Assuntos
Haemophilus influenzae/isolamento & purificação , Meningite por Haemophilus/microbiologia , Pneumonia/microbiologia , Doença Aguda , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Meningite por Haemophilus/complicações , Pneumonia/etiologia , Sepse/complicações , Sepse/etiologiaRESUMO
22 consecutive cases of pleural empyema due to H. influenzae in children are reported. An increment of its incidence during the 1975-76 period is observed. All cases were in children under 3 years of age, with a mean of 15.5 months. The presenting syndrome at admission was varied. In 50% of cases, pleuropulmonary infection was ignored. Nearly one half of cases of pleural empyema due to H. influenzae had simultaneous purulent meningitis caused by the same microorganism. This type of empyemas, though having a prolonged evolution, apparently appear to have a good prognosis, compared with that produced by S. aureus. There are some differences, being the most outstanding: low frequency of pyoneumothorax and the lack of radiological evidences of abscesses and or pneumotoceles, in any phase of the clinical course. Stress is placed on the value of the bacteriological study of blood and CSF in children under 3 years of age with pleural empyema. A high rate of positive blood cultures was found. (75%). Pieuropulmonary complications, as a frequent event during severe infections (septicemic disease) due to H. influenzae is considered. A clinical characterization of children in whom a pleural empyema could occur is proposed. A discussion is made about diagnostic, therapeutic and prognostic implications of these complications.
Assuntos
Empiema/microbiologia , Haemophilus influenzae/isolamento & purificação , Meningite/microbiologia , Líquido Cefalorraquidiano/microbiologia , Empiema/sangue , Empiema/líquido cefalorraquidiano , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Meningite/sangueRESUMO
The study comprised 458 infants complaining of recurrent obstructive bronchitis from the clinical, chest X-rays and gastroesophageal reflux investigation view points. Spontaneous radiological reflux was found in 49.1% of the patients, although a history of vomiting was present only in 26.6%. In infants with positive radiological reflux, manometrics showed a shorter gastroesophageal sphincter and with lesser pressures than a group of normal infants. With medical treatment of the reflux, remission of the respiratory symptoms was seen in 63.5% of the patients. In a group of infants treated, control X-rays, and manometrics were practiced at the end of the medical treatment showing significant improvement of pressure and length of the gastroesophageal sphincter. The long-term follow-up in infants showing failure of the medical treatment, bronchial asthma appeared in 56.6%.
Assuntos
Bronquite/etiologia , Refluxo Gastroesofágico/complicações , Doenças do Recém-Nascido/etiologia , Bronquite/fisiopatologia , Pré-Escolar , Junção Esofagogástrica/fisiopatologia , Feminino , Refluxo Gastroesofágico/fisiopatologia , Humanos , Lactente , Recém-Nascido , Doenças do Recém-Nascido/fisiopatologia , Masculino , ManometriaRESUMO
The incidence of the gastroesophageal reflux was studied in 39 healthy infants with ages between 2 and 24 months. X-ray studies of gastroesophageal passage and esophageal manometry were practiced in all cases. Only 3 infants showed radiological reflux. The pressure in the gastroesophageal sphincter was normal in all babies and the highest pressures were reached less--than 6 months--old infants. Older infants showed lesser pressures. The same was true for the length of the gastroesophageal sphincter. The factors involved in the genesis of the gastroesophageal reflux are discussed.
Assuntos
Refluxo Gastroesofágico/diagnóstico por imagem , Doenças do Recém-Nascido/diagnóstico por imagem , Humanos , Lactente , Recém-Nascido , Manometria , RadiografiaRESUMO
22 cases of several types of vascular rings are presented. Most of them were double aortic arch (15): 12 were operated on without mortality before the first years of age because of the great severity of the symptoms. The precocity of the symptomatology and the predominance of the respiratory distress is emphasized. Our data point out to the importance of the differential diagnosis of vascular rings in newborns and infants in the presence of laryngeal stridor or respiratory distress, essentially because the surgical correction is very effective and the risk of the intervention is minimal.