Cirugía cardíaca en niños con síndrome de Down. ¿Conflicto médico o moral? / Heart surgery in children with Down´s syndrome. Medical or moral conflict?

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[Sessions of clinical anatomy in Mexico at the dawn of the 21st century]. / Las sesiones anatomoclínicas en México en los albores del siglo XXI.

The authors present a defense of postmortem clinical anatomy sessions, which contributed enormously to the development of clinical medicine but which today draw little interest in medical studies. Nevertheless, the sessions still provide an unrivalled exercise in diagnosis for medical students and an excellent method of continuing education for practicing professionals. Autopsies make it possible to confirm or correct clinical diagnoses, including those obtained through highly complex technological procedures; they contribute to the discovery of new diseases and other abnormalities; they promote research; they provide reliable statistics on morbidity and mortality; they produce useful genetic information; they facilitate interdisciplinary discussion and knowledge exchange; and they can serve as an indicator of the quality of medical care. The authors recommend reviving the high academic standards of postmortem clinical anatomy sessions and urge professionals in health institutions to contribute as much as possible to the continuation and improvement of these sessions.

[Status epilepticus in children. Study of 70 cases]. / Estado epiléptico en niños. Estudio de 70 casos.

We presented the experience at the Emergency Unit of the National Institute of Pediatrics with children with Status Epilepticus (SE). This series studied 70 patients, the greatest frequency was seen among infants (55%), followed by preschool children (17%). The most frequent type of SE was generalized tonic clonic (54%) also being the most critical. The simple partial status or epilepsia partialis continua was found to be another frequent variety. In newborns babies the most common type of SE was generalized tonic. Sixty percent originated as acute process, their main causes were central nervous infections, ischemic-hypoxic encephalopathy, intracranial hemorrhages and intoxications. The remaining 40% were due to chronic processes, the most important was secondary epilepsy. Among these children the main cause was the irregular use of antiepileptic drugs. Other factors were intercurrent infections with fever, head trauma and hyponatremia. Only 12.8% of the cases were idiopathic. Fifteen percent of the SE were successfully treated with diazepam; 44% with phenytoin plus phenobarbital, in 34.2% we used generalized anesthesia with thiopental. In 33% of the acute cases os SE there were sequelae, there were nine deaths (12.8%) all of them with serious illness of the central nervous system.