ABSTRACT
OBJETIVO: Evaluar la correlación entre hallazgos de la ecografía pulmonar realizada precozmente con las escalas de gravedad clínica y su asociación con la evolución posterior en la bronquiolitis aguda (BA) leve-moderada. PACIENTES Y MÉTODOS: Estudio observacional prospectivo. Se incluyó a lactantes con BA leve-moderada evaluados mediante ecografía pulmonar en las primeras 24 h tras la atención hospitalaria. Se graduó la afectación pulmonar (rango 0-50 puntos) sobre la base de un score ecográfico (ScECO). Se evaluó la correlación entre el ScECO y 2 escalas clínicas de uso habitual: escala de Wood Downes Ferres modificada (WDFM) y escala del Hospital Sant Joan de Déu (HSJD). Así mismo se valoró la asociación entre el ScECO y la evolución clínica posterior (ingreso en la Unidad de Cuidados Intensivos Pediátricos [UCIP], días de hospitalización y días de oxigenoterapia). RESULTADOS: Se incluyó a 59 pacientes con una edad mediana de 90 días (RIQ: 30-270 días). La puntuación mediana del ScECO fue de 6 puntos (2-8) en los pacientes que no requirieron ingreso, 9 (5-13,7) en los ingresados en planta y 17 (14,5-18) en los pacientes que precisaron traslado de planta a la UCIP (p = 0,001). El ScECO tuvo una correlación lineal moderada con la escala de WDFM (rho = 0,504, p < 0,001) y HSJD (rho = 0,518; p < 0,001). El ScECO se asoció al ingreso en UCIP (OR 2,5 [IC del 95%: 1,1-5,9]; p = 0,035), mayor estancia hospitalaria (1,2 días (IC del 95%: 0,55, 1,86); p = 0,001) y duración de oxigenoterapia (0,87 días (IC del 95%: 0,26, 1,48); p = 0,006). CONCLUSIONES: La ecografía pulmonar precoz se correlaciona de forma moderada con la gravedad de la BA evaluada por escalas clínicas y guarda cierta relación con la evolución clínica
OBJECTIVE: To determine the correlation between the findings seen in early lung ultrasound with the clinical severity scales, and its association with the subsequent progression of the mild-moderate acute bronchiolitis (AB). PATIENTS AND METHODS: An observational prospective study conducted on infants with mild-moderate BA, using lung ultrasound in the first 24 hours of hospital care. The lung involvement was graded (range 0-50 points) based on an ultrasound score (ScECO) and 2 routinely used clinical scales: the modified Wood Downes Ferres (WDFM), and the Hospital Sant Joan de Deu (HSJD). The relationship between the ScECO and the subsequent clinical progression (admission to the Paediatric Intensive Care Unit (PICU), days in hospital, and days of oxygen therapy), was also determined. RESULTS: The study included a total of 59 patients, with a median age of 90 days (IQR: 30-270 days). The median ScECO score was 6 points (2-8) in the patients that did not require hospital admission, with 9 points (5-13.7) admitted to the ward, and 17 (14.5-18) in the patients who needed to be transferred from the ward to the PICU (P = .001). The ScECO had a moderate lineal association with the WDFM scale (rho = 0.504, P<.001) and the HSJD (rho = 0.518; P<.001). The ScECO was associated with admission to PICU (OR 2.5 (95% CI: 1.1-5.9); P=.035), longer hospital stay (1.2 days 95% CI: 0.55-1.86); P=.001] and duration of oxygen therapy [0.87 days (95% CI: 0.26-1.48); P=.006). CONCLUSIONS: There is a moderate correlation between early lung ultrasound findings with the severity of the AB evaluated by the clinical scales, as well as some relationship with the clinical progression
Subject(s)
Humans , Infant , Bronchiolitis/diagnostic imaging , Ultrasonography , Pilot Projects , Early Diagnosis , Prospective Studies , Observational Study , Oxygen/therapeutic useABSTRACT
OBJECTIVE: To determine the correlation between the findings seen in early lung ultrasound with the clinical severity scales, and its association with the subsequent progression of the mild-moderate acute bronchiolitis (AB). PATIENTS AND METHODS: An observational prospective study conducted on infants with mild-moderate BA, using lung ultrasound in the first 24hours of hospital care. The lung involvement was graded (range 0-50 points) based on an ultrasound score (ScECO) and 2routinely used clinical scales: the modified Wood Downes Ferres (WDFM), and the Hospital Sant Joan de Deu (HSJD). The relationship between the ScECO and the subsequent clinical progression (admission to the Paediatric Intensive Care Unit (PICU), days in hospital, and days of oxygen therapy), was also determined. RESULTS: The study included a total of 59 patients, with a median age of 90 days (IQR: 30-270 days). The median ScECO score was 6 points (2-8) in the patients that did not require hospital admission, with 9 points (5-13.7) admitted to the ward, and 17 (14.5-18) in the patients who needed to be transferred from the ward to the PICU (P=.001). The ScECO had a moderate lineal association with the WDFM scale (rho=0.504, P<.001) and the HSJD (rho=0.518; P<.001). The ScECO was associated with admission to PICU [OR 2.5 (95% CI: 1.1-5.9); P=.035], longer hospital stay [1.2 days 95% CI: 0.55-1.86); P=.001] and duration of oxygen therapy [0.87 days (95% CI: 0.26-1.48); P=.006]. CONCLUSIONS: There is a moderate correlation between early lung ultrasound findings with the severity of the AB evaluated by the clinical scales, as well as some relationship with the clinical progression.
Subject(s)
Bronchiolitis/diagnostic imaging , Lung/diagnostic imaging , Acute Disease , Early Diagnosis , Female , Humans , Infant , Male , Pilot Projects , Prospective Studies , Severity of Illness Index , UltrasonographyABSTRACT
El feocromocitoma es un tumor raro, infrecuente en la edad pediátrica. Los síntomas clásicos derivados del exceso de catecolaminas son cefalea, sudoración y palpitaciones, aunque los niños pueden tener una clínica más atípica. La hipertensión arterial suele ser un signo constante en la mayoría de los pacientes. Existen pocos casos descritos de poliuria como forma de presentación de feocromocitoma. Se presenta el caso de una niña de 13 años remitida a consulta de Nefrología Pediátrica por enuresis secundaria de un año de evolución. La tensión arterial clínica tomada durante la exploración era superior al percentil 99 para su edad y talla, motivo por el que se decidió el ingreso para su estudio y tratamiento.
Pheochromocytoma is a rare tumor which is infrequent in children. Although the clinical presentation in children can be atypical, the classic symptoms are headache, sweating and tachycardia. Hypertension is often a constant sign in most patients. There are few cases in literature reporting pheochromocytoma presented with polyuria. We present a 13-year-old girl who came to the Pediatric Nephrologist due to a year of evolution of secondary enuresis. When her blood pressure was taken, she was above the 99th percentile that corresponds to her age and her height that is why she was admitted for treatment and diagnostic study.
Subject(s)
Humans , Female , Adolescent , Pheochromocytoma/complications , Adrenal Gland Neoplasms/complications , Enuresis/etiology , Pheochromocytoma/diagnosis , Adrenal Gland Neoplasms/diagnosisABSTRACT
Pheochromocytoma is a rare tumor which is infrequent in children. Although the clinical presentation in children can be atypical, the classic symptoms are headache, sweating and tachycardia. Hypertension is often a constant sign in most patients. There are few cases in literature reporting pheochromocytoma presented with polyuria. We present a 13-year-old girl who came to the Pediatric Nephrologist due to a year of evolution of secondary enuresis. When her blood pressure was taken, she was above the 99th percentile that corresponds to her age and her height that is why she was admitted for treatment and diagnostic study.
El feocromocitoma es un tumor raro, infrecuente en la edad pediátrica. Los síntomas clásicos derivados del exceso de catecolaminas son cefalea, sudoración y palpitaciones, aunque los niños pueden tener una clínica más atípica. La hipertensión arterial suele ser un signo constante en la mayoría de los pacientes. Existen pocos casos descritos de poliuria como forma de presentación de feocromocitoma. Se presenta el caso de una niña de 13 años remitida a consulta de Nefrología Pediátrica por enuresis secundaria de un año de evolución. La tensión arterial clínica tomada durante la exploración era superior al percentil 99 para su edad y talla, motivo por el que se decidió el ingreso para su estudio y tratamiento.
