[Hyperfrequent consultations: is there a relationship with the mother's personality?]. / Hiperfrecuentación en las consultas: hay relación con la personalidad de la madre?

OBJECTIVES: To study the psychological profile of mothers who overuse pediatric services and associated social and demographic characteristics, as well as to evaluate the association between maternal personality profile and greater use of pediatric services. MATERIAL AND METHOD: Cross-sectional descriptive study, at the Basic Health Areas of Granollers Sud and Granollers Oest-Canovelles in Barcelona (Spain). SUBJECTS: Forty-four mothers, representing 21.5 % of the population meeting the inclusion criteria were studied. The population consisted of mothers of children who visited the center on an equal or higher number of occasions as two standard deviations. PROCEDURE: One-hour interviews were conducted. A data sheet to assess social and demographic variables, Milton's Multiaxial Inventory II, and Goldberg's Anxiety and Depression Scale to detect symptoms of depression and anxiety were administered. RESULTS: Forty-four mothers (21.5 %) attended the interviews. The mean age was 36.6 years. Most of the mothers (90.9 %) were married, 73 % had completed primary studies, 5 % were housewives, and 75 % had no family support. Fifty percent of the children were the youngest in their family, and 30 % were only children. Concerning personality disorders, 55.8 % of overusing mothers showed compulsive personality, 30.23 % schizoid personality, and 14 % dependent personality while 47.7 % of mothers presented significant symptoms of anxiety. CONCLUSIONS: Sociodemographic profile, anxiety, and maternal personality profile are related to overuse of pediatric services. Compulsive, schizoid and dependent personality disorders seem to be associated with overuse.

Hiperfrecuentación en las consultas: ¿hay relación con la personalidad de la madre? / Hyperfrequent consultations: is there a relationship with the mother's personality

Objetivos: Estudiar el perfil psicológico materno de los niños hiperfrecuentadores de diferentes consultas. Estudiar las características sociodemográficas asociadas. Medir el grado de asociación entre el tipo de personalidad materna y un perfil de mayor demanda de consulta pediátrica. Material y métodos Estudio descriptivo transversal, en las áreas básicas de salud Granollers Sud y Granollers Oest-Canovelles (Barcelona).Se incluyeron 44 madres, que representan el 21,5 per cent de la población con criterios de inclusión. La población eran 205 madres de niños que habían acudido al centro un número de veces igual o superior a dos desviaciones estándar.Se realizaron entrevistas de una hora donde se administrando una hoja de datos para estudiar las variables sociodemográficas, el Inventario Clínico Multiaxial de Millon II (Millon Clinical Multiaxial Inventory Manual II, MCMI-II) y la Escala de Ansiedad y Depresión de Goldberg para la detección de síntomas de depresión y ansiedad. Resultados Asistieron 44 madres, el 21,5 per cent citado. La edad media era de 36,6 años. El 90,9 per cent de las madres estaban casadas, el 73 per cent tenían estudios primarios completos, el 5 per cent eran amas de casa y el 75 per cent no recibía apoyo familiar. Respecto a los hijos, el 50 per cent eran los hermanos pequeños y el 30 per cent eran hijos únicos. En relación con los trastornos de personalidad, el 55,8 per cent de las madres hiperfrecuentadoras presentaban una personalidad compulsiva, el 30,23 per cent personalidad esquizoide y el 14 per cent personalidad dependiente.El 47,7 per cent de las madres mostraban síntomas significativos de ansiedad. Conclusiones Existe relación entre el perfil sociodemográfico antes citado, la ansiedad y el perfil de personalidad materna con la hiperfrecuentación. Parece existir relación entre los trastornos de personalidad compulsiva, esquizoide y dependiente con la hiperdemanda pediátrica materna (AU)

[Bilateral serous retinal detachments in acute posterior multifocal placoid pigmentous epitheliopathy]. / Desprendimientos retinianos serosos bilaterales en la epiteliopatía pigmentaria placoide multifocal posterior aguda.

PURPOSE/METHOD: A particular subtype of acute posterior multifocal placoid pigmented epitheliopathy (APMPPE), different from the classical Gass description, is presented. A 22 year old woman who suffered a sudden decrease in visual acuity associated to bilateral serous retinal detachment concurrent with anterior uveitis is studied. We remark the fact that patient had been using contraceptives and antibiotics (norfloxacin) for the past two months prior to first visit. One month later, visual acuity does not show any recovery. A corticosteroid treatment is prescribed showing improvement. RESULTS/CONCLUSIONS: We believe that although APMPPE usually resolves spontaneously, treatment is needed for clinical subtypes involving serous retinal detachment.

Desprendimientos retinianos serosos bilaterales en la epiteliopatía pigmentaria placoide multifocal posterior aguda / Bilateral serous retinal detachments in acute posterior multifocal placoid pigmentous epitheliopathy

Objetivo/Métodos: Presentamos una forma particular de epiteliopatía pigmentaria placoide multifocal posterior aguda (EPPMPA) que difiere de la descripción clásica de Gass. Exponemos el caso de una paciente de 22 años que presentó una pérdida brusca de agudeza visual asociada a desprendimientos serosos bilaterales de retina y a uveítis anterior. Destacamos la toma de anticonceptivos y antibióticos (norfloxacino) en los dos últimos meses. Después de un mes de evolución y ante la nula recuperación visual de la paciente se instauró tratamiento corticoideo consiguiendo una rápida mejoría. Resultados/Conclusiones: Aunque la EPPMPA suele ser un proceso autolimitado sin tratamiento, en las formas con desprendimientos serosos creemos necesario usar fármacos para la recuperación visual. Planteamos la posibilidad de que haya más fármacos desencadenantes de este cuadro inflamatorio, además de los descritos previamente (AU)

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Moyamoya disease: long term follow-up including a normal pregnancy.

We present a woman with moyamoya disease. The patient was born by prolonged vaginal delivery after a long pregnancy lasting 43 weeks. During her first years of life she depicted poor psychomotor development. When she was 9 years old a diagnosis of moyamoya disease was made. Annual neurologic evaluations have revealed moderate motor deficiency, slurred speech and borderline mental capacity. At 26 years of age she became pregnant and was prophylactically treated with 40 mg/day oral nicardipine. She had a healthy child after an uncomplicated 40 week pregnancy. When she was 33 years old a magnetic resonance (MR) study disclosed a zone of ischemic parenchyma. MR angiography yielded results similar to those of conventional arteriography. At present, the patient is 36 years old, lives a normal life and works in a factory.

[Acute neurologic dysfunction associated with a hypodensity of the basal ganglia]. / Disfunción neurológica aguda asociada a hipodensidad de los ganglios basales.

A previously healthy five years old boy, following a mild nonspecific upper respiratory infection developed, fever (39 degrees C), vomiting, clouding of consciousness and focal seizures. The CSF showed a mononuclear cell reaction with negative bacterial and viral cultures. A cranial CT scan on the 4th day of admission showed bilateral low density lesions on the basal ganglia region. After 30 days of severe involvement of muscle tone (rigidity) which kept the patient immobilized in bed and without a meaningful communication with his surroundings, improvement was noticed. A repeated CT scan 40 days after admission, was considered normal. Two months after the beginning of disease, patient's physical examination was normal. This case shows striking clinical and radiological similarities to the ones described by Aicardi and Goutieres in 1982 and most likely is explained by bilateral basal ganglia edema complicating viral encephalitis. Mumps virus, being so far, the most commonly implicated.

[Neonatal cholestatic icterus simulating atresia of the bile ducts in a patient with alpha-1-antitrypsin deficiency]. / Ictericia colestásica neonatal simulando atresia de vías biliares en un paciente con déficit de alfa-1-antitripsina.

A 40 days old infant with cholestasis is described. The liver was enlarged at 3 cm below the costal margin. No bile ducts were seen at the liver scan (IDA Tc 99) neither bile was collected after cholecystokinine IV administration. Fibrosi, bile ducts proliferation, and cholestasis without intracellular PAS positive material were seen at liver biopsy. Serum alpha-1-antitrypsin level was 42 mg/100 ml. Follow-up was satisfactory after phenobarbital and cholestiramine treatment. Cholestasis decreased and two weeks later bile excretion was obtained after cholecystokinine administration. This stress the importance of alpha-1-antitrypsin determination in cholestasis in infancy.