Renovascular disease in childhood.

Fifty-four children referred for investigation of hypertension had renovascular disease. In eight patients it was associated with neurofibromatosis, in three with idiopathic hypercalcemia of infancy, and in five cases it followed an arteritic illness. Fibromuscular dysplasia was the underlying abnormality in the majority of cases (46%). Twenty-six patients (48%) were first seen with accelerated hypertension; 38 children (70%) had bilateral renal arterial disease, and in 41 (76%), disease of the small intrarenal vessels was found. Renal vein renin ratios indicated unilateral disease in 31 cases; the results correlated with arteriography findings in 32 (62%) of 51 patients. Eleven children also had the middle aortic syndrome, and 9 of 16 patients, investigated by cerebral arteriography because of cranial bruits or focal neurologic signs, had cerebral vascular abnormalities. Twenty patients were treated surgically--10 by reconstructive procedures, 11 by nephrectomy or heminephrectomy, and 6 by transluminal angioplasty. Of these, 9 (45%) are normotensive with no treatment, 10 have a decreased requirement for antihypertensive drugs, and 1 had no improvement. Thirty-four patients were treated medically because of the extent of their disease; two patients have died of hypertensive complications. We conclude that renal vascular disease in children is often widespread, may be associated with intracerebral vascular disease, frequently affects both kidneys, including both intrarenal and extrarenal vessels, and is therefore not always amenable to surgical intervention and cure.

Alimentos que pueden consumir los ninos.Tiempo optimo de hervido de la leche que se utiliza en los laticinios para lactantes, en nuestro medio. / Food that can be consumed by children.Best time to boil the milk used in milk products for babies in our milieu

El Departamento de Educacion Sanitaria del Ministerio de Salud Publica aconseja hervir la leche con destino al lactante sin determinar tiempo. Morquio ensenaba: "hervir cinco minutos, enfriar los biberones y mantenerlos frios". Proveyendose de leche pasteurizada a 200.000 ninos en la capital y aledanos se procuro conocer la realidad y el mejor consejo posible, concluyendose: es necesario que la distribucion de la leche cumpla las disposiciones que establece el Decreto del 24 de enero de 1954, de la Intendencia Municipal de Montevideo, por las que la temperatura de la leche al llegar al consumidor debe ser no mayor de 10oC. sobre cero. Los cinco minutos aconsejados por Morquio pueden no ser de estricto cumplimiento si la higiene de los utensilios y el hervido del agua de la mezcla, son correctos. La conservacion en frio,durante 24 horas a no mas de 10oC. asegura la potabilidad de la mezcla. Si no se usa heladera los cinco minutos de hervido son de rigor. La educacion sanitaria debe llegar al hogar por multiples medios; al efecto los murales confeccionados por Salud Publica deben contener en uno, todas las secuencias, desde el rechazo de la leche que no llegue fria al consumidor,hasta el final -conservacion en frio- con lo cual la vista del conjunto sera aleccionante