Correccion del desequilibrio hidroelectrolitico mediante la rehidratacion por via oral. / Correction of water-electrolyte imbalance by oral fluid therapy

Se analizaron 250 pacientes que ingresaron en un lapso de tres meses al Servicio de Urgencias del CMN, IMSS, deshidratados por gastroenteritis que fueron rehidratados por via oral, con el objeto de evaluar la correcion de las alteraciones electroliticas y la capacidad de las madres para administrar el tratamiento. La edad de los pacientes fue en promedio de 7,6 meses (3 dias a 36 m); la diarrea de 4.1 dias y 83% presentaban vomito, 65% presentaban desnutricion de grado variable y la deshidratacion fue en promedio de 5.5% en todo el grupo. Los resultados en las muestras sanguineas tomadas previamente al tratamiento y despues de corrigida la deshidratacion demostraron que las alteraciones del sodio en los pacientes hipo e hipernatremicos tienen a la correccion. De la misma manera sucedio con las alteraciones del potasio serico, con la acidosis y la uremia. No hubo diferencia para corregir adecuadamente el desequilibrio entre los recien nacidos y los desnutridos con los ninos de mayor edad y peso normal. Diarrea aguda, hidratacion por via oral

[Mortality from an asthma-like syndrome in pediatrics]. / Mortalidad por síndrome asmatiforme en pediatría.

The medical records of children who died from asthmatiform syndrome at Hospital de Pediatría del Centro Médico Nacional, during 1963 through 1980. were examined. There were sixteen asthmatic deaths; out of these, ten were males and six females; 88% occurred before the age of five years. Half of the deaths occurred during the first asthmatiform attack. In 69%, an upper respiratory tract infection was the precipitating factor and in 31%, bronchopneumonia was associated. There were cardiac failures in 88%. A poor medical management was the main factor in about 66%. The mortality rate was 0.5%. The significance of the clinical course is discussed and a program for treatment outlined.

Mortalidad por sindrome asmatiforme en pediatria. / Mortality from asthmatiform syndrome in pediatrics

Se presenta el analisis de los 16 fallecimientos por sindrome asmatiforme en el Hospital de Pediatria del Centro Medico Nacional.IMSS., de 1963 a 1980. Catorce (88%) fueron menores de cinco anos. La mitad de las defunciones ocurrieron en el primer ataque asmatiforme. La infeccion de vias respiratorias altas se observo como factor desencadenante en 69% de los casos y en 31% se asocio bronconeumonia. Catorce pacientes (88%) presentaron insuficiencia cardiaca. El manejo medico inadecuado se considero el factor principal en mas de las 2/3 partes de los casos. El indice de mortalidad fue de 0.5%. Se analizan los factores condicionantes de la muerte. Se comparan los resultados con los de la literatura. Se hace enfasis en la elevada frecuencia de fallecimientos durante la primera crisis asmatiforme y en el mal pronostico de su asociacion con insuficiencia cardiaca. Se hacen recomendaciones sobre la valoracion adecuada y oportuna de la gravedad de la crisis y lineamentos sobre el manejo

Rotavirus. II. Virus relacionados con la gastroenteritis aguda en el nino. / Rotavirus. II. Viruses associated with acute gastroenteritis in children

Se estudio la presencia de rotavirus en la materia fecal de 232 ninos menores de cinco anos con gastroenteritis infecciosa aguda por medio de la tecnica de electroforesis del RNA viral. Se encontraron 15.1 por ciento de casos positivos, no observandose predominio en relacion con la edad o la epoca del ano.Aproximadamente 50 por ciento correspondieron a cada uno de los dos tipos de rotavirus, pero el tipo 2 (2 L) predomino en los seis primeros meses del ano y el tipo 1 (2 S) en los otros seis. Los resultados concuerdan con los obtenidos por otros autores, ya que se considera que aproximadamente 20 por ciento de las diarreas agudas de la infancia son causadas por estos agentes virales

[Methemoglobinemia caused by inhalation of aniline vapors by a newborn]. / Metahemoglobinemia por inhalación de vapores de anilina en un lactante.

Most cases of toxic methemoglobinemia in children are caused by direct contact of the methemoglobinizing agents with the skin and mucosa and in a shorter scale, by the ingestion of such compounds. The first case we know is reported where the toxic was inhaled. The basis to establish the diagnosis of methemoglobinemia, together with the differential diagnosis with other diseases in children that show cyanosis in their course are discussed.

[Sodium hemostasis in hypovolemic shock in the newborn]. / Homeostasis del sodio en el choque hipovolémico del recién nacido.

Twenty newborns with hypovolemic shock due to gastroenteritis, were treated with a solution of lactate Ringer. The clinical course, complications and the evolution of the seric levels of sodium were analyzed. The average sodium administered was 17.8 mEq./kg./d., higher than the recommended dose for that age; nevertheless, after 24 hours of treatment, the seric levels in 95 per cent of the patients showed figures within normal range. The conclusion is that the ability of the kidney to regulate sodium excretion is present and adequate since the first days of life.

[Poisoning by nalidixic acid in children]. / Intoxicación por ácido nalidíxico en niños.

A review was made of the clinical histories of 18 children who were admitted to the Emergency Department of the Hospital de Pediatría del C.M.N. (IMSS) with the diagnosis of nalidixic acid intoxication. The study covered a period of 3 years, from 1976 through 1978. There were no differences as to sex; infants under one year were most frequently attached; iatrogenesis was the most frequent mechanism. The clinical manifestations were characterized by neurological disorders of the state of alertness, hypertensive cranial syndrome and neuronal damage; there was metabolic acidosis in other cases. Treatment included gastric lavage, general measures, correction of acid-base unbalance, control of convulsive crises. Indications for the use of nalidixic acid are reviewed stressing that it must be used in urinary infections and as second choice drug.

[Halothane: another resource for the asthmatic patient]. / Halotane: un recurso más en el paciente en estado de mal asmático.

A case of severe asthma which did not improve with the usual management is presented. Ventilations was assisted with an orotracheal cannula and the patient was given halothane with a good response and improvement of his crisis. Halothane must be considered as a possibility in the treatment of severe asthma. However, further studies in this area are necesary.