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La Cardiología infantil es la especialidad pediátrica que se encarga de la asistencia integral al niño (desde la concepción hasta la adolescencia) con enfermedad congénita o adquirida del sistema cardiovascular. Aunque la herramienta principal para el diagnóstico es la ecocardiografía, la anamnesis y la exploración física son fundamentales para sospechar una cardiopatía, de ahí que el pediatra de Atención Primaria tenga en este campo una labor crucial. Con entrenamiento, este será capaz de detectar con una alta fiabilidad una cardiopatía mediante la auscultación. Paediatric cardiology is the speciality that refers to the care of children (from conception through adolescence) with congenital or acquired disorders of the heart and vessels. Although the main diagnostic tool is echocardiography, medical history and physical examination are essential to suspect heart diseases, hence the primary care paediatrician in this field has crucial work. With training, they will be able to detect, with high reliability, heart disease by auscultation.

Neonatal mercury poisoning, especially that due to merbromin ingestion, is uncommon. We describe the case of a 10 day old newborn infant who was given mercurochrome orally for 7 days due to misunderstanding of medical instructions. Initial symptoms included loss of appetite and low weight increase. Elevated blood mercury concentrations were found. Chelating therapy with dimercaprol was initiated and the patient's evolution was good. We discuss the potential toxicity of mercury and emphasise the importance of the transmission of information by physicians, especially to the immigrant population.

The few existing studies on the demand for neuropediatric care in Spain offer information of enormous value, contributing to our knowledge of this specialty and of the needs of specialists and their training, as well as to the correct planning and use of economic and human resources.To determine the real demand, predominant disorders and usefulness of complementary examinations with a view to determining the need for neuropediatric care in a general hospital.Descriptive, retrospective study of patients attending the neuropediatric department for the first time during a 7-year period and for follow-up visits during a 4-year period. The periods were randomly selected.During this period 1130 children, generating 5033 consultations, were assessed. The total number of visits amounted to 25% of all consultations in the Pediatric Department, involving 31% of the children under 14 years of age in the pediatric population of Segovia. The overall rate of reexaminations/new patients was 3.4. The most frequent diagnosis was headache (32%), followed by non-epileptic paroxysms, febrile convulsions and epilepsy. The disorders requiring the greatest number of follow-up consultations were epilepsy (20%), headache (9%) and febrile convulsions (5%). The rate of reexamination/new patients was significantly higher in pediatric cerebral palsy and epilepsy. Electroencephalogram was the most frequently requested complementary examination, followed by neuroradiological studies.Demand for neuropediatric care mainly involves headaches, epilepsy, convulsions, non-epileptic paroxysmal disorders, and neonatal neurology in the first years of life. Pressure on neuropediatric departments is great due to the number of patients attending consulting rooms because of functional or self-limiting disorders. This pressure could be reduced by appropriate neurological training of general pediatricians or family doctors.

Introduccion. La hemiplejia aguda (HA) infantil es un sindrome que aparece, caracteristicamente, en lactantes sin dano neurologico de base. Su etiologia es diversa, y representan un papel importante las infecciones viricas. Presentamos un caso de HA causada por el virus Coxsackie B. Caso clinico. Se trata de una nina de 20 meses que consulta por fiebre, vomitos y hemiparesia izquierda progresiva. En la exploracion, no presenta alteracion del nivel de conciencia, y unicamente llama la atencion la hemiparesia izquierda, con reflejos musculares profundos debiles. De los examenes complementarios realizados, cabe destacar: LCR con 80 leucocitos/mm3 (predominio mononuclear), EEG con foco persistente en la region temporal derecha (que se normalizo a los cuatro dias) y serologia positiva para el virus Coxsackie B. La evolucion fue a la normalidad absoluta. Conclusiones. La HA infantil se produce como complicacion de una encefalitis focal, que da lugar a un fenomeno vasculitico. Dentro de las causas infecciosas, un agente etiologico importante es el virus herpes simple, y son infrecuentes los enterovirus. De ahi que, hasta que no se determine la etiologia exacta, parece conveniente instaurar un tratamiento empirico con aciclovir. Cuando los germenes implicados en esta entidad son los enterovirus, el pronostico es bueno, aunque se han descrito en la literatura casos con secuelas neurologicas.