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Coronavirus disease 2019 (COVID-19) has increased the risk of developing severe acute respiratory distress syndrome and subsequent moderate to severe laryngotracheal stenoses (LSTs) with an early presentation that occurs between two and three months after SARS-CoV-2 infection. We present a series of 12 cases of LST following SARS-CoV-2 infection. Dense lymphocyte infiltration with multinuclear giant cell granulomas was found on biopsy with intranuclear inclusions, suggestive of viral cytopathic effects in one case and intravascular fibrin thrombi with perivascular mononuclear infiltrate of CD3 + T lymphocytes. We present the largest and only series that describes clinical and histopathological characteristics of LTS and the management and outcomes after early laryngotracheal reconstruction in the context of the SARS-CoV-2 outbreak.

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Although the frequency of pregnancy in women on chronic dialysis is extremely low, it is associated with severe maternal and perinatal morbidity and mortality. This situation represents a challenge for the therapeutic team, which requires multidisciplinary management, as well as measures to adequate dialysis treatment. Such efforts include increasing the time and frequency of dialysis session, maintaining low uremia levels and ensuring hemodynamic stability by avoiding intra-treatment arterial hypotension and hydro electrolytic fluctuations. Regarding the dialysis modality, literature makes references to hemodialysis or peritoneal dialysis in pregnancy women, but little is known about the of high volume online hemodiafiltration (HVHDF) as well as the appropriate type of replacement fluid (pre-dilution or post-dilution). We present two cases of patients who were pregnant while being treated with HVHDF modality and had a favorable evolution, where the decision to continue with this dialysis modality was motivated by a best hemodynamic stability and the highest clearance of all types of uremic toxins offered by HVHDF.

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OBJECTIVE: To evaluate whether early treatment with methotrexate (MTX) prevents the onset of uveitis in children with juvenile idiopathic arthritis. STUDY DESIGN: The clinical charts of all consecutive patients seen between January 2002 and February 2011 who had a disease duration <1 year at first visit and had received a stable management for at least 2 years with or without MTX were reviewed. Patients who were given systemic medications other than MTX (except nonsteroidal anti-inflammatory drugs) were excluded. Patients with systemic arthritis, rheumatoid factor-positive arthritis, or enthesitis-related arthritis were also excluded. In each patient, the 2-year follow-up period after first visit was examined to establish whether uveitis had occurred. RESULTS: A total of 254 patients with a median disease duration of 0.3 year were included. Eighty-six patients (33.9%) were treated with MTX, whereas 168 patients (66.1%) did not receive MTX. During the 2-year follow-up, 211 patients (83.1%) did not develop uveitis, whereas 43 patients (16.9%) had uveitis a median of 1.0 year after the first visit. The frequency of uveitis was lower in MTX-treated than in MTX-untreated patients (10.5% vs 20.2%, respectively, P = .049). Survival analysis confirmed that patients treated with MTX had a lower probability of developing uveitis. CONCLUSION: Early MTX therapy may prevent the onset of uveitis in children with juvenile idiopathic arthritis. Because our study may be affected by confounding by indication, the potential of MTX to reduce the incidence of ocular disease should be investigated in a randomized controlled trial.

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Hepatoxicity of isoniazid, mainly in association with rifampin, is a rare secondary effect of tuberculostatic treatment. In the United States, it accounts for 0.2% of all pediatric orthotropic liver transplant, and 14% of transplants for drug hepatotoxicity. We report the case of a 10 year-old patient who presented with acute liver failure requiring orthotropic liver transplant after forty days of tuberculostatic treatment with isoniazid, rifampin and pyrazinamide.

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La toxicidad hepática por isoniacida, sobre todo asociada a rifampicina, es un raro efecto adverso de la terapia antituberculosa. En EE.UU., es la causa de 0,2% de los trasplantes hepáticos pediátricos y del 14% de los trasplantes por toxicidad medicamentosa. Comunicamos el caso de una paciente de 10 años de edad con falla hepática fulminante que requirió trasplante hepático luego de cuarenta días de tratamiento tuberculostático con isoniacida, rifampicina y pirazinamida.(AU)

Hepatoxicity of isoniazid, mainly in association with rifampin, is a rare secondary effect of tuberculostatic treatment. In the United States, it accounts for 0.2% of all pediatric orthotropic liver transplant, and 14% of transplants for drug hepatotoxicity. We report the case of a 10 year-old patient who presented with acute liver failure requiring orthotropic liver transplant after forty days of tuberculostatic treatment with isoniazid, rifampin and pyrazinamide.(AU)

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La toxicidad hepática por isoniacida, sobre todo asociada a rifampicina, es un raro efecto adverso de la terapia antituberculosa. En EE.UU., es la causa de 0,2% de los trasplantes hepáticos pediátricos y del 14% de los trasplantes por toxicidad medicamentosa. Comunicamos el caso de una paciente de 10 años de edad con falla hepática fulminante que requirió trasplante hepático luego de cuarenta días de tratamiento tuberculostático con isoniacida, rifampicina y pirazinamida.

Hepatoxicity of isoniazid, mainly in association with rifampin, is a rare secondary effect of tuberculostatic treatment. In the United States, it accounts for 0.2% of all pediatric orthotropic liver transplant, and 14% of transplants for drug hepatotoxicity. We report the case of a 10 year-old patient who presented with acute liver failure requiring orthotropic liver transplant after forty days of tuberculostatic treatment with isoniazid, rifampin and pyrazinamide.

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La toxicidad hepática por isoniacida, sobre todo asociada a rifampicina, es un raro efecto adverso de la terapia antituberculosa. En EE.UU., es la causa de 0,2% de los trasplantes hepáticos pediátricos y del 14% de los trasplantes por toxicidad medicamentosa. Comunicamos el caso de una paciente de 10 años de edad con falla hepática fulminante que requirió trasplante hepático luego de cuarenta días de tratamiento tuberculostático con isoniacida, rifampicina y pirazinamida.(AU)

Hepatoxicity of isoniazid, mainly in association with rifampin, is a rare secondary effect of tuberculostatic treatment. In the United States, it accounts for 0.2% of all pediatric orthotropic liver transplant, and 14% of transplants for drug hepatotoxicity. We report the case of a 10 year-old patient who presented with acute liver failure requiring orthotropic liver transplant after forty days of tuberculostatic treatment with isoniazid, rifampin and pyrazinamide.(AU)

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Se presentó una paciente de 52 días de nacida con acalasia cricofaríngea congénita, con el siguiente cuadro clínico: tos, falta de aire, de salida de los alimentos por fosas nasales y curva de peso estacionaria. El diagnóstico se realizó mediante estudio contrastado con bario. La acalasia cricofaríngea congénita es una enfermedad rara...(AU)

A -52 days old female patient with congenital cricopharyngeal achalasia was presented in this paper. Several clinical manifestations were observed such as cough, shortness of breath, nasal reflux, and loss of weight. The diagnosis was done by barium studies. Congenital cricopharyngeal achalasia is a rare disease...(AU)

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Se presentó el caso de un paciente masculino, con manchas hiperpigmentadas en la piel con un tiempo de evolución de un año y prurito discreto. Se constataron lesiones máculo papulosas generalizadas respetando palmas, plantas y mucosas, con signo de Darier positivo. El estudio histopatológico de piel fue compatible con una Mastocitosis indolente, variedad Urticaria pigmentosa. La respuesta al tratamiento aplicado, fue satisfactoria, el paciente se encuentra estable, sin progresión de la enfermedad...(AU)

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El acné es una dermatosis crónica autolimitada que afecta el folículo pilosebáceo, representa la enfermedad cutánea más frecuente en los adolescentes, ésta no reacciona de manera máxima a un grupo aislado de fármacos y se requiere de la combinación de medicamentos tópicos, sistémicos y la microcirugía para complementar el tratamiento. Decidimos rescatar el instrumento extractor de comedón para el drenaje de las lesiones cutáneas elaborándolo a partir de instrumentos desechados en la clínica dental, con un material accesible de bajo costo y lo más semejante posible al importado con la posibilidad de la generalización en el país...(AU)

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OBJECTIVES: To value the utility of the third-hour plasma glucose measurement of the oral glucose tolerance test (OGTT) for diagnosis of gestational diabetes mellitus (GDM). To analyse the relation of rate insulin therapy, type of delivery and morbidity and mortality perinatal with the third-hour plasma glucose measurement or not for diagnosis of GDM. METHODS: Historic cohort study. SUBJECTS: Women diagnosed of GDM from 1993 to March of 2002 in Pregnancy Consultation in periurban Primary Care Center in Camas (Seville, Spain) by consecutive sampling design (n=112). INTERVENTION: To apply the screening and diagnosis criteria from Third International Conference of GDM. To value obstetric outcome history, anthropometric parameter before, treatment and delivery type and perinatal complications. Statistic analysis: A chi2 test, with Fisher's correction was used. RESULTS: A 63% of women were diagnosed of GDM with normal third-hour plasma glucose measurement (Group 1). In 21.4% this value was increase (> 145 mg/dL) but it was not necessary to diagnosis (Group 2). In 15.1%, the third-hour plasma glucose measurement was essential to diagnose GDM (Group 3). Insulin therapy was recommended in 17% (Group 3) and 5% (Group 1 and 2). There are not significant difference between groups about perinatal complications and cesarean delivery incidence. DISCUSSION: We suggest it is not recommended the omission of the third-hour plasma glucose measurement of OGTT because a 15.1% were undiagnosed and would be a substantial decrease in sensitivity. In addition, that group was higher rate insulin therapy.

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