Alicia Halac

We report a case of a 17-year-old patient with severe hematuria from an ileocystoplasty-augmented bladder for vesical exstrophy, with associated cirrhosis secondary to autoimmune hepatitis, diagnosed years later. Varix development and further bleeding from ectopic varices, related to cirrhosis and portal hypertension, are a rare cause of hematuria in patients with surgically augmented bladder volume. This child was successfully treated with a transjugular intrahepatic portosystemic shunt procedure as a bridge to hepatic transplantation.

In a total of 1, 003 children (805 inpatients and 198 outpatients) with acute lower respiratory infections (ALRI), clinical, social, and environmental data were analyzed. The major clinical entities were bronchiolitis, pneumonia, bronchitis, and laryngitis. The first two of these predominated in inpatients; pneumonia and bronchitis were more common in older children, while bronchiolitis was observed in infants. Respiratory rates of >50/min. were more common in younger children and in cases with bronchiolitis and bronchitis. Retractions showed markedly less age-dependent variations and were present in all severe cases with different clinical diagnoses. Retractions alone or associated with cyanosis were the best indicators for severity of ALRI. Among outpatients, fever and wheezing were more common; inpatients were younger, more frequently malnourished, and from a lower socioeconomic level; family history of chronic bronchitis, crowding, and parental smoking also prevailed in this ...

Twenty-nine cases of pediatric acute lower respiratory disease associated with adenovirus genome type 7h were evaluated retrospectively. They constituted 2.4% of 1233 cases of acute respiratory infections treated in five hospitals in Buenos Aires, between September 1984 and September 1988. Pneumonia and bronchiolitis were the principal diagnoses. The mean age of patients was 8.8 months and 82.7% of the children were less than one year of age. None of the patients had previously been exposed to measles or was immunocompromised. A mixed infection, viral or bacterial, was demonstrated in 8 of the 29 patients. Sixteen children developed a severe pulmonary disease which required intensive care. Ten with a clinical diagnosis of multifocal pneumonia and necrotizing bronchiolitis died. Extrapulmonary manifestations were observed in the most severe cases. Observations suggest a possible high pathogenicity of adenovirus type 7h and emphasize the need for adequate control and case management programs.