Bilateral and multilobar cystic adenomatoid malformation of the lung.

We report a case of bilateral and multilobar congenital cystic adenomatoid malformation (CCAM) in a four-months-old child with good clinical results after resections of the lesions. This is a relatively rare form of pulmonary disease. The final prognosis in these patients depends on the type of malformation, the presence or absence of fetal hydrops and on the extent of affected lung. Few cases of multiple involvement have been reported. We will consider the physiopathological aspects of the case, late clinical presentation and treatment and the positive surgical response based on the findings of the functional and anatomic imaging studies.

[Clinical and epidemiological survey of RSV infection in infants]. / Estudio clínico-epidemiológico de la infección por virus respiratorio sincitial en el lactante.

OBJECTIVE: A prospective study was performed to assess the clinical and epidemiological characteristics of RSV infections in hospitalized infants. PATIENTS AND METHODS: Between October 1988 and September 1991, we studied 322 cases of RSV respiratory infections diagnosed by EIA of nasopharyngeal lavage and/or serology by complement fixation. Clinical, analytical and radiological data were reviewed. RESULTS: Time-analysis showed higher incidences of RSV infections in December, January, November and February, with an increase in hospital admissions due to respiratory problems before the peak in RSV infections. The mean age of the population was 6.84 +/- 7.07 months. The mean weight was 7.4 +/- 2.68 kg and the sex distribution was 61.2% males and 38.8% females. Blood count was not useful in the differential diagnosis between bronchiolitis/bronchitis and pneumonias, but the erythrocyte sedimentation rate was higher in the last group (25.2 +/- 20.1 versus 38.2 +/- 29.5, t = 2.52, p < 0.05). Clinical status, with a mean value of 6.09 +/- 2.31 as assessed by the modified Downes's Score, showed a significant relationship with the time of hospitalization (mean: 8.77 days; r = 0.2108, p < 0.01), but not with gas exchange, weight or age. Chest X-rays showed air trapping in 48% of the cases, but the incidence of condensation was lower than in other series (16%), probably because we do not believe that any infiltration of the lungs on chest roentgenograms places the patients in the pneumonia category. CONCLUSIONS: We found a high frequency of RSV infection among hospitalized infants and there was seasonal variation with a higher incidence during the winter months.

[Epidemiology of respiratory syncytial virus infections in the Canary Islands]. / Epidemiología de la infección por virus respiratorio sincitial en las islas Canarias.

Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract infection in young children. Outbreaks of RSV infection occur yearly during the winter or spring in temperate climates. Our study of 634 hospitalized children under 3 years of age with bronchiolitis and pneumonia (November 1988 to January 1990) revealed that 227 (35.8%) had VRS infections. These cases showed a yearly epidemic pattern with 86.8% of the cases occurring during the winter. Furthermore, 67.4% of the cases occurred in children between 1-6 months of age and the boy/girl ration was 1.2/1. In 26.9% of the infections there was an antibody response. These results for RSV infection on this island show the same epidemiological pattern as that in the temperate climates.

[Echocardiographic follow-up of insulin-dependent diabetics]. / Seguimiento ecocardiográfico en diabéticos insulinodependientes.

Results of echocardiographic test made on 29 patients with Diabetes Mellitus type I, under 14 years of age, on two occasions with an average of 33 months between test are presented. Anomalies were detected in approximately 30% of patients and persisted in re-evaluations of those patients with more than three altered parameters. Decrease of septal movement, as an index of myocardial contractibility affectation, is the only parameter which increased rate with time. Authors do not find any correlation between echocardiographic anomalies and age, sex, duration of diabetes, insulin doses and glycohemoglobin values. Due to high incidence of echocardiographic anomalies detected, they recommend these test be conducted periodically on type I diabetics, even though relation between control of the illness and long-term complications still appears to be uncertain.