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1.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1450171

ABSTRACT

El propósito de este artículo de actualización es brindar información de la epidemiología, etiología manifestaciones clínicas para un diagnóstico preciso, recomendaciones para solicitar exámenes de laboratorio y gabinete y finalmente el tratamiento sintomático con corticoides y cuando hacer uso de epinefrina o adrenalina. La laringotraqueítis es una infección respiratoria aguda desencadenada por una infección viral de la vía aérea superior que afecta al 3% de los niños de seis meses a tres años. Es responsable del 7% de las hospitalizaciones anuales por fiebre y/o enfermedad respiratoria aguda en niños (as) menores de 5 años. Es la causa más frecuente de obstrucción de la vía aérea superior, secundaria a la inflamación de la laringe, la tráquea y los bronquios que genera estridor respiratorio y tos perruna o de foca. En la mayoría de los casos, el agente causal de la enfermedad es el virus parainfluenza. Si bien, muchos niños experimentan fiebre de bajo grado, su presencia no es necesaria para el diagnóstico, el cual es esencialmente clínico y rara vez se necesitan exámenes de laboratorio y gabinete para este propósito. El cultivo viral y la prueba rápida para identificar antígenos, tienen mínimo impacto en el tratamiento y no se recomiendan de rutina. La radiografía y la laringoscopia deben reservarse cuando se sospechan diagnósticos alternativos. El tratamiento es sintomático con el uso habitual de corticoides y en ocasiones epinefrina o adrenalina. Una sola dosis de dexametasona oral, intramuscular o endovenosa mejora los síntomas y disminuye las visitas de retorno, readmisiones y la duración de hospitalización en niños con LT de cualquier gravedad. La adición de epinefrina nebulizada mejora los síntomas en niños con LT moderada o severa, disminuye el porcentaje de intubación y evita la insuficiencia respiratoria. La intervención oportuna al inicio de la enfermedad, disminuye la severidad de los síntomas, la atención médica en servicios de urgencia pediátrica y la internación hospitalaria.


The purpose of this update article is to provide information on the epidemiology, etiology, clinical manifestations for an accurate diagnosis, recommendations for requesting laboratory and cabinet tests, and finally symptomatic treatment with corticosteroids and when to use epinephrine or adrenaline. Laryngotracheitis (LT) is an acute respiratory infection triggered by a viral infection of the upper airway that affects 3% of children from six months to three years. It is responsible for 7% of annual hospitalizations for fever and / or acute respiratory illness in children under 5 years. It is the most frequent cause of obstruction of the upper airway, secondary to inflammation of the larynx, trachea and bronchi that causes respiratory stridor and barking cough. In most cases, the causative agent of the disease is the parainfluenza virus. While many children experience low-grade fever, their presence is not necessary for diagnosis, which is essentially clinical and laboratory and cabinet tests are rarely needed for this purpose. Viral culture and rapid test to identify antigens have minimal impact on treatment and are not recommended routinely. Radiography and laryngoscopy should be reserved when alternative diagnoses are suspected. The treatment is symptomatic with the usual use of corticosteroids and sometimes epinephrine or adrenaline. A single dose of oral, intramuscular or intravenous dexamethasone improves symptoms and decreases return visits, readmissions and length of hospitalization in children with LT of any severity. The addition of nebulized epinephrine improves symptoms in children with moderate or severe LT, decreases the percentage of intubation and prevents respiratory failure. Timely intervention at the onset of the disease, decreases the severity of symptoms, medical attention in pediatric emergency services and hospitalization.

2.
World Journal of Emergency Medicine ; (4): 125-126, 2020.
Article in English | WPRIM | ID: wpr-787793

ABSTRACT

@#Glyphosate is a nonselective herbicide commonly used in agriculture worldwide. Glyphosate targets the shikimate metabolic pathway, which is found in plants but not in animals. Therefore, it is considered to be of low toxicity to humans, supported by the finding of high concentrations of oral and dermal LD50 (>5,000 mg/kg body weight) of glyphosate in experimental animals.[1,2] Ingesting commercial formulations of glyphosate surfactant herbicide (GlySH), however, has been reported to be associated with various toxic effects, including gastrointestinal injury, laryngeal injury, impaired renal function, metabolic acidosis, arrhythmias, pulmonary toxicity, shock, and even death.[3] Recently, glyphosate surfactant has been used with increasing frequency in suicide attempts, and clinical toxicologists have encountered fatal cases of glyphosate surfactant poisoning.[4] Mortality from ingesting glyphosate surfactant varies from 0% to 29.3%, depending on patients’ characteristics such as age and intent of exposure. [5–7] Acute fi brinous laryngotracheobronchitis is often seen in infants and children, but it is rare in adults. Here we present a case with acute obstructive fibrinous laryngotracheobronchitis induced by severe glyphosatesurfactant intoxication.

3.
International Journal of Pediatrics ; (6): 819-822, 2019.
Article in Chinese | WPRIM | ID: wpr-823449

ABSTRACT

The croup is a common disease of upper airway obstruction in children,with high incidence rate.In severe case,it is life-threatening.Because there is no guidelines or consensus on diagnosis and treatment in China,the evidence-based research on Chinese children's croup is also seriously lacking.Therefore,the article mainly reviews the recent research progress of croup abroad.

4.
International Journal of Pediatrics ; (6): 819-822, 2019.
Article in Chinese | WPRIM | ID: wpr-801561

ABSTRACT

The croup is a common disease of upper airway obstruction in children, with high incidence rate.In severe case, it is life-threatening.Because there is no guidelines or consensus on diagnosis and treatment in China, the evidence-based research on Chinese children′s croup is also seriously lacking.Therefore, the article mainly reviews the recent research progress of croup abroad.

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