Epstein-Barr virus mononucleosis: neurologic complications.
Explore the source record for details and available documents.
Acyclovir↗
Biomedical subjects
A Morant
Publications and source records attributed to A Morant.
[Infrequent etiology of upper airway resistance syndrome].
We present the case of a thirty-eight years-old man bearing of frequent crisis of asphyxiating wakefulness and breathnessless whenever he was asleep. There also were excessive daytime sleepiness and a strong snore before every wakefulness, but not for the rest of sleep. A polysomnographic study revealed normal values in the oxygen desaturation index, minimum oxygen saturation, an sleep structure alteration with a decrease of III-IV stages, high arousals index and RDI < 5. Pharyngeal diameters measured by mean of TC were normal, but sleepiness degree detected in the Epworth scale was high. Nasal fiberoptic endoscopy study allowed to see a swinging epiglottis that closed totally the upper airway during forced inspiration. The lack of desaturation episodes with numerous wakefulness along the sleep and excessive daytime sleepiness drove to the diagnosis of upper airway resistance syndrome (UARS). Treatment whit C-PAP just provoked an impairment in symptoms, but a CO2-laser partial epiglottectomy improved them. Patophysiological aspects of UARS, as well as its follow-up and therapeutic alternatives are commented.
Adult↗
Epidemiology of invasive streptococcus pneumoniae infections in children in Spain, 1996-1998.
BACKGROUND: Streptococcus pneumoniae is a significant cause of meningitis and septicemia in early infancy, being associated to a high case-fatality rates and serious sequelae. OBJECTIVE: To investigate the burden of invasive disease caused by S. pneumoniae in Valencia, Spain, during a three-year period (1996-1998). METHODS: Hospital-based prospective active surveillance program for invasive bacterial diseases in children < or = 15 years of age in Valencia, from December 1, 1995 to January 1999. RESULTS: A total of 94 cases of invasive pneumococcal disease were detected in patients < or = 15 years of age. The overall annual incidence of invasive pneumococcal disease was 4.6/100,000 persons, < or = 15 years of age. The incidence of invasive disease and meningitis was higher among children younger than 2 years of age (16.8 and 3.8, respectively). Serotypes 19, 14 and 6 accounted for 83% of the isolates. CONCLUSIONS: The age distribution of invasive pneumococcal disease and meningitis shows a peak in the first two years of life and a decline thereafter. Serotypes 19, 14 and 6 are those primarily responsible for invasive pneumococcal disease in children of this region of Spain.
Adolescent↗
[The pharmacological approach to the autistic spectrum].
OBJECTIVE: To describe our experience of the drug treatment of children within the autistic spectrum. DEVELOPMENT: We analyze some neuroleptic drugs, the serotonin uptake inhibitors and antiepileptic drugs, emphasizing the most suitable drugs for each symptom we wish to treat and how to do so. CONCLUSIONS: The treatment of children within the autistic spectrum should be specific, meticulous and well controlled by the neuropaediatrician. It should be changed according to the symptoms and never expected to be the same during the patient s entire life. More studies are needed in this field.
Anticonvulsants↗
Impact of non-routine vaccination on the incidence of invasive Haemophilus influenzae type b (Hib) disease: experience in the autonomous region of Valencia, Spain.
OBJECTIVE: This study assessed the impact of non-routine vaccination against invasive Haemophilus influenzae (Hib)disease before the introduction of universal childhood Hib vaccination. METHODS: Data were obtained from a prospective surveillance program for invasive bacterial diseases in children <15 years of age that was begun in the Autonomous Region of Valencia on 1 December 1995. RESULTS: An incidence of 15.5 cases of invasive Hib disease per 100,000 children <5 years of age was reported in the first year of the surveillance program (from 1 December 1995 to 30 November 1996), when Hib vaccination coverage was estimated to be 32.5%. An increase in vaccination coverage to 44% in the second year (1 December 1996 to 30 November 1997) was associated with a reduction in disease incidence to 3.3 cases per 100,000. After the initiation of universal vaccination in December 1998, only two cases were reported. The effectiveness of non-routine vaccination was 71% in 1997. CONCLUSIONS: These results show that before the introduction of routine childhood Hib vaccination, widespread use of the vaccine can dramatically reduce the occurrence of invasive Hib disease.
Child, Preschool↗
Epidemiological pattern of meningococcal disease in Valencia, Spain. Impact of a mass immunization campaign with meningococcal C polysaccharide vaccine.
The objective of this study was to define the epidemiological pattern of meningococcal disease in the autonomous region of Valencia, Spain, and the impact of a mass immunization campaign against serogroup C meningococcus. Data were obtained from a prospective surveillance program for invasive bacterial diseases in children < 15 y of age that began in the Valencia region on 1 December, 1995. During the period 1996-98, 213 cases of meningococcal disease were detected, representing an annual incidence of 11.3/100,000 children < 15 y. Serogroup C accounted for 31% and 38.5% of cases in 1996 and 1997, respectively (annual incidences of 2.9 and 5.4 cases/100,000 children < 15 y). An immunization campaign with the meningococcal C polysaccharide vaccine, which included all persons between 18 months and 19 y of age, began in late 1997 (vaccination coverage of 86%). In 1998, the annual incidence of meningococcal C disease fell to 1.4 cases per 100,000 children < 15 y of age. These results mirror the increase in the reported incidence of serogroup C meningococcal disease in Spain in the 1990s, a trend that was reversed after the introduction of the mass vaccination campaign. Meningococcal polysaccharide vaccine seems to be an effective public health tool for the management of this serious communicable disease.
Adolescent↗
Epidemiologic aspects of pediatric multiple trauma in a Spanish urban population.
BACKGROUND/PURPOSE: Trauma is still the most frequent cause of mortality and disability in childhood and adolescence. An epidemiologic prospective study on children under 16 years of age with multiple trauma (MT) was conducted in a large Spanish urban university hospital over a 6-year period. METHODS: Of 1,937 children admitted at the pediatric trauma unit for musculoskeletal injuries from March 1988 until March 1994, 56 patients including 37 boys and 19 girls had MT. MT was considered when at least 2 long bones were fractured or there was a fracture of 1 long bone combined with an injury of 4 other major anatomic regions (face and neck, thorax, abdomen, or neural system). The severity of injuries was evaluated according to the modified injury severity score (MISS). RESULTS: Injury to pedestrians was the most frequent cause of MT (54%). The overall mortality rate of the series, including those children dying during transport to the hospital was 11.5%. The average MISS for the whole group was 15 (range, 5 to 59). Head trauma was the most frequent associated injury (52%), two thirds of which were considered minor injuries (Glasgow Coma Scale >15). Seventy-seven fractures were registered, 10% of which were open fractures. External fixation was the most common surgical technique among operated fractures. The average hospitalization period was 16 (median, 13; range, 1 to 150) days. Children with a MISS above 18 points showed a significant longer hospitalization period (mean, 31 +/- 45 days) as compared with those with MISS below 18 points (mean, 10 +/- 7 days; P < .05). There was a strong correlation between the MISS and both the period of hospitalization at the pediatric intensive care unit and the total length of hospital stay. CONCLUSIONS: Pedestrian accidents caused by motor vehicles in children playing at the street contributed most significantly to MT in the urban pediatric population. Special care for prevention must be taken in the age group of 6 to 10 years. Head injury was the main cause of death in children with multiple trauma. MISS was found to be a good predictor of survival and duration of hospital stay in pediatric MT.
Adolescent↗
Auditory neuropathy in children.
Auditory neuropathy is a sensorineural disorder characterized by absent or abnormal auditory brainstem evoked potentials and normal cochlear outer hair cell function. A variety of processes is thought to be involved in its pathophysiology and their influence on hearing may be different. We present here the diagnostic sequence and management of two new cases of auditory neuropathy in breastfeeding children.
Acoustic Stimulation↗
A cost benefit analysis of routine varicella vaccination in Spain.
The objective of the study was to assess varicella epidemiology and the cost of disease in Spain, in order to perform a cost benefit analysis of universal vaccination at 15 months of age. Epidemiological data were obtained from a survey of 150 children with varicella, from hospitalizations and from the Spanish literature. A Markov decision tree was designed with two alternatives, vaccination or nonvaccination. Direct costs derived from the disease were lower than the cost of vaccination (ratio 0.54:1), however when indirect costs, such as working time loss were taken into account, vaccination was the best alternative, with a saving of P(T)2627 per vaccinated subject (P(T)1.6 recovered per peseta invested in the program). Sensitivity analysis shows that decreasing vaccine coverage and efficacy to 0.7, increasing the annual discount rate to 20% and with a vaccine price less than P(T)6000, vaccination is always the best alternative. In conclusion, from the economic point of view, a universal varicella vaccination program in children at 15 months of age would be justified in Spain.
Adult↗
[Haemophilus influenza type b invasive disease in the Community of Valencia. Study Group on Invasive Diseases].
The objective of this study was to estimate the incidence of systemic Haemophilus influenzae type b (Hib) disease in the Valencian Community, Spain, and to study the microbiological characteristics of the strains. Prospective, active surveillance of children in the Valencian Community. Data were obtained from microbiology laboratories and paediatricians. A case was considered when a child younger than 15 years of age had clinical invasive disease and a Haemophilus influenzae (Hi) was isolated from a normally sterile site, or when a positive capsular antigen was identified with a compatible Gram strain. In the first year of surveillance, starting on December 1, 24 cases were identified. Of the 20 strains studied in our laboratory, 19 were serotype b and one non typable. 75% of the strains were beta-lactamase positive. Meningitis was the most frequent clinical presentation. All children were less than five, and 51.2% were less than one year of age. The mortality was 8.3%. For unvaccinated children less than 5 years the estimated incidence of invasive disease was 18.2/100,000 and of meningitis 14.0/100,000. The incidence of Hib invasive disease in unvaccinated children justifies the universal Hib vaccine programme in the Valencian Community.
Adolescent↗
[Children at risk for learning disorders].
INTRODUCTION: To find what is meant by normal learning, it is essential to understand learning difficulties not only from the anatomical but also from the functional point of view. DEVELOPMENT: We review the literature concerning risk factors for learning difficulties in order to treat them early on and attain satisfactory long-term development. CONCLUSIONS: Learning difficulties are the largest groups of disorders in everyday neuropaediatric practice. It should be remembered that in most children with learning difficulties there are undiagnosed preexisting neurological disorders, which come to light on reaching an age at which improved academic achievement is obligatory.
Child↗
Adverse events after polysaccharide meningococcal A&C vaccine.
The incidence of adverse events due to meningococcal polysaccharide A&C vaccine was studied in 312 subjects 18 months to 20 y of age who were part of a mass vaccination program. Fever > 38 degrees C occurred in 5.1% (95% CI: 3.1-8.4%). Injection site pain was reported in 78.8% (95% CI: 74.3-83.4%), was severe in 7.4% (95% CI: 4.7-10.9%) and was most frequent in the oldest age group.
Adolescent↗
[Epidemiology of Haemophilus influenzae type b, Neisseria meningitidis, and Streptococcus pneumoniae in children in the Valencia Community, Spain. Acute diseases study group].
OBJECTIVE: To asses the incidence of Haemophilus influenzae type b (Hib), Neisseria meningitidis and Streptococcus pneumoniae meningitis in children of de Valencian Community (VC), Spain, and to describe the microbiologic characteristics. MATERIAL AND METHODS: Prospective surveillance system with paediatrician and microbiologist participation of all public hospitals of the VC. Cases are children less than 15 with clinical meningitis and with isolation of Hib, N. meningitidis or S. pneumoniae from CSF of blood. RESULTS: From 1st December 1995 to 30th November 1996, 51 cases were declared, 33.3% were Hib, 49.0% N. meningitidis and 17.7% S. pneumoniae. The annual incidence of meningitis was 7.6 cases/100,000 < 15 years, 20.5/100,000 < 5 years and 56.2/100,000 < 1 year. 84.3% of the cases occurred in children younger than 5. S. pneumoniae had the highest mortality. CONCLUSIONS: Hib is a frequent cause of meningitis in spite of that one third of children are vaccinated. 43% of the N. meningitidis isolated in meningitis are serogroup C. S. pneumoniae meningitis are more frequent in children less than one, and has a high mortality rate.
Adolescent↗
[Risk factors in learning difficulties].
OBJECTIVE: To review the literature of the risk factors in learning difficulties (LD) and to assess these factors in children diagnosed as having LD in the Neuropaediatric Department of the Hospital Universitario Infantil La Fe in Valencia, in 1996 and 1997. MATERIAL AND METHODS: A retrospective study was done of children diagnosed in the Hospital Infantil Universitario La Fe in Valencia as having learning difficulties. The different factors related to LD were assessed. RESULTS: Between 1 January 1996 and 31 December 1997 a total of 32 children were diagnosed as having learning difficulties. There were 62.5% boys and 37.5% girls of an average age of 10 years and 10 months. The average intelligence quotient was 82.1. The commonest LD was difficulty with reading and writing. CONCLUSION: Learning difficulties form a large proportion of the routine pathology seen in the Neuropaediatric Department. It must be remembered that in most children with learning difficulties there is undiagnosed underlying neurological pathology which becomes noticeable on reaching an age at which schooling becomes more demanding.
Child↗
[Application of the distortion products register in newborns. Preliminary results].
Following the development of an up-to-date audiological technique--as it seems to be--the register of acoustic distortion products 2F1-F2, the AA. have undertaken the study of the characteristics of otoacoustic emissions in a new-born normal hearing group. They describe the features of distortion products audiogram (DP-gram) of the collective, the limitations of the test and its possible clinical appliances.
Acoustic Stimulation↗
Distortion product otoacoustic emissions in healthy newborns: normative data.
Distortion product otoacoustic emissions (DPOAE) offer an alternative to transiently evoked otoacoustic emissions (TEOAE) as an audiological test. The former can be used as a screening technique, and may also provide frequency-specific information about the functional state of the cochlea. We recorded DPOAE in a group of healthy newborns to establish the characteristics of a DPOAE "audiogram" (DP-gram) in this population. The DP-gram can be obtained with characteristics quite similar to those observed in adults, with two sharp peaks of maximum amplitude at F2 frequencies of 2 kHz and 5-6 kHz, and a decline in DPOAE amplitude in midfrequencies. The results confirm the limitations of DPOAE recording for testing parts of the basilar membrane where lower frequencies are coded.
Acoustic Stimulation↗
Prognostic factors in tympanoplasty: a statistical evaluation.
In a group of 52 patients with chronic otitis media that underwent a myringoplasty, pressure equalization mucociliary clearance of the Eustachian tube and degree of pneumatisation of the mastoid have been studied, and their statistical relationship with surgical outcome evaluated. The only statistically being significant correlation was mucociliary clearance time.
Adolescent↗
[Congenital cholesteatoma of the middle ear].
The AA. inform about 8 patients suffering from congenital cholesteatoma of the tympanomastoidal cleft. They underline the difficulties for achieving a correct diagnosis when the eardrum remains intact and remark the need to keep in mind this process for differential diagnosis of the conductive hypoacusis in childhood. As a matter of fact the AA. emphasize the few cases of recurrences after surgery, in contrast with that of relapses in child's acquired cholesteatoma.
Adolescent↗