Fuentes de información de los padres respecto a la salud de sus hijos / Sources of information for parents regarding their children's health

Objetivo: Evaluar la información que los padres buscan sobre la salud de sus hijos. Material y métodos: Estudio descriptivo de la población urbana atendida en un centro de atención primaria por el servicio de pediatría. Durante un periodo de 5 meses, un total de 201 padres que acudían a nuestras consultas rellenaron un cuestionario sobre las fuentes de información que utilizan respecto a la salud de sus hijos. Resultados: El 66% de los padres consulta algún medio de comunicación sobre problemas de salud. Los medios más utilizados son Internet (85%), las revistas especializadas (36%) y la televisión (18%). El 96% de respondedores tiene acceso a la red, y de éstos el 85% tiene conexión en casa. El 67% consultó algún problema médico en Internet durante el último año, y de éstos a un 93% le resultó útil. El 84% de los padres que habían consultado Internet en el último año se informaron por este medio de algún problema de salud antes y/o después de visitar a su pediatra/enfermera. Un 45% de los padres se alarmó después de leer alguna información médica en algún medio de comunicación, y un 65% de éstos consultó a su pediatra o enfermera por este motivo. Un 98% confía más en su pediatra que en Internet. Conclusión: Una elevada proporción de padres tiene acceso a Internet y lo utiliza para obtener información sobre temas de salud de sus hijos. Frecuentemente, esta búsqueda está relacionada con las visitas realizadas al personal sanitario. Los profesionales de la salud deberíamos estar preparados para orientar a los padres en la búsqueda de información en la Red(AU)

Objective: To evaluate the information that parents are looking for about their children’s health. Material and methods: Descriptive study of the urban population attended at a primary care center by the pediatric services. During a 5-month period, a total of 201 parents came to our consultations and filled out a questionnaire about the information sources that they use regarding their children’s health. Results: 66% of the parents consulted some kind of mass media about health issues. The most widely used are Internet (85%), specialized magazines (36%) and television (18%). 96%of respondents have access to the internet; of these 85% have access at their home. 67% consulted for a medical problem on the Internet during the last year, 93% of these found it helpful. 84% of the parents who had accessed Internet got information through this source about any kind of health problem before and or after visiting the pediatrician or nurse. 45% of the parents were alarmed after reading some medical information in mass media and 65% of these, consulted their doctor or nurse about it. A 98% have more confidence in their pediatrician tha non the Internet. Conclusion: A high percentage of parents have Internet access and uses it to obtain information on health issues about their children. This search is often related to visits by health professionals. Health professionals should be prepared on guiding parents to find information on the Internet(AU)

Hemorragias vaginales repuberales. Un dilema diagnóstico de etiología múltiple y pronóstico variable / Prepubertal vaginal bleeding. A diagnostic dilema of multiple etiology and variable prognosis

Introducción y justificación. La hemorragia genital en la niña sin signos de desarrollo puberal, es motivo de alarma y consulta urgente, que plantea un dilema diagnóstico, dada la diversidad etiológica. Una casuística amplia, que incluye observaciones de menarquia prematura, seguida a lo largo plazo, nos permitirá valorar su frecuencia e importancia, los procedimientos diagnósticos, el tratamiento y el pronóstico final. Material y métodos. Abarca 143 observaciones de hemorragia vaginal en niñas sin otros signos de desarrollo sexual, de las cuales ocho presentaron menarquia prematura y hemorragia vaginal recidivante. En todas se realizó anamnesis, examen físico, que incluyó exploración ginecológica y vaginoscopia, estudio bacteriológico y citológico y ecografía abdominopelviana. En ausencia de etiología independiente de alteraciones hormonales, se practicaron, entre otras, determinaciones hormonales basales, test de LH-RH, secreción nocturna de gonadotropinas y RMN del área hipotálamo-hipofisaria. Resultados y conclusiones. La hemorragia vaginal en niñas sin signos de madurez tiene una diversidad etiológica, cuya causa más frecuente son las infecciones vulvovaginales, seguidas, en un número más limitado de traumatismos, cuerpos extraños y otros desórdenes. La menarquia precoz, seguida de hemorragia vaginal recurrente, es un proceso autolimitado posiblemente ocasionado por una activación transitoria e incompleta del eje hipotálamo-hipofisario (AU)

Introduction and justification. Genital bleeding in girls without signs of pubertal development is cause of alarm and prompt consultation, causing a diagnostic dilema given its high etiological diversity. A high casuistry, including the observation and long-term follow up of cases of premature menarche, will allow us to assess the frequency, relevance, diagnostic procedures, treatment and prognosis of this entity. Material and methods. It covers the observation of 143 cases of genital bleeding in girls without presented premature menarche and recurring vaginal bleeding. In all the cases we performed anamnesis and physical exam, including gynecological and vaginoscopy, citology, bacteriological study and pelvic and abdominal ultrasound. When non-hormone measurement levels, LHRH test, evaluation of gonadotropin secretion during sleep and NMR of the hypothalamus-hypophyseal area. Results and conclusions. Genital bleeding in girls with-out signs of pubertal development has a high etiological diversity. The most frequent causes are vulvovaginal infections, followed in a lower number of cases by traumatisms, foreign by recurring vaginal bleeding, is a self-limited process possibly originated in the transitory and incomplete activation of the hypothalamus-hypophysisasis (AU)

Soft tissue Burkitt's lymphoma: radiological findings.

An unusual case is reported of a soft tissue mass in the lower extremity, without bone involvement, in an 85-year-old woman; the histopathological diagnosis was Burkitt's lymphoma. Pertinent clinical history, histological examination, and imaging procedures allowed early diagnosis. To our knowledge, the radiological findings in Burkitt's lymphoma with this unusual clinical presentation have not been described previously.

[Condyloma acuminatum in children]. / Condiloma acuminado en niños.

A retrospective study of eleven children affected of condyloma acuminatum is presented. Authors evaluated: age of presentation and consulting, sex, social history, predisposing factors, characteristic and extension of disease, previous venereal diseases, microscopic pathology, treatment and follow up. Age presentation ranged between 1.5 months and 14 years old. Two were male and nine were female. In two cases obvious sexual abuse was demonstrated; close contact without sexual goals in four; in two transmission during labor existed; early sexual activity in one and they didn't evidence mechanism of transmission in two. Predisposing factors include social problems, lack of hygiene, promiscuity, diabetes, ammoniacal erythema and others. Culture was positive for gonococcus in two children. VDRL test was negative in all cases. All of them were treated with 5% 5-fluorouracil cream. Recovery oscillated between seven and twenty-one days, without adverse reactions, except reddening of adjacent skin.

Imipenem/cilastatin vs. gentamicin/clindamycin for the treatment of moderate to severe infections in hospitalized patients.

Imipenem/cilastatin was compared with the combination of gentamicin plus clindamycin in terms of efficacy and safety for the treatment of moderate to severe infections in an open, randomized study. The rates of cure achieved with the two regimens were similar. Gentamicin/clindamycin treatment failed only in two of four instances of severe infection. Patients given imipenem/cilastatin seemed to respond more rapidly to treatment; this observation applied both to the entire group treated and to the subgroup with moderate intraabdominal infections. Susceptible etiologic agents were more frequently eradicated by imipenem/cilastatin (95%) than by gentamicin/clindamycin (79%). The most common adverse reactions were nausea or vomiting in patients given imipenem/cilastatin and urinary abnormalities in those given gentamicin/clindamycin. Self-limited diarrhea was observed with equal frequency in the two groups. No adverse reactions required the discontinuation of treatment. Colonization or superinfection with resistant organisms and Pseudomonas aeruginosa occurred significantly more often among patients given gentamicin/clindamycin. These results suggest that imipenem/cilastatin is a promising alternative to the combination of gentamicin and clindamycin for the treatment of moderate to severe infections in hospitalized patients.