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Objetivos: Describir las características clínicas de una serie de pacientes con Síndrome de West (SW) con acceso a la medicación de primera línea. Material y métodos: Estudio retrospectivo observacional, de niños con SW que fueronatendidos entre 1996 y 2014. Resultados: Se incluyeron 37 casos, con una promedio de inicio de espasmos de 6,4 meses, con predominio del sexo masculino (75,7%), la mayoría procedentes de Lima. La etiología más frecuente fue secundaria (83,8%), como prenatales, malformaciones cerebrales, Esclerosis Tuberosa, Síndrome de Down y causas perinatales. El SW fue controlado en 67,6% de los casos; Vigabatrina o ACTH fueron efectivas en 20/32 (62,5%). Dos pacientes fueron controlados con levetiracetam, uno con topiramato, uno con lamotrigina, y uno con cirugía. El patrón electroencefalográfico de hipsarritmia fue predominante 24/37 (64,9%). La comorbil...

La epilepsia es la principal causa de consulta neurológica en niños peruanos. Sin embargo, hay escasa información sobre sus características clínicas y epidemiológicas. Objetivos: Presentar las características clínicas de los niños epilépticos atendidos en el Hospital Cayetano Heredia, entre los años 2010 y 2016. Material y métodos: Se realizó un estudio observacional descriptivo, retrospectivo, tipo serie de casos, basado en las historias clìnicas de en niños menores de 14 años con diagnóstico de epilepsia, seguimiento clínico, registro electroencefalogràfico y neuroimagenes. Resultados: Se incluyeron 193 pacientes. El 47,2% (91/193) presentaron su primera crisis epiléptica antes del año de edad, cuya etiología fue secundaria en el 59,3% (54/91), destacando los factores perinatales y las malformaciones cerebrales. La etiología primaria fue más frecuente en los ni�...

Objective: To describe clinical characteristics of head trauma in neonates. Material and methods: This is a case series of neonate patients with head trauma. All of them had a clinical diagnosis and computed tomography scans performed. They were taken care of in both Neuropediatrics and Neonatology services in Cayetano Heredia National Hospital in Lima, Peru from 2014 to 2019. Results: Twelve neonates were included, 67% (8/12) were male, 33% (4/12) were less than four days old, and 25% (3/12) were born to mature mothers. Free fall was the mechanism of lesion for all cases, and three of them fell down from baby trolleys. Places where these accidents occurred were at the hospital. Three neonates were in joint housing, two were in the waiting room of the outpatient clinic, and one fall occurred in the hospitalization ward. Eightythree per cent (10/12) of all cases fell from ≥0.5- m height...

Objective: To determine the incidence of neonatal macrocephaly in a third level hospital from Lima, Peru. Methods: Macrocephaly was defined on the basis of a cephalic perimeter higher than the 97th percentile for age and sex. The report records of the Perinatal Computer System of Cayetano Heredia Hospital between January 1st., 2016 and December 31st, 2017 were used, as well as the Fenton growth chart to determine the limits of normality. Results: A total of 210 cases of neonatal macrocephaly was registered, a general rate of 26 per 1,000 live births. Neonatal macrocephaly incidence were inversely proportional to gestational age. Conclusions: Macrocephaly was higher in preterm neonates, with a risk factor five times higher in this population group.

Objective: To describe clinical characteristics of head trauma in neonates. Material and methods: This is a case series of neonate patients with head trauma. All of them had a clinical diagnosis and computed tomography scans performed. They were taken care of in both Neuropediatrics and Neonatology services in Cayetano Heredia National Hospital in Lima, Peru from 2014 to 2019. Results: Twelve neonates were included, 67% (8/12) were male, 33% (4/12) were less than four days old, and 25% (3/12) were born to mature mothers. Free fall was the mechanism of lesion for all cases, and three of them fell down from baby trolleys. Places where these accidents occurred were at the hospital. Three neonates were in joint housing, two were in the waiting room of the outpatient clinic, and one fall occurred in the hospitalization ward. Eightythree per cent (10/12) of all cases fell from ≥0.5- m height...

Objective: To determine the incidence and clinical characteristics of intraventricular hemorrhage in premature infants younger than 28 weeks, born in a general hospital. Material and methods: This is an observational, retrospective cohort study, which included premature infants under 28 weeks gestational, who survived the first day of life and who had a brain ultrasound, born in the Cayetano Heredia Hospital from 2013 to 2017. Neonates with brain malformations and those with incomplete perinatal data were excluded. Results: During the study period, 21 722 newborns were born, of whom 84 were under 28 weeks of age, 72 children from 24 to 27 gestational weeks were included. The male / female ratio was 1.6. The HIV frequency was 58.3% (42/72). 52.4% (22/42) were found in the early form and 47.6% (20/42) in the late form. The severe degrees corresponded to 64% (27/42). Post hemorrhagic hydroc...

Objective: To analyze the variations of head circumference (HC) in preterm infants, born with less than 34 weeks of gestation, exposed to histologic chorioamnionitis (CAH), and observed until 2 years of corrected age. Materials and methods: This is a cohort study derived from two prospective studies. The analyzed data corresponded to HC measures obtained from the subjects at three points: birth, 40 weeks, and 2 years of corrected age. The subjects were classified in two groups: exposed and not exposed to CAH. Preterm infants with CAH were divided according to its subtype in chorioamnionitis, subchorionitis and chorioamnionitis plus funisitis. Results: Out of 91 preterm infants included in the study. 41.8% (38/91) presented CAH. At birth, the average measure of HC in exposed infants was 27.7 cm (31,2 percentile), while in not exposed infants it was 28.3 cm. (42,1 percentile). At 40 w...

Objetivos: Describir el nivel de conocimiento sobre epilepsia, creencias y factores asociados, en padres de familia de un hospital nacional. Material y métodos: Se aplicó un instrumento validado a 103 padres de niños con diagnóstico de epilepsia y 103 padres de niños sin epilepsia, que acudieron a los consultorios externos de un hospital nacional del tercer nivel de atención. Resultados: En el grupo de padres con niños sin epilepsia, 46,6% (48/103) tenían un nivel de conocimiento bajo y 31,1%(32/103) un nivel de conocimiento intermedio. En los padres de niños con epilepsia, 21,4% (22/103) tenían un nivel de conocimiento bajo y 43,7% (45/103) un nivel de conocimiento intermedio (p=0,001). El nivel de conocimiento sobre epilepsia se encontró asociado al grado de instrucción (p<0,001), al lugar de nacimiento (p=0,017) y al tiempo de residencia en Lima (p=0,002). No se ...

Objective: To determine the incidence and clinical characteristics of intraventricular hemorrhage in premature infants younger than 28 weeks, born in a general hospital. Material and methods: This is an observational, retrospective cohort study, which included premature infants under 28 weeks gestational, who survived the first day of life and who had a brain ultrasound, born in the Cayetano Heredia Hospital from 2013 to 2017. Neonates with brain malformations and those with incomplete perinatal data were excluded. Results: During the study period, 21 722 newborns were born, of whom 84 were under 28 weeks of age, 72 children from 24 to 27 gestational weeks were included. The male / female ratio was 1.6. The HIV frequency was 58.3% (42/72). 52.4% (22/42) were found in the early form and 47.6% (20/42) in the late form. The severe degrees corresponded to 64% (27/42). Post hemorrhagic hydroc...

Objective: To describe the most frequent pathogenic agents identified in neonatal meningitis in Peru. Material and methods: Descriptive, comparative, cross-sectional study based on data bases from PubMed and SciELO, using the key words “Neonatal”, “Meningitis” and “Perú”, and from virtual repositories of medical schools in Peru, with the key words “Neonatal” and “Meningitis”, between 2001 and 2021. Two independent reviewers assessed the articles’ titles and abstracts to be included. Results: 477 articles were found from which only 5 were included; 2 studies were excluded due to lack of descriptive identification of the microorganisms, so that only 3 studies were finally selected.Conclusions: The most frequently found microorganisms were Listeria monocytogenes, coagulada-negative. Staphylococcus and Escherichia coli, predominantly grampositive bacterias. The vi...

Objective: A cultural-linguistic adaptation of the Age and Stages Questionnaire third edition (ASQ-3)-Spanish version was performed in order to determine its reliability, validity and cut-off points in an urban population and pediatric outpatient setting of Lima, Perú.  Material and Methods: Questionnaire forms were applied to parents of children between 1 to 66 months old of age, chosen through a convenience sampling method. Results: A total of  5,830 questionnaires were applied to parents of 3,507 children, 2 667 (45.7%) of whom had between 14 and 36 months of age. The general internal consistency and that of five specific areas, measured by means of the Ordinary alpha index oscillated between 0.70-0.94. Content validity by judges’ criteria, using the index by Lawshe method, the Aiken V coefficient, or both, was  valid for most of the questionnaires. The biserial item...

Objective: To determine the incidence of neonatal microcephaly in the Hospital Cayetano Heredia, throughout a well-defined period. Material and Methods: Microcephaly was determined by a cephalic perimeter lower than the third percentile for age and sex. Reported records of the Hospital’s Perinatal Computer System between January 1st, 2016 and December 31st, 2017, were used. Fenton growth chart’s parameters were used to determine the limits of normality. Results: A total of 416 cases of neonatal microcephaly were registered, a general rate of 53.4 per 1,000 live births, up to 185 per 1000 live births in preterm infants (<37 weeks), with higher figures among males. Conclusions: A high incidence rate of microcephaly was found, probably higher in preterm infants and due to multiple causes. Observational biases cannot be discarded.

The objective of this study was to determine the effects of histologically diagnosed chorioamnionitis on neurodevelopment of premature babies born with less than 34-week gestational age who were assessed at two-year corrected age. A secondary case-control study was carried out. Clinical data, placental histological findings, and development indexes assessed using the Bayley III scale were analyzed in 38 exposed children and 53 non-exposed children. Genitourinary infections in mothers and early sepsis were more frequent in the exposed group (p<0.005). Cognitive development, motor development and language were normal in both groups. Those children exposed to the chorionitis subtype had lower scores in the aforementioned variables. Histologically diagnosed chorioamnionitis did not show any influence on neurodevelopment in premature babies born with less than 34-week gestational age when ...

MELAS Syndrome is a mitochondrial disease associated with epileptic seizures. The case of two siblings with genetically confirmed MELAS is presented, with a history of recurrent status epilepticus accompanied by neurological deficits, failure to thrive, hyperlacticaemia, and brain lesions resembling strokes. The neurological presentation with epileptic status is highlighted to be considered in the corresponding differential diagnosis in emergency rooms and pediatric hospitals.

The objective of this study was to determine the effects of histologically diagnosed chorioamnionitis on neurodevelopment of premature babies born with less than 34-week gestational age who were assessed at two-year corrected age. A secondary case-control study was carried out. Clinical data, placental histological findings, and development indexes assessed using the Bayley III scale were analyzed in 38 exposed children and 53 non-exposed children. Genitourinary infections in mothers and early sepsis were more frequent in the exposed group (p<0.005). Cognitive development, motor development and language were normal in both groups. Those children exposed to the chorionitis subtype had lower scores in the aforementioned variables. Histologically diagnosed chorioamnionitis did not show any influence on neurodevelopment in premature babies born with less than 34-week gestational age when ...

Objetivo: Determinar los niveles de plomo en leche materna en puérperas primíparas provenientes de nueve distritos de la ciudad de Lima. Materiales y método: Se realizó un estudio transversal entre octubre de 2010 y agosto de 2012. Se incluyeron 100 muestras de leche materna, de mujeres que vivieron como mínimo cinco años en la misma zona de Lima. El método de análisis fue la espectrofotometría de absorción atómica. Resultados: El 37% de las muestras tuvieron un nivel detectable de plomo, seis de ellos entre 5,0 y 9,9 ng/g y cinco mayores de 10 ng/g. No se identificaron condiciones de riesgo asociados. Conclusión: Se concluye que un porcentaje importante de nuestras muestras de leche materna presentaron contaminación con plomo, particularmente en residentes de la zona norte de Lima.

Objectives:  A study was carried out to determine the reliability, validity and cut-off points of the Spanish version of Ages & Stages Questionnaires: Social-Emotional, 2nd Edition (ASQ:SE-2). Material and Methods: Questionnaire forms of ASQ:SE-2 between 15 to 48 months were applied to parents of children chosen by convenience sampling. Reliability was determined by the internal consistency through Ordinal alpha coefficient (α), and validity of content through Item-test correlation (r). The cut-off points to establish risk zones were determined using the 65th percentile and ROC curve. Results: Two hundred thirty-six questionnaires were applied. The Ordinal alpha coefficient reached a between acceptable to good level (α = 0.73-0.87) for all 5 age-intervals questionnaires between 18 to 48 months. The Item-test correlation index pointed a good discriminatory power for most i...

Objetivo: Determinar los niveles de plomo en leche materna en puérperas primíparas provenientes de nueve distritos de la ciudad de Lima. Materiales y método: Se realizó un estudio transversal entre octubre de 2010 y agosto de 2012. Se incluyeron 100 muestras de leche materna, de mujeres que vivieron como mínimo cinco años en la misma zona de Lima. El método de análisis fue la espectrofotometría de absorción atómica. Resultados: El 37% de las muestras tuvieron un nivel detectable de plomo, seis de ellos entre 5,0 y 9,9 ng/g y cinco mayores de 10 ng/g. No se identificaron condiciones de riesgo asociados. Conclusión: Se concluye que un porcentaje importante de nuestras muestras de leche materna presentaron contaminación con plomo, particularmente en residentes de la zona norte de Lima.