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E Blesa

Publications and source records attributed to E Blesa.

At least 19 recordsLinked to original sources
PubMed2003

[Testicular and epididymal appendages. Contribution about it's embryology and pathogenesis].

OBJECTIVE: The testicular appendages are structures with biologic activity and with the possibility to become ischaemic or to degenerate before determined stimulus. Laterly, we have seen an apparent increase in our cases of torsion of testicular appendages. The said, together with the questions about embriology and pathogenesis of this structures, encourage us to do this work. PATIENTS AND METHODS: 1- Retrospective clinical study of patients operated of torsion of testicular appendages, from January 1984 to December 2001. We asses age, year of operation and clinical features. 2- Prospective clinical study of patients operated of torsion of testicular appendages, between March 1999 and March 2000. We asses age, time of evolution, degree of ischaemia, nutritional status, sexual maturity stage and testicular volume. 3- Inmunocytochemical study of testicular and epididymal appendages. We identified the oestrogen receptors. RESULTS: There is a meaningful increase in the yearly incidence of ischaemia of testicular appendages. The mean age of the patients was 9.3 +/- 2.5 years, similar alone of the study. In the patients of group 2, the mean time of evolution was 49.2 +/- 46.6 hours. The appendages showed oedema and several degrees of ischaemia in the absence of torsion (14/21). The body mass index was 19.5 +/- 3.7, and 90% of patients had stages I and II of Tanner. The mean of testicular volume was 2.1 +/- 1.6 ml. By means of inmunocytochemical study we identified oestrogen receptors in 7 of all testicular appendages studied and absence of oestrogen receptors in all epididymal appendages. CONCLUSIONS: The clinical syndrome of the acute scrotum in the majority of cases is due to oedema and ischemia of the appendages, in absence of torsion, probably related to its enlargement in response to hormonal stimulation, at least in some grade, in prepubertal boys. The difference found, related to oestrogen receptors, suggest a different origin for testicular and epididymal appendages.

Child↗
PubMed2001

[Severe caustic injuries of the esophagus: when to replace the esophagus].

From June 1985 to May 1998, 20 patients have been treated in our hospital by esophageal dilatations due to serious esophageal caustic stenosis. A retrospective analysis of these 20 patients was performed, evaluating age, sex, causative agent, number and time of dilatations, iatrogenic esophageal perforations, gastroesophageal reflux (GER) and psychological and social consequences. Follow-up has ranged from 1.5 to 14.5 years (mean = 8.07 years). The mean age at the time of accidental swallow was 42.2 months. The causative agent was dishwashing detergent in 11 patients and caustic soda in 9 patients. The mean of dilatations needed was 19.1 and the average duration of dilatations was 24.7 months. Seven patients had esophageal perforation during dilatation and none of them required surgical treatment. All patients had improvement of swallowing and an easier esophageal dilatation afterwards. Oral contrast studies demonstrated distortion of the esophago-gastric junction in the majority of patients. Ten patients were screened for GER with 24-hour esophageal pH monitoring in the first year postburn and it was pathological in 5. Antireflux surgery was carried out in 4 patients with a conspicuous improvement following surgery. Dilatations proved successful in 16 patients in less than two years, and in more than two years in 3 patients. The authors conclude that the majority of children with esophageal caustic stenosis can be managed successfully by esophageal dilatations, even with dilatation periods longer than two years or when an esophageal perforation occur during the procedure. The paramount importance of early diagnosis and treatment of GER is stressed.

Burns, Chemical↗
PubMed2001

[Colonic aganglionosis with ileal involvement. Ileocolic plasty].

During 1994 through 1999, we have treated five patients (3 boys, 2 girls) with total colonic aganglionosis (TCA) and ileal involvement. In three of them we performed a diverting ileostomy in the neonatal period and at the age of four and five months respectively in the remaining two patients, due to intestinal obstruction. In these two last patients a diagnosis of Hirschsprung's disease was made by anorectal manometry and rectal biopsies in the neonatal period. During laparotomy, a cutaneous ileostomy was created in all patients at the distal end of normal ileum, which was 30 to 110 cm (mean = 71 +/- 37 cm) from the ileocecal valve. After operation, a short bowel syndrome developed in three patients causing fluid and nutritional problems that required prolonged total parenteral nutrition (TPN). The definitive operative repair is performed at 4.5 to 14 months (mean = 8 +/- 3.7 months) by a 12 to 20 cm side-to-side ileocolostomy created between the ileum and aganglionic ascending color (Boley procedure) and ileorectal primary anastomosis (Rehbein procedure) using a circular stapler. Rectal dilatation, irrigation of the colon with saline, loperamide hydrochloride and resincholestyramine were begun in all patients postoperatively. Oral antibiotic prophylaxis, was given to the three patients who suffered from SBS. Oral feedings with semielemental diet were tolerated once stools were semiformed and TPN was discontinued at 8 to 34 days (mean = 21 +/- 1.7 days). postoperatively. After the definitive operation, enterocolitis developed in two patients, requiring one of them a short hospitalization during the episode. A possible explanation for the low incidence of enterocolitis in this series is the systematic postoperative use of irrigations of the colon with saline in all patients. These five patients have been followed-up for growth, development, bowel habit and continence. Follow-up has ranged from 15 to 62 months (mean = 32.2 +/- 19.2 months). Presently, all patients in this series have full enteral feeding and one to three bowel movements per day, with formed or semiformed stools. No patients is incontinent of stool. The patient's body weights (74 to 93%) and heights (89 to 92%) for their age were below average (four patients) or within normal range (one patient). Hemoglobin levels are within normal range in all patients. One patient has iron deficiency and another one has serum ferritin concentration below normal. Three patients have folic acid deficiency. Vitamin B12 absorption is normal in all patients. Although we can not conclude this is a better procedure than others, with is use we have obtained satisfactory results, with an excellent survival, scanty morbidity, a rapid return of bowel function and continence, and an acceptable physical development. During long-term follow-up, patients mus be evaluated for iron and folic acid deficiency.

Child↗
PubMed2000

[Usefulness of anorectal manometry in the neonatal diagnosis of Hirschsprung disease].

During 1992 through 1998 anorectal manometry studies have been carried out on 32 newborn, with age between 48 hours and 28 days and weight range of 1,400 and 4,200 g at the test moment. The test has been prescribed due to a retard in meconial evacuation in the 32 patients, moreover, 13 out of them also presented an intestinal obstruction or subobstruction. The anorectal manometry is carried out with a probe especially designed by us for newborn and a Hellige polygraph. Presence or absence or rectoanal inhibitory reflex (RAIR) is assessed. The test is repeated after one and three weeks from the first study in the cases of RAIR absence. A barium enema was carried out in case of RAIR absence. The RAIR was present in 20 out of the 32 newborn, which allowed the exclusion of Hirschsprung's disease (HD) in these patients. Of the remaining 12 patients, in 11 it was shown the absence of RIAR in the first anorectal manometry study, making it possible the early diagnosis of HD in 9 patients and transient functional obstruction of the colon in 2 newborns. This former diagnosis was corroborated by the findings of the enema, which showed a small left colon and by the presence of RAIR in a later anorectal manometry control. There was a doubtful case in the first study, showing later the absence of RAIR. The first enema in 10 newborn with HD was considered normal in 3 cases and with transitional zone in 4 newborns and microcolon in 1 case.

Hirschsprung Disease↗
PubMed1997

[Pancreatic pseudocyst. Review of 22 cases].

The management of 22 children with pseudocyst of the pancreas presenting over a 15-year period at three pediatric Hospitals is reviewed. The mean age of patients was 7 years being more common in boys (17:5). Ninety one per cent were due to trauma, while in 9% the cause was unknown. Vomiting (81.8%), abdominal pain (77.2%), a mass (72.7%), fever (31.8%) and anorexia (31.8%) were the most frequent findings. The diagnosis was confirmed by finding hyperamylasemia (elevated in 72.7% of cases), by barium meal and ultrasound. Operative treatment included external drainage in 4 children, cystgastrostomy in 9, cystjejunostomy in 6, and excision in 1. One patient was successfully managed nonoperatively and another had spontaneous gastric drainage. There were no deaths or significative complications in this series.

Abdominal Pain↗
PubMed1996

[Effects of several methods of thoracic drainage on respiratory function].

UNLABELLED: The object of this study was to verify the influence on the pulmonary function of the pleural space ampliation with pleural drainage tube underwater seal, with several volumes or with variables negative pressures. We performed 42 New Zealand white rabbits of both sexes with an average age of 57 +/- 9.31 days and an average weight of 1720 +/- 181 g. The experimental protocol consisted of study group: P1 (n = 14) was performed a unilateral thoracostomy at the 5th. Intercostal space and P2 (n = 14) with bilateral pleural drainage. The pleural drainage tube (drain trocart ORX Vygon number 8) connected at small bottle (Fp), with 35 ml of extrapleural volume and at big bottle (FG) with 3940 ml of extrapleural volume and vacuum suction of various negative pressures (-5, -10, -15 and -20 cm H2O). CONTROL GROUP: C1 (n = 7) with unilateral pleural drainage clamped and C2 (n = 7) with bilateral pleural drainage clamped. Anesthesia was induced with ketamine hydrochloride (7.5 ml/Kg) and propionilpromazyne (1.5 ml/Kg) intramuscular cocktail and after maintained with bolus injection of 1/4 induction dose. We studied the mortality, the the fluctuations of drain hydrostatic column, heart rate (FC), respiratory rate (FR) and blood gas tensions, after cannulation of right jugular vein and during the different phases of experimental design. Venous blood samples were obtained for pO2, pCO2 and pH measurements were repeated at 5' in both groups. The 50% of animals died in the P2 group during the drainage pleural of FG. The fluctuation of column of Fp was similar in both groups: P1 = 6.39 +/- 1.0, with a decrease of 0.64 +/- 0.23 and P2 = 6.37 +/- 1.29, with a decrease of 0.63 +/- 0.28, respectively. The vacuum suction of pleural cavity may produce a FR fall which recovery fast. The bilateral pleural drainage with negative pressures produced decreases of pCO2 and pO2. There is not modifications of Acid Base Balance in the experimental groups. We concluded that during bilateral pleural underwater seal connected a FG, because the increase of extrapleural space may produce a high mortality and a fall of respiratory rate with fast recovery. Also the pleural suction improved the CO2 diffusion into the alveolus. There is not modifications of pO2 in P1 group or decrease in the P2 group.

Animals↗
PubMed1996

[Multicystic renal dysplasia and Wilms tumor].

We review a case of multicystic right dysplasia containing nodular renal blastema in a 3-year-old girl with left Wilms tumor. In relation to this finding the management of the asymptomatic multicystic dysplastic kidney in discussed.

Child, Preschool↗
PubMed1995

[Transitional cell papilloma of the ureter causing uretero-hydronephrosis in a child].

A case of transitional cell papilloma of the ureter is reported in a seven-year-old boy who had a history of left flank pain, involuntary voiding and nocturnal enuresis, and was found to have ureterohydronephrosis of a solitary left kidney and renal insufficiency. Renal function and morphology were restored by cutaneous loop ureterostomy, neoureterocystostomy and ureterostomy closure in a staged repair.

Child↗
PubMed1995

[Epidermoid cysts of the spermatic cord].

We report two cases of epidermoid cyst of the spermatic cord in infants 14 months and 2 1/2 years old, respectively. The initial diagnosis in one patient was funicular hydrocele and paratesticular mass no transilluminable in the other case. The treatment was the local excision of tumor and the diagnostic was histological in both patients. Postoperative course was excellent in both, the first after fistullization and surgical treatment. Must be explored the transillumination of the mass which would have led us to think other of the diagnoses different from that of the cord hydrocele before the operation, since it would have given negative. During the operation, must be assured that the cystic anomaly is limited to spermatic cord, to evite fistulization in the postoperative course.

Child, Preschool↗
PubMed1993

Congenital diaphragmatic hernia and intrathoracic intestinal volvulus.

The main symptom of the congenital diaphragmatic hernia (CDH) is the respiratory distress due to the pulmonary hypoplasia and the persistence of foetal pulmonary circulation. Sometimes the CDH appears outside of the neonatal period with respiratory symptoms, abdominal pain and seldom with intestinal obstruction. A case of CDH presenting with intrathoracic volvulus is reported. This case shows that tendency of delayed repair until the newborn has been recovered, require more attention because the good condition of the patient can be changed not only by the pulmonary hypoplasia and the persistence of the foetal pulmonary circulation but also by the symptoms of the intrathoracic gut complications.

Diaphragm↗
PubMed1993

[Neonatal hepatocholecystectomy because of an incarcerated umbilical hernia].

Two newborns are described, both with a hernia of the umbilical cord, which contained a piece of liver and gallbladder united to the normal liver by a thin pedicle. One of them showed typical features of Beckwith syndrome. In one patient the gallbladder was removed together with the accessory liver lobe, in the other, the accessory liver lobe was excised, and the gallbladder replaced into the abdominal cavity.

Cholecystectomy↗
PubMed1993

[Anorectal manometry in the newborn].

Anorectal manometry was performed in 32 newborn. There were 18 preterm and 14 fullterm infants, mean ages 6.1 and 7.1 days respectively. The rectoanal inhibitory reflex (RIR) was positive in 31 of the newborn, and the relaxation waves produced by rectal distention were recorded along the anal canal and were directly correlated to intensity of the stimulus. In the remaining patient RIR was negative, due to Hirschsprung's disease, confirmed at surgery. The length of the anal canal was 10.3 +/- 2 mm. in preterm newborn infants and 14.7 +/- 2.9 mm, in fullterm (p < 0.0001). These findings suggests that presence of RIR is independent of the weight, gestational age and birth age of the infant, and that anal canal length is correlated with the weight of the infant. We conclude that anorectal manometry, in the neonatal period, is a simple, reliable and safe method to test anorectal functionality, including the study of Hirschsprung's disease.

Female↗
PubMed1993

[Study of intestinal motility in the child with acute appendicitis using phonoenterography].

Our experience in using the phonoenterographic procedure in measuring the sounds produced by the intestinal motility in 75 patients is reported: 30 underwent surgery, won acute appendicitis, 20 appendicular peritonitis and 25 underwent surgery without abdominal pathology. We performed in all patients a temporary record of 3 minutes of duration, one spectrogram and one sonogram before the surgery and after surgery in the following 6, 12 and 24 hours. We obtained the number of sounds recorded by our informatic program, and also its intensity measure in dB and frequency in Hz. The procedure we have used can distinguished the characteristics of the intestinal sound of each patient and allow to show a qualitative and quantitative activity, different in the three group of patients. The number of sounds is bigger in the patients with non digestive abdominal pathology and smaller in patients with peritonitis. In general, the lesser number of sounds the lesser intensity and a more grave tones.

Acute Disease↗
PubMed1987

[Biochemical complications of experimental vesico-sigmoidostomy].

Three experimental models of vesico-sigmoidostomy are studied (model-1, end to side V-S plus urethral ligation, model-2, end to end V-S, in "Y of Rous" plus urethral ligation and model-3, vesico-sigmoidoplasty), with aim of reproducing chemical imbalance observed in human subjects with ureterosigmoidostomy. Authors have evaluated clinical biochemical (serum acido-base balance, Cl, Na+, K+, BUN, creatinine, ammonia and albumin), and histologic variables in the first, third and fifth month after operation in 225 rats. Animal of model-1 presented more frequently than model-2 and model-3, alterations (hyperchloraemic acidosis, uraemia, hyperammonemia and hypoalbumin) as well as affectation of upper urinary system for acute or chronic pyelonephritis.

Animals↗