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L Gómez López

Publications and source records attributed to L Gómez López.

9 recordsLinked to original sources
PubMed2006

[Home enteral nutrition in Spain. Results of the register of the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition in 2003].

INTRODUCTION: The number of children receiving prolonged home enteral nutrition (HEN) is increasing. However, precise information on the incidence and prevalence of HEN in Spain is lacking. Consequently, the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition created a patients' register (NEPAD). The aim of the present study was to analyze the results of the first year of the NEPAD register (2003). MATERIAL AND METHODS: The NEPAD is an on-line register that gathers information on the indications for HEN, route of access, type of diet and duration of nutritional support. Quantitative data are expressed as mean and standard deviation, and qualitative data as percentages. RESULTS: In 2003, 124 children from 6 hospitals were registered. The mean age at the beginning of HEN was 3.6 years. The underlying disease was gastrointestinal in 20%, neurological or mental retardation in 20%, cystic fibrosis in 14.5%, tumor in 11%, innate error of metabolism in 10%, congenital cardiac disease in 6%, severe primary malnutrition in 6%, and other causes in 13%. A nasogastric tube was used as the first route of access in 56%, and gastrostomy was used in 42%. Sixty percent of the children received continuous nocturnal enteral nutrition and 90% used an infusion pump. The type of feeding consisted of blenderized natural food in 14%, polymeric pediatric formula in 50%, and infant formulae in 18%. On December 31st, 84 children continued to receive enteral nutrition (68%). CONCLUSIONS: Despite the efforts made to maintain the on-line national register, it has been underused in its first year of existence (2003). Patients with gastrointestinal or neurological diseases constitute the main group of patients in the register. There is a slight preference for the use of nasogastric tube over gastrostomy.

Adolescent↗
PubMed2002

[Ruptured aneurysm of the sinus of Valsalva in a boy with ventricular septal defect].

Aneurysmal dilatation of the sinus of Valsalva is a rare structural cardiac abnormality in children. It appears to be more common in Asia. It may be clinically silent for many years but these defects frequently coexist with other cardiac malformations, causing, when rupture occurs, unexpected symptoms that are not explained by the original defects. We report a case of ruptured aneurysm of the sinus of Valsalva in a 12-year-old boy diagnosed with ventricular septal defect in the neonatal period with an uneventful course. The boy suddenly developed acute prechordal pain, symptoms of low heart output and systolic-diastolic murmur. The diagnosis of ruptured aneurysm of the sinus of Valsalva was based on echocardiography. Surgical treatment was required to close the ventricular septal defect and repair the aorta, without valvular replacement. The postoperative course was uneventful. We conclude that is extremely important to have a degree high suspicion of this entity in previously asymptomatic children, with or without cardiac anomalies, who suddenly present this kind of heart failure and abrupt changes in cardiac auscultation.

Aortic Rupture↗
PubMed2002

[Acute Gastroenteritis in hospitalized children. 14-Year evolution].

OBJECTIVES: To analyze the etiology and evolution of patients with acute gastroenteritis hospitalized in our pediatric department and to study the clinical and laboratory differences between acute viral and bacterial gastroenteritis. PATIENTS AND METHODS: We studied the children with a diagnosis of acute gastroenteritis, aged between 0 and 14 years, who were consecutively admitted between 1987 and 2000. Differences were considered statistically significant if p < 0.05. RESULTS: A total of 2,613 patients diagnosed with acute gastroenteritis were hospitalized (10.4 % of hospital admissions). The most common pathogens isolated were rotaviruses (46.5 %), followed by Salmonella (32.6 %) and Campylobacter (19.3 %). Hospital admissions due to Salmonella (p < 0.0001), other bacteria (Escherichia coli and Shigella) (p < 0.002) and adenoviruses (p < 0.01) significantly decreased. Rotaviruses were the most frequently detected pathogens in winter and in children aged less than 1 year (p < 0.0001). The incidence of Salmonella spp was greater in summer and in children older than 2 years (p < 0.0001). The incidence of hyperthermia (rectal temperature higher than 38.5 degreeC) (p < 0.0001), dehydration (p < 0.0005) and fecal blood (p < 0.0001) was higher in bacterial diarrheas. Erythrocyte sedimentation rate (p < 0.001) and leukocyte counts were higher in bacterial gastroenteritis (p < 0.01). CONCLUSIONS: Rotaviruses were the most frequently isolated enteropathogens. The features that best distinguished between bacterial and viral diarrhea were hyperthermia and fecal blood. Hospital admissions due to Salmonella Shigella E. coli, and adenoviruses significantly decreased.

Acute Disease↗
PubMed1999

[Neurological and growth follow-up of cardiac patients operated on before 45 days of life].

OBJECTIVE: Our aim was to study the neurological and growth disorders in patients undergoing cardiac surgery during the neonatal period. PATIENTS AND METHODS: Ninety clinical records of newborns with congenital heart disease that were operated between 1985 and 1996 and were under the age of 45 days with a minimum follow-up period of 12 months were reviewed. RESULTS: Of the 37 patient records considered, 33 (89.1%) were neurosensorially normal, 2 had minor handicaps and 2 moderate handicaps. There were 15 (40.5%) with the weight and 9 (24.3%) with the length below the 10th percentile. Although exitus, handicaps and growth disorders were more frequent in those patients operated in the extracorporal circulation, there were no significant differences. The growth disorders were greater in complex heart diseases and in pulmonary atresia, but significant differences were only related to the weight. CONCLUSIONS: Because at least 11% of these patients showed neurological disorders, a neurological follow-up is necessary. The number of post-operated patients with growth disorders was high, but catch-up growth resulted in recovery. A greater number of neurological and growth disorder has been found in complex heart disease, where only a palliative treatment could be employed. Although the complete correction of the cardiopathy may imply an early mortality, long time prognosis for survivors is much better.

Follow-Up Studies↗
PubMed1998

[Complications of cerebrospinal fluid shunt].

OBJECTIVE: The objective of this study was to know the incidence, mode of presentation, clinical and microbiological aspects, as well as the management of ventriculo-peritoneal shunt malfunction. PATIENTS AND METHODS: A retrospective study was carried out where thirty-seven children with malfunctioning shunts were studied. The mechanical causes of shunt malfunction included disconnection, fracture and obstruction, while infection was considered as either a clinical or analytical change (blood and/or CSF). RESULTS: The mean age of the patients was 5.5 years. The most common indication for the insertion of the ventriculoperitoneal shunt was congenital hydrocephalus. The average stay in the ICU was 8.2 days. Mechanical dysfunction was detected in 25 patients (68%) and infectious etiology in 12. The most common clinical manifestations were vomiting, fever and headache. CSF biochemical alteration was found in 8 of the infected group. Staphylococcus was isolated in six of the 8 cases. The ventriculoperitoneal shunt was changed during the first 24 hours in 17 of 25 patients (68%) with mechanical malfunction, while 11 cases with an infective cause (92%) were managed with an external shunt. The interval between the insertion of the ventriculoperitoneal shunt and the malfunction was over 6 months in 20 cases (54%). CONCLUSIONS: Ventriculoperitoneal shunts are the main method for treating hydrocephaly, although they are not without complications which may require surgical procedures. Appropriate surgical technique, asepsis, as well as prophylactic antibiotics are essential to decrease the incidence of complications.

Cerebrospinal Fluid Shunts↗
PubMed1996

[Sexual child abuse. Our one-year experience].

OBJECTIVE: We have analyzed our population in regards to child sexual abuse during 1994 and propose a diagnostic classification of our findings. PATIENTS AND METHODS: We reviewed retrospectively 18 cases of abuse, collection in each case the following data: age, sex, reason for the consultation, family situation, perpetrator, positive clinical history or not, physical findings, psychological disorders and complementary examinations. We established 4 classification levels: normal, compatible with abuse, suspicious and sexual contact or certain penetration. RESULTS: The number of children attended was 18. Thirteen (72%) were female. The youngest was 1 month old and the oldest 14.5 years. The clinical history was positive in 6 cases. The physical findings allowed a certain diagnostic in 3 cases. Presence of semen was demonstrated in 1 case and 1 positive culture for gonococci was obtained. The final diagnosis was normal in 6 cases, compatible with abuse in 4, suspicious in 3 and certain sexual contact or penetration in 5. CONCLUSIONS: The diagnosis of sexual abuse is very difficult. The clinical history is still necessary due to the fact that physical findings and complementary tests tend to not be conclusive. We propose that once the information has been evaluated the conclusion be classified into 4 groups: normal, compatible with abuse, suspicious and certain sexual contact or penetration.

Adolescent↗
PubMedDate not supplied

[Brucellar orchiepididymitis].

Brucellosis is a cause of human disease, especially in regions whose brucellosis in animals is enzootic. Brucella orchitis is a rare complication of systemic brucellosis (2-14%). Necrotizing orchitis is posible and it must be distinguished from necrotizing involvement arising from other pathogens (TB or Salmonella). Treatment with specific antimicrobial medication helps to avoid unnecessary orchiectomy and prevent infectious disease in the contralateral testis as well as systemic manifestations. We report a case of brucellar epididymo-orchitis presenting as an acute scrotal mass in a 19 years old male who lived in a city. The anamnesis was crucial in the diagnosis of this rare testicular infection. We review the diagnosis and management of this patology.

Adult↗