Archivos argentinos de pediatría
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Arch Argent Pediatr · Oct 2013
Case Reports[Protein losing gastroenteropathy and possible relationship to cytomegalovirus infection: Ménétrier disease in a child].
Ménétrier's disease is a childhood protein-losing gastroenteropathy characterized by hypertrophy of the gastric mucosa, of unknown etiology, although most of reported cases have been associated with viral infections. Clinical manifestation is edema and biochemically there are hypoproteinemia and hypoalbuminemia. This disease is very rare in children and they have a benign and self-limiting course in contrast to adults where tend to be chronic and occasionally to become malignant. We present a child with Ménétrier disease with edema and ascites possibly associated with a cytomegalovirus infection.
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Arch Argent Pediatr · Jul 2013
Randomized Controlled Trial Comparative StudyHypotonic versus isotonic maintenance fluids in critically ill pediatric patients: a randomized controlled trial.
Hypotonic fluids have been associated with the development of iatrogenic hyponatremia. ⋯ Neither hypotonic nor isotonic maintenance fluids increased the risk of developing iatrogenic hyponatremia with the 24 hour infusion.
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Hydrofluoric acid is a highly dangerous substance with industrial and domestically appliances. Clinical manifestations of poisoning depend on exposure mechanism, acid concentration and exposed tissue penetrability. Gastrointestinal tract symptoms do not correlate with injury severity. ⋯ We present a 5 year old girl who accidentally swallowed 5 ml of 20% hydrofluoric acid. We performed gastrointestinal tract endoscopy post ingestion, which revealed erythematous esophagus and stomach with erosive lesions. Two months later, same study was performed and revealed esophagus and stomach normal mucous membrane.
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As a result of the increased number of both diagnostic and therapeutic procedures in pediatric outpatients, sedation and analgesia have gained relevance in this context. ⋯ In this group of patients, intravenous outpatient sedation and analgesia administered by a specialized team were safe and effective.
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There is currently a deficiency of physicians in pediatric intensive care units (PICU). The cause of this deficit is multifactorial, although the burnout phenomenon has been described as relevant. ⋯ A significant percentage of doctors working in the PICU of Argentina have a high risk of burnout syndrome and a low expectation of continuing in the field.