Double crush syndrome: Epidemiology, diagnosis, and treatment results.

BACKGROUND: Double Crush Syndrome (DCS) is a clinical condition that involves multiple compression sites along a single peripheral nerve. The present study aims to describe the epidemiology of DCS and surgical results. METHODS: A retrospective observational analytic study included patients with clinical diagnosis of cervical radiculopathy and carpal tunnel syndrome who underwent surgery between January 2009 and January 2019. General demographic characteristics were noted, and 3 groups were distinguished: spinal surgery, carpal tunnel release, and bimodal decompression (BD); statistical differences were analyzed between them. RESULTS: The sample comprised 32 patients. DCS prevalence was 10.29%. Mean age at presentation was 59.25±10.98 years. There was female predominance (75%). Paresthesia was the main symptom (65.6%). Post-surgical results of BD showed significant improvement in sensory nerve conduction velocity, motor nerve conduction velocity (both P=0.008), and disability on Douleur Neuropathique 4 questions, Neck Disability Index, and Boston Carpal Tunnel Questionnaire (P=0.001, 0.004, 0.008, respectively). CONCLUSIONS: Diagnosis and management of DCS are a challenge. It is necessary to determine the site with maximal compression and risk of complications to decide on treatment. If first-line surgery is adequate, proximal and distal symptomatology can be improved. To maximize success, we recommend BD, according to the present results.

Enfoque diagnóstico y terapéutico de la eosinofilia. A propósito de un caso / Diagnosis and treatment of eosinophilia. A case report

La eosinofilia es el aumento del número total de eosinófilos por encima de 500/μl. En la edad pediátrica la causa más frecuente es la parasitosis por helmintos; otras causas frecuentes son la ingesta de algunos fármacos y las enfermedades alérgicas. Presentamos el caso de una niña de cinco años con dolor abdominal y analítica con eosinofilia moderada en repetidas ocasiones, sin causa secundaria aparente y con normalidad en el resto de las pruebas complementarias realizadas en el centro de salud y en el hospital de referencia. Ante una eosinofilia persistente sin causa secundaria que la explique y con normalidad de las pruebas complementarias indicadas, se recomienda tratamiento empírico con antiparasitarios (AU)

Eosinophilia is the increased number of eosinophils above 500/μl. The most common cause in pediatric patients is parasitic worm disease; other common causes are ingestion of some drugs and allergic diseases. We present the case of a five year old girl with abdominal pain and moderate eosinophilia in repeated ocasions, without apparent secondary cause, and with normality in other complementary tests in the health center and in the reference hospital. In case of persistent eosinophilia without secondary causes and normal complementary tests, empiric antiparasitic therapy is recommended (AU)

[Multiple sclerosis in childhood: our experience and a review of literature]. / Esclerosis múltiple en la infancia: nuestra experiencia y revisión de la literatura.

INTRODUCTION: Multiple sclerosis (MS) is infrequent in childhood (0.3-2% of all cases of MS). At the present time more and more paediatric patients are being described. In this paper we describe our experience. MATERIAL AND METHODS: We review seven patients diagnosed as having MS before the age of 16, between 1984 and 1996. We have recorded: age, sex, personal and family history, form of onset and clinical course. CSF, neurophysiological and neuroimaging tests, treatment and diagnostic category according to the criteria of Poser. RESULTS: Four boys and three girls aged between three and thirteen years at the onset of the disorder. In one case there was a family history of MS. The most frequent form of onset was hemiparesia, followed by oculomotor paralysis and cerebellar disorders. Six cases followed a recurrent-remittent course and one followed a secondarily progressive course. There were oligoclonal bands (OGB) in the CSF in three cases. Visual evoked potentials (VEP) were abnormal in six cases. Magnetic resonance (RM) was a great help in diagnosis and in six cases was very informative. Six patients were treated with corticosteroids during the acute phase and two with long-term azathioprine. CONCLUSION: The commonest form of presentation, hemiparesia, makes the differential diagnosis with acute hemiplegia of childhood obligatory. Neurophysiological techniques, especially the VEP are very useful for initial assessment. RM is the most sensitive method, although it is not specific for diagnosis. The average follow-up period (4.5 years) is too short to determine the prognosis.

[Prophylaxis of bacterial endocarditis in children with congenital heart disease: current status of parents' knowledge]. / Profilaxis de endocarditis bacteriana en niños con cardiopatía congénita: Estado actual de conocimientos por parte de los padres.

OBJECTIVE: The purpose of this study was to assess the knowledge that parents of children with congenital cardiac disease have about bacterial endocarditis (EB) and its prophylaxis (PEB). PATIENTS AND METHODS: To this end, an elusive questionnaire was prepared and offered to one hundred parents of children who needed PEB. The group was classified according to the age of the children, the cultural level of the parents an the event of a dental or if another septic focus was known in the past. Likewise, the parents' knowledge of their child's disease was analyzed. RESULTS: Of the results obtained, it stood-out that the parents appeared well informed about their child's illness, but their information was insufficient in relationship to EB and PEB. Of those tested, 85% defined the child's heart disease, while only 14% did so for EB. Likewise, only 67.7% of the children who underwent an intervention for a septic focus performed PEB correctly. The knowledge of this theme are in relationship to the family's cultural formation. CONCLUSIONS: We emphasize the need to reinforce the information about PEB that the cardiologists, pediatricians and general physicians give to the families in order to prevent the morbidity and mortality caused by EB.