Neurofibromatosis tipo 1 en Mali: a propósito de un caso de colaboración CIMIC / Type 1 Neurofibromatosis in Mali: a case report complying with CIMIC

Un niño de cuatro años atendido en el Centro de Salud «Santa Clara» de Koulikoro en Mali, por el personal del Cuerpo Militar de Sanidad de la European Union Training Mission Mali XIX, por presentar tumoración facial que condiciona proptosis ocular izquierda, provocando asimetría a nivel ocular izquierdo. En la exploración se observan manchas ligeramente marrones, efélide axilar y nódulos de Lisch en ambos ojos. Se sospecha de neurofibromatosis tipo I y se decide trasladar a territorio nacional, cumpliendo con los procedimientos de cooperación cívico-militar, imprescindibles en las nuevas formas de conflicto asimétrico, donde dicha relación es una herramienta fundamental para poder coordinar todas las operaciones en zona de operaciones. En el Hospital Universitario Miguel Servet, asociado al Hospital General de la Defensa de Zaragoza, se confirma el diagnóstico de neurofibroma plexiforme del trigémino izquierdo mediante estudio genético y pruebas complementarias de imagen. Se decide tratamiento con selumetinib. (AU)

A 4-year-old boy who was treated at the Santa Clara Health Center in Koulikoro by the medical team of the European Union Training Mission Mali XIX for a facial tumor that developed left ocular proptosis, causing a significant facial asymmetry at the level of the left eye. Medical examination revealed light brown stains, axillary ephelid and Lisch nodules in both eyes. Because of the suspicion of neurofibromatosis type 1 and following civil-military cooperation procedures, he is transferred to Spain. Civil-military cooperation is essential in the new forms of conflict, where these relationships are a fundamental tool in the coordination of all operations in the area. At the Miguel Servet University Hospital, in association with the General Defense Hospital of Zaragoza, the earlier diagnosis is confirmed (left trigeminal plexiform neurofibroma) with a genetic study and complementary imaging tests. It is decided to start treatment with selumetinib. (AU)

Neurofibromatosis tipo 1 en Mali: a propósito de un caso de colaboración CIMIC / Type 1 Neurofibromatosis in Mali: a case report complying with CIMIC

Un niño de cuatro años atendido en el Centro de Salud «Santa Clara» de Koulikoro en Mali, por el personal del Cuerpo Militar de Sanidad de la European Union Training Mission Mali XIX, por presentar tumoración facial que condiciona proptosis ocular izquierda, provocando asimetría a nivel ocular izquierdo. En la exploración se observan manchas ligeramente marrones, efélide axilar y nódulos de Lisch en ambos ojos. Se sospecha de neurofibromatosis tipo I y se decide trasladar a territorio nacional, cumpliendo con los procedimientos de cooperación cívico-militar, imprescindibles en las nuevas formas de conflicto asimétrico, donde dicha relación es una herramienta fundamental para poder coordinar todas las operaciones en zona de operaciones. En el Hospital Universitario Miguel Servet, asociado al Hospital General de la Defensa de Zaragoza, se confirma el diagnóstico de neurofibroma plexiforme del trigémino izquierdo mediante estudio genético y pruebas complementarias de imagen. Se decide tratamiento con selumetinib. (AU)

A 4-year-old boy who was treated at the Santa Clara Health Center in Koulikoro by the medical team of the European Union Training Mission Mali XIX for a facial tumor that developed left ocular proptosis, causing a significant facial asymmetry at the level of the left eye. Medical examination revealed light brown stains, axillary ephelid and Lisch nodules in both eyes. Because of the suspicion of neurofibromatosis type 1 and following civil-military cooperation procedures, he is transferred to Spain. Civil-military cooperation is essential in the new forms of conflict, where these relationships are a fundamental tool in the coordination of all operations in the area. At the Miguel Servet University Hospital, in association with the General Defense Hospital of Zaragoza, the earlier diagnosis is confirmed (left trigeminal plexiform neurofibroma) with a genetic study and complementary imaging tests. It is decided to start treatment with selumetinib. (AU)

Effects of manipulating relative and absolute motion information during observational learning of an aiming task.

In the visual perception perspective of observational learning, the manipulation of relative and absolute motion information in visual demonstrations optimally directs learners' search towards appropriate task solutions. We assessed the effect of emphasizing transformational information and removal of structural information using point-light kinematic displays in approximating the model's relative motion patterns. Participants viewed computer-simulated point-light demonstrations or normal video demonstrations before and intermittently throughout 100 acquisition trials with knowledge of results on an underarm modified-dart aiming task. On the next day, all participants performed 20 retention trials without demonstrations. The kinematics of spatial and temporal coordination and control variables were examined relative to the model's action, as well as performance scores. The results indicated that approximation of the model's spatial and temporal coordination and control patterns was achieved after observation of either type of demonstrations. No differences were found in movement outcomes. In a second experiment, the effects of manipulating absolute motion information by slow-motion demonstrations were examined relative to real-time demonstrations. Real-time demonstrations led to a closer approximation to the model's spatial and temporal coordination patterns and better outcome scores, contradicting predictions that slow-motion displays convey intact relative motion information. We speculate that the effect of visual demonstration speed on action perception and reproduction is a function of task constraints--that is, novelty or familiarity of relative motion of demonstrated activities.

[Bacterial meningitis. Clinical-epidemiological study. Review of 8 years (1988-1995)]. / Meningitis bacterianas. Estudio clínico-epidemiológico. Revisión de 8 años (1988-1995).

OBJECTIVE: The objective of this study was to determine the epidemiological and clinical characteristics of the bacterial meningitis assisted in the Hospital Materno-Infantil of Complejo Hospitalario Carlos Haya of Malaga. PATIENTS AND METHODS: The epidemiological, clinical, biological and therapeutical aspects are analyzed between the period of January 1988 to December 1995. RESULTS: The number of cases was 322, with the pathogen known in 240 (74.6%) and undetermined in 82 cases (24.6%). Meningococcal meningitis was the predominant cause with 162 cases (67.5%), followed by Haemophilus influenzae (40 cases, 16.7%) and pneumococcal meningitis (27 cases, 11.3%). Neisseria meningitidis type B was the most common serogroup, with an increasing number of type C from 1993.

[Prognostic value and accuracy of crisis indicators in severe asthma]. / Valor pronóstico y precisión de los indicadores de crisis asmática severa.

OBJECTIVE: The objective of this study was to evaluate the predictive index of several scores such as the Scarfone score. Wood-Downes modified by Ferrés and transcutaneous oxygen saturation. (Stc,O2) for the detection of severe asthma exacerbations. PATIENTS AND METHODS: A transverse study design was used. Sixty patients under 15 years of age admitted consecutively with acute asthma were included in the study. We evaluated the relation (Pearson "r" correlation), precision (sensibility and specificity) and odds ratio (logistic regression) of the scores and Stc,O2 with the number of salbutamol doses required by the patients during their hospitalization. RESULTS: The number of doses of bronchodilator needed to revert acute asthma relates to the hospital stay (r = 0.74, p < 0.0002), to all the scores taken into account (r > 0.65, 0 < 0.001) an to the Stc,O2 (r = -0.66, p < 0.001). The evaluated scores are prognostic factors for severe acute asthma, while heart rate and respiratory rate did not predict severe acute asthma. CONCLUSIONS: We have to identify, treat and classify as having severe acute asthma those patients who after receiving three doses of inhaled bronchodilator show a Scarfone score over 10 or a Ferrés score over 8, these being situations related to an increased need of bronchodilator therapy and a longer hospital stay.

[Acute respiratory failure secondary to Pneumocystis carinii pneumonia in children]. / Fracaso respiratorio agudo secundario a neumonía por Pneumocystis carinii en la infancia.

OBJECTIVE: The objective of this study was to ascertain the clinical and epidemiological characteristics of Pneumocystis carinii pneumonia (PCP) cases admitted to the Pediatric Intensive Care Unit (PICU). PATIENTS AND METHODS: A retrospective study was carried out on the 8 PCP cases admitted to the PICU from July 1991 to September 1994. The variables studied were: age, sex, geographic origin, associated pathology, immunological status, clinical manifestations, biochemical data, radiology, findings in bronchoalveolar lavage fluid (BAL), response to therapy and clinical follow-up. RESULTS: Age of the patients varied between 3 months and 9 years and there were 5 males and 3 females. Associated pathologies included AIDS (4 cases), severe combined immunodeficiency (SCID), Job's syndrome, and immunodeficiencies secondary to non-Hodgkin's lymphoma (NHL) and acute lymphoid leukemia (ALL), one case of each. Four cases appeared in a 22 day period. All cases but one suffered acute respiratory failure and needed mechanical ventilation. Diagnosis was established by means of BAL in every case. All cases showed a bilateral diffuse alveolo-interstitial pattern on chest films. Treatment was trimethoprim-sulfamethoxazole. In the acute illnesses, 2 patients died (cases of terminal SCID and NHL). CONCLUSIONS: To date, epidemic presentation of PCP has not been reported in our community. Four of our cases, with no demonstrable previous relation, appeared over a short period of time. We have not found a relationship between LDH levels and severity, as expressed by mechanical ventilation time. Every AIDS case survived the acute episode and CD4 counts were normal in most cases.