Arturo Hernández González

Hospital Universitario Puerta del Mar, Cádiz · Pediatría

The case of a 9 year-old-boy transferred to our Pediatric Intensive Care Unit (PICU) for mechanical ventilation, suffering a severe status asthmaticus is reported that did not respond to continuous intravenous infusion of beta 2-agonists, aminophylline and ketamine, and high doses of corticosteroids, anticholinergic drugs, and magnesium sulfate. O...

Objective To describe the different types of child deaths in Paediatric Intensive Care Units (PICU) in Spain, and to analyse the characteristics of those dying from a limitation of therapeutic effort (LET). Method A multicentre retrospective study by conducted by reviewing the hospital discharge reports corresponding to deceased patients in 8 Span...

Resumen Objetivo Describir los modos de muerte de los niños en las Unidades de Cuidados Intensivos Pediátricos (UCIP) en España y analizar las características de aquellos que fallecen tras decidir una limitación del esfuerzo terapéutico (LET). Métodos Estudio retrospectivo multicéntrico mediante revisión de informes de alta de los pacientes falle...

Introduction: Spinal muscular atrophy type 1 (SMA-1) is a progressive and fatal disease that leads to ethical problems for Paediatric professionals. Our objective was to determine the ethical options of Paediatric Intensive Care Unit (PICU) paediatricians as regards a child with SMA-1 and respiratory failure. Material and methods: A cross-sectio...

Introduction Bioethics has been recently incorporated in to the educational programs of both medical students and medical residents as part of their curriculum. However, its training based on clinical practice is not well structured. Objective To evaluate the knowledge of bioethics in Spanish paediatric residents, and to analyse how this relates t...

Bioethics has been recently incorporated in to the educational programs of both medical students and medical residents as part of their curriculum. However, its training based on clinical practice is not well structured. To evaluate the knowledge of bioethics in Spanish paediatric residents, and to analyse how this relates to the medical education...

The case of a 9 year-old-boy transferred to our Pediatric Intensive Care Unit (PICU) for mechanical ventilation, suffering a severe status asthmaticus is reported that did not respond to continuous intravenous infusion of beta 2-agonists, aminophylline and ketamine, and high doses of corticosteroids, anticholinergic drugs, and magnesium sulfate Onl...

Introducción La ventilación mecánica domiciliaria (VMD) es una técnica cada vez más frecuente en el niño. Existen pocos estudios que hayan analizado las características y necesidades de los niños sometidos a esta técnica. Material y métodos Estudio descriptivo observacional transversal multicéntrico de pacientes entre un mes y 16 años dependientes...

INTRODUCTION: Domiciliary mechanical ventilation (DMV) use is increasing in children. Few studies have analysed the characteristics of patients using this technique. MATERIALS AND METHODS: An observational, descriptive, transversal, multicentre study was conducted on patients between 1 month and 16 years of age dependent on domiciliary mechanical v...

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...

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 wi...

Objective: To determine the incidence, etiology and risk factors of nosocomial urinary tract infections (nUTI) in a second level Pediatric Intensive Care Unit (PICU). Patients and methods: 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 Decemb...

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...

To search for biochemical and molecular markers for the diagnosis of patients and carriers with 2-Methyl-3-hydroxybutyryl-CoA dehydrogenase (MHBD) deficiency. Organic acids in urine, MHBD activity in fibroblasts, immunoblotting and molecular studies were performed in seven patients. Seven carriers were also studied. Under low protein diet or poor f...

Ethical issues are of increasing interest in current medicine, and pediatrics is no exception. In critical care, the relevance of these considerations becomes even greater. Commonly used expressions in bioethics, frequently lead to terminological confusion and misunderstandings, as reported by several publications, revealing a lack of clear concept...

Ethical issues are of increasing interest in current medicine, and pediatrics is no exception. In critical care, the relevance of these considerations becomes even greater. Commonly used expressions in bioethics, frequently lead to terminological confusion and misunderstandings, as reported by several publications, revealing a lack of clear concept...

Concomitant administration of carbapenem antibiotics and valproic acid may produce a significant decrease in the plasmatic levels of this last one, as a consequence of mechanism interaction that is not yet established. We describe the cases of two lactants treated with valproic acid, that after beginning therapy with meropenem suffered a decrease t...

To assess physicians' awareness and experience of ethical problems that arise when dealing with critically ill children in pediatric intensive care units (PICUs). Questionnaires containing 20 questions about ethical dilemmas and attitudes related to the care of children admitted to PICUs were mailed to 43 PICUs in Spain. Ninety-five responses corre...

Objectives To asses physicians’ awareness and experience of ethical problems that arise when dealing with critically ill children in pediatric intensive care units (PICUs). Material and methods Questionnaires containing 20 questions about ethical dilemmas and attitudes related to the care of children admitted to PICUs were mailed to 43 PICUs in Sp...

Lemierre syndrome is a clinical entity characterized by an acute oropharyngeal infection that causes thrombophlebitis of the internal jugular vein and multiple septic embolisms that preferentially affect the lung. We describe the case of a 13 year old girl who was admitted to our unit due to cavitated pneumonia and thrombophlebitis of the internal...

Diagnosis of Leishmania infection maybe difficult to establish because its clinical presentation may be incomplete in cases of coinfection. We describe the case of a 6-year-old boy who presented severe meningococcal disease, prolonged fever and unsuspected Leishmania co-infection. The patient had no clinical evidence of immunosuppression prior to t...

Introduction: Termination of artificial life-support in critically-ill patients without chance of recovery or with severe damage is frequent in the intensive care unit (UCI). Patients and methods: We studied the present situation concerning the withdrawal of life support in Spain using data collected over 10 years in referral hospitals with pediatr...

The case of a 9 year-old-boy transferred to our Pediatric Intensive Care Unit (PICU) for mechanical ventilation, suffering a severe status asthmaticus is reported that did not respond to continuous intravenous infusion of beta 2-agonists, aminophylline and ketamine, and high doses of corticosteroids, anticholinergic drugs, and magnesium sulfate. On...

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 pro...

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...

We present two cases of hyponatremia caused by loss of cerebrospinal fluid through temporary ventricular drains in two infants with hydrocephalus. When treating these types of patients, pediatricians should take into account the possibility that electrolyte disturbance can develop, so they may be able to prevent it by replacing the lost volume with...

Background. The most common electrolytic abnormality observed in hospitalized children is hyponatremia. Sometimes this abnormality can produce severe brain damage. Main factors determining the development of clinical symptomatology include: the rate of fall in serum sodium, severity and duration of hyponatremia and the serum sodium increase rate du...

Four cases of obstructive sleep apnea syndrome (OSAS) secondary to tonsillar hypertrophy are reported. All the patients had breathing problems during sleep and episodes of obstructive apnea, inspiratory stridor, and hypoxemia. Two patients were at risk: a patient with Down's syndrome and a patient with dysmorphia and micrognathia. The third child h...

We report a case of a two years old girl who was admitted in our Pediatric Intensive Care Unit affected of hypovolemic shock secondary to duodenal rupture and peritonitis. Injuries caused by accident were suspected, although child abuse was presumed and later confirmed due to inconsistencies in her mother's explanations. We wish to emphasize that c...

Since children with cystic fibrosis have a high content of salt in the sweat, they are liable to suffer severe dehydration and electrolyte depletion when long exposed to hot climatic conditions. We present the cases of two girls diagnosed of cystic fibrosis (aged 26/12 and 13/12 years, respectively) who were admitted to our pediatric intensive care...

The castor-oil plant is distributed widely in our region and is used sometimes as an ornamental plant. Ingestion of castor-oil beans can cause severe, potentially fatal intoxication. Although there are many reports in the international literature, we found no cases of castor-oil bean intoxication in the recent Spanish literature. We present the cas...

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...

Cardiorespirography is a method of monitoring which establishes a correlation between cardiac and respiratory activity. During the first twelve hours following birth cardiorespirographic parameters undergo a series of evolutionary modifications, becoming stable between the sixth and twelfth hours. Authors analyse how the manner in which birth is te...