[Frequency of postoperative fever in children with congenital heart disease undergoing cardiovascular surgery and associated risk factors]. / Frecuencia y factores de riesgo asociados con el desarrollo de fiebre postoperatoria en niños con cardiopatía congénita sometidos a cirugía cardiovascular.

OBJECTIVES: To determine the frequency of postoperative fever in children with congenital heart disease who undergo cardiovascular surgery, and the risk factors associated. PATIENTS AND METHODS: In a prospective cohort study, 100 children under the age of less than 9 years were followed-up during hospitalization in order to detect fever after cardiac surgery. Preoperative, perioperative, and postoperative variables were assessed to determine their relationship with postoperative fever. The cases were patients who developed fever. Multivariate analysis was used, and the odds ratio (OR) and 95% confidence intervals (95% CI) were calculated. RESULTS: The frequency of postoperative fever was 46%. Fever appeared within 24 hours of surgery in 56% cases. In 32/46 (70%) cases, fever remitted within 72 hours. Fever was more common in patients who underwent open-heart surgery than in those treated with a closed technique (28 vs. 18, P = 0.045). Prolonged extracorporeal circulation (OR = 1.024; 95% CI, 1.004-1.045), aortic cross-clamping (OR = 2.83; 95% CI, 1.21-6.61) and postoperative infections (OR = 24.07; 95% CI, 7.2-75.0) were the risk factors associated with the development of postoperative fever. CONCLUSIONS: Postoperative fever is common in children with congenital heart disease. The identification of risk factors associated to the development of fever should help clinicians to identify the cause of fever in this group of patients.

[Allergens and risk factors in pediatric patients with allergic seasonal conjunctivitis]. / Alergenos y factores de riesgo en pacientes pediátricos con conjuntivitis alérgica estacional.

BACKGROUND: The seasonal allergic conjunctivitis is an inflammatory disease of the ocular surface that affects mainly children, with predominance of male sex. It is an immunological disease with a typical reaction of hypersensitivity type 1 (IgE), resulted from several biological reactions (antigen-antibody) and it's associated to several risk factors. OBJECTIVE: To determine the more frequently identified allergens and the associated risk factors to the seasonal allergic conjunctivitis in children living in Mexico City. MATERIAL AND METHODS: Ophthalmologic clinical study done to 50 patients with diagnosis of seasonal allergic conjunctivitis, during the months of March to October, 2001, at the Ophthalmology Department of the National Pediatric Institute. A control group was integrated by 50 patients of the consultation of ophthalmology with non-allergic ocular pathology, and percutaneous skin tests were made. A direct interrogation was applied to both groups to investigate associated risk factors of atopy. RESULTS: The associated risk factors to the development of allergic conjunctivitis are: family atopic background, negative antecedent of breast feeding, asthma o rhinitis (statistically significant). The most frequently identified allergens were Dermatophagoides pteronissinus, Dermatophagoides farinae, Lolium perenne and Atriplex bacteosa, of the group of dust mites and pollen, respectively. CONCLUSION: It is important to see our patients in an integral way. In the case of patients with seasonal allergic conjunctivitis, it should not be forgotten to make an interrogation of the factors associated to atopy and, if it is possible, to inform to the patient and their relatives about these, in order to prevent them.