Trastornos vestibulares y del equilibrio en niños y adolescentes mexicanos: revisión de registros clínicos de 8 años / Vestibular and balance disorders in Mexican children and adolescents: Review of 8-year clinical records

Introducción: El vértigo es un síntoma poco estudiado en la población pediátrica, donde la prevalencia es inferior al 1%. Los trastornos vestibulares en el niño no son equiparables a los del adulto y a menudo son subdiagnosticados. Identificar las principales causas de estos trastornos proporcionaría datos fidedignos y precisos de las enfermedades en ciertos grupos de edad, mejorando el proceso de diagnóstico.Material y métodosEstudio observacional, transversal y retrospectivo. Se revisaron los expedientes consecutivos de pacientes, de entre 3 y 17años, atendidos por síntomas vestibulares, del equilibrio y asociados (vértigo, mareo, hipoacusia, alteraciones del equilibrio y cefalalgia) en el servicio de Otoneurología de un hospital de tercer nivel de atención entre septiembre de 2010 y septiembre de 2018. Se utilizó estadística descriptiva e inferencial para el análisis. Todos los valores de p informados de estos análisis fueron de dos colas con un nivel de significación <0,05.ResultadosSe registraron 212 casos entre 6.444 consultas, por lo que la frecuencia fue del 3,3%. La proporción entre hombres y mujeres fue similar. La edad media del grupo fue de 14,5 (±3,9) años, la mediana de la edad de inicio de los síntomas fue de 11 (RIC 8-14) años y la de la primera consulta fue de 13 (RIC 10-15) años. Como síntoma cardinal, el 51,9% acudieron por vértigo, el 25,5% por mareo, el 9,9% por inestabilidad de la marcha, el 7,5% por hipoacusia y el 5,2% por cefalalgia. El 61,8% de los episodios de vértigo tuvieron un origen periférico, el 32,5% central y el 5,7% fuera del sistema vestibular. El vértigo paroxístico benigno de la infancia, la disfunción y migraña vestibular representaron más del 65% de los casos. No se encontraron diferencias entre los diagnósticos con respecto al sexo y la edad de los participantes (p>0,05). (AU)

Introduction: Vertigo is a seldom studied symptom in the paediatric population, where the prevalence is less than 1%. Vestibular disorders in children are not comparable to those of adults and are often underdiagnosed. Identifying the main causes of these disorders would provide reliable and accurate data of the diseases in certain age groups, improving the diagnostic process.Material and methodsObservational, cross-sectional, and retrospective study. Consecutive records of patients, aged 3 to 17years, attended due to vestibular, balance and associated symptoms (vertigo, dizziness, hearing loss, balance disorders and headache), attended by the otoneurology service of a tertiary hospital, between September 2010 and September 2018, were included. Descriptive and inferential statistics were used for the analysis. All p-values reported from these analyses were two-tailed with a significance level <.05.Results212 cases were registered from 6,444 consultations (3.3%). The proportion between males and females was similar. The mean age of the group was 14.5 (±3.9) years, the median age of onset of symptoms was 11 (IQR 8-14) years and that of the first consultation was 13 (IQR 10-15) years. As a cardinal symptom, 51.9% attended due to vertigo, 25.5% due to dizziness, 9.9% due to gait instability, 7.5% due to hearing loss and 5.2% due to headache. Of the episodes of vertigo, 61.8% were of peripheral origin, 69 32.5% central and 12 5.7% outside the vestibular system. Benign paroxysmal vertigo of childhood, dysfunction and vestibular migraine accounted for more than 65% of cases. No differences were found between the diagnoses regarding the sex and age of the participants (P>.05).ConclusionVestibular and balance disorders are rare in the study population and most of the causes are benign and potentially self-limited disorders. (AU)

Vestibular and balance disorders in Mexican children and adolescents: Review of 8-year clinical records. / Trastornos vestibulares y del equilibrio en niños y adolescentes mexicanos: revisión de registros clínicos de 8 años.

INTRODUCTION: Vertigo is a seldom studied symptom in the paediatric population, where the prevalence is less than 1%. Vestibular disorders in children are not comparable to those of adults and are often underdiagnosed. Identifying the main causes of these disorders would provide reliable and accurate data of the diseases in certain age groups, improving the diagnostic process. MATERIAL AND METHODS: Observational, cross-sectional, and retrospective study. Consecutive records of patients, aged 3 to 17years, attended due to vestibular, balance and associated symptoms (vertigo, dizziness, hearing loss, balance disorders and headache), attended by the otoneurology service of a tertiary hospital, between September 2010 and September 2018, were included. Descriptive and inferential statistics were used for the analysis. All p-values reported from these analyses were two-tailed with a significance level <.05. RESULTS: 212 cases were registered from 6,444 consultations (3.3%). The proportion between males and females was similar. The mean age of the group was 14.5 (±3.9) years, the median age of onset of symptoms was 11 (IQR 8-14) years and that of the first consultation was 13 (IQR 10-15) years. As a cardinal symptom, 51.9% attended due to vertigo, 25.5% due to dizziness, 9.9% due to gait instability, 7.5% due to hearing loss and 5.2% due to headache. Of the episodes of vertigo, 61.8% were of peripheral origin, 69 32.5% central and 12 5.7% outside the vestibular system. Benign paroxysmal vertigo of childhood, dysfunction and vestibular migraine accounted for more than 65% of cases. No differences were found between the diagnoses regarding the sex and age of the participants (P>.05). CONCLUSION: Vestibular and balance disorders are rare in the study population and most of the causes are benign and potentially self-limited disorders.

Risk factors for amputation in periprosthetic knee infection.

Treatment for prosthetic knee replacement is becoming more common. Infection is an arthroplasty-related complication leading to prolonged hospitalization, multiple surgical procedures, permanent loss of the implant, impaired function, impaired quality of life and even amputation of the limb. Previous studies have evaluated the risk factors associated with periprosthetic knee infection, but scarce information related to risk factors associated with amputation in this group of patients is available. The purpose of this study was to identify risk factors for amputation in periprosthetic infected knee through a case-control study, analyzing patients treated from January 2012 to November 2016 in a hospital with a high incidence of this diagnosis. We included 183 patients with periprosthetic knee infection; 23 required amputation as definitive management (cases). We found that patients with surgical time >120 min (p = 0.01), surgical risk higher than two points according to the American Society of Anesthesiology score (p = 0.00), smokers (p = 0.04), obesity and diabetes mellitus (p = 0.00) had an increased risk of amputation.

DNA barcodes effectively identify the morphologically similar Common Opossum (Didelphis marsupialis) and Virginia Opossum (Didelphis virginiana) from areas of sympatry in Mexico.

Two morphologically similar species of opossum from the genus Didelphis-Didelphis virginiana and Didelphis marsupialis-cooccur sympatrically in Mexico. High intraspecific variation complicates their morphological discrimination, under both field and museum conditions. This study aims to evaluate the utility and reliability of using DNA barcodes (short standardized genome fragments used for DNA-based identification) to distinguish these two species. Sequences of the cytochrome c oxidase subunit I (Cox1) mitochondrial gene were obtained from 12 D. marsupialis and 29 D. virginiana individuals and were compared using the neighbor-joining (NJ) algorithm with Kimura's two-parameter (K2P) model of nucleotide substitution. Average K2P distances were 1.56% within D. virginiana and 1.65% in D. marsupialis. Interspecific distances between D. virginiana and D. marsupialis varied from 7.8 to 9.3% and their barcode sequences formed distinct non-overlapping clusters on NJ trees. All sympatric specimens of both species were effectively discriminated, confirming the utility of Cox1 barcoding as a tool for taxonomic identification of these morphologically similar taxa.

A new species of Pelecitus (Filarioidea: Onchocercidae) from the endangered Tehuantepec jackrabbit Lepus flavigularis.

Pelecitus meridionaleporinus n. sp. from the Tehuantepec jackrabbit is described. The new species differs from Pelecitus helicinus (Molin, 1860) in having delicate transverse striations, a salient vulva, and a readily apparent preesophageal ring; P. helicinus has teardrop cells around the vulva, which are lacking in the species presently described. The new species is different from Pelecitus scapiceps (Leidy, 1886) in having the vulva anterior to the esophageal-intestinal junction and wider lateral alae. Pelecitus scapiceps is found in the tarsal bursa of the hind feet of lagomorphs, whereas P. helicinus is found around tendons of legs and feet of birds. Pelecitus meridionaleporinus n. sp. occurs in the subcutaneous tissue at the base of both ears. This is the second species in Pelecitus Railliet and Henry, 1910 that occurs in New World lagomorphs, and the third found infecting mammals.

Tratamiento de la luxación congénita de cadera mediante la técnica Klisic / Tratamiento of the congenital luxación of hip by means of the technique Klisic

El presente es un estudio retrospectivo que incluye ocho casos de niños mayores de 3 años, seis mujeres y dos varones admitidos en el Servicio de Traumatología y Ortopedia del Hospital Pediátrico Roberto Gilbert Elizalde, diagnosticados de luxación congénita de cadera e intervenidos quirúrgicamente mediante técnica combinada en un tiempo quirúrgico incluyendo acortamiento femoral, reducción más fijación articular y acetábuloplastia. El objetivo del estudio es valorar los resultados radiológicos clínicos y funcionales obtenidos con la técnica. Se obtuvieron resultados excelentes con el 12.5 por ciento de los pacientes, 87.5 por ciento presentaron un cuadro catalogado como satisfactorio, no se obtuvieron resultados deficientes...

Lipomas da laringe: relato de caso e revisäo de literatura / Lipoma of the larynx: a case report and literature review

Os lipomas da laringe constituem um grupo de patologias raras, representando aproximadamente 0,6 por cento dos tumores benignos da laringe. Atualmente, existem menos de 90 casos descritos na literatura mundial. Os autores apresentam um caso de lipoma laríngeo localizado na regiäo supraglótica em um paciente do sexo masculino, queixando-se de dispnéia de decúbito, engasgos e sensaçäo de corpo estranho na garganta. Enfatizam os métodos diagnósticos e o tratamento microcirúrgico realizado

Envenenamiento con agentes inhibidores de la colinesterasa / Envenenamiento with inhibiting agents of colinesterasa

Expone que los agentes inhibidores de la colinesterasa son empleados ampliamente tanto en los hogares como en la agricultura para la eliminación de insectos, sin embargo el uso y manejo de este tóxico es delicado y al servicio de urgencias muchos pacientes suelen acudir ya sea por envenenamiento accidental o por la ingesta voluntaria del mismo. Los agentes inhibidores de la colinesterasa se dividen en dos grupos: los carbamatos y los órganos fosforados, presentando ambos tóxicos la misma sintomatología entre los cuales tenemos sialorrea, naúseas, vómitos, miosis, diaforesis, diarrea, etc., la cual se presenta por la estimulación de los ganglios post-sinápticos al inhibirse la acetilcolinesterasa y por consiguiente la persistencia de la acetilcolina a este nivel.