Delayed Presentation and Prolonged Survival of a Child with Surfactant Protein B Deficiency.

Surfactant protein B encoding gene mutations have been related to early onset fatal respiratory distress in full-term neonates. We report a school-aged male child homozygous for a surfactant protein B encoding gene missense mutation who presented after the neonatal period. His respiratory insufficiency responded to high dose intravenous methylprednisolone and hydroxychloroquine.

Bronquitis obliterante secundaria a neumonía por virus Influenzae B y sobreinfección por Staphylococcus aureus / Bronchitis obliterans due to Influenza B pneumonia complicated with Staphylococcus aureus infection

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Respuesta rápida de hemangiomas subglóticos a propranolol / Fast response of subglottic haemangiomas to propranolol

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Paediatric environmental health speciality units in Europe: integrating a missing element into medical care.

Paediatricians are in an excellent position to identify children with environmental risk, to advise their parents about the best way of reducing or preventing such risks, and to recommend actions to the responsible politicians involved. Paediatric environmental health speciality units (PEHSU) can help to qualify and support paediatricians in this task. PEHSU is defined as a unit within a paediatric hospital or clinic that is able to recognize, assess, and prevent environment-related health risks, to help other paediatric specialists in the management of such diseases in children, as well as to provide education, training, and research, putting emphasis on thorough and adequate establishment of paediatric environmental histories (PEHis) and to the application of the precautionary principle. Although activities and services provided by each PEHSU would differ depending on the centre or community where it is located, all should include training, research, medical care and community and school health.

Prevalence and determinants of obesity and dietary habits among adults in rural area, Chile.

This study was undertaken to examine the prevalence of obesity and its determinants among adults in a rural area of Chile. A community-based cross-sectional study was conducted in April-June 2004 in San Carlos (8th region). Height, weight, and waist and hip circumferences were measured for 603 adults (female 447, male 156) aged 20-64 years, and data on socio-economic factors, dietary intake, and dietary habits were obtained by questionnaire interviews. The prevalence of obese individuals was 45.2% among females and 30.1% among males, whereas that of overweight individuals was higher among males than females. Obesity was associated with socio-economic factors for females but not for males. With regard to diet, different patterns between females and males were observed in terms of frequency of food intake, as well as in dietary habits. Our findings of a high prevalence of obese/overweight individuals, together with the characteristics of their diets including changes in the cooking process, suggest that nutrition transition is underway in rural regions as well. Appropriate interventions, therefore, should be introduced to control obesity among women and to enhance health awareness among men throughout the country.

Enfermedad celíaca y miocardiopatía dilatada / Celiac disease and dilated cardiomyopathy

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Salut mediambiental escolar: propostes d’actuació Prevenir el tabaquisme: una assignatura pendent / No disponible

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Tratamiento domiciliario de los pacientes con displasia broncopulmonar / No disponible

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[Pulmonary hemorrhage after abciximab. Risk factors and the role of protamine]. / Hemorragia pulmonar por abciximab. Factores de riesgo y papel de la protamina.

Large clinical trials have demonstrated the clinical effectiveness of therapy with inhibitors of the platelet surface-membrane glycoprotein IIb-IIIa receptor in a broad range of patients with ischemic heart disease. Abciximab, a platelet glycoprotein IIb-IIIa receptor blocker, is associated with improved long-term prognosis in patients who require angioplasty and stent placement. Severe bleeding from abciximab use is an uncommon event. We describe a patient with severe pulmonary hemorrhage after treatment with abciximab, and discuss predisposing factors and protamine infusion in this potentially fatal complication.

Hemorragia pulmonar por abciximab. Factores de riesgo y papel de la protamina / Pulmonary hemorrhage after abciximab. Risk factors and the role of protamine

Diversos ensayos clínicos han demostrado la eficacia de los inhibidores de la glucoproteína plaquetaria IIb/IIIa en un amplio espectro de pacientes con cardiopatía isquémica. El abciximab, un bloqueador de este receptor, mejora el pronóstico a largo plazo de los pacientes que requieren angioplastia e implante de stent. Los eventos hemorrágicos graves derivados del uso del abciximab son infrecuentes. Comunicamos el caso de una hemorragia pulmonar severa tras el tratamiento con abciximab. Discutimos los factores predisponentes y la administración de protamina en esta complicación potencialmente mortal

Diversos ensayos clínicos han demostrado la eficacia de los inhibidores de la glucoproteína plaquetaria IIb/IIIa en un amplio espectro de pacientes con cardiopatía isquémica. El abciximab, un bloqueador de este receptor, mejora el pronóstico a largo plazo de los pacientes que requieren angioplastia e implante de stent. Los eventos hemorrágicos graves derivados del uso del abciximab son infrecuentes. Comunicamos el caso de una hemorragia pulmonar severa tras el tratamiento con abciximab. Discutimos los factores predisponentes y la administración de protamina en esta complicación potencialmente mortal

Late enterocutaneous fistula as a complication after umbilical hernioplasty.

Umbilical hernia is a high-prevalence problem in adults. Traditional herniorrhaphy is marked by high recurrence rates, but nowadays, the use of prosthetic materials has improved results and has even brought about lower morbidity rates, making the enterocutaneous fistula an exceptional complication of umbilical hernioplasty. We report on a case of a 54-year-old male who developed a high-debt enterocutaneous fistula 1 year after undergoing an operation for an umbilical hernia by means of a plug-technique hernioplasty. We discuss the case, treatment, and preventable aspects of this complication.

Inflammatory pulmonary nodules in Kawasaki disease.

Symptomatic pulmonary manifestations of Kawasaki disease (KD) are uncommon. However, epidemiologic, radiologic, and histologic studies have indicated that respiratory symptoms and findings occur in KD and suggest that the KD agent may have a respiratory portal of entry. We report on three young infants with KD who developed pulmonary nodules, in addition to coronary artery aneurysms. Two patients had pathologic specimens available, one from biopsy and the other from autopsy. The nodules had predominantly mononuclear cell infiltrates, which were within the lung parenchyma and infiltrating vessel walls. Immunohistochemical studies of the nodules, using antibodies to common leukocyte antigen (LCA) and factor VIII-related antigen, confirmed the inflammatory nature of the lesions and showed capillary proliferation. IgA plasma-cell infiltration was observed in the nodule, consistent with previous KD findings of IgA plasma-cell infiltration in the vessel walls, kidneys, pancreas, and upper respiratory tract. The two patients with nonfatal KD were treated with intravenous immunoglobulin and aspirin, with resolution of the nodules. We propose that when pulmonary involvement occurs in KD, it ranges from subclinical interstitial micronodular infiltrates to larger inflammatory pulmonary nodules. These pulmonary infiltrates and nodules likely reflect the host response to the etiologic agent of KD, and may resolve with the disease process. Recognition of this pulmonary complication of KD may enable cautious observation of such lesions for spontaneous resolution.

Antibióticos nebulizados en pacientes con fibrosis quística / Nebulized antibiotics in patients with cystic fibrosis

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