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S1409-009020010003 Acta Pediátrica Costarricense Acta pediátr. costarric 1409-0090 Asociación Costarricense de Pediatría S1409-00902001000300003 La prevención del abuso físico contra los niños y niñas menores de cinco años de edad González Brenes Rosario ,Hospital Nacional de Niños Trabajo Social San José Costa Rica 2001 2001 15 106 113 Fontana V En Defensa del Niño Maltratado En Defensa del Niño Maltratado 1979 Editorial Pax La Prevención del Abuso Desde la Escuela La Prevención del Abuso Desde la Escuela 2001 San José Estadísticas año 2000 y Primer Trimestre año 2001 Estadísticas año 2000 y Primer Trimestre año 2001 2001 San José Estadísticas sobre Morbilidad General y Accidentes Atendidos en el Servicio de Urgencias Estadísticas sobre Morbilidad General y Accidentes Atendidos en el Servicio de Urgencias 2000 San José Internet. Advertencia a tiempo Internet. Advertencia a tiempo 2001 Internet. Estado Mundial de la Infancia 2001 Internet. Estado Mundial de la Infancia 2001 Bengio José Rafael Clínicas Pediátricas de Norteamérica. Violencia en niños y adolescentes Clínicas Pediátricas de Norteamérica. Violencia en niños y adolescentes 1998 McGraw-Hill Interamericana Acciones Rectoras del Ministerio de Salud en Violencia Intrafamiliar Acciones Rectoras del Ministerio de Salud en Violencia Intrafamiliar 2001 San José Normas de Atención en Salud a las Personas Afectadas por la Violencia Intrafamiliar Normas de Atención en Salud a las Personas Afectadas por la Violencia Intrafamiliar 2000 San José Programa de la Mano. Consejos para Mis Primeros Cinco Años de Vida Programa de la Mano. Consejos para Mis Primeros Cinco Años de Vida 2001 San José Salud Mundial: La Violencia Aspectos de Salud Revista 1993 46 ^s1 Código de la Niñez y la Adolescencia Código de la Niñez y la Adolescencia 1998 1a.ed San José Por Nuestros Niños y Niñas. Pasado, Presente y Futuro Por Nuestros Niños y Niñas. Pasado, Presente y Futuro 1998 San José Jaffe Peter Estrategias de Prevención, Evaluación e Intervención para Niñas y Niños Testigos de Violencia Intrafamiliar Estrategias de Prevención, Evaluación e Intervención para Niñas y Niños Testigos de Violencia Intrafamiliar 1999 Ontario London Family Court Clinic Memoria Memoria Congreso Nacional de Victimología "Las Víctimas También Tienen Derechos" 2001 San José Abuso Físico por Fracturas Abuso Físico por Fracturas 2000 San José Hospital Nacional de Niños Estado de los Derechos de la Niñez y la Adolescencia en Costa Rica Estado de los Derechos de la Niñez y la Adolescencia en Costa Rica 2000 San José UNICEF Estado Mundial de la Infancia 2000. Una Visión para el Siglo XXI Estado Mundial de la Infancia 2000. Una Visión para el Siglo XXI 2000 UNICEF Reforma en salud y derechos de la niñez Reforma en salud y derechos de la niñez 2000 San José La Disciplina La Disciplina 1994 3 Heredia
S1409-009020010003 Acta Pediátrica Costarricense Acta pediátr. costarric 1409-0090 Asociación Costarricense de Pediatría S1409-00902001000300004 Factores de riesgo y complicaciones en pacientes con infecciones por adenovirus en una epidemia en el Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera" Hernández de Mezerville Marcela Soto Quirós Manuel Umaña Sauma María de los Angeles Alfaro Wilberth ,CCSS Hospital Nacional de Niños Laboratorio de Inmunología 2001 2001 15 114 119

Objetivo: Analizar los datos de pacientes hospitalizados con infecciones por Adenovirus durante una epidemia observada en el Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera" (HNN) de octubre de 1999 a marzo del 2000. Diseño: Estudio retrospectivo y descriptivo. Materiales y métodos: Se revisaron los expedientes de pacientes hospitalizados en el HNN con inmunofluorescencia viral positiva por Adenovirus durante el periodo descrito. Resultados: Cuarenta y seis pacientes se hospitalizaron con el diagnóstico de infección por Adenovirus. Todos los pacientes fueron menores de 4 años y seis meses, con una edad promedio de 12.7 meses. Predominó el sexo masculino. El 71,7% de los pacientes ya habían tenido hospitalizaciones previas. Se identificó que el tener enfermedades como displasia broncopulmonar, reflujo gastroesofágico, oxígenodependencia e hipertensión pulmonar, aumenta el riesgo de tener complicaciones como la ventilación mecánica y la mortalidad. El 68,9% de los pacientes tenían un estado nutricional normal. Los diagnósticos de ingreso más frecuentes fueron bronconeumonía, bronquiolitis, y diarrea. Los síntomas y signos más frecuentes al ingreso fueron fiebre, dificultad respiratoria y tos. La mayoría (93,5%) requirió oxígeno desde el ingreso, el 54% de los pacientes ameritaron ventilación mecánica, un 71,7% esteroides sistémicos, un 80,4% broncodilatadores y un 89,1% antibióticos. La proteína c reactiva, las concentraciones absolutas de leucocitos, neutrófilos y bandas se elevaron durante las infecciones por adenovirus. Las complicaciones más frecuentes fueron ventilación mecánica, choque séptico, bronquiolitis obliterante y bronconeumonía. Un 28,2% de los pacientes fallecieron. Conclusiones: Los lactantes mayores, el sexo masculino, el antecedente de hospitalizaciones previas y el tener alguna enfermedad crónica asociada constituyen factores de riesgo para infecciones por adenovirus. La morbimortalidad aumenta principalmente en pacientes con enfermedades pulmonares de fondo. Los exámenes de laboratorio pueden confundir la infección por adenovirus con infecciones bacterianas. Las complicaciones fueron infecciosas y pulmonares principalmente. Estas infecciones pueden tener una mortalidad alta.

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