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3.
Acta pediatr. esp ; 71(8): e233-e236, sept. 2013. ilus
Artigo em Espanhol | IBECS | ID: ibc-116760

RESUMO

Se presenta el caso de una niña de 6 años que refería un dolor abdominal leve de 2 meses de evolución, en la que la radiografía de tórax permitió hacer el diagnóstico de síndrome de Chilaiditi (AU)


We report the case of a 6-year-old girl who was recounting abdominal slight pain of 2 months of evolution, in which the X-ray picture of thorax allowed us to do the diagnosis of Chilaiditi's syndrome (AU)


Assuntos
Humanos , Feminino , Criança , Síndrome de Chilaiditi/diagnóstico , Diagnóstico por Imagem/métodos , Dor Abdominal/etiologia
4.
An. pediatr. (2003, Ed. impr.) ; 69(5): 400-405, nov. 2008. tab
Artigo em Es | IBECS | ID: ibc-69171

RESUMO

Antecedentes: El virus respiratorio sincitial (VRS) y otros virus son causas conocidas de hospitalización en lactantes. Menos conocido es el patrón de virus en infecciones extrahospitalarias en menores de 6 meses. Objetivo: El objetivo de este estudio es describir las características clínicas y los factores epidemiológicos asociados con las infecciones respiratorias virales de ámbito extrahospitalario en menores de 6 meses. Pacientes y métodos: Estudio prospectivo en cohorte de niños de las áreas 8 y 9 de Madrid controlados desde el nacimiento mediante llamadas telefónicas quincenales durante una temporada invernal. Se registraron datos clínicos y epidemiológicos en cuestionarios prediseñados. Se exploró y recogió el aspirado nasofaríngeo (ANF) cuando el paciente presentó sintomatología compatible con una infección respiratoria. El diagnóstico de los virus más comunes se realizó con inmunofluorescencia directa (IFD) y amplificación genómica (PCR). Resultados: Fueron seleccionados 316 recién nacidos. Se realizaron 1.865 llamadas telefónicas (mediana 4), y 106 visitas, en 89 de las cuales se confirmó la enfermedad. Los síntomas más frecuentes fueron rinitis (91 %) y tos (69 %). El diagnóstico clínico principal fue infección respiratoria de vías altas (82 %); 17 de 72 ANF realizados (23,2 %) fueron positivos. Se detectaron rinovirus (41,1 %) y VRS (35,2 %). Ingresaron un 16 % (17/106) de los niños atendidos por enfermedad (el 5,3 % de la cohorte), diagnosticados de síndrome febril y de bronquiolitis. No encontramos ningún factor epidemiológico asociado con la infección respiratoria viral en los casos positivos. Conclusiones: En nuestro medio las infecciones respiratorias de los lactantes son en su mayoría banales y no precisan atención hospitalaria. El rinovirus y el VRS son los principales agentes etiológicos. No se encontraron factores epidemiológicos relacionados con la infección respiratoria asociada a virus (AU)


Background: Respiratory syncytial virus and Influenza virus infections are known causes of hospital admission in infants. It is less well known the pattern of virus infections in infants under 6 months of age in the outpatient setting. Objective: To describe the clinical and epidemiological pattern of community-acquired viral respiratory infections in infants under 6 months. Patients and methods: A cohort of infants from the 8 and 9 Madrid Health Districts was followed by telephone calls every two weeks since birth during the epidemic winter season. Clinical and epidemiological data were collected in pre-designed questionnaires. Nasopharyngeal aspirate was obtained in every patient with symptoms compatible with respiratory infection. Diagnosis of the more common virus was made with direct immunofluorescence and nucleic acid amplification test (PCR). Results: Were recruited 316 newborns. The 1,865 phone calls made (median 4 for every child), produced 106 visits, and the illness confirmed in 89 illness. Rhinitis (91 %) and cough (69 %) were the most common symptoms. Upper respiratory infection was the principal clinical diagnosis (84.5 %), and 17 of the 72 samples (23.2 %) were positive. Most common viruses were RSV (41.1 %) and rhinovirus (35.2 %). Of the children visited, 17 out of 106 (16 %) (5.3 % of the cohort) were admitted to hospital. Diagnoses were febrile syndrome and bronchiolitis. We did not find any epidemiological factor associated with viral respiratory infection in positive cases. Conclusions: In our population most of the respiratory infections in infants are minor and do not need hospital assistance. Rhinovirus and RSV are the major pathogens. We did not find any epidemiological factor associated with viral respiratory infection (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/prevenção & controle , Vírus Sincicial Respiratório Humano/imunologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Técnica Direta de Fluorescência para Anticorpo/instrumentação , Técnica Direta de Fluorescência para Anticorpo , Bronquiolite/diagnóstico , Bronquiolite/epidemiologia , Rinite/epidemiologia , Rhinovirus/isolamento & purificação , Rhinovirus/patogenicidade , Infecções por Vírus Respiratório Sincicial/etiologia , Estudos Prospectivos , Espasmo Brônquico/complicações , Espasmo Brônquico/diagnóstico
5.
An Pediatr (Barc) ; 68(2): 92-8, 2008 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-18341872

RESUMO

INTRODUCTION: Streptococcus pneumoniae is the microorganism most frequently associated with complicated pleural effusion. After the introduction of the heptavalent pneumococcal vaccine, there was a decline in the incidence of invasive pneumococcal disease and, to a lesser extent, in that of pneumonia. However, the incidence of empyema apparently increased. The antipneumococcal heptavalent vaccine was introduced in Spain in 2001. OBJECTIVES: To determine whether the incidence of pleural effusion secondary to pneumonia has increased in hospitalized patients and to examine the possible influence of the antipneumococcal heptavalent vaccine on the incidence rate of parapneumonic effusions. PATIENTS AND METHODS: Patients aged less than 16 years old admitted to our hospital with a diagnosis of pneumonia between 1999 and 2005 were retrospectively reviewed. We calculated the annual incidence rate of pleural effusion with respect to the total number of patients admitted with pneumonia and with respect to patients considered to have probable bacterial pneumonia, based on previously established criteria. RESULTS: A total of 337 patients were analyzed, of which 213 (63.2%) met the criteria for a diagnosis of probable bacterial pneumonia. Pleural effusion was found in 34 patients (15.9%), and 13 of these effusions (38%) were complicated. No clear trend was detected in the annual incidence of probable bacterial pneumonia per 100 admitted patients, although the highest numbers were detected in the last two years of the study period. The percentage of complications (effusions) remained constant (mean: 16.28%). No differences were found in the effusion rate between vaccinated and unvaccinated patients (12.5% vs 18.6%). CONCLUSIONS: The trend in the incidence of parapneumonic pleural effusions was parallel and proportional to that of probable bacterial pneumonia.


Assuntos
Derrame Pleural/epidemiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Estudos Retrospectivos
6.
An. pediatr. (2003, Ed. impr.) ; 68(2): 92-98, feb. 2008. ilus, tab
Artigo em Es | IBECS | ID: ibc-63781

RESUMO

Introducción: Streptococcus pneumoniae es el agente etiológico aislado con más frecuencia en los derrames paraneumónicos complicados. Desde la introducción de la vacuna antineumocócica heptavalente (VCN-7), ha disminuido la enfermedad neumocócica invasiva y, en menor grado, la incidencia de neumonías, pero con un aparente aumento del empiema. En España la vacuna fue comercializada en 2001. Objetivos: Determinar si existe un aumento de la incidencia de derrames pleurales en los pacientes ingresados por neumonía y la posible influencia de la vacunación con VCN-7 sobre la incidencia de dichos derrames. Pacientes y métodos: Estudio retrospectivo de los pacientes menores de 16 años ingresados en nuestro hospital por neumonía entre 1999 y 2005. Se calculó la incidencia anual de derrames pleurales respecto al número total de neumonías ingresadas y respecto a las consideradas como de probable origen bacteriano (NPOB) según criterios establecidos. Resultados: Se analizaron 337 pacientes. De éstos, 213 cumplían criterios de NPOB (63,2 %). Un total de 34 pacientes presentaron derrame pleural (15,9 %), 13 de los cuales (38 %) fueron complicados. No se pudo objetivar en el período estudiado una tendencia clara en la incidencia anual de NPOB por 100 pacientes ingresados, aunque en los dos últimos años se detectaron las cifras más altas. La proporción de complicaciones (derrames) se mantuvo constante (media 16,28 %). No existieron diferencias en la aparición de derrames entre los pacientes vacunados con VCN-7 y los no vacunados (12,5 % frente a 18,6 %). Conclusiones: Se objetiva una evolución de la incidencia de derrames pleurales paraneumónicos paralela y proporcional a la de las neumonías bacterianas (AU)


Introduction: Streptococcus pneumoniae is the microorganism most frequently associated with complicated pleural effusion. After the introduction of the heptavalent pneumococcal vaccine, there was a decline in the incidence of invasive pneumococcal disease and, to a lesser extent, in that of pneumonia. However, the incidence of empyema apparently increased. The antipneumococcal heptavalent vaccine was introduced in Spain in 2001. Objectives: To determine whether the incidence of pleural effusion secondary to pneumonia has increased in hospitalized patients and to examine the possible influence of the antipneumococcal heptavalent vaccine on the incidence rate of parapneumonic effusions. Patients and methods: Patients aged less than 16 years old admitted to our hospital with a diagnosis of pneumonia between 1999 and 2005 were retrospectively reviewed. We calculated the annual incidence rate of pleural effusion with respect to the total number of patients admitted with pneumonia and with respect to patients considered to have probable bacterial pneumonia, based on previously established criteria. Results: A total of 337 patients were analyzed, of which 213 (63.2 %) met the criteria for a diagnosis of probable bacterial pneumonia. Pleural effusion was found in 34 patients (15.9 %), and 13 of these effusions (38 %) were complicated. No clear trend was detected in the annual incidence of probable bacterial pneumonia per 100 admitted patients, although the highest numbers were detected in the last two years of the study period. The percentage of complications (effusions) remained constant (mean: 16.28 %). No differences were found in the effusion rate between vaccinated and unvaccinated patients (12.5 % vs 18.6 %). Conclusions: The trend in the incidence of parapneumonic pleural effusions was parallel and proportional to that of probable bacterial pneumonia (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Derrame Pleural/epidemiologia , Derrame Pleural/etiologia , Estudos Retrospectivos , Infecções Pneumocócicas/complicações , Incidência , Pneumonia Bacteriana/epidemiologia , Pneumonia Bacteriana/etiologia , Pneumonia Bacteriana/diagnóstico , Pneumonia Bacteriana/tratamento farmacológico , Antibacterianos/uso terapêutico , Vacinas Bacterianas/uso terapêutico , Fatores Etários
7.
An Pediatr (Barc) ; 69(5): 400-5, 2008 Nov.
Artigo em Espanhol | MEDLINE | ID: mdl-19128739

RESUMO

BACKGROUND: Respiratory syncytial virus and Influenza virus infections are known causes of hospital admission in infants. It is less well known the pattern of virus infections in infants under 6 months of age in the outpatient setting. OBJECTIVE: To describe the clinical and epidemiological pattern of community-acquired viral respiratory infections in infants under 6 months. PATIENTS AND METHODS: A cohort of infants from the 8 and 9 Madrid Health Districts was followed by telephone calls every two weeks since birth during the epidemic winter season. Clinical and epidemiological data were collected in pre-designed questionnaires. Nasopharyngeal aspirate was obtained in every patient with symptoms compatible with respiratory infection. Diagnosis of the more common virus was made with direct immunofluorescence and nucleic acid amplification test (PCR). RESULTS: Were recruited 316 newborns. The 1,865 phone calls made (median 4 for every child), produced 106 visits, and the illness confirmed in 89 illness. Rhinitis (91%) and cough (69%) were the most common symptoms. Upper respiratory infection was the principal clinical diagnosis (84.5%), and 17 of the 72 samples (23.2%) were positive. Most common viruses were RSV (41.1%) and rhinovirus (35.2%). Of the children visited, 17 out of 106 (16%) (5.3% of the cohort) were admitted to hospital. Diagnoses were febrile syndrome and bronchiolitis. We did not find any epidemiological factor associated with viral respiratory infection in positive cases. CONCLUSIONS: In our population most of the respiratory infections in infants are minor and do not need hospital assistance. Rhinovirus and RSV are the major pathogens. We did not find any epidemiological factor associated with viral respiratory infection.


Assuntos
Infecções Respiratórias/virologia , Humanos , Lactente , Recém-Nascido , Estudos Prospectivos , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia
8.
Pediatr. aten. prim ; 7(supl.2): S107-S125, abr. 2005. tab
Artigo em Es | IBECS | ID: ibc-69260

RESUMO

El tratamiento de la crisis asmática en pediatría debe ser precedido de una breve historia clínica y descansa principalmente en el uso de oxígeno, los fármacos beta-adrenérgicos de acción corta y los corticoides sistémicos. Las crisis leves y moderadas pueden ser tratadas en el centro de salud, que debe contar con oxígeno y con un pulsioxímetro. Se deben modificar las dosis de los fármacos y los tiempos de administración en relación con la gravedad de la crisis y la respuesta al tratamiento. En las crisis graves la adición de múltiples dosis del anticolinérgico bromuro de ipratropio inhalado aporta alguna ventaja a los beta-adrenérgicos solos. La vía ideal para ambos es la inhalada, tanto en nebulización como con inhalador presurizado y cámara espaciadora, y es preciso asegurarse del uso correcto de este último dispositivo. Los corticoides ejercen una excelente acción antiinflamatoria modulando la síntesis, la liberación y la actividad de los mediadores de la inflamación, y han mostrado su eficacia cuando se utilizan precozmente y por vía sistémica, si bien su efecto no es inmediato y nunca serán el primero ni el único fármaco a utilizar. En la actualidad no se recomienda la administración inhalada de los corticoides para el tratamiento de las crisis asmáticas. En el caso de una crisis asmática grave, existen otras medidas farmacológicas como la teofilina, cada vez menos utilizada, el sulfato de magnesio, y otras medidas más propias de las Unidades de Cuidados Intensivos Pediátricos


Before starting treatment for paediatric acute asthma a brief patient data must be obtained about previous asthma history. Treatment should include the use of oxygen, shortacting beta-adrenergic drugs, and systemic steroids. Mild and moderate asthma attacks can be treated at the Primary Care Paediatric Office, where oxygen source and a pulsyoxymeter device should be available. Drug dosage and administration schedules must be modified in relation with the exacerbation severity and patient response to therapy. In severe acute asthma, addition multiple inhaled ipratropium doses may bring some benefits to the betaadrenergic drugs alone. The best way for both beta-adrenergic and ipratropium is inhaled way, nebulization or inhalation with an inhalator and spacer, and it is necessary to be sure that child use the spacer properly. Steroids have an excellent anti-inflammatory action, by modulating the synthesis, liberation and activity of inflammation mediators, and its effectiveness has been shown when used early and in a systemic pattern. The clinical effect of steroids is not immediate, therefore must not be the first nor the only drug used. Currently, inhaled administration of steroids in the treatment of acute asthma exacerbation is not recommended. In case of severe asthma exacerbation, there are other therapeutic options as theophylline, magnesium sulphate, and other Intensive Care Unit measures if necessary


Assuntos
Humanos , Criança , Estado Asmático/terapia , Oxigenoterapia , Antiasmáticos/uso terapêutico , Corticosteroides/uso terapêutico , Nebulizadores e Vaporizadores , Índice de Gravidade de Doença , Protocolos Clínicos
9.
Pediatr. aten. prim ; 7(26): 277-302, abr.-jun. 2005. ilus, tab
Artigo em Es | IBECS | ID: ibc-041915

RESUMO

Los electrocardiogramas (ECG) sigue siendo el método de elección para el diagnóstico no invasivo de las arritmias, siendo una prueba fácil de realizar, rápida, barata y uno de los pocos métodos diaggnósticos inmediatos con los que cuenta el pediatra de AP. Cuando se interpreta un electrocardiograma de un niño se deben considerar las variaciones normales que aparecen con el desarrollo, debidas a los cambios fisiológicos del aparato circulatorio, y tener a mano una tabla de valores normales. La intención de este artículo es repasar los conceptos generales de la interpretación de ECG en pediatría, mostrar un método sistemático de lectura del mismo y proporcionar tablas de valores de referencia. El pediatra de Atención Primaria no necesita tenergrandes conocimientos de electrofisiología sino, en la mayoría de los casos, saber si un ECG es normal o no


Electrocardiography is the method of choice for non-invasive diagnosis of arrhythmia being a procedure easy to perform, fast, not expensive and a procedure often available for the primary care paediatrician. Interpretation requires considering the normal changes with age brought about by the physiological variations that occur in the circulation system. In order to interpret paediatric electrocardiograms, the age of the patient and a table of normal values are essential. This article outlines general concepts of paediatric ECGs, shows a systematic approach for interpretation and includes tables of normal values. Primary care paediatricians do not needs a vast knowledge on electrophysiology but to distinguish between a normal and a pathological ECG


Assuntos
Masculino , Feminino , Criança , Humanos , Eletrocardiografia/métodos , Doenças Cardiovasculares/diagnóstico , Atenção Primária à Saúde/métodos , Diagnóstico Diferencial
10.
An Esp Pediatr ; 55(6): 561-4, 2001 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-11730593

RESUMO

The case of an 9-year-old girl with precocious puberty and a non-functioning pituitary adenoma is described. A review of the literature on the incidence, evolution and therapeutic options of pituitary incidentalomas in children and adults is performed.


Assuntos
Adenoma/diagnóstico , Neoplasias Hipofisárias/diagnóstico , Puberdade Precoce/etiologia , Criança , Feminino , Humanos
11.
An. esp. pediatr. (Ed. impr) ; 55(6): 561-564, dic. 2001.
Artigo em Es | IBECS | ID: ibc-15669

RESUMO

Se describe el caso de una niña de 9 años con pubertad precoz y el hallazgo casual de un adenoma hipofisario no funcional, así como su evolución a lo largo de 2 años y medio de seguimiento. También se realiza una revisión bibliográfica de la prevalencia de "incidentalomas" hipofisarios en la infancia y en la edad adulta, su evolución y las opciones terapéuticas (AU)


Assuntos
Criança , Feminino , Humanos , Puberdade Precoce , Adenoma , Neoplasias Hipofisárias
12.
Kidney Int ; 54(2): 509-17, 1998 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9690217

RESUMO

BACKGROUND: Cationic streptococcal proteinase (erythrotoxin B) and its precursor, zymogen, are putative nephritogenic antigens. The present study was designed to test whether serum titers to these antigens were good markers of streptococcal infection associated with glomerulonephritis. METHODS: We studied 153 patients (male/female = 104/49, age range, 2 to 23 years old) with acute poststreptococcal glomerulonephritis (APSGN) from three countries (Venezuela, Chile and Argentina). The site of the initial infection was the skin in 84 patients, the throat in 55 patients and was unknown in 14 patients. In addition, we studied 23 patients (1 to 24 years old) with streptococcal infection not associated with glomerulonephritis (14 patients with impetigo and 9 patients with pharyngitis). As control group, 93 healthy individuals (54 males, 2 to 19 years old) were studied. Anti-zymogen and anti-proteinase titers were determined in a single laboratory by ELISA, and the intra- and interassay coefficients of variation were 5.3% and 8.5%, respectively. ASO titers and anti-DNAse B titers were also done. RESULTS: Anti-zymogen titers of 1:800 to 1:3200 had likelihood ratios (sensitivity/1-specificity) for detection of streptococcal infection in APSGN patients ranging from 2.00 to 44.2 in Argentina, Chile and Venezuela. Anti-zymogen titers decreased one to two months after APSGN and they were 1 to 3 log2 dilutions higher that anti-proteinase titers. Receiver operating characteristic (ROC) curves showed that anti-zymogen titers were consistently superior to anti-streptolysin O and anti-DNAse B titers as markers for streptococcal infection in APSGN. CONCLUSIONS: These results suggest that increased anti-zymogen antibody titers are the best available marker for streptococcal infection associated with acute glomerulonephritis.


Assuntos
Anticorpos Antibacterianos/sangue , Proteínas de Bactérias , Cisteína Endopeptidases/imunologia , Precursores Enzimáticos/imunologia , Exotoxinas/imunologia , Glomerulonefrite/microbiologia , Proteínas de Membrana , Streptococcus pyogenes/imunologia , Doença Aguda , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Impetigo/microbiologia , Masculino , Sensibilidade e Especificidade
13.
Nephron ; 78(3): 278-83, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9546687

RESUMO

Anticardiolipin (aCL) antibodies have been associated with thrombocytopenia, hemolytic anemia and an increased risk of thrombosis in different vascular locations, even in the absence of lupus. The classic hemolytic-uremic syndrome is a postinfectious acute renal failure characterized by hemolytic anemia, thrombocytopenia and the presence of widespread glomerular thrombosis in the kidney, with pathogenic mechanisms that remain to be identified. In order to establish the frequency of aCL antibodies in this syndrome and to identify a possible role in the pathogenesis and clinical manifestations, 17 patients were studied during the reactant phase of the disease looking for an association between the presence of aCL antibodies (isotypes IgG, IgA and IgM) and the main clinical variables of the syndrome. In 8 patients IgG aCL was present, 2 patients had IgM aCL, and 1 had IgA antibodies on the solid-phase ELISA aCL assays, but no association could be demonstrated with the clinical variables studied. Although it might correspond to an epiphenomenon related to the triggering intestinal infection, a pathogenic role cannot be discarded and additional studies should be performed.


Assuntos
Anticorpos Anticardiolipina/sangue , Síndrome Hemolítico-Urêmica/sangue , Pré-Escolar , Feminino , Síndrome Hemolítico-Urêmica/etiologia , Humanos , Isotipos de Imunoglobulinas/sangue , Lactente , Masculino
14.
J Am Soc Nephrol ; 8(2): 234-41, 1997 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-9048342

RESUMO

Acute poststreptococcal glomerulonephritis (APSGN) is characterized by diffuse glomerular hypercellularity, primarily as a result of accumulation of neutrophils (exudative glomerulonephritis), increase in intrinsic glomerular cells, and transient pathological mesangial matrix expansion. Cytokines and growth factors are supposed to play an important role as mediators of inflammation and as progression factors in various renal disorders. Interleukin-8 is a recently described cytokine, defined as a selective activator and chemoattractant of polymorphonuclear leukocytes (PMNL) and transforming growth factor (TGF)-beta plays a central role in the accumulation of pathological extracellular matrix in glomerulonephritis. This study analyzed the biopsies of ten patients with APSGN, using immunohistochemistry (avidin-biotin complex/horseradish peroxidase method) using monoclonal antibodies anti-IL-8, anti-TGF-beta 1, beta 2, beta 3. Controls consisted of non-immune mouse serum, or anti-TGF-beta preabsorbed with human recombinant TGF-beta. Compared with normal renal tissue, and minimal change disease, an increased glomerular IL-8 and TGF-beta staining was observed in all of the biopsies. Furthermore, in one patient, we observed a weak deposit of TGF-beta in tubulointerstitium. Immunoreactive IL-8 and TGF-beta in glomeruli was correlated with light microscopic and clinical features. There was a significant association (P < 0.05), between IL-8 glomerular immunoreactivity and neutrophil infiltration and between TGF-beta glomerular staining and mesangial matrix expansion. Otherwise, there was no correlation with the mesangial cellularity. It was concluded that increased protein expression of IL-8 and TGF-beta are observed in APSGN and may play a role in the acute glomerular inflammation.


Assuntos
Glomerulonefrite/imunologia , Glomerulonefrite/metabolismo , Interleucina-8/metabolismo , Infecções Estreptocócicas/imunologia , Infecções Estreptocócicas/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Adolescente , Adulto , Animais , Criança , Feminino , Glomerulonefrite/etiologia , Humanos , Imuno-Histoquímica , Glomérulos Renais/imunologia , Glomérulos Renais/metabolismo , Glomérulos Renais/patologia , Masculino , Camundongos , Pessoa de Meia-Idade , Infecções Estreptocócicas/complicações
15.
An Esp Pediatr ; 44(5): 456-60, 1996 May.
Artigo em Espanhol | MEDLINE | ID: mdl-8796956

RESUMO

The aim of this study was to assess the clinical outcome of two different durations of triple therapy in children with Helicobacter pylori infection. We established two treatment groups: 1) Short treatment, including 2 week of bismuth subcitrate, amoxycillin and metronidazole treatment (n = 21) and 2) Long treatment, which included the same therapy for two weeks plus bismuth subcitrate alone for two weeks more (n = 26). We found no difference between the short and long treatments. The infection remained in 14% and 19%, respectively. In both groups, we observed children (19%) with persistent abdominal pain in spite of Helicobacter pylori eradication and gastritis healing. We conclude that it is not necessary to prolong triple therapy more than 2 weeks in order to have therapeutic success.


Assuntos
Duodenite/tratamento farmacológico , Gastrite/tratamento farmacológico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Adolescente , Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Bismuto/administração & dosagem , Criança , Pré-Escolar , Avaliação de Medicamentos , Quimioterapia Combinada , Feminino , Humanos , Masculino , Metronidazol/administração & dosagem , Compostos Organometálicos/administração & dosagem , Penicilinas/administração & dosagem , Fatores de Tempo
16.
Nephron ; 69(2): 135-9, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-7723894

RESUMO

Mean platelet survival time in patients with acute poststreptococcal glomerulonephritis (APSGN) is reduced to 50-60% of the control values, and glomerular deposits of platelet factor 4 are found in these patients. In order to investigate further systemic platelet changes of pathogenic, clinical or prognostic significance, we measured the platelet serotonin (5-HT) content and the blood platelet counts during the 1st week of the disease in 27 patients with APSGN. Platelet 5-HT was significantly reduced in patients with APSGN as compared with patients with impetigo without glomerular involvement (785 +/- 54 vs. 1,329 +/- 94 ng 5-HT/10(9) platelets; p < 0.001). Similarly, the mean blood platelet count was reduced to 247 +/- 16 x 10(3) as compared with 303 +/- 14 x 10(3) in the controls (p < 0.05). Thirteen (48%) of these patients had individual values of platelet 5-HT lower than the 95% confidence interval calculated in the control group. No significant correlation was observed between the concentration of 5-HT and either the severity of the disease judged by the amount of urinary protein excretion and the serum creatinine value or the presence of circulating immune complexes. Significant correction of the platelet 5-HT content (to 1,180 +/- 111 ng/10(9) platelets; p < 0.01) and of the platelet counts (to 309 +/- 21 x 10(3); p < 0.01) were observed in the longitudinal study at least 2 weeks later. Platelet activation, with secretion of granular content and increased consumption, may explain these findings. Additionally, the reduced mean age of the circulating platelets could contribute to their decreased 5-HT levels.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Plaquetas/metabolismo , Nefrite/sangue , Contagem de Plaquetas , Serotonina/sangue , Infecções Estreptocócicas/complicações , Doença Aguda , Adolescente , Adulto , Complexo Antígeno-Anticorpo/sangue , Criança , Pré-Escolar , Creatinina/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nefrite/imunologia , Nefrite/microbiologia , Nefrite/urina , Proteinúria/complicações
17.
Rev Med Chil ; 122(1): 36-41, 1994 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-8066341

RESUMO

We measured circulating immune complexes, tumor necrosis factor and antineutrophil cytoplasmatic antibodies in sera coming from 25 patients during the acute reactant phase of the classical form of hemolytic uremic syndrome, aiming to elucidate a potential participation of these parameters in the pathogenesis of the disease. Circulating immune complexes were elevated in the 18 patients in whom they were measured. Tumor necrosis factor was not elevated and antineutrophil cytoplasmatic antibodies were not detected. It is concluded that these results rule out the participation of antineutrophil cytoplasmatic antibodies in the pathogenesis of the disease and that the role of circulating immune complexes, although elevated, remains undefined.


Assuntos
Síndrome Hemolítico-Urêmica/imunologia , Complexo Antígeno-Anticorpo/sangue , Autoanticorpos/sangue , Pré-Escolar , Chile , Feminino , Síndrome Hemolítico-Urêmica/sangue , Humanos , Lactente , Masculino , Estudos Prospectivos , Fator de Necrose Tumoral alfa/análise
18.
Nephron ; 66(1): 58-61, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-8107954

RESUMO

Circulating immune complexes (CIC) have been described in the hemolytic uremic syndrome (HUS) in children. They may represent an epiphenomenon or could be related to the platelet activation and endothelial damage observed in this disease. In an attempt to define this relationship, we investigated the CIC isolated in 17 patients with the classic form of HUS, by means of monoclonal antibodies against platelet surface glycoprotein Ib and IIb-IIIa complex. The negative results obtained do not support the possibility of platelet antigens being constituents of CIC and make an antibody-induced platelet activation in HUS very unlikely.


Assuntos
Complexo Antígeno-Anticorpo/sangue , Complexo Antígeno-Anticorpo/imunologia , Antígenos/sangue , Síndrome Hemolítico-Urêmica/imunologia , Glicoproteínas da Membrana de Plaquetas/imunologia , Anticorpos Monoclonais , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Síndrome Hemolítico-Urêmica/sangue , Síndrome Hemolítico-Urêmica/etiologia , Humanos , Lactente , Masculino , Ativação Plaquetária/imunologia
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