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Background: Pediatric intensive care units have developed as treatment areas with a concentration of specialized equipment and personnel. Critically ill children often need to be moved to and from these critical care areas for diagnostic or therapeutic procedures. Such transport may pose additional risk to the critically ill patient., Patients and Methods: In order to assess the problems encountered in our transport process, a prospective study was performed. A questionnaire was undertaken to evaluate the transport of critically ill children hospitalized in the Pediatric Intensive Care Unit of the Hospital Universitario Puerta del Mar from Cádiz over an eleven month period., Results: Two hundred children transported were evaluated. Forty-seven (23.5%) were interhospital transported patients and one hundred fifty-three (76.5%) were intrahospital transported patients. The most common type of intrahospital transport involves transfers between the operating room and the intensive care unit (73 patients, 36.5%). Deterioration in respiratory, cardiovascular and other physiological systems was registered in twenty-two patients (11%). One hundred four equipment-related mishaps were noted in eighty-six patients (43%) during the transport process. Dislodgement of intravenous catheters, loss of oxygen supply, endotracheal tube problems and equipment malfunction were the most common mishaps noted., Conclusions: Our results would suggest that more training regarding the transport of the critically ill child are needed in our area.

We have performed 18 plasmapheresis [correction of plasma exchange] sessions in a group of 5 patients diagnosed as having Guillain-Barré Syndrome. These patients were diagnosed according to clinical, analytical and electromyographic criteria. In three patients we observed an obvious clinical improvement during the treatment. In one of the patients there was no appreciable evolution. This patient suffered from acute lymphocytic leukemia. We were unable to evaluate the remaining patient since this child underwent posthypoxic encephalopathy secondary to cardiac arrest. On the basis of the results obtained, we advocate the treatment of this polyneuropathy by plasmapheresis [correction of plasma exchange].

We present two cases of neonatal varicella in newborn twins, who had serious complications in spite of being given human anti-chickenpox immuneglobulin (zoster immuneglobulin ZIG) prophylaxis. We comment on current criteria of the prophylaxis in newborns with risk of severe neonatal varicella.

Two cases of Ewing's sarcoma primary found in the skull are presented. Both started with neurologic symptoms, the first case with intracraneal hypertension syndrome, and the second case with Jackson-like crisis. We emphasize the rareness of the initial localization, as well as the favorable evolution of both cases after surgery and radiotherapy and chemotherapy treatment.

Abdominal ultrasound imaging performed in 100 children with recurrent abdominal pain have been reviewed. Organic abnormalities were found in 7% of cases. It is emphasized the importance of a careful clinical history, physical examination as well as biological and bacteriological investigations before abdominal echography. In spite of that we believe abdominal ultrasonography is useful in this type of patients, even when non-organic causes are suspected, because of its harmlessness. If the study were normal, others more aggressive explorations could be avoided.

The brain abscess is not frequent in childhood. However, they have important and serious consequences. We have studied the natural history of fifteen cases, emphasizing the situations in which they appear with the purpose to avoid them. Our results are similar to those of other series in regard to the etiology, manifestations, diagnosis and treatment. The incidence was greater in males (66.6%) and between 10 to 15 years of age (53.3%). ENT infections and meningoencephalitis were the main origin in the same proportion (33.3%), followed by cyanotic congenital heart diseases (13.3%). Mortality rate was 20% and two survivors (13.3%) showed very important motor sequel. One of them (6.6%), also had a partial epilepsy. Our results recall the need for a better knowledge of pathogenesis and treatment of these patients.