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Objective: There are numerous published papers on TAR syndrome. Nevertheless, most of them refer to cases or families with several affected members, but we could find no publication epidemiologically analyzing a consecutive series of cases., Patients and Methods: We show the characteristics of the six cases with TAR syndrome identified in the consecutive series of 25,967 malformed live born infants detected among 1,431,368 live births surveyed by the ECEMC (Spanish Collaborative Study of Congenital Malformations) since April 1976 until June 1997., Results: The minimal estimated frequency of TAR syndrome in our area is 0.42 per 100,000 live born infants, with a confidence interval of 0.15 to 0.91. There was no known consanguinity among the cases' parents, nor other affected family members. The sex ratio was 1:1. Although it is generally considered that the syndrome is autosomal recessive, genetic heterogeneity cannot be ruled out., Conclusions: Our cases concur with published data with respect to the low frequency of consanguineous parents. However we did not find a higher proportion of girls affected as has been described previously.

Objective: Review of the literature shows that, for the moment, the cause of idiopathic scoliosis remains unknown. It has been attributed to a wide variety of conditions, including genetics. The aim of this paper was to determine the frequency of antecedents and family prevalence of idiopathic scoliosis in first and second degree relatives., Patients and Methods: During 1994-1995, the families, including first and second degree relatives, of 100 schoolchildren with idiopathic scoliosis were surveyed for scoliosis. The screening was done initially by clinical examination, the test of Adams and subsequently the diagnosis was confirmed by roentgenography., Results: Our study showed the following results. Twenty-five percent of patients investigated had one or more affected individuals in their family. Prevalence of idiopathic scoliosis in first degree relatives was 5.16% and in second degree relatives 4.31%. It was more frequent in females than in males (p < 0.05). This prevalence is larger than that in the general population (1-2%)., Conclusions: Our conclusion is that the mechanism of inheritance is most likely multifactorial. In view of the predominance of females, an X-linked inheritance is suggested.

Sudden infant death syndrome (SIDS) occurs with a high frequency, about 2 in every 1,000 live newborns, and could be prevented by home monitoring. However, identification of infants at high risk must first be made. In this paper, we report the epidemiological factors of 36 selected infants with a well known high risk of SIDS. Two different scorings for the evaluation of high risk SIDS were compared and used in these children. The Sheffield scoring showed high risk in 11 (30.5%) of the cases versus 7 (9.7%) in the normal control group (p = 0.013). By using the multistage scoring method, 27 (75.0%) of the cases had a high risk versus 8 (11.1%) in the controls (p < 0.001). Nevertheless, by the latter method, too many normal infants (41 = 56.9%) were predicted to have a moderate risk of SIDS. The multistage test seems more useful than the Sheffield test, but has the limitation of having to be evaluated at one month of age, whereas results of the Sheffield test are obtained at birth. The epidemiological circumstances could be different in every social level or geographical area, so the usefulness of each scoring procedure must be evaluated in the normal population previous to being used in study groups.

The rate of suicides among adolescents has shown a disturbing increase during the last decades, becoming one of the most important issues in child and adolescent psychiatry. Suicide attempts increase steadily with age, especially among girls, who grossly out-number boys in the number of attempted suicides. However, clinicians face a difficult dilemma in identifying those children who are at the greatest risk for medically serious suicide attempts. This paper presents the results of the risk factors studied in 30 children and adolescents who have made suicide attempts compared to a matched control group. A broken home or loss of the father, alcoholism, disturbed upbringing and family relationships, previous suicide attempts, school failure and social isolation of the family were among the risk factors most frequently present.

In this paper we report a review of the omphalic pathology that was admitted to our hospital from january 1973 through december 1990. Eleven cases of Beckwith-Wiedemann Syndrome were diagnosed during this period of time. Our eleven cases comply with at least three of the four major criteria (omphalocele, macroglossia, gigantism and neonatal hypoglycemia) and several of the minor criteria. The interest of this paper is based on the rareness of this syndrome and its association in two of our cases with Cacchi-Ricci Syndrome. Moreover, one of these cases later presented with a Wilms' tumor. Finally, we emphasize the importance of an early diagnosis of this syndrome in order to avoid the metabolic disturbances (hypoglycemia), to establish prompt treatment of the serious anomalies (omphalocele) and to control and follow these patients since they have increased risk to develop neoplastic disease.

In this paper an attempt is made to analyze the variations in the incidence and severity of bronchopulmonary dysplasia (BPD) in our environment. A review has been made of the clinical records of premature infants with a diagnosis of BPD from 1979 to 1989, both inclusive. The existence of BPD was accepted when, after assisted ventilation with intermittent positive pressure for a minimum of 72 hours, there were respiratory difficulties, a compatible radiography of the thorax and requirements of over 0.21 FiO2 on the 28th day of life. Between 1985 and 1989, the incidence of BPD was similar to that of the five previous years (38.3% versus 42.3%), but mortality decreased (21.7% versus 36.3%). Other epidemiological data worth noting are the appearance of BPD in 2.6 per 1000 live newborns, 9.6 per 1000 newborns kept in hospital and 15.9% of premature infants treated with ventilation. BPD was found in 73% of newborns weighing less than 1.000 g, 41% weighing between 1000 and 1.499 g and only 16% of those weighing over 1,499 g. BPD was found in all newborns of less than 28 weeks, in 38% of those between 28 and 30 weeks and only in 4% of those aged more than 30 weeks. BPD appeared specially after hyalline membrane disease (30.7%).

During the period between 1981 to 1985, 40,243 children have been born. Among these children, 1,747 suffered from dysplasia, subluxation or dislocation of the hip. In this paper the following parameters are examined: frequency, sex, the hip affected and the order of birth. Dislocation of the hip is more frequent in females with a ratio of 5.3 to 1. The hip more frequently affected is the left. Fifty percent of the children affected are first-born. In this study we want to emphasize the importance of a thorough explanation of the newborn, due to the frequency of the affection and especially its greater frequency in female and its predominance in the left hip.

This paper reports the incidence of Campylobacter jejuni isolation (19,21%) among 229 samples of diarrheal stools examined during a period of 12 months and which corresponded to children whose ages were between 1 and 18 months. Campylobacter gastroenteritis is more common than salmonella gastroenteritis. A peak incidence was observed in the first year of life. The various clinical aspects of the infection are examined: Diarrhea was the most frequent symptom (100%) with macroscopic blood in stools in 25% of the cases. Some epidemiological, diagnostic and therapeutic aspects are commented upon. Clinical course with or without antibiotic treatment was favorable. Microbiological search of Campylobacter must be carried out as a routine in every child that presents diarrheal symptomatology.

In the present paper the incidence and severity of croup during the months of september, october and november of the last three years is analyzed. The existence of an important outbreak of laryngitis in the autumn of 1987, with a peak of incidence during the month of october is shown. A prospective study about the children with croup admitted in a pediatric center during the epidemic period in 1987. Was done after serologic and cell-virus culture tests it became clear that the parainfluenza virus type 1 was the cause of the outbreak, as excepted. We suggest the possibility of another laryngitis outbreak in 1989 if there is not change in the epidemiologic pattern of the virus.

Authors studied in a total of 189 newborns, incidence of minor and variant malformation normalities, excluding craniofacial ones (already analyzed in a previous paper). After grouping the results in different corporal zones where these could be found, they find a greater incidence, in the cutaneous system and less in other corporeal areas. Since results differ mainly from those which already exist, therefore, they think that new studies are necessary in distinct geographic areas due to variation o their incidence in them.

This paper reports the results of hip examination screening in 15,509 alive newborns during the first 24 hours of life, carried out by the same trained person. Congenital dislocation incidence was 6.18%, with dislocated hips in 3.2% and instable hips in 2.4%. Primaparity was not a predisposing factor. There was a seasonal incidence with a peak in April. Late diagnosis rate was low, but not nil. We insist about the need for a careful hip examination in newborn performed by the same trained persons.

This paper presents three cases of children suffering from repeated diseases and failure to thrive as a consequence of maternal inability in providing health care. Mother's oligophrenia, poverty, and familial unbalance were underlying causes. Authors define maternal incompetence syndrome as the association of mother's incapacity to provide proper health care with direct injury to the child and decreased growth rate. The relationship between this syndrome and the pediatric social illness is discussed. Strategies for treatment should include creation of multidisciplinary teams of social pediatricians, social workers and psychologists, and development of health education programs.

This paper presents an historic study of the medical criteria used for the diagnosis of rickets up to the present time. It mainly refers to diagnosis at very early stages. The publications edited in Spain were chiefly used as source material. Attention is drawn to the progress in clinical and differential diagnosis in each historic period. The physiopathological mentality tried to discover biochemical sings at early stages which were characteristic of the illness. These data later suffered a progressive devaluation so that nowadays the early diagnosis of the illness represents an almost identical challenge to that of the XIXth century.

This paper presents a programm for prevention of children's accidents written by the Committee for Prevention of Children's Accidents (Asociación Española de Pediatría) and delivered to the Public Health Department. The programm has three parts: The first deals with the need of a stronger action in preventive measures. The second gives general lines of action and organization. The third suggests technical and educatives advices for prevention of each class of accident.

Since 1977, 64 children were diagnosed with cancer in the Department of Pediatrics of the University of Granada. Incidence and mortality rates from specific tumor types are discussed. Most common malignant neoplasms of children are: 1. Leukemia (36.3%). 2. Tumors of central nervous system (10.7%). 3. Lymphoma, and tumors of sympathetic nervous system (19.9%). 4. Soft tissue (6.1%). 5. Kidney (7.6%). 6. Bone (4.6%). Most of the male excess (1.9:1, p less than 0.01) is accounted for by acute lymphocytic leukemia, and central nervous system tumors. It is evident that about one-half of all children diagnosed currently with a malignant disease will survive for a long period. Psychosocial aspects of cancer in the young are commented. This paper examines how patients, family members and medical staff feel and behave in response to occurrence of cancer in adolescent.

The object of this paper is the presentation of the problem griented medical record now in use at the Department of Pediatrics of the Faculty of Medicine of the University of Valencia. The main documents of this medical record (problem list, discharge summary, anamnesis and physical examination summary, and medical record summary) are given describing the characteristics of format and the rules for its completion. The relationships between the main documents are shown.