RESUMEN

A retrospective review of yearly admissions of acute rheumatic fever between 1971 and 1990 showed a declining trend with relative stability since 1986. The incidence rate of acute rheumatic fever (new attacks/year) was 2/100,000 total population or 7/100,000 childhood population (< 19 years old) or 9/100,000 schoolchildren. The incidence rate per 10,000 hospital admissions was a high of 20 in 1971 and remained a low of three since 1986. This low incidence of acute rheumatic fever should not give rise to complacency in its control, as there is an unexplained resurgence in the developed countries.

Asunto(s)

RESUMEN

Acute purulent pericarditis caused by Haemophilus influenzae is an unusual condition, especially in childhood. In most cases, respiratory symptoms are the presenting features, and children aged less than 4 years are most often affected. A high index of suspicion and aggressive microbiological and cardiological evaluation are often warranted to make an early diagnosis. We herein report two cases of pericarditis caused by H. influenzae in children aged less than two years. Pericardiocentesis was performed in each case. Early recognition, rapid diagnosis and aggressive medical and surgical therapy are paramount in the successful treatment of this condition.

Asunto(s)

RESUMEN

A randomized placebo-controlled prospective trial was conducted to evaluate the efficacy of erythromycin therapy in 69 patients affected with Bacillus Calmette-Guérin lymphadenitis. When patients who developed subsequent regional abscesses were excluded, erythromycin caused significantly earlier resolution of lymphadenitis (5.1 months vs. 5.7 months for placebo; P < 0.01) compared with placebo. There was no significant difference in the proportion of patients who developed subsequent regional abscesses between the 2 groups (47% for erythromycin, 60% for placebo, P = 0.14). When the entire group of 69 patients was evaluated for "duration to heal" (regardless of subsequent abscess formation), erythromycin therapy (4.1 +/- 1.5 SD months) did not differ significantly from the placebo group (3.5 +/- 1.3 months, P = not significant). Patients who developed subsequent abscess (n = 36) along with those with B. Calmette-Guérin regional abscesses at presentation (n = 27) were further studied to compare oral erythromycin therapy with that of single dose 50-mg intranodal isoniazid instillation. Local isoniazid therapy caused significantly earlier resolution of the abscesses (3.9 months) compared with erythromycin therapy (5.2 months; P < 0.001).

Asunto(s)

RESUMEN

A retrospective review of adolescent deliveries (maternal age range: 12-19 years) at the maternity unit of the main General Hospital, Grenada, was undertaken for the years 1987 and 1988 using the delivery room register and hospital medical records. These mothers were compared with women who delivered during the same period but were aged between 20 and 30 years. Of the 3203 deliveries which occurred during the study period, 613 (20%) involved adolescents, giving a prevalence rate of one in five pregnancies. chi 2 and Fisher's exact test analyses revealed that pregnancies occurring in younger adolescents (age less than 16 years, n = 58) carried an increased risk of preterm labour, operative delivery, prematurity, small-for gestational age infants, asphyxia and perinatal mortality when compared with the 'optimum reproductive age group'. Older adolescents (16-19 years, n = 555) had a higher risk of pregnancy induced hypertension but otherwise compared well with the optimal reproductive age group. Adolescent pregnancy is very prevalent in Grenada and the reproductive outcome for young adolescents < 16 years of age is relatively poor.

Asunto(s)

RESUMEN

Clinical characteristics of 58 patients admitted to Bustamante Hospital for Children with lead poisoning are described. The most common source of lead exposure was backyard battery smelters and most (58%) of the patients were aged below 3 years. Lead toxicity was more severe in younger children as evidenced by higher lead levels and greater incidence of encephalopathy. Patients with lower haemoglobin values had relatively higher lead levels and significantly higher incidence of encephalopathy. Radiological evidence of lead poisoning was present in 96% of our patients demonstrating the usefulness of X-rays in diagnosis, particularly in areas where blood lead levels are not easily available.

Asunto(s)

RESUMEN

In a two-year period (October 1985 - September 1987), 65 children presented to the Child Health department and/or rheumatology clinic at the University Hospital with arthritis. Eighteen children (28%) had Juvenile Chronic Arthritis, ten (15%) rheumatic fever, eight (12%) systemic lupus erythematosus and thirteen (20%) had self-limiting arthritis. Systemic onset of Juvenile Chronic Arthritis occurred only in one child; nine children had polyarticular and eight pauci-articular onset of disease. The self-limiting arthritis was difficult to differentiate from Juvenile Chronic Arthritis; therefore serological testing for bacterial and viral infections should be performed before anti-rheumatic therapy is undertaken. Arthritis in childhood is not uncommon in Jamaica. However, the outcome appears to be generally favorable except in a few cases of Juvenile Chronic Arthritis.

Asunto(s)

RESUMEN

In a two-year period (Octuber 1985 - September 1987), 65 children presented to the Child Health department and/or rheumatology clinic at the University Hospital with arthritis. Eighteen children (28%) had Juvenile Chronic Arthritis, ten (15%) rheumatic fever, eight (12%) systemic lupus erythematosus and thirteen (20%) had self-limiting arthritis. Systemic onset of Juvenile Chronic Arthritis occurred only in one child; nine children had polyarticular and eight pauci-articular onset of disease. The self-limiting arthritis was difficult to different from Juvenile Chronic Arthritis; therefore serological testing for bacterial and viral infections should be performed before anti rheumatic therapy is undertaken. Arthritis in chilhood is not uncommon in Jamaica. However, the outcome appears to be generally favourable except in a few cases of Juvenile Chronic Arthritis

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Retrospective evaluation of records pertaining to 316 children admitted to the Queen Elizabeth Hospital for febrile seizures showed a recurrence rat of 24 per cent. Age at onset of first febrile seizure, a positive family history and atypical initial seizzure were identified as risk factors for subsequent seizures. Other factors, namely abnormal pregnancy, gestational age, birthweight, neonatal problems and neurological abnormality, did not affect the chances of recurrence

Asunto(s)

RESUMEN

This report describes a three-year-old girl with an omental cyst masquerading as ascites. A review of the literature has shown that large omental cysts are frequently misdiagnosed as ascites. Ultrasonography is a valuable aid in the diagnosis

Asunto(s)

Asunto(s)

RESUMEN

Retrospective evaluation of records pertaining to 338 children presenting with a first episode of febrile seizure revealed a high performance rate of routine haemoglobin levels, total white cell and differential count, blood glucose, serum electrolyte and urea levels, lumbar puncture for cerebrospinal fluid examination and blood cultures. Lumbar puncture emerged as the most useful investigation in detecting eight children with meningitis, three of whom were over the age of two years. Transient elevation in blood glucose levels hyponatraemia and low serum bicarbonate levels were noted in some children but their significance is not known. Routine haemoglobin estimation detected sixteen children with unsuspected anaemia, but the remaining investigations were largely unhelpful

Asunto(s)

Asunto(s)

RESUMEN

Details of a bed utilisation study of 1,654 paediatric medical ward admissisons to the Queen Elizabeth Hospital, Barbados, during 1983 ara analysed. Forty-one per cent of admissisons had a respiratory problem, 14% had infections diseases, 9% central nervous system conditions, and 36% had diseases of other systems. Analysis of hospital stay revealed that 20% of patients spent less than 24 hours and these mostly for bronchial astma (31%), repiratory tract infections (15%), and gastroenteritis (10%). Most long-stay patients had either congenital heart disease (12%), social problems (11%) or diabetes mellitus (10%).. We recommend that the establishment of a short-stay unit could eliminate 20% of admissions, spent less than 24hours. A further 21% (poisoning and gastroenteritis) could be significantly reduced with good health education

Asunto(s)