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Biomedical subjects

J Lloret

Publications and source records attributed to J Lloret.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Laparoscopy for the undescended testis].

The authors show their experience in the use of the laparoscopic approach in 18 cases of unilateral exploratory anorchia. They highlight the advantages that this method offers in efficiency, speed, security and minimal aggression compared with conventional exploration of the inguinal channel in the search of the undetectable testis. In the 18 cases studied through the insertion of 5 mm lense in the umbilical area, it was established that a testicular hypoplasia was present in 8 cases. In another 5 cases testicular agenesia was diagnosed, and in the remaining 5, intraabdominal testis were found. In four of these testicles, a laparoscopic approach helped in their correct placement and also in the removal of the fifth in a patient with recurrent leukemia.

Child↗
PubMed1997

[The usefulness of manometry in the determination of the morphology of the anal canal].

The appearance of the new lecture systems for the manometry studies by computer, like the Polygram by Synectics (vector volume), offer the possibility to see the circumferential pressure forces, that even in rest conditions as in voluntary contraction, they keep coaptation of the anal canal, and this will act as a continent closure system in the most distal part of the G.I. tract. The study is with the normal parameters obtained in 14 individuals, considered as normal, getting the mean +/- sd pressure of the anal canal convey in mm Hg, from de anal canal profile in rest as in voluntary contraction, and the maximum variability that could exist between the six profile waves, that are obtained in the same individual to develop an image of the anal canal. This valves will allow the author's to get to the bottom of fecal incontinence derivative from anorectal malformations, defining the pressure valves of muscular hypoplasia or surgical outcomes of the malformations.

Adolescent↗
PubMed1995

Ionic Stress and Osmotic Pressure Induce Different Alterations in the Lipopolysaccharide of a Rhizobium meliloti Strain.

A halotolerant strain of Rhizobium meliloti was isolated from nodules of a Melilotus plant growing in a salt marsh in Donana National Park (southwest Spain). This strain, EFB1, is able to grow at NaCl concentrations of up to 500 mM, and no effect on growth is produced by 300 mM NaCl. EFB1 showed alterations on its lipopolysaccharide (LPS) structure that can be related to salt stress: (i) silver-stained electrophoretic profiles showed a different mobility that was dependent on ionic stress but not on osmotic pressure, and (ii) a monoclonal antibody, JIM 40, recognized changes in LPS that were dependent on osmotic stress. Both modifications on LPS may form part of the adaptive mechanism of this bacterium for saline environments.

Journal Article↗
PubMed1993

[Prognostic factors in congenital diaphragmatic hernia. Can they modify our therapeutic approach?].

Mortality rate from congenital diaphragmatic hernia (CDH) is still high despite current therapeutic advances. For some time now we have been looking for prognostic parameters which be enable us to determine, in the prenatal and postnatal period, the patients who will die from their pulmonary hypoplasia in spite of treatment and those who will survive. The authors review 94 newborns with CDH diagnosed during the first 24 hours of life. The following prognostic parameters were studied: preoperative arterial gases, position of stomach, right or left sided hernia, liver in thorax and presence of postoperative pneumothorax. All these factors were related to mortality. The arterial gases were the most sensitive factor. Eighty per cent of patients with poor gasometric prognosis died. Thoracic stomach is also a poor prognostic parameter with a 76.7% mortality rate, however we think this does not justify prenatal surgical measures. The remaining parameters were not significant with regard to mortality.

Blood Gas Analysis↗
PubMed1993

[Surgical technique in reduced hepatic transplantation in children].

The lack of availability of pediatric donors for liver transplant has resulted in a high mortality rate among children awaiting transplantation, especially in patients weighing less than 10 kg. Knowledge of techniques of liver reduction allows liver transplantation in low-weight children with an adult liver graft, although with increased risk. The authors studied 70 pediatric liver transplants, 14.3% of whom received a reduced-size organ. Maximal difference between donor and recipient weight was 7.7. Segments II, III and IV (right hepatectomy) were transplanted in eight cases while segments II and III were transplanted in two cases. Transfusional requirements during the 48 hour postoperative period were not significantly different between patients with reduced-size liver and patients who received the full-size organ. There was not morbi-mortality secondary to surgical technique in reduced liver transplant group of patients.

Body Weight↗
PubMed1993

[Biliary complications in hepatic transplantation in children].

Biliary reconstruction continuous to be a source of severe complications in paediatric liver transplantation (PLT). Five (7%) biliary complications in 70 PLT in patients aged from 8 months to 13 years with a body weight of 4-37 Kg. were studied. End-to-end common duct anastomosis (group I) with Kehr drainage was performed in 18 cases. End-to-side common duct jejunostomy (group II) was performed in the remaining 52 cases. In this group, two patients were found to have stenosis and biliary stones or sludge respectively and one obstruction with sludge without evident stenosis. All cases required surgery and there was no mortality. Transparietohepatic cholangiography has provided early diagnosis of these complications and has proved to be a reliable method of choice. The use of inert biological material in Kher tubes and steroids slow down the organization of a fistulous tract, thereby causing the complications which arose in group I.

Adolescent↗
PubMed1993

[7 years' experience with hepatic transplantation in children].

UNLABELLED: Between the 7th of June 1985 and december 1991, 71 liver transplants (LTx) were performed in 60 patients (pts) with ages ranging from 8 months to 14 years and weight between 4 and 38 kg. Sixty-two percent were cholestatic diseases (32 biliary atresia, 3 sclerosing cholangitis and 2 biliary paucity), 25% metabolic hepatic-based diseases (6 glycogen storage disease, 4 Byler disease, 3 tyrosinaemia and 2 alpha-1-antitrypsin deficiency) and 13% miscellaneous diagnosis (2 post-hepatitic cirrhosis, 2 autoimmune hepatitis, 2 fulminant hepatitis and one case of cholesteryl ester storage disease and one case of Budd-Chiari disease). Primary non-function was observed in 4 cases (5.5), severe bacterial infection in 4 pts. (5.5%), severe viral infection in 2 (3%), arterial thrombosis in 2 (3%), arterial rupture in 1 (1.5%), recurrence in 3 cases (5%) and chronic rejection in two (3%). Two patients were in III and IV coma respectively prior to surgery. Intraoperative mortality was nil. Total mortality was 19 cases, which represents an actuarial survival rate of 70%. Our philosophy has always been to offer this treatment to all patients candidates for LTx. In some end-stage situation it is very difficult to objectively assess their possibilities and when necessary refuse the only opportunity the patient has. Nevertheless, results are satisfactory. IN CONCLUSION: 1. LTx in children has been confirmed in our programme over 7 years as efficient treatment for end-stage liver diseases. 2. Advances in the therapeutic arsenal and increased experience have notably improved the progress of these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Paediatric liver transplantation: life after portoenterostomy in biliary atresia.

Seventy-five percent to 80% of patients with biliary atresia (BA) will be candidates for paediatric liver transplantation (PLTx) throughout the first 14 years of life. They form the main group of recipients in our Paediatric Liver Transplant Unit. Of 48 children transplanted, 21 (44%) had BA. These patients present particular features, average weight of 12 kg, mean age of 3 years, and severe malnutrition prior to PLTx, which distinguish them from other paediatric candidates. With the advent of PLTx, portoenterostomy (PE) has ceased to be the only recourse for treating the majority of patients with BA. Different factors converge in these patients: some, including haemorrhage and adhesions, may present technical difficulties, and others, such as infections (19% in this series) due to severe malnutrition and malabsorption and consequent chronic rejection (14% in this series), often lead to death in the postoperative period (33% in this series). BA is treated by all paediatric surgeons, but the overall success rate now depends not only on PE but also on PLTx. In an attempt to facilitate possible later PLTx in pts with BA, the authors as paediatric surgeons performing PE or PLTx present surgical modifications and emphasize the most important medical aspects conducive to the improved general status of these pts. Our aim was to establish guidelines for taking full advantage of PE while preventing posterior problems and facilitating future transplant surgery.

Biliary Atresia↗
PubMed1992

[Anorectal manometry in Hirschsprung disease].

To show the absence of inhibitory reflex of the anus (R.I.A.) by ano-rectal manometry is an important sign in the diagnosis of Hirschsprung's disease. Between 1989 and 1991, a series of 199 patients was studied. The patients were divided into two groups: 0-1 month and 1 month to 50 years. Both groups were subdivided into cases with or without clinical and radiological suspicion of aganglionism. In this series, R.I.A. was absent in 88 patients and present in 111. Histologic study and follow-up confirmed the existence of aganglionism in 86 patients, hyperganglionism in 1, anal stenosis in 8, cystic fibrosis in 4 and 1 coeliac disease; the rest were megarecta to a greater or lesser degree. There was 1 false negative, signifying a percentage of error of 0.5%.

Adolescent↗
PubMed1992

[Abdominal trauma at a third-level pediatric hospital: study of 150 patients].

All paediatric patients with abdominal trauma admitted in our hospital from 1975 to 1989 were retrospectively studied. We present 150 children with ages ranging from 1 to 14 years, mean age 6 +/- 2.6 years. Sixty-five percent of them were male. Trauma was classified as severe (37%) and mild (63%) and relationated with associated extra-abdominal injuries. The 42% of patients could be attended in other less specialized centres. Since 1982, severe abdominal trauma patient with parenchymal lesions of liver, kidney and spleen were treated according to a non-surgical protocol without secondary complications.

Abdominal Injuries↗
PubMed1992

[The "abdominal zipper": a surgical surprise].

In our surgical department there are two kinds of mandatory reoperations: the second look and enterostomies. How many times are we thinking to use a zip in a laparotomy, for avoiding abdominal wall damage? The first experience using zip in a newborn with neonatal sepsis and intestinal ischemia is presented. This device allowed to check the bowel every day and to perform the appropriate surgery. Seven days after last surgery we removed the zip and closed the abdominal wall.

Abdomen↗