[Adenovirus infections in an emergency department]. / Infecciones por adenovirus en un servicio de urgencias.

We have reviewed 108 emergency ward reports of patients with adenoviral positive cultures in "Doce de Octubre" Hospital in Madrid. Our aim was to know the most frequent symptoms of the infection so that identification and treatment could be managed more efficiently in our department. Cellular cultures were negative for other viruses such as CMV, enterovirus and herpesvirus. No bacteria were found in the throat cultures. Of the children who were evaluated, 78% were younger than 3 years old. The most frequent symptom was high fever with an otherwise good state of health. During the physical examination, a reddened throat with an exudate was found in half of the patients. A white blood cell count of over 15,000 was found in 33% of the patients with a left shift in 20%. The clinical findings overlapped with throat bacterial infections in 66%, lower respiratory infections in 14%, and more unusual, gastroenteritis, hematuria, intestinal invagination or exanthemas. Only 15% were not given antibiotic therapy.

[Marfan syndrome in childhood: cardiovascular manifestations. Echocardiographic changes]. / Síndrome de Marfan en la infancia: clínica cardiovascular. Alteraciones ecocardiográficas.

We report the cases of eight children with Marfan syndrome. Seven (87.5%) were diagnosed with cardiopathy, everyone with auscultatory findings. Electrocardiographic patterns were nonspecific. Enlargement of the aortic root was present in two of the cases as seen by thorax x-rays. Echocardiography detected the presence of mitral valve prolapse in 87.5% of the patients (7 cases) and aortic enlargement in 75% of the patients (6 cases). Echocardiography also detected the presence of aortic dysplasia, tricuspid valve prolapse and right and left ventricular hypertrophy. During the follow-up period, no case had cardiac failure. There was no mortality. The aortic enlargement was progressive and was not modified by propranolol treatment. Surgical treatment was not needed. Family history related to this condition was present in a very small percentage (37.5%). We comment on one infantile form of Marfan syndrome with its own phenotype different from that of classical Marfan syndrome.

[Biliary lithiasis in childhood]. / Litiasis biliar en la infancia.

We have reported 28 cases of pediatric cholelithiasis in our hospital between 1980 and 1990. We found risk factors in 15 of these cases (53.6%). The most frequent risk factors were hereditary spherocytosis, cholestasis and obesity. A high frequency of non-hemolytic cholelithiasis was noted. Lithiasis was a casual finding in 13 cases (46.4%). The most frequent symptom was nonspecific abdominal pain, which occurred in 8 patients. Diagnosis was made with echography in every case. The range of time in which the patients were followed ranged between 1-5 years. Eight children required surgery. Among the other twenty, twelve were asymptomatic and six improved spontaneously. The mean age at the moment of diagnosis was younger in the children that spontaneously recovered than in children with permanent lithiasis. Therefore, for this reason, we recommend an observation period before surgery in children younger than 3 years of age.