RESUMO
El papiledema es la inflamación del nervio óptico causada por un aumento de la presión intracraneal. Existen otras patologías que pueden dar imágenes fundoscópicas con elevación de la cabeza del nervio óptico, semejantes al papiledema, que deben diferenciarse debido a la importancia de dicho signo clínico. Presentamos un caso de una paciente en que la imagen fundoscópica, con la presencia bilateral de drusas del nervio óptico, precisó realizar un diagnóstico diferencial con papiledema (AU)
Papilledema is inflammation of the optic nerve caused by increased intracranial pressure. There are other conditions that can give rise fundus images of the optic nerve head, similar to papilledema, which must be distinguished because of the importance of this clinical sign. We present a case of a patient in the fundus image, the presence of bilateral optic nerve drusen needs a differential diagnosis with papilledema (AU)
Assuntos
Humanos , Feminino , Adolescente , Papiledema/etiologia , Papiledema , Nervo Óptico/patologia , Nervo Óptico , Pressão Intracraniana/fisiologia , Drusas do Disco Óptico/patologia , Drusas do Disco Óptico , Diagnóstico Diferencial , Calcinose/complicações , Calcinose , Pressão Intracraniana/efeitos da radiação , Fundo de Olho , Oftalmoscopia , Tomografia Computadorizada de Emissão/instrumentação , Tomografia Computadorizada de Emissão/métodos , Tomografia Computadorizada de EmissãoRESUMO
Los errores innatos del metabolismo son un grupo de enfermedades genéticas con sintomatología muy inespecífica y por tanto difícil diagnóstico si no existe una sospecha clínica elevada. Sin embargo existen algunos datos de la exploración física y de las pruebas complementarias que pueden enfocar el proceso diagnóstico hacia la solicitud de pruebas específicas que lo confirmen. El caso que presentamos trata de destacar algunos de estos datos que pueden hacer sospechar la existencia de un defecto congénito de la glucosilación de proteínas, trastorno infrecuente pero con algunas formas tratables, por lo que su sospecha y diagnóstico precoz es de vital importancia (AU)
Inborn errors of metabolism are a group of genetic diseases with non specific symptoms and therefore difficult to diagnose without high clinical suspicion. However there are some physical examination data and laboratory tests that can focus the diagnostic process to the implementation of specific tests to confirm them. The case exposed highlights some of these data that can make us suspect the existence of a congenital defect of glycosylation of proteins, rare disorder but with some treatable variations, that make their suspicion and early diagnosis of great importance (AU)
Assuntos
Humanos , Masculino , Lactente , Doenças Metabólicas/diagnóstico , Erros Inatos do Metabolismo/complicações , Erros Inatos do Metabolismo/diagnóstico , Erros Inatos do Metabolismo/fisiopatologia , Diagnóstico Precoce , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância MagnéticaRESUMO
INTRODUCTION: Bladder catheterization (BC) is frequently performed to diagnose urinary tract infection (UTI) (the most common serious bacterial infection among young children). The purposes of this study were to evaluate performance and complications of BC to obtain a urine specimen. MATERIAL AND METHODS: This was a prospective study conducted in an urban children's hospital on patients who had a urine specimen obtained in the emergency department (ED) by BC between November 1, 2009 and December 15, 2009. Epidemiological data and the medical reasons why the BC was performed were reviewed. Finally, to determine the complications we contacted the family by telephone at least one month after the BC. RESULTS: A total of 126 BC were performed in 124 patients, 45 males (35.7%) and 81 female (64.3%). A urine sample was obtained in all cases. The median age was 7 months (5 days-35 months). Of the 126 urine cultures collected, 34 were positive (26.98%) and 1 was considered contaminated (0.8%). Escherichia coli was the most common pathogen (27, 79.41%). Fever (76.2%) was the main reason why BC was performed in children. Of the 116 patients contacted by telephone, only 5 mentioned complications: genital pain (3), unconfirmed hematuria (1) and UTI 12 days after (1). CONCLUSIONS: BC performed in ED to obtain a urine sample in non toilet-trained children is effective and safe. BC is an invasive method which needs to be quality controlled.
Assuntos
Urinálise/métodos , Cateterismo Urinário/efeitos adversos , Pré-Escolar , Emergências , Serviço Hospitalar de Emergência , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Infecções Urinárias/diagnóstico , Infecções Urinárias/urinaRESUMO
Los importantes movimientos poblacionales y los viajes a países exóticos tan frecuentes en los tiempos modernos hacen que cada vez más a menudo el médico sea consultado sobre vacunaciones o medidas preventivas que un viajero debería recibir antes de emprender su viaje. Actualmente la Organización Mundial de la Salud (OMS) sólo exige la vacunación de la Fiebre Amarilla cuando se viaje a zonas endémicas así como la vacuna antimeningocócica para entrar en Arabia Saudí, el resto de las vacunas disponibles serán recomendadas según el tipo de viaje y la situación del viajero (AU)
