Tumoración genital interlabial en recién nacida / Genital interlabial mass in newborn girl

El himen imperforado es una rara malformación congénita que ocurre en el 0,1% de los recién nacidos; sin embargo, es la anomalía obstructiva más frecuente del aparato genital femenino. Suele presentarse de forma esporádica y aislada, pero en ocasiones se puede presentar asociado a otras malformaciones, principalmente genitourinarias. Hay dos picos de máxima incidencia: en el periodo neonatal y en la adolescencia. Debido a las múltiples complicaciones que puede presentar, es importante un diagnóstico precoz, preferentemente en la etapa neonatal. El tratamiento es siempre quirúrgico. Presentamos el caso de una recién nacida que en la exploración en las primeras horas de vida presenta una tumoración genital interlabial

The imperforate hymen is a rare congenital malformation that occurs in 0.1% of newborns; however, is the most frequent obstructive anomaly of the female genital tract. It usually occurs sporadically and isolated, but sometimes it can occur associated with other malformations, mainly genitourinary. There are two peaks of maximum incidence: neonatal and in adolescence. Due to the multiple complications that can present, an early diagnosis is important, preferably in the neonatal stage. The treatment is always surgical. We present the case of a newborn girl with a genital interlabial mass detected in the first hours of life

The Use of the Fracture Risk Assessment (FRAX®) Tool in Predicting Risk of Fractures in Patients With Inflammatory Bowel Disease: A Systematic Review.

Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is associated with an increased prevalence of osteoporosis and osteopenia. We aim to evaluate the use of the World Health Organization Fracture Risk Assessment (FRAX®) tool in these patients to assess 10-yr risk of fracture. Electronic searches were performed with key words relating to IBD and FRAX in the MEDLINE, EMBASE, and SCOPUS databases. Summary estimates were calculated. A fixed or random-effects model was used depending on heterogeneity (I2). The search yielded 146 references; 7 that included research carried out in adult patients, were used in the systematic review and quantitative summary. No significant publication bias was noted according to the Harbord test. The 10-yr probability of hip and major osteoporotic fracture in adult IBD patients was 1.03% (95% confidence interval [CI]: 0.37%-2%; I2 = 0%) and 4.05% (95% CI: 2.61%-5.79%; I2 = 49%), respectively. In those patients with Crohn's disease, hip and major osteoporotic fractures calculated with FRAX increased to 1.74% (95% CI: 0.42%-3.93%; I2 = 37.5%) and 6.65% (95% CI: 2.97%-11.66%; I2 = 8.7%), respectively. Risks of fracture in adults with ulcerative colitis were provided by a single study only. The FRAX tool has been limitedly used in patients with IBD; however, the evidence currently available only shows a modest increase in the 10-yr risks of bone fracture and does not support unequivocally the need for specific interventions. Further well-designed studies are needed to confirm the results obtained from this systematic review.

Efficacy of Dietary Treatment for Inducing Disease Remission in Eosinophilic Gastroenteritis.

OBJECTIVES: Various dietary interventions have been used to treat patients with eosinophilic gastroenteritis (EGE). Concrete evidence as to the effectiveness of such treatments in inducing disease remission is, however, lacking. The aim of the study was to systematically review the efficacy of dietary therapies in inducing EGE remission. METHODS: We performed a systematic search for the MEDLINE, EMBASE, and SCOPUS libraries for studies investigating the efficacy of dietary interventions (in both histological and symptomatic remission) for children and adults with EGE and colitis. RESULTS: The search yielded 490 references; 30 were included in the review, with most of these references being "low-quality" individual cases or short case series. No significant publication bias was found. Elemental diets in children were linked to 75.8% of clinical improvement, but few of these patients underwent a histological evaluation. Allergy-testing results have been used scarcely in EGE. Empiric elimination of allergy-associated foods was the most commonly used option. The variable results in terms of symptom relief, however, were scarcely accompanied by histological confirmation. Clinical and methodological heterogeneity hindered the performance of quantitative summaries for the efficacy of dietary therapies in inducing disease remission. CONCLUSIONS: Symptomatic improvements reported for dietary treatment in EGE by most of the available literature are questionable because of the lack of objective evaluation of clinical changes and the very limited assessment of histological remission. Because of the relative lack of well-designed, high-quality studies, the unequivocal use of dietary treatment for patients with EGE and colitis cannot be supported. Further research should be undertaken.