RESUMEN
AIM: We aimed to validate the incidence of, risk factors for, and postoperative outcomes of acute kidney injury (AKI) according to the modified Kidney Disease Improving Global Outcomes (m-KDIGO) criteria and compare this criteria with both the paediatric Risk, Injury, Failure, Loss, End-stage disease (pRIFLE) and Acute Kidney Injury Network (AKIN) criteria in infants after cardiac surgery. METHODS: We retrospectively enrolled 145 consecutive infants who underwent open-heart surgery at Kagoshima University Hospital. RESULTS: Acute kidney injury was present in 55 (37.9%), 111 (75.9%), and 95 (65.5%) patients according to the m-KDIGO, pRIFLE, and AKIN criteria, respectively. Among these, 71.9% of patients pRIFLE Risk patients and 60.5% of AKIN 1 patients were categorized in the 'no-AKI' group according to the m-KDIGO criteria. Low body weight (m-KDIGO odds ratio [OR], 0.73; P = 0.015; pRIFLE OR, 0.66; P = 0.001; AKIN OR 0.69, P = 0.002) and prolonged cross-clamp time (m-KDIGO OR, 1.02;
Asunto(s)
Lesión Renal Aguda , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Cardiopatías Congénitas/cirugía , Complicaciones Posoperatorias , Terapia de Reemplazo Renal , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/etiología , Procedimientos Quirúrgicos Cardíacos/métodos , Femenino , Mortalidad Hospitalaria , Humanos , Incidencia , Lactante , Recién Nacido de Bajo Peso , Japón/epidemiología , Tiempo de Internación , Masculino , Tempo Operativo , Evaluación de Procesos y Resultados en Atención de Salud , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/epidemiología , Pronóstico , Terapia de Reemplazo Renal/métodos , Terapia de Reemplazo Renal/estadística & datos numéricos , Medición de Riesgo/métodos , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
We present two cases of biopsy-proven hypertrophic cardiomyopathy (HCM). Both cases showed abnormal electrocardiographic (ECG) findings more than 8 years before diagnosis. A 16-year-old healthy male experienced a rescued cardiac arrest. Another male adolescent showed abnormal Q wave and thickened ventricular wall at 15 years old. Retrospective analyses of ECGs performed at 6 years old indicated abnormal ECG findings. However, the diagnosis was normal because no ventricular wall thickening was present in echocardiography. For early diagnosis of HCM to prevent sudden cardiac arrest or death, it is essential to establish ECG and echocardiographic criteria to screen HCM in the young.
RESUMEN
We report the case of a 12-year-old girl who developed Guillain-Barré syndrome (GBS) and optic neuritis (ON) following Mycoplasma pneumoniae infection. Her symptoms, including bilateral vision impairment and tingling in her hands and right foot, were resolved after methylprednisolone pulse therapy. Serum anti-galactocerebroside (Gal-C) IgM antibodies were detected in our patient. This is the first report of a child with GBS and ON associated with M. pneumoniae infection.
Asunto(s)
Síndrome de Guillain-Barré/complicaciones , Neuritis Óptica/complicaciones , Autoanticuerpos/sangre , Niño , Femenino , Galactosilceramidas/análisis , Galactosilceramidas/sangre , Síndrome de Guillain-Barré/microbiología , Humanos , Metilprednisolona/farmacología , Mycoplasma pneumoniae/patogenicidad , Neuritis Óptica/tratamiento farmacológico , Neuritis Óptica/microbiologíaRESUMEN
The early-onset form of carnitine palmitoyltransferase (CPT) II deficiency has severe outcomes; patients typically die during the newborn period. We report a case of neonatal-onset CPT II deficiency with prolonged survival, exceeding 24 months. The patient was successfully treated by continuous hemodialysis (CHD), which enabled her to overcome repeated crises. We suggest that early intensive treatment, including CHD, is a key for prolonged survival in patients with neonatal-onset CPT II deficiency.
RESUMEN
Stenotrophomonas maltophilia causes pneumonia and CVC-CRBSI in HSCT. However, there are few reports of pyomyositis due to S. maltophilia. We report a patient with CRBSI and pyomyositis due to S. maltophilia after allogeneic HSCT who was successfully treated by removing the CVC and antibiotics without surgical drainage. Removing the CVC and the combined antibiotics without preventing the neutrophil engraftment could avoid surgical drainage in pyomyositis due to S. maltophilia when detected in an early stage.
Asunto(s)
Anemia Aplásica/terapia , Trasplante de Médula Ósea , Cateterismo Venoso Central/efectos adversos , Catéteres Venosos Centrales , Piomiositis/sangre , Piomiositis/complicaciones , Stenotrophomonas maltophilia , Adolescente , Anemia Aplásica/complicaciones , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Humanos , Masculino , Neutrófilos/citología , Neutrófilos/efectos de los fármacos , Trasplante Homólogo , Resultado del TratamientoRESUMEN
Cat scratch disease (CSD) is an infectious disease caused by Bartonella henselae. Atypical clinical presentations of CSD include prolonged fever and multiple hepatosplenic lesions. Furthermore, multiple renal lesions are extremely rare in CSD. An 11-year-old Japanese girl presented at our hospital with a prolonged fever of unknown cause after being scratched and bitten by a kitten. Abdominal computed tomography (CT) revealed multiple small, round hypodense lesions in both kidneys and the spleen. Based on her history and the CT results, her diagnosis was CSD. The diagnosis was confirmed by serological tests, which indicated antibodies against B. henselae. After treatment with azithromycin, her fever immediately improved. Careful history taking and imaging are essential for the diagnosis of atypical CSD. In CT images, not only hepatosplenic lesions but also renal lesions are important features indicative of a diagnosis of atypical CSD. Subsequently, a diagnosis of CSD can be confirmed by specific serological tests. This is the first reported Japanese case of multiple renal and splenic lesions in a patient with CSD. Although difficult to diagnose, an early diagnosis atypical CSD and appropriate treatment are important to prevent complications and the need for invasive examinations.