Search

Pneumomediastinum is the presence of air in the mediastinal space, originated in bronchi, alveoli or esophageal rupture, which runs through the vascular tissue pods and towards the mediastinal space. Pneumomediastinum is classified as spontaneous or traumatic. Secondary pneumomediastinum is considered an unusual entity in children, with very variable incidence. It is associated with acute asthma airway infections, trauma, vomiting, intense efforts, anxiety with hyperventilation and drug use. This is a case report of a previously healthy, 4 year old female toddler with secondary pneumomediastinum, without trauma or thoracic procedures or instrumentation in child's pathophysiology associated with cough, with communityacquired pneumonia. It was confirmed by chest and neck radiographs. The pathology was of short duration and required treatment during a short time in the hospital. According to the chest CT scan performed at admission, air was observed migrating from the perivascular bronchial sheaths to the mediastinum ("Macklin effect"). [ABSTRACT FROM AUTHOR]

Pertussis is an endemic disease in our population. Every 3 to 4 years, pertussis has an epidemic pattern even in countries with good health conditions. Antipertussis vaccine first dose is administered at the age of 2 months; a second and third dose are given at 4 and 6 months of age. This vaccine has an 8 to 10 year protective effect, for which reason it is suggested that pregnant women in the third trimester should be vaccinated in order to prevent pertussis in newborns. It should also be administered to older people to avoid turning them into asymptomatic carriers. Clinic manifestations are easily identifiable due to respiratory symptoms, especially to the particular characteristics of the cough. The diagnosis is supported by the presence of leukocytosis (predominantly lymphocytes) and by certain thoracic radiologic findings. The diagnosis is confirmed with a positive culture for Bordetella pertussis or with a polymerase chain reaction (PCR). In a non complicated clinic course macrolides are still the best therapeutic choice. Nonetheless clinic observation is highly recommended in order to avoid complications. Redefinition of vaccine programs against Bordetella pertussis in Mexican population is recommended and also to notify the presence of the disease to the corresponding health authorities. [ABSTRACT FROM AUTHOR]

Introduction. Asthma is the most common chronic disease in children. It is characterised by coughing, wheezing and breathlessness. Symptoms, seasonality and triggering factors differ for each individual. Objective. To describe the clinical and spirometric characteristics of Mexican asthmatic children, as well as triggering factors, use of rescue therapy, seasonality and allergic sensitization. Method. Medical history, clinical evaluation, spirometric tests, and skin prick tests were performed in children attending an allergy outpatient clinic for the first time, with symptoms suggestive of asthma in the last year. Asthma severity was classified according to GINA 2002. Results. A total of 104 patients between 7 and 18 years old (10.1±2.79) were included. Male gender predominated with a 1.3:1 ratio. 58.7% had mild asthma; 29.8% mild to moderate asthma, and 11.5% moderate to severe asthma. Coughing, wheezing and nocturnal asthma were the predominant symptoms. Forced expiratory volume in one second (FEV1) (%) was between 80 and 117% (92.1±7) in the first group; between 80 and 105% (90±7.4) in the second group; and between 72 and 89% (79.2±4.8) in the third group. 58.2% of the patients had received bronchodilators in the last year (average 1.3 times/week). Most children (89.4%) were sensitized to at least one allergen. Conclusions. Asthma symptoms, triggering factors, as well as FEV1 vary individually according to asthma severity. [ABSTRACT FROM AUTHOR]