Trombosis de grandes vasos en el recién nacido / Thrombosis involving large vessels in the new born

En este estudio se revisan las historias clínicas de un periodo de cuatro años de los recién nacidos diagnosticados de trombosis en el Hospital 'Son Dureta' de Palma de Mallorca. Se registraron cuatro casos, lo que representa una incidencia de 1,28/10.000 nacidos vivos. La localización fue en la vena renal en dos casos, intracardiaca y aórtica. El diagnóstico se estableció en todos los casos mediante ecografía Doppler. Los cuatro pacientes sobrevivieron tras un cuadro agudo y fueron sometidos a tratamiento fibrinolítico con urocinasa. La trombosis neonatal presenta una incidencia variable, más elevada en estudios prospectivos de pacientes canalizados. Los déficits congénitos o transitorios de sustancias del sistema fibrinolítico pueden favorecer su aparición. El tratamiento varía entre los diferentes centros, aunque la urocinasa es el agente trombolítico más utilizado (AU)

[Risk factors in retinopathy of prematurity]. / Factores de riesgo en la retinopatía del prematuro.

OBJECTIVE: The objective of this study was to determine the potential risk factors in acute retinopathy of prematurity (ROP). PATIENTS AND METHODS: A retrospective study of preterm infants with birth weights less than 1,501 g, or more if mechanical ventilation and oxygen administration were needed, was carried out. Indirect ophthalmoscopy (mydriasis) with indentation was done every 15 days from the fourth week. Fifteen factors were analyzed. Statistically significant differences between the groups with and without ROP were sought with Fisher's exact probability test, two-sample t-test, and the chi-square contingency-table. A logistic regression was done. RESULTS: Thirty-six of the 137 infants examined (26.2%) with birth weight < or = 1,500 g had acute ROP. Only 7.1% of the infants with birth weights > or = 1,501 g had retinopathy. There were significant differences (p < 0.05) in the following variables: birth weight, gestational age, blood transfusion, mechanical ventilation, FiO2 (fraction inspired oxygen) maximum, time of FiO2 > or = 0.60 (hours) and time of FiO2 > or = 0.21 (days). However, the birth-weight was the only independent risk factor related to ROP. CONCLUSIONS: Retinopathy of the premature has a multifactorial etiology. The low gestational age and the oxygen had influence on ROP; however, low birth weight was the independent risk factor.

[Subcapsular hepatic hematoma in the neonatal period: echographic diagnosis]. / El hematoma subcapsular hepático en el período neonatal: diagnóstico ecográfico.

We report a case of Subcapsular Hematoma in a preterm neonate. The etiology, clinical findings and therapeutic features of this entity are reviewed and emphasis is made on the importance of radiographic and sonographic images in early diagnosis. We also discuss the absence of intestinal air in the premature, as well as possible etiologies and differential diagnosis.