Procalcitonin and C-reactive protein serum levels as markers of infection in a pediatric population with febrile neutropenia and cancer.

BACKGROUND: Procalcitonin and C-reactive-protein are inflammatory markers for sepsis. The authors evaluated their sensitivity and specificity in pediatric patients with cancer and febrile neutropenia. PROCEDURE: Serum procalcitonin and C-reactive-protein were evaluated. Patients (n = 54) were divided into 2 groups, with severe infection (n = 18) or without documented infection (n = 36). RESULTS: Procalcitonin and C-reactive protein were significantly higher in the high-risk group. Procalcitonin displayed 72.2% sensitivity and 80.5% specificity. C-reactive-protein had a sensitivity of 77.7% and specificity of 77.2%. CONCLUSIONS: Procalcitonin is an accurate predictor of bacterial infection in neutropenic children, while C-reactive-protein may be a better screening test in emergency settings.

[Occurrence of preterm and term low birth weight deliveries and presence of the Sydney crease]. / Incidencia de nacimientos pretérmino y de término con peso bajo al nacer y existencia de línea Sydney.

OBJECTIVE: To determine whether simian and Sydney creases are associated to preterm delivery or to term low birth weight. PATIENTS AND METHODS: We performed a cross-sectional study of 490 live newborns without apparent malformations from the Hospital Civil de Guadalajara Dr. Juan I. Menchaca (Guadalajara, Mexico). Patients were categorized in three groups: group I: 175 infants with preterm delivery; group II: 140 term low birth weight infants; group III: 175 at term newborns with adequate weight for gestational age. On all groups, perinatal history was registered and palm creases were studied by direct inspection and classified as normal, simian crease (single palmar flexion crease) or Sydney crease (continuation of the proximal palmar crease until the ulnar border of the palm). We used the odds ratio as an association measurement, with 95% confidence intervals. RESULTS: The simian crease frequency did not show significant differences between groups. Sydney crease frequencies on groups I, II and lll were 29.7, 34.2 and 18.2%, respectively (p = 0.0037). Sydney crease presence was associated with near to two-fold frequency to preterm birth (OR: 1.89, 95% CI: 1.11-3.23) and more than double with low birth weight (OR: 2.33, 95% Cl: 1.07-5.23). CONCLUSIONS: Sydney crease was associated with occurrence of the preterm and term low birth weight deliveries.

Malformaciones congénitas en 75,788 nacimientos consecutivos en cuatro hospitales de Guadalajara, México / Incidence of congenital abnormalities in 75,788 consecutive birth in four Guadalajara's hospitals(Mexico)

Se realizó un estudio de casos y controles de malformaciones congénitas en 4 hospitales del área metropolitana de Guadalajara. Se estudiaron 75,788 recién nacidos durante el periodo de noviembre de 1988 a junio de 1993, recolectándose la información a través de la exploración física del recién nacido y por entrevista a la madre sobre la condición del producto al nacer, antecedentes patológicos y exposición a factores físicos y químicos. Por cada malformado se seleccionó un control no malformado del mismo sexo, no necesariamente sano, pero del mismo hospital. La prevalencia hospitalaria general de las malformaciones congénitas fue de 22.3 x 1,000 RN; en nacidos vivos fue de 21.4 x 1,000 y de 69.6 x 1,000 en nacidos muertos. Los diagnósticos más importantes de malformaciones mayores por 10,000 RN fueron; defectos del cierre del tubo neural con tasa de 26.5; la anencefalia con tasa de 12.8. Las anomalias cromosómicas tuvieron una tasa de 14.8; la malformación más frecuente fue el Síndrome de Down con tasa de 12.1 , el labio paladar endido 11.1 y la polidactilia con 11.0. Las malformaciones se encontraron asociadas a: edad mayor de 40 años de la madre (RR=2.4; IC=1.5-3.8)~ antecedentes de un malformado previo (RR=4.6; IC=3.6-5.9), metrorragia en el primer trimestre de embarazo (RR=1.4; IC=1.0-1.9) y diabetes en el embarazo (RR=4.7; IC=1.2-20.4)