S1409-009020020002 Acta Pediátrica Costarricense Acta pediátr. costarric 1409-0090 Asociación Costarricense de Pediatría S1409-00902002000200001 Capacidad de decisión de los niños enfermos Gamboa Ana Yéssika Quesada Lisbeth ,CCSS Hospital Nacional de Niños Unidad de Cuidados Paliativos San José Costa Rica 2002 2002 16 41 44 Shooter M Watson A The ethics of withholding and withdrawing dialysis therapy in infants Pediatric Nephrology 2000 Bishop AJ Participation of ligetheatened children and their parents in therapeutic dicision making Essence 1978 2 Doyal L Henning P Stopping treatment for end-stage renal failure: the rights of children and adolescents Pediatric Nephrology 1994 8 Alderson P In the genes or in the stars? Children's competence to consent J medica ethics 1992 18 Thompson R Behavioral Involving children: A developmental Perspective on risk HRB Research 1990 12 ^s2 Erickson S Hopking MA Gray areas: Informed consent in pediatric and comatose adult patients Heart and Lung 1987 16 ^s3 Brent N The Pediatric patient and consent for Treatment Home Healthcare Nurse 9 ^s5 Holder AR Childhood Malignancies and Decision Making Yale J Biol Med 1992 65 Henry PF Who Speaks for the Children: Consent for treatment of Minors Nurse Preactitioner Forum 1992 3 ^s1 Lecture M Do children's rights to health care in the UK ensure their best interests? J Royal College of Physicians of London 1995 29 ^s6 Bradley JG Zia MJ Hamilton N Patient Preferences for control in Medical Decision Making: a scenario-based approach Family Medicine 1996 28 ^s7 Fleischman AR Nolan K Dubler NN Caring for Gravely III Children Pediatrics 1994 94 Harrison H The Principies for Family Centered Neonatal Care Pediatrics 1993 92 Ohanian N Informational Needs of Children and adolescents with Cancer Journal of Pediatric Oncology Nursing 1989 6 Petersen A Leftert N Developmental Issue Influencing Guidelines for Adolescente Health Reserch: a review Journal of Adolescente Health 1995 17 Streiner D Saigal s Burrowx E Attitudes of Parents and Health Care Professionals Toward Active Treatment of Extremely Premature Infants Pediatrics 108 General Principies in the Care of Children and Adolescentes with Genetic Disorders and other Chronic Health Conditions Pediatrics 1997 99 Roberts E Medicine and the Law The Lancet 1992 349 Selbst SM Trating mínors without their parents Pediatric Emergency Care 1985 1 Elze D Rubin A Dore P The association berween types of víolence exposure and youths mental health problems International Journal of Adolescent medicine and Health 1999
S1409-009020020002 Acta Pediátrica Costarricense Acta pediátr. costarric 1409-0090 Asociación Costarricense de Pediatría S1409-00902002000200002 Síndrome del niño sacudido: la importancia de las hemorragias retineanas y hematomas subdurales en su diagnóstico Porras Velásquez Rocío Pérez Herra Víctor ,Hospital Nacional de Niños Unidad de Cuidados Intensivos San José Costa Rica 2002 2002 16 45 47 Shaken baby syndrome: inflicted cerebral trauma Pediatrics 1993 92 Wetzel RC Slater AJ Dover GJ Fatal Intramuscular bleeding misdiagnosed as suspected non accidental bleeding Pediatrics 1995 95 Duhaime AC Christian WC Rorke LB Zimmerman RA Non accidental head injury in infants: The shaken baby syndrome N Engl J Med 1998 338 Starling SP Holden JR Jenny C Abusive head trauma: the relationship of perpetrators to their victims Pediatrics 1995 95 Ludwig S Warman M Shaken baby syndrome: a review of 20 cases Ann Emerg Med 1984 13 Levin AV Ocular manifestations of child abuse Ophtalm Clin North Am 1990 3 Duhaime AC Alario AJ Lewander WJ Shut L Sutton LN Head injury in very young children: mechanisms, injury types, and ophthalmologic findings in 100 hospitalized patients younger than 2 years of age Pediatrics 1992 90 Caffey J Fatalities associated with misinterpretation of bloody cerebrospinal fluid in the "Shaken Baby Síndrome Am J Dis Child 1992 146 Jayawant AR Gibbon F Price J Schulte J Shrples P Subdural haemorrhages in infants: population based study BMJ 1998 317 Duhaime AC Gennarelli T A Thibault LE The shaken baby sindrome: a clinical and biomechanical study J Neurosurg 1987 66 Billmire ME Myers PA Serious head injury in infants: accident or abuse? Pediatrics 1985 75
S1409-009020020002 Acta Pediátrica Costarricense Acta pediátr. costarric 1409-0090 Asociación Costarricense de Pediatría S1409-00902002000200003 Análisis y seguimiento de los niños que desarrollaron oxigenodependencia por más de 14 días durante 1997 Acuña Victoria E. Alfaro Braulio A. Soto Manuel E. Castro Oscar Umaña María de los A. Jiménez Ana L. ,CCSS Hospital Nacional de Niños Servicio de Neumología ,CCSS Hospital Nacional de Niños San José Costa Rica 2002 2002 16 48 60

Objetivo: Analizar y dar seguimiento en forma prospectiva hasta los 6 meses de edad a todos los niños que continuaban con oxígeno a los 15 días de edad, identificando la casuística, factores de riesgo, manejo y evolución. Materiales y métodos: del 1 de enero de 1997 al 30 de junio de 1998, se incluyeron todos los pacientes internados que requirieron oxígeno por más de 14 días continuos a quienes se les dio seguimiento hasta suspender el oxigeno o egresar, continuándose en la Clínica de oxigenodependencia el seguimiento hasta los 6 meses de edad, cerrándose el estudio el 30 de Junio de 1997. Sitio: Servicio de Neonatología del Hospital Nacional de Niños "Dr. Carlos Saénz Herrera", San José Costa Rica, de Enero a Diciembre de 1997. Resultados: Se incluyeron 749 recién nacidos. De ellos, 526 (71%) ameritaron ventilación mécanica. 88 pacientes (12%) requirieron oxigeno suplementario por más de 14 días. El promedio de edad en que se suspende el oxígeno fue de 95.7 días (rango 16 y 395 días). De los niños que ameritaron O2 por más de 27 días, resolvieron su dependencia antes de los 6 meses el 77% (57/74), del resto solo 1 continuo con O2 al año de edad. La patología de ingreso más frecuente fue el S.I.R.I. (Síndrome de Insuficiencia Respiratoria por Inmadurez) o Membrana Hialina en el 66%. El 100% de los pacientes con peso menor de 1000 g vivos a los 28 días, eran oxígenodependientes. La	ventilación mecánica fue necesaria en 86 (97.7%) pacientes, la duración media fue de 16.4 días (1- 82 días). Ameritaron oxígeno a los 28 días, 48 de 58 niños que se complicaron con septicemia, 37/43 con Bronconeumonía, 23/29 con PCA, 13/15 con neumotorax y un paciente que hizo enfisema. Conclusión: Con los resultados de las nuevas técnicas ventilatorias que han demostrado disminución en la incidencia de DBP, como la ventilación de alta frecuencia y el uso nuevas drogas que estan en investigación para utilizar en forma temprana y reducir el proceso inflamatorio que desencadena el desarrollo de esta enfermedad, se espera mejorar la evolución y prónostico de estos niños.

 Northway WH Rosan RC Porter DY Pulmonary disease following respirator therapy of hyaline menbrane disease: bronchopulmonary dysplasia N Engl J Med 1967 276 Zimmerman F Advances and Issues in Bronchopulmonary Dysplasia Curr Pediatr 1994 24 Currie AE Kotecha S Chronic lung disease of prematurity Crit Care Med 1997 12 Campbell A Poulton EP Oxygen and Carbon Dioxide Oxygen and Carbon Dioxide 1934 London Oxford University Cone TE History of the Care and Feeding of the Prenature Infant History of the Care and Feeding of the Prenature Infant 1985 Little Bancalari E Abdenur GE Feller R Diagnosis of BPD. Bronchopulmonary Dysplasia: Clinical presentation J Pediatr 1979 95 Shennan AT Dunn MS Ohlsson A Abnormal pulmonary outcome in premature infants: Prediction from oxygen requiriment in the neonatal period Pediatrics 1988 82 Hack M Horbar JD Malloy MH Very low birth weith outcomo of the National Institute of Child Helth and Human Development Neonatal Network Pediatrics 1991 87 Hudak BB Egan EA Efecto del tratamiento con surfactante pulmonaren las enfermedades pulmonares crónicas de los lactantes prematuros Clin Perinatol 1992 3 Farrell PA Fiascone JM Bronchopulmonary dysplasia in the 1990s:A review for the Pediatriciam Curr Probl Pediatr 1997 27 O'Brohovich HM Mellins RB Bronchopulmonary dysplasia: unresolved neonatal acute lung injury Am Rev Respir Dis 1991 29 Boros SJ Orgell AA Mortality and morbility associated with pressure and volume limite infant's ventilations Am J Dis Child 1978 32 Bryan M Hordie M Reillt B Pulmonary funcion studies during the first year of life in infants recovering from the respiratory distress syndrome Pediatrics 1973 52 Fitzharding PM Follow up studies in infants treated by mechanical ventilation Clin Perinatal 1979 5 Horbar JD Mc Auffe TL Adler SM Variability in 28 day outcomes for very low birth weight infants: an analysis of 11 neonatal intensive care units Pediatrics 1988 82 Parker RA Lindstrom DP Cotton RB Improved survival accounts for but no all of the in crease in BPD Pediatrics 1992 90 Avery ME Toley WH Keller JB Is chronic lung disease in low birth weigth infants preventable? A survery of 8 centrers Pediatrics 1987 110 Rojas MA Gonzales A Bancalari E Changing trends in the epidemiology and pathogenesis of neonatal chronic lung disease J Pediatr 1995 126 Palta M Gabbort D Weinstein MR Multivariate assessment of traditional risk factors for chronic lung disease in very low weight neonates J Pediatr 1991 11 Rhodes PG Hall RT Leonidas JC Chronic pulmonary disease in neonates with assited ventilation Pediatrics 1975 55 Compagnone P Singer DB Neonatal sepsis due to monty pable Haemophilus influenzae Am J Dis Child 1986 140 Sawyer MH Edwards DK Spector SA Cytomegalovirus infection and bronchopulmonary dysplasia in premature infants Am J Dis Child 1987 141 Stenmark KR Eyzaguirre M Westocott Potential role of eicosanoids and PAF in the pathophysiology of bronchopulmonary dysplasia Am Rev Respir Dis 1987 136 Mayes L Perkett E Stahlman MT Severe bronchopulmonary dysplasia : a retrospective review Acta Paediatr Scand 1983 72 Truog WE Jackson JC Badura RJ Bronchopulmonary dysplasia and pulmonary insufficiency of prematurity. Lack of correlation of outcome with gas exchange abnormalities at one month of life Am J Dis Child 1985 139 Liechty EA Donovan E Purohit D Reduction in neonatal mortality after multipledosis of bovine surfactant in low birth weigh neonates with respiratory distress syndrome Pediatrics 1991 88 Thurlbeck WM Prematurez y desarrollo pulmonar Clin Perinatol 1992 3 Mc Carthy K Bhogal M Nardi M Pathogenic factors in bronchopulmonary dysplasia Pediatr Res 1984 18 MerriU T A Harris JP Roghmann K Early clouse of patent ductus arterious in very low birth-weight infants: a controlled trial J Pediatr 1981 99 Krueger E Mellander M BraUon Prevention of syntomatic patent ductus arterious with a single dose of indomethacin J Pediatr 1987 111 Abman SH Groothius JR Pathophysiology and treatment of bronchopulmonary dysplasia Pediatr Clin North Am 1994 41 Zimmerman JJ Bronchoalveolar inflamatory pathophisiology of bronchopulmonary dysplasia Clin Perinatol 1995 22 Moylan FMB Walker AM Kammer SS Alveolar ruptura as an independent predictor of bronchopulmonary dysplasia Crit Care Med 1978 6 Brown ER Stark A Sosenko IRS Bronchopulmonary dysplasia: posible relationship to pulmonary edema J Pediatr 1978 92 Yeh TF Mc Clenan DA Ajayi OA Metabolic rate and energy balance in infants with bronchopulmonary dysplasia J Pediatr 1989 114 Frank L Sosenko IRS Undernutrition as a majar contributing factor in the pathogenesis of bronchopulmonary dysplasia Am Rev Respir Dis 1988 138 Wang EEL Cassell GH Sanchez PJ Ureaplasma urealyticum and chrnic lung disease of prematurity: critical appraisal of the literature on causation Clin Infect Dis 1993 17 Kotecha S Cytokines in chronic lung disease of prematurity Eur J Pediatr 1996 155 Abman SH Bancalari E Aspen Conference on BPD Pediatr Pulmonol 1987 3 Grenough A BPD: Early diagnosis prophylaxis and treatment Arch Dis Child 1990 65 Holtzman RB Frank L BPD Clin Perinatol 1992 19 Northway WH Displasia broncopulmonar: venticinco años después Pediatrics 1992 33 Ogden BE Murphy SA Saunders GC Neonatal lung neutrophils and elastase/proteinase inhibitor imbalance Am Rev Respir Dis 1984 130 Murch SH Mc Donald TT Wood CHS Tumor necrosis factor in the bronchoalveolar lavage secretions of infants with the respiratory distress syndrome and the effect of dexamethasone tretament Thorax 1992 47 Arnon S Grigg J Silverman M Pulmonary inflamatory cells in ventilated preterm infants: effect of surfactant tretment Arch Dis Child 1993 69 Murch SH Costeloe K Klein NJ Early increase of macrophage inflamatory protein 1 a occurs in respiratory distress syndrome and is assocoated with poor outcome Pediatr Res 1996 40 Kotecha S Silverman M Shaw RJ Soluble L-selectin concentration in bronchoalveolar lavage fluid obtained from infants who develop chronic lung disease of prematurity Arch Dis Child Fetal Neonatal Ed 1998 78 Kotecha S Chan B Azam N Increase in interleukin-8 and soluble intercelular adhesion	molecule-1 in bronchoalveolar lavage fluid from premature infants who develop chronic lung disease Arch Dis Child 1995 72 Kotecha S Wangoo A Siverman M Increase in transformin growthfactorbeta1 concentration in broncho alveolar lavage fluid obtained from infants with chronic lung disease of prematurity J Pediatr 1996 128 Bagchi A Viscardi RM Taciak V Increased activity of interleukin-6 but not tumor necrosis factor-alfa in lung lavage of premature infants is associated with the development of bronchopulmonary dysplasia Pediatr Res 1994 36 Streiter RM Lukas NW Standiford TJ Cytokines and lung inflamation mechanisms of neutrophil recruitment to the lung Thorax 1993 48 Jonsson B Tullus K Brauner A Early increase of TNFalfa and iL-6 in tracheobronchial aspirate fluid indicator of subsequent chronic lung disease in preterm infants Arch Dis Child 1997 77 Munshi UK Nin JO Siddiq MM Elevation of interleukin-8 interleukin-6 precedes the influx of neutrophils in tracheal aspirates from pretem infants who develop bronchopulmonary dysplasia Pediatr Pulmonol 1997 24 Northway broncopulmonar 1992 3 Rhodes PG Graves GR Patel DM Minimizing pneumotorax and BPD in ventilated infants with HMD J Pediatr 1983 103 Notter RH Marin FC Double blind, randomized trial of calf lung surfactant extract administred at birth to very premature infants for prevention of RDS Pediatrics 1985 76 Mc Colley SA Bronchopulmonary dysplasia. Impact of surfactant rephacenment therapy Pediatr Cin North Am 1998 45 Cotton RB merrit TA Northway WH Boynton BR Contribution of the patent ductus arteriosus to lung injury Bronchopulmonary dysplasia Bronchopulmonary dysplasia 1988 Boston Blackwell Scientfic Publications Chytil F The lung and vitmin A Am J Physiol 1992 262 Frank L Antioxidants, nutrition and BPD Clin Perinatol 1992 19 Avery GB Fletcher AB Kaphan M Controlled trial of dexamethasone in resoirator-dependent infants with bronchopulmonary dysplasia Pediatrics 1985 75 Cummings JJ D'Eugenio DB Gross SJ A controlled trial of dexamethasone in preterm infants at high risk for bronchopulmonari dysplasia N Engl Med 1989 320 Mammel MC Green TP Jhonson DE Controlled trial of dexamethasone theraphy in infants with bronchopulmonary dysplasia Lancet 1983 1 Rush MG Hazinski TA Tratamiento actual de la displasia broncopulmonar Clin Perinatol 1992 3 Bland RD Edema fromation in the newborn lung Clin Perinatol 1982 9 Hazinski TA Blalock WA Engelhardt B Control of water balance in infants with bronchopulmonary dysplasia: Role of endogenus vasopressin Pediatr Res 1988 22 Bland RD Mc Millan DD Bressack MA Decreased pulmonary transvascular fluid filtration in awake newborn lambs after intravenous furosemid J Clin Invest 1978 62 Kao LC Warburton D Cheng MH Effect of oral diuretics on pulmonary mechanics in infants with chronic bronchopulmonary dysplasia: Results of a double-blind crossover sequential trial Pediatrics 1984 74 Kao LC Durand DJ Phillisps BL Oral theophylline and diuretics improve pulmonary mechanics in infants with bronchopulmonary dysplasia J Pediatr 1987 111 Engelhardt B Blalock WA DonLevy S Effect of spironolactonehydrochlorothiazide on lung function in infants with chronic bronchopulmonary dysplasia J Pediatr 1986 109 Engelhardt B Blalok WA DonLevy S Effect of spironolactonehydrochlorothiazide on lung function in infants with chronic bronchopulmonary dysplasia J Pediatr 1989 114 Albersheim SG Solimano AJ Sharma AK Randomized, doble-blind, controlled trial of long-term diuretic theraphy for bronchopulmonary dysplasia J Pediatr 1989 115 Najak ZD Harris EM Lazzara A Pulmonary effects to furosemide in preterm infants with lung disease J Pediatr 1983 102 Kao Lc Warburton D Chang MH Effect of oral diuretics on pulmonary mechanics in infants with chronic bronchopulmonary dysplasia: Results of a double-blind crossover sequential trial Pediatrics 1984 74 Kao Lc Warbarton D Sargent CW Furosemide acutely decreases airways resistance in chronic bronchopulmonary dysplasia J Pediatr 1983 103 Mc Cann EM Lewis K Deming DD Controlled trial of furosemide theraphy in infants with chronic lung disease J Pediatr 1985 106 Rush MG Engelhardt B Parker RA Doble.blind, placeo-controlled trial of alternate-day furosemide theraphy in infants with bronchopulmonary dysplasia J Pediatr 1990 117 Wessner Km Dillard RG Furosemide theraphy in infants with chronic lung disease J Pediatr 1986 108 Davis JM Bhutari VK Stefano JL Changes in pulmonary mechanics folowing caffeine administration in infants with bronchopulmonary dysplasia Pediatr Pulmonol 1989 6 Kao LC Warburton D Platzker ACG Effect of isoproterenol inhalation on airway resistence in chronic bronchopulmonary dysplasia Pediatr 1984 73 Gomez-Del Rio M Gerhardt T Hehre D Effect of a beta-agonist nebulization on lung function in neonates with increased pulmonary resistence Pediatr Pulmonol 1986 2 Motoyama EK Fort MD Klesh KW Early onset of airway reactivity in premature infants winth bronchopulmonary dysplasia Am Rev Respir Dis 1987 136 Kao LC Durand DS Nickerson BG Effects of inhaled metaproterenol and atropine on the pulmonary mechanics of infants with bronchopulmonary dysplasia Pediatr Pulmonol 1989 6 Wilkie RA Bryan MH Effect of bronchodilators on air way resistance in ventilator-dependent neonates with chronic lung disease J Pediatr 1987 111 Rotschild A Silimano A Puterman M Increased compliancemresponse to salbutamol in premature infants with developing bronchopulmonary dysplasia J Pediatr 1989 115 Stefano JL Bhutani VK Fox WW A randomized placebo-controlled study to evaluate the effects of oral albuterol on pulmonary mechanics in ventilatordependent in infants at risk of developing BPD Pediatr Pulmonol 1991 10 Brundage KL Mohsini KG Froese AB Bronchodilator response to ipratropiun bromide in infants with bronchopulmonary dysplasia Am Rev Respir Dis 1990 142 Murciano D Aubier M Lecocquic Y Effects of theophilline on diaphragmatic strength and fatigue in patients with chronic obstructive pulmonary disease N Engl J Med 1984 311 Dexamethasone therapy in neonatal chronic lung disease: An international placebo-controlled trial Pediatr 1991 88 Kramer LI Hultzen C The role of steroids in early bronchopulmonary dysplasia Pediatr Res 1987 12 Mammael MC Fiterman C Coleman M Short.term dexamethasone theraphy for bronchopulmonary dysplasia: acute effects and one-year follow up Dev Pharmacol Ther Bourchier D Dexamethasone theraphy in severe bronchopulmonary dysplasia Aust Pediatr J 1988 24 Benini F Rubaltelli FF Griffith P Dexamethasone in the tretment of bronchopulmonary dysplasia Acta Pediatr Scand 1989 360 Gladstone IM Ehrenkrans RA Jacobs HC Pulmonary function tests and fluid balance in neonates with chronic lung disease during dexamethasone tretment Pediatrics 1989 84 Treatment KL Scanlon JW Chowdhry PK Dexamethasone theraphy for chronic lung disease in ventilator-and oxygen-dependent infants: A controlled trial J Pediatr 1989 115 Merz U Kuehl G Linderkamp O Dexamethasone theraphy in bronchopulmonary dysplasia Klin Padiatr 1989 201 Kazzi NJ Brans YW Poland RL Dexamethasone effects on the hospital course of infants with bronchopulmonary dysplasia who are dependent on artificial ventilation Pediatrics 1990 86 Pappagallo M Bhutani VK Abbasi S Nebulized steroid trial in ventilatordependent preterm infants Pediatr Res 1991 29 Kennedy KA Dietary antioxidants in the prevention of oxygen-induced injury Sem Perinatol 1989 13 Corbet A Bucciarelli R Goldman S Decreased mortality rate among small premature infants treated at birth a single dose of synthetic surfactant: A multicenter controlled trial J Pediatr 1991 118 White CW Bancalari E Stocker JT Pulmonary ogygen toxicity: Cellular mechanisms of oxidant injury and antioxidant defense Bronchopulmonary dysplasia Bronchopulmonary dysplasia 1988 Washington,DC Enrenkramz RA Bonta BW Ablow RC Amelioration of bronchopulmonary dysplasia after vitamin E administration: A preliminary report N Engl J Med 1978 299 Ehrenkranz RA Ablow RC Warshaw JB Effect of vitamin E on the development of oxygen-induced lung injury in neonates Ann NY Acad Sci 1982 393 Hustead KG Gutcher GR Anderson SA Relationship of vitamin A (retinal) status to lung disease in the preterm infant J Pediatr 1984 105 Shenai JP Rush MG Stahlman MT Plasma retinol-binding protein response to vit A administration in infants susceptible to bronchopulmonary dysplasia J Pediatr 1990 116 Rosenfeld W Evans H Concepcion L Prevention of bronchopulmonary dysplasia administration of bovine 	superoxide dismutase in preterm infants with respiratory distress syndrome J Pediatr 1984 105 Abman SH Wolfe RR Accurso FJ Pulmonary vascular response to oxygenin infants with severe bronchopulmonary dysplasia Pediatrics 1985 75 Pinney MA Cotton Ek Home management of BPD Pediatrics 1978 61 Abman SH Accurso FJ Koops BL Experience with home oxygen in the management of infants with BPD Clin Pediatr 1984 23 Thibeault DW Lang MJ Northway WH Boynton BE Mechanisms and pathologic efects of barotrauma Bronchopulmonary dysplasia Bronchopulmonary dysplasia 1988 Cambridge Blackwell Scientific Wispe JR Robert JR Merritt TA Northway WH Development of antioxidant systems Boynton Bronchopulmonary Combridge, Massachussetts Boynton Bronchopulmonary Combridge, Massachussetts 1988 Blackwell Scientific Solis A Sánchez F Umaña MA Análisis de morbi-mortalidad en la Clínica de Oxigeno-dependencia del Hospital Nacional de Niños, San José, Costa Rica. Resumén del trabajo libre Acta Pediatrica Costarricense 1996 10 Ariagno RL Fulroth R Baldwin RB Incidence of Bronchopulmonary Dysplasia, Growth failure, and Pulmonary Dysfunction Assessed by Clinucal Scarin J Perinatol 1991 XI Sinkin RA Cox C Phelps DL Predicting risk for BPD: selection criteria for clinical trials Pediatrics 1990 86 Boyton BR Merrit TA Northway WH Boyton BR The epidemiology of bronchopulmonary dysplasia Bronchopulmonary Dysplasia:Contemporany Issues in fetal and neonatal Medicine Boston Bronchopulmonary Dysplasia:Contemporany Issues in fetal and neonatal Medicine Boston 1998 Blackwell Scientific Hagan R Minutillo C French N Neonatal Chronic Lung Disease, Oxygen Dependency, and a Family History of Asthma Pediatr Pulmonol 1995 20 Nickerson BG Taussing LM Family history of asthma with brochopulmonary dysplasia Pediatrics 1980 65 Bertrand JM Riley SP Popkin J The long-term secuelae of prematury:	the role of familial airway hyperreactivity and the respiratory distress syndrome N Engl J Med 1985 312 Smith JA Tabachnik E Duncan WJ Pulmonary function and bronchial BR (eds): dysplasia. hyperreactivity in Ion term survivors of bronchopulmonary dysplasia Pediatrics 1981 68 Chan KN Elliman A Bryan E Clinical significanse of airway responsiveness in - children of low birth weigth Pediatr PulmonoI 1989 7 MacLusky lB Stringer D Zarfen J Cardiorespiratory satatus in long-term survivors of prematurity, with and without hyaline membrana disease Pediatr Pulmonol 1986 2 Effect of antenatal dexamethasone administration on the prevention of respiratory distress syndrome Am J Obstet Gynecol 1981 141 Van Master LJ Levinton A Kuban K Maternal glucocorticid theraphy and- reduced risk of bronchopulmonary dysplasia Pediatrics 1990 86 Aristizábal R Aristizábal R Reyes MA Enfermedad pulmonar 	crónica del recién nacido-DBP Neumología Pediátrica Neumología Pediátrica 1998 III ed Bogotá Panamericana Wung jt Koons AH Driscoll JM Changing incidence of bronchopulmonary 162- dysplasia J Pediatr 1979 95 Yeh TF Torre JA Rastogi A Early postnatal dexamethasone therapy in premature infants with severe respiratory distress syndrome: A double-blind, controlled study J Pediatr 1990 117 Rastogi A Akintorin S Bez M Estudio clínico controlado de la dexametasona para prevenir la	 displasia broncopulmonar en los recién nacidos tratados con surfactante Pediatrics 1996 98 Pandit PB Duhu MJ Kelly EN Reposición con surfactante en recién nacidos con enfermedad pulmonar crónica precoz Pediatrics 1995 39 Taghizadeh A Reynolds EOR Pathogenesis of bronchopulmonary dysplasia folowing hyaline membrane disease Am J Pathol 1976 83 Truog WE Jackson JC Alternative modes of ventilation in the prevention and treatment of BPD Clin Perinatol 1992 19 Johnson V Systemic hypertension in infants with severa bronchopulmonary dysplasia Am J Perinatol 1993 10 Abman S Bradley A Systemic hypertension in infants withbronchopulmonary dysplasia Pediatrics 1984 1 04 Edward DK Dyer WM Nortway WH Twelve years experience with bronchopulmonary dysplasia Pediatrics 1977 59
S1409-009020020002 Acta Pediátrica Costarricense Acta pediátr. costarric 1409-0090 Asociación Costarricense de Pediatría S1409-00902002000200004 Conjuntivitis hemorrágica aguda en Costa Rica y el origen del Enterovirus 70 en humanos Herrero Uribe Libia ,Universidad de Costa Rica Facultad de Microbiología San José Costa Rica 2002 2002 16 63 67

Este estudio presencia la evidencia clínica y serológica de la epidemia de conjuntivitis hemorrágica aguda (CHA) que ocurrió en Puriscal, entre de 1981 y 1982, además de presentar la epidemiología en los años siguientes a su primera aparición y se discute sobre el origen del enterovirus 70, el agente etiológico más frecuente de esta entidad clínica. Las características clínicas encontradas fueron similares a otros estudios. En todas las personas estudiadas, al igual que en el personal de campo y de laboratorio, se detectó seroconversión, y infección subclínica. Seis meses después del primer caso de CHA, se determinó un 43 por ciento de seropositividad en 100 sueros recolectados de la población general en Puriscal. Esta virosis se presenta en forma endémica en Costa Rica, presentándose los picos epidémicos cada dos o tres años, con una estacionalidad marcada en los meses de octubre, noviembre y diciembre. Existen varias posibilidades sobre el origen del enterovirus 70; una de ellas es que el virus se haya derivado de algún otro enterovirus humano que afecte la conjuntiva, o pudo haber existido como una forma no patogénica. También se ha sugerido que el EV-70 pudo haberse derivado de un picornavirus de un invertebrado como un insecto, ya que este virus tiene diferencias muy importantes con el resto de los enterovirus humanos. Hasta el momento no hay evidencia para probar ninguna de estas posibilidades, pero en todo caso, el virus tuvo que haber sufrido una mutación para adquirir la patogenicidad en humanos Estudios filogénticos han demostrado que el enterovirus 70 se origina de un ancestro común y en la actualidad circulan diferentes cepas que varían antigénicamente entre sí.

 Conjuntivitis hemorrágica aguda Enterovirus 70 endémico y estacional Costa Rica zoonosis Chatterqee S Ouarcoopome CO Apenteng H An Epidemic of acute conjunctivitis in Ghana Ghana Med. J 1970 9 Chatterjee S Ouarcoopome CO Apenteng A Unusual type of epidemic conjunctivitis in Ghana Br. J. Ophthalmol 1970 54 Kono RA Sasawaga S Yamazaki Seroepidemiological studies of acute hemorrhagic conjunctivitis virus (Enterovirus 70) in West Africa Am J Epidemiol 1981 114 Kono R Apollo 11 disease or acute hemorrhagic: conjunctivitis: A pandemic of a enterovirus infection of the eyes Am. J. Epidemiol 1975 101 Acute hemorrhagic conjuntivitis 47 outbreaksin the Caribbean Surveillance report 1981 7 Acute Hemorrhage conjunctivitis Latin America. MMWR 1981 ;30:450-451. CDC. Acute Hemorrhagic conjunctivitis Florida MWR 1981 30 Acute Hemorrhagic conjunctivitis Key. West, Florida MMWR 1981 230 Semana Epidemiológica. División Epidemiológica Semana Epidemiol 1981 Kono R Sasagawa A Ishii K Ochi M Sugiura S Matsumiya Y Pandemic of new type of conjunctivitis Lancet 1972 1 Mirkovic RR Kono R Yin-Murphy M Sohier K Schmidt NJ Melnick JL Enterovirus type 70: the etiologic agent of pandemic acute hemorrhagic conjunctivitis Bull. WHO 1973 49 Ryan MD Jenkins O Hughes PJ Brown A Knowles NJ Booth D Minor PD Almond W The complete nucleotide sequence of enterovirus type 70: relationships with other members of the Picornaviridae J Gen Virol 1990 71 Sarawaga A Miyamura K Kono R Enterovirus type 70 neutralizing IgM in animal antisera Jpn J Med Science Biol 1982 35 Miyamura K Tanimura M Taketa N Kono R Yamazaki S Evolution of enterovirus 70 in nature: all isolates were recently derived from a common ancestro Arch Virol 1986 89 Yamazaki K Oishi I Minekawa Y Nucletide sequence analysis of recent epidemic strains of enterovirus 70 Microbiol lmmunol 1995 39 Taketa NK Miyamura T Ogino K Natori S Yamazaki N Sakurai N Nakasono K Ishii K Kono R Evolution of Eneterovirus Type 70: Oligonucleotide Mapping Analysis of RNA genome Virology 1984 134 Kono R Miyamura K Yamazaki S Sasagawa A Kurahashi H Seroepidemiological studies of acute hemorrhagic conjunctivits virus (enterovirus 70) in West África. 11. Studies with human sera collected in West African countries other than Ghana Amer. J. Epidemiol 1981 114 Morse SS Morse S.S Examining the Originins of Emerging Viruses Emerging Viruses Emerging Viruses 1993 Oxcford University Press Auki K Sawada H Long- term observation of neutralization antibody after enterovirus 70 infection Jpn J Ophtalmol 1992 36 Kew OM Nottay BK Hatch MH Hierholzer JC Obijeski JF Oligonucleotide fingerprint analysis of eneterovirus 70 isolates from the1980 to 1981 pandemic of acute hemorrhagic conjunctivitis: evidence for a close genetic relantionship among Asian and Americanstrains Infect Immun 1983 412 Pallansh MA Roos RP Enterovirus: Polioviruses, Coxsackieviruses, Echoviruses, and Newer Eneroviruses Virology Virology 2001 Knipe DM & Howley Wimmer E Hellen CUT Cao XM Genetics of poliovirus Annu. Rev. Genet 1993 27 Gromeier M Wimmer E Gorbalenya E Domingo E Webster R Holland J Genetics, Pathogenesis and Evolution of Picornaviruses Origin and Evolution of Viruses Origin and Evolution of Viruses 1999 San Diego Academic Press Koike S Taya C Kurata T Transgenic mice susceptible to poliovirus Proc. NatI. Acad. Sci. USA 1991 88 Mendelsohn CL Wimmer E Racaniello VR Cellular receptor for poliovirus: molecular cloning, nucleotide sequence, and expression of a new memberof the immunoglobulin superfamily Cell 1989 56 Baranowski E Ruiz-Jarabo CM Domingo E Evolution of Cell recognition by Viruses Science 2001 292 Cameron-Wilson CL Pandolfino YA Zhang HY Pozzeto B Archard LC Nucleotide Sequence of an attenvated mutant of Coxsackie B3 compared with the cardiovirulent wildtype: assessment of candidate mutations by analysis of a revertant to cardiovirulence Clin. Diagn. Virol 1998 9 Herrero L Vargas H Castro B Conjuntivitis Hemorrágica Aguda en Costa Rica Rev. Cost. Cienc. Med 1986 7 Lim KH Yin-Murphy M Epidemic conjunctivitis in Singapore in 1970 and 1971 Singapore Med. J 1973 14 Quarcoopome CO Hosaka A Uchida Y Mtyamvra K Minami K Clinicoepidemological studies of acute hemorrhagic conjunctivitis in Ghana. Jpn J.OphthalmoI 1979 23 Castro B Jiménez P Mata L Vives M García M Estudio de Puriscal. IV. Morbilidad Infecciosa del niño Revista Médica. Hospital Nacional de Niños 1982 17 Herrero L Alfaro W Virus Influenza circulantes en Costa Rica 1998 - 2001 Acta Pediátrica Costarricense 2002
S1409-009020020002 Acta Pediátrica Costarricense Acta pediátr. costarric 1409-0090 Asociación Costarricense de Pediatría S1409-00902002000200005 Caracterización de ofensores sexuales juveniles: experiencia de la Clínica de Adolescentes del Hospital Nacional de Niños Ramírez Mora Walter ,CCSS Hospital Nacional de Niños Clínica de Adolescentes San José Costa Rica 2002 2002 16 69 74

Objetivo: Dar a conocer las características principales de los ofensores sexuales juveniles que reciben tratamiento en la Clínica de Adolescentes del Hospital Nacional de Niños. Diseño: Estudio exploratorio. Sitio: Hospital Nacional de Niños, Clínica de Adolescentes. Resultados: La mayoría de los encuestados se encuentra en la adolescencia inicial y media (92.2%) y más de la mitad está cursando estudios secundarios. Pertenecen a familias tradicionalmente constituidas. La Corte Suprema de Justicia es la institución que más refiere casos, seguido por Hospitales Nacionales. Tres cuartas partes de los delitos cometidos son abusos deshonestos y un tercio de violación, donde la mayoría de los ofensores al momento de cometer sus delitos, estaban en la etapa inicial de la adolescencia (12 a 14 años). En el 88.2 % de los casos los ofensores guardan una gran cercanía con sus víctimas, y de estas en su mayoría son niñas (85%). Encontramos como factores de riesgo asociados a las conductas sexuales abusivas en los jóvenes, el acceso a la pornografía, trastornos de conducta, historia de abuso previa y consumo de alcohol. Conclusiones: La educación sexual dirigida hacia lo biológico, el acceso a la pornografía sin la guía de un adulto responsable, las historias de violencia de los adolescentes en sus hogares, la falta de contención en el hogar y las distorsiones de la sexualidad y masculinidad, figuran como elementos relevantes para la predicción y prevención de los delitos sexuales en jóvenes.

 abuso sexual Abel G The outcome of Assessment Treatmente at the sexual behavior clinic and its Relevance to the need for Treatment Programs for Adolescent Sex Offender In New York State The outcome of Assessment Treatmente at the sexual behavior clinic and its Relevance to the need for Treatment Programs for Adolescent Sex Offender In New York State 1984 Antología: Proceso del interaprendizaje para el tratamiento de ofensores sexuales juveniles: Una estrategia para le prevención del abuso sexual Antología: Proceso del interaprendizaje para el tratamiento de ofensores sexuales juveniles: Una estrategia para le prevención del abuso sexual 1999 Corte Suprema de Justicia Estadísticas de los años 2001 y 2002 Estadísticas de los años 2001 y 2002 Claramunt MC Casitas quebradas: El problema de la violencia doméstica en Costa Rica Casitas quebradas: El problema de la violencia doméstica en Costa Rica 1997 San José Editorial EUNED Cunningham C When children abuse When children abuse 1996 Vermont Saber Society Press Acercamiento integrador a los ofensores sexuales Acercamiento integrador a los ofensores sexuales 2002 Finkelhor D El abuso sexual infantil El abuso sexual infantil 1992 San José ILANUD Gil E Tratamiento para el abuso infantil y programas de entrenamiento Tratamiento para el abuso infantil y programas de entrenamiento 1992 San José Ministerio de Justicia y Gracia Green A Children traumatized by physical abuse American Psychiatric Press 1985 Isaac C Lane S Citados en Antología: Interaprendizaje para el tratamiento de ofensores sexuales juveniles Citados en Antología: Interaprendizaje para el tratamiento de ofensores sexuales juveniles 1992 Johnson R Reality monitoring Psychological Review 1981 88 Pathways Kahn T J A guide workbook for youth beginning treatment A guide workbook for youth beginning treatment 1995 Longo R Juvenile Sexual Offenses in the histories of adults rapists and child molesters Int J Offender Ther 1983 27 Meza L Terapia grupal de orientación de orientación cognitivo conductual para tratamiento de ofensores sexuales juveniles Terapia grupal de orientación de orientación cognitivo conductual para tratamiento de ofensores sexuales juveniles Pratt H Ofensores sexuales adolescentes: Asunto para pediatras Int Pediatrics 2001 16 Rush F The best keep secret.Sexual abuse of children The best keep secret.Sexual abuse of children 1981 New York McGraw-Hill Ryan G Agresores sexuales juveniles: desarrollo y corrección Agresores sexuales juveniles: desarrollo y corrección 1987 San José ILANUD
S1409-009020020002 Acta Pediátrica Costarricense Acta pediátr. costarric 1409-0090 Asociación Costarricense de Pediatría S1409-00902002000200006 Pelagra: revisión y reporte de caso Gamboa Chaves Ana Yéssika Mora Guevara Alfredo Calvo Espinoza Mónica ,CCSS Palmares 2002 2002 16 75 78 Clayton P Bridges NA Atherton DJ Bender A Pellagra with colitis die to a defect in tryptophan metabolism Eur J Pediatric 1991 150 Mustafa S Bender D McCreanor G Lethal Familial Pellagra-like Skin Lesion Associated with Neurologic and Deveopmental Impairment and the Development of Cataracts Pediatrics 1985 76 William JD BcNutt K Todhunter EN Niacin Nutrition Rev 1975 33 Gopalan C So me Recent Studies in the Nutrition Research Laboratories, Hyderabad The Am J Clin Nutr 1970 23 Prinsloo JG Plessis JP Cruger H Protein Nutrition Status in Childhood Pellagra Am J Clin Nut 1968 21 Granes M Rubio M Van LJ Skin sores in Kwashirkor, Pellagra and Vitamina B6 deficiency Lancet 1980 Vannucchi H Salvador F Interaction of niacin and zinc metabolism in patient with alcoholic pellagra Am J Clin Nut 1989 50 Mc Cauley K Nelson R A case which treatment proved the diagnostic Geriatrics 1984 39 Benítez MD Tercedor J Pérez de la Blanca A García M Dermatitis y alteraciones neurológicas Revista Clínica Española 1995 195 Morein N Pellagra in Mozambican refugees Lancet 1990 335 Ingenorg K Stotter M Tryptophan deficiency and picolic acid effect on zinc metabolism and clinical manifestation of pellagra Am J Clin Nut 1987 46 Álvarez M Pelagra en pacientes alcohólicos Pelagra en pacientes alcohólicos 1996 18
S1409-009020020002 Acta Pediátrica Costarricense Acta pediátr. costarric 1409-0090 Asociación Costarricense de Pediatría S1409-00902002000200007 Reporte de un caso de síndrome torácico agudo en una paciente portadora de drepanocitosis Jiménez Gabriela Rodríguez Carlos Hurtado Eduardo ,CCSS Clínica de Abangares ,CCSS Hospital Nacional de Niños Servicio de Emergencias ,CCSS San Francisco de 2 Ríos 2002 2002 16 79 81

Los autores reportan el caso de una paciente de 12 años de edad, portadora de drepanocitosis que ingresa al Hospital Nacional de Niños referida por el Hospital de Liberia con cuadro de crisis vasooclusiva esternal y vertebral que ameritó tratamiento con opioides, a lo cual asocia cuadro de dificultad respiratoria y fiebre. El hemograma mostraba una importante leucocitosis con predominio de segmentados y la proteína C reactiva estaba elevada. Los laboratorios bioquímicos y de orina eran normales. En la radiografía de tórax en el servicio de emergencias se documenta un derrame pleural derecho y un proceso bronconeumónico asociado. Se realizan un estudio ecocardiográfico que fue normal y un ultrasonido abdominal que documentaba colelitiasis. Se maneja en la unidad de cuidados intermedios con diagnóstico de Síndrome Torácico Agudo, con tratamiento de soporte, analgesia con opioides y cobertura antibiótica de amplio espectro. La paciente evolucionó satisfactoriamente.

 drepanocitosis opioides derrame pleural colelitiasis Kwesi S Anemia Hemolítica: Parte 2 Pediatrics in Review 1999 20 Lane P Sickle cell Disease Pediatric Clin North Am 1996 43 Quinn C The acute chest syndrome of sickle cell disease J Pediatr 1999 135 Yaster M The management of pain in sickle cell disease Pediatrics Clin North Am 2000 47 Wethers DL Sickle cell disease in childhood: Part l. Laboratory diagnosis, pathophysiology and health maintenance American Family Physician 2000 62 Wethers DL Sickle cell disease in childhood: Part 11. Diagnosis and treatment of major complications and recent advances in treatment American Family Physician 2000 62 Yale SH Approach to the vaso-occlusive crisis in adults with sickle cell disease American Family Physician 2000 61 Hui Ming C Randomised trial of oral morphine for painful episodes of sickle-cell disease in children J Pediatr 1998 132 King K Treating Anemia. Hematology/Oncology Clin North Am 1996 10 Scott P Hydroxyurea therapy in children severely affected with sickle cell disease J Pediatr 1996 128