Point-of-care lung ultrasound in three neonates with COVID-19.

Since March 2020, the world is involved in the COVID-19 pandemic, a disease caused by a novel virus called SARS-CoV-2. Some authors have described the ultrasonographic findings of COVID-19 pneumonia in adults and children, but data on neonates are lacking. Our objective was to describe the ultrasonographic lung pattern on newborns with SARS-CoV-2 infection during the COVID-19 pandemic. Newborns who tested positive for SARS-CoV-2 PCR in respiratory samples and were evaluated with point-of-care lung ultrasound (LU) from March to April 2020 were included. LU was performed bedside by a single investigator at the time of diagnosis and every 48 h during the first week following diagnosis. Six areas were studied. Three neonates were included. Infants' comorbidities included meconium aspiration syndrome, bronchopulmonary dysplasia, and Hirschsprung's disease. One required mechanical ventilation. No deaths occurred. LU showed B-lines, consolidation, and spared areas. No pneumothorax or pleural effusion was observedConclusions: LU could be of value when managing COVID-19 neonates. We describe the findings of lung ultrasound monitoring during the first week following diagnosis in three neonates with SARS-CoV-2 infection. What is known: • Lung ultrasound (LU) is a useful tool in COVID-19 management in adults. To date, no report on LU and neonates with SARS-CoV-2 infection has been published. What is new: • This study adds evidence about LU findings in neonates with SARS-CoV-2 infection.

[Meconium periorchitis prenatal diagnosis: review of the literature, about 3 cases]. / Periorquitis meconial diagnóstico prenatal: revisión de la literatura, a propósito de 3 casos.

OBJECTIVE: To assess the importance of prenatal ultrasound diagnosis of the fetus carrying meconium periorchitis and its predictive relevance for fetal monitoring and prognosis in the context of acute fetal intestinal disease. MATERIAL AND METHODS: Three male fetuses have been diagnosed of meconium periorchitis in our Unit of Fetal Medicine in the last 5 years. Their prenatal ultrasound diagnoses were: testicular tumor (n=1); Meconium periorchitis with acute fetal intestinal perforation (n=2). Gestational age at diagnosis was 33, 34 and 35 weeks. Ultrasound signs at diagnosis were: Increased size of scrotal zone, with hyperechogenic lesions inside and permanence of peritoneum-vaginal canal; at abdominal zone, echographic signs of intestinal disease with or without meconium peritonitis were found (hyperechogenic lesions, edema of intestinal loops and ascites). All three neonates were assessed postnatally by ultrasound and therapeutic indication. RESULTS: Fetal ultrasound findings influenced both evolution and termination of pregnancy. The diagnosis of meconium periorchitis was confirmed postnatally in all cases: in the 1st case, delivered at term, scrotal tumoral pathology was ruled out and did not require abdominal surgery; the other 2 patients were delivered at the same week of prenatal diagnosis and an inguinal-scrotal surgery with intestinal approach because of meconium peritonitis was performed. No patient underwent orchiectomy, maintaining the teste-epididymal binomial intact. CONCLUSION: Prenatal ultrasound diagnosis of meconium periorchitis requires a strict ultrasound follow-up of the fetus as it is a specific marker of intestinal perforation, which can lead to the termination of pregnancy and avoid appearance of complicated meconium peritonitis.

OBJETIVO: Evaluar la importancia del diagnóstico ecográfico prenatal del feto portador de periorquitis meconial y su relevancia predictiva del seguimiento y pronóstico fetal en el contexto de una enfermedad intestinal fetal aguda. MATERIAL Y METODOS: En los últimos 5 años en la Unidad de Medicina Fetal se han diagnosticado tres fetos varones de periorquitis meconial cuyos diagnósticos ecográficos prenatales fueron: tumor testicular (n=1); y periorquitis meconial con perforación intestinal aguda fetal (n=2). La edad gestacional al diagnóstico fue de 33, 34 y 35 semanas. Los signos ecográficos al diagnóstico fueron: a nivel escrotal, aumento del tamaño, lesiones hiperecogénicas y permanencia del conducto peritoneo-vaginal; a nivel abdominal pueden existir signos ecográficos de enfermedad intestinal con o sin peritonitis meconial (lesiones hiperecogénicas, edemas de asas y ascitis). Los tres neonatos fueron evaluados postnatalmente mediante ecografía comparativa de los hallazgos prenatales e indicación terapéutica. RESULTADOS: Los hallazgos ecográficos fetales influyeron en la evolución y finalización de la gestación. El diagnóstico de periorquitis meconial fue confirmado postnatalmente en los tres casos: en el 1er caso a término, se descartó patología tumoral escrotal y no requirió cirugía abdominal; en los otros dos pacientes se indicó finalizar la gestación tras el diagnóstico prenatal y se realizó cirugía inguino-escrotal y abordaje intestinal por la peritonitis meconial. CONCLUSION: El diagnóstico ecográfico prenatal de periorquitis meconial obliga a un seguimiento ecográfico estricto del feto al ser un marcador específico de perforación intestinal, que puede conllevar la finalización de la gestación y evitar la aparición de una peritonitis meconial complicada.

Periorquitis meconial diagnóstico prenatal: revisión de la literatura, a propósito de 3 casos / Meconium periorchitis prenatal diagnosis: review of the literature, about 3 cases

Objetivo: Evaluar la importancia del diagnóstico ecográfico prenatal del feto portador de periorquitis meconial y su relevancia predictiva del seguimiento y pronóstico fetal en el contexto de una enfermedad intestinal fetal aguda. Material y métodos: En los últimos 5 años en la Unidad de Medicina Fetal se han diagnosticado tres fetos varones de periorquitis meconial cuyos diagnósticos ecográficos prenatales fueron: tumor testicular (n=1); y periorquitis meconial con perforación intestinal aguda fetal (n=2). La edad gestacional al diagnóstico fue de 33, 34 y 35 semanas. Los signos ecográficos al diagnóstico fueron: a nivel escrotal, aumento del tamaño, lesiones hiperecogénicas y permanencia del conducto peritoneo-vaginal; a nivel abdominal pueden existir signos ecográficos de enfermedad intestinal con o sin peritonitis meconial (lesiones hiperecogénicas, edemas de asas y ascitis). Los tres neonatos fueron evaluados postnatalmente mediante ecografía comparativa de los hallazgos prenatales e indicación terapéutica. Resultados: Los hallazgos ecográficos fetales influyeron en la evolución y finalización de la gestación. El diagnóstico de periorquitis meconial fue confirmado postnatalmente en los tres casos: en el 1er caso a término, se descartó patología tumoral escrotal y no requirió cirugía abdominal; en los otros dos pacientes se indicó finalizar la gestación tras el diagnóstico prenatal y se realizó cirugía inguino-escrotal y abordaje intestinal por la peritonitis meconial. Conclusión: El diagnóstico ecográfico prenatal de periorquitis meconial obliga a un seguimiento ecográfico estricto del feto al ser un marcador específico de perforación intestinal, que puede conllevar la finalización de la gestación y evitar la aparición de una peritonitis meconial complicada

Objective: To assess the importance of prenatal ultrasound diagnosis of the fetus carrying meconium periorchitis and its predictive relevance for fetal monitoring and prognosis in the context of acute fetal intestinal disease. Material and methods: Three male fetuses have been diagnosed of meconium periorchitis in our Unit of Fetal Medicine in the last 5 years. Their prenatal ultrasound diagnoses were: testicular tumor (n=1); Meconium periorchitis with acute fetal intestinal perforation (n=2). Gestational age at diagnosis was 33, 34 and 35 weeks. Ultrasound signs at diagnosis were: Increased size of scrotal zone, with hyperechogenic lesions inside and permanence of peritoneum-vaginal canal; at abdominal zone, echographic signs of intestinal disease with or without meconium peritonitis were found (hyperechogenic lesions, edema of intestinal loops and ascites). All three neonates were assessed postnatally by ultrasound and therapeutic indication. Results: Fetal ultrasound findings influenced both evolution and termination of pregnancy. The diagnosis of meconium periorchitis was confirmed postnatally in all cases: in the 1st case, delivered at term, scrotal tumoral pathology was ruled out and did not require abdominal surgery; the other 2 patients were delivered at the same week of prenatal diagnosis and an inguinal-scrotal surgery with intestinal approach because of meconium peritonitis was performed. No patient underwent orchiectomy, maintaining the teste-epididymal binomial intact. Conclusion: Prenatal ultrasound diagnosis of meconium periorchitis requires a strict ultrasound follow-up of the fetus as it is a specific marker of intestinal perforation, which can lead to the termination of pregnancy and avoid appearance of complicated meconium peritonitis

Melanosis óculi / Ocular melanosis

No disponible

[Pharyngitis due to Burkholderia cepacia. Person-to-person transmission]. / Faringitis por Burkholderia cepacia. Transmisión de persona a persona.

Burkholderia cepacia is a Gram-negative bacillus that is widely distributed in nature; it is isolated from the ground, water, plants and vegetables. Generally, it produces nosocomial infection due to contamination of disinfectants, medical equipment, prosthetic material and drugs, such as anesthetics or liquids used in urological irrigation. The most probable mechanism of transmission is through hospital material or through fomites among people after contact for several weeks or months. Recently, it has been considered as an important pathogen in immunocompromised patients, or in those with significant underlying diseases, such as chronic granulomastosis or cystic fibrosis. We present a case of pharyngitis due to B. cepacia and its transmission within a few days in two immunocompetent twin siblings without previous underlying diseases. The infection disappeared after specific treatment for this microorganism was started. We believe that samples should be taken from the pharynx and nasal pits in patients with acute upper respiratory tract processes that do not respond to empiric antibiotic treatment, before classifying them as viral infection without etiologic diagnosis.

Faringitis por Burkholderia cepacia. Transmisión de persona a persona / Pharyngitis due to Burkholderia cepacia. Person-to-person transmission

Burkholderia cepacia es un bacilo gramnegativo que se encuentra ampliamente distribuido en la naturaleza, y se aísla del suelo, el agua y las plantas y verduras. Generalmente produce infección nosocomial por contaminación de desinfectantes, equipos médicos, material protésico y fármacos, como anestésicos o líquidos de irrigación urológicos. El mecanismo de transmisión más probable es a través del material hospitalarios o de fomites entre personas tras un contacto de varias semanas o meses. Recientemente, se ha considerado como un patógeno importante en pacientes inmunodeprimidos o con enfermedades de base importantes, como la granulomatosis crónica y la fibrosis quística. Se presenta el caso de una faringitis por B. cepacia y su transmisión en pocos días en dos hermanos gemelos, inmunocompetentes y sin enfermedades de base previas y, la desaparición de la enfermedad tras la instauración de un tratamiento específico para este microorganismo. Consideramos que se deben tomar muestras de faringe y fosas nasales ante un proceso agudo del tracto respiratorio superior que no responde al tratamiento antibiótico empírico, antes de clasificarlo como viriasis sin diagnóstico etiológico (AU)

[Cerebral dominance. A study on left-handedness in a Mexican population group]. / La dominancia cerebral. Un estudio de zurdera en un grupo de población mexicana.

The term "cerebral dominance" suggests that one hemisphere is leader and the other subordinate; however, cerebral dominance concerning all psychic functions is less frequent than we could suppose. Among the functions in which cerebral dominance is manifested the most notorious is the manual preference. Thus according to the hand being used for general motor activities the persons are named right-handers or left-handers; nevertheless people are less lateralized than we could suppose, and most right-handers may have hidden left-handedness. In order to obtain some data on this subject in Mexican population, a study was done in 300 university students. Of the 275 right-handers only 144 fulfilled the requirements to qualify as such after performing the complementary tests; 25 left-handers came to a mere amount of 5. The data indicate that partial lateralization is more frequent than total lateralization.

Clinical, electrophysiologic and neuroimaging findings in Wernicke's syndrome.

Wernicke's encephalopathy is a disease that when not diagnosed in time, can lead to severe CNS damage and death. It is characterized by specific clinical and radiologic findings; however, there are few reports dealing with the usefulness of neurophysiologic studies in this syndrome. We present a patient with Wernicke's encephalopathy, diagnosed postmortem on autopsy, in whom the neurophysiologic studies showed abnormalities in all the different pathways tested. This suggests that EEG and evoked potentials may be useful tools in the diagnostic workup of this entity. We propose performing these tests when this syndrome is being considered.

[Schwannomas. Clinical and pathological study of 85 cases]. / Schwannomas. Estudio clínico patológico de 85 casos.

A survey of the files of the Department of Neuropathology at the Mexican Neurological Institute, disclosed a total of 100 biopsies from 85 patients, 47 of whom females, with the histological diagnosis of Schwannoma. The survey comprised a period between July 1985 and June 1990. Schwannomas accounted for 4.08 per cent of 2,447 biopsies during that period. The age range was from 15 to 69 years with and average of 37.6 years. In 64 cases the tumors were localized intracranially, and in 18 within the spinal canal. The eighth never was the origin in 57 cases, the fifth in two, and the seventh in one; in four other cases the origin could not be ascertained. The intraspinal tumors were cervical in seven cases thoracic in nine, and lumbosacral in two. The most common clinical findings in 52 cases were decreased audition, increased intracranial pressure in 20, cerebellar involvement in 17, trigeminal in 16, facial paresis in 16, oculomotor disorder in six and motor neurone impairment in five.

The acute encephalitic phase of neurocysticercosis: computed tomographic manifestations.

Brain infestation by Cysticercus cellulosae, the larval form of Taenia solium, is a common disorder in Mexico and other Latin American countries, Asia, Africa, and some Eastern European countries. Recent immigration has caused an increase in the number of cases of neurocysticercosis in the United States. This work describes the acute encephalitic form of neurocysticercosis in 26 cases. The clinicopathologic and neuroradiologic manifestations are discussed with particular emphasis on the use of computed tomography as a main diagnosis modality which demonstrates multiple diffuse (85%) or localized (15%) enhancing nodules associated with severe edema.