ABSTRACT
Resumen: Introducción: La sarcoidosis es una enfermedad sistémica de etiología desconocida que raramente se presenta en la infancia. Generalmente afecta los pulmones; sin embargo, puede involucrar diversos órganos. Ocasionalmente afecta el estado general, y origina fiebre, hepatomegalia y esplenomegalia. Caso clínico: Se presenta el caso de un adolescente de doce años de edad con sarcoidosis infantil de inicio tardío, cuyo diagnóstico fue confirmado con un estudio histopatológico de ganglio linfático. El paciente cursó con afección general, hipercalcemia, eritema nodoso, alteraciones pulmonares graves, adenopatías, hepatomegalia y masa testicular. Recibió tratamiento con esteroides, con excelente respuesta clínica. Conclusiones: Se resalta la importancia de considerar el diagnóstico de sarcoidosis en los pacientes con hepatomegalia, adenopatías, daño pulmonar difuso, eritema nodoso, masa testicular e hipercalcemia, así como la necesidad del abordaje multidisciplinario para valorar el compromiso orgánico múltiple y el inicio oportuno de la terapia con esteroides, con el fin de evitar la progresión de la enfermedad.
Abstract: Background: Sarcoidosis is a systemic disease of unknown etiology that rarely occurs in children. It usually affects the lungs, however, it may involve various organs. It occasionally affects the general condition, and causes fever, hepatomegaly and splenomegaly. Case report: We report the case of a twelve-year-old adolescent with late-onset childhood sarcoidosis which diagnosis was confirmed by lymph node histopathological study. The patient presented general condition, hypercalcemia, erythema nodosum, severe lung disorders, lymphadenopathy, hepatomegaly and testicular mass. He received treatment with steroids, with excellent clinical response. Conclusions: We highlight the importance of considering the diagnosis of sarcoidosis in patients with hepatomegaly, lymphadenopathy, diffuse lung damage, erythema nodosum, testicular mass and hypercalcemia, as well as the need for a multidisciplinary approach to assess multiple organ involvement and the early beginning of steroid treatment in order to prevent the progression of the disease.
ABSTRACT
BACKGROUND: Sarcoidosis is a systemic disease of unknown etiology that rarely occurs in children. It usually affects the lungs, however, it may involve various organs. It occasionally affects the general condition, and causes fever, hepatomegaly and splenomegaly. CASE REPORT: We report the case of a twelve-year-old adolescent with late-onset childhood sarcoidosis which diagnosis was confirmed by lymph node histopathological study. The patient presented general condition, hypercalcemia, erythema nodosum, severe lung disorders, lymphadenopathy, hepatomegaly and testicular mass. He received treatment with steroids, with excellent clinical response. CONCLUSIONS: We highlight the importance of considering the diagnosis of sarcoidosis in patients with hepatomegaly, lymphadenopathy, diffuse lung damage, erythema nodosum, testicular mass and hypercalcemia, as well as the need for a multidisciplinary approach to assess multiple organ involvement and the early beginning of steroid treatment in order to prevent the progression of the disease.
ABSTRACT
BACKGROUND: There is a lack of valid health care transition readiness (HCT) scales in Spanish. OBJECTIVE: To provide initial validation of the UNC TRxANSITION Scale™ among Mexican adolescents and young adults (youth) with chronic kidney disease (CKD). METHODS: We used the professionally translated/back translated, provider-administered UNC TRxANSITION Scale™ (Ferris et al., 2012). This 33-question scale measures HCT in ten sub-scales including knowledge about diagnosis or treatment, diet, reproductive health, school/work, insurance, ability to self-manage and looking for new health providers. Its maximum score is 10. We enrolled 163 Mexican adolescents (48.5% females) with CKD stage≥3, mean age of 15.1years (±2.1) and whose primary language is Spanish. There were 15 patients on hemodialysis (9.2%) and 30 transplant recipients (18.4%). Results were compared to those reported in adolescents with chronic conditions from the USA. RESULTS: Our cohort's overall median total score was 5.9. Patients≥16years old had a median total score of 6.4, whereas younger patients had median score of 5.6 (p<0.05). Transplant patients had greater scores in the total and the sub-scales of medication knowledge, issues of reproduction, insurance, trade/work and adherence (p<0.05). When comparing the total score (by age), results from our Mexican youth were similar to those reported in youth from the USA. CONCLUSIONS: In our Mexican cohort of youth with CKD, health care transition readiness is greater in older patients and in transplant recipients. Our cohort's overall score is low, indicating the need for a health care transition preparation program. The UNC TRxANSITION Scale™ results in Mexican youth with CKD are comparable to findings in youth from the USA.
Subject(s)
Outcome Assessment, Health Care , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/therapy , Transition to Adult Care/organization & administration , Adolescent , Adult , Age Factors , Female , Humans , Kidney Failure, Chronic/diagnosis , Kidney Failure, Chronic/therapy , Kidney Transplantation/methods , Kidney Transplantation/statistics & numerical data , Male , Mexico , Program Evaluation , Renal Dialysis/methods , Renal Dialysis/statistics & numerical data , Risk Assessment , Severity of Illness Index , Sex Factors , Translating , Treatment Outcome , Young AdultABSTRACT
Las complicaciones asociadas con el uso de catéteres intravenosos incluyen flebitis, flebitis supurada y septicemia. Sin embargo, se ha prestado poca atención a la duración y características de flebitis en niños. Durante una investigación prospectiva y observacional se estudiaron 1.032 venoclisis instaladas en 342 niños, realizándose el diagnóstico de flebitis en 570 (55.2%) de ellos. La mayoría de los episodios de flebitis se presentaron entre 24 y 48 horas de instalada la venoclisis. Los primeros signos de flebitis aparecieron, en promedio, 24 horas antes de retirarse la venoclisis, resolviéndose aproximadamente después de 60 horas de evolución dejando lesión residual. Diversos factores parecieron predisponer al desarrollo de flebitis, como la presencia de infección en otros órganos y sistemas, de dermatosis y la administración de dicloxacilina por la venoclisis; otros factores se relacionaron con la mayor frecuencia de aparición temprana o prolongación de la fase aguda de la flebitis e incluyeron: instalación de la venoclisis en el pie, utilización de catéteres de teflón, administración de dextrosa al 5% y uso de alimentación parenteral
Subject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Humans , Phlebitis/etiology , Catheterization/adverse effects , Phlebitis/diagnosis , MexicoABSTRACT
La terapia de hidratación oral, se fundamenta en el empleo de una fórmula única recomendada por la Organización Mundial de la Salud, que proporciona en mmol/L: sodio 90, cloro 80, potasio 20, citrato 10 y glucosa 111. Está diseñada para expander el espacio intravascular y reponer el potasio intracelular. Su osmolaridad y concentración proporcional de glucosa y sodio, promueven la óptima absorción de agua y electrolitos. El citrato favorece esta absorción así como la incorporación del potasio a la célula y contribuye a corregir la acidosis y a disminuir los vómitos. La fórmula es útil tanto para prevenir como para corregir la deshidratación, independientemente de la etiología de la diarrea y de la edad del paciente. En este trabajo se revisa el método de hidratación oral en niños con o sin deshidratación por diarrea aguda, se indican las limitaciones del uso del suero oral, las indicaciones de la hidratación por vía endovenosa y el manejo dietético durante la diarrea
