Infecciones respiratorias agudas bajas en niños menores de 2 años: hospitalizaciones durante el invierno del año 2014 / Low acute respiratory infections in children under 2 years: 2014 winter hospitalizations / Infecções agudas das vias respiratórias inferiores em crianças menores de 2 anos: hospitalizações em 2014

Durante el invierno las infecciones respiratorias agudas bajas (IRAB) determinan un incremento en la demanda asistencial, afectando sobre todo a los niños más pequeños. El objetivo de la investigación fue describir las características clínicas, modalidades de tratamiento y evolución de los menores de 2 años hospitalizados en el Hospital Pediátrico-Centro Hospitalario Pereira Rossell por IRAB de etiología viral durante el invierno de 2014. Se realizó un estudio descriptivo, retrospectivo, describiendo las características de los menores de 2 años hospitalizados del 9/6 al 21/9/2014 por IRAB de probable etiología viral. Se describieron las características epidemiológicas y clínicas, el tratamiento realizado y la evolución de los pacientes. En el período evaluado egresaron 742 niños (34% de los egresos de la institución). Tenían una mediana de edad de 4 meses; 18% presentaba al menos un factor de riesgo de IRAB grave. Se identificó al virus respiratorio sincicial en 59,6%. La estadía hospitalaria tuvo una mediana de 4 días. En las salas de cuidados moderados se aplicó ventilación no invasiva a 46 niños, y oxigenación de alto flujo a 129 niños, logrando una mejoría clínica en el 87,0% y el 87,6% respectivamente. Ingresaron a unidades de cuidados intensivos 217 niños, 54% requirió asistencia ventilatoria mecánica. Dos pacientes fallecieron. En el período evaluado los niños pequeños con IRAB representaron una importante proporción de los egresos, con importante carga asistencial. La mayoría eran niños sin factores de riesgo. La aplicación de las técnicas de tratamiento en cuidados moderados fue efectiva, permitiendo disminuir la demanda de camas de cuidados intensivos.

During the winter, low acute respiratory infections (LARI) determine an increase in care demand, especially affecting younger children. The objective of the research was to describe the clinical characteristics, treatment modalities and evolution of children under 2 years of age hospitalized at the Hospital Pediátrico-Centro Hospitalario Pereira Rossell for viral etiology LARI during the 2014 winter. A descriptive, retrospective study was conducted, describing the characteristics of children under 2 years hospitalized between 9/6 and 9/21/2014 for LARI of probable viral etiology. The following features were described: epidemiological and clinical characteristics, treatment performed and patient's evolution. During the period evaluated, 742 children were discharged (34% of the institution's admissions). They had a median age of 4 months; 18% had at least one risk factor for severe LARI. Respiratory syncytial virus was identified in 59.6%. The hospital stay had a median of 4 days. In moderate care rooms noninvasive ventilation was applied to 46 children, and high flow oxygenation to 129 children, achieving clinical improvement in 87.0% and 87.6%, respectively. Two hundred and seventeen children were admitted 54% required mechanical ventilation. Two patients died. In the evaluated period small children with LARI represented a significant proportion of the discharges, with an important burden of care. The majority were children without risk factors. The application of treatment techniques in moderate care was effective, allowed a decrease in the demand for intensive care beds.

Durante o inverno, as infecções respiratórias agudas baixas (IRAB) determinam o aumento da demanda de cuidados, afetando especialmente as crianças menores. O objetivo da pesquisa foi descrever as características clínicas, as modalidades de tratamento e a evolução de crianças menores de dois anos hospitalizados no Hospital Pediátrico-Centro Hospitalario Pereira Rossell devido a IRAB de etiologia viral, durante o inverno de 2014. Foi realizado um estudo descritivo e retrospectivo, descrevendo as características das crianças menores de 2 anos hospitalizadas entre 9/6 e 21/9/2014 devido a IRAB de provável etiologia viral. Descreveram-se: características epidemiológicas e clínicas, tratamento realizado e evolução dos pacientes. Durante o período avaliado, 742 crianças foram hospitalizadas (34% dos ingressos da instituição). Tinham uma idade média de 4 meses; 18% tinham pelo menos um fator de risco para IRAB severa. O vírus sincicial respiratório foi identificado em 59,6%. A estadia hospitalaria teve uma mediana de 4 dias. Em salas de cuidados moderados, a ventilação não invasiva foi aplicada a 46 crianças e a oxigenação de alto fluxo a 129 crianças, atingindo melhora clínica em 87,0% e 87,6%, respectivamente. Foram internadas em unidades de terapia intensiva 217 crianças, 54% necessitaram de ventilação mecânica. Dois pacientes faleceram. No período avaliado, as crianças pequenas com IRAB representaram uma proporção significativa das despesas, com um carga importante de atendimento. A maioria carecia de fatores de risco. A aplicação de técnicas de tratamento em cuidados moderados foi eficaz, permitindo uma diminuição da demanda por leitos de terapia intensiva.

Hospitalizaciones por IRAB de probable etiología viral en niños durante el año 2012: estrategia asistencial / Child hospitalizations for acute lower respiratory infections probably caused by virus in 2012: a healthcare strategy

Introducción: en el Hospital Pediátrico del Centro Hospitalario Pereira Rossell (HP-CHPR) durante los meses fríos, las infecciones respiratorias agudas bajas (IRAB) determinan gran demanda asistencial. Para afrontarlas se pone en práctica una estrategia de diagnóstico y tratamiento denominada Plan de Invierno (PI), que se planifica anualmente, en función de las características de los pacientes tratados en años anteriores. Objetivos: describir las características epidemiológicas, clínicas y evolutivas de los niños que requirieron admisión por IRAB en el HP-CHPR durante los meses fríos del 2012 y describir las principales acciones de la estrategia Plan Invierno del año 2012 (PI-2012). Metodología: se describieron las características epidemiológicas, clínicas y evolutivas de los menores de 24 meses que egresaron del HP-CHPR, en el marco de la estrategia PI-2012, por IRAB de probable etiología viral. Se describió las principales acciones de la estrategia de diagnóstico y tratamiento realizada. Resultados: durante el PI-2012 egresaron 887 niños (25,5% de los egresos hospitalarios). La mediana de edad fue 4 meses. Menos de 10% tenía factores de riesgo para enfermedad grave. El virus respiratorio sincitial (VRS) fue el más frecuentemente identificado. Se aplicó un protocolo de diagnóstico y tratamiento. Se pusieron en práctica técnicas especiales de tratamiento en salas de cuidados moderados. Se aplicó ventilación no invasiva (VNI) en 87 niños, con éxito en 80% de los casos. Se realizó oxigenación de alto flujo (OAF) a 22 niños, con éxito en 100%. Requirieron ingreso a terapia intensiva (CTI) 149 niños, 55,7% requirió asistencia ventilatoria mecánica (AVM). Dos pacientes fallecieron en salas de cuidados moderados, cuatro en CTI. Conclusiones: las IRAB representaron una causa muy importante de morbimortalidad durante el período descripto. Los niños que requirieron ingreso hospitalario eran en su mayoría pequeños. Un porcentaje importante cursó una enfermedad grave, requiriendo modalidades especiales de tratamiento. Es importante continuar en la búsqueda de la mejor estrategia terapéutica para estos niños.

Introduction: during the colder months, acute lower respiratory infections (ALRI) determine a considerable increase in the demand for care at the Pereira Rossell Pediatric Hospital (HP-CHPR). In order to respond to such demand the hospital implements a diagnosis and treatment strategy called Winter Plan (WP), which is planned annually based on the characteristics of patients treated in previous years. Objectives: to describe the epidemiological and clinical characteristics and evolution of children with ALRI who required hospitalization in the HP-CHPR during the cold months of 2012, and to describe the main actions of the 2012 Winter Plan strategy (2012 WP). Methodology: epidemiological, clinical and evolution characteristics of children under 24 months discharged from HP-CHPR within the 2012WP strategy were described. The strategy’s main action for diagnosis and treatment were described. Results: 887 children were discharged during the 2012 WP strategy, representing 25.5% of hospital discharges. Median age was 4 months. Less than 10% presented risk factors for severe disease. Respiratory syncytial virus (RSV) was the most frequently identified virus. A protocol for diagnosis and treatment was applied. Special techniques for treatment were implemented in transitional care rooms. 87 children were administered non-invasive ventilation, which was successful in 80% of cases. High-flow oxygen was used in 22 children, being this successful in all patients. 149 children required admission to intensive care unit (ICU) , 55.7% needed mechanical ventilation assistance. Two patients died in the medium unit and four in the ICU. Conclusions: ALRI represent a major cause of morbidity and mortality during the period described . Most children who required hospitalization were young. A significant percentage presented a severe disease, requiring special treatment modalities. It is important to continue searching for the best therapeutic strategy for these children.

Changes in morpho-physiological attributes of Eucalyptus globulus plants in response to different drought hardening treatments

Morpho-physiological attributes exhibited in response to drought hardening at the end of the growing season of Eucalyptus globulus Labill under nursery conditions were studied to evaluate the effect of three drought hardening treatments in morpho-physiological traits used as suitable indicators of drought hardiness, such as, plant growth, root growth potential, plant water relationships and survival. Freezing resistance of drought hardened plants was also studied in order to evaluate cross hardening effects in cuttings of Eucalyptus globulus Labill. Drought hardening consisted in induced water stress by watering restriction, until plant stem xylem water potentials (psipd) reached to-0.2, -1.3 and -2.4 MPa. Two water stress-rewatering cycles were applied during 54 days of treatment. The hardening treatments caused a significant reduction in plant height, leaf area, specific leaf area, plant, leaf, stem and root biomass. However, stem diameter was not affected. Root growth potential increased with the exposure to moderate water stress (-1.3 MPa). Drought hardening treatments have not effect on water relationship parameters such as saturation osmotic potential (psipisat), volumetric module of elasticity (e), relative water content (RWCtlp) and osmotic potential (psitlp) at the turgor loss point. Only 1.7 percent and 6 percent of dehydrated dead plants were observed on treatments at -1.3 and -2.4 MPa respectively. Finally, the freezing damage index of leaves (LT50) was not significantly affected by drought hardening treatments. Furthermore, a reduction of 1.1ºC of supercooling capacity was observed at -2.4 MPa. As a conclusion, drought hardening is an important step of plants production programs during the final phase of nursery, because changes in morphological attributes caused by exposure to moderate drought, enable the plants to maintain the balance between transpiration and absorption areas and increase the capacity of plants to generate n...

Effect of long-term dehydration on serum constituents in extreme climatic conditions in camel (Camelus dromedarius).

Eight healthy female adult camels were used to study the effect of long term dehydration on serum constituents in extreme climatic conditions viz. cold and hot. The dehydration phases were of 24 days in cold and 13 days in hot conditions. The changes in sodium, potassium, calcium and phosphorus were non significant (P > 0.05) while in chloride, glucose, total proteins, urea, bilirubin, cholesterol and creatinine were significant (P < or = 0.05) during dehydration phase. The mean values of all the constituents tended to return to normal as the rehydration phase advanced. Changes in sodium and potassium in dehydrated camels reflected that they were able to maintain the salt balance.

Infarto del miocardio provocado por ingesta de bebida fría inmediatamente después de ejercicio físico intenso / Myocardial infarction after ingestion of cold beverage and strenous physical exercise

Se describe el caso de un paciente del sexo masculino de 36 años de edad, con sólo sexo masculino como factor mayor de riesgo coronario, quien presentó infarto agudo del miocardio asociado a ingestión de bebida fría inmediatamente después de ejercicio físico intenso. El estudio coronariográfico postinfarto mostró una lesión mínima de la DA. Se concluye que el espasmo coronario más ateroesclerosis es la causa más probable del infarto del miocardio en este caso. Se hace una revisión de la literatura sobre el tema.

Influencia de virus respiratorios, frío y contaminación aérea en la infección respiratoria aguda baja del lactante / Influence of respiratory viruses, cold weather and air pollution in the incidence of lower respiratory tract infections in infants

Background: All winters, there is an increase in the number of pediatric consultations, associated to three factors: cold weather, air pollution and respiratory virus epidemics. Aim: To study the influence of these three factors in the demand for pediatric consultations between march and september, in an area of Metropolitan Santiago. Patients and Methods: The number of consultations between march and september 1998 in the emergency room and the number of hospital discharges due to lower respiratory tract infections, were registered in a public pediatric hospital of Santiago. A respiratory virus surveillance (respiratory syncytial virus, adenovirus, influenza and parainfluenza virus) was done among children admitted for lower respiratory infections. Atmospheric temperature values and air pollution, measured as the number of particles of 10 µm or more per m3 (MP 10), were obtained from local health services. Results: Two elevation waves of outpatient consultations were detected at weeks 19 and 26, that coincided with the periods of maximal detection of influenza and syncytial respiratory virus, respectively. The epidemics of respiratory syncytial virus coincided with the maximal number of hospital admissions for lower respiratory tract infections at week 27. There was no correlation between air pollution and the number of pediatric consultations. The lower ambient temperatures coincided with the higher detection of respiratory syncytial virus at week 28, moment in which the demand for consultations or hospital admissions was descending. Conclusions: There is a direct relationship between respiratory virus epidemics and the demand for pediatric consultations. There is also a minor influence of ambient temperature

Traqueitis bacteriana: 22 casos atendidos en el Hospital para el Niño, DIFEM, de 1985 a 1994 / Bacterial tracheitis: 22 cases from Hospital para el Niño DIFEM, from 1985 to 1994

La traqueitis bacteriana (TB) es una enfermedad aguda bacteriana caracterizada por la obstrucción respiratoria alta con fiebre y es diagnosticada por la presencia de secreciones purulentas en la tráquea. Reportamos 22 casos de TB admitidos entre 1985 y 1994 en el Hospital para el Niño de Toluca que fueron diagnosticados por broncoscopia y cultivos bacterianos. Se presentó en los meses de frío (90 por ciento) y 16 casos tuvieron entre uno y tres años de edad. Se encontraron las siguientes bacterias: S. aureus, S. pyogenes, H. influenzae, Enterobacter, E. coli y P. aureus, S. pyogenes, H. influenzae, Enterobacter, E. coli y P. aeruginosa. Es conveniente que el médico mantenga un alto índice de sospecha de TB en aquellos niños con fiebre y obstrucción respiratoria alta que no responde al tratamiento habitual para crup

Ranunculus bulbosus: 1ra. parte / Ranunculus bulbosus: 1fts. part

Se resalta el tropismo tisular del medicamento, como así también los principales síntomas característicos y los diversos síndromes para los cuales se adapta. Se hacen resaltar las modalidades de las algias las cuales darán el diagnóstico medicamentoso con exactitud y se traen a consideración cuadros clínicos para los cuales el medicamento es muy útil y poco tenido en cuenta

Paralisia facial periférica em Petrópolis / Peripheral facial paralysis in Petropolis, Brazil

O autor apresenta 83 casos de paralisia facial periférica <> ocorridos em Petrópolis, cidade montanhosa de clima tropical , sem estaçäo seca, com média de temperatura 10-C a 23-C. Faz relaçäo delas com viroses que ocorrem durante o ano. Cinquenta e seis pacientes säo de sua clínica e têm <>, enquanto 25 outros säo pacientes de outra clínica, para os quais säo relatados apenas o início de instalaçäo da paralisia, o sexo, o lado e a idade. Mostra que a maior incidência ocorreu nos meses de maio, agosto, setembro e outubro. Faz também consideraçöes sobre a etiología, incidência, prevalência, conduta terapêutica e resultados na paralisia facial periférica