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Biomedical subjects

M Gómez Tellado

Publications and source records attributed to M Gómez Tellado.

14 recordsLinked to original sources
PubMed2002

[Dog bite-related injuries treated in a pediatric surgery department:analysis of 654 cases in 10 years].

BACKGROUND: Dog bites to children have increasingly come to the forefront of public attention in recent years, especially attacks by certain breeds classified as aggressive. Dog bites account for approximately 1 % of all emergency pediatric department visits and 75 % of these bites occur in children. Although these lesions are rarely serious, 20-45 % of children under the age of 15 years have been bitten. OBJECTIVE: To analyze the reality of this problem in our population in order to determine the ideal prehospital preventive measures that would reduce the incidence of dog bites. MATERIALS AND METHODS: A retrospective study of children with dog bites who received emergency treatment in the Hospital Infantil Teresa Herrera of the Complejo Hospitalario Juan Canalejo in La Coruña, Spain, between 1991 and 2000 was undertaken. A register of patients was created that included data on age and sex of the children, the race of the dog, the relationship between the child and the animal, characteristics of the injuries, circumstances of the attack, probable sequelae, need for hospital admission and complications during treatment. Nonparametric data were analyzed using Pearson's 2 test. The Ox ratio was estimated with a 95 % confidence interval (0.05). RESULTS: In the 10-year period between January 1991 and December 2000, 654 patients under the age of 14 years were treated for dog bite-related injuries. The mean age was 5.09 years. A greater number of boys had been bitten than girls (2.75/1). In 79 % of the cases the dogs were known (family, friends, neighbors). Thirty-eight percent of the attacks were made by German Shepherds and 35 % by crossed breeds. Sixty-five percent of the bites were located on the head, face and neck, especially in patients aged less than 4 years. Five percent of the lesions were severe. Thirteen patients were admitted to the pediatric intensive care unit and 98 patients required hospitalization due to the characteristics of the injuries. The mean hospital stay was 6 days. Infectious complications occurred in 32 patients. CONCLUSIONS: Although dog bite-related injuries to children in our community are rarely serious, they can produce important facial cosmetic sequelae. The high incidence of these lesions indicates the need for preventive measures and public policy strategies.

Adolescent↗
PubMed2000

[Contraindications for the endoscopic treatment of vesicoureteral reflux].

The endoscopic treatment of vesicoureteral reflux (VUR) has acquired a great importance as a therapeutic option during the last years. We present our experience with two substances, teflon paste and macroplastic, used in 86 patients, with 147 refluxing renal units. After first injection, the successful rate was 86% for teflon pastes versus 91% for macroplastic in the middle grade VUR units. We analyze our complications rates (14.25%) and we conclude that there is a close relation with a right technic performance. In our experience we consider a major contraindication for this technical option patients less than 1 year of life. At the same time we presume that an special care must be taken in monorenal patients as well.

Contraindications↗
PubMed1999

[Paratesticular rhabdomyosarcoma].

We report a case of paratesticular rhabdomyosarcoma in a six-year-old boy. The clinical presentation was subacute. The patient underwent a radical right inguinal orchidectomy. It was classified in IRS-III stage IA (based in the Third Intergroup Rhabdomyosarcoma Study). Subsequently, the child received 3 chemotherapy courses (9 weeks) with vincristine and actinomycin D. The patient is found to be asymptomatic 1 year after the treatment.

Antibiotics, Antineoplastic↗
PubMed1998

[Retrocaval ureter in children: surgical approach based on the obstructive pattern in the diuretic renogram with 99mTc DTPA].

Retrocaval ureter is a rare disease in childhood which is due to a abnormal development of the inferior cava vein. We report a new case of retrocaval ureter in a 9 year-old girl who had consulted for macrohematuria and right flank pain. Preoperative intravenous urography and DTPA diuretic renogram suggested this entity. CT scan was no necessary for the diagnosis. We consider the diuretic renogram the best diagnostic method in the surgical decision of this disease.

Child↗
PubMed1997

[Use of Tc 99m DTPA in the follow-up of 2 pediatric patients diagnosed with megacalycosis or Puigvert's disease].

OBJECTIVE: Megacalycosis or Puigvert's disease is a congenital anomaly of renal development characterized by caliceal dilatation, an increased number of calyces, associated with hypoplasia of the pyramids of Malpighi, and a normal renal pelvis. Renal function is always normal and there is no evidence of obstruction to urinary flow. The foregoing are important in distinguishing megacalycosis from congenital hydronephrosis. We have studied two pediatric patients with this renal anomaly by means of non invasive techniques, in order to demonstrate they had no urinary flow obstruction despite the caliceal dilatation. METHODS: Two cases of megacalycosis that had been diagnosed at our hospital from 1991 to 1995 are described and the literature is reviewed. Diagnosis was basically by intravenous urography. A diuretic renogram with technetium 99m diethylenetriaminepentaacetic acid (Tc 99m DTPA) showed no urinary flow obstruction in the anomalous kidney. This test was repeated several times, together with renal function studies like the technetium 99m dimercaptosuccinic acid scan (DMSA Scan). RESULTS: Both patients are asymptomatic and have a normally functioning kidney with no scars demonstrable on the DMSA scan. Renal urinary flow studies have remained within the normal ranges (elimination of more than 40% of the radionuclide 20 min after the administration of furosemide). US control evaluations have shown adequate renal growth and persistent caliceal dilatation in both cases. CONCLUSIONS: This congenital malformation must be considered when investigating renal dilatation, since megacalycosis does not require surgical treatment. Intravenous urography is useful in the diagnosis of this condition and Tc 99m DPTA is the best test for subsequent control evaluations.

Child↗
PubMed1997

[Ureteral hydronephrosis secondary to appendicular abscess].

OBJECTIVE: To report a case of ureterohydronephrosis secondary to an undiagnosed appendiceal abscess. METHODS/RESULTS: Herein we describe a case of a 4-year-old girl with right ureterohydronephrosis arising from extrinsic compression of the right ureter due to an undiagnosed appendiceal abscess. The patient was treated with intravenous antibiotics and the abscess was drained. Regular isotope and US assessments showed both the residual retroperitoneal fibrosis and renoureteral dilation had decreased. CONCLUSIONS: Acute appendicitis is still the most common cause of emergency abdominal operations in children. Although the symptoms are easily recognizable and generally lead to the correct diagnosis in most cases, the peculiarities of childhood can lead to errors in the diagnosis resulting in the complications reported herein. We emphasize the usefulness of ultrasound in the diagnosis and conservative treatment is advocated.

Abscess↗
PubMed1996

[Blunt abdominal trauma. Nonoperative management].

During the 7 year period, 1987 to 1994, 48 patients with blunt abdominal trauma were treated in our Hospital. There were splenic injury in 50% cases, liver trauma in 25% and renal injury in 40%. Seven patients suffered injuries to multiple sites. The clinical findings were confirm with ultrasound (47 children) and Computed Tomography scanning (CT) (19 children). Intravenous pyelography were performed in nine cases with previously suspect of renal affection. The CT scan provided diagnosis in four patients with negative findings in the sonography. In the present serine, 42 cases were managed by nonoperative means with 100% survivals. One patient surgically treated died from associated severe head injury. The postoperative complications appeared in ten nonoperatively cases (recurrence of bleeding in four children). 14 of these non surgical patients required blood transfusion, and the mean volume of transfusion was 30 ml/kg. A follow-up abdominal sonography was obtained in all survivors, showing resolution of the injury in all of them. We conclude that non surgical managements must be the first choice in all blunt abdominal trauma in pediatrics. Laparotomy is mandatory in masive bleeding or hemodynamically inestable patients. Ultrasonography is a simple method without risks and fast available, well indicated for diagnosis and follow-up of this children.

Adolescent↗
PubMed1996

[Benign gingival granular cell tumor in the newborn: congenital epulis].

Gingival granular cell tumor, or congenital epulis, was first described by Neumman in 1871 and subsequently 201 cases have been published in 173 patients. It is an uncommon benign tumor that is present like a pedunculated, smooth surfaced, isolated lesion on the alveolar mucosa of the maxillar of the newborn child. Its firm consistency and variable size can occasionally cause problems in the child's breathing or feeding. This tumor is easily diagnosed clinically and, although spontaneous regression of the tumor mass has occasionally been reported, the current treatment is surgical removal. Two new cases of congenital epulis are reported and a literature review is included.

Female↗
PubMed1995

[Necrotizing enterocolitis: a 10-year survey].

We reviewed the records of all infants with necrotizing enterocolitis (NEC) who had been diagnosed in "Teresa Herrera" Hospital in La Coruña between 1984 and 1994. We tried to determine the risk factors that could influence at the beginning of the disease, the clinic presentation, and the basic aspects of treatment. All cases of ECN with clinic-radiologic confirmation were examined (Bell stages II and III). With this approach, a general questionnaire containing records, clinical presentation, and treatment, was applied to all cases. In our revision, we found that neonate most at risk is that one with an average gestational age of 35 weeks, a mean weight of 2500 gr., with a laborious delivery and who was admitted in the neonatal intensive care unit for an important disease. The onset of NEC was more frequent in the first 15 days of life, and clinical and radiological features were used to confirm the disease. In 86% of the cases, oral feeding had begun. Surgery was needed in 36% of the cases, of which 86% suffered from gut perforation, terminal ileum being the most frequent localization. The general mortality was 12%. Only one of the operated patient died. We conclude that in the appearance of NEC there are a lot of influential factors, including perinatal stress, prematurity and a low birth weight. Clinical symptoms are haemodynamic instability, abdominal distension and bloody stools, obtaining confirmation through radiology in 87%. We consider the importance of early diagnosis and treatment and exhaustive observation by children's surgeon to indicate early surgery.

Birth Weight↗
PubMedDate not supplied

[Testicular microlithiasis. Clinical significance and therapeutic implications].

Testicular microlithiasis is a rare condition usually diagnosed by scrotal ultrasound and associated with pathology of the testis. We report two pediatric cases presented with acute scrotum. Testicular sonography revealed significant bilateral testicular microlithiasis. One case was diagnosed as having torsion of the right testis and the other case as orchiepididymitis. A careful review of the literature is made and a periodic follow-up of this disease is advocated.

Calculi↗
PubMedDate not supplied

[Treatment of pyeloureteral duplication associated with ureterocele or ectopic ureter].

INTRODUCTION: Pyeloureteral duplication is often associated to ureterocele and ectopic ureter. Therapeutic approach of ureterocele is actually a debated subject because of the differences treatments. There is controversy about the classic heminefrectomy with ureterocele aspiration and the minimal invasive endoscopic approach. MATERIAL AND METHODS: We made a retrospective study about 34 children with pyeloureteral duplication associated with ureterocele (26) or with ectopic ureter (8). The election of treatment was mainly based on renal function, showed on gammagraphy. It was performed heminephrectomy and ureterocele aspiration in patients with hypofunctioning upperpole, and surgery saving the kidney when the renal function was normal. RESULTS: Heminephrectomy was curative in 66.5% of children with ureterocele. In the others was required a correction of the vesicoureteral reflux associated with the lower pole or removal of the ureterocele with ureteral reimplantation due to failure in ureterocele collapse. 88.5% of ureterocele was collapsed. None of the heminefrectomies performed on patients with ectopic ureter needed further surgery. Pathology studies showed a high incidence of renal dysplasia (63%). CONCLUSION: We consider the heminephrectomy the treatment of choice in pyeloureteral duplication associated with ureterocele and ectopic ureter when gammagraphy studies show hypofunctioning upperpole.

Abnormalities, Multiple↗