Biomedical subjects
Publications and source records attributed to L Lassaletta Garbayo.
Breast pathology is uncommon in infancy and adolescence. Fibroadenoma is the most frequent lesion. The juvenile variant is rare, occurring in only 2-7% of all the fibroadenomas. We report a case of juvenile breast fibroadenoma in a patient of 17 months of age.
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Six children with tracheobronchial stenosis secondary to cardiovascular ring were operated with extracorporeal surgery. Three of them with pulmonary sling had a tracheobroncoplasty with costal cartilage, one with xiphoides appendix and another with pericardio. One girl 2 years old was operated resecting three tracheal rings and anastomosis end to end. The child that was operated with pericardio died with infection and sepsis three months after the operation. The other five are well five, four and two years after plasty.
BACKGROUND: Some neonates with congenital diaphragmatic hernia (CDH) and persistent pulmonary hypertension are not adequately oxygenated with conventional treatment. The extracorporeal membrane oxygenation (ECMO) has been successful in some of them as an alternative in their management. PATIENTS AND METHODS: We studied the charts of 47 neonates with CDH, symptomatic within 24 hours of birth, treated in our institution during the last seven years (1987-1994). In all of them, conventional ventilation and hemodynamic support was used. In 12 patients high frequency ventilation (HFV) was used and two survived. In all patients we analyzed the following ventilatory and gasometric parameters: Oxygenation index (OI)*, ventilatory index (VI)** and postductal PCO2. In 15 neonates who did not survive, a necropsy was performed and a morphometric parameter, pulmonary index (PI)*** was studied. RESULTS: The overall survival was 60%. VI and OI showed significant differences (p < 0.001) between survivors and non-survivors with values of 460.9 +/- 303 vs 1532 +/- 500.6, respectively for VI and 10.3 +/- 5.7 vs 46.2 +/- 37.8, respectively for IO. There were no significant differences in postductal PCO2. Mean PI in the 15 non-survivors was 0.0072 +/- 0.002 (normal > 0.015). Regression coefficients of PI with OI or VI were not significant. Neonates with VI < 1000 and OI < 40 survived. All patients with VI > 1000 and OI > 40 died. Some babies with VI > 1000 and OI < 40 (21.6%) survived. CONCLUSIONS: In our experience, the use of HFV did not improve the prognosis of these patients, but we believe that the use of ECMO in those patients with VI > 1000, and overall, patients with VI > 1000 and OI < 40 would improve the survival rates of this congenital malformation. *QI = FiO2 x MAP/PO2 postductal x 100. (MAP = Median airway pressure). **VI = VR x MAP (VR = Ventilatory rate). ***PI = Pulmonary weight/Body weight.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Six cases of bilateral diaphragmatic hernia are described between 145 congenital diaphragmatic hernia in Department of Pediatric Surgery, "La Paz" Children's Hospital of Madrid since 1966 to 1986. All patients showed symptoms early after birth. Death occurred almost immediately in five cases, for the severe bilateral pulmonary hypoplasia and the malformations associated in the most them (cardiac, genitourinary, digestive system and metabolic). One patient was alive for 22 days. We study the obstetrical history and the evolution of our patients.
Two patients with Cricopharyngeal achalasia have been treated at the Clínica Infantil "La Paz" (Madrid) in the last 20 years. They were one and a half, and four and a half months old at the time of operation. The postoperative period and follow-up has been satisfactory. Clinical symptoms in both of them were cough, cyanosis, regurgitation and aspirative pneumonia. One of them came with the diagnosis of congenital esophageal stenosis, and the other one with the diagnosis of tracheoesophageal fistula. The diagnosis was confirmed by endoscopy and barium-X-ray. Section of the Cricopharyngeus muscle was curative and recovery of the normal function has been complete.
Authors present three patients with acute appendicitis developed during the first month of life. Up to 1975 they found only 106 cases described in the Spanish, French and English literature. The rarity of this pathology together with extreme difficulty in clinical and radiological diagnosis, usually produces a delay of treatment with logical increase of mortality. Their three patients were operated through laparotomy and one through right herniography. None of them had intestinal aganglionosis.