ABSTRACT
El desarrollo de la ecocardiografía fetal en los últimos años ha convertido a esta técnica en la principal modalidad para el diagnóstico y abordaje prenatal de la patología cardiaca fetal. El ecocardiograma nos permite diagnosticar la existencia de problemas estructurales, además de inferir e! mecanismo e!ectrofisiológico de las arritmia s fetales, así como la necesidad de iniciar el tratamiento médico en caso de ser este necesario. En esta monografía se presentan los resultados acaecidos en nuestro centro en los últimos 11 años. Se realizaron en la Sección de Cardiología Pediátrica de nuestro centro 6.246 ecocardiografías fetales. La edad materna fue 31 +/- 5 años y la edad gestacional en e! momento de la prueba de imagen de 24 +/- 5 semanas. Se detectaron un total 317 cardiopatías congénitas lo que representa un 5,07% de todas las exploraciones. Las cardiopatías congénitas diagnostícadas más frecuentementediagnosticadas fueron la comunicación interventricular ICIV) en un 31,5% de los casos, seguida de la tetralogía de Fallot en un 13,8% de los casos y de! síndrome de corazón izquierdo hipoplásico con un 13,5% de los casos. En conclusión la ecocardiografía fetal permite e! diagnóstico preciso de la mayor parte de las cardiopatías congénitas permitiendo realizar un diagnóstico preciso, establecer el pronóstico y preparar la estrategia adecuada (AU)
The development of the fetal echocardiography in recent years has con verted this technique in the main modality for prenatal diagnosis and approach of fetal heart disease. The echocardiogram allows us to diagnose the existence of structural problems and to deduce the e!ectrophysiological mechanism of fetal arrhythmias as well as the need to initiate medical treatment if necessary. The results occurring in our center in the last 11 years in are presented in this monograph. A total of 6246 fetal echocardiographies were performed in the pediatric cardiology section of our center. Maternal age was 31 +/- 5 years and gestational age at the time of the imaging test was 24 +/- 5 weeks. A total of 317 congenital heart diseases were detected, this representing 5.07% of all the studies. The congenital Heart diseases most frequently diagnosed were interventricular communication in 31.5% of the cases followed by Fallot's Tetralogy in 13.8% of the cases and hypoplastic left heart syndrome accounting for 13.5% of the cases. In conclusion, fetal echocardiography permits the precise diagnosis of most of the congenital heart diseases, making it possible to perform an exact diagnosis, establish the prognosis and prepare the adequate strategy (AU)
Subject(s)
Adult , Child , Female , Humans , Male , Heart Defects, Congenital/diagnosis , Prenatal Diagnosis/instrumentation , Prenatal Diagnosis/methods , Ultrasonography, Prenatal/methods , Fetal Diseases/epidemiology , Fetal Diseases , Heart Defects, Congenital/physiopathology , Heart Defects, Congenital , Prenatal Diagnosis , Tetralogy of Fallot , Slit Ventricle Syndrome , Prognosis , Quality of LifeABSTRACT
No disponible
Subject(s)
Humans , Male , Child , Cardiac Tamponade/etiology , Cardiac Tamponade/prevention & control , Central Venous Catheters/adverse effectsABSTRACT
Describimos el caso de una niña con enfermedad de Chagas congénita. Su diagnóstico se realizó a los 8 meses de edad por persistencia de la serología positiva, ya que no estaba disponible la reacción en cadena de la polimerasa (PCR) para esta enfermedad al nacimiento. Se trató a la paciente con benznidazol durante 60 días, sin que presentara reacciones adversas ni toxicidad. La serología disminuyó tras el tratamiento. Es importante detectar estos casos pediátricos lo antes posible. Para ello, debe realizarse un cribado de serología a Chagas en mujeres gestantes procedentes de áreas endémicas que emigran a Europa y, si es positiva, realizar una PCR y una serología en el niño (AU)
We present the case of a child affected by congenital Chagas disease. Her serologys for the detection of Chagas persisted positive and she was diagnosed and treated at the age of 8 months. Chagas PCR was not available. She was treated with benznidazole for 60 days, without secondary effects or toxicity. After treatment her serologies decreased. It is important to detect these children as soon as possible. That is the reason why Chagas screening tests should be performed in pregnant women who come from endemic areas and emigrate to European countries and if it is positive, to do a PCR and serological tests to the child (AU)
Subject(s)
Humans , Female , Child, Preschool , Chagas Disease/complications , Chagas Disease/diagnosis , Chagas Disease/pathology , Polymerase Chain Reaction/instrumentation , Polymerase Chain Reaction/methods , Trypanosoma cruzi/parasitology , Trypanosoma cruzi/pathogenicity , Enzyme-Linked Immunosorbent Assay/instrumentation , Enzyme-Linked Immunosorbent Assay/methodsABSTRACT
La hiperglucemia es un motivo cada vez más frecuente de consulta en pediatría. Su enfoque diagnóstico depende del contexto en el que se encuentre. Bajo la denominación de diabetes se incluyen numerosas entidades clínicas distintas. La diabetes tipo MODY (maturity onset diabetes of the young) es, tras la diabetes tipo 1, el tipo de diabetes más frecuente en la infancia. Para su diagnóstico es necesario un alto índice de sospecha, y es fundamental tener en cuenta la historia familiar (AU)
Hyperglycemia is an increasing cause of consultation in Paediatrics. Diagnosis depends on the context. Under the name of diabetes numerous clinical entities are included. MODY (maturity onset diabetes of the young) is, after type 1 diabetes, the most frequent cause of diabetes in childhood. For its diagnosis, a high degree of suspicion is needed and we have to be aware of the family history (AU)
Subject(s)
Humans , Male , Child , Hyperglycemia/complications , Hyperglycemia/diagnosis , Hyperglycemia/etiology , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 1/therapy , Blood Glucose/analysis , Blood Glucose/physiology , Autoimmunity/physiologyABSTRACT
In the last decade treatment of hyperlipidemia has changed substantially due to the use of statins, a group of drugs that inhibit the enzyme hydroxymethylglutaryl coenzyme-A-reductase (HMG-CoA reductase). Its use has been proven to be efficient and safe in adults, and could also be of benefit in the treatment of hypercholesterolemia in children. Up to date, six of these drugs have been used in children: lovastatin, fluvastatin, pravastatin, simvastatin, atorvastatin and more recently, rosuvastatin. In some of these studies the follow-up has been up to three years and, as regards their use during childhood, we can conclude that they are safe as well as efficient in reducing the blood levels of total cholesterol (TC) and low-density lipoproteins cholesterol (LDL-C).
Subject(s)
Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hypercholesterolemia/drug therapy , Child , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effectsABSTRACT
En la última década el tratamiento de las hiperlipidemias se ha modificado sustancialmente debido a la introducción de las estatinas, fármacos inhibidores de la enzima hidroximetilglutaril-coenzima A (HMG-CoA) reductasa. Su uso ha sido demostrado como eficaz y seguro en adultos, por lo que podría ser también beneficioso para el tratamiento de las hipercolesterolemias durante la infancia. Hasta el momento, seis han sido utilizadas en población infantil: lovastatina, fluvastatina, pravastatina, simvastatina, atorvastatina y más recientemente rosuvastatina. En algunos de estos estudios el seguimiento ha sido de 3 años y, sobre su uso en la infancia, puede concluirse que a la vez de seguras, son muy eficaces para reducir las concentraciones tanto de colesterol total (CT) como de colesterol de las lipoproteínas de baja densidad (c-LDL) en sangre (AU)
In the last decade treatment of hyperlipidemia has changed substantially due to the use of statins, a group of drugs that inhibit the enzyme hydroxymethylglutaryl coenzyme-A-reductase (HMG-CoA reductase). Its use has been proven to be efficient and safe in adults, and could also be of benefit in the treatment of hypercholesterolemia in children. Up to date, six of these drugs have been used in children: lovastatin, fluvastatin, pravastatin, simvastatin, atorvastatin and more recently, rosuvastatin. In some of these studies the follow-up has been up to three years and, as regards their use during childhood, we can conclude that they are safe as well as efficient in reducing the blood levels of total cholesterol (TC) and low-density lipoproteins cholesterol (LDL-C) (AU)
Subject(s)
Humans , Male , Female , Child , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Anticholesteremic Agents/therapeutic use , Hypercholesterolemia/drug therapy , Hyperlipidemias/drug therapy , Arteriosclerosis/epidemiology , Arteriosclerosis/prevention & control , Risk FactorsABSTRACT
Hyperglycemia is an increasing cause of consultation in Paediatrics. Diagnosis depends on the context. Under the name of diabetes numerous clinical entities are included. MODY (maturity onset diabetes of the young) is, after type 1 diabetes, the most frequent cause of diabetes in childhood. For its diagnosis, a high degree of suspicion is needed and we have to be aware of the family history.
Subject(s)
Diabetes Mellitus, Type 2/complications , Hyperglycemia/etiology , Adolescent , Child , Humans , MaleABSTRACT
No disponible
Subject(s)
Male , Infant, Newborn , Humans , Femur/abnormalities , Diagnosis, Differential , Femur , Femur/surgery , Orthopedic Procedures/methodsABSTRACT
INTRODUCTION: Listeria monocytogenes is a rare cause of bacterial meningoencephalitis in the non-immunocompromised pediatric population. On occasions, the absence of differential characteristics with other bacteria that cause meningitis delays diagnosis and hence treatment, worsening the prognosis. CASE REPORT: We present a case of a previously healthy, non-immunocompromised teenager who was admitted to hospital with meningitis caused by Listeria. DISCUSSION: We review the literature related to this case, noting the increasing incidence of this microorganism in the etiopathogenesis of meningoencephalitis, reason for which it has to be kept in mind in the differential diagnosis at the time of admission.
Subject(s)
Listeriosis , Meningitis, Bacterial/microbiology , Adolescent , Humans , Listeriosis/diagnosis , Male , Meningitis, Bacterial/diagnosisABSTRACT
Introducción. Listeria monocytogenes es una causa de meningoencefalitis bacteriana poco frecuente en la población pediátrica no inmunoafectada. En ocasiones, la ausencia de características diferenciales con otras bacterias causantes de meningitis retrasa el diagnóstico y, con ello, el tratamiento, lo que ensombrece el pronóstico. Caso clínico. Se presenta el caso de un adolescente sano, no inmunodeprimido, que ingresó en nuestro hospital con una meningoencefalitis por Listeria. Discusión. Además, se realiza una revisión de la bibliografía relacionada con el caso, haciendo hincapié en la incidencia ascendente de este microorganismo en la etiopatogenia de la meningoencefalitis, lo que debe tenerse en cuenta en el momento del ingreso, para el diagnóstico diferencial de esta entidad (AU)
Introduction. Listeria monocytogenes is a rare cause of bacterial meningoencephalitis in the non-immunecompromised pediatric population. On occasions, the absence of differential characteristics with other bacteria that cause meningitis delays diagnosis and hence treatment, worsening the prognosis. Case report. We present a case of a previously healthy, non-immunecompromised teenager who was admitted to hospital with meningitis caused by Listeria. Discussion. We review the literature related to this case, noting the increasing incidence of this microorganism in the ethiopathogenesis of meningoencephalitis, reason for which it has to be kept in mind in the differential diagnosis at the time of admission (AU)
Subject(s)
Male , Humans , Adolescent , Listeriosis , Meningitis, BacterialABSTRACT
No disponible
Subject(s)
Child, Preschool , Humans , Adolescent , Male , Telephone , Lightning Injuries , Recurrence , ParotitisABSTRACT
Se presenta el caso de una adolescente sana que, como consecuencia de una deshidratación secundaria a un episodio de gastroenteritis aguda, manifiesta un cuadro compatible con necrosis tubular aguda (NTA), con buena evolución posterior. En la población infantil, esta entidad es, mayoritariamente, postisquémica, debido a hipoperfusión y fallo prerrenal prolongado que, al no ser corregido con prontitud, evoluciona de forma insidiosa a fracaso renal intrínseco. A pesar de estar descrito en la bibliografia, lo infrecuente del caso en la actualidad, debido a las pautas establecidas de rehidratación oral, obliga a reflexionar sobre la necesidad de una mayor atención en los pacientes de riesgo (diarrea o vómitos cuantiosos), para diagnosticar de forma precoz las lesiones prerrenales y corregirlas adecuadamente, evitando así un daño mayor. Se resumen las causas de fracaso renal agudo (FRA) en la población infantil; realizándose un diagnóstico diferencial entre las más frecuentes. Asimismo, se describe brevemente la fisiopatología de la NTA. (AU)
Subject(s)
Adolescent , Female , Humans , Kidney Tubular Necrosis, Acute/diagnosis , Diagnosis, Differential , Kidney Tubular Necrosis, Acute/etiology , Gastrointestinal Diseases/complicationsABSTRACT
No disponible
Subject(s)
Child , Male , Humans , Parvovirus B19, Human , Parvoviridae Infections , Red-Cell Aplasia, Pure , Blood Cell Count , ErythroblastsABSTRACT
Management of neonatal hyperglycemia is complex, especially in immature newborns. Etiology is diverse, the most frequent cause being iatrogeny. Neonatal diabetes mellitus is a rare cause of hyperglycemia during the first days of life. Insulin treatment is sometimes required to control the condition. When insulin requirements exceed 2I U/kg/day insulin resistance syndrome should be suspected. We present the case of a newborn infant with Donohue syndrome, or leprechaunism, which is a rare, genetically determined dysmorphic syndrome leading to significant insulin resistance.
Subject(s)
Hyperglycemia/complications , Hyperinsulinism/complications , Abnormalities, Multiple , Humans , Hyperglycemia/etiology , Hyperinsulinism/etiology , Infant, Newborn , Insulin Resistance , Male , SyndromeABSTRACT
La hiperglucemia neonatal es un cuadro de complejo tratamiento sobre todo en recién nacidos inmaduros. La etiología es muy variada, aunque la causa más frecuente suele ser la yatrogénica. La diabetes mellitus neonatal es una causa rara de hiperglucemia en los primeros días de vida, que en ocasiones necesita tratamiento insulínico para su control. Cuando los requerimientos de insulina sobrepasan las 2 U/kg/día hay que sospechar un síndrome de resistencia a la insulina. Se presenta el caso de un recién nacido con un síndrome de Donohue o leprechaunismo que es un raro síndrome dismórfico de causa genética y que determina una importante resistencia a la insulina (AU)
Subject(s)
Male , Infant, Newborn , Humans , Syndrome , Abnormalities, Multiple , Hyperinsulinism , Hyperglycemia , Insulin ResistanceABSTRACT
OBJECTIVE: To present the use of intrapleural urokinase as an alternative to surgical management of complicated pleural effusions in children. To add new cases to the literature and set bases for the development of a standardized protocol. METHOD: Presentation of three cases in children under three years of age treated with intrapleural urokinase. RESULTS: Resolution of the effusions with lack of adverse effects. CONCLUSION: Treatment of pleural effusions when loculations develop. This invasive approach might be avoided in some cases by instillation of a fibrinolytic agent such as urokinase into the pleural space, this being an efficient and safe procedure.
