ABSTRACT
La hemorragia intraventricular (HIV) es una causa importante de daño cerebral en los recién nacidos prematuros. Su impacto negativo en el resultado del desarrollo neurológico se relaciona no sólo a su impacto directo, sino que también a las lesiones asociadas, como la hidrocefalia posthemorrágica (HPH). En la mayoría de los casos, la hidrocefalia es causada por la alteración de la reabsorción del líquido cefalorraquídeo (LCR) debido a la inflamación de las vellosidades subaracnoideas por el contacto con la sangre. El drenaje ventricular se utiliza a menudo como un procedimiento temporal para manejo de la HPH y algunos pacientes tratados con drenaje ventricular no requieren una derivación permanente; de no ser así, las derivaciones más usadas en los prematuros incluyen la ventriculoperitoneal (DVP), seguida por las derivaciones ventriculosubgaleal y ventriculoatrial. Las derivativas se consideran el tratamiento definitivo para la HPH; pero puede asociarse a complicaciones, tales como la infección, obstrucción, rechazo y el drenaje insuficiente. Otra alternativa, es la derivación ventrículopleural. Sin embargo, esta alternativa de derivación se vincula a otras complicaciones específicas, principalmente el neumotórax y el derrame pleural. Se presenta el caso clínico de EAV, quien a raíz de un parto prematuro, complicado con Hemorragia intraventricular, desarrolló Hidrocefalia y un quiste de Fosa Posterior, debiendo intervenirse en 36 oportunidades, por múltiples complicaciones. Durante su evolución se instalaron catéteres en prácticamente todos los sitios posibles, lográndose finalmente la solución del problema. Se revisa la literatura
Ventricular haemorrhage is an important cause of neurologic damage in preterm babies. Its negative impact in the final neurologic damage is not just related with the direct impact, but also with associated lesions like posthaemorrhagic hydrocephalus (PHH). In most of cases, hydrocephalus is caused by impaired cerebrospinal fluid (CEF) resorption due to the inflammation of the Arachnoid granulations because of the contact with blood. Ventricular drainage system is often used as a temporal procedure for the management of the PHH in children who have not a good response to serials lumbar punctures. Some patients treated with ventricular drainage don't need a permanent derivation, but if they do the most used in preterm babies include ventriculoperitoneal derivation (VPD) followed by ventriculosubgaleal and ventriculoatrial derivation. Derivation is considered the definitive treatment for PHH, but it can be associated with some complications as infection, obstruction and insufficient drainage. Another option is ventriculopleural derivation but this alternative is related to other complications like pneumothorax and pleural effusion. The presentation is about the case of the newborn EAV, who after preterm birth, complicated with intraventricular haemorrhage, developed hydrocephalus and a posterior fossa cyst, requiring 36 surgical interventions because of multiple complications. During its evolution he needed catheters installations in almost every possible sites, finally getting the problem solved. The literature is reviewed
Subject(s)
Humans , Male , Cerebral Ventricles , Drainage/methods , Cranial Fossa, Posterior , Intracranial Hemorrhages , Intracranial Hemorrhages/complications , Hydrocephalus , Diagnostic ImagingABSTRACT
Toxoplasmosis, a world wide zoonotic infection, is generally asymptomatic and benign in immunocompetent individuals, but it can be serious in immunodeficiencies particulary in patients with acquired immunodeficiency syndrome and in children infected in utero. So, it is important to dispose methods which permit discriminate between recent and chronic infections. In order to contribute to improve the diagnosis of toxoplasmosis ELISA IgG, IgG, IgM, IgA and ELISA IgG, avidity were performed in 15 and 24 sera from patients suspectec of having acute and chronic infection respectively, according dye test (DT) titres. ELISA IgG was positive in both groups, ELISA IgM was positive in 78,6 and 58,3 percent respectively, while ELISA IgA was positive in 85,7 and 33,3 percent of recent and chronic group respectively. In those sera with low IgG avidity (18,8 percent) we found specific IgM in 71,5 and 4,2 percent and IgA in 78,6 and 0,0 percent of recent and chronic groups respectively. Parallelly, 208 sera samples were clasified according to the results of DT, indirect hemagglutination and complement fixation tests in the following groups: acute (97), intermediate (36), chronic (35) and negative (40). The results were: acute (96,9-64,9-55,6 and 65,9 percent); intermediate (97,2-63,8-44,4 and 47,2 percent); chronic (45,7-42,8-5,7 and 34,3 percent) for IgG, IgM, IgA and low IgG avidity respectively. The use of both acute markers, IgA and low IgG avidity in the diagnosis of toxoplasmosis is discussed
Subject(s)
Humans , Immunologic Tests/methods , Toxoplasmosis/diagnosis , Antigens, Protozoan , Enzyme-Linked Immunosorbent Assay , Immunoglobulin A , Immunoglobulin G , Immunoglobulin M , Complement Fixation Tests , Hemagglutination Tests , Toxoplasma/immunologySubject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant Mortality/trends , Prevalence , Prospective StudiesABSTRACT
Presenta un diagnóstico de situación del sistema de venta ambulante de alimentos en la ciudad de Bogotá, Colombia. Evalúa las condiciones sanitarias de almacenamiento y conservación de los alimentos después de su preparación. Recomienda soluciones para el mejoramiento de las ventas ambulantes de alimentos