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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J. Deaf children with additional disabilities (AD+): CODEPEH recommendations. Acta Otorrinolaringol Esp (Engl Ed) 2023; 74:386-396. [PMID: 37149127 DOI: 10.1016/j.otoeng.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/10/2022] [Indexed: 05/08/2023]
Abstract
Approximately 40% of children with deafness have an additional developmental disorder or major medical problem, which may delay the age of diagnosis of hearing loss and/or require intervention by other professionals. This situation is referred to as "deafness with added disability" (AD+). The reason why the population of hearing-impaired children is more likely to have associated added disabilities is that the risk factors for hearing impairment overlap with those for many other disabilities. These factors can influence various aspects of development, including language acquisition. It is important to check that appropriate care is received, the effectiveness of hearing aids or implants, as well speech therapy intervention strategies, and family adherence to sessions and appointments. The challenge posed by AD+ is early detection, to allow early and appropriate intervention, and the need for fluid transdisciplinary collaboration between all professionals involved, together with the involvement of the family.
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Epalza C, Prieto-Tato L, Pino R, Escartín-Paredes P, Leoz I, Grasa C, Vivanco-Allende A, Rivière JG, Carrasco-Colom J, Villate O, Fumadó V, Hermoso-Ibañez C, Herrero B, Aguilera-Alonso D, Tagarro A, Moraleda C. Safety and Acceptance of COVID-19 Vaccination After Multisystem Inflammatory Syndrome in Children (MIS-C) in Spain. J Pediatric Infect Dis Soc 2022; 11:471-473. [PMID: 35904132 PMCID: PMC9384566 DOI: 10.1093/jpids/piac076] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In this cohort of 42 adolescents with a previous multisystem inflammatory syndrome (MIS-C) diagnosis, 32 (76.2%) were vaccinated with COVID-19 vaccines, with a low incidence of relevant adverse events. More importantly, no new MIS-C or myocarditis occurred after a median of 10 weeks (range 5.3-19.7) post-vaccination.
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Affiliation(s)
- Cristina Epalza
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain,Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12), Madrid, Spain,Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain,RITIP (Translational Research Network in Pediatric Infectious Diseases), Madrid, Spain
| | - Luis Prieto-Tato
- Corresponding Author: Luis Prieto-Tato, PhD, Hospital Universitario 12 de Octubre, Servicio de Pediatría, Avenida de Córdoba s/n, 28041 Madrid, Spain. E-mail:
| | - Rosa Pino
- Department of Pediatrics, Hospital Universitario Sant Joan de Deu, Barcelona, Spain
| | - Paula Escartín-Paredes
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Inés Leoz
- Pediatric Intensive Care Unit, Pediatrics Department, Hospital Universitario Niño Jesús, Madrid, Spain
| | - Carlos Grasa
- Pediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain,RITIP (Translational Research Network in Pediatric Infectious Diseases), CIBER en Enfermedades Infecciosas (CIBERINFEC) (ISCIII), Madrid, Spain
| | - Ana Vivanco-Allende
- Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Jacques G Rivière
- Infection in Immunocompromised Pediatric Patients Research Group, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, Barcelona, Spain,Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d’Hebron, Barcelona, Spain,Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Barcelona, Spain
| | - Jaume Carrasco-Colom
- Pediatric Infectious Diseases Unit, Pediatric Department, Hospital Universitario Son Espases, Palma (Illes Balears), Spain
| | - Olatz Villate
- Pediatric Oncology Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Victoria Fumadó
- Pediatric Infectious Diseases Unit, Pediatric Department, Hospital Universitario Sant Joan de Deu, Barcelona, Spain
| | - Concepción Hermoso-Ibañez
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Blanca Herrero
- Pediatric Hemato-Oncology Unit, Pediatric Department, Hospital Universitario Niño Jesús, Madrid, Spain
| | - David Aguilera-Alonso
- Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12), Madrid, Spain,Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain,RITIP (Translational Research Network in Pediatric Infectious Diseases), Madrid, Spain,Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiGM), Madrid, Spain,CIBER en Enfermedades Infecciosas (CIBERINFEC) (ISCIII), Madrid, Spain
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3
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J. Ototoxicity in childhood: Recommendations of the CODEPEH (Commission for the Early Detection of Childhood Hearing Loss) for prevention and early diagnosis. Acta Otorrinolaringol Esp (Engl Ed) 2022; 73:255-265. [PMID: 35872300 DOI: 10.1016/j.otoeng.2022.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/18/2021] [Indexed: 11/22/2022]
Abstract
Ototoxicity is defined as the damage, reversible or irreversible, produced in the inner ear by various substances that are called ototoxic and that can cause hearing loss and/or an alteration of the vestibular system. Permanent hearing loss significantly affects quality of life and is especially important in children. The lack or delay in its detection is frequent, since it often progresses in an inconspicuous manner until it affects communication and overall development. This impact can be minimized by following a strategy of audiological monitoring of ototoxicity, which allows for its early detection and treatment. This document recommends that children who are going to be treated with cisplatin or aminoglycosides be monitored. This CODEPEH review and recommendation document focuses on the early detection, prophylaxis, otoprotection, monitoring and treatment of ototoxicity caused by aminoglycosides and platinum-based antineoplastics in the paediatric population.
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Villanueva-Fernández E, Casanueva-Muruáis R, Vivanco-Allende A, Llorente JL, Coca-Pelaz A. Role of steroids in conservative treatment of parapharyngeal and retropharyngeal abscess in children. Eur Arch Otorhinolaryngol 2022; 279:5331-5338. [PMID: 35767057 PMCID: PMC9519669 DOI: 10.1007/s00405-022-07423-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/25/2022] [Indexed: 11/17/2022]
Abstract
Purpose To characterize the clinical features and outcomes of pediatric patients with retropharyngeal (RPA) or parapharyngeal abscesses (PPA) managed only with medical treatment and showing the importance of early symptoms and imaging studies in the diagnosis of deep neck space infections (DNIs) in children. Methods A retrospective analysis of all patients diagnosed with RPA and PPA between 2007 and 2017 was performed in Hospital Universitario Central de Asturias. Results 30 children were identified, with 11 RPA and 19 PPA. 23 children (76.7%) were under 5 years old, and all were treated with intravenous amoxicillin/clavulanic acid and corticosteroids. Torticollis and fever were present in all patients. The mean length of hospital stay was 7.5 days. There were no complications associated. Conclusion DNIs can be treated in a conservative way, reserving the surgical drainage for cases with a complication associated (airway compromise, lack of response to antibiotic therapy, immunocompromised patients). Treatment with intravenous antibiotics and corticosteroids is a safe option, reducing the duration of symptoms and the length of hospital stay.
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Affiliation(s)
- Eva Villanueva-Fernández
- Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 3301, Oviedo, Spain.
| | - R Casanueva-Muruáis
- Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 3301, Oviedo, Spain
| | - A Vivanco-Allende
- Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J L Llorente
- Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 3301, Oviedo, Spain.,University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, CIBERONC, Oviedo, Spain
| | - A Coca-Pelaz
- Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 3301, Oviedo, Spain.,University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, CIBERONC, Oviedo, Spain
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5
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Pérez-Pérez A, Vivanco-Allende A, Concha-Torre A, Rey Galán C. Experiencia de una UCIP asistiendo pacientes adultos durante la pandemia por COVID-19. An Pediatr (Barc) 2022; 97:370-371. [PMID: 35754555 PMCID: PMC9212913 DOI: 10.1016/j.anpedi.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Alicia Pérez-Pérez
- UCI Pediátrica, Hospital Universitario Central de Asturias, Oviedo, España
| | - Ana Vivanco-Allende
- UCI Pediátrica, Hospital Universitario Central de Asturias, Oviedo, España
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España
| | - Andrés Concha-Torre
- UCI Pediátrica, Hospital Universitario Central de Asturias, Oviedo, España
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España
| | - Corsino Rey Galán
- UCI Pediátrica, Hospital Universitario Central de Asturias, Oviedo, España
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España
- Red para el Desarrollo de la Salud Materno-Infantil (REDSAMID), Instituto de Salud Carlos III, Madrid, España
- Área de Pediatría, Universidad de Oviedo, Oviedo, España
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Mayordomo-Colunga J, Vivanco-Allende A, López-Alonso I, López-Martínez C, Fernández-Vega I, Gil-Peña H, Rey C. SARS-CoV-2 Spike Protein in Intestinal Cells of a Patient with Coronavirus Disease 2019 Multisystem Inflammatory Syndrome. J Pediatr 2022; 243:214-218.e5. [PMID: 34843710 PMCID: PMC8626144 DOI: 10.1016/j.jpeds.2021.11.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 12/30/2022]
Abstract
A previously healthy 12-year-old boy had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related multisystem inflammatory syndrome (MIS-C) that was rapidly fatal. Autopsy revealed the presence of a large intracardiac thrombus. SARS-CoV-2 spike protein was detected in intestinal cells, supporting the hypothesis that viral presence in the gut may be related to the immunologic response of MIS-C.
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Affiliation(s)
- Juan Mayordomo-Colunga
- Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Centro de Investigación Biomédica En Red-Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
| | - Ana Vivanco-Allende
- Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Inés López-Alonso
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain,Centro de Investigación Biomédica En Red–Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain,Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Cecilia López-Martínez
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain,Centro de Investigación Biomédica En Red–Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Iván Fernández-Vega
- Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Helena Gil-Peña
- Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Corsino Rey
- Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain,Department of Pediatrics, University of Oviedo, Oviedo, Spain,Maternal and Child Health and Development Research Network, Institute of Health Carlos III, Madrid, Spain
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7
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J, Olleta Lascarro I. New-born Hearing Screening Programmes in 2020: CODEPEH Recommendations. Acta Otorrinolaringol Esp (Engl Ed) 2021; 72:312-323. [PMID: 34535222 DOI: 10.1016/j.otoeng.2020.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 10/20/2022]
Abstract
Programmes for early detection of congenital hearing loss have been successfully implemented mainly in developed countries, after overcoming some conceptual errors argued against their implementation and some criticism of their efficacy. However, some difficulties and weaknesses are still identified in these programmes: the detection of late-onset hearing loss and the percentage of children who did not pass the screening and did not complete the process of diagnosis and treatment, these being cases that are lost in the process. The purpose of this Document is to analyse these problems to determine areas for improvement and to emphasize one of the basic principles for the success of the programmes: continuous training for the interdisciplinary team. The result of the review process carried out by CODEPEH has been drafted as Recommendations for updating the Programmes with the evidence of the last decade, including advances in screening technology, the impact of the present knowledge on congenital infection by cytomegalovirus, genetic hearing loss research and control systems of lost to follow-up cases, treatment and follow up.
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J, Olleta Lascarro I. Programas de cribado de la hipoacusia congénita en 2020: recomendaciones CODEPEH. Acta Otorrinolaringológica Española 2021. [DOI: 10.1016/j.otorri.2020.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Alonso A, Anés G, Vivanco-Allende A, Menezes A, Hevia M, Santos F. Unrelenting lumbar pain in a female adolescent: Answers. Pediatr Nephrol 2021; 36:309-312. [PMID: 32556956 DOI: 10.1007/s00467-020-04626-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Agustina Alonso
- Department of Pediatrics, Hospitalization and Emergency Unit, Hospital Universitario Central de Asturias, Health Service of the Principality of Asturias, 33011, Oviedo, Spain
| | - Gonzalo Anés
- Department of Radiology, Pediatric Radiology Unit, Hospital Universitario Central de Asturias, Health Service of the Principality of Asturias, 33011, Oviedo, Spain
| | - Ana Vivanco-Allende
- Department of Pediatrics, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Health Service of the Principality of Asturias, 33011, Oviedo, Spain
| | - Ana Menezes
- Department of Radiology, Interventional Radiology Unit, Hospital Universitario Central de Asturias, Health Service of the Principality of Asturias, 33011, Oviedo, Spain
| | - Miguel Hevia
- Department of Urology, Hospital Universitario Central de Asturias, Health Service of the Principality of Asturias, 33011, Oviedo, Spain
| | - Fernando Santos
- Department of Pediatrics, Pediatric Nephrology, Hospital Universitario Central de Asturias, Medical School, Health Service of the Principality of Asturias, University of Oviedo, 33011, Oviedo, Spain.
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Alonso A, Anés G, Vivanco-Allende A, Menezes A, Hevia M, Santos F. Unrelenting lumbar pain in a female adolescent: Questions. Pediatr Nephrol 2021; 36:307-308. [PMID: 32556958 DOI: 10.1007/s00467-020-04625-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Agustina Alonso
- Department of Pediatrics, Hospitalization and Emergency Unit, Health Service of the Principality of Asturias, Hospital Universitario Central de Asturias, 33011, Oviedo, Spain
| | - Gonzalo Anés
- Department of Radiology, Pediatric Radiology Unit, Health Service of the Principality of Asturias, Hospital Universitario Central de Asturias, 33011, Oviedo, Spain
| | - Ana Vivanco-Allende
- Department of Pediatrics, Pediatric Intensive Care Unit, Health Service of the Principality of Asturias, Hospital Universitario Central de Asturias, 33011, Oviedo, Spain
| | - Ana Menezes
- Department of Radiology, Interventional Radiology Unit, Health Service of the Principality of Asturias, Hospital Universitario Central de Asturias, 33011, Oviedo, Spain
| | - Miguel Hevia
- Department of Urology, Health Service of the Principality of Asturias, Hospital Universitario Central de Asturias, 33011, Oviedo, Spain
| | - Fernando Santos
- Department of Pediatrics, Pediatric Nephrology, Hospital Universitario Central de Asturias, Medical School, Health Service of the Principality of Asturias, University of Oviedo, 33011, Oviedo, Spain.
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Rodríguez-García L, Concha-Torre A, Rojo-Alba S, Melón-García S, Vivanco-Allende A, Rey Galán C. Influenza and Respiratory Syncytial Bronchiolitis, Are There Any Differences? Indian J Pediatr 2020; 87:1084. [PMID: 32399758 DOI: 10.1007/s12098-020-03334-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Lucía Rodríguez-García
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
| | - Andrés Concha-Torre
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Susana Rojo-Alba
- Laboratory of Virology, Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Santiago Melón-García
- Laboratory of Virology, Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Ana Vivanco-Allende
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Corsino Rey Galán
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.,University of Oviedo, Oviedo, Asturias, Spain
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Vivanco-Allende A, Rey C, Concha A, Martínez-Camblor P, Medina A, Mayordomo-Colunga J. Validation of a Therapeutic Intervention Scoring System (TISS-28) in critically ill children. Anales de Pediatría (English Edition) 2020. [DOI: 10.1016/j.anpede.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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13
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Menéndez Del Castro M, Coca-Pelaz A, Menéndez S, Vivanco-Allende A, Pedregal-Mallo D, García-Cabo P, Fernández-Vañes L, Llorente JL. Retropharyngeal abscess and mediastinitis as an uncommon complication of varicella infection. Int J Pediatr Otorhinolaryngol 2020; 132:109904. [PMID: 32018164 DOI: 10.1016/j.ijporl.2020.109904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/21/2020] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
Varicella infection is one of the most common and contagious infection in children and could course with severe complications. We report the case of a 4-year-old patient derived to our hospital for suspicion of suppurative complication in the context of a varicella infection. A computerized tomographic scanning was performed, showing a large retropharyngeal abscess with mediastinitis. Complications of varicella are up to 2% of patients, but this is the first report of a retropharyngeal and mediastinal abscess in this context. In the face of clinical suspicion, early intervention is important through imaging, intravenous antibiotics and surgical drainage in necessary cases.
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Affiliation(s)
| | - Andrés Coca-Pelaz
- Department of Otolaryngology. Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturia, IUOPA, Oviedo, Spain
| | - Sergio Menéndez
- Pediatric Intensive Care Unit, Department of Pediatrics. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ana Vivanco-Allende
- Pediatric Intensive Care Unit, Department of Pediatrics. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Daniel Pedregal-Mallo
- Department of Otolaryngology. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Patricia García-Cabo
- Department of Otolaryngology. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Laura Fernández-Vañes
- Department of Otolaryngology. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - José Luis Llorente
- Department of Otolaryngology. Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturia, IUOPA, Oviedo, Spain
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J. Early Diagnosis and Treatment of Unilateral or Asymmetrical Hearing Loss in Children: CODEPEH Recommendations. Acta Otorrinolaringologica (English Edition) 2020. [DOI: 10.1016/j.otoeng.2018.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J. Early diagnosis and treatment of unilateral or asymmetrical hearing loss in children: CODEPEH recommendations. Acta Otorrinolaringol Esp (Engl Ed) 2020; 71:45-55. [PMID: 30579510 DOI: 10.1016/j.otorri.2018.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 09/20/2018] [Indexed: 11/28/2022]
Abstract
The aim of this document is to improve the management and the treatment of unilateral or asymmetrical hearing loss in children. One in one thousand newborn infants has unilateral hearing loss and this prevalence increases with age, due to cases of acquired and delayed-onset hearing loss. Although the impact on the development and learning processes of children of these kinds of hearing loss have usually been minimized, if they are not treated they will impact on language and speech development, as well as overall development, affecting the quality of life of the child and his/her family. The outcomes of the review are expressed as recommendations aimed at clinical diagnosis and therapeutic improvement for unilateral or asymmetrical hearing loss.
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Vivanco-Allende A, Rey C, Concha A, Martínez-Camblor P, Medina A, Mayordomo-Colunga J. [Validation of a Therapeutic Intervention Scoring System (TISS-28) in critically ill children]. An Pediatr (Barc) 2019; 92:339-344. [PMID: 31776065 DOI: 10.1016/j.anpedi.2019.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/23/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION There are numerous scales in intensive care units that are used to quantify the severity of patients. Most of them are very useful, although sometimes laborious to complete, thus limiting their use in usual practice. One of these scales, the Therapeutic Intervention Scoring System (TISS 76), has been validated in adult and paediatric units. Its simplified and updated version, the Simplified Therapeutic Intervention Scoring System (TISS 28), has not yet been validated in paediatric units. The aim of this study is to validate TISS 28, in order to have a simple and rapid scale. MATERIAL AND METHOD A prospective non-interventional observational study was conducted in a Paediatric Intensive Care Unit (PICU) of a university hospital. Data were collected from 935 consecutive patients admitted to the PICU over a 3-year period. These included the values of TISS 76 and TISS 28 during the first 4days of admission and the subsequent outcome of the patients. RESULTS The mean values of TISS 76 and TISS 28 for the first day of admission were 18.27 and 18.02, respectively. Values were higher in patients who had sequelae or died (17.58 versus 27.23 and 37.44, respectively for TISS 76 (P<.01); and 17.51 versus 23.80 and 33.44, respectively for TISS 28 (P<.01). A very good correlation was found between TISS 76 and TISS 28, with Pearson correlation and intraclass correlation coefficients> 0.9 (except for the 2nd day). The correlation equation for the overall 4 days was: TISS76=- 1.74+1.05×TISS28. TISS 28 was able to explain 82.4% of variability of TISS 76. The area under the curve with a confidence interval (CI) of 95% for the first day was 0.80 (0.73-0.87) for TISS 76, and 0.76 (0.67-0.84) for TISS 28. CONCLUSIONS On observing the results obtained, TISS 28 can replace TISS 26 in our PICU, without worsening the information provided. Being a reliable scale and easier to apply, its practical application could be useful.
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Affiliation(s)
- Ana Vivanco-Allende
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España.
| | - Corsino Rey
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España; Universidad de Oviedo
| | - Andrés Concha
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España
| | - Pablo Martínez-Camblor
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, 7 Lebanon Street, Suite 309, Hinman Box 7251, Hanover, NH 03755, USA
| | - Alberto Medina
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España; CIBER-Enfermedades Respiratorias. Instituto de Salud Carlos III, Madrid, España
| | - Juan Mayordomo-Colunga
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España; CIBER-Enfermedades Respiratorias. Instituto de Salud Carlos III, Madrid, España
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Rodriguez Garcia L, Medina A, Modesto I Alapont V, Palacios Loro ML, Mayordomo-Colunga J, Vivanco-Allende A, Rey C. Safety of aerosol therapy in children during noninvasive ventilation with helmet and total face mask. Med Intensiva 2018; 43:474-479. [PMID: 30060892 DOI: 10.1016/j.medin.2018.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/18/2018] [Accepted: 06/04/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the consequences of using nebulized drugs in patients subjected to noninvasive ventilation (NIV) with total face mask (TFM) and helmet. DESIGN A descriptive analytical study of a prospective patient cohort was carried out. AMBIT Pediatric intensive care unit (PICU) of a tertiary hospital. PATIENTS Consecutive sampling was used to include all patients admitted to the PICU and requiring NIV with helmet or TFM over a period of 29 months. No patients were excluded. INTERVENTIONS Nebulized treatment was added according to medical criteria. VARIABLES OF INTEREST Independent variables were age, sex, diagnosis, disease severity, ventilation parameters and nebulized drugs (if administered). Secondary outcomes were duration and failure of NIV, and length of PICU stay. RESULTS The most frequent diagnoses were bronchiolitis (60.5%) and asthma (23%). Patients received NIV for a median of 43h. Nebulized drugs were administered in 40% of the cases during NIV, and no adverse effects were registered. Using Bayesian statistics, the calculated probability of suffering an adverse effect was 1.3% with helmet and 0.5% with TFM (high density 95% probability intervals). Patients with helmet and nebulized therapy were in more serious condition than those who did not receive nebulization; nevertheless, no differences were observed regarding the need to change to bilevel modality. With TFM, PICU stay was shorter for the same degree of severity (p=0.033), and the NIV failure rate was higher in patients who did not receive inhaled drugs (p=0.024). CONCLUSIONS The probability of suffering an adverse effect related to nebulization is extremely low when using a helmet or TFM. Inhaled therapy with TFM may shorten PICU stay in some patients.
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Affiliation(s)
- L Rodriguez Garcia
- Paediatric Intensive Care Unit, Department of Paediatrics, Complejo Asistencial Universitario de León, León, Spain.
| | - A Medina
- Paediatric Intensive Care Unit, Department of Paediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain; CIBERes
| | - V Modesto I Alapont
- Department of Anesthesiology and Critical Care, Hospital Universitari i Politècnic La Fe de Valencia, Valencia, Spain
| | - M L Palacios Loro
- Department of Paediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Mayordomo-Colunga
- Paediatric Intensive Care Unit, Department of Paediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain; CIBERes
| | - A Vivanco-Allende
- Paediatric Intensive Care Unit, Department of Paediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - C Rey
- Paediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain
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18
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Mayordomo-Colunga J, Rey C, Medina A, Martínez-Camblor P, Vivanco-Allende A, Concha A. Helmet Versus Nasal-Prong CPAP in Infants With Acute Bronchiolitis. Respir Care 2018; 63:455-463. [PMID: 29382794 DOI: 10.4187/respcare.05840] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Nasal prongs are frequently used to deliver noninvasive CPAP in bronchiolitis, especially in the youngest children. A helmet interface is an alternative that might be comparable to nasal prongs. We sought to compare these interfaces. METHODS We performed a prospective, randomized, crossover, single-center study in an 8-bed multidisciplinary pediatric ICU in a university hospital. Infants age <3 months who were consecutively admitted to the pediatric ICU during a bronchiolitis epidemic season and fulfilled inclusion criteria were recruited. Subjects were randomly allocated to receive CPAP via a helmet or nasal prongs for 60 min. The subjects were then placed on the other CPAP system for another 60-min period (helmet then nasal prongs [H-NP] or nasal prongs then helmet [NP-H]). Measurements were taken at 30, 60, 90, and 120 min. Failure was defined as the need for further respiratory support. RESULTS Sixteen subjects were included, with 9 in the H-NP group and 7 in the NP-H group. CPAP significantly reduced respiratory distress, showing no differences between the H-NP and NP-H groups in terms of improving the Modified Wood's Clinical Asthma Score from 4.8 ± 1 to 3 ± 0.9 and 2.7 ± 1.7 points at 60 min and 120 min in the H-NP group, respectively, and from 4.2 ± 0.9 to 2.8 ± 0.9 and to 2.9 ± 0.9 at 60 min and 120 min, respectively, in the NP-H group. Sedatives were used in only 3 subjects (2 in the NP-H group, P = .77). The failure rate was similar in both groups (3 of 9 subjects vs 3 of 7 subjects, P = .70). No significant differences were seen for heart rate, breathing frequency, FIO2 , or transcutaneous oxygen saturation response. CONCLUSIONS Our results suggest that CPAP delivered by nasal prongs and CPAP delivered by helmet are similar in terms of efficacy in young infants with acute bronchiolitis.
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Affiliation(s)
- Juan Mayordomo-Colunga
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain.
| | - Corsino Rey
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain
| | - Alberto Medina
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain
| | - Pablo Martínez-Camblor
- Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire, and with the Universidad Autónoma de Chile, Santiago, Chile
| | - Ana Vivanco-Allende
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain
| | - Andrés Concha
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain
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Sariego-Jamardo A, Rey C, Medina A, Mayordomo-Colunga J, Concha-Torre A, Prieto B, Vivanco-Allende A. C-reactive protein, procalcitonin and interleukin-6 kinetics in pediatric postoperative patients. J Crit Care 2017; 41:119-123. [PMID: 28514716 DOI: 10.1016/j.jcrc.2017.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/04/2017] [Accepted: 05/10/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Andrea Sariego-Jamardo
- Paediatric Department, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain.
| | - Corsino Rey
- University of Oviedo, Oviedo, Spain; Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - Alberto Medina
- Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Juan Mayordomo-Colunga
- Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Andrés Concha-Torre
- Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Belén Prieto
- Department of Biochemistry, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ana Vivanco-Allende
- Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
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20
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J, Cabanillas-Farpón R. Aetiological Diagnosis of Child Deafness: CODEPEH Recommendations. Acta Otorrinolaringologica (English Edition) 2017. [DOI: 10.1016/j.otoeng.2016.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Rey C, García-Cendón C, Martínez-Camblor P, López-Herce J, Concha-Torre A, Medina A, Vivanco-Allende A, Mayordomo-Colunga J. High levels of atrial natriuretic peptide and copeptin and mortality risk. An Pediatr (Barc) 2016. [DOI: 10.1016/j.anpede.2016.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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22
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J. CODEPEH 2014 recommendations for the early detection of delayed hearing loss. An Pediatr (Barc) 2016. [DOI: 10.1016/j.anpede.2015.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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23
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J. Recomendaciones CODEPEH 2014 para la detección precoz de la hipoacusia diferida. An Pediatr (Barc) 2016; 85:215.e1-215.e6. [DOI: 10.1016/j.anpedi.2015.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 07/03/2015] [Accepted: 07/06/2015] [Indexed: 11/24/2022] Open
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24
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J. 2014 CODEPEH Recommendations: Early Detection of Late Onset Deafness, Audiological Diagnosis, Hearing Aid Fitting and Early Intervention. Acta Otorrinolaringologica (English Edition) 2016. [DOI: 10.1016/j.otoeng.2015.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Vivanco-Allende A, Concha-Torre A, Menéndez-Cuervo S, Rey-Galán C. [Parkour: a new cause of serious internal injury]. An Pediatr (Barc) 2013; 79:396-7. [PMID: 23601476 DOI: 10.1016/j.anpedi.2013.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 12/06/2012] [Accepted: 03/05/2013] [Indexed: 11/26/2022] Open
Affiliation(s)
- A Vivanco-Allende
- Unidad de Cuidados Intensivos Pediátricos, Área de Gestión de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
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26
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Coca-Pelaz A, Vivanco-Allende A, Meilán-Martínez Á, Gómez-Martínez JR. Grisel's Syndrome as a Sequela of a Complicated Acute Mastoiditis. Acta Otorrinolaringologica (English Edition) 2013. [DOI: 10.1016/j.otoeng.2013.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Coca-Pelaz A, Vivanco-Allende A, Meilán-Martínez Á, Gómez-Martínez JR. Grisel's syndrome as a sequela of a complicated acute mastoiditis. Acta Otorrinolaringol Esp 2012; 64:161-4. [PMID: 22264911 DOI: 10.1016/j.otorri.2011.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 11/08/2011] [Accepted: 11/10/2011] [Indexed: 11/16/2022]
Abstract
Grisel's syndrome is a rare complication of ENT area infections. It consists of a non-traumatic atlantoaxial subluxation after an infectious process. Its characteristic symptom is persistent torticollis despite a resolved infection. The knowledge of this condition helps early diagnosis and treatment. We therefore present the case of a patient with Grisel's syndrome as a sequela of an acute mastoiditis complicated by a Bezold's abscess.
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Affiliation(s)
- Andrés Coca-Pelaz
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
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Vivanco-Allende A, García-González M, González-Jiménez D, Pérez-Guirado A, Fernández I, Gómez-Illan R. Precocious puberty produced by an osteolipoma of the tuber cinereum. J Pediatr Endocrinol Metab 2012; 25:1165-8. [PMID: 23329765 DOI: 10.1515/jpem-2012-0192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Accepted: 08/31/2012] [Indexed: 11/15/2022]
Abstract
Central precocious puberty (CPP) is fairly common in girls. In most girls, the etiology for the CPP is unknown. Among the more rare causes of CPP in girls are central nervous system tumors and hamartomas. Osteolipoma of the tuber cinereum, which is the most commonly diagnosed at autopsy, has been reported as a cause of CPP. We describe an 8-year-old girl with central precocious puberty in whom MRI demonstrated a lesion compatible with osteolipoma. Her symptom was breast development that begun at age 7 years and 9 months. Her case history, laboratory studies and imaging are presented. Her puberty was rapidly progressive. She was treated successfully with a GnRHa (Triptorelin 3.75 mg IM q 4 weeks). Her case brings to the forefront the need to perform an MRI in children with rapidly progressing puberty.
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Affiliation(s)
- Ana Vivanco-Allende
- Department of Pediatrics, Hospital Carmen y Severo Ochoa, Cangas del Narcea, 33012 Oviedo, Asturias, Spain.
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Mayordomo-Colunga J, Medina A, Rey C, Concha A, Menéndez S, Arcos ML, Vivanco-Allende A. Non-invasive ventilation in pediatric status asthmaticus: a prospective observational study. Pediatr Pulmonol 2011; 46:949-55. [PMID: 21520437 DOI: 10.1002/ppul.21466] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 01/23/2011] [Accepted: 02/17/2011] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Non-invasive ventilation (NIV) has been shown to be effective in different causes of respiratory failure in both adult and pediatric patients. However, its role in status asthmaticus (SA) remains unclear. We designed a prospective study to assess the feasibility of NIV in children with SA. STUDY DESIGN Prospective observational study, over a 4.5-year period. PATIENT SELECTION Children with SA unresponsive to conventional therapy with a modified Wood's clinical asthma score (m-WCAS) ≥4 and marked increased work of breathing, were included. METHODOLOGY Patients were placed on pressure support NIV. During NIV therapy, salbutamol was nebulized continuously and ipratropium bromide every 2 hr; methyl-prednisolone was given at a dose of 1-2 mg/kg/6 hr. Clinical variables were measured at baseline and at 1, 6, 12, 24, and 48 hr. RESULTS During the study period, there were 122 PICU admissions due to SA; 72 episodes fulfilled inclusion criteria. Baseline mean values were as follows: m-WCAS of 5.7 points, heart rate (HR) of 166.7 beats/min, respiratory rate (RR) of 49.5 breaths/min and FiO(2) of 45.3%. In the first hour m-WCAS fell 2.3 ± 1.5 points, HR 13.5 ± 14 beats/min, and RR 9.8 ± 10 breaths/min (P < 0.01). After institution of NIV therapy, 5 children required intubation due to increasing respiratory distress. There was one case of massive subcutaneous emphysema, with no other serious adverse effects associated with NIV. CONCLUSIONS These results show that NIV is a feasible therapy in children with SA unresponsive to conventional treatment. Pediatr. Pulmonol. 2011; 46:949-955. © 2011 Wiley-Liss, Inc.
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Affiliation(s)
- Juan Mayordomo-Colunga
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
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Vivanco-Allende A, Mayordomo-Colunga J, Coca-Pelaz A, Rey C, Medina A. Helmet-delivered heliox-CPAP in severe upper airway obstruction caused by PHACES syndrome. Pediatr Pulmonol 2011; 46:306-8. [PMID: 20967839 DOI: 10.1002/ppul.21367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 08/23/2010] [Accepted: 08/23/2010] [Indexed: 11/09/2022]
Abstract
We present the case of a 4-month-old girl with PHACES syndrome and severe upper respiratory airway obstruction secondary to multiple subglottic and tracheal hemangiomas effectively treated with heliox-CPAP delivered by helmet (HH-CPAP).
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Affiliation(s)
- A Vivanco-Allende
- Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Ovideo, Asturias, Spain.
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