[Posterior reversible encephalopathy syndrome (PRES) and hemolytic anemia: two severe and unusual complications of acute post-streptococcal glomerulonephritis].

Unlabelled: The most frequent cause of nephritic syndrome in the pediatric population is acute post-infectious glomerulonephritis (PIGN). A rare complication is posterior reversible encephalopathy syndrome (PRES), characterized by subcortical vasogenic cerebral edema associated with variable neurological symptoms. The development of autoimmune hemolytic anemia is an atypical clinical presentation.

[Overnight extubation is not associated with extubation failure in pediatric intensive care unit patients: a retrospective cohort study].

Unlabelled: There is little known about the time of the day and the nature of it (business day/non-business day) at which extubation is performed, and whether it is safe during the night.

Objective: to describe the frequency of nocturnal extubation (NE) and non-business day extubation (nBDE). In addition, to determine the association between these and clinical outcomes.

[Fortuna and Serendipity: history of some drugs used in Pediatric Intensive Care].

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.

[Development of nephrotic syndrome in a patient with Hashimoto's Thyroiditis].

Unlabelled: 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.

[Historical milestones for the control of severe infections and sepsis in pediatrics. Approach through medical philately].

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.

[Pathologies of the immigrant child in the Intensive Care Unit. Update].

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.

René Théophile Hyacinthe Laënnec (1781-1826). Two hundred years of the stethoscope. A brief overview.

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.

[About the Chilean meningococcal epidemic (1941-1942): The children with septic shock 80 years ago from a medical and social perspective].

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.

[Infectious glomerulonephritis and pleuropneumonia due to Streptococcus pneumoniae. Pediatric clinical case].

Acute glomerulonephritis caused by Streptococcus pneumoniae is a low prevalence pathology. There are several reports communicating different nephritogenic serotypes, however, 6C has been scarcely indicated as such. It is presented the case of a 4-year-old patient who entered Intensive Therapy Unit with pleuropneumonia due to Streptococcus pneumoniae serotype 6C and concomitantly developed edemas, arterial hypertension, hematuria, proteinuria, decreased glomerular filtration rate and C3 complement level.

[The child with infectious diseases in the visual arts: Painting].

The catastrophic impact of infectious diseases on children's health, as well the transcendental and be neficial role played by the establishment and execution of health measures and immunoprevention, has been a recurrent subject in the history of medicine, although once the disease has been controlled, they are easily forgotten. In view of this, it seems necessary to recall that social scenario through an approach through painting. The pictorial works are witnesses of that since diseases are subject of representation, and at the same time, they have become an invaluable document in the history of me dicine.

[Origin of medical eponyms derived from mythology].

Many myths and legends have had a profound influence on modern medical language and are exten ded to all specialties as part of their culture and the history of medicine. This article briefly reviews the history of some eponyms which are usually used in medical practice. It is the knowledge of a few the mythological origin in its denomination.

Origin of certain eponyms used in pediatrics derived from literature.

Eponyms are commonly used in medicine; some of them derive from the name of literary characters or make reference to classical myths. In this article, we underline some eponyms obtained from literature and review the characteristics of the literary characters, the circumstances that led to their creation, and the physicians who coined and adapted them to the field of medicine. A literary eponym offers a cultural and humanist perspective to our daily practice and is part of the history of medicine.

Childhood obesity: Pharmacokinetics considerations for drugs used in the Intensive Care Unit.

An adequate drug dosage at treatment initiation is particularly relevant for critically ill patients. An inadequate dosage may result in therapeutic failure, potentially severe adverse events, and unnecessary health expenditures. At present, due to the higher incidence of childhood obesity, primary care physicians are more commonly faced with this population, so they need to make appropriate therapeutic decisions.

[Origin of commonly used eponyms in the Intensive Care Unit daily job].

Eponyms reflect the history of medicine, diseases, and doctors in their time. Their use is controversial, presenting supporters and detractors. However, the use of eponyms persist in the modern medical language in the Intensive Care Units and includes some frequently used ones such as Foley, Seldinger, Down, Macintosh, Magill, Ringer, Yankauer, Doppler, and French.

[Down Syndrome child in the Intensive care unit].

Down syndrome is the most common chromosomal abnormality in newborns, with a high incidence in Chile. This condition presents unique physiological aspects that should be known, which can affect the child during their stay in an Intensive Care Unit, beyond the neonatal period This review is focused on the respiratory, cardiovascular, infectious and neurological disorders. Anesthetic management and postoperative analgesia considerations, weaning from mechanical ventilation, cervical spine instability and prognosis of the critically ill child with Down syndrome are also analyzed.

[Pulmonary-renal crosstalk in the critically ill patient].

Despite advances in the development of renal replacement therapy, mortality of acute renal failure remains high, especially when occurring simultaneously with distant organic failure as it is in the case of the acute respiratory distress syndrome. In this update, birideccional deleterious relationship between lung and kidney on the setting of organ dysfunction is reviewed, which presents important clinical aspects of knowing. Specifically, the renal effects of acute respiratory distress syndrome and the use of positive-pressure mechanical ventilation are discussed, being ventilator induced lung injury one of the most common models for studying the lung-kidney crosstalk.

[Septic shock in intensive care units. Current focus on treatment].

Essential therapeutic principles in children with septic shock persist over time, although some new concepts have been recently incorporated, and fully awareness of pediatricians and intensivists is essential. Fluid resuscitation is a fundamental intervention, but the kind of ideal fluid has not been established yet, as each of these interventions has specific limitations and there is no evidence supportive of the superiority of one type of fluid. Should septic shock persists despite adequate fluid resuscitation, the use of inotropic medication and/or vasopressors is indicated.

[Ventilation strategies in the child with severe hypoxemic respiratory failure].

In this review, we assemble the fundamental concepts of the use of mechanical ventilation (MV) in children with acute respiratory failure (ARDS) and refractory hypoxemia. We also discusses topics of protective ventilation and recruitment potential, and specifically examine the options of ventilation and/or maneuvers designed to optimize the non-aerated lung tissue: alveolar recruitment maneuvers, positive end-expiratory pressure (PEEP) titulation, high frequency oscillatory ventilation (HFOV), airway pressure release ventilation (APRV), aimed at correcting the mismatch ventilation/perfusion (V/Q): use of prone position. The only pharmacological intervention analyzed is the use of neuromuscular blockers.

[Nephrobronchial fístula in pediatric patient: case report].

Nephrobronchial fistula is a rare complication of kidney infections, usually occurring in adult patients with xanthogranulomatous pyelonephritis and very occasionally in children. We reported a 12-year-old girl, with a history of myelomeningocele and recurrent urinary tract infection, who presented with a four-week fever, cough and dyspnea, developing septic shock and presenting flood of airway by pus which caused cardiac arrest. A diagnosis of left perirenal extensive collection was established by abdominal computed tomography (CT).

[Septic shock in ICU: advanced therapeutics, immunoparalysis and genomics. State of the art].

New and important concepts have emerged for the advanced management of the child with septic shock in the recent decades. Attending physicians in the Pediatric intensive care unit must be fully aware of them to improve patient care in the critical care unit. It should be considered the use of immune therapy only in selected groups of patients.

[PIRO classification in pediatric severe sepsis and septic shock: a new model for staging and its potential usefulness in prognoses].

Background: Sepsis is a dynamic process that involves complex interactions between the pathogenic micro-organisms and the host. The understanding of this heterogeneous disease has led to the development of a new system for stratification of septic patients: the PIRO system: Predisposition (P) -Insult/Infection (I) -Response (R) -Organ disfunction (O), a classification aimed to determine the risk of death in patients with sepsis. Only a few studies have validated this classification system in children.