RESUMO
Shwachman-Diamond syndrome (SDS) is a rare autosomal recessive disorder of marrow failure syndrome and exocrine pancreatic dysfunction with an estimated incidence of 1/76,000. When present, characteristic skeletal abnormalities are strongly suggestive of SDS but most often they are seen during childhood and adolescence. We present a case of preterm twins with prenatal diagnosis of thoracic hypoplasia and a clinical evolution that lead to an early diagnosis of SDS. This report highlights the importance of a high index of suspicion for SDS in case of neonatal thoracic hypoplasia.
RESUMO
Eleven HIV-infected and 30 otherwise healthy children hospitalized for H1N1 influenza were studied. Leukopenia was recorded in 64% of HIV-infected and in 20% of healthy children (P = 0.01). Chest radiograph was abnormal in 18 (46%) children. Interstitial pneumonia was more frequent in HIV-positive children and consolidation was more frequent in HIV-negative children. Although the duration of symptoms and hospital stay was significantly longer in HIV-negative than in HIV-positive children, only 37% of HIV-negative children and 91% of HIV-positive received oseltamivir. The H1N1 influenza attack rate was very high (20%) in HIV-infected children, but it consistently ran a mild course.
Assuntos
Infecções por HIV/diagnóstico , Vírus da Influenza A Subtipo H1N1/imunologia , Influenza Humana/diagnóstico , Pneumonia Viral/diagnóstico , Adolescente , Antivirais , Criança , Pré-Escolar , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Hospitalização , Humanos , Influenza Humana/tratamento farmacológico , Influenza Humana/imunologia , Leucopenia , Masculino , Pandemias , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/imunologiaRESUMO
BACKGROUND: Diosmectite (DS), an antidiarrheal absorbent natural clay, was proposed for treatment of acute gastroenteritis and more recently considered for diarrhea within the functional bowel disorder syndrome. OBJECTIVE: To review pharmacology efficacy, mechanisms of action and safety of DS. METHODS: We consulted PubMed/Medline using the keywords of smectite and diarrhea or gastroenteritis, and reviewed most recent recommendations by scientific societies. CONCLUSIONS: Solid data show that DS is effective in infectious diarrhea, mainly as an ion antisecretory agent and in preventing intestinal damage. Despite clinical data being consistent and convincing, DS is not considered as first-line treatment because of the presence of alternative therapeutic options. However, it definitely may play a role in infectious colitis, where treatment options are less convincing. Some available evidences demonstrate a role of DS in functional diarrhea.
