Biomedical subjects

Fernando Stein

Publications and source records attributed to Fernando Stein.

5 recordsLinked to original sources

PubMed2006

Tracheitis in pediatric patients.

Despite the advances that have been achieved in supportive pediatric intensive care, tracheitis remains a significant cause of reversible upper-airway obstruction in pediatric patients. This discussion highlights the epidemiology and clinical presentation of tracheitis in the twenty-first century and reviews diagnostic and therapeutic modalities. The gold standard for therapy remains supportive airway management in conjunction with appropriate antibiotic therapy. Finally, the unique challenges of diagnosis and treatment of tracheitis in the technology dependent child with an existing artificial airway (endotracheal tube or tracheostomy) are addressed.

Airway Obstruction↗

PubMed2006

Nitric oxide.

Nitric oxide (NO) is a gas that is involved in many biologic processes. It is synthesized, by the NO synthases. The synthesis of NO by vascular endothelium is responsible for the vasodilator tone. In the central nervous system, it is a neurotransmitter, involved in the formation of memory; in the periphery, some nerves operate through NO-dependent mechanisms to mediate neurogenic vasodilatation in the respiratory, gastrointestinal, and genitourinary tracts. NO also contributes to control of platelet aggregation and regulation of cardiac contractility. In addition, NO is produced in large quantities during host defense and immunologic reactions. Because it has cytotoxic properties and is generated by activated macrophages, it is likely to have a role in nonspecific immunity. This review discusses the physiology, the mechanism of action, and the role of NO in inflammation and immune responses.

Humans↗

PubMed2006

Integrated management of childhood illness: an emphasis on the management of infectious diseases.

The Integrated Management of Childhood Illness (IMCI) strategy has helped strengthen the application and expand coverage of key child survival interventions aimed at preventing deaths from infectious disease, respiratory illness, and malnutrition, whether at the health services, in the community, or at home. IMCI covers the prevention, treatment, and follow-up of the leading causes of mortality, which are responsible for at least two-thirds of deaths of children younger than 5 years in the countries of the Americas. The IMCI clinical guidelines take an evidence-based, syndrome approach to case managment that supports the rational, effective, and affordable use of drugs and diagnostic tools. When clinical resources are limited, the syndrome approach is a more realistic and cost-effective way to manage patients. Careful and systematic assessment of common symptoms and well-selected clinical signs provide sufficient information to guide effective actions.

Ambulatory Care↗

PubMed2003

Recurrent conjunctivitis as a presentation of munchausen syndrome by proxy.

PURPOSE: To report a case of Munchausen syndrome by proxy, which manifested as recurrent bilateral keratoconjunctivitis in an infant. DESIGN: Interventional case report. INTERVENTION: The patient underwent numerous diagnostic studies, including two endoscopies, skin biopsy, conjunctival pH measurement, and a skeletal survey. She underwent daily eye examinations until the corneal and conjunctival epithelial defects resolved. MAIN OUTCOME MEASURE: Resolution of cutaneous, mucosal, corneal, and conjunctival epithelial defects. RESULTS: A punch biopsy of the right postauricular area was performed, and pathology subsequently determined that the findings seemed to be the result of an exogenous injury. The conjunctival pH was 8.0, consistent with exposure to an exogenous, caustic agent. The acute ocular lesions resolved. CONCLUSIONS: Munchausen syndrome by proxy can be seen with ophthalmic manifestations and should be considered in the differential diagnosis when ocular abnormalities cannot be explained after a thorough and methodical evaluation.

Conjunctivitis↗

PubMed2003

Pediatric septic shock: why has mortality decreased?-the utility of goal-directed therapy.

Mortality from septic shock in children has decreased by 92 percent in the last 36 years. The contributions of goal-directed therapy, intensive care, and other forms of support are responsible for this decrease. A deeper and more specific understanding of innate immunity and the biomolecular processes that operate in septic shock has offered the scientific basis to implement goal-directed therapies. However, therapies that are aimed specifically at manipulating the inflammatory cascade have yet to prove safe and effective.

Anti-Infective Agents↗