BACKGROUND: Recurrent wheezing (RW) plays an important role in the morbidity and mortality of children during the first year of life in developing regions and its actual incidence in those areas is virtually unknown. METHODS AND RESULTS: This study describes the occurrence of wheezing during the first year of life in a birth cohort of 188 infants followed monthly and living in a poor urban area in Santiago de Chile. This study showed that 80.3 % of the infants in the cohort had one or more wheezing episode during the first year of life, 43.1 % had RW (3 or more wheezing episodes), 44.1 % had their first wheezing within the first three months of life and 13.3 % had pneumonia (PN). Having one or more episode of wheezing in the first three months of life was the main risk factor for suffering from RW during the first year and RW was a significant risk factor for having PN. CONCLUSIONS: This study found a high prevalence of RW in infants from a low-income population during the first year of life with the disease starting very early in their lives, progressing with more frequent episodes and being significantly associated to PN, particularly in the first 6 months of life.

Age of Onset↗

PubMedDate not supplied

[Can sural nerve biopsy be used to orientate the treatment of chronic inflammatory demyelinating polyneuropathy?].

INTRODUCTION: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired neuropathy characterized by demyelination of the peripheral nerves and roots. The course of the illness is progressively chronic or of relapses and remissions. Biopsy of the sural nerve is not essential for diagnosis. It is therefore not necessary to carry it out on all occasions, but probably permits a more rational approach to treatment. OBJECTIVE: To show whether biopsy of the sural nerve is useful for orientation of the treatment required in cases of CIDP. PATIENTS AND METHODS: We studied a total of 16 patients admitted to hospital with a diagnosis of CIDP. They had neurophysiological studies, sural nerve biopsy and other studies to rule out other diagnoses. The patients were assigned to the therapeutic protocols recommended. During 8 years of follow up we compared the response to treatment with intacglobin/plamapheresis, steroids and cytostatic drugs. RESULTS: It was highly significant (p< 0.001) that the patients with axon lesions on sural nerve biopsy did not respond to treatment with intac globin/plasmapheresis or steroids but did respond to cyclophosphamide, without any serious adverse effects being seen. CONCLUSIONS: Axonal histopathological lesions of CIDP at the onset of the disease may require cytostatic treatment since they do not usually improve on standard treatment. Sural biopsy is usually invaluable in such cases.

Adult↗

PubMedDate not supplied

[Recurring ischemic cerebral infarction caused by primary thrombocytosis in infancy].

INTRODUCTION: Ischemic cerebrovascular disease includes a set of entities that are produced by disorders in components of the blood, the blood flow, the walls of blood vessels or the heart, and can be anatomical, functional or even mixed. CASE REPORT: We describe the case of an 18-month-old male patient with compensated celiac disease, with repeated ischemic strokes in different territories, including the right posterior cerebral artery and middle cerebral artery, in the course of a hypercoagulable state due to essential thrombocytosis. Computerised axial tomography scans, brain angioresonance, a complete blood chemistry analysis and bone marrow biopsy were all performed and confirmed the previous diagnosis. Exchange transfusion, antiplatelet drugs and a platelet production inhibitor (anagrelide) were begun as therapy. At present, the patient is 2 years old and still has a slight direct hemiparesis, which is complete and predominantly faciobrachial, with no alterations to language. CONCLUSIONS: Cerebral infarctions in infancy are infrequent, and their presentation obliges the attending clinician to seek causes that are not usual. In our patient the hypocoagulability came about due to essential thrombosis, which is rare in infancy. The cause behind the infarction determines the chances of its recurring. Acetylsalicylic acid did not prove to be effective for this purpose. We suggest using carbamazepine for the treatment of kinesigenic dystonias.

Brain Ischemia↗

PubMedDate not supplied

[Neuropathies due to vasculitis in infancy].

INTRODUCTION: Vasculitis are characterised by the inflammatory infiltrate, chiefly of mononuclear cells, in the walls of the blood vessels, which can lead to occlusion with necrosis and the subsequent infarction of the affected tissue. AIMS: The Objective of this study was to determine the clinical, anatomicopathological and neurophysiological aspects of vasculitic neuropathies in infancy. PATIENTS AND METHODS: Each patient was submitted to the following tests: a complete hemogram, systemic lupus erythematosus cells (LE cells), lupus anticoagulant, antinuclear antibodies, neutrophil anticytoplasmic antibodies, venereal disease research laboratory test (VDRL), erythrocyte sedimentation rate, liver transaminases, serological testing for hepatitis C, B and A, cytochemical study of the cerebrospinal fluid, study of motor and sensory conduction, electromyography and nuclear magnetic resonance, when required; a biopsy of the sural nerve was performed, which was replaced by a necropsy if the patient died. RESULTS: 15 patients from a total of 25 who were studied had vasculitic neuropathies; the most usual presentation was multiple mononeuropathy; aetiologies found included microscopic polyangiitis, systemic lupus erythematosus, JRA, overlap syndrome and several undetermined vasculitis. Of the patients who were submitted to a biopsy, 75% showed signs of vasculitis, which affected the small and medium sized vessels in 62.5% of patients. CONCLUSIONS: The presence of neuropathy in association with symptoms and signs of systemic involvement suggested the possibility of a neuropathy in the course of a vasculitis. The examination of biopsy specimens of the sural nerve is useful for the diagnosis and classification of the aetiology of vasculitis. Response to treatment with immunosuppressant drugs was good, both in the case of the neuropathy and of the underlying disease.

Adolescent↗

PubMedDate not supplied

[Diagnostic reviews from a scientific and ethical viewpoint].

Explore the source record for details and available documents.

Aged↗