[Long term consequences among children exposed to lead poisoning]. / Efectos clínicos a largo plazo en niños intoxicados con plomo en una región del sur de Chile.

BACKGROUND: In 1996 there was a massive lead poisoning in a southern rural community in Chile. The contamination source was a mill whose grinding stone was repaired with lead and contaminated the flour. AIM: To assess the presence of sequelae ten years later, among subjects that were exposed to lead on that occasion. MATERIAL AND METHODS: Cross sectional study of 77 individuals (47 males), aged 10 to 25 years, that were exposed to lead in 1996 and were treated with EDTA. RESULTS: Twenty one percent of subjects had a subnormal intelligence quotient (IQ). The risk of having a low IQ was significantly higher among those exposed before the age of six years. IQ was significantly lower among subjects that, immediately after the exposure, had a lead level over 48 microg/dl, compared with those that had a lead level below 43 microg/dl (86.7+/-7.3 and 93+/-11.6 respectively). No subjects with high blood pressure or evidences of nephrotoxicity were detected. CONCLUSIONS: Subjects aged less than six years at the moment of lead exposure had a lower IQ when assessed ten years later.

Efectos clínicos a largo plazo en niños intoxicados con plomo en una región del sur de Chile / Long term consequences among children exposed to lead poisoning

Background: In 1996 there was a massive lead poisoning in a southern rural community in Chile. The contamination source was a mill whose grinding stone was repaired with lead and contaminated the flour. Aim: To assess the presence of sequelae ten years later, among subjects that were exposed to lead on that occasion. Material and methods: Cross sectional study of 77 individuals (47 males), aged 10 to 25 years, that were exposed to lead in 1996 and were treated with EDTA. Results: Twenty one percent of subjects had a subnormal intellingence quotient (IQ). The risk of having a low IQ was significantly higher among those exposed before the age of six years. IQ was significantly lower among subjects that, immediately after the exposure, had a lead level over 48 fig/dl, compared with those that had a lead level below 43 fig/dl (86.7±7.3 and 93±11.6 respectively). No subjects with high blood pressure or evidences of nephrotoxicity were detected. Conclusions: Subjects aged ¡ess than six years at the moment of lead exposure had a lower IQ when assessed ten years later.

Tuberculosis osteoarticular: caso clínico y revisión de la literatura / Osteoarticular tuberculosis: case report and literature review

La tuberculosis es menos frecuente que hace unas decada, pero es importante para el pediatra considerarla entre los diagnósticos diferentes de la artritis séptica de cadera, como lo demuestra el caso clínico que se publica a continuación.

Fiebre tifoidea en niños / Fever typhoid in children

Se analizan 503 casos de fiebre tifoidea en niños mayores de 2 años de edad, hospitalizados en la Unidad de Infecciosos del Hospital Luis Calvo Mackenna entre 1978 y 1990. En su mayor parte (86,4%) eran escolares entre 5 y 15 años, con leve predominio del sexo masculino (51%). Los síntomas más frecuentes fueron la fiebre (100%), anorexia (75%), cefalea (72%) diarrea (65%), dolor abdominal (62%) y vómitos (54%). Entre los signos, los más constantes fueron la lengua saburral (87%), la hepatomegalia (65%), la esplenomegalia (53%) y la distensión abdominal (49%). Todos los casos fueron certificados por hemocultivo y/o mielocultivo. El hemograma mostró como caracteres más orientadores la aneosinofilia, un porcentaje de baciliformes cercano al 30%y una VHS inferior a 50 mm/h. El tratamiento con cloramfenicol o cotrimoxazol fue efectivo en todos los niños, con caída de la fiebre al quinto día y reducción de la hepatoesplenomegalia entre el sexto y séptimo día. Hubo un 7,75%de complicaciones, predominando la hepatitis tífica y hemorragia digestiva, con letalidad cero y un 8,49%de recaídas

Hematuria esencial de origen glomerular / Essential hematuria of glomerular origin

Se describen 32 niños con hematuria recurrente idiopática, de quienes se tomaron biopsias renales que fueron estudiadas morfológicamente mediante microscopio óptico, electrónico e imunoflorescencia en un hospital de Santiago entre los años 1972 a 1982. En 21,5% de los casos se encontró enfermedad de Berger, en 66% alteraciones mínimas glomerulares y en 12,5% membrana basal delgada glomerular. Se propone una clasificación en sub-grupos para las alteraciones mínimas glomerulares. Se concluye que esta es en general una afección benigna en la infancia, que habitualmente no requiere de biopsia renal, con excepción de la enfermedad de Berger y la membrana basal delgada en los que se ha descrito excepcionalmente progresión a insuficiencia renal