Inhibidores de la aromatasa para estatura baja en niños y adolescentes de sexo masculino / Aromatase inhibitors for short stature in male children and adolescents

Resumen Los inhibidores de la aromatasa son fármacos disponibles por vía oral que inhiben la conversión de la testosterona en estradiol. Los estrógenos desempeñan un papel esencial en la maduración del cartílago de crecimiento y del cierre epifisario, evento que marca el final del proceso de crecimiento esquelético. Por este motivo, los inhibidores de la aromatasa se han probado como una intervención para mejorar la talla en niños y adolescentes de sexo masculino mediante el retraso en la maduración esquelética al disminuir la concentración de estradiol en la placa de crecimiento. Se resumen los resultados de una revisión sistemática Cochrane en la cual se evaluaron la eficacia y la seguridad de los inhibidores de la aromatasa para el tratamiento de la estatura baja en niños.

Abstract Aromatase inhibitors are orally administered drugs that inhibit the conversion of testosterone to estradiol. Estrogens have an important role in growth plate maturation and epiphyseal closure. Thus, aromatase inhibitors have been used to improve final height in male children and adolescents by delaying skeletal maturation through a decrease in estradiol concentration. The results of a Cochrane systematic review evaluating the efficacy and safety of aromatase inhibitors for the treatment of short stature in children are summarized below.

Two Cases of Epiglottitis Caused by Haemophilus Influenzae Type b Infection / 소아알레르기및호흡기학회지

Epiglottitis is an uncommon but potentially life threatening infectious disease in young children. And it is rapidly progressing cellulitis of the epiglottis and adjacent structures that has the potential for causing abrupt, complete airway obstruction. The most common cause of acute epiglottitis is Haemophilius influenzae type b(Hib), therefore in USA, the acute epiglottitis is seen less commonly since the wide spread use of immunization against Hib. In Korea, there has been no report of acute epiglottitis caused by known bacterial organism, and a little investigation of the effects of the immunization against Hib, or Hib related respiratory diseases. In this report, we describe two cases of acute epiglottitis caused by Hib, occurred in non-immunized young-male children admitted to Ajou University Hospital. They had visited to the emergency center of Ajou University hospital with the complaints of acute fever, drooling, dysphagia and severe respiratory difficulties. In both cases, we observed the cherry-red colored, severely swollen epiglottis by the direct laryngoscopic examination. Hib was cultured in blood samples from both two cases, and the patients treated successfully by the 3 days of endotracheal intubation and proper antibiotics therapy without any complications such as pneumonia, meningitis, osteomyelitis, or pericarditis.

Preputial condition and urinary tract infections

Recently, an increase in incidences of urinary tract infections in uncircumcised male infants has been reported. However, determining what is the best management for the prepuce of newborns and infants is still to be solved. I investigated prospectively how much foreskins are retracted with age and what correlations it has with urinary tract infection in 122 males children below 15 years of age. Under 6 months of age, the majority of the foreskins were unretractable. As they got older, over 3 years of age, their prepuces became retractable. The incidence of bacteriuria was 11.4% in uncircumcised but none in circumcised and hypospadias. In 8 patients showing bacteriuria, their foreskins were retracted below 25% in length. Among them, 5 patients, in whom E. coli were grown in their urine, showed radiologic renal abnormalities and suffered from high fever indicating systemic infection. However, the other 3 cases infected by Proteus mirabilis in their urine complained of only local penile symptoms.