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Salvá-Arteaga M, García-Muro C, Toledo-Gotor C, Fernández-Vallejo MB. Massive Bleeding from a Congenital Hemangioma: A Dermatologic Emergency. Actas Dermosifiliogr 2024; 115:422-424. [PMID: 37871893 DOI: 10.1016/j.ad.2023.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 10/25/2023] Open
Affiliation(s)
| | - C García-Muro
- Servicio de Pediatría, Hospital San Pedro, Logroño, España
| | - C Toledo-Gotor
- Centro de Salud Puerta de Arnedo, Arnedo, La Rioja, España
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Salvá-Arteaga M, García-Muro C, Toledo-Gotor C, Fernández-Vallejo MB. [Translated article] Massive Bleeding from a Congenital Hemangioma: A Dermatologic Emergency. Actas Dermo-Sifiliográficas 2024; 115:T422-T424. [PMID: 38331173 DOI: 10.1016/j.ad.2023.02.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 02/09/2023] [Indexed: 02/10/2024] Open
Affiliation(s)
| | - C García-Muro
- Servicio de Pediatría, Hospital San Pedro, Logroño, Spain
| | - C Toledo-Gotor
- Centro de Salud Puerta de Arnedo, Arnedo, La Rioja, Spain
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Esteban-Zubero E, García-Muro C, Alatorre-Jiménez MA. Fluid therapy and traumatic brain injury: A narrative review. Med Clin (Barc) 2023:S0025-7753(23)00107-0. [PMID: 37031064 DOI: 10.1016/j.medcli.2023.03.003] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 04/10/2023]
Abstract
Traumatic brain injury (TBI) is an important health and social problem. The mechanism of damage of this entity could be divided into two phases: (1) a primary acute injury because of the traumatic event; and (2) a secondary injury due to the hypotension and hypoxia generated by the previous lesion, which leads to ischemia and necrosis of neural cells. Cerebral edema is one of the most important prognosis markers observed in TBI. In the early stages of TBI, the cerebrospinal fluid compensates the cerebral edema. However, if edema increases, this mechanism fails, increasing intracranial pressure. To avoid this chain effect, several treatments are applied in the clinical practice, including elevation of the head of the bed, maintenance of normothermia, pain and sedation drugs, mechanical ventilation, neuromuscular blockade, controlled hyperventilation, and fluid therapy (FT). The goal of FT is to improve the circulatory system to avoid the lack of oxygen to organs. Therefore, rapid and early infusion of large volumes of crystalloids is performed in clinical practice to restore blood volume and blood pressure. Despite the relevance of FT in the early management of TBI, there are few clinical trials regarding which solution is better to apply. The aim of this study is to provide a narrative review about the role of the different types of FT used in the daily clinical practice on the management of TBI. To achieve this objective, a physiopathological approach to this entity will be also performed, summarizing why the different types of FT are used.
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Toledo-Gotor C, García-Muro C, García-Oguiza A, Poch-Olivé ML, Ruiz-Del Prado MY, Domínguez-Garrido E. Phenotypic comparison of patients affected with DeSanto-Shinawi syndrome: Point mutations in WAC gene versus a 10p12.1 microdeletion including WAC. Mol Genet Genomic Med 2022; 10:e1910. [PMID: 35266333 PMCID: PMC9034681 DOI: 10.1002/mgg3.1910] [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: 12/04/2021] [Revised: 01/14/2022] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction DeSanto‐Shinawi syndrome is a rare neurodevelopmental disorder caused by loss‐of‐function variants of WAC, located on chromosome 10p12.1. This syndrome is characterized by dysmorphic facial features, intellectual disability, and behavioral problems. Case report In this case report, we present a new deletion case and summarize the clinical data of previously reported individuals, comparing the similarities and differences between cases caused by point mutations versus those which are caused by deletions in the 10p region. Conclusion Some differential features could facilitate the diagnostic suspicion guiding the optimal diagnostic tests that should be requested in each case scenario.
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Affiliation(s)
- Cristina Toledo-Gotor
- Pediatric Neurology Unit, Department of Pediatrics, San Pedro Hospital, Logroño, Spain
| | | | - Alberto García-Oguiza
- Pediatric Neurology Unit, Department of Pediatrics, Txagorritxu Hospital, Vitoria, Spain
| | - Mª Luisa Poch-Olivé
- Pediatric Neurology Unit, Department of Pediatrics, San Pedro Hospital, Logroño, Spain
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García-Muro C, Sáenz-Moreno I, Gómez-Sáez F, Navazo-Eguia A. Type 2 laryngeal cleft associated with OpitzG/BBB syndrome. Acta Otorrinolaringologica (English Edition) 2022; 73:196-198. [DOI: 10.1016/j.otoeng.2021.05.001] [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] [Received: 03/14/2021] [Accepted: 05/02/2021] [Indexed: 11/25/2022]
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Esteban-Zubero E, García-Muro C, Alatorre-Jiménez MA, Johal V, López-García CA, Marín-Medina A. High Flow Nasal Cannula Therapy in the Emergency Department: Main Benefits in Adults, Pediatric Population and against COVID-19: A Narrative Review. Acta Med (Hradec Kralove, Czech Repub ) 2022; 65:45-52. [DOI: 10.14712/18059694.2022.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
This review aims to summarize the literature’s main results about high flow nasal cannula therapy (HFNC) HFNC benefits in the Emergency Department (ED) in adults and pediatrics, including new Coronavirus Disease (COVID-19). HFNC has recently been established as the usual treatment in the ED to provide oxygen support. Its use has been generalized due to its advantages over traditional oxygen therapy devices, including decreased nasopharyngeal resistance, washing out of the nasopharyngeal dead space, generation of positive pressure, increasing alveolar recruitment, easy adaptation due to the humidification of the airways, increased fraction of inspired oxygen and improved mucociliary clearance. A wide range of pathologies has been studied to evaluate the potential benefits of HFNC; some examples are heart failure, pneumonia, chronic pulmonary obstructive disease, asthma, and bronchiolitis. The regular use of this oxygen treatment is not established yet due to the literature’s controversial results. However, several authors suggest that it could be useful in several pathologies that generate acute respiratory failure. Consequently, the COVID-19 irruption has generated the question of HFNC as a safety and effective treatment. Our results suggested that HFNC seems to be a useful tool in the ED, especially in patients affected by acute hypoxemic respiratory failure, acute heart failure, pneumonia, bronchiolitis, asthma and acute respiratory distress syndrome in patients affected by COVID-19. Its benefits in hypercapnic respiratory failure are more discussed, being only observed benefits in patients with mild-moderate disease. These results are based in clinical as well as cost-effectiveness outcomes. Future studies with largest populations are required to confirm these results as well as establish a practical guideline to use this device.
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García-Muro C, Sáenz-Moreno I, Gómez-Sáez F, Navazo-Eguía A. Type 2 laryngeal cleft associated with OpitzG/BBB syndrome. Acta Otorrinolaringol Esp (Engl Ed) 2021; 73:S0001-6519(21)00090-X. [PMID: 34404523 DOI: 10.1016/j.otorri.2021.05.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/14/2021] [Accepted: 05/02/2021] [Indexed: 11/19/2022]
Affiliation(s)
| | | | - Fernando Gómez-Sáez
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario de Burgos, Burgos, España
| | - Ana Navazo-Eguía
- Servicio de Otorrinolaringología, Hospital Universitario de Burgos, Burgos, España
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García-Muro C, Sáenz-Moreno I, Riaño-Méndez B, Gutiérrez-Delgado JM, Valencia-Ramos J, Esteban-Zubero E. Malignant hyperthermia syndrome: A rare entity. Bol Med Hosp Infant Mex 2020; 77:337-340. [PMID: 33186346 DOI: 10.24875/bmhim.20000047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Malignant hyperthermia syndrome is a hereditary pharmacogenetic disorder of skeletal muscle characterized by hypermetabolic state related to the exposure of volatile anesthetic gases or depolarizing muscle relaxants. It is an infrequent entity that occurs in genetically predisposed individuals, with a very low incidence in pediatrics (1 in 10,000-15,000 anesthetic procedures). Case report We report a case of malignant hyperthermia related to exposure to sevoflurane during adenoidectomy surgery in a 6-year-old female. The patient presented with tachycardia, hypercapnia, and hyperthermia, requiring two successive doses of dantrolene sodium administration, with an adequate response to the treatment. Conclusions Malignant hyperthermia syndrome is a rare condition in pediatric patients that should be detected in early stages since it is essential to initiate the treatment as soon as possible.
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Affiliation(s)
| | | | | | | | - Juan Valencia-Ramos
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario de Burgos, Burgos. España
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