Severe pulmonary hypertension and circulatory failure associated with Congenital syphilis. Case report.

BACKGROUND: Congenital syphilis is a vertical infection caused by Treponema pallidum. Despite the implementation of preventive strategies during pregnancy, its incidence is increasing, and it constitutes an important public health problem. Most patients with congenital syphilis are asymptomatic; however, a small group may develop severe disease at birth with the need of advanced resuscitation in the delivery room, acute hypoxemic respiratory failure, and hemodynamic instability. Therefore, awareness is needed. METHODS AND RESULTS: This series describes the clinical course of two late preterm infants with congenital syphilis who developed acute hypoxemic respiratory failure, pulmonary hypertension, and circulatory collapse early after birth. Integrated hemodynamic evaluation with neonatologist-performed echocardiography (NPE) and therapeutic management is provided. CONCLUSIONS: A comprehensive hemodynamic evaluation including early and serial functional echocardiography in these patients is needed to address the underlying complex pathophysiology and to help to establish accurate treatment.

Design and verification of the shielding around the new Neutron Standards Laboratory (LPN) at CIEMAT.

The construction of the new Neutron Standards Laboratory at CIEMAT (Laboratorio de Patrones Neutrónicos) has been finalised and is ready to provide service. The facility is an ∼8 m×8 m×8 m irradiation vault, following the International Organization for Standardization 8529 recommendations. It relies on several neutron sources: a 5-GBq (5.8× 10(8) s(-1)) (252)Cf source and two (241)Am-Be neutron sources (185 and 11.1 GBq). The irradiation point is located 4 m over the ground level and in the geometrical centre of the room. Each neutron source can be moved remotely from its storage position inside a water pool to the irradiation point. Prior to this, an important task to design the neutron shielding and to choose the most appropriate materials has been developed by the Radiological Security Unit and the Ionizing Radiations Metrology Laboratory. MCNPX was chosen to simulate the irradiation facility. With this information the walls were built with a thickness of 125 cm. Special attention was put on the weak points (main door, air conditioning system, etc.) so that the ambient dose outside the facility was below the regulatory limits. Finally, the Radiation Protection Unit carried out a set of measurements in specific points around the installation with an LB6411 neutron monitor and a Reuter-Stokes high-pressure ion chamber to verify experimentally the results of the simulation.

El aspecto clínico de la enfermedad celíaca se amplía / Celiac disease: new clinical aspects

Se hace una revisión de las alteraciones neurológicas frecuentemente asociadas con la enfermedad celíaca descritas en la literatura. Entre las mismas destaca la elevada prevalencia de crisis convulsivas febriles y epilepsia, tanto generalizada como asociada a calcificaciones cerebrales occipitales bilaterales. También es relevante la asociación con síndromes espino-cerebelosos con ataxia, alteraciones psiquiátricas y de conducta, neuropatía periférica, miopatía inflamatoria, cefalea tanto tensional como migrañosa, síncope vagal, hipotonía muscular y vasculitis cerebral. Se revisa la posible etiopatogenia de tales alteraciones que en dependencia del tipo de manifestación obedecería a factores genéticos, mecanismos inmunológicos o tóxicos o por deficiencia vitamínica o alteración de las aminas biógenas en relación con una alteración malabsortiva intestinal (AU)

Nutrición del prematuro tras el alta hospitalaria / Nutrition of the premature after hospital discharge

No disponible