[Primary meningococcal conjunctivitis: implications beyond the conjunctiva]. / Conjuntivitis meningocócica primaria: implicaciones más allá de la conjuntiva.

BACKGROUND: Neisseria meningitidis is a uncommon cause of acute bacterial conjunctivitis. However, its diagnosis has important therapeutic implications. METHODS: From December 1993 to January 1984, a prospective study on acute bacterial conjunctivitis was performed at the Hospital Universitario Materno-Infantil Vall d'Hebron. Primary meningococcal conjunctivitis (PMC) was diagnosed in 34 patients. The diagnosis of PMC was made on the basis of consistent clinical manifestations together with isolation of Neisseria meningitidis from conjunctival exudate culture. RESULTS: There were 16 men and 18 women with a mean age of 3.5 +/- 3.3 years. PMC was bilateral in 7 patients and unilateral in 27. Initial therapy for PMC included only topical antibiotics in 24 patients and systemic antibiotic therapy in 10. Ten patients (29.4%) developed invasive meningococcal disease. None of the patients died neither developed ocular sequelae. Forty one percent of the patients who received only topical therapy and none [corrected] of those who received systemic therapy, developed invasive meningococcal disease (p = 0.04). CONCLUSIONS: PMC may represent the portal of entry for invasive meningococcal disease, which occurs in almost a third of patients. Patients with PMC and higher risk of developing invasive meningococcal disease are those treated only with topical antibiotic therapy.

[Anatomical correction in transposition of the great arteries and double-outlet right ventricle. Our initial experience]. / Corrección anatómica en la transposición de grandes arterias y en la doble salida de ventrículo derecho. Experiencia inicial.

INTRODUCTION AND OBJECTIVES: Anatomical correction of transposition of great arteries and double outlet right ventricle with subpulmonary ventricular septal defect is a surgical approach that has not been generally adopted in our clinical environment. Our aim with this paper is reporting on our initial experience with this technique. METHODS: The clinical data and additional investigations are reviewed from 15 infants with transposition of the great arteries and 2 with double outlet right ventricle who underwent anatomical repair, with a postoperative follow-up of one year. RESULTS: The survival rate has been 76% (13 out of 17 cases). The 13 survivors are in good hemodynamic condition, with no treatment whatsoever. Thirteen patients are in sinus rhythm with normal repolarization patterns and 5 patients show a right bundle branch block. Neither aortic nor pulmonary gradients have been detected on Doppler examination, and slight valvular insufficiencies are found at aortic level in 4 patients, pulmonary in 2 and mitral in one. CONCLUSION: Anatomical correction is the method of choice for transposition of the great arteries and double outlet right ventricle with pulmonary-related ventricular septal defect.

[Umbilical colonization in normal newborns. A comparative study of 4 methods for umbilical antisepsis]. / Colonización umbilical en recién nacidos normales. Estudio comparativo de cuatro métodos de antisepsia umbilical.

We report the results of a prospective study in which the effectiveness of 70% alcohol (A), mercurochrome (M), a solution of alcohol and mercurochrome (AM) and 1% chlorhexidine (C) as umbilical antiseptics was tested on 311 normal newborn infants. Similar results were obtained by using A, M, or AM; however, when C was used umbilical colonization was significantly reduced as compared to when the other three antiseptic agents were used. The umbilical cords that had been scrubbed with A, M or AM were detached by the 8th day after birth, whereas those treated with C took 14 days to fall off. The use of chlorhexidine resulted in a marked increase in pure cultures positive for Gram negative bacteria (Proteus spp. and Pseudomonas spp.) which was not the case with the other three antiseptics tested.

[Aortic coarctation in the neonatal period. Study of 137 cases]. / Coartación aórtica en el período neonatal. Estudio de 137 casos.

The clinical records of 137 newborns, diagnosed by cardiac catheterization of aortic coarctation, have been reviewed. According to the presence of associations, three different groups have been established. Group A: isolated coarctation or coarctation associated with patient ductus arteriosus (40 cases); Group B: coarctation associated with ventricular septal defect or atrial septal defect (37 cases); Group C: coarctation associated with other complex congenital cardiac lesions (60 cases). The aortic coarctation has been surgically repaired in 73 cases, by using the following techniques: End-to-end anastomosis in 26 patients, Waldhausen repair in 43 and other procedures in the remaining 4 cases. For the surgically treated patients the survival has been: 88% in group A, 90% in group B and 48% in group C. In non-operated patients the survival has been: 21%, 6% and 14%, respectively.

[Sepsis, as the presenting form of hereditary tyrosinemia type I]. / Sepsis, como forma de presentación de tirosinemia hereditaria tipo I.

A case of hereditary tyrosinemia type I with a septic onset is reported. Diagnosis was established by the urinary presence of succinylacetone (SA) and deficiency in fumarylacetoacetate hydrolase (FAAH) in a culture of fibroblasts. Response to treatment with a diet in which the aminoacids phenylalanine, tyrosine and methionine were restricted is commented upon.

[Influence of atmospheric changes on childhood bronchial pathology]. / Influencia de los cambios atmosféricos en la patología bronquial infantil.

Influence of pollution of bronchial pathology in children, over 5 years (1978-1982) in Barcelona was studied. Index of contamination (mainly SO2 and fumes were measured daily at 18 points of city. Average values were compared with the children seen in the Emergency Service in the Children's Hospital "Valle de Hebrón" of Barcelona. Results have been statistically studied. In conclusion, there were a relation between number of respiratory problems and levels of atmospheric contamination.

[Jaundice associated with urinary infection in the first three months of life. Study of 66 cases (author's transl)]. / Ictericia asociada a infección urinaria en el primer trimestre de la vida. Revisión de 66 casos.

Sixty-six infants aged 8 days to 3 months presented jaundice as a sign of urinary infection during a ten-year period 1968-1977. The main clinical and biochemical aspects are described. "E.coli" grew in 49 urine cultures (74.2%), but other bacteria were also found ("Klebsiella", "Proteus", "Pseudomonas", "A. aerogenes"). Hepatic function tests seem to prove that intrahepatic colostasis is the main mechanism involved, although hemolysis was also found in some cases. The importance of considering urinary infection in the diagnosis of jaundice during infancy is stressed.