OBJECTIVES: To establish the main clinical characteristics of convulsive syncope and the usefulness of the tilt test in its diagnosis. METHODS: A total of 317 patients (aged 5-18 years old) under clinical suspicion of neurocardiogenic syncope underwent a multiparametric tilt test. Our tilt test protocol includes continuous noninvasive measurement of heart rate, blood pressure, and arterial oxygen saturation, as well as continuous noninvasive measurement of cerebral oxygen saturation by near-infrared spectrophotometry. In selected patients, simultaneous electroencephalogram (EEG) was performed. RESULTS: The tilt test was positive in 216 patients (68.1 %). Of these, 25 (11.6 %) showed seizures during the test (convulsive syncope). Convulsions were asymmetric-tonic in 15 patients (60 %), generalized tonic in 5 (20 %), and tonic-clonic in 5 (20 %). In all patients, convulsive episodes lasted less than 30 seconds and spontaneously ceased upon placing the patient in a horizontal or Trendelenburg position. When simultaneous EEG was performed, diffuse brain wave slowing was observed, without paroxysmal activity. CONCLUSIONS: Convulsive syncope is not an uncommon event in children and is easily elicited by means of the tilt test. Pediatricians should be aware of this finding in order to avoid the frequently established unidirectional association between seizures and epileptic disorders. Consequently, the tilt test should be considered an essential tool in the differential diagnosis between convulsive syncope and epilepsy.

Adolescent↗
PubMed2001

The relation between hyperventilation and pediatric syncope.

OBJECTIVE: The objective was to evaluate prospectively the role of hyperventilation in the development of neurocardiogenic syncope in children during head-upright tilt testing (HUTT). STUDY DESIGN: Tilt testing was performed in 34 children (mean age 10.6 years) with clinical suspicion of syncope. Respiratory rate and end-tidal carbon dioxide pressure were continuously monitored during HUTT. RESULTS: Tilt test was negative in 12 cases; 3 (25%) patients of this group exhibited hyperventilation any time during the test. In the remaining 22 cases the HUTT was positive, and 15 (68.2%) patients of this group exhibited hyperventilation at the onset of clinical symptoms and during syncope. In the positive HUTT group, the mean time elapsed from the tilt to the onset of syncope and the mean time elapsed from the onset of clinical symptoms to syncope (latency time) were significantly longer for patients who hyperventilated than for those who did not hyperventilate, (21.8 vs 11.5 minutes) (P =.002) and (78 vs 51 seconds) (P =.04), respectively. CONCLUSIONS: Spontaneous hyperventilation could play a relevant role in the pathophysiology of pediatric neurocardiogenic syncope, and it could point out a specific subtype of response to orthostatic stress in susceptible patients. We suggest the inclusion of capnography in tilt-test protocols could improve the assessment of syncope in children.

Adolescent↗
PubMed2001

[Acute bronchiolitis: evaluation of evidence-based therapy].

Bronchiolitis is the leading cause of lower respiratory tract infection in infants and produces significant morbidity. Limited progress has been made in the treatment of this disease and, in many cases, the therapy employed is controversial and mainly based on general recommendations and not on evidence-based strategies. This report uses evidence-based methodology to provide a critical review of the data available on the treatment of acute bronchiolitis (understood as the first episode of respiratory syncytial virus bronchiolitis in a previously healthy infant). After this analysis, we conclude that the only justifiable therapeutic interventions in these patients are supportive treatment, nebulized epinephrine and mechanical ventilation. Other therapies such us physiotherapy, nebulization, heliox, anticholinergics or exogenous surfactant, among others, require further randomized controlled trials to determine their utility. No evidence supports the routine use of corticosteroids, beta-adrenergic drugs, antibiotics, immunoglobulins, interferon, vitamin A or ribavirin in these patients. Finally, we consider that a national consensus review for the implementation of evidence-based clinical practical guidelines on the management of acute bronchiolitis would be of great interest.

Acute Disease↗
PubMed2000

Cerebral syncope in children.

We report a child with recurrent syncopal episodes who underwent head-up tilt testing according to a protocol that includes continuous and noninvasive measurement of brain oxygen saturation. We demonstrated significant cerebral hypoxemia during syncope without concomitant systemic hemodynamic disturbances. This response to head-up tilt test suggested the diagnosis of cerebral syncope.

Blood Pressure Determination↗
PubMed2000

["Deep" figurate erythema].

Deep figurate erythema is a rare dermatologic disease of unknown etiology. Early onset is exceptional. We report a clinical observation of neonatal onset, which serves to confirm the characteristic presentation of this disease, its benign nature and lack of response to different therapeutic attempts.

Erythema↗