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J Elías Pollina

Publications and source records attributed to J Elías Pollina.

At least 19 recordsLinked to original sources
PubMed2001

[Primary torsion of the greater omentum].

OBJECTIVE: Primary torsion of the greater omentum is an infrequent cause of acute abdomen in children. A retrospective review was conducted to establish the prevalence and clinical features of omental torsion as a cause of acute abdominal pain in childhood. PATIENTS AND METHODS: We reviewed the clinical histories of the children given surgical treatment for torsion of the greater omentum in our hospital in the last 25 years. The following data were studied: age at presentation, sex, predisposing factors, symptomatology, complementary investigations, treatment and evolution. RESULTS: The male:female ratio among the 15 patients who underwent surgery was 2:1. Symptomology was similar to that of acute appendicitis with certain peculiarities such as a longer period of evolution at the moment of diagnosis, lower temperature and leucocytosis lower than would be expected in appendicitis at the same time of evolution and, in 12 patients, absence of vomiting. After surgical treatment evolution was satisfactory. Torsion was primary in 13 patients, secondary to inguinal hernia in 1 and secondary to cystic lymphangioma of the omentum in 1. The etiology and pathogenesis, as well as the diagnostic and therapeutic problems of this process, are discussed. CONCLUSIONS: In all the patients with primary torsion the clinical diagnosis was of acute appendicitis. Although primary torsion is classically associated with obesity, only 1 of the 13 patients weighed significantly more than the average for the same age and sex in our region and none of the patients showed a clearly associated anatomic malformation.

Abdomen, Acute↗
PubMed2001

[Cholelithiasis].

Explore the source record for details and available documents.

Adolescent↗
PubMed2001

[Increase of the chondroitin-sulfate proteoglycan, fibronectin and fibroblasts in infantile hypertrophic pyloric stenosis].

INTRODUCTION: Infantile hypertrophic pyloric stenosis (IHPS) consists of hypertrophy of the muscular layer of the pylorus. Its etiology is still unknown. In the last years only few jobs that studied the extracellular matrix (ECM) in the muscular layer in the IHPS have been reported. Our aim was to investigate the expression of two ECM molecules: chondroitin-sulfate proteoglycan (CSPG) and fibronectin (FN), and fibroblasts. MATERIAL AND METHODS: Full-thickness muscle biopsy specimens were obtained from 33 IHPS patients at pyloromyotomy and 12 controls. Indirect immunohistochemistry was performed using CSPG, FN and fibroblasts monoclonal antibodies. The results were showed by a semiquantitative scale as follows: strong (++), moderate (+), weak (+/-), and absent (-). RESULTS: We demonstrated that the CSPG immunoreactivity was localized in the connective tissue septa and the expression of FN molecules in the pericellular space. Both molecules were significantly the increased in the muscle layer of the pylorus with IHPS in relation to control pylorus. We also demonstrated a marked increased expression in the number of fibroblasts in the muscle layer of the pylorus with IHPS. Even-though the most striking increase was localized in the septa, we also observed great number of fibroblasts amongst the smooth muscle cells. CONCLUSIONS: We suggest that IHPS is characterized, not only by the muscle layer hypertrophy, but also by the increase of several ECM molecules, such as CSPG and FN. We also think that the increase of fibroblast could explain the higher expression of both ECM molecules in the muscle layer of pylorus in IHPS.

Chondroitinases and Chondroitin Lyases↗
PubMed2001

[Mortality in patients with esophageal atresia: influence of birth weight and cardiac anomaly].

BACKGROUND: Waterston's prognostic classification of esophageal atresia has been used in most hospitals throughout the world. A number of technical advances, mainly in neonatal intensive care units have contributed to a reduction in mortality. Although the Waterston classification continues to be widely used, increased survival in the highest risk groups in this classification has led to new classifications being described in the last few years. OBJECTIVE: To determine the influence of birth weight and cardiac anomaly on the outcome of patients with esophageal atresia. MATERIAL AND METHODS: The outcome of 100 infants with esophageal atresia was analyzed. The patients were divided chronologically into two groups according to advances in ICUs and surgical techniques: 45 patients treated in the first period (1971-1982) and 55 in the second (1983-2000). The influence of birth weight in the groups described by Waterston and Spitz and the association with cardiac malformation were compared between both periods. RESULTS: Mortality in the birth weight groups described by Waterston decreased significantly between periods but this decrease was lower when the birth weight groups at highest risk described by the Spitz (1,500 g) were compared. Survival in patients with esophageal atresia improved from the first period (57.8 %) to the second (80 %) but mortality was still high when an associated major cardiac anomaly was present (80 % vs 75 %). CONCLUSIONS: Although advances in the medical and surgical management of neonates have rendered birth weight less important to prognosis than previously, mortality continues to be high in patients with very low weight and major cardiac malformation.

Abnormalities, Multiple↗
PubMed2001

[Prognosis assessment of esophageal atresia: our experience of 29 years].

INTRODUCTION: The major advances in neonatal intensive care have made less useful the Waterston's criteria for esophageal atresia (EA) and/or tracheoesophageal fistula (TEF), and other prognostic classifications have been reported. The aim of this study was to determine the influence of various parameters on the outcome of EA-TEF. MATERIAL AND METHODS: We reviewed 97 cases admitted in our hospital for 29 years. We divided the cases in two groups in relation to the improvement of our neonatal unit care during the years: 1st. 1971-1982 (n = 46); 2nd. 1983-1999 (n = 51). chi 2 squared test and logistic regression analysis of the influence of several parameters before surgical treatment (Waterston's and Spitz's birth weight groups, pneumonia, ventilator dependence, severity of associated anomalies and cardiac malformations) on mortality was performed. RESULTS: The survival rate increased since 1983, reaching 86.2% in the last 10 years, although the number of neonates with birth weight < 1500 g has increased. Association with a major anomaly increased the mortality significantly in the 2nd. group only (45.5% major vs 7.1% minor and 8.3% none). The cardiac malformations were the most common, not only before 1983 (26.8%), but also since then (31.3%). When the neonate associated a major cardiac malformation the mortality was significantly higher in the 2nd. group (71.4%). The mortality, when pneumonia was present, was significantly higher before 1983 only (75% vs 32.4%), whereas the mortality was significantly increased by the need of ventilator in the 2nd. group only (85.7% vs 9.1%). Before 1983, the best prognostic parameters were the pneumonia and the severity of associated anomalies, whereas only the ventilator dependence was selected between 1983 and 1999. CONCLUSIONS: The EA-TEF mortality has decreased in the last years. The associated cardiac malformation is the most common. We think that the ventilator dependence is the most reliable prognostic risk factor, showing a poor physiologic status of the neonate.

Abnormalities, Multiple↗
PubMed1997

[Cystic dilation of the bile duct in childhood].

OBJECTIVES: Common bile duct dilatation (CBDD) represents part of a wide spectrum of pancreaticobiliary disorders, with different etiopathogenic mechanisms. The objective of this study was to compile the cases treated in our service during the last five years. PATIENTS AND METHODS: Four cases of CBDD (17 months to 10 years of age) are reported. All of them presented abdominal pain and bilious vomiting. One patient previously had pancreatitis. Cholestatic jaundice was associated in only one patient. The diagnosis was made by ultrasound, being confirmed by endoscopic retrograde cholangiopancreatography (ERCP) in three cases and by computed tomography scan (CT) in one case. RESULTS: Three patients had a single fusiform dilation of the extrahepatic bile duct (type I cyst, Alonso Lej-Todani classification), which were treated by cyst excision and hepaticojejunostomy by using a Roux-en-Y limb. In one patient, the ERCP detected a combined dilatation of the intra- and extrahepatic bile duct (type IV cyst), associated with an anomalous choledochopancreticoductal junction with a distal obstruction of the common bile duct. In the case, the treatment consisted of a transduodenal esfintherotomy. CONCLUSIONS: Based on our experience and a literature review, an increasing incidence of this pathology is deduce. Therefore, the relevance of ultrasounds and ERCP in the diagnosis and visualization of pancreatobiliary ducts and the choice of treatment, depending on the CBDD, are discussed.

Child↗
PubMed1997

[Severe caustic esophagitis in childhood].

OBJECTIVE: A retrospective analysis of patients treated for serious caustic esophagitis in our hospital was performed with the aim of defining epidemiological factors, initial treatment and therapeutic criteria for esophageal stricture with long evolution. PATIENTS AND METHODS: Thirty-four cases of serious caustic esophagitis treated since 1982 were analyzed surveying epidemiologic, clinical and endoscopy data, as well as initial medical treatment, dilatation session number, treatment period, complications, surgical treatment indications if necessary and actual situation. RESULTS: Alkaline caustic agents were swallowed in 71% of the cases, with dishwashing detergent being the most frequent (16 patients), Grade II esophagitis was noticed in 13 cases, grade III in 18. Established esophageal stricture was present in 3 patients when admitted. Repeated esophageal dilations were necessary in 13 patients (38%), with between 1 and 21 dilatation sessions needed. Esophageal stricture persistence forced us to perform an esophageal substitution technique by esophagocoloplasty. Resection and enlargement of a short stenotic segment was performed in 1 patient. Long-term evolution in all cases has been satisfactory. CONCLUSIONS: We consider that adequate treatment of these patients includes conservative corticosteroids, sucralfate and anti-H2 combined with a previous endoscopy evaluation. If evolution turns into stricture, dilatations must be done, sometimes throughout years. If this treatment fails and the injury is extensive, esophagocoloplasty is the surgical technique of choice. Nevertheless, as any accident, the best treatment is good prevention.

Adrenal Cortex Hormones↗
PubMed1992

[Dog bites in children. Epidemiologic and clinical study of 144 cases].

We have done a prospective study of 144 cases of dog bites in children between 1 and 13 years of age that were attended at the Emergency Department of the "Miguel Servet" Children's Hospital of Zaragoza over a period of 30 months. The average child is an 8 year old boy who is bitten at 4 p.m. in the lower limbs by a dog belonging to either the family, a neighbor, or to some friends. The dog of unknown breed and the German shepherd are those most frequently involved (39.5% and 22.2%, respectively). There is a low incidence of infection (4.8%). The attacks were provoked by petting in 52.7%; therefore, we recommend not to get close to the animals even if they are known. In our area, 83.3% of the children are correctly vaccinated. Finally, we compare our results with other studies and we suggest that it is of great interest to establish measures in order to reduce the incidence of dog bites.

Adolescent↗
PubMed1992

[Cholelithiasis in childhood. Proposals based on a multicentric study].

Fifty six cases of cholelithiasis in patients aged two months to 15 years (mean age 7.65 years) concerning to 11 hospitals are reviewed. The study protocol followed was the same in all medical records, although own criterions were considered on management performed in each center. From the cases, it follows: 1. Male/female rate is 1/1.5. 2. Symptomatology in infancy is relatively poor and pain localization is not orientative. 3. It was an incidentally finding in 41 per 100 of the cases. 4. Ultrasonography is the best examination procedure rendering diagnosis in the 51 cases it was underwent. 5. Hematologic study was abnormal in six of 46 cases. 6. Medical treatment was not performed in any hospital. 7. Existence of "lithogenic families" seems to be demonstrated. 8. The presence of four patients with Down syndrome in this series must be pointed out. 9. Among total 56 cases, 21 underwent surgical treatment, 29 were conservatively treated, two have died and four patients had spontaneous stone resolution. 10. In the face of these, we propose: A) Surgical treatment in symptomatic cases, porcelain gallbladder and nonfunctionating gallbladder. B) Expectant management and sonographic monitoring in asymptomatic cases. C) Carefully evaluation in patients with predisposing factors and patients with recurrent abdominal pain.

Adolescent↗
PubMed1992

[Beckwith-Wiedemann syndrome: study of eleven cases].

In this paper we report a review of the omphalic pathology that was admitted to our hospital from january 1973 through december 1990. Eleven cases of Beckwith-Wiedemann Syndrome were diagnosed during this period of time. Our eleven cases comply with at least three of the four major criteria (omphalocele, macroglossia, gigantism and neonatal hypoglycemia) and several of the minor criteria. The interest of this paper is based on the rareness of this syndrome and its association in two of our cases with Cacchi-Ricci Syndrome. Moreover, one of these cases later presented with a Wilms' tumor. Finally, we emphasize the importance of an early diagnosis of this syndrome in order to avoid the metabolic disturbances (hypoglycemia), to establish prompt treatment of the serious anomalies (omphalocele) and to control and follow these patients since they have increased risk to develop neoplastic disease.

Beckwith-Wiedemann Syndrome↗
PubMed1991

[Accidents in childhood: apropos of 14,301 cases treated in the course of one year].

The present study aims: to revise all the cases of paediatric accidents attended at a Emergency Service of a tertiary Hospital; to analyze the epidemiological variables; and to try to draw conclusions in view of prevention. In order to achieve that, the 14.301 accidents attended during 1989 have been collected. The relation between little boys and little girls is 58.2:41.8. The average age is 7.12 years, though the mode has been 2 years. A larger number of accidents occur during non holiday. 44.3% of cases are attended between 18 and 23 hours. 89% of the accidents are, first of all, traumatisms and/or wounds; secondly, those which are produced by strange bodies (4.4%). In 51.9% of cases no complementary trial was carried out. Only 2.9% of cases were admitted to hospital, whereas 104% requires observation, and the rest returns home. The variables in the admitted patients are also analyzed, and a brief exposition of results for each of the 6 diagnostic groups is made.

Accidents↗
PubMed1990

[A new clinical evaluation scale for incontinence: its use in anorectal atresias].

We present a clinical scoring system to obtain a quantitative and accurate assessment of anorectal incontinence. We evaluate ten components, each of one is pointed between 0 and two, then overall incontinence punctuation (I.P.) is between 0 and 20. Variables define clinical data relative to patient's intestinal habits and hygienic methods, voluntary control degree of defecation and repercussion of patient's incontinence in social and physical capabilities. Punctuation lower than nine concerns to a poor continence; It is fair between nine and 14 points and 15 or higher punctuation indicates a good continence mechanism. This incontinence punctuation method (I.P.) has been applied to 23 patients, aged between two and 17 years, operated because high imperforate anus by PSARP procedure in 15 cases and by abdomino-perineal pull-through according to Romualdi-Soave technique in eight cases. We found statistic significative difference between the group of patients aged less than 5 years and the group aged between 5 and 10 years. There is not statistic significative differences between the two procedures used in surgical treatment, although I.P. is slightly higher in cases operated by PSARP procedure than in cases treated with Romualdi-Soave technique, when we compare the two groups with similar mean age.

Adolescent↗
PubMed1990

[Results of biofeedback on incontinence caused by anorectal atresia].

Eight patients with anorectal incontinence because of anorectal atresia, aged between seven and seventeen years, following surgical treatment with Romualdi-Soave procedure in seven cases and with PSARP in one case, have received biofeedback training to improve their continence. Clinical evaluation has been performed with a new numeric punctuation method that allows a quantitative and precise appraisal of incontinence (Incontinence Punctuation: IP). From a clinical point of view, biofeedback training has increased 4.16 points IP in patients in whom the method has been effective. It has prolonged the mean duration of voluntary contraction in 5.9 sec. and elevated in 13.6 mm. Hg. the maximal pressure contraction. In two patients, clinical evolution and manometry measurements indicated surgical treatment and PSARP was performed, improving IP in 5.5 points. We considered biofeedback training, when indicated, an adequate and innocuous technique to achieve an important clinical continence improvement in these patients.

Adolescent↗
PubMed1987

[Epididymo-testicular disjunction. Presentation of 23 cases and review of the literature].

Twenty three cases of alterations of the epididymis-testicular union found in 1,000 children with cryptorchism are discussed. Anatomical and pathological findings are described and world literature on the subject is reviewed, finding very scanty references to this problem in spite of the fact that expected incidence of epididymis testicular non-junction is between 1 and 2% of the patients with cryptorchism.

Child↗
PubMed1987

[Analysis of mortality in myelomeningocele].

Authors present a study of 84 patients with myelomeningocele between years 1971 to 1985. They analyze morbimortality related to level and condition of the lesion, Lorber's selection criteria and treatment received. They find better survival in females and in patients in whom surgical closure of the lesion was carried out without variations if one Lorber's criteria is present. The moment of operation did not change survival and was not related with development of hydrocephaly.

Adolescent↗
PubMed1985

[Intestinal invagination: 12 years of experience].

One hundred and forty two cases of intussusception were treated in our hospital since 1970 to 1982. Patients were divided for analysis into two groups, each consisting of 71 consecutively treated patients. In the second group (1977-1982) the hydrostatic pressure reduction was attempted under general anaesthesia an was successful in 50% of the patients. We compare both groups from the point of view of hydrostatic pressure reduction and conclude that anaesthesia significantly reduces the number of surgical procedures in children with intussusception.

Adolescent↗