RESUMO
Benign acute childhood myositis (BACM) is a rare clinical condition that mainly affects pre-school and school age-children. It is usually preceded by a viral illness, particularly influenza virus infection. OBJECTIVE: To describe a cluster of BACM cases that were seen in a paediatric unit. PATIENTS AND METHODS: A retrospective series of cases that presented with a clinical picture suggestive of BACM between August and November 2012 in the paediatric emergency department of a private clinic. RESULTS: Nine children, between 4 and 12 years, presented with a history of a recent febrile upper viral respiratory infection, followed by intense calf pain and claudication. They all recovered without complications. Laboratory results showed a marked increase in CK, with a mean of 4,066 IU/l. Three of the cases had influenza B infection and one Mycoplasma pneumonia infection. They were managed conservatively with hydration and non-steroidal anti-inflammatory drugs. CONCLUSIONS: BACM is a benign entity with a characteristic clinical presentation that can be managed most of the time in the ambulatory setting, avoiding invasive studies and unnecessary hospital admission.
Assuntos
Influenza Humana/complicações , Miosite/etiologia , Infecções Respiratórias/complicações , Doença Aguda , Criança , Pré-Escolar , Feminino , Humanos , Vírus da Influenza B/isolamento & purificação , Masculino , Miosite/diagnóstico , Miosite/terapia , Pneumonia por Mycoplasma/complicações , Estudos RetrospectivosRESUMO
La miositis aguda benigna de la infancia (MABI) es una entidad clínica autolimitada, infrecuente, que afecta a niños en edad preescolar y escolar. Dada su asociación a cuadros virales, se sugiere una relación con este tipo de agentes, entre los que predomina el virus influenza. OBJETIVO: Describir un brote de casos de MABI presentados en un servicio pediátrico. PACIENTES Y MÉTODO: Serie clínica retrospectiva de pacientes que consultaron por un cuadro clínico compatible con MABI en el período agosto-noviembre de 2012, en el Servicio de Urgencia pediátrico de un centro asistencial. RESULTADOS: Se presentan una serie de 9 niños, edades entre 4 y 12 años, con un pródromo de fiebre asociado a síntomas respiratorios, seguido de dolor agudo intenso de ambas pantorrillas y claudicación. En los exámenes de laboratorio destacaba un alza de creatincinasa, con un valor promedio de 4.066 UI/L. El estudio etiológico evidenció influenza B en 3 pacientes y Mycoplasma pneumoniae en uno. El manejo consistió en hidratación y antiinflamatorios no esteroidales, con favorable evolución clínica y de laboratorio. CONCLUSIONES: La MABI es una entidad benigna, autolimitada, de excelente pronóstico, con una presentación clínica que en la mayoría de los casos requiere manejo ambulatorio. Deben evitarse estudios invasivos y hospitalizaciones innecesarias.
Benign acute childhood myositis (BACM) is a rare clinical condition that mainly affects pre-school and school age-children. It is usually preceded by a viral illness, particularly influenza virus infection. OBJECTIVE: To describe a cluster of BACM cases that were seen in a paediatric unit. PATIENTS AND METHODS: A retrospective series of cases that presented with a clinical picture suggestive of BACM between August and November 2012 in the paediatric emergency department of a private clinic. RESULTS: Nine children, between 4 and 12 years, presented with a history of a recent febrile upper viral respiratory infection, followed by intense calf pain and claudication. They all recovered without complications. Laboratory results showed a marked increase in CK, with a mean of 4,066 IU/l. Three of the cases had influenza B infection and one Mycoplasma pneumonia infection. They were managed conservatively with hydration and non-steroidal anti-inflammatory drugs. CONCLUSIONS: BACM is a benign entity with a characteristic clinical presentation that can be managed most of the time in the ambulatory setting, avoiding invasive studies and unnecessary hospital admission.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Infecções Respiratórias/complicações , Influenza Humana/complicações , Miosite/etiologia , Vírus da Influenza B/isolamento & purificação , Pneumonia por Mycoplasma/complicações , Doença Aguda , Estudos Retrospectivos , Miosite/diagnóstico , Miosite/terapiaRESUMO
Según distintos trabajos (2,3,4) el embarazo en una mujer adolescente conlleva mayor riesgo tanto de patología propia del embarazo, parto y puerperio, como en el niño durante el primer año de vida. El objetivo de este trabajo es ver si en una comuna precordillerana como es Curacautín se observan estas diferencias en nuestras embarazadas adolescentes con respecto a las no adolescentes. En conclusión, nuestros resultados indican que las embarazadas adolescentes son más enflaquecidas, se enferman más durante el embarazo teniendo más anemia y síntomas de parto prematuro, los recién nacidos son de más bajo peso, presentan más ictericia fisiológicas, patologías dérmicas y retardo del desarrollo psicomotor el primer año de vida. Por lo tanto el embarazo en una adolescente es siempre un factor de riesgo tanto para la madre como para el hijo, ya sea en un área rural como es Curacautín o en áreas urbanas como lo describe la literatura
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Lactente , Gravidez na Adolescência/estatística & dados numéricos , Fatores de Risco , Doenças do Recém-Nascido/epidemiologia , Complicações na Gravidez/epidemiologia , Classe Social , Estado Nutricional , Estudos Retrospectivos , Estado Civil , História Reprodutiva , Escolaridade , Complicações do Trabalho de Parto/epidemiologiaRESUMO
What is the future of community psychiatry in Quebec, more precisely in the Montreal area? Initially aimed at globally reorganizing psychiatric services, community psychiatry intended to take care of psychotic patients outside psychiatric hospitals, and in a different way. After an initial period of positive influence on psychiatric services in Quebec, the early objectives seem to be deteriorating. At the beginning, the geographical division of the territory in catchment areas was but one of the many characteristics of community psychiatry : with years the part has become more important than the whole and is consuming an increasing amount of energy among clinicians as well as administrators in the fiels of psychiatry. Professionalism (professions claiming more autonomy) has become a threat to team work, another characteristic of community psychiatry. As one could have expected, theses changes have brought, it seems, some modifications in the quality of care, as witnessed by the many psychiatric patients waiting for many days on streatchers in emergency wards and by the lenghtening of waiting lists in out-patient clinics.
RESUMO
The author sets forth some reflections on the present state of mental health services in the Montreal Region, concerning himself primarily with the problems encountered in the application of the theoretical model underlying the existing services, that being community psychiatry. These problems are of three orders: the distribution of establishments and the geographic distribution of the population do not correspond; because of the liberation of many psychotics a backlash is starting to make itself felt in the population, and chronic patients have become immigrants in the city; the multidisciplinary <
RESUMO
The author, head of a psychiatric department in a general hospital, presents results of a study conducted with 15 psychiatric department chiefs. Questions were related to population ; distribution of professionals ; clinical work ; and various teams. The author then comments results.
RESUMO
This article presents discussions held in workshops during the first symposium on sectorial psychiatry. The themes are : continuity in care, team work ; the use of para/professionals ; education ; consultation ; the place of the ill in society ; prevention.
RESUMO
This exposé attempts to draw a portrait as accurate as possible of the practice of sectorial psychiatry within a general hospital setting in 1976. The author works in a university hospital of 700 beds in downtown Montréal. In this article, he underlines his perception of difficulties and satisfactions mental health professionals can experience within a general hospital setting.