RESUMO
No disponible
Assuntos
Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Humanos , Comorbidade , Malária/complicações , Malária/diagnóstico , Malária/terapia , Doenças Transmissíveis/complicações , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/mortalidade , Doenças Respiratórias/complicações , Doenças Respiratórias/diagnóstico , Malária/epidemiologia , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/diagnóstico , Tuberculose/complicações , Tuberculose/diagnóstico , Hepatite/complicações , Hepatite/diagnóstico , Ascaris lumbricoides/isolamento & purificação , Ascaris lumbricoides/parasitologia , Emigração e Imigração/tendênciasRESUMO
No disponible
Assuntos
Masculino , Recém-Nascido , Humanos , Sepse/complicações , Sepse/diagnóstico , Sepse/mortalidade , Herpes Simples/complicações , Herpes Simples/diagnóstico , Herpes Simples/mortalidade , Insuficiência Hepática/complicações , Insuficiência Hepática/diagnóstico , Hemorragia/complicações , Mortalidade Infantil/tendências , Necrose , Hemocromatose/complicações , Infecções/complicaçõesRESUMO
No disponible
Assuntos
Feminino , Pré-Escolar , Humanos , Acetaminofen/intoxicação , Acetilcisteína/uso terapêutico , Anti-Inflamatórios não Esteroides/intoxicação , AntídotosRESUMO
INTRODUCTION: Acute thoracic syndrome (pneumonia and/or lung infarction) is a significant cause of morbidity and mortality in sickle cell anemia. OBJECTIVE: To review the clinical manifestations, management and outcome of episodes of acute thoracic syndrome in our hospital. METHODS: We performed a retrospective review of all the episodes of acute thoracic syndrome diagnosed at our center in patients younger than 18 years of age with sickle cell anemia. Clinical, laboratory and radiological findings, outcome and treatment were analyzed. Data from patients < 3 years and > 3 years of age were compared (Fisher's exact test and the Mann-Whitney U test). RESULTS: Twenty-three episodes of acute thoracic syndrome were evaluated in eight out of 12 patients with sickle cell anemia followed-up in our hospital. These episodes represented 36 % of the total time of admission in these patients. The most frequent cause was infection. The most frequent symptoms were fever (87 %), cough (61 %) and cold (35 %) symptoms. Seventy-four percent of the patients were not diagnosed at admission, either because the chest X-ray was normal (52 %) or because it was not performed (22 %) due to the absence of pulmonary manifestations. Patients aged more than 3 years old had more severe episodes, with greater clinical compromise and radiological involvement and increased use of analgesia. Transfusions were administered in 65 % of the episodes and in five patients (> 3 years) a partial exchange transfusion was performed. In five patients corticoid treatment was associated with febrile relapses. CONCLUSIONS: Acute thoracic syndrome is frequent in sickle cell disease and is more severe in children older than 3 years. Its diagnosis requires a high index of suspicion, due to multiple forms of clinical presentations and normal chest radiology at admission.
Assuntos
Anemia Falciforme/complicações , Pneumonia/complicações , Embolia Pulmonar/complicações , Doença Aguda , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , SíndromeRESUMO
Introducción: El síndrome torácico agudo (neumonía y/o infarto pulmonar) es una causa importante de morbimortalidad en la drepanocitosis. Objetivo: Revisar la sintomatología y el manejo de estos episodios en nuestro medio y estudiar las posibles diferencias por grupos de edad. Métodos: Revisión restrospectiva de todos los episodios de síndrome torácico agudo diagnosticados en nuestro hospital en pacientes menores de 18 años con drepanocitosis, y analizar los hallazgos clínicos, analíticos, radiológicos, evolutivos y de tratamiento. Se compararon los datos entre los menores y mayores de 3 años (test exacto de Fisher y U de Mann-Whitney). Resultados: Se evaluaron 23 episodios en 8 de 12 pacientes controlados por drepanocitosis. Los episodios representaron el 36% del tiempo total de ingreso en estos pacientes. La etiología predominante fue la infección. Los síntomas más frecuentes fueron fiebre (87 %), tos (61 %) y síntomas catarrales (35 %). El 74% de los pacientes no fueron diagnosticados al ingreso, bien porque la radiografía de tórax era normal (52 %) o no se realizó (22 %) al no presentar sintomatología pulmonar. Los mayores de 3 años tuvieron episodios más graves, con mayor compromiso radiológico y clínico y mayor empleo de analgesia. Se administraron transfusiones en el 65 % de los episodios y en cinco (> 3 años) se realizó exanguino-transfusión parcial. El tratamiento con corticoides en 5 pacientes se asoció a recaídas febriles. Conclusiones: El síndrome torácico agudo es frecuente en la drepanocitosis y es más grave en mayores de 3 años. El diagnóstico exige un alto índice de sospecha, debido a las múltiples formas de presentación y a la frecuente normalidad del estudio radiológico inicial
Introduction: Acute thoracic syndrome (pneumonia and/or lung infarction) is a significant cause of morbidity and mortality in sickle cell anemia. Objective: To review the clinical manifestations, management and outcome of episodes of acute thoracic syndrome in our hospital. Methods: We performed a retrospective review of all the episodes of acute thoracic syndrome diagnosed at our center in patients younger than 18 years of age with sickle cell anemia. Clinical, laboratory and radiological findings, outcome and treatment were analyzed. Data from patients 3 years of age were compared (Fishers exact test and the Mann-Whitney U test). Results Twenty-three episodes of acute thoracic syndrome were evaluated in eight out of 12 patients with sickle cell anemia followed-up in our hospital. These episodes represented 36 % of the total time of admission in these patients. The most frequent cause was infection. The most frequent symptoms were fever (87%), cough (61%) and cold (35%) symptoms. Seventy-four percent of the patients were not diagnosed at admission, either because the chest X-ray was normal (52%) or because it was not performed (22%) due to the absence of pulmonary manifestations. Patients aged more than 3 years old had more severe episodes, with greater clinical compromise and radiological involvement and increased use of analgesia. Transfusions were administered in 65% of the episodes and in five patients (> 3 years) a partial exchange transfusion was performed. In five patients corticoid treatment was associated with febrile relapses. Conclusions: Acute thoracic syndrome is frequent in sickle cell disease and is more severe in children older than 3 years. Its diagnosis requires a high index of suspicion, due to multiple forms of clinical presentations and normal chest radiology at admission -in 1987 did not increase cases of TM in our hospital; on the contrary, these have decreased. A considerable percentage of children with advanced stages of TM show severe sequels
