Anales españoles de pediatría
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Review Comparative Study
[Procalcitonin. A new marker for bacterial infection].
Procalcitonin is a polypeptide present in the plasma of healthy subjects in minimal levels (< 0.5 ng/ml). Serum procalcitonin is markedly increased a few hours after the administration of endotoxin to human volunteers and in invasive bacterial infection (sepsis, septic shock, meningitis). Procalcitonin is moderately increased in local bacterial infection (pneumonia pyelonephritis) and is unchanged in viral infections or bacterial colonization. ⋯ We studied 54 children with sepsis in whom plasma procalcitonin levels showed a positive correlation with the vasoactive drugs necessary to maintain cardiovascular activity. The semiquantitative procalcitonin test is simple and easy to use at the bedside at any time and in any hospital as no instruments are required. Within 30 minutes, the test identifies the type of infection and whether antibiotics are indicated.
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Case Reports Comparative Study
[Fatal hypernatremia due to accidental administration of table salt].
Hypernatremia is a common electrolyte abnormality, but it is rarely attributable to excess sodium. Hypernatremia due to exogenous salt intake, caused either by accidental ingestion or as a form of child abuse, is rare, difficult to manage and results in high mortality. Although hypernatremia is easily recognized by laboratory tests, its etiology is often difficult to determine. ⋯ In the second case, a mistake in the preparation of salt-saturated water as an oral rehydration solution provoked seizures, coagulopathy and longitudinal venous sinus thrombosis. Both cases developed encephalic death. We discuss the clinical course and the difficulties in the treatment of these cases in the context of the available literature.
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Biography Historical Article
[Virginia Apgar and her postnatal test half a century later].
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Chronic recurrent parotitis is an uncommon disease in childhood. Its cause remains unknown. ⋯ The epidemiological data were similar to those found by other authors. In all cases, diagnosis was made by sialography, a technique that may itself resolve symptoms. Ultrasonography is also useful and, because it is innocuous, it could be a first step investigation.
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High-frequency oscillatory ventilation (HFOV) constitutes an important advance in the management of children with respiratory failure. Although it has been used mainly as "lung rescue therapy", pediatric indications for HFOV can be broader. The principal advantages of this modality compared with conventional ventilation are the lower incidence of barotrauma, volutrauma, atelectrauma and biotrauma. To date, experience with HFOV in our country has been scarce and limited to neonatal patients. ⋯ HFOV is a safe and effective ventilatory modality in critically ill pediatric patients in whom conventional ventilation is not effective. To obtain better results, HFOV should be started early. Every child with refractory respiratory failure should be referred early to centers where HFOV can be offered.