[Risk factors for home deaths due to pneumonia among low socioeconomic level Chilean children, Santiago de Chile (1994)]. / Factores de riesgo de fallecer en domicilio por neumonía, de niños chilenos de estratos socioeconómicos bajos, Santiago de Chile (1990-1994).

BACKGROUND: Pneumonia is the main cause of late infant mortality in Chile. Over 60% of these deaths occur at home. The lack of hospital beds and the inadequate outpatient management are contributing factors. AIM: To assess risk factors for home deaths due to pneumonia in Chilean children. PATIENTS AND METHODS: The clinical and environmental histories of 53 (39 male) children that died due to pneumonia in their homes were analyzed. The cause of death was confirmed by necropsy with histopathological studies in all cases. These cases were compared with 88 control children of similar age, gender, socioeconomic status and living in the same geographical area of Metropolitan Santiago. RESULTS: Fifty four percent of deceased children were of less than 3 months of age and only 3 cases and their controls were above 1 year old. Identified risk factors for death were malnutrition with an odds ratio of 30.6 (CI 3.9-64.8, p < 0.001), low birth weight with an odds ratio of 5 (CI 1.8-14.1, p < 0.001), previous admissions to hospitals with an odds ratio of 5.79 (CI 2-17.1, p < 0.001), congenital malformations (mainly cardiac) with an odds ratio of 8.4 (CI 2-39.9, p = 0.001) and a history of bronchial obstruction with an odds ratio of 5.68 (p < 0.001). Identified maternal risk factors were smoking with an odds ratio of 4.13 (CI 1.6-10.7 p < 0.001) and being a teenager with an odds ratio of 4.3 (CI 1.7-11, p < 0.001). Malnutrition, low birth weight, history of previous hospital admissions and having a teenager or smoker mother were considered as independent risk factors using a stepwise analysis. CONCLUSIONS: Chilean low income children have identifiable risk factors for death at their homes due to pneumonia, that can be preventively managed.

[Clinical epidemiological findings in infants who were dead on arrival to hospital]. / Muertes infantiles extrahospitalarias en un servicio de salud metropolitano.

Some clinical and social aspects of 262 infants who were considered to be dead on arrival to the emergency care room of a suburban hospital at south east metropolitan Santiago, Chile, in the last five years were analysed. This figure amounts for 24% of infant mortality rate of that area. Males under age 6 month were more frequently affected (61.2%) than any other group; low birth weight was present in 25.4% of the cases and previous hospital admission in 41.7% incidence of death before hospital admittance was more frequent in spring and summer than in autumn and winter (22.9 vs. 77.1%); monthly family income was under U$50 in 58% of cases, 30% of mothers were under age twenty year, and 43% of patients had been reared by maritally unstable couples. Previous denial of care was reported in only four cases. Body temperature was recorded at hospital arrival in 72.5% of dead on arrival infants and it was above 40 degrees C in 20% of them. Preventive measures to control family based infant mortality should probably include education of mothers at the well baby clinic on risk factors, early consultation, appropriate initial management of fever and other emergencies at home, together with measures to provide easy access for everybody to timely an efficient medical care.

Sindrome hemolitico uremico. / Hemolytic uremic syndrome

Se realizo un estudio retrospectivo en 14 lactantes hospitalizados en el Servicio de Pediatria del Hospital Sotero del Rio, durante el periodo Enero 1979 a Marzo 1983, dados de alta con diagnostico de S.H.U. Efectuamos en analisis de los parametros clinicos y de laboatorio en cada uno de los pacientes, ademas de discutir el manejo terapeutico, indicaciones de dialisis y sus complicaciones. Se incluye la descripcion de un caso clinico como prototipo de sindrome. Proponemos la dialisis peritoneal precoz para el tratamiento del S.H.U.guiados por la evolucion de la anuria. Se analiza finalmente los actuales conceptos etiopatogenicos de sindrome

Hemiplejia infantil aguda y septicemia. / Acute infantile hemiplegia and septicemia

Se presenta el caso de un lactante de 10 meses con septicemia y hemiplegia infantil aguda. Se describe anamnesis, evolucion y seguimiento, comentandose las principales caracteristicas de esta enfermedad

Tratamiento con tiopental del estado epileptico en ninos. / Treatment with thiopental of status epilepticus in children

Se estudio el efecto del tiopental sodico en el manejo del estado convulsivo en 10 pacientes hospitalizados en U.C.I.P., del Hospital Dr. Sotero del Rio.Se analizan en detalle las dosis usadas y los efectos de sobre-dosis del farmaco, proponiendose un esquema terapeutico util para coartar el sindrome convulsivo y evitar efectos colaterales. Se describen las tecnicas usadas y los resultados de este sindrome. Se concluye que este esquema terapeutico es de gran utilidad en el estado convulsivo logrando remision de las crisis convulsivas en todos los pacientes, siempre que se utilice en las dosis adecuadas y con un cuidadoso monitoreo de los signos vitale

Trombosis carotidea secundaria a traumatismo oral. / Carotid thrombosis secondary to oral trauma

Se presenta el caso de una nina de 6 anos con trombosis de carotida interna secundaria a traumatismo intraoral. Se revisan la literatura, el cuadro clinico y la necropsia del caso. Se hace hincapie en el tratamiento del edema cerebral

Asfixia por inmersion (a proposito de trece casos). / Asphyxia due to immersion (apropos of 13 cases

Se presentan trece casos de ninos con asfixia por inmersion, se hace hincapie en la escasa experiencia nacional, se destacan las caracteristicas socioculturales que rodean el accidente y se resumen algunos aspectos del tratamiento, con especial enfasis en el edema cerebral y las complicaciones pulmonares