Agenesia de vesícula biliar: una causa inusual de hipertransaminasemia / Absence of the gallbladder: an unusual cause of hypertransaminasemia

La agenesia de vesícula biliar es una entidad poco frecuente, y su presentación con algún síntoma asociado es más infrecuente aún. La mayoría de casos se detectan de forma accidental en el curso de una exploración quirúrgica ante un cuadro sugestivo de litiasis biliar. Se presenta el caso de una niña de 4 años de edad con elevaciones transitorias y recurrentes de enzimas hepáticas, en quien sólo se encontró, tras un estudio exhaustivo, una agenesia de vesícula biliar como posible causa de esta alteración. Es un cuadro que hay que tener en cuenta para evitar procedimientos invasivos en estos pacientes(AU)

Abscence of the gallbladder is a very rare malformation and its symptomatic presentation is even more unusual. Most of the cases reported were discovered while a surgical exploration of the abdomen was performed in patients with biliary symptoms. It is reported a rare paediatric case. The patient was 4 years old and presented recurrent and transient elevation of liver transaminases. After a complete study only absence of the gallbladder was found as cause. Awareness of this entity by clinicians and surgeons is important because invasive diagnostic procedures can be avoided(AU)

[Breast feeding promotion: is health education effective?]. / Promoción de la lactancia materna. Es efectiva la educación sanitaria?

A program founded on health education, habitually realized in the national health centers to increase the breast-feeding practice, was evaluated. In 1990, in order to know social and economic characteristics and alimentation practices associated to the incidence and duration of breast-feeding, mothers answered a questionnaire at the first week and sixth month of their child's life. Some aspects about breast-feeding promotion in our country are discussed.

[Nutritional state as reflected in chromium levels in a population of healthy and diabetic children]. / Estado nutricional de cromo en una población de niños sanos y de niños diabéticos.

The importance of chromium (Cr) for carbohydrate metabolism is unclear from the existing literature. Therefore, we have measured the concentration of chromium in the hair of 44 insulin dependent diabetic children and 95 healthy children. In the diabetic children the mean +/- SEM of Cr was 1.96 +/- 0.51 micrograms/ml, with 1.04 +/- 0.18 micrograms/ml being the mean for the females and 2.66 +/- 0.93 micrograms/ml the mean for the males. In the healthy children the mean concentration +/- SEM of Cr was 1.69 +/- 0.27 micrograms/g with 1.18 +/- 0.21 micrograms/ml and 2.35 micrograms/ml being the result for females and males, respectively. No significant differences were found in Cr levels in the hair with regard to age, sex, weight and height, neither when comparing between the two groups (diabetic children and healthy children) nor within these groups. A distribution has been made of the Cr levels in hair according to percentiles in both groups. For concentrations under 0.457 +/- g/g there is a significantly larger percentage of healthy children than diabetic children (p less than 0.001). A new, fast and reliable method for the determination of Cr in hair is described. This method employs spectrophotometry of atomic absorption with a graphite oven and dramatically reduces the time normally required for this determination.

[Importance of childhood accidents. Results of a regional study]. / Importancia de los accidentes en la infancia. Datos de un estudio regional.

In order to know the importance and epidemiology of childhood accidents, a prospective study was made in a Spanish region, this study was founded in death certificates and 3,344 questionnaires from children under 7 years old, accidented in 1986 and attended in emergency departments in our region. The information was coded and analysed by computer of the Murcia University. Accidents are the main cause of death in children aged over 1 year, as a common cause of assistance in emergency departments. Its characteristic are common to most countries, but the authors find some differences in our region. It is necessary to dedicate bigger effort to study and prevention of childhood accidents.

[Neonatal meningitis. Study of 26 cases and a review of its sequelae after 5 years]. / Meningitis neonatal. Estudio de 26 casos y revisión de sus secuelas a los cinco años.

Twenty-six cases of neonatal meningitis in term newborns are studied. Incidence, etiological features, treatment, clinical and biochemical evolution and mortality are analysed. Lief motif of this paper is the search for deficits in psychomotor growth in propositi of four and six years old, finding an important relation between neonatal bacterial meningitis and neuropsychological deficits (hyperkinesia, perceptive area impairment, reading-writing disorders, etc.) in contrast to the good evolution of lymphocytic meningitis.

[Non-immune hydrops fetalis. Review of 11 cases]. / Hydrops fetalis no inmune. Revisión de 11 casos.

Eleven cases of non-immune hydrops fetalis (NIHF) are presented. Incidence was 1.8 out of 10,000 births. NIHF became more common than immune hydrops fetalis (1.4/10,000 births). Mortality was of 81% and complications were frequent. NIHF is associated with prematurity, neonatal anoxia, polyhydramnios, hypoalbuminemia and hypoproteinemia. Considerable emphasis must be placed on antenatal diagnosis to achieve a precocious treatment and so improve the present poor prognosis.

[Campylobacter jejuni gastroenteritis. 1 year's case review]. / Gastroenteritis por campylobacter jejuni. Casuística de un año.

This paper reports the incidence of Campylobacter jejuni isolation (19,21%) among 229 samples of diarrheal stools examined during a period of 12 months and which corresponded to children whose ages were between 1 and 18 months. Campylobacter gastroenteritis is more common than salmonella gastroenteritis. A peak incidence was observed in the first year of life. The various clinical aspects of the infection are examined: Diarrhea was the most frequent symptom (100%) with macroscopic blood in stools in 25% of the cases. Some epidemiological, diagnostic and therapeutic aspects are commented upon. Clinical course with or without antibiotic treatment was favorable. Microbiological search of Campylobacter must be carried out as a routine in every child that presents diarrheal symptomatology.