[Urinary tract infection caused by Shigella sonnei].
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Biomedical subjects
Publications and source records attributed to F Anaya Barea.
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Neonatal diabetes mellitus is defined as hyperglycemia detected in the first month of life of more than 2 weeks' duration, requiring insulin treatment. It is extremely uncommon (1/500,000 neonates) and is permanent in only 30% of cases. Several hypotheses concerning its etiology have been postulated, such as pancreatic immaturity, paternal uniparental isidisomy of chromosome 6, and the existence of a gene located in the 6 q 22-23 chromosome region subjected to imprinting and exclusively of paternal expression. The management of these patients is usually difficult. These neonates are underweight for their gestational age, and neither anti-insulin antibodies nor anti-islets are detected. We studied a neonate hospitalized because of low weight for his gestational age with dimorphic features and hyperglycemia since the 17 th day of life. Clinical and anatomical follow-up has been periodically performed to the present date. The child presents permanent neonatal diabetes with negative antibodies. Although various insulin patterns have been used since the onset of the syndrome, management remains difficult. The child presents hypothyroidism, bilateral neurosensory deafness, bilateral congenital cataract, myopia, dimorphic features, congenital stridor and slow weight-stature curve. The results of muscle biopsy and metabolic studies were normal. Wolfram's syndrome and mitochondrial diabetes were ruled out. This is an exceptional case of permanent neonatal diabetes associated with other malformations corresponding to no known syndromic patterns.
BACKGROUND: Because of the lack of data from our province, we performed the present study to determine the current situation and future evolution in our region of the most frequent chronic disease in childhood. OBJECTIVE: To evaluate the incidence of diabetes mellitus and the prevalence of type 1A diabetes mellitus in children younger than 16 years old from the province of Ciudad Real. MATERIAL AND METHODS: We performed an epidemiological, cross-sectional, observational study. The mark-release-recapture method was used to calculate exhaustivity. The patients were selected through surveys to primary care centers, hospital registries and diabetics associations in our province. All type 1A diabetics were included in the calculation of prevalence. Only diabetics with onset of symptoms in 1999 were included in the calculation of incidence. RESULTS: The incidence of diabetes mellitus in children younger than 16 years old was 26 per 100,000. Twenty-three children were diagnosed with the disease, with an exhaustivity rate of 88.5 %. The prevalence of type 1A diabetes mellitus in children younger than 16 years old was 2.1 per 1,000 and 0.42 per 1,000 inhabitants. The prevalence in the general population was 0.88 per 1,000 inhabitants. CONCLUSIONS: The incidence of diabetes mellitus in children younger than 16 years old and the prevalence of type 1A diabetes mellitus in the province of Ciudad Real are higher than expected and are the highest of currently known rates in Spain.
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From 1974 to 1987 we have diagnosed thirty three patients with rheumatic fever. The age of onset ranged from three to sixteen years with a mean age of nine years and six months. Carditis was the most frequent major criteria (27/33) followed by arthritis (14/33) and Sydenham's chorea (6/33). All the patients with carditis had the mitral valve affected. The usual treatment in the acute phase was penicillin and aspirin. The prophylaxis recommended to the patients was penicillin G benzatine every 21 days if they had carditis and every 28 days if they didn't. Two patients allergic to penicillin are receiving erythromycin. We have observed that the incidence of rheumatic fever has remained unchanged that the age of onset increased and that the antiinflammatory drug of choice in most patients with carditis is aspirin.
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