Chikungunya appeared during the second half of 2014 in Colombia. A prospective cohort study was carried to detect differences and severity between neonates and older children. Of 54 children with chikungunya, neonates had a higher viral load and greater frequency of severe laboratory and clinical findings.

with lower and Hispanic ethnicity with higher ALD rate only among the disabled born 1945-65 but not other cohorts. CONCLUSIONS: ALD prevalence patterns were complex and were modified by race, elderly/disability status, and the extent of health care access and screening capacity in the county of residence. These study results help inform treatment strategies for HCV in the context of coordinated models of care.

El síndrome de opsoclonia mioclonía es una entidad neurológica poco frecuente que afecta a los niños en la etapa preescolar. Clínicamente se caracteriza por una triada clásica de opsoclonía, mioclonía y ataxia aguda, con una evolución progresiva o incluso de manera incompleta. Su etiología puede ser paraneoplásica, en la mayoría de los casos en asociación con neuroblastomas, así como postinfecciosa o parainfecciosa, autoinmune o idiopática. En objetivo del tratamiento es la inmunomodulación con terapia de primera línea con esteroides endovenosos aunque pudiendo asociarse a recaídas y secuelas a largo plazo en el ámbito neurológico y conductual. El síndrome de opsoclonia mioclonía representa un reto diagnóstico en los pacientes con ataxia aguda dada la variedad de presentación clínica, por tanto es importante tener una alta sospecha diagnostica para garantizar un tratamiento oportuno y evitar secuelas futuras.

Objective The aim of this study was to assess the prognostic capabilities of the Pediatric Appendicitis Score (PAS), the Alvarado score, and the modified Alvarado score in diagnosing appendicitis in children in a developing country setting (Cartagena, Colombia).Methods A retrospective cohort study was designed and carried out in Hospital Infantil Napoleó n Franco Pareja (HINFP), a reference pediatric center in Cartagena, Colombia. Children under 18 years of age, of any sex, admitted during 2013 were included in the present study. The sensitivity and specificity of each score value in diagnosing appendicitis were estimated through the area under the receiver operative characteristics curve (AUC).Results A total 187 patients were admitted in HINFP with abdominal pain presumptive of appendicitis. The median age of the cohort sample was 11.58 years (interquartile range, 8.33-13.61); AUC was not statistically different in the three scores assessed (P = 0.549). PAS had an AUC of 0.628 [95% confidence interval (CI), 0.495-0.763]; Alvarado score had an AUC of 0.642 (95% CI, 0.514-0.770); and modified Alvarado score had an AUC of 0.611 (95% CI, 0.471-0.751).Conclusion Our study shows a relatively poor overall performance of the scores in diagnosing appendicitis in a developing income setting. The applicability and prognostic usefulness of the PAS, the Alvarado score, and the modified Alvarado score in developing countries should be based on the stratification of appendicitis risk in the pediatric population.