Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)
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Priapism, prolonged and painful erection, is an exceptional cause of consultation in the pediatric population. High- and low-flow priapism and recurrent prolonged erection must be differentiated, as the prognosis and treatment of these entities differ. ⋯ The definitive diagnosis is given by penile Doppler ultrasonography, corpora cavernosa blood gas analysis, and pelvic arteriography. We present two patients who attended our emergency service in the last year and propose an algorithm for the diagnosis and treatment of this entity.
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The short bowel syndrome is the result of a congenital or acquired loss of a large part of the small intestine. The most frequent causes of surgical resection of the intestine in infants are arterial or venous thrombosis, intestinal volvulus, necrotizing enterocolitis, and Crohn's disease. Symptoms include nutrient and electrolyte malabsorption, steatorrhea and diarrhea, which can result in failure to thrive. ⋯ We present the case of an 11-year-old boy with short bowel syndrome secondary to multiple resections during the postnatal period who was admitted to hospital for episodes of confusion and altered behavior. The diagnosis was lactic acidosis. Outcome was favorable due to prompt instauration of treatment.
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Nosocomial sepsis is a major problem in neonatal units. Because the clinical signs are nonspecific, highly reliable diagnostic markers are required to guide diagnosis. The aim of this study was to evaluate the utility of procalcitonin (PCT) as a diagnostic marker for nosocomial neonatal sepsis, and to compare the results of PCT with those of the most widely used laboratory tests for sepsis. ⋯ PCT may be a useful marker for the diagnosis of nosocomial neonatal sepsis. Studies with larger samples are required to compare the accuracy of PCT with that of other markers of sepsis.
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To evaluate procalcitonin (PCT) as a diagnostic marker of neonatal sepsis of vertical transmission and to compare the results of PCT with those of the most widely used laboratory tests for sepsis. ⋯ PCT may be a useful marker for the diagnosis of vertically transmitted sepsis. Studies with larger sample sizes are required to establish the accuracy of PCT.
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Case Reports
[Middle latency auditory evoked potentials in critical care children: preliminary study].
Middle latency auditory evoked potentials (MLAEP) reflect changes in electroencephalogram waves after an auditory signal and represent the earliest cortical response to acoustic stimulus. They are therefore used to measure variations in the level of consciousness. MLEAP have been used to measure the depth of anesthesia during surgical procedures, but experience in critical care patients is very limited. ⋯ MLAEP can be useful in evaluating the level of consciousness and sedation in critically ill children. Further studies with larger samples are required to analyze the limitations and reproducibility of this type of monitoring in children of different ages.