<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0034-7531</journal-id>
<journal-title><![CDATA[Revista Cubana de Pediatría]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Pediatr]]></abbrev-journal-title>
<issn>0034-7531</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias MédicasEditorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0034-75312019000200005</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Utilidad de la identificación de los signos de alarma en niños y adolescentes con dengue]]></article-title>
<article-title xml:lang="en"><![CDATA[Usefulness of warning signs´ identification in children and adolescents with dengue]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Izquierdo Estévez]]></surname>
<given-names><![CDATA[Arnaldo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez Torres]]></surname>
<given-names><![CDATA[Eric]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Pediátrico Universitario &#8220;Angel A. Aballí&#8221;  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Medicina Tropical &#8220;Pedro Kourí&#8221; (IPK)  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<volume>91</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-75312019000200005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-75312019000200005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-75312019000200005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  El dengue es una enfermedad capaz de producir extravasación importante de plasma con hipovolemia y choque, signos frecuentes de gravedad y causa de muerte.  Objetivo:  Valorar la utilidad de la identificación de los signos de alarma en niños y adolescentes con dengue.  Métodos:  Estudio prospectivo de 110 pacientes (0-18 años de edad y de ambos sexos) quienes presentaron signos de alarma de dengue grave y se trataron con soluciones cristaloides por vía intravenosa durante su ingreso hospitalario y un número igual de pacientes que no tuvieron esos signos y no requirieron dicho tratamiento. Se aplicó retrospectivamente la clasificación de la OMS 2009 y se comparó con la precedente de1977.  Resultados:  Los signos de alarma encontrados con mayor frecuencia fueron: dolor abdominal intenso y mantenido (50 %) y vómitos repetidos 3 o más en 4 horas (34,3 %), que aparecieron durante el dia de la defervescencia en 46 % de los pacientes y la mitad mostró ascitis. Después de seis horas de tratamiento con soluciones cristaloides por vía intravenosa, el porcentaje de pacientes con dolor abdominal disminuyó a 30 %, y el de pacientes con signos de bajo gasto cardiaco (hipotensión) disminuyó de 30 a 10 %. No hubo fallecidos.  Conclusiones:  Los signos añarma del dengue grave cuya identificación ha sido recomendada por OMS y OPS y tambien en las Guías Cubanas, tienen especial importancia en la atención de niños y adolescentes hospitalizados y demostrada su utilidad tanto en la prevencion del agravamiento como en la mejoria del cuadro grave cuando fue tratado en sus inicios.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Dengue is a disease that is capable of producing an important plasma extravasation with hypovolaemia and shock, which are frequent signs of seriousness and causes of death.  Objective:  To value the usefulness of warning signs identification in children and adolescents with dengue.  Methods:  A prospective study was carried out to 110 children (0-18 years old, both sexes) at &#8220;Dr. Angel A. Aballi&#8221; University Pediatric Hospital who had confirmed dengue´s warning signs and were admitted to the Intensive Care Unit and treated with crystalloids solutions by intravenous route. An equivalent number of confirmed dengue patients who did not have warning signs nor received that treatment were the control group. Clinical data and the results of laboratory tests were recorded since patients were admitted in the Intensive Care (ICU) and after 6 hours of treatment. The 2009 World Health Organization (WHO) Dengue Classification was used to classify patients retrospectively and a comparison was made with the WHO 1977 Dengue Classification.  Results:  Clinical warning signs that were more frequently identified were: intensive and continuous abdominal pain (50 %) and frequent vomiting (3 or more in 4 hours) (34.3 %) that appeared during defervescence (46 % of patients), and half of them presented ascites. After 6 hours of treatment with the crystalloids solutions, the number of patients with abdominal pain decreased to 30% and those with low cardiac output (hypotension) from 35 % to 10 %. No fatalities occurred.  Conclusions:  Warning signs of severe dengue, which identification has been recommended by WHO and PAHO and also in the Cuban Guidelines, has special importance in the care of hospitalized children and adolescents; and it was demonstrated its usefulness in the prevention of severity as in the improvement of the signs of severity when those were treated in the onset period.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[dengue grave]]></kwd>
<kwd lng="es"><![CDATA[signos de alarma]]></kwd>
<kwd lng="es"><![CDATA[tratamiento rehidratante]]></kwd>
<kwd lng="en"><![CDATA[severe dengue]]></kwd>
<kwd lng="en"><![CDATA[warning signs]]></kwd>
<kwd lng="en"><![CDATA[rehydrating treatment]]></kwd>
</kwd-group>
</article-meta>
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