Recommendations on the clinical management of the COVID-19 infection by the «new coronavirus¼ SARS-CoV2. Spanish Paediatric Association working group.

On 31 December 2019, the Wuhan Municipal Committee of Health and Healthcare (Hubei Province, China) reported that there were 27 cases of pneumonia of unknown origin with symptoms starting on the 8 December. There were 7 serious cases with common exposure in market with shellfish, fish, and live animals, in the city of Wuhan. On 7 January 2020, the Chinese authorities identified that the agent causing the outbreak was a new type of virus of the Coronaviridae family, temporarily called «new coronavirus¼, 2019-nCoV. On January 30th, 2020, the World Health Organisation (WHO) declared the outbreak an International Emergency. On 11 February 2020 the WHO assigned it the name of SARS-CoV2 and COVID-19 (SARS-CoV2 and COVID-19). The Ministry of Health summoned the Specialties Societies to prepare a clinical protocol for the management of COVID-19. The Spanish Paediatric Association appointed a Working Group of the Societies of Paediatric Infectious Diseases and Paediatric Intensive Care to prepare the present recommendations with the evidence available at the time of preparing them.

El 31 de diciembre de 2019, la Comisión Municipal de Salud y Sanidad de Wuhan (provincia de Hubei, China) informó sobre la existencia de 27 casos de neumonía de etiología desconocida con inicio de síntomas el 8 de diciembre, incluyendo siete casos graves, con exposición común a un mercado de marisco, pescado y animales vivos en la ciudad de Wuhan. El 7 de enero de 2020, las autoridades chinas identificaron como agente causante del brote un nuevo tipo de virus de la familia Coronaviridae, denominado temporalmente "nuevo coronavirus", 2019-nCoV. El 30 de enero de 2020 la Organización Mundial de la Salud declara el brote un Emeregencia Internacional. El día 11 de febrero la OMS le asigna el nombre de COVID-19 (Coronavirus Infectious Disease). El Ministerio de Sanidad convoca a las Sociedades de Especialidades para la elaboración de un protocolo clínico de manejo de la infección por COVID -19. La Asociación Española de Pediatría nombra un grupo de trabajo de las Sociedades de Infectologia Pediátrica y Cuidados Intensivos Pediátricos que se encargan de elaborar las presentes recomendaciones con la evidencia disponible en el momento de su realización.

Surgical management of unilateral body fractures of the edentulous atrophic mandible.

INTRODUCTION: Management of body fractures in patients with edentulous atrophic mandibles represents a challenging task due to patient's age, medical comorbidities, poor bone quality, and vascularity, as well as reduced contact area between the fracture ends. The aim of the study was to assess the demographic and clinical variables, the surgical technique, and outcomes of unilateral body fractures of the edentulous atrophic mandible managed at several European departments of oral and maxillofacial surgery. METHODS: This study is based on a systematic computer-assisted database that allowed the recording of data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between 2008 and 2017. The following data were recorded for each patient: gender, age, comorbidities, etiology, synchronous body injuries, degree of atrophy of the mandible according to Luhr classification, type of surgical approach and fixation, length of hospitalization, and presence and type of complications. RESULTS: A total of 43 patients were included in the study: 17 patients' mandibles were classified as class I according to Luhr, 15 as class II, and 11 as class III. All patients underwent open reduction and internal fixation by extraoral approach in 25 patients, intraoral in 15 patients, and mixed in 3 patients. A single 2.0 miniplate was used in 16 patients, followed by a single 2.4 reconstruction plate in 13 patients, by two 2.0 miniplates, and three 2.0 miniplates. Outcome was considered to be satisfying in 30 patients, with no complications. Complications were observed in 13 cases. CONCLUSIONS: Treatment of unilateral body fractures of the edentulous mandible must still be based on the type of fracture, degree of atrophy, experience of the surgeon, and patients' preference. An adequate stability can be obtained by different plating techniques that have to be appropriately tailored to every single specific patient.

Documento español de consenso sobre diagnóstico, estabilización y tratamiento del síndrome inflamatorio multisistémico pediátrico vinculado a SARS-CoV-2 (SIM-PedS) / Spanish consensus document on diagnosis, stabilisation and treatment of pediatric multisystem inflammatory syndrome related to SARS-CoV-2 (SIM-PedS)

Se ha descrito un nuevo síndrome inflamatorio multisistémico pediátrico vinculado a SARS-CoV-2. Este cuadro presenta una expresividad clínica variable y se asocia a infección activa o reciente por SARS-CoV-2. En este documento se revisa la literatura existente por parte de un grupo multidisciplinar de especialistas pediátricos. Posteriormente, se realizan recomendaciones sobre estabilización, diagnóstico y tratamiento de este síndrome

A new paediatric multisystem inflammatory syndrome, linked to SARS-CoV-2, has been described. The clinical picture is variable and is associated with an active or recent infection due to SARS-CoV-2. A review of the existing literature by a multidisciplinary group of paediatric specialists is presented in this document. Later, they make recommendations on the stabilisation, diagnosis, and treatment of this síndrome

Recomendaciones sobre el manejo clínico de la infección por el «nuevo coronavirus» SARS-CoV2. Grupo de trabajo de la Asociación Española de Pediatría (AEP) / Recommendations on the clinical management of the COVID-19 infection by the «new coronavirus» SARS-CoV2. Spanish Paediatric Association working group

El 31 de diciembre de 2019, la Comisión Municipal de Salud y Sanidad de Wuhan (provincia de Hubei, China) informó sobre la existencia de 27 casos de neumonía de etiología desconocida con inicio de síntomas el 8 de diciembre, incluyendo 7 casos graves, con exposición común a un mercado de marisco, pescado y animales vivos en la ciudad de Wuhan. El 7 de enero de 2020, las autoridades chinas identificaron como agente causante del brote un nuevo tipo de virus de la familia Coronaviridae, denominado temporalmente «nuevo coronavirus», 2019-nCoV. El 30 de enero de 2020 la Organización Mundial de la Salud (OMS) declara el brote una Emergencia Internacional. El día 11 de febrero la OMS le asigna el nombre de SARS-CoV2 e infección COVID-19 (Coronavirus Infectious Disease). El Ministerio de Sanidad convoca a las Sociedades de Especialidades para la elaboración de un protocolo clínico de manejo de la infección. La Asociación Española de Pediatría nombra un grupo de trabajo de las Sociedades de Infectología Pediátrica y Cuidados Intensivos Pediátricos que se encargan de elaborar las presentes recomendaciones con la evidencia disponible en el momento de su realización

On 31 December 2019, the Wuhan Municipal Committee of Health and Healthcare (Hubei Province, China) reported that there were 27 cases of pneumonia of unknown origin with symptoms starting on the 8 December. There were 7 serious cases with common exposure in market with shellfish, fish, and live animals, in the city of Wuhan. On 7 January 2020, the Chinese authorities identified that the agent causing the outbreak was a new type of virus of the Coronaviridae family, temporarily called «new coronavirus», 2019-nCoV. On January 30th, 2020, the World Health Organisation (WHO) declared the outbreak an International Emergency. On 11 February 2020 the WHO assigned it the name of SARS-CoV2 and COVID-19 (SARS-CoV2 and COVID-19). The Ministry of Health summoned the Specialties Societies to prepare a clinical protocol for the management of COVID-19. The Spanish Paediatric Association appointed a Working Group of the Societies of Paediatric Infectious Diseases and Paediatric Intensive Care to prepare the present recommendations with the evidence available at the time of preparing them

Linfoma B de localización facial / Facial located B-cell lymphoma

No disponible

Guías de ingreso, alta y triage para las unidades de cuidados intensivos pediátricos en España / Admission, discharge and triage guidelines for paediatric intensive care units in Spain

La unidad de cuidados intensivos pediátricos (UCIP) es una unidad física asistencial hospitalaria independiente especialmente diseñada para el tratamiento de pacientes pediátricos quienes debido su gravedad o condiciones potencialmente letales requieren observación y asistencia médica intensiva integral y continua por un equipo médico que haya obtenido competencia especial en medicina intensiva pediátrica. La aplicación oportuna de terapia intensiva a los pacientes críticos reduce la mortalidad, el tiempo de estancia y los costes asistenciales. Con los objetivos de respetar el derecho del niño al disfrute del más alto nivel posible de salud y a servicios para el tratamiento de las enfermedades y la rehabilitación de la salud y de garantizar la calidad asistencial y la seguridad de los pacientes pediátricos críticos, la Asociación Española de Pediatría (AEP), la Sociedad Española de Cuidados Intensivos Pediátricos (SECIP) y la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) han desarrollado y aprobado las guías de ingreso, alta y triage para las UCIP en España. Mediante la aplicación de estas guías se puede optimizar el uso de las UCIP españolas de forma que los pacientes pediátricos reciban el nivel de cuidados médicos más apropiado para su situación clínica

A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous intensive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition

Guias de ingreso, alta y triage para las unidades de cuidados intensivos pediátricos en España / Admission, discharge and triage guidelines for paediatric intensive care units in Spain

La unidad de cuidados intensivos pediátricos (UCIP) es una unidad física asistencial hospitalaria independiente especialmente diseñada para el tratamiento de pacientes pediátricos quienes debido su gravedad o condiciones potencialmente letales requieren observación y asistencia médica intensiva integral y continua por un equipo médico que haya obtenido competencia especial en medicina intensiva pediátrica. La aplicación oportuna de terapia intensiva a los pacientes críticos reduce la mortalidad, el tiempo de estancia y los costes asistenciales. Con los objetivos de respetar el derecho del niño al disfrute del más alto nivel posible de salud y a servicios para el tratamiento de las enfermedades y la rehabilitación de la salud y de garantizar la calidad asistencial y la seguridad de los pacientes pediátricos críticos, la Asociación Española de Pediatría (AEP), la Sociedad Española de Cuidados Intensivos Pediátricos (SECIP) y la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) han desarrollado y aprobado las guías de ingreso, alta y triage para las UCIP en España. Mediante la aplicación de estas guías se puede optimizar el uso de las UCIP españolas de forma que los pacientes pediátricos reciban el nivel de cuidados médicos más apropiado para su situación clínica

A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition

Trends in nosocomial infections and multidrug-resistant microorganisms in Spanish pediatric intensive care units / Tendencia de la infección nosocomial y microorganismos multirresistentes en unidades de cuidados intensivos pediátricas en España

INTRODUCTION: Nosocomial infections (NI) are a major healthcare problem. National surveillance systems enable data to be compared and to implement new measures to improve our practice. METHODS: A multicentre, prospective, descriptive and observational study was conducted using the data from surveillance system for nosocomial infections created in 2007 for Spanish pediatric intensive care units. Data were collected for one month, between 01 and 31 March, for every study year (2008-2012). The objective was to report 5-years of NI surveillance data, as well as trends in infections by multidrug resistant organisms in Spanish pediatric intensive care units. RESULTS: A total of 3667 patients were admitted to the units during the study period. There were 90 (2.45%) patients with nosocomial infections. The mean rates during the 5 years study were: central line-associated bloodstream infection, 3.8/1000 central venous catheter-days, Ventilator-associated pneumonia 7.5/1000 endotracheal tube-days, and catheter-associated urinary tract infections 4.1/1000 urinary catheter-days. The comparison between the 2008 and 2009 rates for nosocomial infections did not show statistically significant differences. All rates homogeneously decreased from 2009 to 2012: central line-associated bloodstream infection 5.83 (95% CI 2.67-11.07) to 0.49 (95% CI 0.0125-2.76), P = 0.0029; ventilator-associated pneumonia 10.44 (95% CI 5.21-18.67) to 4.04 (95% CI 1.48-8.80), P = 0.0525; and Catheter-associated urinary tract infections 7.10 (95% CI 3.067-13.999) to 2.56 (95% CI 0.697-6.553), P = 0.0817; respectively. The microorganism analysis: 63 of the 99 isolated bacteria (63.6%) were Gram-negative bacteria (36.5% were resistant), 19 (19.2%) Gram-positive bacteria, and 17 (17.2%) were Candida spp. infections. CONCLUSIONS: The local surveillance systems provide information for dealing with nosocomial infections rates

INTRODUCCIÓN: Las infecciones nosocomiales son un problema de salud pública. Los sistemas nacionales de vigilancia permiten comparar datos e implementar medidas para mejorar la práctica asistencial. MÉTODO: Estudio multicéntrico, prospectivo, descriptivo y observacional. En 2007 se creó un sistema de vigilancia para infección nosocomial en las Unidades de Cuidados Intensivos Pediátricas Españolas. Se recogieron datos durante un mes (Marzo) por año (2008-2012). El objetivo fue reportar las tasas de los 5 años de vigilancia de la infección nosocomial y la evolución de las infecciones por microorganismos multirresistentes. RESULTADOS: Ingresaron 3667 pacientes. Número de pacientes con infección nosocomial: 90 (2.45%). Tasas medias de los 5 años de estudio: Bacteriemia relacionada con catéter 3.8/1000 días de catéter venoso central, Neumonía asociada a la ventilación mecánica 7.5/1000 días de tubo endotraqueal e Infecciones urinarias asociadas a sonda 4.1/1000 días de sonda urinaria. La comparación de tasas entre 2008 y 2009 no mostró diferencias estadísticamente significativas. Todas las tasas se redujeron homogéneamente desde 2009 a 2012: Bacteriemia relacionada con catéter 5.83 (95% CI 2.67-11.07) a 0.49 (95% CI 0.0125-2.76), P = 0.0029; Neumonía asociada a la ventilación mecánica 10.44 (95% CI 5.21-18.67) a 4.04 (95% CI 1.48-8.80), P = 0.0525; Infecciones urinarias asociadas a sonda 7.10 (95% CI 3.067-13.999) a 2.56 (95% CI 0.697-6.553), P = 0.0817; respectivamente. Microorganismos: 63 de 99 (83.6%) microorganismos aislados fueron bacterias gram-negativas (36.5% resistentes), 19 (19.2%) bacterias gram-positivas y 17 (17.2%) infecciones por Candida spp. CONCLUSIONES: Los sistemas de vigilancia local aportan información para mejorar las tasas de infección nosocomial

Relevance of level IIb neck dissection in oral squamous cell carcinoma

BACKGROUND: The purpose of this study was to determine the prevalence of level IIb metastasis in patients with oral squamous cell carcinomas (OSCCs). MATERIAL AND METHODS: A prospective analysis of 56 patients with OSCC who underwent surgical treatment of the primary lesion with simultaneous neck dissection was performed. During neck dissection, level IIb lymph nodes were separately removed and processed. Neck dissection was bilateral in 26 patients (46%) and unilateral in 30 patients (54%). RESULTS: The mean number of nodes found in the level IIb specimens was 4.7 (range: 0-8 nodes). The prevalence of metastasis at level IIb was 0% in pN0 necks and 3.4% in pN+ necks, with an overall prevalence of 1.8%. A significant association between metastasis to level IIb and type of neck dissection was observed. There were no isolated metastases to level IIb without the involvement of other nodes in the remaining neck specimen. Four regional recurrences were observed during follow-up. CONCLUSIONS: Based on our findings, we suggest that dissection of the level IIb region in patients with OSCC may be required only in patients with multilevel neck metastasis or if level IIa metastasis is found intraoperatively

Spontaneous fracture of the mandibular genial tubercles. A case report

No disponible

Fracture of the mandibular genial tubercles is an uncommon pathology affecting edentulous patients with severe maxillary atrophy. Usually occurs spontaneously which complicates the diagnosis. Their importance lies in the functional alterations, which occur as a consequence of the disinsertion of the genihyoid and genioglossus muscles. The treatment of fracture of the genial tubercles is controversial, including no surgical intervention, excision of the avulsed bone fragments,and muscular repositioning.There have been only 11 cases reported in the literature of this fracture, most of them spontaneous. We present a difficult diagnosis situation of spontaneous fracture of the genial tubercles in an 86-year-old edentulous female with a painful sublingual and submental hematoma and anterior cervical echimosis. Computerized Tomography should be made to confirm the diagnosis. Surgical treatment was not necessary, and follow-up at 6 months revealed complete symptomatic recovery, and full return of function

Immunohistochemical comparative study of the odontogenic keratocysts and other odontogenic lesions

Objectives: The present study was undertaken to compare the pattern of expression of EGFR, cyclin D1, Ki-67,p-53 and carcinoembryonic antigen (CEA) in the epithelial lining of odontogenic keratocysts, dentigerous cysts,radicular cysts and ameloblastomas.Methods: four micrometers, formalin-fixed, paraffin-embedded tissue sections from 11 odontogenic keratocysts,10 dentigerous cysts, 10 radicular cysts and 10 ameloblastomas were immunohistochemically studied.Results: There were statistically significant differences between cyclin D1 expression in odontogenic keratocysts and radicular cysts (p= 0.001) and ameloblastomas (p= 0.04). The differences in CEA expression between the fourstudied lesions were statistically significant (p< 0.0005). Proliferating cells were significantly more prevalent inodontogenic keratocysts (p< 0.0005) with a mean percentage of Ki-67 positively stained nuclei of 40%. In dentigerouscysts this mean was of 17%, of 15.5% in RC and of 7.8 in ameloblastomas.Conclusion: Some of these findings could support the theory that odontogenic keratocysts are neoplastic in origin,but other results clearly support that these lesions are developmental cysts with some neoplastic properties because of the high intrinsic growth potential (AU)

No disponible

Odontoma intraóseo erupcionado: una infrecuente patología / Intraosseus odontoma erupted into the oral cavity: an unusual pathology

Objetivos: Los odontomas que afectan a los tejidos blandos sonmuy infrecuentes, pudiendo presentarse bajo dos formas clinicas:odontoma periférico y odontoma erupcionado. Se documenta uncaso de odontoma erupcionado con el objetivo de discutir entreambas formas de presentación clínica de esta patología.Diseño del estudio: Estudio de caso.Resultados: Se presenta el caso de un varón con una masa duralocalizada en la región posterior del reborde alveolar izquierdodel maxilar superior, de un año de evolución y lento crecimiento.La ortopantomografía mostró la presencia de una tumoración radiodensaen la región posterior del maxilar izquierdo. El estudiohistológico de la pieza operatoria fue de odontoma complejo.Conclusiones: Hasta el momento se han documentado 11 casosde odontoma erupcionado en la literatura. A diferencia delodontoma periférico, el odontoma erupcionado suele ser del tipocomplejo, afectando a pacientes de mayor edad

Objectives: Odontoma arising in the extraosseous soft tissue isextremely uncommon. Two forms of odontoma are presentlyrecognized: peripheral odontoma and erupted odontoma. Wereport an erupted odontoma arising in the posterior maxilla,and discuss the main differences between both forms of clinicalpresentation.Study design: Case study.Results: A 23-year-old man presented with a firm gingival masson the left posterior maxilla, that had gradually enlarged overone year. Orthopantomography showed a dense radiopaquemass occupying the posterior portion of the left maxilla. Thepathology was reported as complex odontoma.Conclusions: This is the eleventh reported case of eruptedodontoma. Unlike peripheral odontoma, erupted odontoma isgenerally a complex odontoma, and affects older patients

Chondrosarcoma of the temporomandibular joint. A case report and review of the literature

Chondrosarcoma is a malignant tumor characterized by the formation of cartilage, but not bone, by tumor cells. Only 5%to 10% of chondrosarcomas occur in the head and neck, representing 0.1% of all head and neck neoplasms, with the larynxand the maxillo-nasal region being the most common sites. This report describes an unusual case of chondrosarcoma in a54-year-old man who presented with pain and swelling in the left preauricular area. Computed tomography demonstrateda soft tissue mass in the left temporomandibular joint without causing erosion of the adjacent bony structures. The tumorwas treated by excision in a single block with perilesional tissues, preserving the facial nerve. Histopathologic examinationrevealed chondrocytes with irregular nuclei with S-100 immunocytochemical staining positive in 30% of the tumor. Thediagnosis was a grade I chondrosarcoma. There was no evidence of disease at the 16-month follow-up. The occurrence ofchondrosarcoma in the temporomandibular joint (TMJ) is an exceptional event, with only 16 cases described. We report acase of this unusual entity and review the literature (AU)

Papillary cystadenoma and cystadenocarcinoma of salivary glands: Two unusual entities

No disponible

Cystadenoma and cystadenocarcinoma are rare salivary gland tumours histologically characterized by prominentcystic and frequently papillary growth. We present two cases of cystadenoma of a minor salivary gland (upper lip) and parotid cystadenocarcinoma respectively, captured between 834 salivary gland tumors studied in our hospital from 1980 to 2004. The authors review the clinical, histological, and biological features of these two unusual tumours, and differential diagnosis with other salivary glands neoplasms. Both entities usually reveal papillary proliferation of the epithelial lining and are composed of cells that possess bland cytomorphologic features. Differentiation of tumourtypes depends largely on the identification of actual infiltration of salivary gland parenchyma or surrounding connective tissue by either cystic or solid epithelium in cystadenocarcinomas. Step sections of a borderline tumour may yield unequivocal evidence of invasion. The authors discuss the problematic diagnosis between these rare neoplasms and with other tumours and compare histological findings of these two entities

Expresión de las proteínas de los proto-oncogenes ErbB y ErbB-4 en el carcinoma oral de células escamosas: estudio piloto / Expression of ErbB-3 and ErbB-4 protooncogene proteins in oral squamous cell carcinoma: a pilot study

Objetivos: Examinar la expresión de ErbB-3 y ErbB-4 en el carcinoma oral de células escamosas e investigar la posible relación existente entre la expresión de las proteínas codificadas por estos proto-oncogenes y las características patológicas y clínicas del cáncer oral. Diseño de estudio: Diecinueve casos de carcinomas orales de células escamosas (CCE) han sido analizados mediante inmunohistoquímica. Resultados: Se ha observado inmunotinción positiva para ErbB3 en 13 de los 19 casos estudiados (68 por ciento) y para ErbB-4 en 10 de 19 (52 por ciento). La intensidad de la inmunotinción en los casos ErbB-3 positivos fue baja en 8 (42,l por ciento) y alta en 5 (26,3 por ciento); siendo para los ErbB-4 positivos baja en 6 (31,6 por ciento) y elevada en 4 (21 por ciento) de los 19 casos. Se observó una correlación estadísticamente significativa entre la sobreexpresión de ErbB4 y el estadio TNM (coeficiente de correlación de Spearman = 0,467; P= 0,04). En el analisis de Kaplan-Meier se observó que la sobreexpresión de ErbB-3 y ERbB-4 no mostró relación significativa con la supervivencia (P= 0,05), la cual si fue apreciada entre esta y el estadio TNM (P= 0,04). Se observó una relación significativa entre la expresión de ErbB-3 y ErbB-4 v2=6,193; P= 0,037). Conclusiones: Los resultados del presente estudio sugieren que c-erbB-4 puede contribuir al desarrollo y progresión tumoral (AU)