[Early detection of congenital hypothyroidism. Study of 31,609 determinations]

As a result of congenital hypothyroidism (CH) early detection program carried out in our clinic during the period 1978-1981, 31.609 capillary blood samples (35,7% from newborn infants) were taken on filter paper cards. An evaluation of TSH following the specific radioimmunoanalysis technique was made in all the samples, and an evaluation of T4 whenever TSH values were higher than 25 microU/ml serum. Thirteen cases of CH were detected: nine with permanent H and four with transient H. Two cases of hyperthyrotropinemia were also detected. Frequency of permanent CH in our population is of 1/3.512. Corresponding biochemical data and detailed clinical characteristics detected, including the cost of the procedure are shown. Authors emphasize on possibility of preventing brain damage and subsequent subnormality through early detection and treatment of congenital hypothyroidism, together with a suitable cost-benefit ratio, makes necessary to carry out a nationwide campaign in accordance with those centers already established.

[Segmental analysis of the movement of the posterior mitral valve in mitral stenosis]

We have analyzed independently, both, early diastolic and end diastolic (A wave) movements of the posterior mitral leaflet in 302 cases of mitral stenosis with sinus rhythm, as well as in a control group of 100 subjects without mitral stenosis. Studied patients were separated into two groups: 275 that were not treated surgically, and 27 studied after mitral commisurotomy. We described 4 patterns of posterior mitral leaflet early diastolic movement, and 3 patterns of A wave motion. Only those patterns that showed anterior drift of the studied segment of the posterior mitral leaflet, were considered diagnostic of mitral stenosis. The sensitivity found was 49% for the anterior early diastolic movement; 89,5% for the anterior A wave, and 95,3% for both signs considered together. The specificity was 99% for anterior A wave, with a predictive value of 99,6%. When surgical and non surgical groups were compared, the absence of anterior drift in early diastole in the former group, showed to have statistical significance when the Chi square test was employed, while A wave pattern (anterior drift) did not show any difference between both groups. It is concluded that the most sensitive and specific sign for M-mode echocardiagraphic diagnosis of mitral stenosis in patients with sinus rhythm is the anterior drift of posterior mitral leaflet's A wave.

[Partial 10q trisomy (q24;q ter) caused by a balanced maternal translocation t(6;10)(q26;q24)]

Authors have had the opportunity to study a patient affected by a malformative syndrome with severe motricity and mental retardation. Physical findings (namely: spacious forehead, flat and round face, small palpebral fissures, hypotonicity and growth retardation) are similar to the phenotype previously described in trisomy 10q. Chromosomal diagnosis failed until G, Q and R banding technique was applied. With this technique a partial 10q trisomy (q24 leads to q ter) due to a maternal translocation t(6:10)(q26;q24) was found.

[Thrombocytopenia-absent radius syndrome (author's transl)]

A patient affected with thrombocytopenia and bilateral absence of radius is described. Authors present data suggesting an acquired etiology: intrauterine cytomegalovirus infection and X-ray exposure during the ovulatory period. Patient showed some radiological features not previously described: methacarpian synostosis and absence of sternum ossification centers. Anemia was etiologically related to the iron deficiency secondary to bleeding. Chronic diarrhea, a feature common in this syndrome, was caused by cow's milk protein intolerance, other causes of chronic diarrhea, like pancreatic malfunction or disaccharidal intolerance were discarted. Finally comments on the differential diagnosis of the illness, its' evolution and treatment, pointing out the possibility of an intrauterine diagnosis, crucial for a correct genetic counselling are made.

[9p trisomy syndrome. Two new cases (author's transl)]

Two cases of trisomy 9p, are reported affecting different break points involving chromosome 9; one of them showed skeletal abnormalities of importance. An analysis of the two cases reported is done and some of the last hypothesis in order to determine genetical and clinical correlations of the syndrome are considered.

[Leydig cell tumor with pseudoprecocious puberty (author's transl)]

Authors present a case of a Leydig cell testicular tumor in a boy aged three years with a six-month follow-up. This type of tumor which is usually hormone-producing has in children a virilizing effect giving signs of pseudoprecocious puberty. Hormonal tests before and after surgery are described as well as the histological study. The various possibilities of differential diagnosis, treatment and prognosis in the presence of a unilateral testis enlargement in a boy are commented.

Development of visual acuity

A hand-held electrically operated instrument has been devised to assess visual acuity by means of the phenomenon of opto-kinetic fixation nystagmus. An accurate determination of visual acuity has been obtained from an early age, and a graph of the normal visual acuity development produced. It has been confirmed that adult acuity is reached by 3 years of age.