[A descriptive overview of cases of congenital cytomegalovirus at a tertiary hospital between 2017 and 2023]. / Descriptivo de los casos de citomegalovirus congénitos en un hospital terciario entre 2017-2023.

OBJECTIVE: Cytomegalovirus infection (CMV) is the most common congenital infection in developed countries. The aim of our study was to describe the features of the children that have congenital CMV infection at our hospital for the last 6 years. METHODS: A retrospective descriptive study was designed that included all the children with CMV congenital infection that were diagnosed at tertiary hospital of Madrid Community between 2017 and 2023. RESULTS: Twenty-two children were included. 54.5% have a prenatal diagnosis, 50% of them were in the third trimester, 25% at first trimester and 25% at the second. 22.7% were preterm. CMV was isolated in all the samples with CV more than 1000 copies/ml. When CMV was made in blood, 11/22 (50%) had a high CV. Only one newborn had a high CV at CRL. 44% have affectation at transfontanellar ultrasound evidenced by vasculopathy (62%), intraventricular hemorrhage (IVH) or periventricular calcifications (20%). 68% were asymptomatic, al though 20% had a retarded intrauterine growth (RIG) at birth or clinical features or analytical were objectified (neutropenia, thrombocytopenia, cholestasis). 33% got treatment with val ganciclovir and 33% had sequelae (hearing loss). CONCLUSIONS: CMV congenital infection is still a severe public health issue in developed countries. Most of the cases are mild or asymptomatic even though we should have high clinical suspicion with compatible symptoms and consistent maternal history in order to make an early diagnosis and treatment to prevent or reduce sequelae.

Acropustulosis infantil: a propósito de un caso / Infantile acropustulosis: A case report

La acropustulosis infantil es una entidad poco frecuente en Pediatría. Aparece habitualmente en niños menores de 2 años y se caracteriza por brotes de pápulas eritematosas muy pruriginosas que se convierten en vesículas o pústulas, fundamentalmente en zonas acrales (dorso de las manos y los pies). Habitualmente se resuelven de manera espontánea y requieren únicamente tratamiento sintomático. Presentamos el caso de un paciente varón de 6 meses diagnosticado de acropustulosis infantil con resolución espontánea (AU)

Infantile acropustulosis is a rare entity in Pediatrics. It usually appears in children under 2 years of age and it is characterized by pruritic erythematous papules that turn into vesicles or pustules; mainly in acral areas (back of the hands and feet). Acropustulosis usually resolves spontaneously and requires only symptomatic treatment. We present the case of a six-month-old boy diagnosed with childhood acropustulosis with spontaneous resolution (AU)

Hígado graso no alcohólico: prevalencia y factores de riesgo en niños obesos / Nonalcoholic fatty liver disease: prevalence and risk factors in obese children

Introducción: Los cambios en la dieta y el aumento de la obesidad han conllevado un incremento de la esteatosis hepática no alcohólica (EHNA) en niños, que puede evolucionar hacia una inflamación con fibrosis. Objetivos: Determinar la prevalencia de EHNA en niños obesos mediante ecografía y valorar los factores de riesgo clínico-analíticos relacionados. Metodología: Estudio piloto llevado a cabo en un grupo seleccionado de 20 pacientes pediátricos con obesidad (con una desviación estándar en el índice de masa corporal [IMC] de +2,5). Se realizó un registro prospectivo y un análisis descriptivo de los datos clínicos con un cuestionario de hábitos nutricionales y estilo de vida, una exploración física con variables antropométricas, un estudio analítico y un diagnóstico ecográfico de esteatosis hepática. Resultados: Un total de 12 varones y 8 mujeres, con una media de edad de 12,5 años (rango: 6,5-16), el 100% con antecedentes familiares de obesidad y trastornos metabólicos, y un 90% con alteraciones del metabolismo lipídico (35% LDL, 30% triglicéridos) o hidrocarbonado; un 20% de estos pacientes tenía un diagnóstico ecográfico de esteatosis, 2 de ellos con hipertransaminasemia leve (AST 65-35 U/L, ALT 42-100 U/L); un 65% picaba entre horas, bollería y otros dulces (4-5 días a la semana), y se observaba un predominio de actividades sedentarias (8,3 h/semana) en comparación con la realización de ejercicio físico (4,2 h/semana). Conclusiones: El IMC elevado, la dislipemia y la resistencia a la insulina son factores de riesgo asociados a la EHNA. Una intervención temprana puede evitar su aparición y progresión. Dada la inocuidad de la ecografía, se debería considerar un método de diagnóstico precoz en los niños obesos (AU)

Introduction: Changes in diet and obesity are responsible for the emerging nonalcoholic hepatic steatosis (NASH) in children, which may progress to inflammation with fibrosis. Objectives: To determine the prevalence of NASH in obese children by ultrasound and to assess the clinical and laboratory data and risk factors. Methodology: A pilot study in a selected group of 20 pediatric patients with obesity (BMI + 2.5 DS); prospective registry and descriptive analysis of clinical data questionnaire nutritional habits and lifestyle, physical examination with anthropometric variables, analytical study and ultrasound diagnosis of hepatic steatosis. Results: 12 men and 8 women, mean age 12.5 years (range: 6.5 to 16), 100% with a family history of obesity and metabolic disorders, 90% carbohydrate or lipid metabolism disorders (35% LDL, triglycerides 30%); sonographic diagnosis of steatosis in 20%, two of them with hypertransaminasemia (AST 65-35 U/L, ALT 42-100 U/L); 65% had eated between meals, pastries and other sweets (4-5 days a week), and there was predominantly sedentary activity (8.3 h/week) compared to physical exercise (4.2 h/week). Conclusions: The high BMI, dyslipidemia and insulin resistance are risk factors associated with NASH. early intervention can prevent its onset and progression. ultrasonography is safe and it should be considered as a method of early diagnosis in obese children (AU)

Tratamiento de verrugas víricas con sinecatequinas de té verde / Viral wart treatment with green tea sinecatechins

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Curas húmedas en dermatitis atópica. Nuestra experiencia / Wet wraps in atopic dermatitis. Our experience

En ocasiones, los brotes de dermatitis atópica pueden ser graves y de difícil control, resistentes a los tratamientos habituales. En estos casos podemos recurrir al empleo de curas húmedas, un procedimiento con buenos resultados y escasos efectos secundarios. Presentamos una serie de casos de cinco pacientes con brotes moderados-graves resistentes al tratamiento convencional, tratados mediante curas húmedas con betametasona o propionato de fluticasona diluidos al 10% en la crema hidratante durante un intervalo de tiempo de entre 4-6 días. Se obtuvo la resolución completa del brote en cuatro casos, continuándose en el caso restante las curas de forma domiciliaria durante 2-3 días más, con posterior resolución completa. Ningún paciente presentó efectos adversos (AU)

Occasionally, atopic dermatitis outbreaks can be severe and difficult to control, resistant to standard treatments. In these cases we can use wet wraps, a procedure with good results and few side effects. We present five patients with moderate to severe outbreaks resistant to conventional treatment treated with wet wraps with betamethasone or fluticasone propionate 10% diluted for 4-6 days. Complete resolution was obtained in four cases, the last one continued by domiciliary wet wraps for 2-3 days with final complete resolution. Any patient had adverse effects (AU)

Tratamiento de hemangiomas con propranolol sistémico y timolol tópico / Treatment of hemangiomas with propranolol systemic and topical timolol

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