Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study.

BACKGROUND: Oral food challenge (OFC) is the criterion standard for diagnosis of acute food protein-induced enterocolitis syndrome (FPIES). No diagnostic/prognostic biomarkers are available, and OFC assessment criteria are not validated. OBJECTIVE: To assess clinical-hematological changes and predictors of severity of FPIES reactions at OFC. METHODS: This was an observational multicenter prospective study. Children aged 0 to 18 years diagnosed with acute FPIES were recruited at follow-up OFC in 12 tertiary centers in Spain and Italy. OFC outcomes (as positive/negative/inconclusive and mild/moderate/severe) were assessed on the basis of published "2017 FPIES Consensus" criteria. Clinical characteristics were recorded, and full blood cell count was done at baseline, reaction onset, and 4 hours later. Regression analysis was performed to assess predictors of severe reactions at OFC. RESULTS: A total of 81 children had positive OFC (mild in 11% [9 of 81], moderate in 61% [49 of 81], and severe in 28% [23 of 81]). Increase in neutrophils and reduction in eosinophils, basophils, and lymphocytes were observed (P < .05). OFC was inconclusive in 19 cases despite objective signs or neutrophilia. Regression analysis showed that a 2-day OFC protocol where only 25% of an age-appropriate portion is given on day 1 (not sex, age, culprit food, cumulative dose, and previous reaction severity) was associated with reduced odds of severe reaction compared with giving multiple doses in a single day. CONCLUSIONS: Distinct hematological changes may help support FPIES diagnosis. Current OFC assessment criteria may not capture the broad spectrum of acute FPIES presentations. This 2-day protocol may be associated with a reduced risk of severe reactions. Future work should aim to develop safer OFC and non-OFC diagnostics for FPIES.

Prevalencia de marcas de nacimiento y lesiones cutáneas transitorias en 1.000 recién nacidos españoles / Prevalence of Birthmarks and Transient Skin Lesions in 1.000 Spanish Newborns

Introducción: Prácticamente la totalidad de los neonatos presenta alguna marca de nacimiento o lesión cutánea benigna transitoria. Hay pocos estudios, especialmente en nuestro país, que analicen la frecuencia de estos trastornos. Nuestro objetivo es conocer su prevalencia en1.000 recién nacidos del área sanitaria de Ferrol y compararla con los hallazgos de otras 9series de similares características. Pacientes y métodos: Realizamos un estudio descriptivo de 1.000 recién nacidos vistos en los3 primeros días de vida en la consulta de Perinatología del Servicio de Pediatría del Hospital Arquitecto Marcide. En cada caso se investigó la presencia o ausencia de 19 lesiones cutáneas benignas transitorias y 11 marcas de nacimiento. Resultados: 994 neonatos, el 99,4%, presentaban alguna lesión cutánea. El 99,2% y el 72% tenían lesiones cutáneas transitorias y marcas de nacimiento respectivamente. Las 5 más prevalentes fueron la hiperplasia sebácea en el 75% de los neonatos, la mancha salmón en el 64,2%, la hipertricosis en el 59%, el callo de succión labial en el 54% y el quiste palatino en el 53,7%. Conclusiones: En el presente estudio se demuestra la presencia de lesiones cutáneas benignas en la mayor parte de los neonatos. En su desarrollo y detección influyen no solo las características propias del país donde se realiza el estudio (climáticas, sociosanitarias o ‘‘grupos raciales’’), sino también variaciones en el período de exploración, en los criterios de inclusión de neonatos y en la terminología empleada (AU)

Background and objectives: Almost all newborn children have some sort of birthmark or transient benign skin lesion. Few studies, however, have analyzed their frequency, particularly in Spain. The aims of this study were to determine their prevalence in 1000 newborn children in the health care area of Ferrol in northwest Spain and to compare the results with those of 9other studies with similar characteristics. Patients and methods: We undertook a descriptive study of 1000 newborn infants seen in the first 3 days of life at the neonatal clinic in the Department of Pediatrics, Hospital Arquitecto Marcide, Ferrol, Spain. Each infant was examined for the presence of 19 different transient benign skin lesions and 11 birthmarks. Results: Birthmarks or benign skin lesions were present in 994 neonates (99.4%). Transient skin lesions were present in 99.2% and birthmarks in 72%. The 5 most prevalent lesions were sebaceous hyperplasia (75%), salmon patch (64.2%), hypertrichosis (59%), sucking calluses (54%), and palatine cysts (53.7%). Conclusions: The results of this study show that most neonates have benign skin lesions. The findings of studies to assess their frequency are influenced not only by geographic location (affecting variables such as climate, social and health care conditions, and ethnic group) but also by the timing of examination, the inclusion criteria applied, and the terminology used (AU)

Prevalencia y características clínicas de los nevos melanocíticos congénitos en 1.000 recién nacidos españoles / Prevalence and Clinical Features of Congenital Melanocytic Nevi in 1, 000 Spanish Newborns

Introducción: El nevo melanocítico congénito es una proliferación melanocítica benigna presente al nacimiento o en los primeros meses de vida. Aunque es una lesión común, hay pocos estudios en nuestro entorno que analicen su frecuencia. El objetivo de nuestro estudio es conocer su prevalencia y las localizaciones más frecuentes en los recién nacidos de nuestra área sanitaria, y analizar la influencia de los factores neonatales y maternos en el desarrollo de estas lesiones. Pacientes y métodos: Realizamos un estudio prospectivo de 1.000 neonatos consecutivos vistos en las primeras 72 horas de vida en la consulta de Perinatología del Servicio de Pediatría de nuestro hospital (Hospital Arquitecto Marcide, Ferrol, España). En cada caso se recogieron datos referentes a diferentes parámetros maternos y neonatales, y la presencia, el tamaño y la localización de los nevos melanocíticos congénitos. Resultados: Catorce neonatos (el 1,4% de los neonatos incluidos) presentaban al menos un nevo melanocítico congénito. Doce eran caucasianos y 2 árabes. Respecto al sexo, 10 recién nacidos eran de sexo femenino y 4 de sexo masculino. En todos los casos presentaba solo un nevo melanocítico. Ocho se localizaban en el tronco, 2 en el área facial, 2 en las extremidades superiores y 2 en las inferiores. El 50% de los nevos melanocíticos congénitos tenían un diámetro inferior a 1,5cm y la otra mitad entre 1,5 y 3,5cm. Conclusiones: Existe una mayor prevalencia de nevos melanocíticos en los recién nacidos pretérmino, de sexo femenino y no caucasianos. La edad materna, el número de gestaciones previas y el peso al nacimiento no parecen influir en su aparición (AU)

Background: Congenital melanocytic nevus is a benign proliferation of melanocytes that is present at birth or develops in the first months of life. Although such lesions are common, few studies have analyzed their prevalence in Spain. Objectives: The aim of this study was to define the prevalence and most frequent anatomical areas affected by congenital melanocytic nevi in our health service area. We also analyzed the influence of maternal and neonatal factors in the development of these lesions. Patients and methods: We performed a prospective study of 1000 consecutive neonates seen in the first 72hours of life in the perinatology clinic of the Pediatrics Department of Hospital Arquitecto Marcide in Ferrol, Spain, recording specific maternal and neonatal variables and the size and site of congenital melanocytic nevi if present. Results: Fourteen infants (10 girls and 4 boys; 12 white European, 2 North African; 1.4% of the study population) presented at least 1 melanocytic nevus. None had more than 1 lesion. Eight of the nevi were located on the trunk, 2 on the face, 2 on the upper limbs, and 2 on the lower limbs. The diameter of the lesions was less than 1.5cm in half of cases and between 1.5 and 3.5cm in the remainder. Conclusions: There was a higher prevalence of congenital melanocytic nevi in preterm infants, females, and nonwhite infants. Maternal age, number of previous pregnancies, and birth weight do not appear to influence the prevalence of these lesions (AU)

[Prevalence and clinical features of congenital melanocytic nevi in 1,000 Spanish newborns]. / Prevalencia y características clínicas de los nevos melanocíticos congénitos en 1.000 recién nacidos españoles.

BACKGROUND: Congenital melanocytic nevus is a benign proliferation of melanocytes that is present at birth or develops in the first months of life. Although such lesions are common, few studies have analyzed their prevalence in Spain. OBJECTIVES: The aim of this study was to define the prevalence and most frequent anatomical areas affected by congenital melanocytic nevi in our health service area. We also analyzed the influence of maternal and neonatal factors in the development of these lesions. PATIENTS AND METHODS: We performed a prospective study of 1000 consecutive neonates seen in the first 72hours of life in the perinatology clinic of the Pediatrics Department of Hospital Arquitecto Marcide in Ferrol, Spain, recording specific maternal and neonatal variables and the size and site of congenital melanocytic nevi if present. RESULTS: Fourteen infants (10 girls and 4 boys; 12 white European, 2 North African; 1.4% of the study population) presented at least 1 melanocytic nevus. None had more than 1 lesion. Eight of the nevi were located on the trunk, 2 on the face, 2 on the upper limbs, and 2 on the lower limbs. The diameter of the lesions was less than 1.5 cm in half of cases and between 1.5 and 3.5 cm in the remainder. CONCLUSIONS: There was a higher prevalence of congenital melanocytic nevi in preterm infants, females, and nonwhite infants. Maternal age, number of previous pregnancies, and birth weight do not appear to influence the prevalence of these lesions.

[Prevalence of birthmarks and transient skin lesions in 1,000 Spanish newborns]. / Prevalencia de marcas de nacimiento y lesiones cutáneas transitorias en 1.000 recién nacidos españoles.

BACKGROUND AND OBJECTIVES: Almost all newborn children have some sort of birthmark or transient benign skin lesion. Few studies, however, have analyzed their frequency, particularly in Spain. The aims of this study were to determine their prevalence in 1000 newborn children in the health care area of Ferrol in northwest Spain and to compare the results with those of 9 other studies with similar characteristics. PATIENTS AND METHODS: We undertook a descriptive study of 1000 newborn infants seen in the first 3 days of life at the neonatal clinic in the Department of Pediatrics, Hospital Arquitecto Marcide, Ferrol, Spain. Each infant was examined for the presence of 19 different transient benign skin lesions and 11 birthmarks. RESULTS: Birthmarks or benign skin lesions were present in 994 neonates (99.4%). Transient skin lesions were present in 99.2% and birthmarks in 72%. The 5 most prevalent lesions were sebaceous hyperplasia (75%), salmon patch (64.2%), hypertrichosis (59%), sucking calluses (54%), and palatine cysts (53.7%). CONCLUSIONS: The results of this study show that most neonates have benign skin lesions. The findings of studies to assess their frequency are influenced not only by geographic location (affecting variables such as climate, social and health care conditions, and ethnic group) but also by the timing of examination, the inclusion criteria applied, and the terminology used.

Tratamiento con rituximab en un paciente con glomerulonefritis p-ANCA, hemorragia alveolar y múltiples recidivas en hemodiálisis / No disponible

No disponible

Dermatitis de contacto de «Lucky Luke» por pañales / «Lucky Luke» contact dermatitis from diapers

No disponible

No disponible

[Scintigraphy of the intraperitoneal cavity using technetium 99m as a diagnostic technique for diaphragmatic leaks in peritoneal dialysis: regarding two cases]. / La gammagrafía con Tc99m intraperitoneal como técnica diagnóstica de fugas diafragmáticas en pacientes en diálisis peritoneal: a propósito de dos casos.

Pleural effusion secondary to pleuroperitoneal communication is an unusual complication of continuous ambulatory peritoneal dialysis. Many modalities have been used to diagnosis pleuroperitoneal: pleural fluid analysis, chest X- ray, Tc-99m gammagraphy, computed tomography scan and magnetic resonance image. Some of these procedures are invasive or have a high risk of induced-contrast nephrotoxicity. We present two case reports of pleuroperitoneal leak in two patients on peritoneal dialysis diagnosed with Tc-99m gammagraphy. We conclude that Tc- 99m gammagraphy is a simple, safe, non invasive, low radiation exposure and cost effective method in the assessment and evaluation of complications related to peritoneal dialysis such as pleuroperitoneal leak.

La gammagrafía con Tc99m intraperitoneal como técnica diagnóstica de fugas diafragmáticas en pacientes en diálisis peritoneal: a propósito de dos casos / No disponible

Entre las complicaciones de la diálisis peritoneal, se encuentran las fugas de líquido hacia diferentes cavidades, entre ellas a la cavidad pleural. El diagnóstico de fuga diafragmática puede realizarse mediante toracocentesis o diferentes exploraciones de imagen con administración de contrastes iónicos o de gadolinio, considerándose alguna de ellas técnicas invasivas y no estando exentas de riesgo de toxicidad por contraste. Presentamos dos casos de derrame pleural en diálisis peritoneal en los que la prueba diagnóstica no invasiva mediante gammagrafía con Tc99mintraperitoneal permitió confirmar la sospecha de diagnóstica al mínimo coste. Concluimos que la gammagrafía intraperitoneal es la técnica de elección para el diagnóstico de fugas peritoneales en estos paciente (AU)

Pleural effusion secondary to pleuroperitoneal communication is an unusual complication of continuous ambulatory peritoneal dialysis. Many modalities have been used to diagnosis pleuroperitoneal: pleural fluid analysis, chestX- ray, Tc-99m gammagraphy, computed tomography scan and magnetic resonance image. Some of these procedures are invasive or have a high risk of induced-contrastnephrotoxicity. We present two case reports of pleuroperitoneal leak in two patients on peritoneal dialysis diagnosed with Tc-99m gammagraphy. We conclude that Tc-99m gammagraphy is a simple, safe, non invasive, low radiation exposure and cost effective method in the assessment and evaluation of complications related to peritoneal dialysis such as pleuroperitoneal leak (AU)