Anales españoles de pediatría
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Randomized Controlled Trial Clinical Trial
[Efficacy of early administration of nebulized ipratropium bromide in children with asthmatic crisis].
To determine the efficacy of adding ipratropium bromide to nebulized salbutamol in the treatment of children with moderate-to-severe acute asthma attacks. ⋯ Coadministration of ipratropium bromide and repeat doses of nebulized salbutamol produced a small beneficial clinical effect compared with administration of nebulized salbutamol alone. This beneficial effect was related to a decrease in the hospitalization rate, particularly in patients with severe asthma attacks.
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To describe the epidemiological characteristics, clinical features and prognostic indicators of pneumococcal meningitis in children admitted to a children's hospital in Madrid. ⋯ Meningitis caused by S. pneumoniae is a significant cause of morbidity and mortality in children. Deafness is one of the most common and serious sequelae of pneumococcal meningitis. Sequelae were associated with coma, alterations in CT scan, seizures and hypoglycorrhachia. The new, antipneumococcal conjugated vaccine will confer effective prevention from the age of 2 months and will produce a dramatic decrease in the incidence of this serious infection.
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The aim of this study was to analyze the neurological disorders in the Pediatric Intensive Care Unit (PICU) of the Hospital Infantil Miguel Servet in Zaragoza, Spain. Children admitted to the PICU between May 15, 1990 and December 1999 were studied. The information was obtained from the Neuropediatric Department's database, which includes all the children admitted to the PICU with neurological disorders. ⋯ Neurological disorders represent a large part of the activity in our PICU. Some common disorders such as acute encephalopathy or convulsions are difficult to diagnose, given that they may be a manifestation of several neurological and non-neurological disorders. Some of the neurological disorders that require intensive care, such as head injury and several forms of acute encephalopathy, are associated with high morbidity and mortality.
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The absence of the hyperintense signal of the posterior pituitary in magnetic resonance imaging (MRI) is considered by some authors to be evidence of neurohypophyseal dysfunction. To evaluate the utility of MRI as a complementary diagnostic aid in patients with central diabetes insipidus (CDI), we studied the MR images of pediatric patients at diagnosis and during follow-up. ⋯ 1. In most of the patients with CDI the hyperintense signal of the posterior pituitary was absent at diagnosis; however in one patient this signal disappeared during follow-up and consequently its presence does not rule out a diagnosis of CDI. 2. Although a thickened pituitary stalk could reflect only a non-specific, transient inflammatory process, its presence makes ruling out tumoral or infiltrative disease obligatory.