Epidemiología de la faringitis estreptocócica. Período enero de 2018 - diciembre de 2021 / Epidemiology of streptococcal pharyngitis. January 2018 - December 21

La faringoamigdalitis es uno de los motivos más frecuentes de consulta en pediatría. Aproximadamente un 70-80% de las faringoamigdalitis son de etiología viral. El 20-30% restante son de origen bacteriano. El agente causal más frecuente es Streptococcus pyogenes (estreptococo ß-hemolítico del grupo A). El rol de Streptococcus dysgalactiae subsp. equisimilis, (estreptococos ß-hemolíticos grupos C y G) fue claramente establecido como agente etiológico en la faringitis bacteriana, tanto en niños como en adultos. Se realizó un análisis descriptivo y retrospectivo entre enero 2018 y diciembre de 2021. Se evaluó la prevalencia de faringitis estreptocócica, la edad, el período estacional, los agentes etiológicos y la resistencia a macrólidos durante los períodos pre-COVID-19 (2018-2019) y COVID-19 (2020-2021). Se analizaron 11 396 muestras de exudados de fauces de pacientes con sospecha de faringitis bacteriana; las mismas se procesaron mediante el uso de técnicas microbiológicas convencionales. En el período estudiado el porcentaje de positividad de los cultivos de exudados de fauces se mantuvo constante. Al comparar los períodos pre-COVID-19 (2018-2019) y COVID-19 (2020-2021) se observó una disminución en el número de aislados de S. pyogenes con un aumento de S. dysgalactiae subsp. equisimilis, mientras que la resistencia a macrólidos encontrada fue superior en S. pyogenes y para S. dysgalactiae subsp. equisimilis se mantuvo constante. Es importante realizar el cultivo para la identificación del agente etiológico y determinar la sensibilidad antibióticapara continuar con la vigilancia epidemiológica de la resistencia a los macrólidos, porque representan una opción en pacientes alérgicos a ß-lactámicos (AU)

Pharyngotonsillitis is one of the most frequent reasons for consultation in children. Approximately 70-80% of pharyngotonsillitis are of viral etiology. The remaining 20-30% are bacterial in origin. The most frequent causative agent is Streptococcus pyogenes (group A ß-hemolytic streptococcus). Streptococcus dysgalactiae subsp. equisimilis (ß-hemolytic streptococcus groups C and G) was clearly established as an etiologic agent in bacterial pharyngitis in both children and adults. A descriptive and retrospective analysis was conducted between January 2018 and December 2021. The prevalence of streptococcal pharyngitis, age, seasonal period, etiologic agents, and macrolide resistance during the pre-COVID-19 (2018-2019) and COVID-19 (2020-2021) periods were evaluated. We analyzed 11 396 specimens of swabs from patients with suspected bacterial pharyngitis. Conventional microbiological techniques were used. In the study period, the percentage of positivity of swab cultures remained constant. When comparing the preCOVID-19 (2018-2019) and COVID-19 (2020-2021) periods, a decrease in the number of S. pyogenes isolates was observed with an increase in S. dysgalactiae subsp. equisimilis, while the resistance to macrolides found was higher for S. pyogenes and remained constant for S. dysgalactiae subsp. equisimilis. The identification of the etiologic agent and determination of antibiotic sensitivity are important for epidemiological surveillance of macrolide resistance, as they are a treatment option in patients who are allergic to ß-lactams (AU)

Evaluación y seguimiento de los niños y adolescentes sobrevivientes de cancer pediátrico / Evaluation and follow up of children and adolescents who survived cancer

El pronóstico de los niños oncológicos ha mejorado en la últimas décadas, más de un 65 de los pacientes que padecieron alguna forma de cáncer pedíátrico llegara adulto. El objetivo del siguiente trabajo fue la descripción de los resultados de la evaluación y seguimiento a largo plazo de los sobrevivientes de una neoplasia en la infancia. Material y Métodos: Se realizó la evaluación y seguimiento de los sobrevivientes en el período comprendido entre junio de 2003 a mayo de 2006. Se seleccionaron para esta publicación los pacientes ingresados en los protocolos LLA 87, LLA 90 RMS 95. Resultados: el número de pacientes analizados fue de 175 distribuidos 39 mujeres y 61 varones; 17 pacientes RMS, el 65 tenía como localización del sitio primario cabeza y cuello parameningeos, el 80 recibió tratamiento combinado de quimioterapia y radioterapia, el 100 de los parameningeos recibió tratamiento con radioterapia presentaron una o más de las siguientes secuelas: estética, sinusitis crónica, compromiso visual y endocrinológico; 23 pacientes LLA 87, el 5 presento cardiotoxicidad que requirió medicaicón y en el 70 de los pacientes no se detecto nincuna secuela; 135 pacientes LLA 90 el 77 no presento ninguna secuela a largo plazo. Conclusión: El impacto del tratamietno en la calidad de ivda de estos pacintes está siendo evaluada permanentemente para detectar deterioros en las funciones cognitivas, físicas, emocionales y sociales que conllevan a una disminución de la misma. Para ello y esencialmente para ofrecer la mejor calidad de vida posible a los niños curados de cáncer se impone como herramienta un segumiento clínico con enfoque multidisciplinario y muy prolongado en el tiempo.

Reoperation after lumbar disc surgery: results in 130 cases.

Out of a series of 1850 cases operated upon for lumbar disc herniation 130 underwent re-operation because of persistent or recurrent symptoms. Re-operation was successful in 62%. The prognosis of re-operation was not related to special clinical symptoms and signs but only to the operative findings. Herniations at other levels and recurrences of lumbar disc herniations had the best results (excellent in 98% respectively 54%), but scar formations alone came out much less satisfactory (only 38% excellent results). Computed tomography (CT) findings were less reliable in distinguishing between disc prolapse and fibrosis than magnet resonance imaging (MR). Therefore MR is the diagnostic method of choice in these conditions, and scar formations alone should be considered a contra-indication for re-operation.

Malignant mesenchymoma of the brain. A case report.

A case of malignant mesenchymoma of the brain, containing rhabdomyosarcomatous, osteoid and cartilaginous components is presented. The patient received surgery and irradiation for his tumor, but died 10 months after the operation. Previous reports of malignant mesenchymoma of the brain are exceptional. The neurobiological behavior of this tumor is yet to be determined.

Clinical and radiographic response of fourth ventricle cysticercosis to praziquantel therapy.

A case of fourth ventricle cysticercosis treated with praziquantel is presented. The disappearance of the lesion six months after the treatment was demonstrated by CT scan. A review of the literature indicates that this is a very exceptional result, because with recently intraventricular cysticercosis was considered to be non-responsive to praziquantel treatment, making surgery necessary.

[Surgical treatment of unique cerebral metastasis: survival factors]. / Tratamiento quirúrgico de la metástasis cerebral única: factores de supervivencia.

Ninety patients operated for single cerebral metastasis in the Hospital General de Vigo between 1978 and 1986 were retrospectively studied. All of them also received radiotherapy after surgery. Several prognosis factors were studied with the aim of using them in future patients. The most significant factors were: histologic diagnosis Karnofsky's presurgery index, gap between diagnosis of the primary tumor and the time when the metastasis showed up, age and the TAC's morphology of the metastasis. These results are an important help when considering either surgery or a more conservative attitude.

Aspergillosis of the sphenoid sinus simulating a pituitary tumor.

Sphenoidal aspergillosis is an unusual cause of sella turcica enlargement. Pituitary abscess secondary to Aspergillus had been reported. In the present case, a woman with sphenoid sinus aspergillosis mimicked a pituitary tumor. This patient survived her infection with intact pituitary function following a transsphenoidal approach. No postoperative amphotericine-B and 5-fluorocytosine were necessary. CT scan revealed a mass occupying the sphenoid sinus extending to the sella turcica. Factors that should alert the clinican to the presence of a sphenoidal and pituitary abscess in a patient with sella turcica enlargement are prior episodes of sinusitis, meningitis and immunosuppression and, as in the present case, hyperglycemia.

[Cerebral cysticercosis. 10 cases]. / Cysticercose cérébrale. Dix cas.

Ten patients with cerebral cysticercosis seen between 1983 and 1986 were treated with praziquantel and in some cases by a ventriculoperitoneal shunt and/or surgical excision of cysts. Clinical and biological data were of no prognostic value. CT only was useful in orientating therapy and establishing the prognosis. A favorable course was obtained in 7 parenchymatous and meningeal forms, the fatal cases being of the mixed type. Praziquantel was inactive against intraventricular cysts.