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Biomedical subjects

J García-Hortelano

Publications and source records attributed to J García-Hortelano.

6 recordsLinked to original sources
PubMed1998

[Pulmonary tuberculosis in children: its age-dependent aspects].

OBJECTIVE: The aim of this study was to investigate the clinical and radiological particularities of pulmonary tuberculosis depending on the age of the child. PATIENTS AND METHODS: The medical records of all children with pulmonary tuberculosis diagnosed between 1985 to 1996 were reviewed. They were divided into three age groups according to age: < 3 years, 3-5 year and 6-15 years. RESULTS: Of the 173 children identified, 51.4% were male. Forty percent were < 3 years if age, 33.1% between 3 and 5 years and 26.1% between 6 and 15 years old. The frequency of diagnosis derived from a case contact investigation was higher in children < 3 years of age (38.6%) and children aged 3-5 years (52.6%) than in children between 6-15 years old (21.7%, p < 0.05 for both). In the other cases, diagnosis was the result of investigation of an ill child, investigation of a child after pulmonary tuberculosis was diagnosed in a sibling and routine tuberculin skin test reactivity. An adult source of tuberculosis was identified in 68.6% of the children < 3 years old, 59.6% of children aged 3-5, but only in 37% of the children aged 6-15 years (p < 0.05 for both). The case contact was a family member in 92.7% of the children < 6 years of age and in 66.7% of children aged 6-15 years (p < 0.01). Culture of Mycobacterium tuberculosis was positive in 47.1% of children < 3 years old and 43.9% of children aged 6-15 years, but only in 27.5% of children aged 3.5 years (p < 0.05). Pulmonary parenchymal disease was more frequently found in children < 3 years (67.5%) than in children aged 6-15 years (39.4%, p < 0.05). CONCLUSIONS: Investigation of an adult source is essential when a child is diagnosed of pulmonary tuberculosis. Pulmonary tuberculosis is more intense and the source of adult contact is more frequently found in children < 3 years old.

Adolescent↗
PubMed1998

[Brain stem encephalitis in childhood].

OBJECTIVE: To present two cases of post-infectious encephalitis of the brain stem (ETC) in infancy, which is very infrequent at this age. CLINICAL CASES: Two patients aged 4 months and 9 months respectively had a previous history of a catarrhal illness a few days before the onset of encephalitis. The clinical condition was of subacute onset and torpid course, characterized by ataxia, reduced level of consciousness, involvement of the pyramidal tracts and paralysis of the cranial nerves. No significant information for the diagnosis of either case was obtained from CT. MR showed lesions at the level of the pons. However, the MR image did not correspond in seventy to the clinical condition. The clinical courses of the two patients were different. One case recovered with no sequelae. In the other case the cranial nerves and gait did not return to normal. CONCLUSIONS: In our experience, ETC is rarely seen in infancy. A high degree of suspicion and early treatment of ETC caused by the herpes simplex virus is necessary, since there is usually a high mortality or serious neurological sequelae.

Ataxia↗
PubMed1997

Tolerance of pyrazinamide in short course chemotherapy for pulmonary tuberculosis in children.

BACKGROUND: This prospective study was performed to evaluate the tolerance of pyrazinamide in short course chemotherapy in children. METHODS: A total of 114 children ages 6 months to 15 years (4.5 +/- 3.4 years) with diagnosed pulmonary tuberculosis from 1985 to 1995 entered the trial. A 2-month regimen of isoniazid, rifampin and pyrazinamide, followed by rifampin and isoniazid for the remaining 4 months, was administered orally to all children. Clinical adverse effects specifically investigated were gastrointestinal disturbances, rash, signs of hepatotoxicity and arthralgias. Laboratory toxicity data (number of leukocytes, erythrocyte sedimentation rate, aspartate aminotransferase, alanine aminotransferase and serum uric acid) were collected before treatment and 1, 3 and 5 months after the beginning of chemotherapy. RESULTS: Clinical adverse effects were mild in all cases. Three children (2.6%) had fever and 5 (4.4%) had gastrointestinal disturbances. Aspartate aminotransferase and alanine aminotransferase mean values showed no differences along time and no patients had clinical signs of hepatotoxicity. Only 11 children (19.6%) showed a slight increase in alanine aminotransferase (< 194 units/l). Serum uric acid increased in 92.2% of the children compared with pretreatment values. This increase remained within the normal range in all but 9.8% of patients. There was a significant increase in uric acid mean concentrations after 1 month of therapy (from 3.7 +/- 0.7 mg/dl to 5.7 +/- 1.6 mg/dl, P < 0.05), which fell again (4.0 +/- 1.1) 1 month after pyrazinamide was stopped. There were no signs of gout or arthralgias. In no case was the treatment interrupted. CONCLUSION: The addition of pyrazinamide in chemotherapy for pulmonary tuberculosis in children was found to be safe. The slight increase in uric acid concentration during its administration had no recognized adverse consequences.

Adolescent↗
PubMed1991

[Contacts of children with tuberculous patients].

One hundred and nine adults recently diagnosed of active pulmonary tuberculosis (all of them with smear positive sputum) were selected. Their household contacts under fifteen years of age were studied. 73.1 por 100 of the children were tuberculin-positive, and 33.1 por 100 of these "reactors" had developed a pulmonary tuberculosis themselves. The bacillary density in the sputum of the source case was correlated to percentage of infected and ill children among his contacts. Neonatal vaccination with BCG showed a protective effect against the illness in children under eight years of age.

Adolescent↗
PubMed1990

[Pulmonary tuberculosis in infants: apropos of 149 cases].

One hundred and forty-nine cases of childhood pulmonary tuberculosis were analysed being a 77.6% of the 192 cases of tuberculosis diagnosed at the Pediatric Infectious Diseases Department of "La Paz" Hospital, in a ten year period. The children were aged 3 months to 14 years; 65% of them were less than 6 years of age. The source case was found in 67.1% of the children. The primary means of diagnosis was contact screening (38.1%), followed by a 27.5% that presented with non-specific symptoms, while 18.1% of the cases presented with respiratory symptoms. Gastric aspirates yield the organism in 25.8% of cases. Radiologically the following was found: 38.9% mixed patterns, 32.2% nodal patterns, 23.4% parenchymal patterns, 1.34 miliary tuberculosis, 1.34% caverns and 2.68% pleural effusions. Right lung location was more frequent in parenchymatous forms (68%), as well as in nodal forms (61.5%). The duration of the course of therapy changed along this ten years period: from twelve months initially to ten months posteriorly, subsequently becoming a six month course of treatment. All cases experienced full recovery.

Adolescent↗