Eficacia del tratamiento con oligoelementos de la enfermedad de meniere / Efficacy of the treatment with olygoelements of the ménière' s diseases

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[Hospital admissions for varicella complications in children aged less than 15 years old]. / Hospitalizaciones por complicaciones de la varicela en niños menores de 15 años.

BACKGROUND: The complications of varicella are one of the arguments in favor of universal vaccination programs in children. OBJECTIVE: To describe the complications of varicella requiring hospital admission in a well-defined population (Gipuzkoa, Spain) and to compare the incidence of hospitalization with that reported in other series. MATERIAL AND METHODS: Observational, retrospective, multicenter study of admissions for varicella. The medical histories codified as varicella (minimum data set, CIE-0, codes 952.0-052.9) from 1 January 1993 to 31 December 2002 were reviewed. Calculation of hospitalization rates was based on emergency department visits and population data. The pediatric population of Gipuzkoa seeking medical attention at one of the four Basque Country Health Service hospitals in the area: Hondarribia, Mendaro, San Sebastian and Zumarraga. The mean coverage in Gipuzkoa is 54,999 children aged less than 15 years/year. All the children aged 0-15 years old admitted for more than 24 h with a discharge diagnosis of varicella complications. The variables studied are: age, gender, personal history, varicella immunization, immune status, fever, chest X-ray, complementary investigations, length of hospital stay, treatment, discharge diagnosis, clinical course, complications and sequelae at discharge. RESULTS: Seventy-one children were hospitalized. None had been vaccinated against the varicella-zoster virus. Eighty percent were aged less than 5 years and three were immunocompromised. Fifty-six percent had bacterial superinfection and invasive forms were found in seven patients. The mean length of admission was 6.5 days +/- 5.1. No deaths or sequelae were reported. CONCLUSIONS: The annual incidence rate of admissions longer than 24 hours due to varicella complications was 12.9 cases per 100,000 children aged less than 15 years, representing 0.31% of all annual admissions in this age group.

Hospitalizaciones por complicaciones de la varicela en niños menores de 15 años / Hospital admissions for varicella complications in children aged less than 15 years old

Antecedentes Las complicaciones por varicela se consideran una de las indicaciones que apoyan la cobertura vacunal universal. Objetivo Describir las complicaciones por varicela que han precisado hospitalización en una población definida (Guipuzkoa, España) y comparar la incidencia de hospitalizaciones con otras series. Material y métodos Estudio multicéntrico, retrospectivo, observacional, por revisión de historias clínicas, codificadas como varicela (CMBD, CIE-9, códigos 052.0-052.9) desde 1 de enero de 1993 a 31 de diciembre de 2002, y cálculo de las tasas de hospitalización en base a las urgencias asistidas y a los datos poblacionales. Población infantil de Guipuzkoa (España) asistida en el ámbito geográfico de los servicios de pediatría de los hospitales de agudos de Osakidetza-Servicio Vasco de Salud de Hondarribia, Mendaro, San Sebastián y Zumárraga, con una cobertura poblacional media de 54.999 niños menores de 15 años por año. Todos los niños y niñas de 0 a 15 años de edad, hospitalizados más de 24 h con el diagnóstico de varicela complicada. Se estudiaron las siguientes variables: edad, sexo, antecedentes personales, vacuna antivaricela, estado inmunológico, fiebre, radiografía de tórax, exámenes complementarios, duración del ingreso, tratamiento, diagnósticos de alta, evolución, complicaciones y secuelas al alta. Resultados Ingresaron 71 niños no vacunados frente al virus varicela-zoster, 80 por ciento menores de 5 años de edad, 68 inmunocompetentes y 3 no inmunocompetentes. Han predominado las sobreinfecciones bacterianas (56 por ciento) y destacan 7 casos con enfermedad invasiva. La estancia media ha sido de 6,50 5,15 día, sin mortalidad y sin secuelas. Conclusiones La incidencia anual de ingresos hospitalarios por varicela complicada superiores a 24 h ha sido 12,90 casos por cada 100.000 menores de 15 años, lo cual representa el 0,31 por ciento de los ingresos anuales hospitalarios en ese grupo (AU)

[Otoacoustic emissions in sudden deafness]. / Emisiones otoacústicas en sorderas súbitas.

UNLABELLED: The idiopathic type of sudden deafness installed in few hours become evident in audiometry as deafness perceptive of loud tones, neurosensorial deafness of loud tones and completely of treble sounds or cofosis. The otoacoustic emissions are modificated in sudden deafness. OBJECTIVES: To know and describe how are the otoacoustic emissions and the audition in sudden deafness. To analyse a possible relationship between audition, otovestibular and clinic participation with the parameters of the graphoelements of the otoacoustic emissions. PATIENTS AND METHODS: We study 52 patients with diagnostic of sudden deafness with a backward, observational and descriptive and analytic design of the results. Patients with ORL diagnostic were selectioned and audiometric, vestibular test and otoacoustic emissions were made. RESULTS: In our research we find quantitative and qualitative variations statistically significative in the otoacoustic emissions design. Its presence in the different frequencies is altered or is missing in any case of sudden deafness in which there are damages of the inner ear. There is not associative correlation between the alterations of otoacoustic emissions and the kind of sudden deafness, neither its provoking factors, anigiohematical, viral or traumatic. DISCUSSION AND CONCLUSIONS: There are modifications of the otoacoustic emissions but not specificals or the kinds of sudden deafness and its provoking factors. Another publications agree and underwrite our discoveries. We thought that our aportation with this study is fundamental for the clinic application of the otoacoustic emissions in the processes of sudden deafness.

Emisiones otoacústicas en sorderas súbitas / Otoacustic emissions in sudden deafness

La forma idiopática de sordera súbita instalada en pocas horas se manifiesta en audiometría como sordera perceptiva de tonos graves, sordera neurosensorial de tonos graves y total de tonos agudos o cofosis. Están codificadas las emisiones otoacústicas en las sorderas súbitas. Objetivos. 1º Conocer y describir cómo estás las emisiones otoacústicas y la audición en las sorderas súbitas. 2º Analizar una posible relación asociativa entre audición, participación otovestibular y clínica con los parámetros de los grafoelementos de las emisiones otoacústicas. Pacientes (material y métodos). Estudiamos 52 pacientes con diagnóstico de sordera súbita con un diseño retrospectivo, observacional y descriptivo, y analítico de resultados. Se seleccionaron los pacientes con diagnóstico ORL y se les practicaron pruebas audiométricas, vestibulares y emisiones otoacústicas. Resultados. En nuestra investigación hallamos unas variaciones cuantitativas y cualitativas estadísticamente significativas en los trazados de emisiones otoacústicas. Su presencia en las diversas frecuencias está alterada o falta en todos los casos de sorderas súbitas en que hay lesiones de oído interno. No existe correlación asociativa entre las alteraciones de emisiones otoacústicas y tipo de sordera súbita ni sus factores desencadenantes angiohemático, viral o traumético. discusión/conclusiones. Existen modificaciones de las emisiones otoacústicas pero no específicas de las variedades de sorderas súbitas y sus factores desencadenantes. Otras publicaciones coinciden y avalan nuestros hallazgos. Pensamos que nuestra aportación con este estudio es básica para la aplicación clínica de las emisiones otoacústicas en los procesos de sorderas súbitas (AU)

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[Efficacy of the treatment of Ménière's disease with oligoelements]. / Eficacia del tratamiento con oligoelementos de la enfermedad de Ménière.

OBJECTIVES: 1st To study and know better the therapeutical action of the olygoelements in the Ménière's diseases. 2nd To analyse if there are significative statistical associations of therapeutical response to the olygoelements in the Ménière's sickness. MATERIAL AND METHODS: We make a design of observational study of 68 patients with the diagnostic of Ménière's sickness, with classical therapeutic and 34 treated with and without litium olygoelements and manganese&cupper. RESULTS: In the descriptive statistics we find better results in the Ménières treated with olygoelements than in those that were not treated. In the analytic associative statistics we find that for 3 degrees of freedom a chi-square of 13.20 that is equal to 0.00459 (less than 0.05) that indicate that there's significative differences between both treatments not due to casuality. DISCUSSION: There are significative differences of better results in Ménières treated with olygoelements. The new aspect of potentiate the therapeutical arsenal of Ménières evidences a new possibility of soon clinical aplication.

[Acute otitis media caused by Nocardia asteroides]. / Otitis media aguda por Nocardia asteroides.

Nocardia asteroides is a bacteria that is distributed widely in nature and produces infection in most organs. Pulmonary nocardiosis is the most common form of clinical presentation. Few references exist regarding ear disease produced by this microorganism. A case of acute otitis media caused by N. asteroides produced subtotal tympanic perforation in a 45-year-old immunocompetent patient. The causal diagnosis was made by pure culture growth, repeated isolation and visualization of the microorganism in Gram-stained specimens of ear exudate. The strain was resistant to cotrimoxazole, but the patient was treated successfully with ciprofloxacin.