Variantes en la presentación clínica de la enfermedad por arañazo de gato en niños del hospital Garrahan / Variants in the clinical presentation of cat scratch disease in children at Garrahan Hospital

La infección por Bartonella henselae (BH) adopta diversas formas de presentación clínica en pediatría. Según la bibliografía la forma de presentación más frecuente en pacientes inmunocompetentes es la linfadenopatía única asociada a fiebre. En el 85 % de los casos se compromete un solo ganglio siendo los axilares y los epitrocleares los más frecuentemente involucrados. Existen otras formas de presentación menos frecuentes que debemos tener en consideración, para poder realizar un diagnóstico precoz e indicar un tratamiento adecuado si así lo requiere. El diagnóstico requiere de la sospecha clínica del equipo de salud tratante, junto al antecedente epidemiológico, los hallazgos clínicos del examen físico y la realización de serologías que incluyan el dosaje de inmunoglobulina M y G. Los objetivos del presente trabajo fueron reconocer las manifestaciones clínicas típicas y atípicas de la EAG por Bartonella henselae, describir la epidemiología, características clínicas y evolución de esta enfermedad que se presentaron en nuestro hospital. Se estudiaron un total de 187 pacientes. La media de edad fue de 7.6 años (rango 1-14); siendo 53.5% de género masculino. Las formas de presentación más frecuentes en nuestro trabajo fueron la adenitis y la fiebre. La mayoría recibió diversos esquemas de tratamiento antibiótico, secundario al retraso en el diagnóstico. La tasa de hospitalización fue muy baja, remitió con tratamiento ambulatorio con antibióticos o sin ellos (AU)

Bartonella henselae infection has different clinical presentations in pediatrics. According to the literature, the most common form of presentation in immunocompetent patients is single lymphadenopathy associated with fever. In 85 % of the cases a single lymph node is involved, with the axillary and epitrochlear nodes being the most commonly involved. There are other, less frequent, forms of presentation that should be taken into consideration in order to make an early diagnosis and indicate appropriate treatment if required. Diagnosis relies on clinical suspicion by the treating healthcare team, together with the epidemiological history, clinical findings on physical examination, and serology including immunoglobulin M and G dosage. The objectives of this study were to identify both the typical and atypical clinical manifestations of Bartonella henselae cat scratch disease, to describe the epidemiology, clinical characteristics, and outcomes of cases presenting at our hospital. A total of 187 patients were studied. The mean age was 7.6 years (range 1-14); 53.5% were male. The most frequent forms of presentation in our study were adenitis and fever. Most of them received different antibiotic treatment regimens due to delayed diagnosis. The hospitalization rate was very low and the disease typically resolved with outpatient treatment, with or without antibiotics (AU)

A profile of US-Mexico border mobility among a stratified random sample of Hispanics living in the El Paso-Juarez area.

Examination of border-specific characteristics such as trans-border mobility and transborder health service illuminates the heterogeneity of border Hispanics and may provide greater insight toward understanding differential health behaviors and status among these populations. In this study, we create a descriptive profile of the concept of trans-border mobility by exploring the relationship between mobility status and a series of demographic, economic and socio-cultural characteristics among mobile and non-mobile Hispanics living in the El Paso-Juarez border region. Using a two-stage stratified random sampling design, bilingual interviewers collected survey data from border residents (n = 1,002). Findings show that significant economic, cultural, and behavioral differences exist between mobile and non-mobile respondents. While non-mobile respondents were found to have higher social economic status than their mobile counterparts, mobility across the border was found to offer less acculturated and poorer Hispanics access to alternative sources of health care and other services.

Effects of prenatal care on twin gestations.

Twin pregnancies are known to have a higher risk of prematurity, uteroplacental insufficiency and increased perinatal mortality. An almost universally held tenet is that prenatal care is helpful in reducing those risks. In an attempt to support that belief, the records of all twins delivered at R. E. Thomason General Hospital between 1982 and 1985 were reviewed. Thirty-seven twin pregnancies received appropriate antepartum care, and 25 did not. There were statistically significant differences in the perinatal mortality rate of the clinic patients (68/1,000) versus the nonclinic patients (160/1,000). Also, significant differences were demonstrated between the mean birth weights: 2,007 g in the nonclinic group and 2,546 in the clinic group. The results suggest that intensive prenatal care in twin gestations promotes fetal growth and improves perinatal outcome.