Nontropical pyomyositis in an immunocompetent host

Pyomyositis is a primary infection of the striated muscle. We describe the clinical and imaging features of 2 cases with nontropical pyomyositis in immunocompetent hosts. Staphylococcus aureus was the causative agent; the treatment included antibiotics and either computed tomography or magnetic resonance-guided percutaneous needle drainage, avoiding open drainage. This treatment modality was successful with complete recovery of movement. Because of the rarity of pyomyositis in temperate climates, the common lack of specific signs or symptoms, and the frequent negative blood cultures, considerable delay precedes the diagnosis. Fever, elevated erythrocyte sedimentation rate, and muscle stiffness are diagnostic clues. Increased awareness, especially in immunocompetent hosts, should lead to earlier diagnosis and treatment with improved outcomes. Diagnosis and treatment can be reached at the same time in some cases by image-guided percutaneous drainage. Copyright � 2005 by Lippincott Williams & Wilkins

Is executive function intact after pediatric intracranial hemorrhage? A sample of Mexican children with hemophilia

The goal of this study was to examine executive functioning outcomes in children with hemophilia who have suffered intracranial hemorrhage. We assessed 10 boys with hemophilia with intracranial hemorrhage; 6 boys with hemophilia without intracranial hemorrhage; and 10 healthy boys as controls. Intellectual functioning was assessed with subscales from the Wechsler Intelligence Scale for Children-Mexican Revision. Concept formation and reasoning, cognitive flexibility, and planning and organization domains from a neuropsychological assessment battery for Spanish-speaking children were employed for our analysis. Results indicated that children with intracranial hemorrhage demonstrated significant impairment on some measures of executive function compared with the control groups. All differences reflected poorer performance by the intracranial hemorrhage group. These results may reflect the impact of disruption to immature brain circuits and the deficiency of functional specificity within the immature brain. This is the only known study examining neuropsychological functioning in Mexican youth with hemophilia. © The Author(s) 2013

Bone turnover markers and bone mineral density in children with haemophilia

During childhood growth, bone undergoes modelling involving separate osteoblastic and osteoclastic processes. Markers of bone turnover circulate at high concentrations, parallel the childhood growth curve and correlate with height velocity. The aim of this study was to compare serum markers of bone turnover in children with haemophilia and normal bone mineral density (BMD) vs. those with low BMD. In a cross-sectional study, 69 children with haemophilia were evaluated, 45 children with normal spine BMD vs. 24 with low BMD. Lumbar spine BMD was determined using dual X-ray absorptiometry and Z-scores were calculated. Serum samples of markers of bone turnover, osteocalcin (bone formation) and C-telopeptide of type I collagen (bone resorption) were measured using ELISA. The mean BMD (g cm -2) in the normal group was 0.656�0.15 vs. 0.558�0.12 in those with low BMD (P=0.007), osteocalcin levels in children with normal BMD were 9.29�4.97 vs. 7.06�2.17ng ?L -1 in the low BMD group (P=0.012). C-telopeptide levels in the normal group were 1.06�1.4 vs. 0.74�0.3ng mL -1 in the low BMD group (P=0.169). Our results showed that low osteocalcin levels predominated in the group with low BMD, which indicates a diminished osteoblastic bone formation activity while there were no differences with regard to bone resorption markers. Moreover, osteocalcin levels explain 10% of the variation of lumbar spine Z-score. � 2010 Blackwell Publishing Ltd