Decline in pneumococcal meningitis in Spain after introduction of the heptavalent pneumococcal conjugate vaccine.

All patients < or =14 years old with a diagnosis of pneumococcal meningitis (n = 160) were included (2001, 2004-2006). Incidence per 100,000 child <5 years old varied from 6.14 in 2001 to 2.

Clinical data and factors associated with poor outcome in pneumococcal meningitis.

We carried out a 4-year study of 159 children (ages 1 month-14 years) with pneumococcal meningitis. The study was divided into two periods: the retrospective period (1998-2000: 107 patients), and the prospective period (2001-2002: 52 patients). About 2/3 of the children were under 2 years of age: 72 (45%) were under 1 year of age and 38 (24%) had meningitis during the second year of life.

[Prevalence pneumococcal meningitis in Spanish children].

Objective: To determine the prevalence of pneumococcal meningitis in the pediatric population in Spain. Material and methods Retrospective multicenter study performed in five autonomous communities (Catalonia, Galicia, Madrid, Navarre and the Basque Country) between January 1998 and December 2000. All patients aged between 0 and 14 years old with a diagnosis of pneumococcal meningitis (Streptococcus pneumoniae isolation or presence of Gram-positive diplococcus in the cerebrospinal fluid (CSF) and CSF with more than 20 cells) in all the hospitals of the five autonomous communities were included in the study.

Usefulness of the head-upright tilt test for distinguishing syncope and epilepsy in children.

Purpose: Episodic loss of consciousness in children, whether or not associated with hypertonia or short-duration clonic movements, presents a diagnostic challenge to the pediatrician and child neurologist. We provide some evidence of the usefulness of the head-upright tilt test for investigating the causes of transient loss of consciousness in children, and for distinguishing between syncope, convulsive syncope, and epilepsy.

Methods: We studied nine children previously diagnosed as epileptic on the basis of compatible clinical events and epileptiform findings in routine EEGs who were treated over the long term with antiepileptic drugs, but whose clinical records suggested syncope or convulsive syncope rather than epilepsy on reevaluation.

Study of paediatric intensive care units in Spain. Spanish Society of Paediatric Intensive Care.

Objective: To describe the organisation of paediatric intensive care units in Spain and the medical assistance provided during 1996.

Methods: A written questionnaire was sent to all the paediatric ICUs linked to or within the Spanish public health system.

Results: Thirty-one of the 34 paediatric ICUs replied.

Cerebral oxygenation in children with syncope during head-upright tilt test.

The pathophysiology of neurocardiogenic syncope remains incompletely known. In this entity, besides abnormal systemic hemodynamic regulation, potential cerebral circulatory abnormalities have been reported. In this setting, cerebral saturation assessment could detect cerebral blood flow changes and estimate the sufficiency of brain oxygenation during the event.

Glucocorticoid deficiency with achalasia of the cardia and lack of lacrimation.

Four recent reports describe a multisystem disorder in which ACTH insensitivity is associated with achalasia and alacrima. We report studies on a male patient with this rare triad. The patient had alacrima from birth; isolated glucocorticoid deficiency had been diagnosed at 3.

[Dystonia and carbamazepine (author's transl)].

Appearance of dystonic movements in four epileptics children, while carbamazepine administration, is the object of this publication. Human material is formed by four patients in pediatric ages of 4.5, 5, 6 and 7 years old, which presented dystonia after the administration of carbamazepine.

[A small supernumerary metacentric chromosome: interprétation test (author's transl)].

The report relates to a new case of small supernumerary metacentric chromosome. The phenotypical variability of previously published cases suggests that this chromosomal anomaly may arise from multiple origins. Our study shows the difficulties of a cytogenetic interpretation and the limits of the semeiologic arguments.