Comparación de la ecografía y la radiografía de tórax para la localización de catéteres venosos centrales / Comparison of bedside ultrasound and chest x-ray for inserting central lines

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Alergia alimentaria en la infancia, ¿hacia dónde vamos? / No disponible

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Dificultad diagnóstica en la enfermedad de Kawasaki incompleta / Diagnostic difficulty in incomplete Kawasaki disease

El manejo de los pacientes con sospecha de enfermedad de Kawasaki incompleta es difícil. La ausencia de marcadores específicos de la enfermedad y la similitud con otros procesos infecciosos mucho más frecuentes pueden conducir a un retraso en el diagnóstico. Es importante mantener un alto índice de sospecha para poder iniciar el tratamiento con inmunoglobulina precozmente y prevenir la afectación coronaria. Las recomendaciones de la Academia Americana de Pediatría y la Asociación Americana del Corazón son una guía útil para mejorar el rendimiento diagnóstico en estos casos. En el siguiente caso clínico exponemos una EK incompleta y se discuten las bases para el diagnóstico (AU)

The management of patients with suspicion of incomplete Kawasaki disease is difficult. The absence of specific markers of the disease and its similarity to other much more frequent infectious processes may lead to a delay in its diagnosis. It is important to maintain a high index of suspicion to be able to initiate immunoglobin treatment early and to prevent coronary involvement. The recommendations of the American Academy of Pediatrics and the American Heart Association are a useful guide to improve the diagnostic yield in these cases. We present an incomplete Kawasaki disease in the following clinical case and discuss the bases for its diagnosis (AU)

Giant primary amyloidoma of the tonsil.

A case of giant amyloidoma in the left tonsil with extensive osseous metaplasia and a scanty and patchy monoclonal population of IgG Kappa plasma cells, is presented. Localized tumoral amyloidosis is a rare, benign tumour of the upper aerodigestive tract. Organ-limited amyloidosis has been shown to be confined to various systems but, since the lesion was first described, only four cases situated in the tonsils have been reported in the English literature, and none of these had either osseous metaplasia or a monoclonal population of IgG Kappa plasma cells.

[Appropriateness emergency hospital admissions at an ORL service of a third level hospital]. / Adecuación de los ingresos hospitalarios urgentes en un servicio de ORL de un hospital de tercer nivel.

We present a retrospective epidemiological study about an analysis of the emergencies hospital admissions in an ENT service of a tertiary hospital with high assistencial pressure, during one year. We study the parameters: date, sex, age, complementary examinations, diagnosis and appropriateness of the admission following the AEP (Appropriateness Evaluation Protocol) criteria. A remarkable finding is the high incidence (31.74%) of emergency admissions in the total admission in the ENT service. There was a low frequency of inadequate admission of patients. The appropriateness of admissions was highest for foreign bodies and respiratory distress; the lowest was for cancer patients. The most frequent appropriateness criteria was the need of drugs and/or intravenous fluids.