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Biomedical subjects

A Marco Macián

Publications and source records attributed to A Marco Macián.

18 recordsLinked to original sources
PubMed2004

[Environment and pediatric cancer].

BACKGROUND: Cancer is the final result of the variable combination of two determinants: endogenous or constitutional factors and exogenous or environmental factors. Between 85 % and 96 % of pediatric cancers (PC) are probably associated with environmental risk factors (RF), most of which have not been identified. The spectacular progress made in survival in PC contrasts with the lack of knowledge of the RF implicated in its etiopathogenesis. OBJECTIVE: 1) To analyze up-to-date knowledge of the interaction among environmental RF in the etiopathogenesis of PC, and 2) to inform pediatricians of the "Environment and Pediatric Cancer" research project directed by the Pediatric Environmental Health Specialty Unit of the Hospital Infantil Universitari La Fe in Valencia (Spain). MATERIAL AND METHODS: Current medical records focus almost exclusively on the diagnosis and treatment of cancer. The Pediatric Environmental Medical Record will contain the validated items required to document and presence or absence of endogenous and exogenous RF associated with PC described in the literature, as well as the main human cancerogenic agents identified by the International Agency for Research on Cancer and the US National Toxicology Program. RESULTS: The project aims to determine the frequency of endogenous and exogenous RF associated with PC in Spain. This project will enable hypotheses to be formulated for future epidemiologic case-control and cohort studies in Spain and other European countries, thus stimulating the introduction of educational and preventive policies in the Spanish population. CONCLUSIONS: The project requires the aid of all hospital and non-hospital pediatricians involved in pediatric cancer in informing parents and offering them the possibility of voluntarily collaborating in the "Environment and Pediatric Cancer" project by contacting the Pediatric Health Specialty Unit (Unidad de Salud Medioambiental del Hospital Infantil La Fe de Valencia [www.pehsu.org]). The collaboration of our colleagues will be essential in gaining greater insight into the RF associated with PC and in achieving prevention in the medium and long term.

Adolescent↗
PubMed2001

[Usefulness of ultrasonography in the initial assessment of blunt abdominal trauma in children].

Abdominal injuries are frequent in children, and the early assessment is the best guaranty for an accurate management. Although computed tomography (TAC) has been considered the diagnostic modality of choice for children with blunt abdominal trauma, is a costly radiological test that requires the patients be stable and sedated. The aim of this study is to evaluate the usefulness of abdominal ultrasonography, a quick, non-invasive technique, of low cost, and repeatable, during the initial assessment of these patients, arguing about the possibility of replace TAC in the detection of intra-abdominal posttraumatic injury. A retrospective case note review was carried out on the 22 children of less than 8 year-old admitted with blunt abdominal trauma to the Pediatric Surgery Section of our institution between 1991 and 1999. The most common mechanism of injury has been the motor vehicle accident (63.63%). All were initially evaluated with ultrasonography and those with any abnormal ultrasonographic findings (free intraperitoneal fluid, intra-abdominal organ injury) were further evaluated with computed tomography and/or repeated sonographies. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy o the diagnostic methods, have been evaluated. This investigation found abnormalities in 17 patients, 70.59% of whom have been managed conservatively. The accuracy of the abdominal ultrasound in the diagnosis of intra-abdominal injury was 77.27%, with a 82.35% sensitivity, 60% especificity, 87.5% positive predictive value, and 50% negative predictive value. The accuracy of the TAC in the diagnosis was 93.75%. The sensitivity, specificity, positive predictive value, and negative predictive value of the TAC were 92.85%, 100%, 100%, and 66% respectively. We conclude that TAC is the imaging modality of choice in children with severe abdominal trauma but ultrasonography is a reasonable technique to arouse diagnostic suspicion, that can avoid additional tomographic studies. Abdominal computed tomography must be reserved for the hemodynamically stable children with anormal ultrasonographic findings or with suspected injuries by a clinical evolution that gone unnoticed in the previous study.

Abdominal Injuries↗
PubMed2000

[Anal fistula treatment with seton].

The objectives of anal fistula treatment are to drain sepsis, irradicate the fistulous tract, and to preserve sphincter integrity and function. These goals can be achieved by either fistulotomy or fistulectomy. Alternative techniques include chemical setons, drainage setons, cutting setons and two-stage seton fistulotomy. We have treated 6 cases of trans-sphincteric fistula Parks type 2. The progressive fistulotomy technique was employed with a primary or one-stage cutting seton, as an outpatient procedure and without general anaesthetic. Complete division of the sphincter muscle took 18-27 days. No child presented incontinence or any other complications from the technique employed. No recurrences were observed at the 12 month follow-up. We conclude that the use of cutting setons is a simple and effective technique for the treatment of anal fistula in children, with low complication rates.

Anal Canal↗
PubMed1996

[Satisfaction of parents of children undergoing outpatient surgery].

BASIS: The objectives of the study are: 1. Know the grade of satisfaction of the parents of children operated in a program of surgery without admission (CSI). 2. Compare it with another program of surgery with admission (CCI). 3. Know the outputs of reentry and complications of both programs. MATERIAL AND METHOD: 95 children were operated in a program of CSI. They were elected 95 children operated with CCI of similar characteristic. A questionnaire in a type Likert scale was sent for mail to the parents to value diverse looks of the satisfaction: Information, deal, perceived control, security, hostelry and global satisfaction. The questionnaire also picked up social-demographics and cultural data. OUTPUTS: The rate of the answer was from the 83% in the program of CSI and 82% in the CCI. The global satisfaction was over 90% in both programs. They met differences significant in the sensation of insecurity, more frequent in the parents of children operated with CSI (30%) that with CCI (11%). The reentry and complications rate of the evaluated program are similar to other programs of CSI.

Ambulatory Surgical Procedures↗
PubMed1996

[An experimental study of the efficacy of politetrafluoroethylene grafts in tracheal surgery].

We studied the efficacy of polytetrafluoroethylene (PTFE) grafts in the surgical correction of extensive tracheal defects in rabbits. Results showed anastomotic stenosis in 100% of the animals after primary reconstruction when a total of six complete rings were resected. We did not appreciate tracheal stenosis in no animal when we applied a PTFE prosthesis placed around the anastomotic site. Results were not satisfactory upon repairing partial tracheal defect by means of a spindle of PTFE prosthesis. We concluded that the external tutor is useful for the surgical correction of the tracheal stenosis induced after resection of six rings in the cervical tracheal of the animal.

Animals↗
PubMed1995

[Intra-abdominal infections caused by Eikenella corrodens in children].

Eikenella corrodens is a fastidious, facultative anaerobe, not a strict anaerobe, gram-negative bacillus, that was placed in the Brucelaceae family. The difficulties in its isolation delayed its recognition as a human pathogen. The course of disease is usually indolent, and abscess formation is almost universally seen. To date, 30 reported cases describing E corrodens infections of the abdominal cavity have been published and only 17 in children. We reviewed the bacteriology laboratory records for a period of 5 years. This organism was cultured from 5 children, aged 1 to 7 years who had peritonitis secondary to perforated appendicitis. The organism was obteined at the original operation and/or from postoperative intra-abdominal abscesses. Two children required surgical drainage of the abscess and one was treated by means of percutaneous drainage. All patients fully recovered.

Abdominal Abscess↗
PubMed1994

[Fluid dynamics in the Port-a-Cath Low Profile: therapeutic uses].

The treatment of infection and obstruction in totally implantable central venous access catheters is based on the administration of medication into the system. Injected medication may be diluted in the portal which acts as a dead space in the line. We have studied the dynamic of fluids in the Low Profile Port-a-Cath, and developed an infusion-suction technique with double syringe to achieve high concentrations in the system with minimum repercussion in the vascular space. This procedure can be applied both in the treatment of infection with high-dose local antibiotics and in total or partial obstructions.

Anti-Bacterial Agents↗
PubMed1994

[Buccal mucosa free graft for severe hypospadias repair].

We present a boy 6 years old, with a penoscrotal hypospadias and perineal urethrostomy, with several unsuccessful attempts at hypospadias repair in other hospital. Autologous buccal mucosa was used as a free graft for urethral reconstruction. The clinical result was excellent, with a functioning urethra of good caliber throughout the entire length of the penis, without voiding difficulties. A proximal fistula that closed spontaneously 20 days postoperatively was the only complication. We present this technique as an elective option for severe hypospadias repair.

Child↗
PubMed1993

[A critical analysis of school screenings. The performance of each type of examination].

The results of a student screening program performed by the Primary Care Team of Gandía on 359 children (180 males and 179 females) that attended 1. EGB are presented. We reviewed the following: vision, hearing, dentition, somatometry, immunization, and urological and traumatological problems. Children with pathologies were referred to specialists to confirm the diagnosis. Of these children, 78% had some form of pathology. The most frequent system involved was hearing, followed by dentition and vision. The correlation of these results with those of the specialists was good (> 50%). The best results were obtained on vision screening results (100% correlation and 2/3 of the problems formerly detected). Twenty-four percent of the children had caries and this was not of major concern to the families. The worst results were obtained in auditive screening. Because the primary care examination model is not generalized, school screening is still a good method to detect previously undiagnosed pathologies in children.

Child↗
PubMed1992

[Localization of the lower esophageal sphincter: a new formula].

The esophageal length in the study of patients with Gastroesophageal Reflux (G.E.R.) has the importance of assuring us of the correct position of the probe/sound of the esophageal ph-metering. We carried out a prospective study which correlated the size with the location of the Lower Esophageal Sphincter (L.E.S.), and we tried an approximation, greater than the one, obtained by other methods, in the measurement of the esophageal length, to obviate the manometric study, when our only aim was to insert correctly the probe/sound of the esophageal ph-metering.

Child↗
PubMed1992

[A new method for the measurement of the anatomical development of the muscle complex of the anus in children with anorectal malformations].

We present a new method for the measurement of the anorectal muscle complex. We studied 40 children with anorectal malformation (14 low and 16 high). Taking the perineal TAC with a rectal probe and quotient called "C": [formula: see text] A "C" value less than 0.31 indicates little development of the anus muscle complex. In 10/26 patients with high malformation, "C" was less than 0.31. All of these patients had fecal incontinence.

Adolescent↗
PubMed1990

[Neonatal tumors].

We review the cases of congenital and neonatal tumors treated at the Children's Hospital La Fe, Valencia. A total of 25 cases of neonatal benign tumors and 27 cases of malignant tumors were diagnosed. The most frequent benign tumor was solid teratoma (12 cases). The most frequent malignant tumor was neuroblastoma (14 cases). Variations in histology, clinical evolution and therapy in relation to age are described. The results obtained are compared with those previously published.

Hospitals, Pediatric↗
PubMed1990

[The treatment of esophageal achalasia in children by endoscopic pneumatic dilatation. A report on 4 cases].

Four patients underwent pneumatic endoscopic dilatation of achalasia at the La Fe Children's Hospital have been studied. Endoscopic pneumatic dilatation has been performed in only one session with four dilatation maneuvers. In the absence of complications, the patients were only hospitalized for twenty-four hours. The effectiveness of endoscopic pneumatic dilatation and the safety of this method, its ease of application and possibility of repetition make it a useful method in the treatment of achalasia in children.

Child↗