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Biomedical subjects

E Rodríguez

Publications and source records attributed to E Rodríguez.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

[Lipoid nephrosis in children. Development and anatomo-clinical correlation].

Lipoid nephrosis was identified by light, immunofluorescence and electron microscopy in 34 children aged 1 month to 10 years (23 males). These patients were followed up for a mean of 6.8 years (range 2.2 to 14 years). Treatment included oral prednisone (2 mg.kg.day for 4 weeks and then four days a week for 2 months). In steroid dependent or resistant patients oral cyclophosphamide 2.5 mg.kg.day was given for 2 months. Satisfactory responses to steroid therapy were recorded in 73.5% steroid dependence in 23.5% and steroid resistance in 3% of cases respectively. As a whole, 97% of patients responded before 8 week to steroids, cyclophosphamide or both. No morphologic differences were recorded from kidney biopsies among corticoid responders, dependents or resistants, neither between first and second biopsies which were done in four steroid dependent and one steroid resistant children. Slight morphologic differences were observed depending on the time elapsed from initial symptoms to renal biopsy: 39 days (means) when total disappearance of foot processes was seen (5 cases); 11 month (means) in 14 cases with partial pedicular absence and 20 months (means) in 15 children with segmental pedicular absence alternating with zones of normal foot process morphology. The total number of nephrotic episodes was 149, with a mean of 4.3 recurrences per patient, including three children (all girls) whose disease never recurred. Serious infections were detected in 4.7% of recurring episodes. At 5 years follow up 94% of patients were in remission. No deaths occurred among these patients.

Child↗
PubMedDate not supplied

[Chronic hemodialysis in children].

The clinical features of eight patients, four females, aged 4 to 15 years under chronic hemodialysis for terminal renal failure (creatinine clearance 10 ml.min.1,73 m2 or less) are reported. Initial diseases were Alport syndrome, systemic lupus erythematosus, chronic glomerulonephritis (n = 2), bilateral polycystic kidney, prune belly syndrome and reflux nephropathy (n = 2). Distal vascular approach by means of arteriovenous fistulas was preferred for these patients and the kinetic urea model was used to evaluate the performance of the procedure. Patients required nine to twelve hours of hemodialysis per week for optimal results. Mean weight decreases of 1 to 3 kg and reductions in blood urea nitrogen and serum potassium of 40 mg.dl and 2,5 mEq.1, respectively, were observed. The main complications of hemodialysis were the disequilibrium syndrome, infections at the site of insertion of the arteriovenous fistulae and congestive heart failure. Three patients were submitted to renal transplantation with live donors homografts: one died and the other two remain alive but under chronic hemodialysis. Five children are attending school regularly, and two of them are waiting a kidney donor for transplantation. Despite encouraging results chronic hemodialysis in children constitutes only primary supportive therapy prior to renal transplantation.

Adolescent↗
PubMedDate not supplied

[Idiopathic hypercalciuria. Differential diagnosis].

In 50 children with hematuria or urolithiasis and idiopathic hypercalciuria, and in 15 control children, urinary calcium/creatinine concentration rates were measured after fasting and after calcium loading. Patients were classified into two groups depending on the results of an orally administered calcium loading test. Children were considered to have absorptive hypercalciuria (42%) when they had low fasting urinary calcium/creatinine concentration ratio (less than 0.21), and a large increase of this index after calcium administration (greater than 0.28). Patients were labeled as renal hypercalciuria (32%) if they had high fasting urinary calcium/creatinine concentration ratio (greater than 0.21), and variable increases of it after calcium overload. A third group of children (26%), were not classifiable by means of this test. Our data support the contention that this simple ambulatory test is very useful in the diagnostic workup of idiopathic hypercalciuria.

Calcium↗
PubMedDate not supplied

[Hemolytic-uremic syndrome. Experience with 154 cases].

One hundred and fifty four patients with hemolytic uremic syndrome (HUS) were admitted from year 1968 throughout 1989 to a public children's hospital (n = 139) and to a private general clinic (n = 15) at Metropolitan Santiago, Chile. Their mean age at admission was 16 months, 64% of them were 6 to 18 month old. One third of patients were admitted at spring season. The prodromal phase lasted between 1 and 19 days. In 92% of cases there was antecedent diarrhea and 31% showed neurological involvement. Anuria was present in 44 patients (21%) lasting an average of 7 days; sixty one affected children (40%) became hypertensive. Sixty patients (39%) underwent peritoneal dialysis, remaining cases were given maintenance treatment for acute renal failure (ARF). No specific treatment was used except heparin in 5 children along the first years of these series. Ten patients (6%) died during the acute phase of their disease, but death occurred in only 2 of the 76 most recent cases, probably because of more accurate diagnosis and greater experience of the professional team in the management of ARF, even though very heterogeneous clinical presentations were observed along the whole observation period. Three patients developed chronic renal failure.

Acute Kidney Injury↗
PubMedDate not supplied

[Iron nutrition in Mapuche infants fed with human milk (2d phase)].

Blood hemoglobin, serum iron, total iron binding capacity (TIBC) and serum ferritin were measured in 140 healthy rural mapuche (southern Chile's indigenous ethnic group) infants aged 8 to 15 months: 90 had been exclusively breast fed for the first 5 or 6 months of life, then solid foods were introduced but cow's milk was never given to them. The remaining 50, which were all weaned at nearly 4 months of age and then given cow's milk and solid foods at the corresponding age, were designated as controls. Anemia was detected in 4.5% of breast fed infants and in 38% of controls. Evidence of iron deficient erythropoiesis was found in 5% and 81% of cases and controls, respectively. Human milk apparently protects this ethnic group from iron deficiency anemia and this protection seems to be better in mapuche infants than in other groups of chilean infants, because these late have shown 30% incidence of anemia around the first year of life in other studies. More studies on differences in iron nutritional state among mapuche and non mapuche are needed and are under way.

Anemia, Hypochromic↗
PubMedDate not supplied

[Urodynamics in children with recurrent urinary infection, enuresis and bladder incontinence].

Clinical and urodynamic findings in 50 children with normal neurologic examination and: enuresis (n = 5), vesical incontinence (n = 2), recurrent urinary tract infection (n = 10) or association of these abnormalities (n = 33) are described. Renal ultrasonography showed bilateral hydronephrosis in a girl with hypotonic bladder. Reflux nephropathy was detected in two children with vesical hyperactivity and in one patient with hypotonic bladder. Vesical residue was evident in 5 patients with hyperactive bladder. Increased bladder capacity occurred in two children with hypotonic response. Vesical neck formation was observed along micturition in 6 patients with hyperactive bladder. Hyperactive bladder response occurred in 5/5 patients with enuresis, in 1/2 children with vesical incontinence (VI), in 8/10 cases of recurrent urinary tract infection (RUTI) and in 23/33 patients with combined symptoms (CS). Hypertonic response was seen in 1/2 VI, 1/10 RUTI and 5/33 CS patients. Finally in 1/10 RUTI and in 5/33 CS cases bladders were hypotonic and 4/33 CS showed normal urodynamic findings.

Adolescent↗
PubMedDate not supplied

[Analysis of some variables in patients with hydatidosis surgically treated at the Regional Hospital of Valdivia, Chile, 1976-1986].

A survey of surgically treated cases of hydatidosis in the province of Valdivia, Chile, was done. Data were provided by the Regional Hospital of Valdivia, and a period of eleven years was covered (1976-1986). Disease, treatment and related data from each patient were consigned. For the analysis, the information was grouped according to: sex, age, cyst location, condition of the cyst, concomitance with another pathology, condition at time of discharge, hospitalization period and number of repeat hospitalizations. In the period studied, 197 cases of hydatidosis were surgically treated. The sex distribution was 53.3% for males and 46.7 for females; the age group 10-19 years was the most affected by the disease (19.3%). The most frequent locations of hydatid cysts were the liver (58.9%) and lungs (36.5%); the 38.6% of the patients showed complicated cysts, mainly with bacterial infections (11.7%); also, 20% of the cases presented a concomitant liver-related pathology. After the operation, 153 (77.7%) clinically recovered and 27 (13.7%) non-recovered patients left the hospital and 7 (3.5%) cases died while hospitalized. The average hospitalization period was 29 days. During 1976-1986, 24 patients were rehospitalized.

Adolescent↗
PubMedDate not supplied

[Peroperative management of the orthotopic implant of a Jarvik-7 total cardiac prosthesis].

A 31 years old woman with a terminal phase dilated cardiomyopathy and a ventricular ejection fraction of 0.12 was admitted to our hospital to be included in the cardiac transplantation program. When entering the hospital her condition worsened and she suffered an electromechanical dissociation that needed cardiopulmonary resuscitation. Few hours later, energetic medical treatment could not improve her haemodynamic situation. Having no adequate organ available for emergency transplantation, a total orthotopic prosthesis (Jarvik-7-70) implantation was decided. Anesthesia was maintained with fentanyl (50 micrograms/kg), droperidol (0.23 mg/kg) and diazepam (0.25 mg/kg). There were no incidents during or after extracorporeal circulation bypass; despite the use of furosemide (100 mg) and mannitol (1 g/kg) diuresis was less than 40 ml/h. After by-pass, pulmonary hypertension was observed and treated with sodium nitroprusside (1 microgram/kg/min) and isoproterenol (5 micrograms/kg/min), as well as increasing the right ventricle working pressure of the device from 40 to 70 mmHg, obtaining haemodynamic stabilization and good tissular perfusion. After operation, the patient arrived to the Recovery Unit in a steady situation, with a cardiac index of 2.87 l/min/m2 and a diuresis of 150 ml/h. Some other aspects of the anaesthetic management are also discussed in this paper.

Adult↗