Rotavirus y su papel en la génesis de convulsiones / Rotavirus and its role in the genesis of afebrile seizures

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[Nonvaccine Streptococcus pneumoniae serotypes causing acute bacterial meningitis]. / Streptococcus pneumoniae serotipo no vacunal como agente causal de meningitis bacteriana aguda.

The pneumococcal heptavalent conjugate vaccine protects children aged less than 2 years old from invasive pneumococcal disease (IPD). Efficacy is 89-93% in the US population and 71-86% in European studies. The vaccine confers active immunization against the main serotypes causing IPD (4, 6B, 9V, 14, 18C, 19F y 23F). We describe 2 children who presented with pneumococcal meningitis caused by nonvaccine serotypes. As a result of the widespread use of the heptavalent vaccine, there may be a shift in the serotypes causing IPD.

Streptococcus pneumoniae serotipo no vacunal como agente causal de meningitis bacteriana aguda / Nonvaccine Streptococcus pneumoniae serotypes causing acute bacterial meningitis

La vacuna conjugada heptavalente protege a niños de menos de 2 años de la enfermedad neumocócica invasiva (ENI) en el 89-93 % en población estadounidense y en el 71-86 % en población europea. Confiere una inmunización activa frente a los serotipos mayoritariamente causantes de ENI (4, 6B, 9V, 14, 18C, 19F y 23F). Presentamos 2 casos de meningitis neumocócica por serotipos no vacunales. Es posible que haya un desplazamiento de serotipos causantes de ENI, como consecuencia de la generalización de la vacuna heptavalente

The pneumococcal heptavalent conjugate vaccine protects children aged less than 2 years old from invasive pneumococcal disease (IPD). Efficacy is 89-93 % in the US population and 71-86 % in European studies. The vaccine confers active immunization against the main serotypes causing IPD (4, 6B, 9V, 14, 18C, 19F y 23F). We describe 2 children who presented with pneumococcal meningitis caused by nonvaccine serotypes. As a result of the widespread use of the heptavalent vaccine, there may be a shift in the serotypes causing IPD

[Epidural spread of neuroblastoma]. / Extensión epidural en el neuroblastoma.

Epidural spread of neuroblastoma is a point of major concern, on account of implications it entails and differences in criteria regarding its therapeutic management. In this study records of all patients with neuroblastoma who had been followed up from 1966 to 1980, from whom only a thorough neurological examination and plain X-rays of spine had been obtained, were reviewed. Eleven cases of epidural invasion were identified out of 69 neuroblastomas at risk (16%). Between 1980 and 1982, 6 out of 11 patients with neuroblastoma considered likely to spread underwent myelography. This technique disclosed spinal involvement in 5. From 1982 to 1986, 23 new cases of neuroblastoma (14 at risk) have been studied by CT-scan or myelography, with the yield of 2 cases with epidural invasion (14%). Authors, based on the study of this series, set forth their current views with respect to diagnosis and treatment of such patients.

[Non-Hodgkins lymphoma in childhood, preliminary results of the LSA2 L2 protocol modified by high-dose methotrexate]. / Linfoma no Hodgkin en la infancia, resultados preliminares del protocolo LSA2 L2 modificado con metotrexate a altas dosis.

From january 1982 to january 1986 we treated 23 pediatric patients who had non Hodgkin's lymphoma, with a new therapeutic protocol. This protocol is based on the LSA2 L2, modified during the induction phase with high-dose methotrexate and increasing of intrathecal therapy. Nineteen patients (83%) were in stages III and IV and the 47.4% were in stage IV. The distribution according to histology was: 10 Burkitt's undifferentiated lymphomas; 2 non-Burkitt's undifferentiated lymphomas; 5 lymphoblastic lymphomas convoluted-cells; 5 lymphoblastic lymphoma non-convoluted cells and 1 indeterminate lymphoma. The follow-up oscillated between 6 months and 4 years. The total survival rate is 82.6% with a 100% survival in stages I, II and III and 63.5% in stage IV. The survival according histology is 91.7% for undifferentiated lymphomas and 70% for lymphoblastic lymphomas; the actuarial survival rates in the two groups at 30 months are 87% and 55% respectively (p greater than 0.10). We concluded that adding high-dose methotrexate to the LSA2 L2 protocol improve the survival rate in undifferentiated lymphomas and in a less extent in lymphoblastic lymphomas, without significant toxicity. This new protocol is mainly indicated in undifferentiated and indeterminate non-Hodgkin's lymphomas.

[Partially differentiated cystic nephroblastoma]. / Nefroblastoma quístico parcialmente diferenciado.

Two new cases of cystic partially differentiated nephroblastoma, which were treated by nephrectomy, are reported. Their gross appearance is undistinguishable from a multilocular cyst, with the only difference being the presence of buds of blastema within the cystic septa. While cystic partially differentiated nephroblastoma as well as multilocular cyst have never been reported to be associated with local or metastatic recurrence and therefore their treatment consists of simple nephrectomy, the presence of blastema suggests a differentiates stage of Wilms' tumor, thus demanding a close surveillance of the patient.

[Metastatic neuroblastomas: factors influencing survival]. / Neuroblastomas metastáticos: factores que influyen en la supervivencia.

Sixty-two patients with metastatic neuroblastoma admitted to the Hospital Infantil "Valle de Hebrón" de Barcelona during the period of October 1966-March 1985 are reviewed. The survival rate was 16% with an overall cure rate of 9.6%. The age, sex, site of primary tumor, site of metastases, and urinary catecholamine excretion were not independent prognostic factors. Patients with initial stage I, II or III and late evolution to stage IV had a worse prognostic (survival rate 13%, p less than or equal to 0.05). We compare five treatment protocols. We obtain a better response by a multichemotherapy made of cyclophosphamide, vincristine, adriamycin, DTIC combined in a sequential order with cis-platin and VM-26. The median survival for this group was 19.9 months and the survival rate 57.1% (p less than 0.001).

[Calcification of hepatic metastasis in neuroblastoma IV-S]. / Calcificación de metástasis hepáticas en el neuroblastoma IV-S.

We describe a patient diagnosed of neuroblastoma IV-S who presented a hepatic calcification during the treatment. The different possibilities of hepatic calcification in the first year of life are commented.

[Ovarian tumors in childhood]. / Tumores ováricos en la infancia.

Authors report their experience with 33 pediatric patients with ovarian tumors seen in the last 17 years. Total mortality was 12%. The condition was beginning in 76% of cases, most of them cystic tumors, with a 100% survival rate. Only 4 patients, with malignant tumors of different histologic nature, died. Clinical features, diagnostic procedures, therapeutic approaches and outcome are analyzed. The fact that the older the patient higher the probability of harboring a malignant tumor is stressed.

[Neuroblastoma IV-S. A series of 7 cases]. / Neuroblastomas IV-S. Serie de siete casos.

A review of the findings in seven cases of stage IV-S neuroblastoma, that have been observed between 1966 and 1984. Patients under one year stage IV-S neuroblastoma have a favorable prognosis; survival rate was 71%. Primary tumor in some may be relatively small. Chemotherapy and radiation therapy may not be necessary in the management of certain children.