[Economic impact of strategies using ephedrine prefilled syringes]. / Impact économique des stratégies de recours à l'éphédrine en seringues préremplies.

OBJECTIVES: Ephedrine is an emergency drug available in ampules and syringes need to be prepared in advance according to one of two strategies in our establishment: strategy 1 (S1: 1 ampule per patient) and strategy 2 (S2: 1 ampule per operating room). There are also prefilled syringes. Because of their high cost and conflicting results in the literature, we assessed the economic interest of using prefilled syringes compared with strategies S1 and S2. TYPE OF STUDY: This was a prospective observational study. PATIENTS AND METHODS: The consumption of ephedrine was recorded over two periods of 14 days: P1 with syringes prepared in advance according to S1 or S2 and P2 with the on-demand use of prefilled syringes. RESULTS: The cost of a syringe of ephedrine prepared in advance (nurse time preparation included) was evaluated at €1.65 vs. €3.57 for a prefilled syringe. In operating rooms using S1, the use of prefilled syringes reduced overall the cost per patient about €1.22 and global annual costs by 72% (€2830), while the decrease was about €0.32 for the cost per patient and about 47% (€2760) for global annual costs for operating rooms using S2. CONCLUSION: The interest of our study is that we investigated different supply strategies for ephedrine within a large number of operating rooms. In our establishment, it was decided to use prefilled syringes in operating rooms that used S1. As well as the economic interest, prefilled syringes contributed to improved safety and saved nursing time.

Hiperostosis cortical neonatal (enfermedad de Caffey) / Neonatal cortical hyperostosis (Caffey disease)

No disponible

Paciente de 24 meses con tos y estridor: caso radiológico / A 24-month-old patient with cough and stridor: a radiological study

Se presenta el caso de un niño de 24 meses que, estando previamente bien. sufre un cuadro de accesos de tos con estridor inspiratorio, babeo constante y voz bitonal de 5 días de evolución, sin fiebre. ni dificultad respiratoria. y sin mejoría clínica tras tratamiento antibiótico, motivo por el que acude al servicio de urgencias hospitalarias. Se realiza estudio radiológico de tórax y se observa una imagen lineal densa por encima del segmento glótico, que, en proyección lateral de cuello. aparece como una imagen triangular, de densidad cálcica, en laringe. Tras la práctica de una laringoscopia, se extrae una cáscara de huevo. desapareciendo por completo la sintomatología

The case is presented of a previously healthy 24-month-old boy with a five-day history of coughing attacks with inspiratory stridor. sialorrhea and bitonal voice. He had no fever or respiratory difficulty. As he did not respond to antibiotic therapy. he was brought to the emergency room. A radiological study of his chest revealed a dense linear image above the glottis which, in a lateral projection of the neck. appeared as a triangular object of calcific density in the larynx. Laryngoscopy was performed and a piece of eggshell was recovered, after which all the symptoms disappeared

Abceso retrofaríngeo / Retropharyngeal abscess

El absceso retrofaríngeo es una patología poco frecuente y potencialmente letal. Presentamos dos casos de absceso retrofaríngeo que ilustran las dificultades que puede suponer llegar a un diagnóstico correcto de esta entidad (AU)

Retropharyngeal abscess is a rare and potentially lethal disease. We present two cases of retropharyngeal abscess that illustrate the difficulties that may exist to reach a correct diagnosis of this entity (AU)

Pulmonary leukemia in a child presenting with infiltrative and nodular lesions.

A leukemic child developed a pulmonary leukemic infiltration, confirmed by open lung biopsy. His radiograph showed a mixed interstitial and nodular pattern. Nodular lung lesions are rare in pediatric patients and may exceptionally represent leukemic invasion.

[Traumatic duodenal hematoma (author's transl)]. / Hematoma duodenal postraumático

Two cases of duodenal hematoma secondary to abdominal trauma in children are reported. The latent periods between trauma and the onset of symptoms were two and fifteen days. X-ray studies were conclusive for diagnosis. Pancreatic signs were mild in one case. Both cases were treated surgically, draining the fluid collection extramucosally. The authors advise surgical treatment whenever associated lesions need to be ruled out and when obstruction persists after the first days.