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J Flores Serrano

Publications and source records attributed to J Flores Serrano.

12 recordsLinked to original sources
PubMed2004

[Diagnostic utility of radiography in head trauma: a critical review of the literature].

INTRODUCTION: The indication of distinct imaging studies in pediatric head trauma, and especially the use of skull radiography, is controversial. OBJECTIVE: To assess the effectiveness of skull radiography in the management of head trauma in pediatric patients. To do this, we aimed to determine the predictive value of this procedure in detecting intracranial injuries, independently of patients' symptoms and clinical examination. MATERIAL AND METHODS: We performed a review of the medical literature (MEDLINE) and of other resources available for searching biomedical information. Studies limited to pediatric patients (0-18 years old) that provided information on the diagnostic utility of skull radiography in head injury were selected. The source and characteristics of the populations studied and potential design limitations were taken into account. RESULTS: Twelve original studies were selected, three of which were performed in children younger than two years old. Differences were found in the origin of the sample populations, the prevalence of intracranial injury and skull fracture, the severity of the trauma included, and in the criteria for performing imaging tests. CONCLUSIONS: Because of the limited comparability of the articles, the usefulness of skull radiography was difficult to assess. Although the use of this technique is accepted in some circumstances in patients younger than two years old, the data obtained assign little value to the systematic use of radiography to assess head trauma in pediatric patients. Head computed tomography is indicated when symptoms or signs of possible neurological injury are present.

Adolescent↗
PubMed2003

[Cerebrovascular stroke as a sign of atrial myxoma in childhood].

Primary cardiac tumors are uncommon with an estimated incidence of between 0.0017 % and 0.19 %. Most are benign. Whereas myxomas are the most common primary tumor in adults, in children they are exceptionally rare. Cardiac myxomas usually develop in the left atrium, 20 % occur in the right atrium and the remainder develops in the ventricles and rarely in the heart valves. Cerebrovascular strokes secondary to myxoma are rare in childhood. The diagnostic test of choice is transesophageal echocardiogram and early excision is the most effective treatment in preventing serious complications. We report a case of cerebral stroke as the only manifestation of an atrial myxoma in an 11-year-old-girl. The patient presented vertigo, right hemiparesis of the body and dysarthria without loss of consciousness. After diagnostic tests (computerized tomography, magnetic resonance imaging and cerebral angioresonance) she was diagnosed with an ischemic lesion in the left middle cerebral artery. Various investigations were performed to find the cause of the stroke, among them cardiologic study, and a mass in the left atrium suggestive of myxoma was found. The tumor was removed and the diagnosis of myxoma was confirmed by histopathological examination. Outcome was satisfactory. The presence of a cerebral ischemic episode, with or without concomitant heart disease, suggests the need to look for cardiac etiology.

Child↗
PubMed2002

[Ethnic difference in attendance at emergency departments. An approximation to the gypsy reality].

BACKGROUND: Demand for emergency services is increasing, especially among children from non-Caucasian ethnic groups. OBJECTIVES: To objectify this observation and to determine the healthcare and social differences between the gypsy and Caucasian populations. METHODS: We performed a descriptive, observational study in the Pediatric Emergency Unit of a tertiary care hospital. Systematic sampling was performed and 420 children were selected. Data on age, sex, compliance with primary healthcare preventive programs, reason for attendance, type of healthcare center, diagnosis and familial characteristics were collected through a questionnaire. RESULTS: The median age of the patients was 24 months. The percentage of patients of gypsy race was 16.4 %. Most of the gypsy population (68.1 %) attended small, local healthcare centers compared with 34.8 % of the Caucasian population (p 0.0001). Only 58 % of the gypsy children were taken to healthcare centers for regular check-ups compared with 96.7 % of the non-gypsy population (p 0.0001). The percentage of gypsy children who had never being vaccinated was 18.8 %. There were no such cases among the non-gypsy population (p 0.0001). The percentage of gypsy children visiting the emergency unit who were hospitalized was 11.6 % compared with 1.9 % of non-gypsy children. Illiteracy rates were 30.4 % and 15.9 % in gypsy mothers and fathers, respectively, compared with 0.6 % and 0.3 % in non-gypsy mothers and fathers, respectively (p 0.0001). CONCLUSIONS: This study reveals significant differences between the gypsy and Caucasian pediatric populations in terms of healthcare and identifies a group at high health risk.

Child Health Services↗
PubMed2001

[Familial hypomagnesemia with hypercalciuria and nephrocalcinosis].

Familiar hypomagnesemia with hypercalciuria and nephrocalcinosis is a rare syndrome belonging to the group of heterogeneous tubular diseases whose common characteristic is renal magnesium wasting. We present a 9 year old boy with polyuria, polydipsia and enuresis. Radiologic and ultrasonographic examinations showed nephrocalcinosis. Hypomagnesemia, normokaliemia, hypermagnesiuria, hypercalciuria, incomplete distal tubular acidosis, hypocitraturia and mild renal failure were found. Treatment with magnesium salts, hydrochlorothiazide, potassium citrate and sodium bicarbonate did not restore magnesium or calcium levels to normal. Renal function and nephrocalcinosis remain stable after 3 year's treatment. In conclusion, we report a new case of this rare syndrome caused by a congenital defect in magnesium reabsorption and discuss the evolution of the illness during 3 years' treatment.

Adolescent↗
PubMed2000

[Technetium-99m-dimercaptosuccinic acid (DMSA) scintigraphy in the first febrile urinary tract infection in children].

OBJECTIVE: The objective of this study was to evaluate the findings of 99mTc-DMSA renal scintigraphy in children with their first acute febrile urinary tract infection in relation with several clinical-biological parameters and other imaging studies and a long-term follow up. MATERIAL AND METHODS: 103 children between 1 month and 10 years old with their first acute febrile urinary tract infection were studied by means of clinical and laboratory assessment, renal ultrasonography and 99mTc DMSA renal scintigraphy in the acute illness period. Patients were divided into two groups, those under 2 years old (n = 63) and those over 2 years old (n = 40). RESULTS: Cortical scintigraphy showed renal changes in 56 patients (54,5%). Children over 2 years of age had a higher incidence of renal lesions than younger children (39,7% vs. 77,5%). Ultrasonography measuring renal volume showed a simple concordance with scintigraphy in 64% of the patients. Reflux was demonstrated in 23 patients (22,3%) without differences between patients with normal or abnormal cortical scintigraphy. After having studied the factors that were associated independently to the pathological results in the scintigraphy through a logistical multivariant regression, it was observed that the child's age, the elevation of the PCR and the alterations of the renal volume were significant according to statistics and also associated to a larger amount of pathological DMSA scintigraphy. CONCLUSIONS: DMSA scintigraphy associated with other diagnostic methods can improve the sensitivity and specificity to establish renal damage stage. During the follow-up the acute lesions disappeared or improved in all cases and the chronic lesions have not been modificated.

Child↗