Flujo mesentérico en un modelo experimental por isquemia-reperfusión en ratas / Mesenteric flow in an experimental model of ischaemia-reperfusion in rats

INTRODUCCIÓN: La oclusión aguda mantenida seuida de la reperfusión de la arteria mesentérica superior (AMS) puede desencadenar en pocas horas el daño irreversible del intestino. Nuestro objetivo fue determinar los cambios de flujo mesentérico medidos por ecografía Doppler color y la correlación con las lesiones histológicas en un modelo experimental de isquemia-reperfusión. MATERIAL Y MÉTODO: Se estudiaron 3 grupos (control, isquemia y reperfusión) de ratas Sprague-Dawley de 17 días de vida. El modelo utilizado fue de isquemia-reperfusión sobre la AMS. Posteriormente, realizamos una ecografía intraabdominal. Las variables ecográficas fueron: velocidad sistólica máxima (VSM), velocidad media (Vm), flujo diastólico (FD) y los índices de pulsatilidad (IP), resistencia (IR) y sístole/diástole (S/D). Las variables histológicas fueron: lesión intestinal (escala Wallace/Keenan y Chiu), morfométricas (altura [AMV] y espesor medio de vellosidades) y células caliciformes. Utilizamos la correlación de Sperman (rs). RESULTADOS: En el grupo reperfusión la VSM (74,3 cm/s), el IP (7,33) y S/D (25,75) en la AMS se encuentran aumentados respecto a los controles (41,35 cm/s [3,12]; [12.45]). La VSM, IP y S/D establecieron regresiones significativas (p < 0,01) con: Wallace/Keenan (rs = 0,655; rs = 0,593; rs = 0,63), Chiu delgado (rs = 0,569; rs = 0,522; rs = 0,47), la AMV (rs = -0,495; rs = -0,452; rs = -0,459), y células caliciformes del colon (rs = -0,525; rs = -0,45; rs = -0,518). CONCLUSIONES: En la fase de reperfusión el incremento del flujo mesentérico expresado por la VSM y el IP podría pronosticar de forma significativa el potencial daño intestinal que ocurre a nivel macroscópico y microscópico

INTRODUCTION: Maintained acute occlusion followed by reperfusion of the superior mesenteric artery (SMA) in a few hours can trigger irreversible bowel damage. The aim of the study was to determine the changes in mesenteric flow measured by colour Doppler Ultrasound and correlating with histological lesions in an experimental model of ischaemia-reperfusion. Method and material: Three groups of Sprague-Dawley 17 day-old rats were studied (control, ischemia and reperfusion). The model used was ischaemia-reperfusion over the SMA. Intraabdominal ultrasound was then performed. The parameters recorded were: Maximum systolic velocity (MSV), pulsatility index (PI), resistance (RI) and systole-diastole (S/D). The histological variables were: intestinal lesion (Wallace/Keenan-Chiu scale), morphometrics (mean villus height [MVH]), and goblet cells. The Spearman (rs) correlation was used. RESULTS: The MSV in the reperfusion group was 74.3 cm/s, the PI 7.33 and S/D 25.75 in the SMA, which were higher than the controls (41.35 cm/s; 3.12 and 12.45, respectively). A direct association (P<.01) was found between MSV, PI and S/D regarding: Wallace/Kennan scoring system (rs = 0.655; rs = 0.593; rs = 0.63) and the Chiu (rs = 0.569; rs = 0.522; rs = 0.47). While the correlation was the reverse (P<0.01) when associated with the MVH (rs = -0,495; rs = -0,452;rs = -0,459) and goblet cells of the colon (rs = -0,525; rs = -0,45; rs = -0,518).CONCLUSIONS: The reperfusion phase increased mesenteric flow expressed by the MSV and PI and could significantly predict the potential bowel damage at macroscopic and microscopic level

[Mesenteric flow in an experimental model of ischaemia-reperfusion in rats]. / Flujo mesentérico en un modelo experimental por isquemia-reperfusión en ratas.

INTRODUCTION: Maintained acute occlusion followed by reperfusion of the superior mesenteric artery (SMA) in a few hours can trigger irreversible bowel damage. The aim of the study was to determine the changes in mesenteric flow measured by colour Doppler Ultrasound and correlating with histological lesions in an experimental model of ischaemia-reperfusion. METHOD AND MATERIAL: Three groups of Sprague-Dawley 17 day-old rats were studied (control, ischemia and reperfusion). The model used was ischaemia-reperfusion over the SMA. Intra-abdominal ultrasound was then performed. The parameters recorded were: Maximum systolic velocity (MSV), pulsatility index (PI), resistance (RI) and systole-diastole (S/D). The histological variables were: intestinal lesion (Wallace/Keenan-Chiu scale), morphometrics (mean villus height [MVH]), and goblet cells. The Spearman (rs) correlation was used. RESULTS: The MSV in the reperfusion group was 74.3 cm/s, the PI 7.33 and S/D 25.75 in the SMA, which were higher than the controls (41.35 cm/s; 3.12 and 12.45, respectively). A direct association (P<.01) was found between MSV, PI and S/D regarding: Wallace/Kennan scoring system (rs = 0.655; rs = 0.593; rs = 0.63) and the Chiu (rs = 0.569; rs = 0.522; rs = 0.47). While the correlation was the reverse (P<.01) when associated with the MVH (rs = -0,495; rs = -0,452; rs = -0,459) and goblet cells of the colon (rs = -0,525; rs = -0,45; rs = -0,518). CONCLUSIONS: The reperfusion phase increased mesenteric flow expressed by the MSV and PI and could significantly predict the potential bowel damage at macroscopic and microscopic level.

Carcinoma de tiroides en Pediatría: seguimiento a 30 años / Thyroid carcinoma in pediatrics: a 30-year follow-up

Introducción. Los tumores tiroideos son neoplasias de presentación infrecuente en la población pediátrica. El objeto de este estudio fue valorar la evolución terapéutica y seguimiento (supervivencia) a lo largo de 30 años. Materiales. Se revisaron 28 casos con diagnóstico de carcinoma de tiroides desde 1978 a 2008. Las variables a estudiar fueron: epidemiológicas, métodos diagnósticos utilizados, tipo de histología, tratamiento y supervivencia a 300 meses posterior al tratamiento. Consideramos como significativo una p<0,05. Resultados. El 73,1% de los casos fueron de sexo femenino. La edad promedio fue 12,3 años (1,6-19). La ecografía fue la prueba más solicitada (78,5%). La mutación RET se presento en tres casos asociados a MEN. El tipo histológico papilar fue el más frecuente (50%). Latiroidectomía total (TT) fue la cirugía más practicada (67,9%). La radioiodoablación (RIA) se usó en el 46,4% de los casos. La terapia de sustitución hormonal se usó en 27 pacientes de la serie. El 89,29% de la serie al cabo de 300 meses se encontraron libres de enfermedad. Conclusiones. El tratamiento de la serie ha variado a lo largo de (..) (AU)

Introduction. The thyroid tumours are infrequent neoplasms of presentation in paediatric. The object of this study was to value therapeutic evolution and the survival throughout 30 years. Materials. 28 cases with diagnosis of thyroid carcinoma. Were reviewed from 1978 to 2008. Were the variables to study: epidemiologists, methods used diagnostic, type of histology, later treatment and survival to 300 months to the treatment. We like considered significant p <0.05. Results. 73.1% of the cases were of feminine sex. The average age was 12.3 years (1.6 to 19). The ultrasound was asked for the test more(78.5%). The RET mutation associated appear in three cases to MEN. The histology type to papillary was most frequent (50%). The total thyroidectomy (TT) was the (..) (AU)

[Thyroid carcinoma in pediatrics: a 30-year follow-up]. / Carcinoma de tiroides en pediatría: seguimiento a 30 años.

INTRODUCTION: The thyroid tumours are infrequent neoplasms of presentation in paediatric. The object of this study was to value therapeutic evolution and the survival throughout 30 years. MATERIALS: 28 cases with diagnosis of thyroid carcinoma. Were reviewed from 1978 to 2008. Were the variables to study: epidemiologists, methods used diagnostic, type of histology, later treatment and survival to 300 months to the treatment. We like considered significant p <0.05. RESULTS: 73.1% of the cases were of feminine sex. The average age was 12.3 years (1.6 to 19). The ultrasound was asked for the test more (78.5%). The RET mutation associated appear in three cases to MEN. The histology type to papillary was most frequent (50%). The total thyroidectomy (TT) was the surgery practice more (67.9%). The radioiodine (RI) was used in 46.4% of the cases. The substitute hormonal therapy was used 27 patients. 89.29% of the were series after 300 months free of disease. CONCLUSIONS: The treatment of the series these are hundreds throughout 30 years, but when valuing our experience we include / understand that: 1) the TT with selective lymphatic dissection, 2) it in the RI cases with positive to the body tracking and/or of factors of risk and 3) the substitute hormonal therapy, is the at the moment best offer alternatives to than we can these paediatric patients and prolong the survival in adult its age.

Dinámica renal: comparación entre el renogramadiurético y la resonancia magnética / Renal dynamics: Comparison between diuretic renogram and magnetic resonance imaging

Introducción. El objetivo del trabajo es comparar los datos obtenidos en el estudio funcional renal realizado mediante la resonancia magnética con gadolinio y carga diurética (RM-Gd-D) respecto a los parámetros obtenidos en el renograma diurético (RD) clásico (función renal diferencial –FRD– y curva renográfica – CR–).Material y Método. Fueron estudiados 10 pacientes de ambos sexos,6 hombres y 4 mujeres, entre 1 mes y 6 años de edad. A todos los pacientes se les practicó una RM-Gd-D y un RD. En ambos casos se empleó lafurosemida como sobrecarga. Las patologías observadas fueron síndrome de la unión pieloureteral, vaso polar, válvula de uréter, uréter ectópico, sistema doble, displasia renal, ectasia renal, riñón pélvico y riñón en herradura. Fue comparado el porcentaje de captación de gadolinioversus la FRD, y la curva de la RM versus la CR. Para describir el patrón de las curvas de RM-Gd-D fue adaptado un patrón similar al descrito por O’Reilly para la CR. En 5 casos fue necesario el tratamiento quirúrgico y en 3 se adoptó una conducta expectante. En los pacientes intervenidos, la sospecha diagnóstica fue confirmada en la cirugía y en el estudio patológico. El Chi-2 fue utilizado para el análisis estadístico. Resultados. Se encontró un 80% de concordancia (..) (AU)

Objective. This study aimed to establish a comparison between the data obtained in the renal functional study through magnetic resonance using gadolinium with diuretic (furosemide) charge (MR-Gd/F), on the one hand, and the parameters obtained with the classical diuretic renogram (DR) (differential renal function –DRF– and renographiccurve –RC–), on the other hand. Material and Method. 10 patients were studied, 6 male and 4female, aged between 1 month and 6 year-old. All the patients were submitted to a MR-Gd/F and a DR. In both cases, furosemide was used as overload. The pathologies observed included syndrome of the pyeloureteral junction, polar vessel, ureter valve, ectopic ureter, duplexkidney, renal dysplasia, renal ectasy, pelvic kidney and horseshoe kidney. The percentage of gadolinium uptake was compared versus the DRF, and the MR curve was compared versus the RC. Surgical treatment was required in 5 cases and an expectancy behaviour was taken in 3 cases. Among the operated patients, the diagnosis accurry was confirmed by the surgery and the pathological study. Results. A 80% consistency was found between the gadolinium uptake and the DRF. There was a 90% correlation between the MRGd/F curve and the RC. In two cases, the MR-Gd/F required to modify the surgical criterion –previously based on the DR- and an expectancy behaviour was taken. In 90% of the operated cases, the diagnostic assumption obtained through the MR-Gd/F coincided with the surgical and pathological findings, whereas there was a coincidence in just 60%of the cases studied through the DR (p>0,0008).Conclusions. The MR offers a real time study: anatomical, vascular and functional. Good correlation between DR and MR with respectto: (% DRF,%Gd MR and diuretic curve). The MR demonstrates greater precision in diagnosis. The MR allows recognition of non obstructive polar vessels that can then be conservatively managed (AU)

Identification of loss-of-function mutations of SLC35D1 in patients with Schneckenbecken dysplasia, but not with other severe spondylodysplastic dysplasias group diseases.

BACKGROUND: Schneckenbecken dysplasia (SBD) is an autosomal recessive lethal skeletal dysplasia that is classified into the severe spondylodysplastic dysplasias (SSDD) group in the international nosology for skeletal dysplasias. The radiological hallmark of SBD is the snail-like configuration of the hypoplastic iliac bone. SLC35D1 (solute carrier-35D1) is a nucleotide-sugar transporter involved in proteoglycan synthesis. Recently, based on human and mouse genetic studies, we showed that loss-of-function mutations of the SLC35D1 gene (SLC35D1) cause SBD. OBJECT: To explore further the range of SLC35D1 mutations in SBD and elucidate whether SLC35D1 mutations cause other skeletal dysplasias that belong to the SSDD group. METHODS AND RESULTS: We searched for SLC35D1 mutations in five families with SBD and 15 patients with other SSDD group diseases, including achodrogenesis type 1A, spondylometaphyseal dysplasia Sedaghatian type and fibrochondrogenesis. We identified four novel mutations, c.319C>T (p.R107X), IVS4+3A>G, a 4959-bp deletion causing the removal of exon 7 (p.R178fsX15), and c.193A>C (p. T65P), in three SBD families. Exon trapping assay showed IVS4+3A>G caused skipping of exon 4 and a frameshift (p.L109fsX18). Yeast complementation assay showed the T65P mutant protein lost the transporter activity of nucleotide sugars. Therefore, all these mutations result in loss of function. No SLC35D1 mutations were identified in all patients with other SSDD group diseases. CONCLUSION: Our findings suggest that SLC35D1 loss-of-function mutations result consistently in SBD and are exclusive to SBD.

[Renal dynamics: comparison between diuretic renogram and magnetic resonance imaging]. / Dimámica renal: comparación entre el renograma diurético y la resonancia magnética.

OBJECTIVE: This study aimed to establish a comparison between the data obtained in the renal functional study through magnetic resonance using gadolinium with diuretic (furosemide) charge (MR-Gd/F), on the one hand, and the parameters obtained with the classical diuretic renogram (DR) (differential renal function -DRF- and renographic curve -RC-), on the other hand. MATERIAL AND METHOD: 10 patients were studied, 6 male and 4 female, aged between 1 month and 6 year-old. All the patients were submitted to a MR-Gd/F and a DR. In both cases, furosemide was used as overload. The pathologies observed included syndrome of the pyeloureteral junction, polar vessel, ureter valve, ectopic ureter, duplex kidney, renal dysplasia, renal ectasy, pelvic kidney and horseshoe kidney. The percentage of gadolinium uptake was compared versus the DRF, and the MR curve was compared versus the RC. Surgical treatment was required in 5 cases and an expectancy behaviour was taken in 3 cases. Among the operated patients, the diagnosis accurry was confirmed by the surgery and the pathological study. RESULTS: A 80% consistency was found between the gadolinium uptake and the DRF. There was a 90% correlation between the MR-Gd/F curve and the RC. In two cases, the MR-Gd/F required to modify the surgical criterion -previously based on the DR- and an expectancy behaviour was taken. In 90% of the operated cases, the diagnostic assumption obtained through the MR-Gd/F coincided with the surgical and pathological findings, whereas there was a coincidence in just 60% of the cases studied through the DR (p > 0.0008). CONCLUSIONS: The MR offers a real time study: anatomical, vascular and functional. Good correlation between DR and MR with respect to: (% DRF,%Gd MR and diuretic curve). The MR demonstrates greater precision in diagnosis.The MR allows recognition of non obstructive polar vessels that can then be conservatively managed.

Hernia diafragmática congénita asociada a secuestro pulmonar, quiste dermoide y duplicación intestinal / Congenital diaphragmatic hernia associated with pulmonary sequestration, dermoid cyst and intestinal duplication

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[Comparison between MRI and the techniques traditionally used in the study of uropathies in children]. / Análisis prospectivo y comparativo entre la resonancia magnética y las exploraciones tradicionales utilizadas en el estudio de las uropatías con afectación funcional del niño.

BACKGROUND: To correlate the anatomical and functional information obtained using MRI in comparison to the techniques traditionally used in the study of uropathies, and to compare their physical and socioeconomic impacts. METHODS: For a period of eleven months we carried out a prospective study of 22 patients of both sexes ranging in age from 1 to 180 months. All suffered from one or another uropathy. Fifty-five percent of the patients were from external consultation while 45% had been diagnosed prenatally. The imaging techniques compared with MRI were as follows: echography, renogram, renal DMSA scan, urography and cystography. For the MRI gadolinium was used, as well as general anesthesia in some cases. RESULTS: There was a significant correlation (r = 0.942 p < 0.01) between MRI and the traditional explorations for the diagnosis of hydronephrosis, horseshoe kidney, kidney duplication, kidney hypoplasia and hypertrophy, multicystic kidney, ureterocele, pyeloureteral stenosis, vesicoureteral stenosis, atrophy of the renal artery, and missing kidney. It was not useful for reflux. Comparing to renal function differential on renogram there was an 86% agreement between the results. The average number of visits was 5.7 and missed workdays 4.1. The cost as a result of MRI was less than that for other explorations (Chi2 = 27,909 p < 0.001). CONCLUSIONS: MRI provides the same information, both morphological and concerning functional quality, as well as vascular, as that obtained through traditional explorations. Irradiation with MRI is nil. At times it requires anesthesia. Its practice reduces costs, visits, missed workdays, and travel time. In the future it could probably be possible to carry out cystography and hydric/diuretic overload testing at the same time, the efficacy will be increased.

[Salivary calculi in children]. / Litiasis salival en la infancia.

UNLABELLED: The main salivary glands are the submaxillary, sublingual and parotid glands. Infectious and tumoral conditions are prominent in the parotid gland whilst calculi are in submaxillary and sublingual glands. METHODS. Medical record review of 18 cases with a diagnosis of salivary calculi over a 13 year period. Data collected consisted in, clinical presentation, ultrasound (US), sialography (SG) and computarized tomography (CT), and treatment. RESULTS: 13 male and 5 female. Mean age was 7.2 years. All of them presented with pain and tenderness. Parotid gland was affected in 10 cases. An infectious cause for calculi was found in 7 while 3 presented calculi with no underlying infectious cause. Submaxillary gland was affected in 6 and sublingual in 2. No infectious condition was associated to submaxillary and sublingual calculi. Surgical treatment consisted in duct canalization for calculi removal and was performed in all patients after initial treatment with antibiotics. Neither complications nor relapse was found after surgical removal. CONCLUSIONS: Diagnosis of salivary calculi is made by clinical symptoms and imaging exams. Treatment is surgical and has to be performed after medical treatment for infection and inflamation.

Análisis prospectivo y comparativo entre la resonancia magnética y las exploraciones tradicionales utilizadas en el estudio de las uropatías con afectación funcional del niño / Comparison between MRI and the techniques traditionally used in the study of uropathies in children

Objetivo. Correlacionar la información anatómica y funcional obtenida mediante la resonancia magnética (RM) frente a las técnicas que se utilizan tradicionalmente en la estudio de las uropatías, y comparar sus repercusiones físicas y socio-económicas. Material y método. Durante un período de 11 meses fueron estudiados prospectivamente 22 pacientes de ambos sexos y edades comprendidas entre 1 y 180 meses, afectos de diversos tipos de uropatía. 55% de los pacientes procedían de la consulta externa y el 45% tuvieron diagnóstico prenatal. Las técnicas de imagen comparadas con la RM fueron: ecografía, renograma, gammagrafía, urografía y cistografía. Para la RM se utilizó gadolinio y en algunos casos anestesia general. Resultados. Existió una correlación significativa (r= 0,942 p < 0,01) entre la RM y las exploraciones tradiciones para los diagnósticos de hidronefrosis, riñón en herradura, duplicidad renal, hipoplasia e hipertrofia renal, riñón multiquístico, ureterocele, estenosis pieloureteral, estenosis vesicoureteral, atrofia de la arteria renal y ausencia renal. No fue útil para reflujo. Comparando con la función renal diferencial del renograma existió un 86% de concordancia en los resultados. El promedio de número de visitas fue de 5,7 y de ausencias laborales 4,1. El costo motivado por la RM respecto del resto de exploraciones, fue menor (Chi2= 27,909 p < 0,001). Conclusiones. La RM aporta la misma información morfológica y de función cualitativa, que la obtenida con las exploraciones tradicionales, además de la vascular. La irradiación de la RM es nula. En ocasiones precisa anestesia. Su práctica disminuye gastos, visitas, faltas laborales y desplazamientos. En un futuro, si en el curso de la misma se logra realizar la cistografía y la sobrecarga hídrica/diurética se incrementará su eficacia (AU)

Objetivo. Correlacionar la información anatómica y funcional obtenida mediante la resonancia magnética (RM) frente a las técnicas que se utilizan tradicionalmente en la estudio de las uropatías, y comparar sus repercusiones físicas y socio-económicas. Material y método. Durante un período de 11 meses fueron estudiados prospectivamente 22 pacientes de ambos sexos y edades comprendidas entre 1 y 180 meses, afectos de diversos tipos de uropatía. 55% de los pacientes procedían de la consulta externa y el 45% tuvieron diagnóstico prenatal. Las técnicas de imagen comparadas con la RM fueron: ecografía, renograma, gammagrafía, urografía y cistografía. Para la RM se utilizó gadolinio y en algunos casos anestesia general. Resultados. Existió una correlación significativa (r= 0,942 p < 0,01) entre la RM y las exploraciones tradiciones para los diagnósticos de hidronefrosis, riñón en herradura, duplicidad renal, hipoplasia e hipertrofia renal, riñón multiquístico, ureterocele, estenosis pieloureteral, estenosis vesicoureteral, atrofia de la arteria renal y ausencia renal. No fue útil para reflujo. Comparando con la función renal diferencial del renograma existió un 86% de concordancia en los resultados. El promedio de número de visitas fue de 5,7 y de ausencias laborales 4,1. El costo motivado por la RM respecto del resto de exploraciones, fue menor (Chi2= 27,909 p < 0,001). Conclusiones. La RM aporta la misma información morfológica y de función cualitativa, que la obtenida con las exploraciones tradicionales, además de la vascular. La irradiación de la RM es nula. En ocasiones precisa anestesia. Su práctica disminuye gastos, visitas, faltas laborales y desplazamientos. En un futuro, si en el curso de la misma se logra realizar la cistografía y la sobrecarga hídrica/diurética se incrementará su eficacia (AU)

Litiasis salival en la infancia / Salivary calculi in children

Introducción. Las glándulas salivales principales son la submaxilar, sublingual y la parótida. La patología infecciosa y tumoral predomina en la parótida mientras que la litiásica en las glándulas submaxilar (mayor frecuencia) y sublingual. Material y método. Nuestro trabajo consistió en la revisión de 18 casos con diagnóstico de litiasis salival, tratados en nuestro Servicio en los últimos 13 años. Se compararon la forma de presentación, métodos de diagnóstico (ecografía, sialografía y TC), tratamiento y evolución de los mismos. Resultados. Los pacientes estudiados (de edades comprendidas entre 4-16 años) fueron hombres en 13 casos y mujeres en 5. Clínicamente presentaron cuadro de dolor y tumefacción. De los 10 casos con afectación de glándula parótida, en el 70% se demostró origen infeccioso y fueron catalogados posteriormente de parotiditis crónica; el 30% tenía verdadera litiasis (3 casos). Seis casos correspondieron a glándula submaxilar y 2 casos a glándula sublingual. La litiasis salival se presentó, por lo tanto, con mayor frecuencia en la glándula submaxilar. El tratamiento quirúrgico estuvo indicado en el 100% de los pacientes con patología litiásica y consistió en la apertura del conducto excretor y extracción del cálculo. Se realizó tras remisión del cuadro inflamatorio inicial con antibioterapia y antiinflamatorios. En el seguimiento se constató una buena evolución postoperatoria en todos los casos y no hubo recidivas. Conclusiones. La historia clínica, la exploración minuciosa y las técnicas por imagen permiten establecer el diagnóstico de litiasis salival. El tratamiento es quirúrgico y debe realizarse de manera diferida tras el tratamiento médico del cuadro inflamatorio (AU)

The main salivary glands are the submaxillary, sublingual and parotid glands. Infectious and tumoral conditions are prominent in the parotid gland whilst calculi are in submaxillary and sublingual glands. METHODS. Medical record review of 18 cases with a diagnosis of salivary calculi over a 13 year period. Data collected consisted in, clinical presentation, ultrasound (US), sialography (SG) and computarized tomography (CT), and treatment. RESULTS: 13 male and 5 female.Mean age was 7.2 years. All of them presented with pain and tenderness. Parotid gland was affected in 10 cases. An infectious cause for calculi was found in 7 while 3 presented calculi with no underlying infectious cause. Submaxillary gland was affected in 6 and sublingual in 2. No infectious condition was associated to submaxillary and sublingual calculi. Surgical treatment consisted in duct canalization for calculi removal and was performed in all patients after initial treatment with antibiotics. Neither complications nor relapse was found after surgical removal. CONCLUSIONS: Diagnosis of salivary calculi is made by clinical symptoms and imaging exams. Treatment is surgical and has to be performed after medical treatment for infection and inflammation (AU)

[Palatal necrosis in children. Case report]. / Necrosis palatina en el lactante. A propósito de un caso.

Palate necrosis as a consequence of palate infection it's an exceptional condition about there's not too much references at literature. We present a case of a 6 months old child who present a palatal necrosis after a supurative medial otitis that involved hard and soft palate, with positive culture for Pseudomona aeruginosa causing a almost complete absence of the palate that simulate a bilateral palatal cleft.

Necrosis palatina en el lactante. A propósito de un caso / Palatal necrosis in children. Case report

La necrosis palatina secundaria a patología infecciosa es un cuadro excepcional del que existen muy pocas referencias en la literatura. Presentamos un caso de un paciente de 6 meses de edad que tras un cuadro de otitis media supurada, presenta necrosis palatina que afecta al paladar duro y blando, con cultivos positivos a Pseudomona aeruginosa, provocando una ausencia casi completa del paladar, equivalente a una fisura palatina bilateral completa (AU)

Palate necrosis as a consequence of palate infection it’s an exceptional condition about there´s not too much references at literature. We present a case of a 6 months old child who present a palatal necrosis after a supurative medial otitis that involved hard and soft palate, with positive culture for pseudomona aeruginosa causing a almost complete absence of the palate that simulate a bilateral palatal cleft (AU)