RESUMO
The development of nephrotic syndrome in concomitance with Hashimoto's thyroiditis is an in frequent association in the pediatric age. OBJECTIVE: To report an infrequent complication of au toimmune thyroiditis, such as the appearance of nephrotic syndrome. CLINICAL CASE: A 10-year-old patient presenting with nephrotic syndrome and goiter. A history of autoimmune thyroiditis and un treated hypothyroidism was detected. Corticosteroid and hormone replacement therapy (levothyro- xine) is started, achieving a good clinical and laboratory response. CONCLUSION: Autoimmune thyroi ditis impacts renal physiology through immunological and non-immunological mechanisms. At the same time, renal repercussions can affect thyroid function. The importance of this communication lies in reporting an infrequent complication of autoimmune thyroiditis, such as the appearance of nephrotic syndrome.
Assuntos
Doença de Hashimoto , Hipotireoidismo , Síndrome Nefrótica , Tireoidite Autoimune , Humanos , Criança , Tireoidite Autoimune/complicações , Síndrome Nefrótica/complicações , Síndrome Nefrótica/diagnóstico , Doença de Hashimoto/complicações , Doença de Hashimoto/diagnóstico , Hipotireoidismo/complicações , RimRESUMO
Serendipity has played a crucial role in the history of many different areas of science, including modern medicine. This corresponds to the ability to make a discovery, which occurs accidentally or by chance, in combination with the sagacity of the observer. Many of the most important and revolutio nary findings in medical science, specifically pharmacology, involved serendipitous events of a natu re. Some examples related to drug discovery and pharmacological research are briefly reviewed, such as the history of benzodiazepines, chloral hydrate, clonidine, warfarin, Ringer's solution, valproic acid, barbiturates, penicillin and insulin, in which there were events related to serendipity. All these drugs or their derivatives are currently in frequent use in Intensive Care Units.
Assuntos
Hidrato de Cloral , Ácido Valproico , Criança , Humanos , Penicilinas , Cuidados CríticosRESUMO
Medical philately, with its diverse themes, is a faithful testimony of the historical events that have affected humanity. Likewise, it allows us to evidence its role as a diffuser of diverse prevention cam paigns carried out to control and eradicate serious infections, together with other achievements of health policy in the child population. Nowadays, the knowledge and collection of postage stamps is an increasingly unusual pastime. On the other hand, sometimes there is a marked historical ignoran ce and lack of appreciation of the effective actions for the control of infectious diseases, forgetting the enormous effect of these on the daily life of the current society. Through the visual testimony offe red by the postage stamps, we review the sanitary, educational, and therapeutic actions destined to control the infections in the pediatric patient, with emphasis on our country. In addition, we discuss the new populations at risk for the appearance of septic episodes. Even today, serious infections and sepsis represent an important public health problem.
Assuntos
Política de Saúde/história , Promoção da Saúde/história , Filatelia , Sepse/história , Sepse/prevenção & controle , Adolescente , Criança , Saúde da Criança/história , Pré-Escolar , Chile , Saúde Global/história , Promoção da Saúde/métodos , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Lactente , Recém-Nascido , América Latina , Sarampo/história , Sarampo/prevenção & controle , Gravidade do Paciente , Pediatria/história , EspanhaRESUMO
Se han cumplido doscientos años desde la publicación en la que se dio a conocer la aplicación clínica del estetoscopio. Esta fue realizada en 1819 por René Théophile Hyacinthe Laënnec. El Dr. Laënnec vivió su infancia en la efervescencia social de la Revolución francesa y estudió Medicina en París, donde se graduó en 1804. Su experiencia clínica en el Hospital Necker culminó con la invención del estetoscopio en 1816. Tres años después, la publicación de su obra maestra De l'auscultation médiate enfatizó un enfoque clínico-patológico más racional, en especial, para el entendimiento de las enfermedades cardiorrespiratorias. Sin duda, el Dr. Laënnec revolucionó la medicina al perfeccionar el arte de la semiología torácica, que permitió al médico transformar los sonidos que escuchaba en una imagen, la cual podía visualizar.Con ocasión del bicentenario de este trascendental hito de la medicina moderna, se recuerda su historia
Two hundred years have passed since the publication that revealed the clinical use of the stethoscope. René Théophile Hyacinthe Laënnec published it in 1819. Laënnec spent his childhood in the social effervescence of the French Revolution and studied medicine in Paris, where he graduated in 1804. His clinical experience at Necker Hospital peaked with the invention of the stethoscope in 1816. Three years later, he published his masterpiece De L'Auscultation Médiate, which underlined a more rational clinical-pathological approach, especially in the understanding of cardiopulmonary diseases. Undoubtedly, Laënnec revolutionized medicine by perfecting the art of thoracic semiology, which allowed him to translate the sounds he heard into an image that could be visualized.In the bicentennial of the invention of such fundamental milestone in modern medicine, the purpose of this article is to go over its history
Assuntos
Humanos , Estetoscópios/história , Auscultação Cardíaca/história , História da MedicinaRESUMO
Two hundred years have passed since the publication that revealed the clinical use of the stethoscope. René Théophile Hyacinthe Laënnec published it in 1819. Laënnec spent his childhood in the social effervescence of the French Revolution and studied medicine in Paris, where he graduated in 1804. His clinical experience at Necker Hospital peaked with the invention of the stethoscope in 1816. Three years later, he published his masterpiece De L'Auscultation Médiate, which underlined a more rational clinical-pathological approach, especially in the understanding of cardiopulmonary diseases. Undoubtedly, Laënnec revolutionized medicine by perfecting the art of thoracic semiology, which allowed him to translate the sounds he heard into an image that could be visualized. In the bicentennial of the invention of such fundamental milestone in modern medicine, the purpose of this article is to go over its history.
Se han cumplido doscientos años desde la publicación en la que se dio a conocer la aplicación clínica del estetoscopio. Esta fue realizada en 1819 por René Théophile Hyacinthe Laënnec. El Dr. Laënnec vivió su infancia en la efervescencia social de la Revolución francesa y estudió Medicina en París, donde se graduó en 1804. Su experiencia clínica en el Hospital Necker culminó con la invención del estetoscopio en 1816. Tres años después, la publicación de su obra maestra De l'auscultation médiate enfatizó un enfoque clínico-patológico más racional, en especial, para el entendimiento de las enfermedades cardiorrespiratorias. Sin duda, el Dr. Laënnec revolucionó la medicina al perfeccionar el arte de la semiología torácica, que permitió al médico transformar los sonidos que escuchaba en una imagen, la cual podía visualizar. Con ocasión del bicentenario de este trascendental hito de la medicina moderna, se recuerda su historia.
Assuntos
Auscultação/história , Médicos/história , Estetoscópios/história , Auscultação/instrumentação , França , História do Século XVIII , História do Século XIX , HumanosRESUMO
Resumen: Cada vez es más frecuente la atención médica en la Unidad de Cuidados Intensivos (UCI) de niños o adolescentes inmigrantes como también de aquellos nacidos en nuestro país con padres en tal condición. Esto ha ocasionado, en la actualidad, que el equipo de salud se deba enfrentar con problemas diagnósticos derivados del escaso conocimiento de condiciones genéticas propias de esta población y/o el desarrollo de diversas patologías infrecuentes en nuestro país, algunas resultantes de su condi ción sanitaria. En esta revisión se abordan diversos aspectos de la patología hematológica, infecciosa, parasitaria, respiratoria y cardiovascular, todos tópicos relevantes de conocer durante su estadía en la UCI. Es un deber del equipo de salud actualizarse sobre patologías de baja prevalencia en nuestro país, algunas de ellas muy poco conocidas hasta hace una década, pero que, actualmente, están cada vez más presentes en las UCI del sistema de salud público chileno.
Abstract: It is increasingly common to provide medical care in the Intensive Care Unit (ICU) for immigrant children and adolescents as well as those born in Chile with parents in such condition. Currently, this has caused that the health team has to face diverse infrequent pathologies in our country and/ or diagnostic problems derive from the poor knowledge of genetic conditions of this population, some resulting from their health conditions. This review addresses several aspects of hematological, infectious, parasitic, respiratory, and cardiovascular pathologies, all relevant topics to know during their stay in the ICU. It is a duty of the health team to be updated on pathologies of low prevalence in our country, some of them very little known until a decade ago, but which are currently increasingly present in the ICUs of the Chilean public health system.
Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/etnologia , Doenças Respiratórias/terapia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/terapia , Cuidados Críticos/métodos , Emigrantes e Imigrantes , Doenças Hematológicas/diagnóstico , Doenças Hematológicas/etnologia , Doenças Hematológicas/terapia , Infecções/diagnóstico , Infecções/etnologia , Infecções/terapia , Unidades de Terapia Intensiva , Chile/epidemiologia , PrevalênciaRESUMO
In our country, meningococcal disease has a low endemic and high lethality, with epidemic out breaks; some of them of historical character, like the one happened during the first half of the last century. The action of a group of doctors, pioneers in clinical, research and teaching aspects, together with the health personnel that constituted their team, immersed in a successful public health policy, allowed to consolidate the necessary care of the sick child of this serious pathology, as well as many others, thus enabling the development of a structured and scientific proposal, in the light of the knowledge available at that time. Therefore, after 80 years, it is important to review the various clini cal, pathophysiological and therapeutic aspects, in addition to the hospital and social context, of this successful history of the Chilean public health system.
Assuntos
Epidemias/história , Infecções Meningocócicas/história , Choque Séptico/história , Criança , Pré-Escolar , Chile/epidemiologia , História do Século XX , Hospitalização , Humanos , Lactente , Infecções Meningocócicas/diagnóstico , Infecções Meningocócicas/epidemiologia , Infecções Meningocócicas/terapia , Pediatria/história , Choque Séptico/diagnóstico , Choque Séptico/epidemiologia , Choque Séptico/terapiaRESUMO
Resumen: En nuestro país, la enfermedad meningocóccica presenta una baja endemia y alta letalidad, con exis tencia de brotes epidémicos, algunos de ellos de carácter histórico, como el acaecido durante la pri mera mitad del siglo pasado. La acción de un grupo de médicos, pioneros en los aspectos clínicos, de investigación y docencia, junto al personal de salud que constituía su equipo, inmersos en una política pública sanitaria exitosa, permitieron consolidar el cuidado necesario del niño enfermo de esta grave patología, como también de muchas otras, posibilitando así el desarrollo de una propuesta estructurada y científica a la luz del conocimiento disponible en aquella época. Por ello, luego de 80 años, es importante revisar los diversos aspectos clínicos, fisiopatológicos y terapéuticos, además del contexto hospitalario y social de esta exitosa historia del sistema de salud público chileno.
Abstract: In our country, meningococcal disease has a low endemic and high lethality, with epidemic out breaks; some of them of historical character, like the one happened during the first half of the last century. The action of a group of doctors, pioneers in clinical, research and teaching aspects, together with the health personnel that constituted their team, immersed in a successful public health policy, allowed to consolidate the necessary care of the sick child of this serious pathology, as well as many others, thus enabling the development of a structured and scientific proposal, in the light of the knowledge available at that time. Therefore, after 80 years, it is important to review the various clini cal, pathophysiological and therapeutic aspects, in addition to the hospital and social context, of this successful history of the Chilean public health system.