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Background: Despite high levels of vaccination coverage in Spain and Catalonia (98% in 2002), pertussis is a significant cause of morbidity among infants. The study aim was to estimate the incidence of hospitalizations for pertussis among infants from 1997 through 2001 in Catalonia., Methods: A retrospective review of records for patients <12 months of age with a diagnosis of pertussis (International Classification of Diseases, 9th revision, code 033) at discharge from 11 Catalonian hospitals was performed., Results: Three hundred forty-six patients were identified, 62 (1997), 28 (1998), 59 (1999), 150 (2000) and 47 (2001), of whom 284 (82%) were <4 months of age. The incidence of hospitalizations because of whooping cough from 1997 through 2001 in Catalonia was estimated at 118 cases per 100,000 inhabitants <12 months of age. Symptoms included paroxysmal cough (95%), cyanosis (67.9%), vomiting (36.7%) and apneic episodes (27.7%). Three infants (0.8%) died, all <2 months of age. Two hundred thirty-four patients (67.6%) were unvaccinated (222 patients were <3 months of age). Six patients (1.7%) were fully vaccinated (3 doses). Considering that only 220 patients <12 months of age were reported through the Catalonian Notification System in 1997-2001, at least 126 hospitalizations (36.4%) for pertussis were not reported to this system (mean difference per year, 32.6%; range, 8.4-56%)., Conclusions: In this study, hospitalizations exceeded the number of notifications by at least 32.6%; therefore, the real incidence is likely to be greatly underestimated. Pertussis incidence remains high among infants, most of whom are <4 months of age and have had no or 1 dose of vaccine.

Acute otitis media (AOM) is the most common disease requiring antibiotic treatment in young children. This article reviews the incidence of AOM in different age groups of controlled populations, its incidence in pediatricians, consulting rooms and emergency services and the main circumstances that usually complicate the diagnosis (circumstances of examination, methods and devices used and pediatric skills). Host and environmental factors related to otitis- prone children are revisited. Sex predominance (males), ethnicity, birth order (second-born or siblings), early occurrence of infection (when earlier, worse), and sibling history of severe or recurrent ear infections are host factors related to recurrent otitis. Season (inconclusive), socio-economic status (inconclusive) smoke and air pollutants (clearly related), breast-feeding (clearly related, especially when prolonged) and type of day care (the greatest incidence in children in large day-care groups versus home-cared) are environmental factors related to recurrent otitis.

Four newborn babies at term, with massive pulmonary haemorrhage associated with fulminant septicemia due to pseudomonas, are presented. The neonates died in the first day of life. The haematocrit and the proteic contents of the pulmonary effluent showed the existence of a pulmonary lesional edema. The histological findings in the four cases support this hypothesis. A revision of the etiopathogenic possibilities of the noncardiogenic pulmonary edema in the neonate is presented.

The authors reviewed the perinatal histories of 22 newborns malformations of the central nervous system, among 9,323 consecutive births in the last five years, with particular emphasis on the incidence and types of malformations, as well as the most important findings of the parents anamnesis. Prenatal ultrasonography is stressed out as an important tool in the precocious diagnosis of such a kind of malformations.

A case neonatal meningitis by proteus mirabilis is presented. Echographic and CT scan studies were performed during clinical evolution, showing generalized brain abscesses appearances that needed surgical treatment. A ventriculo-peritoneal shunt was later practiced to correct hydrocephaly.

The case of a neonate born to a mother who was treated with indomethacin in the antenatal period is presented. Newborn presented, immediately after birth, severe respiratory distress syndrome, with cyanosis that remain unmodified by oxigenotherapy and mechanical ventilation. Clinical picture and analitic and radiographic findings, suggested persistent fetal circulation syndrome. It has been recently demonstrated that indomethacin is able to affect hemodynamic changes in neonatal period avoiding arteriolar dilatation and consequently, the fall of pulmonary vascular resistences. Administration of tolazoline was followed of rapidly improvement of the patient.