Features of Dengue and Chikungunya Infections of Colombian Children under 24 Months of Age Admitted to the Emergency Department.

We aimed to assess clinical and laboratory differences between dengue and chikungunya in children <24 months of age in a comparative study. We collected retrospective clinical and laboratory data confirmed by NS1/IgM for dengue for 19 months (1 January 2013 to 17 August 2014). Prospective data for chikungunya confirmed by real-time polymerase chain reaction were collected for 4 months (22 September 2014-14 December 2014). Sensitivity and specificity [with 95% confidence interval (CI)] were reported for each disease diagnosis. A platelet count <150 000 cells/ml at emergency admission best characterized dengue, with a sensitivity of 67% (95% CI, 53-79) and specificity of 95% (95% CI, 82-99). The algorithm developed with classification and regression tree analysis showed a sensitivity of 93% (95% CI, 68-100) and specificity of 38% (95% CI, 9-76) to diagnose dengue. Our study provides potential differential characteristics between chikungunya and dengue in young children, especially low platelet counts.

Iniencephaly: Case Report.

The iniencephaly involves a variable defect in the occipital bone, resulting in a large foramen magnum, partial or total absence of the cervical and thoracic vertebrae, accompanied by incomplete closure of arcs and/or vertebral bodies, significant shortening of the spinal column and hyperextension of the malformed cervicothoracic spine; the individual's face is deviated upward, the mandibular skin is directly continuous with anterior thorax due to the absence of neck. Its incidence is about 1:1000-1:2000 births, so this is a pretty rare neural tube defect. We present a case of iniencephaly in association with cardiovascular, spinal cord, and intracranial malformations that ended demonstrating the low survival of patients affected with this condition.

Resultados funcionales y estéticos del manejo quirúrgico de liberación de sindactilia en la mano infantil / Functional and aesthetic results of syndactyly surgical release in a child's hand

Introducción La sindactilia es una de las malformaciones hereditarias que con mayor frecuencia comprometen las manos. Es una de las causas de intervención quirúrgica por parte del Servicio de Ortopedia con poco registro bibliográfico en cuanto a su seguimiento posterior al procedimiento. El Objetivo del estudio es evaluar los resultados funcionales y estéticos posteriores al manejo quirúrgico de liberación de la sindactilia de la mano en niños con diagnóstico de sindactilia congénita. Materiales y métodos Estudio descriptivo retrospectivo, el cual incluyó a pacientes menores de 15 años que acudían a la consulta de ortopedia con diagnóstico de sindactilia congénita, los cuales fueron intervenidos para liberación quirúrgica de este defecto congénito y a los cuales se les realizó un seguimiento posquirúrgico. Resultados Se incluyó a 15 pacientes entre 0 y 15 años, de los cuales el sexo masculino representó el 73,3% el total de la población. El 53,3% de los pacientes con buenos resultados funcionales fueron intervenidos por la técnica reconstructiva del colgajo rectangular dorsopalmar y el 45,4% necesitaron injerto cutáneo. El 20% de los pacientes intervenidos presentaron tanto buenos resultados funcionales como estéticos posquirúrgicos, sin complicaciones y sin reintervenciones en la evaluación a los 3 meses del postoperatorio. Discusión El 73,3% de los pacientes presentaron buenos resultados estéticos y el 60%, al evaluarse los arcos de movilidad, presentaban buena funcionalidad. La intervención precoz estuvo relacionada con la disminución en el número de complicaciones y menor número de reintervenciones. Nivel de evidencia clínica Nivel IV.

Background Syndactyly is one of the inherited malformations that most often involve the hands. It is a frequent cause of surgical intervention, with few literature reports as regards follow-up and outcomes. The objective of the study is to evaluate the functional and aesthetic results after the surgical management of syndactyly release from the hands of children diagnosed with congenital syndactyly. Materials and methods A series of cases was conducted that included patients under the age of 15 who attended an orthopaedic clinic with a diagnosis of congenital syndactyly. All patients were subjected to surgery to release the congenital defect. All patients underwent post-operative follow-up for at least 3 months. Results The study included 15 patients aged 0-15 years, 73.3% of whom were male. The 53.3% of the patients with good functional results, were operated on using the reconstructive technique of the dorsal-palmar rectangular flap, with 45.4% requiring a skin graft. Twenty percent of the patients had both good postoperative functional and aesthetic results, with no complications and with no re-interventions in the 3 months postoperative follow-up. Discussion Almost three-quarters (73.3%) of the patients showed good aesthetic results, and 60% had good functionality,when evaluating the mobility arches. Early intervention was related to a decrease in the number of complications and a lower number of re-interventions. Level of evidence IV.