RESUMEN
Clinical control and monitoring of bilirubin in the neonatal stage are essential to avoid toxicity in the central nervous system. OBJECTIVE: to determine the correlation between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) levels in newborns ≥ 35 weeks. PATIENTS AND METHOD: observational, cross-sectional, analytical, retrospective study that included 90 neonates of gestational age ≥ 35 weeks with mucocutaneous jaundice who underwent TcB and TSB measurement simultaneously between June 1, 2022, and January 31, 2023. Both variables were compared, determining their correlation. RESULTS: the validity indicators were analyzed, obtaining 100% sensitivity and negative predictive value. The mean of TcB determinations was 14.84 mg/dl ± 2.27 and that of TSB was 13.1 mg/dl ± 2.39. The correlation obtained indicates that both variables are related, which is a direct correlation and, according to the prediction equation, there is an appropriate correlation between them. It was determined that TcB overestimated TSB in 95.56% of the determinations, and underestimated TSB in the rest (4.44%). Simultaneous measurements of TcB and TSB were different in all determinations with a mean difference of 1.72 ± 1.48. CONCLUSIONS: the non-invasive TcB method can be used as an initial screening tool for the neonatal population ≥ 35 weeks, given its adequate sensitivity and negative predictive value.
Asunto(s)
Bilirrubina , Tamizaje Neonatal , Humanos , Recién Nacido , Estudios Transversales , Edad Gestacional , Tamizaje Neonatal/métodos , Estudios RetrospectivosRESUMEN
INTRODUCTION: During the SARS-CoV-2 pandemic, efforts have focused on trying to identify the routes of transmis sion of the virus, characterize its symptoms and signs, and investigate the best diagnostic and thera peutic methods. There are fewer published data and series in the pediatric population than in adults. OBJECTIVE: To analyze the clinical and epidemiological characteristics in children under 16 years of age diagnosed with SARS-CoV-2. PATIENTS AND METHOD: Descriptive study carried out on children who underwent SARS-CoV-2 RNA testing due to compatible symptoms, close contact, or requiring hospitalization or surgery, in the Emergency Department of a hospital in Madrid, Spain. 30 variables were collected including epidemiological data, symptoms, and signs of infection. RESULTS: Out of 1378 patients, 12% were positive (165). There was a higher proportion of patients of North African origin in the positive group than in the negative one (p < 0.01). Of all patients, 35.6% reported close contact with a confirmed case, which was more frequent in the positive group. 75.8% of the positive patients had some symptoms, most frequently fever, runny nose, and cough, followed by digesti ve symptoms. There was one case of COVID-19 pneumonia and two patients with MIS-C, one of which had SARS-CoV-2 infection. Eight of the positive patients (4.8%) required hospitalization due to SARS-CoV-2 infection. CONCLUSION: Although SARS-CoV-2 infection is milder in the pediatric population, almost 5% will require hospitalization. No close contact was identified in a high percen tage of patients (61%). Further studies are needed at all levels of care to characterize the infection in children and adolescents.
Asunto(s)
COVID-19 , Adolescente , Adulto , COVID-19/complicaciones , COVID-19/diagnóstico , COVID-19/epidemiología , Niño , Humanos , Pandemias , ARN Viral , SARS-CoV-2 , Síndrome de Respuesta Inflamatoria SistémicaRESUMEN
La epilepsia refleja por agua caliente es un tipo de convulsión poco frecuente cuya fisiopatología se desconoce. Estas crisis reflejas suelen iniciarse pocos segundos tras el contacto con el agua y, comúnmente, a temperaturas de 37-48 ºC. Los automatismos y las crisis parciales complejas, con o sin generalización secundaria, son el modo de manifestación principal.La exploración neurológica y el electroencefalograma intercrítico no suelen presentar alteraciones, lo que puede condicionar un retraso en el diagnóstico, por lo que es fundamental la sospecha clínica.El tratamiento antiepiléptico se inicia cuando se asocia a otro tipo de epilepsia o cuando ciertas medidas sencillas, como el descenso de la temperatura del agua en el baño, no controlan las crisis. Es posible la desaparición espontánea. Cuando es necesaria la terapéutica farmacológica, existe, normalmente, buena respuesta.Se presenta el caso de un lactante con diagnóstico de epilepsia refleja por agua caliente.
Hot-water epilepsy is a rare type of seizure whose pathophysiology is unknown. These reflex seizures usually begin a few seconds after contact with water, commonly at temperatures between 37-48 ºC. Automations and complex partial crises, with or without secondary generalization, are the main manifestation mode of this type of reflex epilepsies.Neurological examination and intercritical electroencephalography are usually normal, which may condition a delay in diagnosis, and the clinical suspicion is fundamental.Antiepileptic treatment is initiated when associated with another type of epilepsy or when certain simple measures, such as lowering the water temperature in the bath, do not control crises. Spontaneous disappearance is possible; when pharmacological therapy is necessary, there is usually a good response.We present the case of an infant diagnosed with hot-water epilepsy.
Asunto(s)
Humanos , Masculino , Lactante , Epilepsia Refleja/diagnóstico , Convulsiones , Baños , Epilepsia Refleja/tratamiento farmacológico , CalorRESUMEN
Hot-water epilepsy is a rare type of seizure whose pathophysiology is unknown. These reflex seizures usually begin a few seconds after contact with water, commonly at temperatures between 37-48 ºC. Automations and complex partial crises, with or without secondary generalization, are the main manifestation mode of this type of reflex epilepsies. Neurological examination and intercritical electroencephalography are usually normal, which may condition a delay in diagnosis, and the clinical suspicion is fundamental. Antiepileptic treatment is initiated when associated with another type of epilepsy or when certain simple measures, such as lowering the water temperature in the bath, do not control crises. Spontaneous disappearance is possible; when pharmacological therapy is necessary, there is usually a good response. We present the case of an infant diagnosed with hot-water epilepsy. Key words: seizures, reflex epilepsies, hot water-induced reflex epilepsy.
La epilepsia refleja por agua caliente es un tipo de convulsión poco frecuente cuya fisiopatología se desconoce. Estas crisis reflejas suelen iniciarse pocos segundos tras el contacto con el agua y, comúnmente, a temperaturas de 37-48 ºC. Los automatismos y las crisis parciales complejas, con o sin generalización secundaria, son el modo de manifestación principal. La exploración neurológica y el electroencefalograma intercrítico no suelen presentar alteraciones, lo que puede condicionar un retraso en el diagnóstico, por lo que es fundamental la sospecha clínica. El tratamiento antiepiléptico se inicia cuando se asocia a otro tipo de epilepsia o cuando ciertas medidas sencillas, como el descenso de la temperatura del agua en el baño, no controlan las crisis. Es posible la desaparición espontánea. Cuando es necesaria la terapéutica farmacológica, existe, normalmente, buena respuesta. Se presenta el caso de un lactante con diagnóstico de epilepsia refleja por agua caliente.
Asunto(s)
Epilepsia Refleja/diagnóstico , Calor/efectos adversos , Agua/efectos adversos , Electroencefalografía , Epilepsia Refleja/etiología , Humanos , Lactante , MasculinoRESUMEN
INTRODUCTION: 1q21.1 microdeletion syndrome is a caused by a recurrent deletion of the 1q21.1 copy-number variant, which spans 800 kb and includes at least seven genes. It is associated with a variable phenotype. Neuropsychiatric abnormalities have been previously described in many of the previously reported cases, but its true prevalence is unknown. AIM: To illustrate the phenotypic variability in 1q21.1 microdeletion syndrome. CASE REPORTS: Four individuals of the same kindred harboring a 1.74-Mb deletion within 1q21.1 are included. In our patients a heterogeneous phenotype is recognized. Neuropsychiatric disorders or more specifically impulse control disorders were common to all the four cases that we present. CONCLUSIONS: 1q21.1 microdeletion syndrome is phenotypically heterogeneous even among members of the same family. Behavioral or neuropsychiatric abnormalities are frequent. Paucisymptomatic forms with individuals presenting exclusively psychiatric disorders have been identified.
TITLE: Variabilidad del fenotipo del sindrome de microdelecion 1q21.1 dentro de una misma familia: importancia de la deteccion de trastornos neuropsiquiatricos para el diagnostico de sindromes geneticos.Introduccion. El sindrome de microdelecion 1q21.1 esta causado por una delecion recurrente de aproximadamente 800 kb que incluye al menos siete genes y se asocia a un fenotipo variable. Esta variacion en el numero de copias patogenica puede aparecer de novo o ser heredada de uno de los progenitores. La presencia de trastornos psiquiatricos se ha descrito en muchos de los casos publicados, pero se desconoce su prevalencia exacta. Objetivo. Exponer la variabilidad fenotipica de los individuos que presentan una microdelecion 1q21.1. Casos clinicos. Se incluyen cuatro individuos portadores de una delecion de 1,74 Mb en 1q21.1, todos miembros de la misma familia. El estudio genetico del caso indice se llevo a cabo mediante array de hibridacion genomica comparada, y el del resto de familiares mediante hibridacion in situ fluorescente, con una sonda especifica para la region delecionada. Los individuos presentan un fenotipo heterogeneo, y es comun a todos ellos la presencia de alteraciones psiquiatricas o del comportamiento, con un claro predominio de la presencia de trastornos relacionados con las dificultades para el control de impulsos en sus diferentes subtipos. Conclusiones. El sindrome de microdelecion 1q21.1 es fenotipicamente heterogeneo, incluso entre los miembros de una misma familia. Destaca la presencia de alteraciones psiquiatricas o del comportamiento como rasgo comun en todos los pacientes que presentamos. Existen formas paucisintomaticas en las que el individuo portador de la delecion presenta exclusivamente alteraciones psiquiatricas.
Asunto(s)
Deleción Cromosómica , Cromosomas Humanos Par 1/genética , Trastornos Disruptivos, del Control de Impulso y de la Conducta/genética , Discapacidad Intelectual/genética , Adulto , Preescolar , Hibridación Genómica Comparativa , Trastornos Disruptivos, del Control de Impulso y de la Conducta/psicología , Femenino , Humanos , Hipertelorismo/genética , Hibridación Fluorescente in Situ , Discapacidad Intelectual/psicología , Masculino , Linaje , Penetrancia , Fenotipo , SíndromeRESUMEN
Introducción. El síndrome de microdeleción 1q21.1 está causado por una deleción recurrente de aproximadamente 800 kb que incluye al menos siete genes y se asocia a un fenotipo variable. Esta variación en el número de copias patogénica puede aparecer de novo o ser heredada de uno de los progenitores. La presencia de trastornos psiquiátricos se ha descrito en muchos de los casos publicados, pero se desconoce su prevalencia exacta. Objetivo. Exponer la variabilidad fenotípica de los individuos que presentan una microdeleción 1q21.1. Casos clínicos. Se incluyen cuatro individuos portadores de una deleción de 1,74 Mb en 1q21.1, todos miembros de la misma familia. El estudio genético del caso índice se llevó a cabo mediante array de hibridación genómica comparada, y el del resto de familiares mediante hibridación in situ fluorescente, con una sonda específica para la región delecionada. Los individuos presentan un fenotipo heterogéneo, y es común a todos ellos la presencia de alteraciones psiquiátricas o del comportamiento, con un claro predominio de la presencia de trastornos relacionados con las dificultades para el control de impulsos en sus diferentes subtipos. Conclusiones. El síndrome de microdeleción 1q21.1 es fenotípicamente heterogéneo, incluso entre los miembros de una misma familia. Destaca la presencia de alteraciones psiquiátricas o del comportamiento como rasgo común en todos los pacientes que presentamos. Existen formas paucisintomáticas en las que el individuo portador de la deleción presenta exclusivamente alteraciones psiquiátricas (AU)
Introduction. 1q21.1 microdeletion syndrome is a caused by a recurrent deletion of the 1q21.1 copy-number variant, which spans 800 kb and includes at least seven genes. It is associated with a variable phenotype. Neuropsychiatric abnormalities have been previously described in many of the previously reported cases, but its true prevalence is unknown. Aim. To illustrate the phenotypic variability in 1q21.1 microdeletion syndrome. Case reports. Four individuals of the same kindred harboring a 1.74-Mb deletion within 1q21.1 are included. In our patients a heterogeneous phenotype is recognized. Neuropsychiatric disorders or more specifically impulse control disorders were common to all the four cases that we present. Conclusions. 1q21.1 microdeletion syndrome is phenotypically heterogeneous even among members of the same family. Behavioral or neuropsychiatric abnormalities are frequent. Paucisymptomatic forms with individuals presenting exclusively psychiatric disorders have been identified (AU)