RESUMO
Introducción: El objetivo del presente estudio es analizar el comportamiento de la calprotectina fecal en los pacientes pediátricos con enfermedad celiaca, comparando sus niveles mientras recibían dieta con y sin gluten. También se han incluido en la comparación pacientes sanos y con diversas patologías digestivas no inflamatorias. Material y métodos: Se han recogido muestras de heces de pacientes celiacos con diagnóstico de novo (con gluten) y pacientes en seguimiento (sin gluten). Se incluyeron en el grupo control niños sanos sin patología digestiva y otros con diversos trastornos digestivos no diagnosticados de enfermedad inflamatoria intestinal. Resultados: La calprotectina fecal fue significativamente más alta en los pacientes celiacos que recibieron una dieta con gluten (119,2 ± 122,6 µg/g) que en los que recibieron una dieta sin gluten (21,5 ± 24,7 µg/g). Estos últimos presentaron valores similares al grupo control sano. Conclusiones: La calprotectina fecal está elevada en los pacientes celiacos con ingesta de gluten respecto a los celiacos con dieta sin gluten y los pacientes sanos. Este marcador podría usarse para la detección precoz de la ingesta de gluten (AU)
Introduction: The objective of the present research is to study the behavior of the faecal calprotectin in the pediatric coeliac disease, comparing its levels while receiving a diet with and without gluten. For the comparison, there were also included healthy children, and patients with diverse non-inflammatory digestive pathologies. Materials and methods: There have been collected stool samples from de novo coeliac patients (with gluten) and from follow-up coeliac patients (without gluten). As control groups, there were included healthy children without any digestive pathology and others with diverse digestive non-diagnosed disorders from the inflammatory bowel disease. Results: The faecal calprotectin was significantly higher in the coeliac patients with gluten (119.2 ± 122.6 µg/g) than in the patients with the gluten-free diet (21.5 ± 24.7 µg/g). The later showed similar values to those in the healthy control group. Conclusions: The faecal calprotectin is higher in the coeliac patients with gluten ingestion than in the coeliac patients with the gluten-free diet and in the healthy group. This could be used as a marker for early detection of gluten ingestion (AU)
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Proteínas de Transporte/análise , Proteínas de Ligação ao Cálcio/análise , Doença Celíaca/fisiopatologia , Inflamação/fisiopatologia , Fezes/química , Mediadores da Inflamação/análise , Biomarcadores/análiseRESUMO
Introducción. Se ha asistido a una importante evolución del tratamiento quirúrgico en los últimos años por la generalización progresiva de la cirugía laparoscópica. Todas las técnicas disponibles pueden hacerse laparoscópicamente con similares resultados a los de la cirugía abierta. En 1978, Villet et al. describieron el síndrome de Dumping (SD) como una complicación frecuente de la fundoplicatura de Nissen. EL SD es un complejo de signos y síntomas que aparecen poco después de la cirugía, incluyendo dolor abdominal, palidez, sudoración, diarrea, náuseas, palidez, incluso pérdida de peso. Los síntomas se pueden diferenciar en dumping precoz, que ocurre entre 30 y 60 minutos después de la comida, y tardío, que ocurre entre 90-240 min. del período postprandial. Material y métodos. Se han estudiado 8 pacientes (3 niños y 5niñas) de edades comprendidas entre 3 y 12 años (media de 9 años) diagnosticados de síndrome de dumping tras la realización de Nissen-Rosseti laparoscópico. A todos ellos se les realizó un estudio de vaciadogástrico por gammagrafía tras administración de un volumen de leche adecuado a su peso marcado con Tc99 DTPA y Test de sobrecarga ora (..) (AU)
Introduction. There has been an important evolution of surgical treatment in recent years due to the progressive generalization of laparoscopic surgery. All of the available techniques can be done laparoscopically with similar results to those of open surgery. In 1978, Villet etal. described the Dumping syndrome (DS) as a frequent complication of Nissen fundoplication. DS is a group of signs and symptoms that appear shortly after surgery, including abdominal pain, paleness, sweating, diarrhea, nausea, even weight loss. These symptoms can be differentiated into early dumping that occurs between 30 to 60 minutes after eating and late dumping that occurs 92-240 minutes after the postprandial period (..) (AU)
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Síndrome de Esvaziamento Rápido/cirurgia , Fundoplicatura/efeitos adversos , Laparoscopia/métodos , Índice Glicêmico , Complicações Pós-Operatórias , Hiperinsulinismo/etiologia , Refluxo Gastroesofágico/complicaçõesRESUMO
INTRODUCTION: There has been an important evolution of surgical treatment in recent years due to the progressive generalization of laparoscopic surgery. All of the available techniques can be done laparoscopically with similar results to those of open surgery. In 1978, Villet et al. described the Dumping syndrome (DS) as a frequent complication of Nissen fundoplication. DS is a group of signs and symptoms that appear shortly after surgery, including abdominal pain, paleness, sweating, diarrhea, nausea, even weight loss. These symptoms can be differentiated into early dumping that occurs between 30 to 60 minutes after eating and late dumping that occurs 92-240 minutes after the postprandial period. MATERIAL AND METHODS: A total of 8 patients (3 boys and 5 girls) have been studied. Their ages ranged from 3 to 12 years (mean 9 years), and they were diagnosed of dumping syndrome after performing the laparoscopic Nissen-Rossetti. All underwent a gastric voiding study by scintigraphy after administration of a volume of milk adjusted to their weight labeled with 99Tc-DTPA and oral glucose overload test with 1.75 g/kg of glucose, determining the baseline glycemia and every 30 minutes post-intake, at 0, 30 and 90 minutes. Insulin was also measured to obtain the glucose/insulin ratio. This study was conducted for all patient diagnosed of dumping syndrome before and after laparoscopic Nissen-Rossetti surgery. RESULTS: The following results were obtained: Glucose Curve: 1. Maximum glycemia. PreNissen. The mean of the maximum glycemia values before surgery was 133.9+/-32.11 mg/dl. Post-Nissen. Mean maximum glycemias after surgery was 208.5 +/- 45.07 mg/dl with a range of 147-276 mg/dl. These differences of maximum glycemia were clearly significant with a p <0.002. Minimum glycemia. The mean value of the minimum glycemias after the surgery, compared with the previous value, did not show significant differences: 62.6+/- 11.51 mg/dl versus 71.8 +/- 28.04 mg/dl. Glucose/insulin ratio. The hyperinsulinism values after the intervention studied by means of the glucose/insulin ratio were abnormal in 70.5% (defined as ratio under 3). The mean value was also characteristic of hyperinsulinism (2.3 +/- 1.62). The mean value of the coefficient prior to the surgery was 4.6 with a deviation of 3.04, the differences not being statistically significant with a p= 0.097. Measurement of gastric voiding: The T1/2 (decay) value in post-Nissen patients was significantly lower than in pre-Nissen patients. The postsurgical mean and standard deviation was 29.74 +/- 7.92 min, while in the presurgical group, the mean and standard deviation was 73.75 +/- 28.34 min with p< 0.011; statistically significant. CONCLUSIONS: From the values obtained, we can state that a significant increase in maximum glycemia has been found in all children after surgery who were diagnosed of dumping syndrome and a significant decrease in the mean time of gastric voiding and therefore an increase in the acceleration of gastric voiding after the performance of the Nissen regarding the previous values. The dumping syndrome is a frequent side effect that we must keep in mind in patients who have been previously operated for anti-reflex surgery, the symptoms being greater in most of the transitory cases. Furthermore, it is important to keep in mind because it has an easy treatment that reverts the symptoms in a short time
Assuntos
Glicemia/análise , Síndrome de Esvaziamento Rápido/sangue , Síndrome de Esvaziamento Rápido/fisiopatologia , Fundoplicatura/efeitos adversos , Esvaziamento Gástrico , Laparoscopia , Criança , Pré-Escolar , Síndrome de Esvaziamento Rápido/etiologia , Feminino , Fundoplicatura/métodos , Humanos , MasculinoRESUMO
No disponible
Assuntos
Masculino , Criança , Humanos , Síndrome de Esvaziamento Rápido/complicações , Síndrome de Esvaziamento Rápido/diagnóstico , Esvaziamento Gástrico , Esvaziamento Gástrico/fisiologia , Transtornos da Motilidade Esofágica/complicações , Transtornos da Motilidade Esofágica/diagnóstico , Transtornos da Motilidade Esofágica , Glicemia/análise , Índice Glicêmico , Índice Glicêmico/fisiologiaRESUMO
Introducción: El virus de la varicela-zoster es el agente etiológico de la varicela (infección primaria) y del herpes zoster (reactivación de la varicela latente). Aunque la varicela suele ser una infección benigna y autolimitada en niños, puede asociarse a complicaciones serias, que pueden ser potencialmente mortales, tanto en personas inmunocompetentes como en inmunocomprometidos1. Objetivo: Estudio descriptivo de los casos de varicela complicados que precisaron ingreso hospitalario en el Área de Salud de Alcoy, durante el periodo de enero a diciembre de 2002. Pacientes y métodos: Revisión de las historias clínicas de todos los enfermos de cualquier edad ingresados en el Hospital de Alcoy, durante el periodo de enero a diciembre 2002, como consecuencia de una complicación de varicela. Resultados: El número total de casos de varicela declarados en el Boletín Epidemiológico Semanal en el área de salud fue de 876 (declaración numérica sin diferencia de edad o sexo). Precisaron ingreso hospitalario por alguna complicación 9 enfermos, siendo un 66,6 por ciento mujeres y un 33,3 por ciento varones. La edad media de presentación fue de 2,4 años (rango entre 1 y 4 años). No se presentó ningún caso complicado en adultos. Los tipos de complicaciones fueron sobreinfección bacteriana en 5 casos, neumonía con derrame pleural en 1 caso, trastornos hidroelectrolíticos en 2 casos y vasculitis en 1 de ellos. Conclusiones: La varicela no es una enfermedad tan leve, dado que puede cursar con complicaciones que suponen una elevada morbilidad, e incluso pueden ocasionar mortalidad, como ocurrió en uno de nuestros pacientes. Ninguno de nuestros casos estaba diagnosticado de inmunodeficienéia congénita o adquirida. No se presentó ninguna complicación que requiriera ingreso en adultos, ni ningún caso de varicela en embarazada o varicela fetal. Debemos insistir en la puesta en marcha del calendario vacunal recomendado por la Asociación Española de Pediatría (AEP) (AU)
Assuntos
Adolescente , Adulto , Feminino , Pré-Escolar , Lactente , Masculino , Criança , Humanos , Varicela/epidemiologia , Varicela/complicações , Herpesvirus Humano 3/patogenicidade , Hospitalização/estatística & dados numéricosRESUMO
INTRODUCTION: Ischemic cerebrovascular disease is an infrequent problem in the paediatric age, but one which we now understand better thanks to modern neuroimaging techniques. We know little about its aetiopathogenesis, which is very varied, and it has been reported as being associated with viral infections such as chicken pox. CASE REPORT: A male, aged 3 years, who presented sudden hemiparesis, facial paralysis and dysarthria, without any other accompanying neurological symptoms. The patient had suffered a bout of chicken pox 6 weeks earlier. Of the abnormal complementary explorations, the most notable were varicella positive serological tests and MRI and MR angiography that pointed to ischemic involvement of the cortex. The patient progressed very well and the clinical features had completely reverted at five weeks. CONCLUSION: Post varicella angiopathy is one of the acquired risk factors for an ischemic stroke, and has been claimed to account for up to a third of all strokes in infants. Neuroimaging techniques allow the topographic determination of the ischemic repercussions. Patients usually progress well and in most cases the clinical features completely revert within a short time. We conclude that chicken pox should be included in the vaccination schedule as soon as possible in order to prevent complications that, as in the case we have reported, can be very serious.
Assuntos
Isquemia Encefálica/diagnóstico , Isquemia Encefálica/etiologia , Artérias Cerebrais/patologia , Artérias Cerebrais/virologia , Varicela/complicações , Varicela/imunologia , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Humanos , Imunoglobulina M/imunologia , Angiografia por Ressonância Magnética , MasculinoRESUMO
Introducción. La enfermedad cerebrovascular isquémica es un problema poco frecuente en la edad pediátrica, pero cada vez mejor estudiado con las modernas técnicas de neuroimagen. La etiopatogenia es poco conocida y muy variada; se ha descrito su asociación con infecciones virales, como la varicela. Caso clínico. Varón de 3 años, que presenta un cuadro brusco de hemiparesia, parálisis facial y disartria, sin otra sintomatología neurológica acompañante. Muestra antecedente de varicela 6 semanas antes. De entre las exploraciones complementarias anormales, destaca la serología positiva para varicela y la RM y la angiorresonancia magnética cerebrales, indicativas de la afectación isquémica cortical. La evolución fue muy satisfactoria y el cuadro revirtió por completo a las cinco semanas. Conclusión. Entre los factores de riesgo adquiridos de un ictus isquémico, se encuentra la angiopatía posvaricela, que se ha llegado a responsabilizar de hasta la tercera parte de los accidentes cerebrovasculares isquémicos de la infancia. Con las técnicas de neuroimagen se pueden perfilar topográficamente las repercusiones isquémicas. La evolución suele ser muy satisfactoria y el cuadro revertir de forma completa con prontitud en la mayoría de las ocasiones. Se concluye con la necesidad de incluirla varicela en el calendario vacunal lo antes posible, para poder evitar complicaciones que en muchas ocasiones, como la que se describe, son muy serias (AU)
Assuntos
Pré-Escolar , Masculino , Humanos , Angiografia por Ressonância Magnética , Artérias Cerebrais , Varicela , Imunoglobulina M , Isquemia Encefálica , Ensaio de Imunoadsorção EnzimáticaAssuntos
Encéfalo/patologia , Encefalomielite Aguda Disseminada/diagnóstico , Encefalomielite Aguda Disseminada/etiologia , Infecções por Vírus Epstein-Barr/complicações , Encéfalo/virologia , Pré-Escolar , Humanos , Imageamento por Ressonância Magnética , Masculino , Medula Espinal/patologia , Medula Espinal/virologia , Fatores de TempoRESUMO
No disponible
Assuntos
Humanos , Masculino , Criança , Encefalomielite Aguda Disseminada/induzido quimicamente , Encefalomielite Aguda Disseminada/complicações , Encefalomielite Aguda Disseminada/diagnóstico , Tonsilite/diagnóstico , Tonsilite/patologia , Encefalomielite Aguda Disseminada/metabolismo , Encefalomielite Aguda Disseminada/mortalidade , Encefalomielite Aguda Disseminada/prevenção & controle , Tonsilite/complicações , Tonsilite/prevenção & controleRESUMO
We have studied a population of 60 children with acute diarrhea. In order to evaluate the benefit of lactose suppression from the diet on the clinical course of the disease, these children were randomly assigned to either the control group or the experimental group. No differences were found in respects to the duration of the illness (lactose containing formula 4.8 +/- 2 days vs lactose free formula 4.4 +/- 3.1 days). Similarly, body weight change did not change significantly (12.5 +/- 235.8 gr vs 55.9 +/- 238.0 gr, t-test non-significant). Children fed with the lactose free diet voided less frequently than did children in the control group (12.8 +/- 10.5 vs 19.8 +/- 9.5 times; p < 0.01). This difference disappeared when only invasive diarrheas were considered (26.6 +/- 12 vs 21.5 +/- 9.5 voidings; t-test nonsignificant). Finally, only 2 of the 32 cases fed with lactose containing formula showed clinical intolerance to lactose. Therefore, we conclude that in patients with mild-to-moderate acute diarrhea, the resumption of feeding should be undertaken with the same formula that they were previously fed, restricting the use of lactose free formulas to selected cases and to those children in whom a standard milk made symptoms reappear.
Assuntos
Diarreia Infantil/tratamento farmacológico , Alimentos Infantis , Lactose/administração & dosagem , Doença Aguda , Peso Corporal , Distribuição de Qui-Quadrado , Diarreia Infantil/epidemiologia , Diarreia Infantil/fisiopatologia , Fezes/química , Fezes/microbiologia , Humanos , Concentração de Íons de Hidrogênio , Lactente , Falha de TratamentoRESUMO
The aim of our work was to review the epidemiological, clinical and laboratory features of the cases of Kala-azar in our hospital during a decade in order to outline data that might be useful in helping to make an earlier diagnosis and subsequently, earlier treatment. We report eighteen cases of visceral Leishmaniasis treated in our hospital between January 1981 and December 1990. The ages of the patients varied between five months and seven years. In our experience, medullar aspirate was the most effective diagnostic method. However, it this test is negative, specific serological tests should be included in the assessment of any pediatric inpatient with fever and splenomegaly. In our opinion, it is very important to keep this disease in mind, especially in non-endemic areas.
Assuntos
Leishmaniose Visceral/epidemiologia , Fatores Etários , Criança , Pré-Escolar , Diagnóstico Diferencial , Humanos , Lactente , Leishmaniose Visceral/diagnóstico , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
The cases of 131 newborns with positive blood cultures have been reviewed. These children were born in our hospital between 1985 and 1990. We found that the incidence of sepsis was 4.3/1000 newborns. Early neonatal sepsis was the most frequent, representing 58% of the cases. Late sepsis in hospitalized infants represented 1.34% of the cases. Streptococcus B was the microorganism most frequently isolated (26.7%), followed by S. epidermidis (19.8%), E. coli (13.7%) and S. aureus (10.68%). In over 50% of the cases of early sepsis, maternal-fetal risk factors were present. Mortality was 7.6%, with half of these cases due to Streptococcus B.
Assuntos
Sepse/microbiologia , Infecção Hospitalar , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Incidência , Recém-Nascido , Masculino , Sepse/epidemiologia , Sepse/etiologia , Espanha/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/isolamento & purificaçãoRESUMO
Three cases of congenital dwarfism are presented. All of them are lethal and represent the three better known nonviable nosologic entities: Achondrogenesis I, Achondrogesis II and Thanatophoric dwarfism. According to clinical features and radiologic data it is possible to approach the diagnosis accurately. We comment genetic, clinic, radiologic and histologic aspects of these processes. It is important to establish a differential diagnosis as these entities have different genetic basis, what influences genetic counsel.
Assuntos
Acondroplasia/genética , Osteocondrodisplasias/genética , Displasia Tanatofórica/genética , Acondroplasia/classificação , Acondroplasia/diagnóstico por imagem , Acondroplasia/mortalidade , Feminino , Aconselhamento Genético , Humanos , Recém-Nascido , Masculino , Osteocondrodisplasias/classificação , Osteocondrodisplasias/diagnóstico por imagem , Osteocondrodisplasias/mortalidade , Diagnóstico Pré-Natal , Radiografia , Displasia Tanatofórica/classificação , Displasia Tanatofórica/diagnóstico por imagem , Displasia Tanatofórica/mortalidadeRESUMO
The mineral metabolism of calcium, magnesium and phosphorus in 20 newborns and infants was studied. All children were born from term deliveries and none presented clinic, biochemistry signs or radiological evidences of bone mineral metabolism disturbances. In this way, metabolic blance technics were applied. Net absorption of calcium, magnesium and phosphorus were: 54,9 +/- 18,8; 8,7 +/- 4,8 and 64,6 +/- 14,2 mg/kg/day respectively. The retentions of the three elements were: 54,4 +/- 20,6; 7,4 +/- 4,5 and 43,2 +/- 13,6 mg/kg/day. A significative lineal correlation between plasmatic levels of 250Hd and 24,25 (OH)2D with calcium retention was found. The correlation of intestinal calcium apsorption was positive and significative only with 250HD levels. It wasn't found signification between the vitamin D metabolites with the magnesium and phosphorus balance. In other way, it was found a relation between the dietary intake of this two elements with absorption and retention of both of them.
Assuntos
Cálcio/metabolismo , Recém-Nascido/metabolismo , Magnésio/metabolismo , Fósforo/metabolismo , Humanos , Valores de ReferênciaRESUMO
Remittance by mail of blood samples and subsequent time of permanency in mail boxes are not supposed to be best thermic conditions for dried blood samples in paper used for neonatal screening. With the idea of checking if temperatures variations can altered or not the content of TSH and T4, some samples of known concentrations of TSH and T4 has been heated to different temperatures between less than -40 degrees C and 100 degrees C during weekly periods. At such temperatures between less than -40 degrees C and 25 degrees C significant hormones losses are not observed. Nevertheless under higher temperatures the percentages of losses increases. Specifically between 37 degrees C and 60 degrees C an hormonal loss of approximately 36% is observed. T4 had also suffered losses of concentration in relation with temperature. These variations make indispensable the change of the way of managing samples that could had suffered modifications with temperatures, and that have been sent by mail. Therefore, considering that about a 40% loss can exist, limit of 40 mu UI/ml should be modified about 25 mu UI/ml.
Assuntos
Erros de Diagnóstico , Hipotireoidismo/diagnóstico , Coleta de Amostras Sanguíneas , Hipotireoidismo Congênito , Humanos , Hipotireoidismo/sangue , Recém-Nascido , Programas de Rastreamento , Manejo de Espécimes , Temperatura , Fatores de TempoRESUMO
Aromatic amino acids tyrosine and phenylalanine have been measured on paper with dried blood samples, using high performance liquid chromatography (HPLC) in reverse phase. The aim of this procedure is to discriminate unclear cases of general screening for aminoacidopathies avoiding unnecessary retest. Plasma normal values of tyrosine and phenylalanine have been obtained in full term babies (0.82 +/- 0.39 mg/dl and 0.53 +/- 0.23 mg/dl) preschool boy (0.78 +/- 0.21 mg/dl and 0.63 +/- 0.20 mg/dl), school boys (0.89 +/- 0.16 and 0.76 +/- 0.22 mg/dl) and normal adults (1.48 +/- 0.19 and 1.41 +/- 0.12 mg/dl). In order to assess if fasting levels can be altered by breast feeding or formula feeding, a sample was obtained after various feeds and postprandially. Results show no differences before or after feeding. A group of malnourished infants showed greater plasma values of tyrosine and phenylalanine (p less than 0.002) conversely a group children suffering for diabetes showed no differences when comparing with matched age controls. In conclusion, measurement of tyrosine and phenylalanine on dried blood in filter paper is accurate enough, to avoid unnecessary recall in unclear cases of screening, and those levels do not alter significantly with normal milk intake.