Effect of Increased Immunosuppression on Developmental Outcome of Opsoclonus Myoclonus Syndrome (OMS).

Opsoclonus myoclonus syndrome (OMS) produces long-term cognitive, behavioral, and motor deficits. Objective was to see if more aggressive treatment improved outcome. Assessment included opsoclonus myoclonus syndrome rating, developmental/cognitive and motor assessment, and adaptive behavior. Fourteen subjects completed testing. Nine had neuroblastoma. Onset was at 10 to 35 months; onset to diagnosis: 2 days to 14 months, and onset to first treatment: 5 days to 15 months. Initial treatment was corticotropin (12), oral steroids (3), plus intravenous immunoglobulin in all. Ten received rituximab, 5 cyclophosphamide. Age at testing ranged from 2.5 to 10.3 years. Adaptive Behavior Score (11 subjects), mean 93.5; estimated Intelligence Quotient/Developmental Quotient mean 93.5; Motor: mean 92.8. Residual opsoclonus myoclonus syndrome symptoms at the time of the evaluation were generally minor; opsoclonus myoclonus syndrome scores ranged from 0 to 6. Comparison to previously reported opsoclonus myoclonus syndrome subjects showed improved outcomes: Adaptive behavior, cognitive and motor scores were significantly higher (P < .001) in new subjects. Outcomes have improved with more aggressive immunosuppression, with most opsoclonus myoclonus syndrome survivors now functioning at or near normal.

Deficiencia de hierro y anemia ferropénica en niños menores de 2 años atendidos en los centros de salud de la Dirección de salud V de Lima / Iron deficiency and iron deficiency anemia in children under 2 years old who attended health centers from Fifth Lima Health Directorate

Fundamento. La deficiencia de hierro y la anemia ferropénica son problemas que muestran tasas altas de prevalencia en los niños menares de 2 años. La reducción de estas tasas puede estar asociada a la aplicación de estrategias integrales. Objetivo. Evaluar los resultados de implementar una estrategia basada en 4 componentes. Materiales y métodos. La Dirección de Salud V Lima Ciudad tiene a su cargo 22 distritos en los cuales se encuentran 125 Establecimientos de Salud del Primer Nivel de Atención. La estrategia implementada estuvo conformada par 4 componentes: i) Normativo; ii) Educativo y de Capacitación; iii) Conformación de un equipo Interdisciplinario mínimo para atender trastornos nutricionales en el Primer Nivel de Atención; y iv) Articulación Multisectorial. Resultados. La prevalencia de Anemia ferropénica en niñas y niños de 6 a 23 meses de edad atendidos en la jurisdicción de la Dirección de Salud V Lima Ciudad disminuyó de 57.2% (ario 2007) a 33.77% (ario 2011). Los niños suplementados (dosis preventiva durante 6 meses continuos) en el año 2008, fueron 2,677; mientras que en el año 2,011 se logró suplementar a 4,476 niños. Conclusión. La implementación de una estrategia de intervención con cuatro componentes contribuyo en la reducción de la prevalencia de Anemia ferropenia en niños y niñas de 6 a 23 meses de edad atendidos en los Establecimientos de Salud del Primer Nivel de Atención de la Dirección de Salud V Lima Ciudad.

Background. Iron deficiency and iron deficiency anemia are problems that show high rates of Prevalence in children under 2 yeras. The reducctionof these rates may be associated with theimplementation of comprehensive strategies. Objetive. Evaluation results of implementing a strategy based on four components. Materials and Methods. The Department of Health V Lima City is responsible for 22 districts in which are 125 health facilities in the primary care level. The implemented strategy consisted of four components: i) Regulatory ii) Education and Training; iii) Establishment of an interdisciplinary team to meet minimum nutritional disorders in the primary care level, and iv) Multisectoral Coordination. Results. The prevalence of iron deficiency anernia in children 6 to 23 months old treated in the jurisdiction of the Department of Health V Lima City decreased from 57.2% (2007) to 33.77% (2011). Children supplemented (preventive dose for 6 months continuous) in 2008 were 2.677, while in the year 2.011 4.476 was achieved supplement to children. Conclusion. The implementation of an intervention strategy has four components contributed in reducing the prevalence of iron deficiency anemia in children 6 to 23 months old treated in healthcare facilities of Level of Care Health Directorate V Lima town.