ABSTRACT
Objetivo: Resaltar la peligrosidad de la posible ingesta accidental de chicles de nicotina en niños, debido a su forma de presentación, similar a la de sus golosinas. Material y Métodos: Estudio observacional retrospectivo de cuatro casos de ingesta accidental de 1-2 chicles de nicotina de 2 mg en niñas, registrados en el Hospital General de Segovia durante el año 2007 con edades comprendidas entre los 4 y los 7 años. Resultados: En los cuatro casos apareció sintomatología tras la ingesta del chicle, que ocurrió 20-30 minutos después de estar masticándolo. Los síntomas predominantes, en el 75% de los casos fueron náuseas, vómitos y mareo. En dos casos, 30 minutos tras la ingesta, se administró en el Servicio de Urgencias carbón activado, a los otros dos por haber pasado 4 horas tras la ingesta no se les administró. Tras permanecer 12 horas en observación y estando asintomáticas fueron dadas de alta. Discusión: La ingesta accidental de chicles de nicotina puede producir importantes efectos adversos, los cuales aparecen más rápidamente en niños que en adultos. Debe considerarse como primera medida, y más aún en la primera hora tras la ingesta la administración de carbón activado. Puesto que los niños los pueden confundir fácilmente e ingerir de forma accidental, debería tenerse en cuenta la modificación en su forma de presentación por parte de la industria farmacéutica, así como, un mayor cuidado por parte de los padres para evitar que los niños los tengan a su alcance y los ingieran (AU)
Objective: Stress the dangerousness of the possible accidental intake of nicotine gums in children due to their presentation form that is similar to that of sweets. Material and Methods: Observational, retrospective study of 4 cases in girls whose ages ranged from 4 to 7 years of accident intake of 1-2 nicotine gums of 2 mg recorded in the Hospital General of Segovia during the year 2007.Results: In the four cases, symptoms appeared after the intake of the gum, this occurring 20-30 minutes after they were chewed. The predominant symptoms in 75% of the cases were nausea, vomiting and dizziness. At 30 minutes of the intake, two cases were administered activated carbon in the Emergency Department, and there maining two were not administered it because 4 hours had passed since the intake. After remaining in observation for 12 hours and being asymptomatic, they were discharged. Discussion: Accidental intake of nicotine gum may cause important adverse effects, these appearing faster in children than in adults. Administration of activated carbon should be considered as the first measure, and even more so during the first hours after its intake. Since children can easily confuse it and accidentally consume it, the pharmaceutical industry should consider changing its presentation form. Furthermore, parents should be more careful so as to prevent their children from having access to it and consuming it (AU)
Subject(s)
Humans , Female , Child , Nicotine/adverse effects , Nicotine/toxicity , Accidents, Home/trends , Alkaloids/adverse effects , Alkaloids/toxicity , Poisoning/diagnosis , Poisoning/therapy , Charcoal/therapeutic use , Electrocardiography , Retrospective Studies , Signs and Symptoms , Vomiting/complications , Vomiting/etiology , Dizziness/complications , Dizziness/etiology , Foodborne Diseases/therapy , Tachycardia/complications , Heart Rate , Heart Rate/physiologyABSTRACT
OBJECTIVES: To determine the incidence and prevalence of type 1 diabetes in children younger than 15 yr in the Autonomous Community of Castilla-Leon (Spain). RESEARCH DESIGN AND METHODS: All type 1 diabetic cases with onset at <15 yr of age were recorded during 2003-2004. Identified case subjects were ascertained from several sources and the capture-recapture method was used to estimate the completeness of ascertainment. For prevalence, all patients younger than 15 yr with type 1 diabetes at the beginning and at the end of the study were identified. RESULTS: Over the study period, 130 children aged 0-14 yr were diagnosed with type 1 diabetes. The average observed incidence of type 1 diabetes in this population was 22.22/100 000/yr (95% CI 14.57-29.81). Age-standardized incidence was 22.01/100 000/yr (95% CI 18.18-25.83). The highest incidence was observed in the 5-9 yr age-group (32.45/100 000/yr, 95% CI 24.31-40.59). The prevalence at the beginning and at the end of the study was 1.01/1000 and 1.18/1000, respectively. CONCLUSION: Castilla-Leon appears to have one of the highest incidences of childhood type 1 diabetes in Spain, with recent incidence approaching those of some northern European countries.
Subject(s)
Diabetes Mellitus, Type 1/epidemiology , Adolescent , Age Distribution , Child , Child, Preschool , Female , Humans , Incidence , Male , Prevalence , Spain/epidemiologyABSTRACT
INTRODUCTION: The incidence of type 1 diabetes shows wide geographical variability and heterogeneity. The aim of this study was to determine the incidence and prevalence of type 1 diabetes in children and adolescents ages less than 15 years in the different provinces of Castilla-León. MATERIAL AND METHODS: To determine incidence, all new cases of type 1 diabetes with onset under 15 years of age in 2003-2004 were obtained. Incidence was expressed as the crude value with the corresponding confidence interval and as standardized incidence. The capture-recapture method was used to calculate the completeness of ascertainment. To determine prevalence, all cases of type 1 diabetes in persons ages less than 15 years at 31 December 2004 were obtained. RESULTS: Incidence showed wide variability among the different provinces of Castilla-León. The highest values were found in Segovia (38.77/100,000/year), Valladolid (32.07/100,000/ year) and Avila (23.21/100,000/year) and the lowest in Zamora (8.14/100,000/year). Incidences were highest in the 5-9 years age group in all provinces except Burgos. Prevalence was highest in Segovia (1.54/1,000), Valladolid (1.41/1,000), Avila (1.38/1,000) and Zamora (1.32/1,000) and lowest in Burgos (0.91/1,000). CONCLUSIONS: Castilla-León seems to have one of the highest incidences of type 1 diabetes in Spain; several of its provinces have values similar to those in Northern Europe.
Subject(s)
Diabetes Mellitus, Type 1/epidemiology , Adolescent , Child , Child, Preschool , Humans , Incidence , Prevalence , Spain/epidemiologyABSTRACT
Introducción La incidencia de diabetes tipo 1 presenta gran heterogeneidad y variabilidad geográfica. El objetivo de este estudio es determinar la incidencia y prevalencia de la diabetes tipo 1 en niños menores de 15 años en las distintas provincias de Castilla y León. Material y métodos Para el estudio de la incidencia se recogieron los nuevos diagnósticos de diabetes tipo 1 en menores de 15 años en 2003-2004. La incidencia se expresó como valor crudo con su intervalo de confianza y como incidencia estandarizada. Se utilizó el método captura-recaptura para calcular la exhaustividad. Para el cálculo de la prevalencia se recogieron todos los diabéticos tipo 1 menores de 15 años existentes en Castilla y León a fecha 31 de diciembre de 2004. Resultados Las cifras de incidencia son muy heterogéneas en las diferentes provincias de Castilla y León: las más altas se observaron en Segovia (38,77/100.000/año), Valladolid (32,07/100.000/año) y Ávila (23,21/100.000/año) y las menores en Zamora (8,14/100.000/año). El grupo de edad con mayor incidencia fue el de 5-9 años en todas las provincias excepto en Burgos. La mayor prevalencia se observa en Segovia (1,54/1.000), Valladolid (1,41/1.000), Ávila (1,38/1.000) y Zamora (1,32/1.000) y la menor en Burgos (0,91/1.000). Conclusiones Castilla y León parece tener una de las mayores incidencias de diabetes tipo 1 en España, con cifras en varias de sus provincias similares a las de algunos países nórdicos
Introduction The incidence of type 1 diabetes shows wide geographical variability and heterogeneity. The aim of this study was to determine the incidence and prevalence of type 1 diabetes in children and adolescents ages less than 15 years in the different provinces of Castilla-León. Material and methods To determine incidence, all new cases of type 1 diabetes with onset under 15 years of age in 2003-2004 were obtained. Incidence was expressed as the crude value with the corresponding confidence interval and as standardized incidence. The capture-recapture method was used to calculate the completeness of ascertainment. To determine prevalence, all cases of type 1 diabetes in persons ages less than 15 years at 31 December 2004 were obtained. Results Incidence showed wide variability among the different provinces of Castilla-León. The highest values were found in Segovia (38.77/100,000/year), Valladolid (32.07/100,000/ year) and Ávila (23.21/100,000/year) and the lowest in Zamora (8.14/100,000/year). Incidences were highest in the 5-9 years age group in all provinces except Burgos. Prevalence was highest in Segovia (1.54/1,000), Valladolid (1.41/1,000), Ávila (1.38/1,000) and Zamora (1.32/1,000) and lowest in Burgos (0.91/1,000). Conclusions Castilla-León seems to have one of the highest incidences of type 1 diabetes in Spain; several of its provinces have values similar to those in Northern Europe
Subject(s)
Child , Child, Preschool , Adolescent , Humans , Diabetes Mellitus , Incidence , Prevalence , Spain/epidemiologyABSTRACT
We report a case of a patient with a unilateral slipped upper femoral epiphysis and primary juvenile hypothyroidism. A satisfactory outcome was observed two years after surgery.
Subject(s)
Epiphyses, Slipped/complications , Femur Head , Hypothyroidism/complications , Thyroiditis, Autoimmune/complications , Adolescent , Epiphyses, Slipped/diagnostic imaging , Epiphyses, Slipped/surgery , Female , Humans , Hypothyroidism/diagnosis , Radiography , Thyroid Function Tests , Thyroiditis, Autoimmune/diagnosisSubject(s)
Lupus Erythematosus, Systemic/diagnosis , Pancreatitis/diagnosis , Adolescent , Anti-Bacterial Agents/administration & dosage , Humans , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/therapy , Male , Pancreatitis/etiology , Pancreatitis/therapy , Parenteral Nutrition , Prednisolone/therapeutic use , Tomography, X-Ray ComputedABSTRACT
The relapses and complications happened on the 17 cases of children with acute lymphoblastic leukemia in the Hospital General de Segovia have been reviewed from November 1974 to September 1989. Those which have a higher interest because of their relevance or infrequency have been under discussion. Among the relapses the pulmonary and the testicular are singled out. We differentiate between the complications produced during the treatment and the long-term ones, pointing up varicella as an infectious complication.
Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Chickenpox/etiology , Child , Child, Preschool , Female , Humans , Infant , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Pulmonary Fibrosis/etiology , Pulmonary Fibrosis/pathology , Recurrence , Testicular Diseases/etiology , Testicular Diseases/pathologyABSTRACT
Authors report case histories of four siblings with Munchausen syndrome by proxy. The diagnosis was made in the third daughter after six years. Two siblings had died as result of sudden unexplained death at two years old and twelve month old respectively. The mother had typical features outlined in some report. She denied the provocation of any episode and refused further psychiatric help but she accepted medical supervision. A review of the literature: warning signals, plan of action in order to assess the diagnosis and management of this problem are outlined, establishing a discussion about the repercussion of this syndrome.
