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Biomedical subjects

M Martínez Verduch

Publications and source records attributed to M Martínez Verduch.

At least 19 recordsLinked to original sources
PubMed2006

[Vesicoureteric reflux endoscopic treatment complications in childhood].

INTRODUCTION: Nowadays, around 1% of children suffer from vesicoureteral reflux (VUR), which represents a risk factor for long-term kidney damage. In the last decade, development in this field has shown that subureteric endoscopic injection of bulking agents for childhood VUR is an acceptable alternative unlike long-term antibiotic prophylaxis and open surgery. OBJECTIVE: To establish the complications of childhood VUR endoscopic treatment. MATERIAL AND METHODS: A retrospective analysis was carried out for every patient treated endoscopically in our department from January 1999 to September 2003, with a total amount of 516 implants of submucous bulking agents. All patients were assessed with an ultrasound as a first diagnostic technique so as to establish the complications associated with it, especially ureteral obstruction and injected agent migration. RESULTS: Out of 516 cases, Macroplastique was used in 455, Deflux in 44 and Polytef in 17. 10 patients (1.9%) (5 girls/ 5 boys), with ages ranging from 15 months to 11,4 years, presented some kind of complications (Macroplastique was used in 8cases and Deflux in 2). Among them, 5 were remarkable due to an ureterohydronefrosis, 2 of which needed a nephrostomy. 3 patients presented an implant migration, 1 epididymitis and 1 bladder edema. CONCLUSIONS: Endoscopic bulking agent injection has become a safe alternative to open surgery in childhood VUR management.

Adolescent↗
PubMed2003

[Vesicostomy in children. Our experience with 43 patients].

INTRODUCTION AND OBJECTIVES: Cutaneous vesicostomy (CV) is a choice temporary urinary diversion technique for patients with upper urinary tract (URT) dilation, secondary to vesical o infravesical disease. The objective of this study is to share our experience in children undergoing such diversion, analysing its efficacy to prevent urinary infections, improve or resolve the ureterectasia, and stabilise or improve renal function; in short the functional and morphological recovery of URT. MATERIAL AND METHODS: 43 children, mean age 2.5 years (range: 1 month-14 years) with ureterohydronephrosis grade IV-V, persistent urinary infection and/or renal function impairment underwent cutaneous vesicostomy (Blocksom's technique in 36 and Lapides' procedure in the rest). Thirty subjects had neuropathic bladder (26 with secondary vesicoureteral reflux), 7 massive primary vesicoureteral reflux, and 6 posterior urethral valve. RESULTS: All children (100%) with neurogenic bladder (30 cases), showed improvement of ureteral-pyelic-calyceal ectasia after the diversion, and 90% improved renal function with disappearance of vesiculoureteral reflux in 65%. Augmentation cystoplasty with gut was performed in 12 patients during vesicostomy closure, using Mitrofanoff's type diversion in 5 of them. The same continent diversion with cecal appendix was used in another 7 children as the only procedure. The remaining 11 children still retain their vesicostomy. In 5 of the 7 children with primary vesicoureteral reflux, the reflux disappeared and so the vesicostomy was closed. Reflux correction during the same surgical procedure was required for the other 2 children. Of the 6 children with posterior urethral valves, 2 received a renal transplant, one is in waiting list and the rest (50%) maintain an acceptable renal function. In the first year of follow-up, 4 patients developed symptomatic urinary infection that later disappeared. The rest had occasional asymptomatic bacteriuria that required no treatment. Complications included vesical prolapse due to ostomy in 4 patients, lithiasis in 3 and stomal stenosis in 2. CONCLUSIONS: We consider vesicostomy to be the choice urinary diversion technique in cases of common section obstruction and/or non-obstructive ureterohydronephrosis in new-borns who do not improve with conservative treatment.

Adolescent↗
PubMed2003

[Bilateral testicular epidermoid cyst in a pediatric patient with Klinefelter syndrome].

Epidermoid cysts of the testis are rare in children (3% of all the testicular tumors). Bilateral appearance has only been described in the pediatric age in 2 cases and none associated to Klinefelter's syndrome. We present, for our knowledge, the first case of bilateral epidermoid testicular cyst associated to klinefelter's syndrome in a boy, highlighting its management and therapeutic approach. We analyze the different kinds of treatment.

Child, Preschool↗
PubMed1998

[Renal adenocarcinoma in children].

Contribution of two cases of renal adenocarcinoma in pediatric patients. Comments on the most updated and relevant aspects of epidemiology, clinical manifestations, diagnosis, treatment, prognosis and follow-up. Comparison to nephroblastoma and renal adenocarcinoma of the adult.

Carcinoma, Renal Cell↗
PubMed1997

[Latex allergy in children with myelomeningocele. Incidence and associated factors].

RATIONALE: The purpose of our work is to know the prevalence of allergies to latex in patients with myelomeningocele (MMC) and to evaluate any potential factors influencing its development. METHODS: The study included 100 children with mean age 7.5 +/- 4.8 years, diagnosed with MMC by skin tests and total and latex-specific IgE determination. The results were compared to those obtained in three "control" groups: atopic patients, patients undergoing their first operation and multi-operated patients. The relationship between the different variables analyzed was assessed using univariant and multivariant statistical studies. RESULTS: 29 were sensitized (15 symptomatic and 14 asymptomatic) and 8 doubtful. Results showed statistically significant (p < 0.05) differences for atopic and first operation groups and non significant differences for the multi-operation group. The multivariant study selected the followed as the most relevant variables: number of surgical interventions, total IgE levels in z units, ventricle-peritoneal by-pass carriers and atopy background. Also in the multivariant study, the following showed statistically significant results: age, Cums' number, inclusion in intermittent catheterism program and total IgE levels. Neither sex or familial background of atopy showed statistical significance. CONCLUSIONS: Allergy to latex in MMC patients is related to multiple antigen contacts, the numerous manipulations and operations undertaken throughout the patient's life plus a personal propensity to allergies. It is essential that this group should adopt certain standards to minimize contact with the antigen and undergo an allergological study so as to detect those who are sensitized, which in nearly half our series has not yet exhibited symptomatology in contact with latex utensils. All diagnostic and therapeutical procedures should be conducted in latex-free environments.

Adolescent↗
PubMed1995

[Tumor of the testicular vitelline sac in children: clinical course and treatment].

Presentation of a review of 10 paediatric patients with tumour of the testis vitelline sack, to report our experience in the management of this pathology. Mean age was 20 months (14-32), and the interval of the study was from 1970 to 1994. After orchiectomy, 7 children were included in stage I, 1 in stage II, and 2 in stage III. Four underwent Retroperitoneal Lymphadenectomy. All patients in stage I are currently free of disease, with a mean follow-up of 132 months, regardless the type of treatment employed (vigilance in 2 cases, chemotherapy in 2, and chemotherapy plus Retroperitoneal Lymphadenectomy in 3). On the contrary, the 3 children with extratesticular disease died 15, 18 and 15 months after orchiectomy. In conclusion, we believe that patients included in stage I should undergo only a strict vigilance, based on the excellent prognosis of this group and the lack of differences between the survival time obtained with the various therapeutical approaches followed. On the other hand, patients with stage II or stage III disease should receive from the beginning chemotherapy, thus saving the Retroperitoneal Lymphadenectomy for the residual disease.

Child, Preschool↗
PubMed1995

[Vesicostomy in children].

OBJECTIVES: To evaluate the upper urinary tract morphology and function in children undergoing vesicostomy for different causes. METHODS: We report on 27 children aged 1 month to 12 years who had undergone a Blocksom vesicostomy procedure. Twenty had a neuropathic bladder and 3 had posterior urethral valves. RESULTS: In the 20 children with neuropathic bladder, renal function improved in 95% and the associated vesicoureteral reflux improved in 56%. The morphology of the upper urinary tract returned to normal prior to the definitive operation in all cases. Only one of the patients with posterior urethral valves has preserved satisfactory renal function two years following vesicostomy. The most common complication was prolapse (14.8%). CONCLUSIONS: In our view, vesicostomy is the best urinary diversion procedure in the cases described herein. Vesicostomy closure must be performed following definitive treatment of the underlying condition, except in those cases with neuropathic bladder who require augmentation cystoplasty to keep upper urinary tract pressures low.

Child↗
PubMed1994

[Paratesticular rhabdomyosarcoma in children. Is retroperitoneal lymphadenectomy necessary in disease limited to the scrotum?].

Between 1970 and 1993, five children with paratesticular rhabdomyosarcoma (PR) and age ranging from 3 to 10 years were treated by our group. Following radical orchidectomy and clinical staging, 4 were rates as Group I-IRS (completely resected local disease) and 1 in Group IV-IRS (distant metastasis). All patients in Group I underwent intensive chemotherapy with vincristine, actynomicin D and cyclophosphamide (VAC) for 18 months, while no case of retroperitoneal lymphadenectomy was performed. Currently, all patients are disease free with a mean follow-up of 8 years and 5 months. The single patient included in Group IV received radiotherapy (800 rads in abdominal field) and chemotherapy with VAC + prednisone (PDR), and retroperitoneal lymphadenectomy of residual masses was performed. The patient developed liver metastasis and died 20 months later. The purpose of this paper is to convey the reader our experience in the treatment of PR in children, making a special reference to the excellent prognosis when the disease is limited to the scrotum and recommending in such cases the use of intensive chemotherapy with VAC after performing radical orchidectomy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Pyeloureteral junction syndrome. Associated vesicoureteral reflux].

We reviewed our series comprised of 106 children that had undergone surgery for congenital hydronephrosis from ureteropelvic junction obstruction. Following our protocol, all patients were evaluated by serial micturition cystourethrography. The only anomaly that had been detected was vesicoureteral reflux in 11.32% of the cases. This incidence is reduced to 8.25% if only the renoureteral systems with both congenital anomalies are considered. This finding is not statistically significant (p less than 0.05) relative to patient age, sex or clinical symptoms. The results of the present study show that children with ureteropelvic junction obstruction are not at risk of developing vesicoureteral reflux. Thus, routine serial micturition cystourethrography appears to be unwarranted.

Adolescent↗
PubMed1987

[Laparoscopy in pediatrics].

Laparoscopy has been performed in 68 infants and children. In 50 cases of non-palpable testis; 7 cases of liver diseases; 4 cases of abdominal trauma; 7 cases for various other indications. In our experience, laparoscopy was a considerable advantage in the diagnosis and management of a number of pediatrics disorders.

Child↗
PubMed1977

[Lung scintigraphy after diphragmatic hernia (author's transl)].

Recuperation of pulmonary function after surgical repair of Bochdaleck's hernia is considered. Gasometric and radiologic features as well as scintigraphy are related in order of prognosis. Of 16 cases, seven had sudden fatal outcome. Survivals achieved total pulmonary recuperation, but some in two to three years.

Hernia, Diaphragmatic↗
PubMed1976

[Local treatment of angiomas with corticoids (author's transl)].

The angiomas studied at the Clinica Infantil "La Fe" in a four and a half years period are reviewed. The different therapeutic approaches are considered. Thirteen cases selected at random have been treated with local injections of steroids, with a 84% satisfactory results. The technique seems to be simple and without complications. It is recommended in the management of the parotideal, small size, subcutaneous and those angiomas in which the therapy could be followed by sequelae and in those where other therapy has failed.

Child↗
PubMedDate not supplied

[Efficacy in endoscopic treatment of secondary vesicoureteral reflux with polydimethylsiloxane].

OBJECTIVE: To value the efficacy in endoscopic treatment of the vesicoureteral reflux (VUR). MATERIAL AND METHOD: We have realized a prospective study in patients with RVU treated with endoscopic polydimethylsiloxane, from January 1999 until December 2001, analyzing the results after an average pursuit of 30 months. We included 144 patients, 92 girls and 52 children, with 213 VUR (124 primary ones and 89 of secondary etiology). The initial efficacy of the treatment was defined as the finished absence of RVU in the isotopic cystography, realized three months after the puncture. RESULTS: The global efficacy of the endoscopic treatment in secondary etiology reflux was lower than the reached one in the treatment of the primary RVU (77.7% against 86.2%) but the differences did not reach statistical significance (p=0,226). We do not also find significant differences on having compared the injected volume and the valuation of resolution of the ebb between the different causes of secondary RVU (p=0.361). We found recurrence in patients with RVU due to lower urinary tract dysfunction (4.34%). CONCLUSIONS: Endoscopic treatment of the secondary VUR is a minimally invasive skill, presents scarce morbidity and it is effective in chosen patients. The risk of a long term recurrence is grater in VUR secondary to functional alterations (neurogenic bladder and functional instability), for what, pursuit has to be established according to the base pathology.

Adolescent↗
PubMedDate not supplied

[Neonatal urinary ascites. Considerations on its diagnosis and treatment].

Seven cases with neonatal urinary ascites are described. In all of the cases the underlying cause was an anatomical or functional obstructive uropathy of the lower urinary tract, the most common pathology being neurogenic bladder secondary to lumbosacral dysphagia. The techniques utilized for patient evaluation (ultrasound, serial micturition cystourethrography and IVP) are described and the findings afforded by each diagnostic technique are presented. The value of serial micturition cystourethrography is underscored. In our view, it is convenient to perform initial diversion by percutaneous nephrostomy, suprapubic punction or placement of a urethral catheter, according to the level of the etiologic process. The definitive surgical approach will depend on the results of subsequent radiologic controls and the existing uropathy.

Ascites↗
PubMedDate not supplied

[Congenital hydronephrosis: pyeloureteral junction syndrome. Surgical treatment].

This paper reviews the surgical procedure performed in 119 kidneys (114 children), diagnosed with congenital hydronephrosis due to pyeloureteral juncture stenosis (PUJS). Approaches used for diagnosis and choice of surgical techniques are commented. Puncture/nephrostomy with functional kidney assessment has been the method selected in extreme cases. Nephrectomy was the chosen option in 8 cases (6.7%) while conservative surgery was indicated in the others. Anderson-Hynes dismembered pyeloureteral plasty was the technique used in 110 cases with a 97.28% rate of success. Post-operative occurrences are commented and are related to the presence of pre- and post-operative derivation.

Adolescent↗