RESUMO
OBJECTIVES: The objective of this study was to compare the risk of contamination for urine samples collected from patients younger than 90 days using 2 different techniques: bladder stimulation and "clean catch" (CC) and urinary catheterization (CATH). METHODS: A case-control study was carried out in the pediatric emergency room of a tertiary hospital between January 2016 and September 2017. All urine samples collected from patients younger than 90 days by CC or CATH were included. The incidence of contaminated urine samples was compared for both methods, and the risk of contamination was estimated using univariate and multivariate analyses. RESULTS: A total of 473 urine samples were collected, 310 via CATH (65.5%) and 163 via CC (34.5%). The median age was 1.4 months (interquartile range, 0.8-2.1 months), and 54.1% were males. Seventeen patients had a history of urinary tract infection (3.6%), and 16 were diagnosed with a congenital urorenal anomaly (3.4%). Sixteen urine samples were found to be contaminated (3.4%): 5 collected via CATH (1.6%) and 11 via CC (6.8%). The univariate analysis revealed a greater risk of contamination in specimens obtained using CC versus CATH (odds ratio, 4.41; 95% confidence interval, 1.51-12.93), and the multivariate analysis confirmed CC collection as an independent risk factor for contamination (odds ratio, 5.61; 95% confidence interval, 1.83-17.19). CONCLUSIONS: The number of contaminated urine samples in infants younger than 90 days in our pediatric emergency department is low. However, using the CC urine collection technique seems to be an independent risk factor for sample contamination.
Assuntos
Cateterismo Urinário , Infecções Urinárias , Estudos de Casos e Controles , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Bexiga Urinária , Cateterismo Urinário/efeitos adversos , Infecções Urinárias/epidemiologia , Coleta de UrinaRESUMO
No disponible
Assuntos
Humanos , Feminino , Criança , Acidente Vascular Cerebral/diagnóstico , Isquemia Encefálica/diagnóstico , Transtornos da Motilidade Ocular/diagnóstico , Tálamo/diagnóstico por imagem , Tálamo/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Isquemia Encefálica/fisiopatologia , Transtornos da Motilidade Ocular/fisiopatologia , Imageamento por Ressonância Magnética/métodosRESUMO
No disponible
Assuntos
Humanos , Masculino , Criança , Dilatação/métodos , Enteroscopia de Balão/métodos , Neoplasias Duodenais/cirurgia , Transtornos Linfoproliferativos/complicações , Constrição Patológica/cirurgia , Obstrução Intestinal/cirurgia , Linfoma/complicações , Neoplasias Duodenais/complicaçõesRESUMO
Intestinal lymphoma can appear as a result of a state of immunosuppression, secondary to the transplantation of solid organs. Treatment with chemotherapy can result in various complications such as intestinal stenosis due to fibrotic scar tissue, which is a complication barely described in the literature. We present the case of a 12-year-old male with a heart transplant, who was diagnosed with intestinal lymphoma. After chemotherapy treatment, he developed 1-2 daily vomiting episodes as a result of intestinal stenosis due to fibrosis without tumor infiltration. Endoscopic balloon dilation was used and the symptoms were resolved without the need for surgical treatment.
Assuntos
Obstrução Duodenal/terapia , Duodenoscopia , Transplante de Coração , Atresia Intestinal/terapia , Complicações Pós-Operatórias/terapia , Enteroscopia de Balão , Criança , Neoplasias Duodenais/complicações , Obstrução Duodenal/etiologia , Humanos , Atresia Intestinal/etiologia , Linfoma/complicações , Masculino , Complicações Pós-Operatórias/etiologiaRESUMO
Objetivo: Analizar la experiencia de tratamiento con OAF en pacientes ingresados por crisis asmática (CA) en una planta de hospitalización pediátrica (PHP), así como analizar la diferencia de la evolución según sean tratados de entrada con flujos de 15lpm o inferiores a 15l pm. Métodos: Estudio retrospectivo y analítico en niños (4 a 15 años) ingresados por CA en la PHP de un hospital terciario entre 2012 y 2016. Se compararon 2 grupos de pacientes: los tratados con OAF y los tratados con oxigenoterapia convencional; se construyó un modelo de regresión logística para identificar variables predictivas de necesidad de OAF. Se comparó la evolución de los pacientes en función del flujo de inicio de la OAF (15l pm vs <15l pm). Resultados: Se incluyeron 536 pacientes con CA, de los que 40 (7,5%) precisaron OAF. La mediana de edad fue de 5 (4-6) años. La OAF en los pacientes con CA produjo una reducción en la frecuencia cardiaca, frecuencia respiratoria y Pulmonary Score en las primeras 3-6horas de tratamiento. En el análisis multivariante los pacientes con una mayor puntuación en el PS y un mayor número de ingresos previos precisaron con más frecuencia OAF. Los pacientes tratados con un flujo de inicio de 15lpm ingresaron menos frecuentemente en UCIP que aquellos con flujo inicial inferior a 15lpm (13% vs. 47%, p = 0,05). Conclusión: La OAF como tratamiento de las CA en las PHP parece ser una terapia de gran utilidad. El Pulmonary Score y el número de ingresos previos permite identificar un grupo de riesgo de precisar OAF
Objective: To assess the experience with oxygen therapy with a high flow nasal cannula (HFNC) in hospital on patients with asthmatic exacerbation (AE) in a paediatric ward, and to assess the clinical outcome according with the initial oxygen flow (15l pm or < 15l pm). Methods: This was a retrospective study of children aged 4 to 15 years with AE admitted to a paediatric ward in a tertiary level hospital between 2012 and 2016. Two groups of patients were compared; Group 1: patients treated with HFNC, and Group 2: patients treated with conventional oxygen therapy. A logistic regression model was constructed in order to identify predictive variables of HFNC. The clinical outcome of the patients was also compared according to the initial flow of HFNC (15l pm VS <15l pm). Results: The study included a total of 536 patients with AE, 40 (7.5%) of whom required HFNC. The median age was 5 (4-6) years. Heart rate (HR), respiratory rate (RR) and Pulmonary Score (PS) significantly decreased at 3-6 hours after starting HFNC in Group 1. In the multivariate analysis, patients with high Pulmonary Score values and greater number of previous admissions required HFNC more frequently. Patients treated with an initial flow of 15lpm were admitted less frequently to the PICU than those with an initial flow less than 15lpm (13% vs 47%, p = .05). Conclusion: HFNC seems to be a useful therapy for asthma exacerbation in paediatric wards. Severity of Pulmonary Score and the number of previous admissions could enable a risk group that needs HFNC to be identified
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Oxigenoterapia/métodos , Estado Asmático/terapia , Hospitalização , Estudos Retrospectivos , Modelos Logísticos , Frequência Cardíaca , Análise Multivariada , Estudo ObservacionalRESUMO
OBJECTIVE: To assess the experience with oxygen therapy with a high flow nasal cannula (HFNC) in hospital on patients with asthmatic exacerbation (AE) in a paediatric ward, and to assess the clinical outcome according with the initial oxygen flow (15lpm or <15lpm). METHODS: This was a retrospective study of children aged 4 to 15 years with AE admitted to a paediatric ward in a tertiary level hospital between 2012 and 2016. Two groups of patients were compared; Group 1: patients treated with HFNC, and Group 2: patients treated with conventional oxygen therapy. A logistic regression model was constructed in order to identify predictive variables of HFNC. The clinical outcome of the patients was also compared according to the initial flow of HFNC (15lpm VS <15lpm). RESULTS: The study included a total of 536 patients with AE, 40 (7.5%) of whom required HFNC. The median age was 5 (4-6) years. Heart rate (HR), respiratory rate (RR) and Pulmonary Score (PS) significantly decreased at 3-6hours after starting HFNC in Group 1. In the multivariate analysis, patients with high Pulmonary Score values and greater number of previous admissions required HFNC more frequently. Patients treated with an initial flow of 15lpm were admitted less frequently to the PICU than those with an initial flow less than 15lpm (13% vs 47%, p=.05). CONCLUSION: HFNC seems to be a useful therapy for asthma exacerbation in paediatric wards. Severity of Pulmonary Score and the number of previous admissions could enable a risk group that needs HFNC to be identified.
Assuntos
Asma/terapia , Oxigenoterapia/métodos , Adolescente , Criança , Pré-Escolar , Progressão da Doença , Feminino , Hospitalização , Hospitais Pediátricos , Humanos , Modelos Logísticos , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
La patología mamaria en pediatría es infrecuente. El hallazgo de una masa a nivel mamario en un lactante es una situación poco común. Los posibles diagnósticos a esta edad son absceso mamario, mastitis, ingurgitación mamaria por estimulación hormonal materna y hemangioma. Es importante llegar al diagnóstico adecuado para emplear un tratamiento acorde y evitar la aparición de complicaciones de dichas patologías. Se presenta un caso de una lactante con una masa en la mama derecha detectada desde el nacimiento. Inicialmente, se trató como una mastitis, pero dada la mala evolución, se plantearon diagnósticos diferenciales y se concluyó que se trataba de un hemangioma. Debido a la ulceración de la lesión, junto con el riesgo existente de desarrollar hipoplasia mamaria, se decidió iniciar tratamiento con propanolol, con resolución casi completa de la tumoración.
Mammary pathology is infrequent during childhood. It is rare the probability of finding a breast mass in an infant. The most frequent possible diagnoses at this age are breast abscess, mastitis, breast engorgement due to maternal hormonal stimulation and hemangioma. Reaching the proper diagnosis is essential in order to apply a suitable treatment and avoid the potential disease complications. We present the case of a female infant having a mass in the right breast from birth. Initially the entity was treated as mastitis. Nevertheless, the bad evolution made necessary considering the differential diagnosis. It was concluded to be a hemangioma. Due to the lesion ulceration and the potential risk of developing breast hypoplasia, treatment with propranolol was started. The tumor was almost completely resolved.
Assuntos
Humanos , Feminino , Lactente , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/tratamento farmacológico , Hemangioma/diagnóstico , Hemangioma/tratamento farmacológico , Mastite/diagnóstico , Mamilos , Diagnóstico DiferencialRESUMO
Mammary pathology is infrequent during childhood. It is rare the probability of finding a breast mass in an infant. The most frequent possible diagnoses at this age are breast abscess, mastitis, breast engorgement due to maternal hormonal stimulation and hemangioma. Reaching the proper diagnosis is essential in order to apply a suitable treatment and avoid the potential disease complications. We present the case of a female infant having a mass in the right breast from birth. Initially the entity was treated as mastitis. Nevertheless, the bad evolution made necessary considering the differential diagnosis. It was concluded to be a hemangioma. Due to the lesion ulceration and the potential risk of developing breast hypoplasia, treatment with propranolol was started. The tumor was almost completely resolved.
La patología mamaria en pediatría es infrecuente. El hallazgo de una masa a nivel mamario en un lactante es una situación poco común. Los posibles diagnósticos a esta edad son absceso mamario, mastitis, ingurgitación mamaria por estimulación hormonal materna y hemangioma. Es importante llegar al diagnóstico adecuado para emplear un tratamiento acorde y evitar la aparición de complicaciones de dichas patologías. Se presenta un caso de una lactante con una masa en la mama derecha detectada desde el nacimiento. Inicialmente, se trató como una mastitis, pero dada la mala evolución, se plantearon diagnósticos diferenciales y se concluyó que se trataba de un hemangioma. Debido a la ulceración de la lesión, junto con el riesgo existente de desarrollar hipoplasia mamaria, se decidió iniciar tratamiento con propanolol, con resolución casi completa de la tumoración.
Assuntos
Neoplasias da Mama/diagnóstico , Hemangioma/diagnóstico , Mastite/diagnóstico , Mamilos , Neoplasias da Mama/tratamento farmacológico , Diagnóstico Diferencial , Feminino , Hemangioma/tratamento farmacológico , Humanos , LactenteRESUMO
BACKGROUND: Ranitidine has not been considered as a potential cause of ocular movement conditions. However, it is known that the vestibular nucleus complex, that has a key role in gaze control and vestibule-ocular reflexes, receives hypothalamic histaminergic innervations. Some studies reported the effect of ranitidine blocking the excitatory responses of vestibular nuclei neurons to histamine. CASE REPORT: We report the first case of a downbeat nystagmus secondary to ranitidine in an infant. A 3-month-old female developed a downbeat gaze after starting treatment with ranitidine for a pediatric gastroesophageal reflux disease. Microbiological test were negative and neuroblastoma evaluation was normal. CONCLUSION: As ranitidine is widely prescribed in the pediatric population, clinicians should be aware of its potential to cause ocular movements disorders.
