ABSTRACT
El arsénico es un elemento químico del grupo de los metaloides o semimetales presente en el aire, en el agua y en la tierra en forma orgánica o inorgánica. La intoxicación por arsénico puede ser aguda (menos de 14 días de exposición), crónica o arsenicosis (por exposición más de 6 meses) y subcrónica. El ayurveda es un sistema de medicina tradicional india; sus medicinas se dividen en hierbas y rasa-shastra, combinación de hierbas, metales, minerales y gemas. Sus expertos mantienen que, preparadas y administradas apropiadamente, son seguras. Sin embargo, se han demostrado múltiples casos de intoxicación por metales pesados relacionados con su uso. Presentamos un caso clínico de exposición al arsénico secundario a la ingesta mantenida de medicamentos ayurvédicos (AU)
Arsenic is a chemical element that belongs to the group of metalloids or semi-metals, present in air, water and soil in organic or inorganic form. Arsenic poisoning can be acute (fewer than 14 days exposure), chronic (arsenicosis, more than 6 months) or subchronic. Ayurveda is a traditional medical system in which medicines are divided into herbal and rasashastra, combining herbs, metals, minerals and gems. Experts assert that they are safe when properly prepared and administered. However, multiple cases of heavy metal poisoning related to their use have been reported. We present a clinical case of subchronic arsenic poisoning secondary to sustained intake of ayurvedic medicine. (AU)
Subject(s)
Humans , Female , Child , Medicine, Ayurvedic/adverse effects , Arsenic/toxicity , 34709 , Risk Factors , Arsenic/bloodABSTRACT
Dentro de las alergias no mediadas por IgE, la enterocolitis inducida por proteínas alimentarias (FPIES) es el cuadro de mayor gravedad, pudiendo cursar con una clínica muy variada. El FPIES crónico se suele manifestar con letargia, palidez cutánea, desnutrición, vómitos intermitentes y/o diarrea crónica, asociados a múltiples alteraciones analíticas (leucocitosis con desviación a la izquierda, eosinofilia, anemia, trombocitosis, hipoproteinemia, hipoalbuminemia, metahemoglobinemia y acidosis metabólica). La resolución ocurre entre los 3 a 10 días tras la exclusión del alérgeno causante; vuelven a tolerarlo aproximadamente a los 3-5 años de edad. Se presenta el caso clínico de un lactante de 47 días alimentado con fórmula de inicio, que debuta con un cuadro de vómitos y diarreas con deshidratación grave, acidosis metabólica, metahemoglobinemia, hipoproteinemia, hipoalbuminemia e hiperamoniemia, siendo esta última una característica solo referenciada en un caso hasta la actualidad (AU)
Food protein-induced enterocolitis syndrome (FPIES) is the most severe non-IgE-mediated allergies, and has a broad clinical spectrum. Chronic FPIES usually manifests with lethargy, pallor, undernutrition, intermittent vomiting and/or chronic diarrhoea associated with multiple laboratory abnormalities (leucocytosis with left shift, eosinophilia, anaemia, thrombocytosis, hypoproteinaemia, hypoalbuminaemia, methemoglobinemia and metabolic acidosis). It resolves 3 to 10 days after exclusion of the causative allergen, and most patients develop tolerance to the protein again at approximately 3 to 5 years of age. We present the case of a 47-day-old infant who presented with vomiting and diarrhoea with severe dehydration, metabolic acidosis, methaemoglobinaemia, hypoproteinaemia, hypoalbuminaemia and hyperammonaemia, the latter being a feature that has only been described in one other case before. (AU)
Subject(s)
Infant , Enterocolitis/diagnosis , Enterocolitis/etiology , Hyperammonemia/diagnosis , Hyperammonemia/etiology , Infant Formula/adverse effects , Dietary Proteins/adverse effects , Milk Proteins/adverse effects , Diagnosis, Differential , SyndromeABSTRACT
OBJECTIVE: During the SARS-CoV-2 state of alarm (SoA), a 30-70% reduction was observed in the number of visits to Pediatric Emergency Departments (ED), as well as frequent delay in diagnosis or difficulty accessing healthcare services. Here we evaluate modifications observed in pediatric healthcare activity during the SoA. STUDY DESIGN: Descriptive retrospective observational study of the hospital pediatric activity. METHOD: We compared the use of pediatric healthcare services during the SoA (March 11th - June 25th, 2020) versus the use during the equivalent periods of years 2018 and 2019, in the "Complejo Hospitalario Universitario Insular Materno Infantil de Canarias" (Mother and Child University Hospital of the Canary Islands). RESULTS: The number of patients visiting the pediatric ED decreased by 66.75% on average (95%CI: -65.6; - 67.7; p < 0.001), with a peak reduction (70.4%; 95%CI: -69.0; -71.7; p < 0.001) during the lockdown. We observed an increase in the number of cases of psychiatric disorders, foreign body ingestions and intoxications, as well as a decrease in respiratory conditions. Hospital admissions decreased by 45.5% (95%CI: - 38.9; -51.3; p < 0.001), while the ratio and duration of hospital stay increased. A proportion of 3.95% of admitted patients experienced complications caused by delayed visit to the ED. CONCLUSIONS: The study shows that more patient education campaigns are needed to improve the efficiency of emergency services. It is important to reinforce the message that adequate healthcare service management is necessary.
