Enriqueta Roman

Diversity of Group A Human Rotavirus Types Circulating over a 4-Year Period in Madrid, Spain

ABSTRACT The incidence and distribution of human rotavirus G types among children under 5 years old with acute gastroenteritis were determined over a 4-year period (1998 to 2002) by using monoclonal antibodies and reverse transcription-PCR methods. Rotavirus was detected in 1,155 (31%) of 3,760 specimens tested. Rotavirus was studied in every month of the 48-month survey period. Rotavirus activity occurred mainly (51%) in the typically cooler months in Spain (November to February). The age distribution of rotavirus-positive cases showed that 90% of patients (1,038 of 1,155) were under 2 years old. Rotavirus types were determined for 576 of 1,155 patients (50%). G1 was the main genotype detected (53%), and the second most common was G4 (24%). The G2, G9, and G3 rotavirus types were detected in 14, 6, and 2% of the cases, respectively. Dual infections were detected in only 0.6%. The seasonal distribution of genotypes showed a significant genotypic shift: whereas G4 strains predominated (57%) during the 1998 to 2000 seasons, the G1 gradually increased to account for 75% in the 2000 to 2002 seasons. In addition, the present study reports the first detection of the G9 genotype in human fecal samples in Spain. Therefore, additional types may be required for vaccine development strategies that currently target only types G1 to G4.

Normal Values of Liver Shear Wave Velocity in Healthy Children Assessed by Acoustic Radiation Force Impulse Imaging Using a Convex Probe and a Linear Probe

Acoustic radiation force impulse (ARFI) is an image-guided ultrasound elastography method that allows quantification of liver stiffness by measurement of shear wave velocity. One purpose of the work described in this article was to determine the normal liver stiffness values of healthy children using ARFI with two different probes, 4 C1 and 9 L4. Another purpose was to evaluate the effects of site of measurement, age, gender and body mass index on liver stiffness values. This prospective study included 60 healthy children (newborn to 14xa0y) divided into four age groups. One thousand two hundred ARFI measurements were performed, that is, 20 measurements per patient (5 measurements in each lobe, with each probe). Means, standard deviations (SD) and confidence intervals for velocity were calculated for each hepatic lobe and each probe in each age group and for the whole group. Mean shear wave velocity measured in the right lobe was 1.19xa0±xa00.04xa0m/s (SDxa0=xa00.13) with the 4 C1 transducer and 1.15xa0±xa00.04xa0m/s (SDxa0=xa00.15) with the 9 L4 transducer. Age had a small effect on shear wave measurements. Body mass index and sex had no significant effects on ARFI values, whereas site of measurement had a significant effect, with lower ARFI values in the right hepatic lobe. ARFI is a non-invasive technique that is feasible to perform in children with both the 4 C1 and 9 L4 probes. The aforementioned velocity values obtained in the right lobe may be used as reference values for normal liver stiffness in children.

Molecular Detection of Human Calicivirus among Spanish Children with Acute Gastroenteritis

ABSTRACT A survey was conducted among Spanish children with gastroenteritis treated in an emergency room. Reverse transcription-PCR with specimens negative for other enteric pathogens was used. The minimum incidence of human calicivirus infection was 7.7%, with Lordsdale as the predominant genotype. The clinical features and severity of calicivirus and rotavirus were similar.

Surveillance of human calicivirus in Spain.

To the Editor: Human caliciviruses (HuCVs) are an important cause of acute viral gastroenteritis in young children worldwide (1,2). In Spain, norovirus infections are not subject to specific surveillance; few data exist about sporadic cases (3,4) and none about outbreaks across the country. We have conducted a surveillance study of acute gastroenteritis epidemics to determine the prevalence of HuCV infections. Our goal was to gain insight into the epidemiology of these infections in Spain and consider new directions to prevent them and control improvements in food and water quality and sanitary practices.

Normal values of spleen stiffness in healthy children assessed by acoustic radiation force impulse imaging (ARFI): comparison between two ultrasound transducers

BackgroundPortal hypertension, a major complication of hepatic fibrosis, can affect the stiffness of the spleen.ObjectiveTo suggest normal values of spleen stiffness determined by acoustic radiation force impulse imaging in healthy children and to compare measurements using two different US probes.Materials and methodsIn a prospective study, 60 healthy children between 1xa0day and 14xa0years of age were assigned to four age groups with 15 children in each. Measurements were performed using two transducers (convex 4C1 and linear 9L4), and 10 measurements were obtained in each child, 5 with each probe.ResultsThe mean splenic shear wave velocities were 2.17xa0m/s (SD 0.35, 95% CI 2.08–2.26) with the 4C1 probe and 2.15xa0m/s (SD 0.23, 95% CI 2.09–2.21) with the 9L4 probe (not significant).ConclusionWe found normal values for spleen stiffness with no difference in the mean values obtained using two types of US transducers, but with higher variability using a convex compared to a linear transducer.

Epidemiología de la gastroenteritis por rotavirus adquirida en la comunidad en el área de Fuenlabrada (Madrid)

INTRODUCTIONnRotavirus is the main aetiological agent of severe acute gastroenteritis in childhood.nnnMATERIAL AND METHODSnA prospective study on the incidence and cost of acute gastroenteritis in children under 5 years.nnnRESULTSnRotavirus was the most frequent aetiological agent. The cumulative incidence of hospitalisation decreased over the study period.nnnCONCLUSIONSnRotavirus is the most common cause of acute community acquired gastroenteritis requiring hospital admission in the area of Fuenlabrada (Madrid).

Racecadotrilo en la gastroenteritis aguda infantil

E n 2 estudios aleatorizados y controlados con placebo a doble ciego, realizados en Francia y en Peru, se valoro la eficacia y la tolerancia del racecadotrilo como tratamiento coadyuvante de la rehidratacion oral en ninos de 3 meses a 4 anos hospitalizados con diarrea aguda. En ambos ensayos se administro, junto con la rehidratacion oral, racecadotrilo o placebo. La tolerancia se establecio con el registro de todos los efectos adversos acaecidos. Se incluyo a 154 pacientes en el grupo tratado con racecadotrilo y 149 en el grupo control. De estos, completaron el seguimiento 117 (76%) en el primer grupo y 116 (78%) en el segundo grupo. En los pacientes tratados con racecadotrilo se observo, respecto al grupo con placebo, una disminucion del volumen fecal producido las primeras 48 h, las primeras 24 h y durante todo el periodo de la enfermedad. Tambien fue significativamente menor la ingesta de solucion de rehidratacion y la presencia de un cociente Na+/K+ urinario < 1. Se observaron efectos adversos en el 10% de los pacientes (16/154) tratados con racecadotrilo y en el 9,4% (14/149) de los tratados con placebo, la mayoria fue de caracter leve o moderado y predominaron los vomitos. Un tercer estudio aleatorizado y controlado a doble ciego se realizo en Francia, en ninos con gastroenteritis aguda, para comparar la eficacia, tolerancia y seguridad del racecadotrilo frente a la loperamida. Se incluyo a 102 ninos/as de 2 a 10 anos de edad, con diarrea aguda sin hospitalizar, de los que 52 se trataron con racecadotrilo y 50 con loperamida. Se considero, como criterio primario de eficacia, el numero de deposiciones liquidas hasta la curacion y, como criterios secundarios, la duracion de la diarrea y la tasa de recurrencias. La tolerancia y la seguridad se evaluaron mediante el registro de los efectos adversos durante el tratamiento, la valoracion de cambios en el perimetro abdominal y la incidencia de estrenimiento. No hubo diferencias entre los 2 grupos respecto a ninguno de los 3 parametros de eficacia considerados. Se observaron efectos adversos en el 11,5% de los pacientes tratados con racecadotrilo y en el 22,5% de los tratados con loperamida, y el mas frecuente fueron los vomitos. La incidencia de estrenimiento fue significativamente mayor en los pacientes tratados con loperamida (58%) que en los tratados con racecadotrilo (36,5%), aunque su duracion fue similar en ambos grupos. Puntos clave Cezard JP, Duhamel JF, Meyer M, Pharaon I, Bellaiche M, Maurage C, et al. Efficacy and tolerability of racecadotril in acute diarrhea in children. Gastroenterology 2001;120:799-805.