Hospital Pediatrico Universitario Juan Manuel Marquez

Havana, Cuba

Hospital Pediatrico Universitario Juan Manuel Marquez

Havana, Cuba

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Amaro A.T.,Hospital Pediatrico Universitario Juan Manuel Marquez | Garcia R.J.,University of Habana | Porben S.S.,University of Habana
Revista Cubana de Pediatria | Year: 2011

Introduction: burns are one of the major causes of accidents in child. Its size and the hypercatabolic status are determinant factors of treatment dynamics and the survival of child with large burns. Objective: to look for the possible relation between the nutritional support established during the firsts hours after resuscitation with some prognostic indicators in burnt children. Methods: an analytical and retrospective study was conducted including 252 children admitted in the burn service of the Juan Manuel Márquez Teaching Children Hospital of Marianao in La Habana with a stay higher of 7 days during the decade of 2000 to 2009. From the audit of medical records it was obtained the following prognostic indicators of burnt child: burnt body surface, stay time, weight loss percentage and mortality. Likewise it was possible to obtain information about the type of metabolic nutritional support used during treatment. Results: the above mentioned more used support was mixed where is combined the peripheral enteral and parenteral modality covering the 52% of treated patients. The children with less percentage of weight loss (under 10%) received the exclusive enteral way (53,1% of treated cases) and in the 37,4% the support was mixed, but using the peripheral modality of parenteral use. Conclusions: the nutritional strategy used in burnt child may to modify some prognostic indicators and must to be a therapeutical priority to prevent the clinical deterioration of these patients.


de la Cruz Y.O.,Hospital Pediatrico Universitario Juan Manuel Marquez | Lamas R.P.,Institute Ciencias Medicas Of La Habana | Duarte M.C.,Institute Ciencias Medicas Of La Habana | Dosal A.G.,Institute Ciencias Medicas Of La Habana
Revista Cubana de Pediatria | Year: 2010

INTRODUCTION. The combination of high blood pressure and obesity in childhood increases the risk of metabolic syndrome (MS) in early ages of life. The aim of present study was to determine the presence of MS in obese hypertensive adolescents and its relation to some clinical and biochemical variants. METHODS. A prospective and descriptive study was conducted in 152 obese children and adolescents aged 5 and 19 from the Nephrology consultation of the "Juan Manuel Márquez" University Children Hospital and also authors studied the fasting microalbuminuria, glycemia, total cholesterol and triglycerides. RESULTS. There was metabolic syndrome in the 35.5% of obese hypertensive and it was more frequent in male sex. There was predominance of severe obesity and 8 of each 10 children had three criteria of the syndrome. The prevalence of each of components was of 33.3% in glucose metabolism alteration, of 100% in central obesity and high blood pressure, of 51.8% in hypertriglyceridemia, and of 13% in high density lipoprotein low cholesterol (HDL-C). Almost half of patients had microalbuminuria. The 31.5% of study subjects had insulin-resistance and in the 29.5% of cases there was non alcoholic fatty liver. CONCLUSIONS. One of each 3 obese hypertensive patient had metabolic syndrome, thus, it is recommended to continue research on this syndrome in childhood and adulthood.


Diaz Alvarez M.,Hospital Pediatrico Universitario Juan Manuel Marquez | Perez Amarillo J.,Hospital Pediatrico Universitario Juan Manuel Marquez | Rivera Ales L.,Hospital Pediatrico Universitario Juan Manuel Marquez
Revista Cubana de Pediatria | Year: 2016

Meningoccocal meningitis is a rare infection in the neonatal period worldwide and there is just one publication in the Cuban medical literature dated 25 years ago, which presented some neonates with bacterial meningitis caused by Neisseria meningitides. This is a febrile neonate with toxicity manifestations and bulging fontanelle; he was performed a lumbar puncture to find spinal fluid pleocytosis and the serogroup B N. meningitides was then isolated, so he was diagnosed with neonatal meningococcal meningitis with favorable progression. Some characteristics of the meningococcal infection, the diagnosis and recommended treatment were described in addition to making reference to case reports published in the international literature. © 2016, Editorial Ciencias Medicas. All rights reserved.


Acosta Batista B.,Hospital Pediatrico Universitario Juan Manuel Marquez | Diaz Alvarez M.,Hospital Pediatrico Universitario Juan Manuel Marquez | Fernandez Nodarse R.,Hospital Pediatrico Universitario Juan Manuel Marquez | Rivera Ales L.,Hospital Pediatrico Universitario Juan Manuel Marquez | Chagues Leyva O.,Hospital Pediatrico Universitario Juan Manuel Marquez
Revista Cubana de Pediatria | Year: 2016

One of the most serious hematological disorders of the neonatal period is congenital C protein deficiency of very rare occurrence and the main cause of severe thromboembolic disease and purpura fulminans in newborns. It may be summarized as a clinical and pathological entity of acute occurrence, with dermis vasculature thrombosis that leads to progressive hemorrhagic necrosis of the skin, associated to disseminate intravascular coagulation and perivascular hemorrhage in the neonatal period. The patient of this report showed the clinical and pathological elements characterizing purpura fulminans the origin of which is due to hereditary C protein deficiency that led to onset of severe thrombotic complications in this patient. © 2016, Editorial Ciencias Medicas. All rights reserved.


Figueredo-Morera M.,Hospital Pediatrico Universitario Juan Manuel Marquez | Fabre-Ortiz D.E.,Hospital Pediatrico Universitario Juan Manuel Marquez | Coutin-Marie G.,Hospital Pediatrico Universitario Juan Manuel Marquez | Del Arco-Perez A.O.,Hospital Pediatrico Universitario Juan Manuel Marquez
Revista Alergia Mexico | Year: 2011

Objective: Asthma is a health problem both in Cuba and throughout the world. Emotional factors play an important role in triggering asthma attacks and in worsening the disorder. The impact of an educational program was evaluated, with regards to emotional factors and the attitude of asthmatic children, adolescents and their parents, for achieving better control of their disease. Method: a prospective intervention longitudinal study was conducted at the Juan Manuel Marquez Pediatric Hospital which grouped all participants who attended the last two meetings of the School for Asthmatic Children, Adolescents and their Parents. Data was collected from the medical records of patients and a validated questionnaire was applied at the beginning of the educational program and six month later. Results: The study showed that at the end of the educational program, 78.9% of the patients were classified as intermittent asthmatics. There was also a significant reduction of the emotional factors during exacerbations, with a relative change of 53.9%. Limitation for participating in daily activities was 45.4% and parents' negative attitudes totaled 44.3%. Conclusions: As a result of the educational intervention, both patients and parents were able to correct their way of handling emotions and attitudes related with asthma, with the subsequent health improvement and a better control of the disease. © 2011 Colegio Mexicano de Inmunología Clínica y Alergia, AC y de la Sociedad Latinoamericana de Alergia, Asma e Inmunología.


Diaz Alvarez M.,Hospital Pediatrico Universitario Juan Manuel Marquez | Claver Isas D.,Hospital Pediatrico Universitario Juan Manuel Marquez | Medina Gonzalez T.,Hospital Pediatrico Universitario Juan Manuel Marquez | Rivera Ales L.,Hospital Pediatrico Universitario Juan Manuel Marquez
Revista Cubana de Pediatria | Year: 2015

Acute suppurative parotitis is a rare infection in the pediatric and neonatological practice. This case presentation showed our experience in the care of a case series affected by acute suppurative parotitis in their neonatal period and described the characteristics of their presentation. The clinical findings obtained in 8 patients with neonatal suppurative parotitis, who had been admitted to the neonatology serviceof “Juan Manuel Marquez” university pediatric hospital in the period of 1992 to 2013, were presented and compared with the reports from the international literature. The presentation characteristics of the disease in our cases agreed with those of the reviewed literature in many aspects, and it was proved that this illness is rate in the neonatal period. This is the first report published about this disease in neonates in Cuba and the highest number of cases in the Latin American context. © 2015, Editorial Ciencias Medicas. All rights reserved.


Acosta Batista B.,Hospital Pediatrico Universitario Juan Manuel Marquez | Perez Cordova F.R.,Hospital Pediatrico Universitario Juan Manuel Marquez | Diaz Alvarez M.,Hospital Pediatrico Universitario Juan Manuel Marquez
Revista Cubana de Pediatria | Year: 2015

There is not a single report in the Cuban scientific literature on neonates with acute suppurative submandibular sialadenitis. With the objective of presenting and describing the clinical characteristics of a newborn with this disease, this report presented the case of a newborn diagnosed with acute suppurative submandibular sialadenitis, which was admitted to the neonatology service of “Juan Manuel Marquez” university pediatric hospital and is the only one seen at this institution in 22 years (1992 through 2013). Acute neonatal suppurative submandibular sialadenitis is rare in term newborn as it occurred here; it can be easily recognized by focal inflammatory signs in addition to purulent secretion in the mouth through Wharton's duct. Staphylococcus aureus is the regular causative agent of this infection. © 2015, Editorial Ciencias Medicas. All rights reserved.


Diaz Alvarez M.,Hospital Pediatrico Universitario Juan Manuel Marquez | Pena Fernandez M.,Hospital Pediatrico Universitario Juan Manuel Marquez | Camejo Medina M.,Hospital Pediatrico Universitario Juan Manuel Marquez | Cespedes Barrientos O.,Hospital Pediatrico Universitario Juan Manuel Marquez | Salinas Verdecia M.E.,Hospital Pediatrico Universitario Juan Manuel Marquez
Revista Cubana de Pediatria | Year: 2015

Split spinal cord malformation is a rare form of occult spinal dysraphia and is reported in 3 % of occult dysraphisms which are mainly located in the lumbar region. The Cuban literature made reference to two patients with this condition, an adult and a child. This is the case of a male newborn referred to our center because he presented with occipital meningocele. The examination revealed a small fossa in the sacrococcygeal region, muscular hypotonic in his right lower limb, varus foot and little movement as well as anal and vessical sphincter incontinence. Imaging studies show the presence of two hemicords at the lumbar region, so it is confirmed that this newborn infant had split spinal cord malformation syndrome, which is an uncommon entity. It is interesting to note that this malformation was diagnosed at the neonatal phase because of its clinical manifestations, a relevant aspect since this illness generally shows its symptoms in later life or remains asymptomatic. © 2015 Editorial Ciencias Medicas. All rights reserved.


Perez M.C.D.,Hospital Pediatrico Universitario Juan Manuel Marquez | Dosal A.G.,Hospital Pediatrico Universitario Juan Manuel Marquez | Silva M.M.,Hospital Pediatrico Universitario Juan Manuel Marquez | Robledo E.H.,Hospital Pediatrico Universitario Juan Manuel Marquez
Revista Cubana de Pediatria | Year: 2012

Introduction: the urinary tract infection is one of the most frequent bacterial infections in the childhood. Objectives: to learn about the acute renal alterations in the first febrile urinary tract infection, and to relate them to the studied variables. Methods: two hundred eleven children diagnosed as first febrile urinary tract infection patients were studied and performed Tc-DMSA renal scintigraphy in the acute phase of infection. The results were correlated to the duration and intensity of the fever before the diagnosis, to the acute phase reactants (hemogram, erythrosedimentation and reactive-C protein) and to the results of imaging studies (renal ultrasound and mictional uretrocystography). Results: females prevailed and 82.4% of patients were under one year-old. In the study group, 54% presented with scintigraphic alterations and the hypocapture pattern of the radiopharmaceutical was the predominant finding in 70% of patients. There was significant association between the duration and intensity of the fever, and the renal alterations. Regarding the lab parameters, leukocytosis above 15 000, accelerated erythrosedimentation and raised reactive-C protein were statistically significant and related to the renal alterations, whereas the radiological findings observed in renal ultrasound and mictional urethrocystography were statistically correlated to the renal lesion detected in the scintigraphy. Conclusions: high percentage of patients suffered the spread of infection over the renal parenchyma; additionally the studied clinical, lab and imaging variables indicated renal injure.


Introduction: recently, the neonatal bacterial meningitis predicting model was developed and validated, which provides an effective tool in medical decision-making to prescribe antibiotic treatment to neonates with cerebrospinal fluid pleocytosis. Objective: to find out retrospectively the procedure to indicate the antibiotic treatment for neonates with cerebrospinal fluid pleocytosis prior to the development of the stated model, and to strengthen and substantiate an antibiotic treatment strategy, based on our neonatal bacterial meningitis prediction model of a newborn with cerebrospinal fluid pleocytosis. Methods: retrospective and implemented study of 290 neonates with probable infection; 44 had bacterial meningitis and 246 aseptic meningitis. They were all admitted to the neonatology service of "Juan Manuel Marquez" pediatric hospital from February 1992 to December 2009. The effectiveness of the neonatal bacterial meningitis prediction model was verified, which allowed classifying the patients into high or low bacterial meningitis risk. The indication and the reasons for antibiotic treatment of a neonate with cerebrospinal fluid pleocytosis were retrospectively determined, as well as the analysis of the association of different clinical circumstances such as the classification of severe bacterial infection risk was made. Results: the neonatal bacterial meningitis prediction model showed negative sensitivity and predictive value of 100 % for the bacterial meningitis. There was statistically significant agreement of the model prediction and the classification of severe bacterial infection risk. The rational use of antibiotic treatment was confirmed, since it was immediately applied to 100 % of cases after the diagnosis of bacterial meningitis, but just in one fourth of neonates with aseptic meningitis. The main causes of indication in cases of aseptic meningitis were suspected bacterial meningitis results of the cerebrospinal fluid test, which were not rated as positive in the model, and positive findings for high risk according to the risk of severe bacterial infection criteria. Conclusions: the indication of antibiotic treatment was pretty rational, but unnecessary in some cases. The suggested model facilitates and endorses the indication of antibiotic treatment when there is high risk of bacterial meningitis and also reliably restricts its application when low risk of bacterial meningitis is predicted, although there might be exceptional clinical situations that warrant it temporarily.

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