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G Solís Sánchez

Publications and source records attributed to G Solís Sánchez.

At least 19 recordsLinked to original sources
PubMed2003

[Drug abuse in pregnancy and neonatal morbidity: epidemiologic changes in the last ten years].

BACKGROUND: In the last few years, patterns of drug abuse have varied. This may have changed the problems presented by the infants of drug-abusing mothers. OBJECTIVES: To determine the incidence of prenatal drug-exposure in neonates in our health area in the last decade, to analyze possible changes in the drugs consumed, routes of administration and the infectious diseases affecting drug-abusing mothers, and to study possible changes in the clinical features presented by their offspring. PATIENTS AND METHODS: An observational, descriptive, retrospective study of all the infants born to drug-abusing mothers from January 1, 1992 to December 31, 2001 was performed. The series was analyzed and the periods 1992-1996 and 1997-2001 were compared. RESULTS: The mean incidence was 7.5 cases per 1000 live-born infants (8.7 in 1992-1996 and 6.3 in 1997-2001). Mothers in the second half of the study were less likely to use heroin and the intravenous route and were more likely to use methadone and cocaine than mothers in the 1997-2001 period. Hepatitis C virus infection and instrumental delivery were more frequent in the 1997-2001 period. No differences were found in neonates born in either period. Birthweight was less than 2500 g in 40 % and was low for gestational age in 20 %. Preterm deliveries were performed in 24 %. Congenital malformations were found in 6 %, neonatal withdrawal syndrome in 79 %, human immunodeficiency virus infection in 2 %, and hepatitic C virus infection in 3 %. Four percent were given in adoption. CONCLUSIONS: Maternal drug abuse patterns changed in the ten years under study, but outcome in their offspring showed no differences. Drug abuse by pregnant women is linked to a high rate of low birthweight, prematurity, neonatal withdrawal syndrome, vertical infection by human immunodeficiency virus and hepatitis C virus, as well as to social and family problems.

Female↗
PubMed2002

[Predictive factors for invasive pnuemococcal disease: a case-control study].

BACKGROUND: Streptococcus pneumoniae causes significant morbidity in children, but data on the incidence of invasive pneumococcal disease in Spain are scarce. The objectives of this study were: 1) to describe the clinical and epidemiological features of invasive pneumococcal disease in our health district and 2) to determine factors predictive of invasive pneumococcal disease in febrile children seen at a hospital Emergency Department. MATERIAL AND METHODS: Design. Observational, retrospective, case-control study, from 1 October, 1992 to 31 March, 2001. LOCATION: Community Hospital in the north of Spain. Entry criteria for cases: febrile children under 14 years of age, seen at the Emergency Department during the study period, with growth of S. pneumoniae in the blood culture. Eligibility criteria for controls: febrile children under the age of 14 years seen at the Emergency Department during the study period with no bacterial growth in the blood culture. The first eligible child seen after each case was included as a control. STATISTICAL ANALYSIS: descriptive analysis of patients with invasive pneumococcal disease and univariate analysis of each variable in relation to the dependent variable (blood culture positive for S. pneumoniae); multivariate analysis was performed using logistic regression techniques. RESULTS: Seventy-six cases of invasive pneumococcal disease were studied. The mean incidence of invasive pneumococcal disease (cases/100,000 children/year) was 174.1 for children under 24 months of age, 38.9 for children aged 24-59 months, and 5.9 for children older than 59 months. The incidence of pneumococcal meningitis in children under 24 months of age was 14.8 cases/100,000 children/ year. The most common diagnoses were occult bacteremia (64.5 %), pneumonia (17.1 %), and meningitis (9.2 %). Mortality was 1.3 %. A total of 56.5 % of the S. pneumoniae strains showed penicillin resistance (11.8 % high-grade resistance) and 12.2 % showed cefotaxime resistance. Predictive factors for invasive pneumococcal disease were temperature greater than or equal to 39 degrees C (OR: 2.09; 95 % CI:91-4.79), generalized malaise (OR: 2.61; 95 % CI: 1.1-6.21), age between 6 and 36 months (OR: 4.06; 95 % CI: 1.79-9.21), and absolute neutrophil count (ANC) greater than or equal to 10,000 cells/mm3 (OR: 8.16; 95 % CI: 3.54-18.79). CONCLUSIONS: 1. The incidence of invasive pneumococcal disease in our health district is high and is greater than that reported for other European regions. 2. In contrast, the incidence of pneumococcal meningitis is similar to that in other European countries. 3. The most frequent diagnosis was occult bacteremia. 4. In the case-control study, four variables showed significant independent association with the risk of invasive pneumococcal disease: temperature greater than or equal to 39 degrees C, general malaise, age between 6 and 36 months, and an ANC greater than or equal to 10,000 cells/mm3. The most powerful predictor of invasive pneumococcal disease in our series was ANC.

Adolescent↗
PubMed2001

[Idiopathic childhood occipital epilepsy].

OBJECTIVE: To describe the clinical and electroencephalographic (EEG) features, as well as the outcome of children diagnosed with idiopathic childhood occipital epilepsy (COE) in our hospital. METHODS: A retrospective review of the clinical records of children diagnosed with COE in the previous 10years was carried out with description of clinical and EEG features and neuroimaging studies. The outcome of patients followed-up for at least 5 years was also reviewed. RESULTS: Ten children were studied: two with type I (Gastaut) COE, six with type II (Panayiotopoulos) COE, and two with intermediate forms of the disorder. Patients with type I COE suffered daytime seizures with visual symptoms (hallucinations and amaurosis) followed by versive motor partial complex seizures with secondary generalized seizures. Age of onset was late childhood and the seizures reappeared in adolescence when therapy was discontinued. Patients with type II COE had nocturnal seizures consisting of tonic deviation of the head and eyes, some degree of disturbance of consciousness and hypotony followed by vomiting and hemiclonic movements or generalized tonic-clonic seizures. In five children, the first presenting symptom was status epilepticus. In all patients the age of onset was between 1 and 4 years. The results of neuroimaging studies were normal. EEG records showed normal baseline activity with slow wave spikes in the occipital region that disappeared or were reduced by eye opening. CONCLUSIONS: Our clinical and EEG findings are similar to those of other published studies. Type II COE frequently presents as status epilepticus and can be confused with other neurologic emergencies. Ictal EEG is useful to clarify the diagnosis. In type II COE, ictal symptomatology may overlap with migraine with aura. Although designated benign, patients with type I COE may develop learning problems and continue to have seizures throughout childhood.

Child↗
PubMed2001

[Enteroviral meningitis. Clinical and laboratory findings in a series of 60 children].

OBJECTIVE: To describe the epidemiologic, clinical and laboratory findings in a series of children with enteroviral meningitis. PATIENTS AND METHODS: We performed a retrospective descriptive study of all the children admitted to our hospital between May 1996 and September 1997 with a diagnosis of enteroviral meningitis, defined as either a positive cerebrospinal fluid (CSF) culture for enterovirus or pleocytosis in conjunction with a positive enterovirus culture at any other site (rectal or pharyngeal swabs). RESULTS: Sixty cases of enteroviral meningitis were found, all of which occurred between May and July. The median age was 6 years. Half the patients were diagnosed in the first 6 hours of illness and 20 % in the first 2 hours. The most frequent symptoms were headache (97 %) and vomiting (80 %). Fever was present in only 56 % of the patients. On physical examination 78 % presented positive meningeal signs. A total white blood cell count of more than 15,000/l was present in 28 %. CSF white cell count was over 500/l in only five patients and in four pleocytosis was absent; a predominance of polymorphonuclear cells was found in 45 %. Enterovirus was isolated 43 % of the CSF specimens. The median length of hospital stay was 2 days. Antibiotic treatment was started in 13 % of the patients and all recovered without sequelae. CONCLUSIONS: All the cases occurred in late spring. Fever was an inconstant finding. Laboratory findings were typical of viral meningitis, although the percentage of neutrophils in CSF varied widely, with more than 50 % of neutrophils in half of the patients; the absence of pleocytosis was not unusual. The enterovirus yield from the CSF specimens was higher than in previously reported in Spanish series but did not influence the management of our patients.

Child↗
PubMed1999

[Pediatricians' opinion on sedation in children].

OBJECTIVE: Our objective was t evaluate the current knowledge and attitudes of pediatricians regarding the issue of pediatric sedation. PATIENTS AND METHODS: In October 1996 we conducted a mail survey of all 686 members of the Asturias, Cantabria and Castilla y Leon Pediatric Society. Physicians were asked to complete and return a confidential 18-item questionnaire. RESULTS: One hundred fifty-seven (23%) of the eligible physicians responded. Of the responding physicians, 90% agreed that they had insufficient training in pain and sedation management. Seventeen percent thought childhood sedation to be very effective, 76% effective and 7% little effective. Fifty-nine percent thought infant sedation was easy and 36% considered it to be difficult. Thirty-six percent of the pediatricians who work in hospitals considered the cooperation of children under 8 to be good versus only 17% of the primary attention pediatricians (p < 0.05). Thirty-nine percent thought that it was only necessary on some occasions that the parents are present when the child is sedated before surgery. Forty-eight percent of the male pediatricians considered that sedation was always or almost always indicated versus 67% of the female pediatricians (p < 0.05). The most used sedative drugs are midazolam (24%), diazepam (23%) and chloral hydrate (14%). Eleven percent indicated that it was necessary to monitor cardiorespiratory function and oxygen saturation during sedation. CONCLUSIONS: Pediatricians in this Society seem to have a lack of knowledge concerning sedation of their patients. Training in childhood sedation is needed.

Adult↗
PubMed1998

[Blood sampling and transfusion therapy in the preterm infant].

OBJECTIVE: The purpose of this study was to determine the number of skin punctures and volume of blood removed for analytical purposes and the number and volume of red blood cell transfusions performed in premature neonates. PATIENTS AND METHODS: A case-control study was performed with a retrospective review of clinical records. Data about blood samples was gathered from the nursery forms and descriptive statistics were performed. Neonates less than 37 weeks gestational age, born in our hospital between 1/1/1992 and 12/31/1996, were studied. They were divided into two groups: Group 1) Those neonates receiving red blood cell transfusions; and Group 2) The control groups, which was comprised of the next premature baby born after each infant who underwent transfusion. RESULTS: There were 419 premature infants out of 9,635 live newborns (4.3%). Of the 419 premature infants, 123 (29.3%) underwent transfusion therapy. The study groups after exclusions were comprised of 105 infants in groups 1 and 105 infants in the control group, or group 2. The average number of blood samples was 5.4 per infant (range 0-37). The mean volume of blood removed was 26.3 cc per infant (range 0-167 cc) or 15.1 cc/kg (birthweight). The total number of transfusions was 187, with a mean of 1.8 per infant (range 1-12). The mean volume transfused was 43.1 cc per infant (range 20-146 cc). The number of blood samples, total volume of blood removed and percentage of blood volume removed were significantly higher in the transfusion group than in the control group. CONCLUSIONS: The number and volume of blood samples in our premature infants are excessive. We should reduce both to minimize the need of red blood cell transfusions and the associated risks.

Anemia↗
PubMed1998

[The opinion of pediatricians on childhood pain].

OBJECTIVE: The objective of this study was to evaluate the current sensibility and knowledge of pediatricians regarding the issue of pediatric pain assessment and management. PATIENTS AND METHODS: In October 1996 we conducted a mail survey of all 686 members of the Asturias, Cantabria and Castilla y León Pediatric Society. Physicians were asked to complete and return a confidential 95-item questionnaire. RESULTS: One hundred fifty-seven (23%) of eligible physicians responded. Ninety percent of the respondents agreed they had insufficient training in pain management. Sixty-nine percent though their knowledge to deal with acute pain was adequate. Only 12% admitted to having enough background to treat chronic pain. Sixty-five percent of the respondents admitted to know no method at all for pain evaluation, while 82% had never applied any in their clinical practice. About half the respondents (42%) did not know any guidelines for the management of pediatric pain, although 75% considered they would be very useful. A high percentage of pediatricians answered that analgesia was required before performing certain diagnostic or therapeutic procedures (lumbar puncture, venous canalization, arterial puncture and others), but differences in relation to age, sex and clinical setting of the physicians were detected in these responses. The most used drug for the treatment of moderate acute pain is acetaminophen (88%), for severe acute pain metamizol (58%) and for severe chronic pain acetaminophen-codeine (37%). Only 48% admitted to having used opioids. CONCLUSIONS: Pediatricians in this society seem to be too confident about the topic of acute pain management in their patients, even though they report a lack of training which could influence the quality of the care they are offering to their patients. Opioid use is very low. Training in childhood pain management is needed.

Adult↗
PubMed1992

[Esophageal atresia and associated anomalies].

Twenty-seven newborns with esophageal atresia were reviewed for the presence of other congenital associated anomalies. The incidence of esophageal atresia was 2.6 cases for every 10,000 live births. Associated anomalies were present in 59.25% of these cases. Cardiac malformations were the most frequent associated defect (40.7%). Ten infants met the criteria for VACTERL association. The birth weights and gestational ages were similar for both the surviving and deceased infants. Broncho-aspiration was the only significant factor associated with mortality: 75% of the infants who had broncho-aspiration died, versus only 26.3% if aspiration was not present. When associated anomalies were present, mortality was 56.25%, whereas only 18.18% of the infants without these anomalies died (p = 0.055). We conclude that only broncho-aspiration and associated anomalies relate to mortality in esophageal atresia, whereas the birth weight, the other Waterston's prognosis factor, is not important.

Abnormalities, Multiple↗
PubMed1990

[Neonatal osteomyelitis. Study of a series of 35 cases].

After a brief literature review, we analyze the results obtained with a retrospective study of 35 neonatal osteomyelitis diagnosed between 1-January-75 and 31-December-87. The valuated frequency was of 0.40% alive newborns. Between the antecedents, we find previous neonatal sepsis in 68% of the cases. The clinical general findings were less apparent, emphasizing among the local symptoms the pain to passive mobilization and swelling. From acute phase reactants, this study rebounds the high sensitivity of C reactive protein and globular sedimentation rate. The most frequently germ isolated was S. aureus followed by K. pneumoniae. The osteomyelitic injure was unifocal in 71% of the cases and the femur was the most probable bone to be affected. At the initial treatment we associated a beta-lactamic antibiotic with an aminoglycoside one in all cases, with surgical removal in 94%. The mortality was null, but grave arthritic sequels appeared in 14% of the patients. Finally, we propose the employance of seriated quantification of C-reactive protein in the follow-up and control of therapeutic efficiency.

Arthritis, Infectious↗
PubMed1990

[Primary pancreatic hydatid cyst and primordial familial dwarfism].

A 10 years and 7 months old male, was studied for a pathologic, primordial hipogrowing disease, probably due to a recessive and autosomic transmission, because he has got a sister with the same illness, and he was diagnostified of a pancreatic cyst, whind was found in an echographical exploration and established by scanner as intraglandular cyst. There are no others cysts found detected in a complete body-check. The chirurgic findings was a solitary hydatidic intrapancreatic cyst whid was extirpated. The patient's and sister's facial characteristics (big nose, long and thin neck, large forehead), the normal hormonal study in this case, the observation of small bone defects (first finger of the foot thicker than usual, cone epifisis in hands), a normal intelligence and the not accordance between them and the usual in literature described kind, suggest to be a different form the congenital autosomic, recessive dwarfism, not according to the usual one.

Child↗