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ABSTRACT: Lymphangioma of the tongue is a rare and benign tumour involving congenital and cystic abnormalities derived from lymphatic vessels. Treatment modalities include surgery and a large number of different intralesional injections of sclerosing agents. Presently, OK-432 (Picibanil(®)) is the preferred sclerosant and when administered intralesionally will result in inflammation, sclerosis, and cicatricial contraction of the lesion. We report a case of microcystic lymphangioma of the tongue in a 5-year-old boy treated with an intralesional injection of OK-432. In the immediate postoperative period, the patient suffered severe diffuse swelling, progressive upper airway obstruction with inspiratory stridor, and respiratory distress requiring emergency fiberoptic nasotracheal intubation. Although OK-432 injections are found to be safe and effective as a first line of treatment for lymphangiomas, local swelling with potentially life-threatening airway compromise should be anticipated, especially when treating lesions near the upper airway.
Archives de Pédiatrie 09/2011; 18(9):983-6. · 0.30 Impact Factor
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ABSTRACT: To determine the incidence, etiology and risk factors of nosocomial urinary tract infections (nUTI) in a second level Pediatric Intensive Care Unit (PICU).
A prospective study of 104 patients admitted to the PICU with a length of stay of more than 48 hours was carried out over a one year period (January to December 2009) to study the incidence and risk factors of nUTI. Urine samples were collected and cultured in all patients admitted for more than 48 hours to our PICU. Those needing indwelling urinary catheters had urine samples collected upon admission and every 24 hours until catheter retrieval, while those who did not need catheters had samples collected upon admission and every 48 hours until discharge from the PICU.
Six patients (5.8% of those admitted) were diagnosed of nUTI, with an incidence density of 5/1000 patients/day and 12.2/1000 catheterization days. Four of these were caused by E. coli (including a multiresistant strain), and two by C. albicans. Patients suffering nUTIs had significantly more relevant medical antecedents and a longer period of admittance than patients without nUTI. A statistically nonsignificant tendency towards increased infection risk was also found in younger patients and in those who needed an indwelling catheter for longer periods.
We found a higher incidence density of catheter associated nUTI than in other reports. This at least partially could be due to the characteristics of our patients, and to the exhaustive methodology used for detection.
Medicina Intensiva 03/2011; 35(6):344-8. · 1.07 Impact Factor
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ABSTRACT: Pediatric intensive care units have developed as treatment areas with a concentration of specialized equipment and personnel. Critically ill children often need to be moved to and from these critical care areas for diagnostic or therapeutic procedures. Such transport may pose additional risk to the critically ill patient.
In order to assess the problems encountered in our transport process, a prospective study was performed. A questionnaire was undertaken to evaluate the transport of critically ill children hospitalized in the Pediatric Intensive Care Unit of the Hospital Universitario Puerta del Mar from Cádiz over an eleven month period.
Two hundred children transported were evaluated. Forty-seven (23.5%) were interhospital transported patients and one hundred fifty-three (76.5%) were intrahospital transported patients. The most common type of intrahospital transport involves transfers between the operating room and the intensive care unit (73 patients, 36.5%). Deterioration in respiratory, cardiovascular and other physiological systems was registered in twenty-two patients (11%). One hundred four equipment-related mishaps were noted in eighty-six patients (43%) during the transport process. Dislodgement of intravenous catheters, loss of oxygen supply, endotracheal tube problems and equipment malfunction were the most common mishaps noted.
Our results would suggest that more training regarding the transport of the critically ill child are needed in our area.
Anales espanoles de pediatria 10/1996; 45(3):249-52.
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ABSTRACT: Foreign body aspiration is not an uncommon problem in infants and toddlers, and should be considered as a serious and sometimes fatal condition. We report three cases of foreign body aspiration which were located below the vocal cords, causing a nearly complete airway obstruction with severe respiratory distress. In all cases they were successfully removed in the emergency department using a laryngoscope and Magill forceps. It is important for physicians who take care of children in emergency department to know the management of these life-threatening situations. Knowledge of pediatric advanced life support measures with airway management and proper training in laryngoscope and Magill forceps management can save lives in many children.
Pediatric Emergency Care 11/1995; 11(5):302-3. · 0.78 Impact Factor
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ABSTRACT: We have performed 18 plasmapheresis [correction of plasma exchange] sessions in a group of 5 patients diagnosed as having Guillain-Barré Syndrome. These patients were diagnosed according to clinical, analytical and electromyographic criteria. In three patients we observed an obvious clinical improvement during the treatment. In one of the patients there was no appreciable evolution. This patient suffered from acute lymphocytic leukemia. We were unable to evaluate the remaining patient since this child underwent posthypoxic encephalopathy secondary to cardiac arrest. On the basis of the results obtained, we advocate the treatment of this polyneuropathy by plasmapheresis [correction of plasma exchange].
Anales espanoles de pediatria 10/1993; 39(3):240-2.
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Anales espanoles de pediatria 08/1990; 33(1):64-5.
