[Effectiveness of trabeculectomy trabeculotomy in the reduction of intraocular pressure in patients with primary congenital glaucoma]. / Efectividad de la trabeculotomía más trabeculectomía en la reducción de la presión intraocular (PIO) en pacientes con glaucoma congénito primario (GCP).

OBJECTIVE: To evaluate the effectiveness of trabeculectomy trabeculotomy in the reduction of intraocular pressure in patients with primary congenital glaucoma. MATERIAL AND METHODS: A pre-experimental before and after study was conducted with several measurements after; patients with intraocular pressure≥21 mmHg were included, of both sexes, and children under six years, which had ​​the trabeculotomy trabeculectomy. Success was defined as the reduction of intraocular pressure<21 mmHg within three months after the procedure. For the descriptive analysis, medians with ranges and quartiles 25 and 75 were used. For the inferential analysis, we conducted a visual graphic and analysis of variance for repeated measures of Friedman. A value of p<0.05 was considered as significant. The software used was SPSSv15. RESULTS: 16 eyes were included with intraocular pressure 27.75 mmHg (23-40), vertical and horizontal corneal diameter of 14 mm (12-16), who had undergone trabeculectomy with mitomycin C trabeculectomy; at three months after surgery the intraocular pressure was 12.5 mmHg (8.5-23) (p<0.001) and no changes were observed in the corneal diameters. An eye with a flat anterior chamber was observed as an adverse effect. Thirteen eyes required topical hypotensors to achieve the target intraocular pressure. CONCLUSIONS: The treatment with trabeculectomy trabeculotomy in primary congenital glaucoma is effective in the reduction of the intraocular pressure.

[Factors associated with advanced thyroid cancer in pediatric patients in a high specialty medical unit in Northeast Mexico]. / Factores asociados a estadios avanzados de cáncer tiroideo en pacientes pediátricos de una UMAE del noreste de México.

INTRODUCTION: Thyroid cancer represents 2% of all childhood malignances. Its incidence rises 1.1% per year. In comparison with adults, childhood thyroid cancer is detected in a more advanced stage, but with a survival rate above 95%. The objective of this study was to evaluate whether there are factors associated with advanced stages of thyroid cancer in pediatric patients. RESULTS: Nineteen patients were included, 13 (68.4%) were female and six male, all between 7-15 years, with a median of 11 years. Fifteen in advanced and four in early stage. The median age of patients in advanced stage at time of diagnosis was 10.6 years (7-15) and 13.2 (12-14) were in early stage (p=0.075). There was a delay of nine months to get a diagnosis in advanced stage, and 7.2 in early stage (p=0.931). Three of the patients with advanced stage and two with early stage were from Nuevo León (Mexico) and the rest were foreign (p=0.567). In the group with advanced stage, two had thyroid cancer familiar history, and none in the early stage group (p=0.452). Nine patients in advanced stage and three in early stage presented thyroid nodule as the first sign of illness. Six patients in advanced stage and one in early stage presented goiter (p=0.590). None of the studied patients had radiation history. Six patients in advanced stage and one in early stage suffered from Hashimoto's Thyroiditis (p=0.590). Eleven in advanced stage and one in early stage had papillary histologic variety. Four in advanced stage and three in early stage had papillary histologic variety with a follicular patter (p=0.083). Eight patients presented lung metastasis at time of diagnosis (p=0.061). CONCLUSIONS: There are no factors associated with advanced stage thyroid cancer in pediatric populations. Although half of studied patients presented lung metastasis, treatment response and survival is satisfactory.

[Prolonged exposure to antibiotics and the risk of late-onset sepsis (LOS) in neonates of 1,000-1,500 g: a cohort study]. / Exposición prolongada a antibióticos y riesgo de sepsis tardía (ST) en neonatos de 1,000 a <1,500 g: estudio de cohorte.

OBJECTIVE: To determine whether prolonged exposure to antibiotics (>5 days) increases the risk of late-onset sepsis (LOS) in newborns of 1,000-1,500 g. METHODS: A cohort study in newborns with suspected perinatal infection, with a survival greater than seven days. The exposed cohort was composed of newborns with antibiotic therapy initiated at first postnatal day, lasting >5 days, with negative blood cultures before the fifth day of life, and without clinical evidence of sepsis. The non-exposed cohort was identical but with antibiotics stopped before the fifth day of life. Patients were followed daily for clinical and laboratory evidence of LOS. Others risk factors for LOS were analyzed. STATISTICAL ANALYSIS: We analyzed the incidence, the relative risk (RR) with 95% CI. To measure the time to occurrence of an event of LOS after exposure, Kaplan-Meier survival curve and log-rank test were used. RESULTS: We followed up 49 patients in each group. The incidence was 33.6%. The time of follow-up was 839 vs. 1,291 person-days. Prolonged exposure to antibiotics was associated with a higher risk of LOS (RR: 21.1; 95% CI: 6.5-68.9; p=0.000). The late-onset sepsis-free time was 17.1±1.1 vs. 26.3±0.8 days. CONCLUSIONS: The risk of LOS was higher in newborns with prolonged exposure to antibiotics and increased with the days of exposure.