Parálisis de la convergencia secundaria a amoxicilina / Convergence palsy secondary to amoxicillin

CASO CLÍNICO: Presentamos el caso de un varón de 11 años, con diplopía aguda en la visión cercana, secundario a una parálisis de la convergencia transitoria, posiblemente relacionada con la toma de amoxicilina. DISCUSIÓN: La parálisis de la convergencia es un trastorno poco frecuente. Repasamos las causas que la pueden producir, e identificamos a la amoxicilina como agente etiológico. Es el primer caso comunicado (AU)

CASE REPORT: We present the case of an 11-year-old boy with acute diplopia in near vision secondary to transient convergence palsy, possibly in relation to amoxicillin. DISCUSSION: Convergence palsy is an uncommon eye disorder. The causes are reviewed, and amoxicilin is identified as presumptive etiologic agent. This is the first case reported

Convergence palsy secondary to amoxicillin. / Parálisis de la convergencia secundaria a amoxicilina.

CASE REPORT: We present the case of an 11-year-old boy with acute diplopia in near vision secondary to transient convergence palsy, possibly in relation to amoxicillin. DISCUSSION: Convergence palsy is an uncommon eye disorder. The causes are reviewed, and amoxicilin is identified as presumptive etiologic agent. This is the first case reported.

Disfonía infantil precoz como síntoma de alerta de la papilomatosis laríngea juvenil / Early infantile dysphonia as an alert symptom of juvenile laryngeal papillomatosis

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Fracturas de temporal graves en niños: presentación, complicaciones y secuelas observadas en los últimos 11 años / Severe temporal bone fractures in children: Clinical presentation, complications and sequelae observed in the last 11 years

OBJETIVO: Analizar las características de presentación, complicaciones y secuelas, de las fracturas de temporal ingresadas en UCIP.MATERIAL Y MÉTODOS: Análisis descriptivo retrospectivo de las historias clínicas y TC craneal. RESULTADOS: Veintisiete pacientes ingresados en UCIP presentaron fractura del temporal: 13 (48%) sin afectación de peñasco (grupo 1) y 14 (52%) con afectación de peñasco (grupo 2). El grupo 2 presentó mayor estancia en la UCIP: 4,5 días (RI: 2,75-22,25) vs. 2 (RI: 1-3) (p = 0,018), mayor frecuencia de secuelas (p = 0,04) y presencia de fístula del LCR (p < 0,02). Los scores de PRIMS III e índice de traumatismo pediátrico no mostraron diferencias significativas. El 31% presentó hipoacusia, 2 pacientes fallecieron y 4 (15%) presentaron secuelas permanentes. CONCLUSIONES: Las fracturas temporales pueden ser graves, especialmente si incluyen al peñasco, bien por las lesiones asociadas, que marcan el riesgo vital, como por las secuelas (déficit auditivo o fístula LCR). Los autores indican el seguimiento de estos pacientes a largo plazo por Otorrinolaringología

OBJECTIVES: To evaluate the clinical presentation, complications and sequelae in patients with temporal bone fracture in the last 11 years. MATERIAL AND METHODS: A total of 27 patient medical records were retrospectively analysed. RESULTS: Of the 27 patients who were admitted for temporal bone fracture from 2001 to 2012, 13 (48%) had no petrous involvement (Group 1), and 14 (52%) with petrous involvement (Group 2). Patients in Group 2 had a longer P-ICU stay: median 4.5 days (RI: 2.75-22.25 d) vs 2 (RI: 1-3 d) (P=.018); more days on mechanical ventilation support: median 3 days (RI: 1.50-17 d) vs 1 (RI: 1-1.25 d). This group also had a higher frequency in sequelae (P=.04 OR = 1.4 (95% CI: 1.05-1.95)) and a higher incidence in cerebrospinal fluid (CSF) fistula (P<.02; OR 2.33; 95% CI (1.27-4.27)). Severity scores (PRIMS III and PTI) showed no significant differences. Some degree of hearing loss was observed in 31% of the patients. Traffic accident was the main cause of trauma (33%), followed by falls (27%). There were 2 deaths and 4 (15%) had permanent sequelae. CONCLUSIONS: Isolated temporal bone fractures usually have a good outcome in children, but in some cases they can be fatal or have permanent sequelae. Long term follow up is recommendedby authors

[Severe temporal bone fractures in children: clinical presentation, complications and sequelae observed in the last 11 years]. / Fracturas de temporal graves en niños: presentación, complicaciones y secuelas observadas en los últimos 11 años.

OBJECTIVES: To evaluate the clinical presentation, complications and sequelae in patients with temporal bone fracture in the last 11 years. MATERIAL AND METHODS: A total of 27 patient medical records were retrospectively analysed. RESULTS: Of the 27 patients who were admitted for temporal bone fracture from 2001 to 2012, 13 (48%) had no petrous involvement (Group 1), and 14 (52%) with petrous involvement (Group 2). Patients in Group 2 had a longer P-ICU stay: median 4.5 days (RI: 2.75-22.25 d) vs 2 (RI: 1-3 d) (P=.018); more days on mechanical ventilation support: median 3 days (RI: 1.50-17 d) vs 1 (RI: 1-1.25 d). This group also had a higher frequency in sequelae (P=.04 OR=1.4 (95% CI: 1.05-1.95)) and a higher incidence in cerebrospinal fluid (CSF) fistula (P<.02; OR 2.33; 95% CI (1.27-4.27)). Severity scores (PRIMS III and PTI) showed no significant differences. Some degree of hearing loss was observed in 31% of the patients. Traffic accident was the main cause of trauma (33%), followed by falls (27%). There were 2 deaths and 4 (15%) had permanent sequelae. CONCLUSIONS: Isolated temporal bone fractures usually have a good outcome in children, but in some cases they can be fatal or have permanent sequelae. Long term follow up is recommended by authors.

Enfisema orbitario pediátrico secundario a disparo con pistola de aire comprimido: a propósito de un caso / Pediatric orbital emphysema caused by a compressed-air pistol shot: A case report

CASO CLÍNICO: Se presenta el caso de un escolar de 2 años con un enfisema orbitario tras disparo con pistola de aire comprimido en la región malar. Se aplicó tratamiento conservador y presentó buena evolución sin complicaciones. DISCUSIÓN: El enfisema orbitario en ausencia de fractura de la pared orbitaria es una entidad muy rara. Normalmente se observa enfisema orbitario asociado a traumatismos que causan fracturas de los senos paranasales o los huesos faciales. En la literatura consultada hay pocos casos de enfisema orbitario secundarios a lesiones producidas por aire comprimido

CASE REPORT: We report the case of a 2 year-old child with orbital emphysema secondary to a compressed-air gun shot in the malar region, with no evidence of orbital wall fracture. Conservative treatment was applied, and no complications were observed. DISCUSSION: Orbital emphysema in the absence of an orbital wall fracture is a rare situation. Orbital emphysema is usually seen in facial trauma associated with damage to the adjacent paranasal sinuses or facial bones. To our knowledge there have been very few reports of orbital emphysema caused by a compressed-air injury

Rotura de catéter pleural: presentación de 2 casos / Pleural catheter rupture: a report of 2 cases

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[Pediatric orbital emphysema caused by a compressed-air pistol shot: a case report]. / Enfisema orbitario pediátrico secundario a disparo con pistola de aire comprimido: a propósito de un caso.

CASE REPORT: We report the case of a 2 year-old child with orbital emphysema secondary to a compressed-air gun shot in the malar region, with no evidence of orbital wall fracture. Conservative treatment was applied, and no complications were observed. DISCUSSION: Orbital emphysema in the absence of an orbital wall fracture is a rare situation. Orbital emphysema is usually seen in facial trauma associated with damage to the adjacent paranasal sinuses or facial bones. To our knowledge there have been very few reports of orbital emphysema caused by a compressed-air injury.

Agenesia de vesícula biliar: una causa inusual de hipertransaminasemia / Absence of the gallbladder: an unusual cause of hypertransaminasemia

La agenesia de vesícula biliar es una entidad poco frecuente, y su presentación con algún síntoma asociado es más infrecuente aún. La mayoría de casos se detectan de forma accidental en el curso de una exploración quirúrgica ante un cuadro sugestivo de litiasis biliar. Se presenta el caso de una niña de 4 años de edad con elevaciones transitorias y recurrentes de enzimas hepáticas, en quien sólo se encontró, tras un estudio exhaustivo, una agenesia de vesícula biliar como posible causa de esta alteración. Es un cuadro que hay que tener en cuenta para evitar procedimientos invasivos en estos pacientes(AU)

Abscence of the gallbladder is a very rare malformation and its symptomatic presentation is even more unusual. Most of the cases reported were discovered while a surgical exploration of the abdomen was performed in patients with biliary symptoms. It is reported a rare paediatric case. The patient was 4 years old and presented recurrent and transient elevation of liver transaminases. After a complete study only absence of the gallbladder was found as cause. Awareness of this entity by clinicians and surgeons is important because invasive diagnostic procedures can be avoided(AU)

Micofenolato mofetilo como alternativa de tratamiento de la anemia hemolítica autoinmunitaria crónica corticodependiente / Mycophenolate mofetil: An alternative treatment for refractory autoimmune hemolytic anemia in children

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