Seguimiento de los recién nacidos con encefalopatía hipóxico-isquémica

Hypothermia treatment for newborn infants with hypoxic-ischemic encephalopathy reduces the number of neonates who die or have permanent neurological deficits. Although this therapy is now standard of care, neonatal hypoxic-ischaemic encephalopathy still has a significant impact on the child's neurodevelopment and quality of life. Infants with hypoxic-ischaemic encephalopathy should be enrolled in multidisciplinary follow-up programs in order to detect impairments, to initiate early intervention, and to provide counselling and support for families.This article describes the main neurodevelopmental outcomes after term neonatal hypoxic-ischaemic encephalopathy. We offer recommendations for follow-up based on the infant's clinical condition and other prognostic indicators, mainly neonatal neuroimaging. Other aspects, such as palliative care and medico-legal issues, are also briefly discussed.     

Terapia prenatal con sulfato de magnesio: evolución clínica de los recién nacidos pretérmino menores de 29 semanas y correlación con la magnesemia neonatal

Introduction

Antenatal magnesium sulphate (MgSO4) administration has shown to be effective in minimising cerebral palsy and severe motor dysfunction at the age of 2 years.The aim of this study is to analyse the initial clinical outcome of preterm neonates less than 29 weeks who have received prenatal MgSO₄, as well as to determine the relationship between the magnesium dose delivered to the mother and the magnesium concentration in the neonates.

Evolución de los ingresos por maltrato infantil durante 15 años

AimTo measure the incidence of admissions for maltreatment between 1995 and 2009 and to determine their main clinical and epidemiological characteristics.MethodsRetrospective review of children diagnosed with maltreatment over 15years in a third level hospital.ResultsA total of 97 cases (median incidence 0.5 cases per 1000 children admitted per year) were found. There was an increasing rate of physical maltreatment, while those of sexual abuse declined. 51 (53.6%) female; median age 3.3 years (p25-75: 7.6 months-10.0 years). Just under half (43.3%) or 42 patients, had a primary complaint unrelated to abuse. The most common injuries were haematomas (43; 44.3%). In 91 (93.8%) cases the perpetrator was found to be a member of the child's own family (77; 74.9%, one of the parents or both).ConclusionsThe increase in admissions for physical maltreatment stresses the need to insist in a prevention policy. The decrease in admissions for sexual abuse was probably attributable to changes in the care circuit rather than a real decrease. In almost half of the cases the suspicion of maltreatment arose upon physical examination or after complementary tests, making it advisable that maltreatment is included in the differential diagnosis in multiple consultations. The majority of maltreatment occurred in the context of the victim's family.     

¿Caminan de manera diferente los niños con trastorno por déficit de atención hiperactividad (TDAH)? Relación entre marcha de puntillas idiopática y TDAH

Introduction

Idiopathic toe-walking (ITW) is described as a gait pattern with no contact between the heels and the ground in children older than 3 years. The diagnosis is clinical, making it necessary to rule out other neurological and orthopaedic conditions. A relationship between ITW and vestibular dysfunction and/or proprioceptive sensibility has been proposed. Children with neurodevelopmental disorders (autism, language and cognitive disorders) often have ITW.