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Biomedical subjects

A Martínez Valverde

Publications and source records attributed to A Martínez Valverde.

At least 19 recordsLinked to original sources
PubMed2001

[Pleurodesis with tetracyclines after fontan operation].

Chemical pleurodesis consists of the fusion of both pleural layers after contact with certain substances, and is used in the treatment of prolonged or recurrent pleural effusions refractory to other therapeutic approaches. This procedure has been extensively used in adults with malignant pleural effusion but has rarely been used in children. The Fontan technique is used in the treatment of tricuspid atresia and other heart diseases that act as a single ventricle. This technique frequently presents complications due to fluid retention (edema, ascites, pleural and pericardial effusions and protein-losing enteropathy). With persistent or recurrent pleural effusion, chemical pleurodesis through the drainage tube might constitute a safe and reliable alternative treatment. We report the case of a female patient with tricuspid atresia, who presented recurrent pleural effusion after undergoing the Fontan procedure. The disorder was resolved by chemical pleurodesis with tetracycline.

Child↗
PubMed2000

[Excessive growth and growth hormone deficiency after treatment for craniopharyngioma].

Some children grow normally or excessively after extirpation of a craniopharyngioma, despite growth hormone deficiency. We report a 4-year-old girl with suprasellar craniopharyngioma. Removal of the tumor resulted in panhypopituitarism. For the next 5 years growth continued at a rate of 8.4-10.6 cm/year and then decreased progressively to 1.2 cm/year. Administration of growth hormone increased growth rate to 9.3 cm/year.

Child, Preschool↗
PubMed2000

[A case of neonatal malaria in Spain].

We report a case of neonatal malaria born in Spain. It is about a female newborn whose mother lived the first eight months of her pregnancy in Ecuatorial Guinea. Although our patient was well, in the third week of her life she developed fever mostly in mornings without any other symptoms except pallor. She kept a good physical state in any moment. In complementary proves we remark: anaemia and thrombocytopenia; as well Plasmodium falciparum ruin was found in blood smears. Treatment with mefloquine was successfully, blood smears was negative of parasites in the eighth day and hemogram was restoring normal. This article suggests neonatal malaria must be considered in those newborns suspected congenital infection born from mothers who have travelled to risk countries or immigrated from endemic areas. Also we remark that malaria clinic development in newborns is nonspecific and indistinguishable from other congenital infections.

Female↗
PubMed2000

[Admissions of patients with AIDS to pediatric intensive care units].

OBJECTIVE: To describe the most significant clinical features of children with acquired immunodeficiency syndrome who required admission to a pediatric intensive care unit (PICU). METHODS: Retrospective study of 12 patients with AIDS who required 13 admissions, between January 1988 and December 1997. RESULTS: Mean age at admission was 15 months (1 month-6 years). Seven patients were under 1 year of age; four were diagnosed during their stay in the unit. The most common reason for admission was respiratory failure (six patients), followed by cardiac failure. Six patients needed mechanical ventilation (5 for respiratory failure). Two patients died during their stay, one of pneumonia due to Pneumocystis carinii infection and one of septic shock. CONCLUSIONS: One-third of patients was diagnosed with HIV Infection during their stay at the PICU. Opportunistic infection was the initial manifestation of the disease. Consequently, with this type of infection, clinical suspicion should be high. The survival rate of up to 84.6% of the admissions to our unit as well as the new, highly active antiretroviral therapy, generally make HIV-infected children suitable for treatment in intensive care units.

Acquired Immunodeficiency Syndrome↗
PubMed2000

[Meningitis due to haemophilus influenzae type f].

We report an immunocompetent 5-month-old boy with Haemophilus influenzae type f (Hif) meningitis. The patient had previously been immunized with two doses of Hib conjugate vaccine (PRP-T). Vaccination failure was initially suspected based on Gram stain report. The results of culture identified a non-b Haemophilus influenzae capsular serotype (Hif).Non-Hib serotypes should be considered as potential pathogenic agents in children under the age of 5 years with invasive diseases. An adequate epidemiological surveillance system would be helpful in detecting the role of these non-b Hif serotypes as significant pathogens, which appear to be on the increase.

Haemophilus influenzae↗
PubMed1999

[Etiology of central diabetes insipidus in children].

OBJECTIVE: The aim of this report were to document the etiology of central diabetes insipidus (CDI) in children under fourteen years of age and to describe the time of onset of CDI after its cause. PATIENTS AND METHODS: A descriptive-retrospective study using the records of 33 children diagnosed of CDI between January 1988 and December 1997 was performed. RESULTS: Brain death produced CDI in seventeen patients, intracranial tumors in five (after excision of the tumor) and seven had other causes. No etiology was detected in four. Time interval from the cause, when known, to the onset of CDI was always less than seven days. CONCLUSIONS: The most frequent etiology of CDI in children was brain death (51%). In all of our patients, the time of onset of CDI was less than one week.

Adolescent↗
PubMed1999

[Usefulness of fiberoptic bronchoscopy in critical pediatric care].

UNLABELLED: Fiberoptic bronchoscopy (FB) is being applied increasingly in pediatrics as a therapeutic and diagnostic technique. OBJECTIVE: To analyze the contribution of FB to the diagnosis and treatment of respiratory disease in patients admitted to the pediatric intensive care unit (PICU). PATIENTS AND METHOD: We reviewed FB performed with 3.5 and 2.2 mm external diameter instruments between January 1989 and October 1998 in patients admitted to the PICU. Underlying disease and purpose of and indications for FB were analyzed. We also analyzed route of insertion, findings of airway inspection and bronco-alveolar lavage (BAL), complications and the contribution of FB to patient management. RESULTS: A total of 51 procedures in 47 patients aged between ten days and 12 years old were performed. Twenty-one children (41%) were under one year old. The initial indications for FB were diagnostic in 73% and therapeutic in 27%. Airway inspection showed abnormality in 65%. BAL was performed in 18 cases, with microbiological findings in 8 of the 18. The patients benefited directly from the technique in 75% of cases. CONCLUSIONS: FB is useful diagnostic and therapeutic procedure in PICU patients and is generally well tolerated.

Age Factors↗
PubMed1998

[Pulmonary symptoms of primary immunodeficiency diseases].

OBJECTIVE: Patients who lack major components of the immune system carry an increased risk for severe and recurrent pulmonary infections at those respiratory sites were the deficient component would, in the normal state, have its greatest concentration. We report different pulmonary manifestations in pediatric patients with primary immunodeficiency disease (PID). PATIENTS AND METHODS: We studied 44 children younger than 14 years old, who were diagnosed of PID in our pediatric department between January 1990 and May 1996. RESULTS: Antibody deficiencies were the most frequent disorders (27/44; 61.3%) followed by PID associated with or secondary to other disorders (10/44; 22.7%) and defects of phagocyte function (5/44; 11.3%). Twenty-seven patients (61.3%) showed relevant pulmonary manifestations that required assistance in the division of pediatric pulmonology. Bronchial responsiveness was seen in 17/27, 11/27 had recurrent pneumonias with development of bronchiectasis in 7/27. Opportunistic or severe pneumonias leading to acute respiratory failure were diagnosed in 9/27. Necrotizing pneumonias leading to development of pneumatoceles, cavities or abscesses was seen in 3/27 with the same rate for lymphoid interstitial pneumonia. Respiratory symptoms were the first manifestations of PID in 19/27 (70.3%). CONCLUSIONS: The findings of the study emphasize the responsibility of the pediatric pulmonologists in avoiding the delayed diagnosis of PID since the prognosis depends on the precocity of diagnosis.

Child↗
PubMed1998

[Spontaneous development of idiopathic short stature. Analysis of a group of 42 children followed to their final body height].

UNLABELLED: Idiopathic short stature is a common pediatric problem that has a heterogeneous nature and an unknown outcome concerning adult height (AH). OBJECTIVE: The main objective of this study was to assess the spontaneous adult height and the influence of several pre and post pubertal predictors over AH. The secondary objective was to create an historical control group to compare these patients with others that had been treated with growth-promoting therapies. PATIENTS AND METHODS: A prospective observational study was made with prepubertal male patients who consulted for short stature before 1986 until they reached AH. They did not receive any treatment. The data are shown as mean and standard deviation. Student's paired t test was used for comparison of groups. Predictive and descriptive models over final height were performed with multivariant analysis. A "p" value of less than 0.05 was considered statistically significant. RESULTS: Data of 42 children was analyzed. Mean age was 10.8 (2.2) years. The standard deviation score (SDS) for adult height spontaneously increased in 0.37 +/- 0.24 (p < 0.05), but it was under target height by 0.59 +/- 0.26 (p = 0.05). Main predictors of AH were: initial height, prognosis of AH and initial age (R2 = 0.58). Final height was no different between children with familial or non-familial short stature. CONCLUSIONS: This group of children had a mean loss of 4 cms below their target height. These children may be considered as an historical control group to evaluate the treatment with growth-promoting therapies.

Adolescent↗
PubMed1998

[Bacterial meningitis. Clinical-epidemiological study. Review of 8 years (1988-1995)].

OBJECTIVE: The objective of this study was to determine the epidemiological and clinical characteristics of the bacterial meningitis assisted in the Hospital Materno-Infantil of Complejo Hospitalario Carlos Haya of Malaga. PATIENTS AND METHODS: The epidemiological, clinical, biological and therapeutical aspects are analyzed between the period of January 1988 to December 1995. RESULTS: The number of cases was 322, with the pathogen known in 240 (74.6%) and undetermined in 82 cases (24.6%). Meningococcal meningitis was the predominant cause with 162 cases (67.5%), followed by Haemophilus influenzae (40 cases, 16.7%) and pneumococcal meningitis (27 cases, 11.3%). Neisseria meningitidis type B was the most common serogroup, with an increasing number of type C from 1993.

Age Distribution↗
PubMed1997

[The development of the incidence of diabetes mellitus I in children 0 to 14 years of age in Malaga (1982-1993)].

OBJECTIVE: A prospective study was conducted to assess the evolution of the incidence of type 1 diabetes mellitus (insulin-dependent) in Málaga among children less than 14 years of age between 1982 and 1993. PATIENTS AND METHODS: The capture-recapture method was chosen for estimating the probability of ascertainment and two sources were used: The hospital registry and Málaga Diabetes Association members. RESULTS: We detected 437 children and the ascertainment achieved was 98.8%. The average annual incidence was 14.3/10(5) and the prevalence at the end of the period was 0.78 patients/10(3). During the last 6 years of the observation period, the incidence rose by 42%. The highest incidence was found among children between 10 and 13 years of age in both sexes. The age of onset and female/male ratio increased during the study period. There was an inverse relationship with monthly temperature. CONCLUSIONS: In comparison with other European epidemiological studies, we found a higher incidence and increased rate of growth of the incidence of type 1 diabetes mellitus during the observation period.

Adolescent↗