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Biomedical subjects

M Perdiguero

Publications and source records attributed to M Perdiguero.

18 recordsLinked to original sources
PubMed2002

[Integra Artificial dermis in pediatric reconstructive surgery].

UNLABELLED: The recent release of artificial dermis for general use, has open wide a new field in pediatric reconstructive surgery. The aim of this paper is to analyze the results of Integra artificial dermis in our Plastic Surgery Department. MATERIALS AND METHODS: The records of the patients treated with Integra between february 1999 and january 2001 were analyzed, focusing on the indications, the complications and the final results. RESULTS: Fourteen Integra implantation procedures in 11 patients aged 16 months to 12 years (mean +/- SD: 80.9 +/- 48.5 months) were performed. Indications were: acute burns in 5 cases, burns sequelae in 5, and partial extirpation of a congenital giant nevus in the last one. Integra was used to replace between 2 and 30% of total body surface area. The percentage of "take" of skin grafts was 85%. The most frequent early complication was the development of infection under the Integra; it occurred in 2 cases and artificial dermis had to be partially removed. Hypertrophic scars developed in 2 patients; both had refused pressure garments. Cosmetic results in the remaining 9 patients are considered excellent. CONCLUSIONS: The use of artificial dermis has settled as a new procedure in plastic pediatric surgery. In spite of possible complications, the easy manipulation and the good results make Integra a perfect skin substitute in several cutaneous disorders.

Biocompatible Materials↗
PubMed2001

[Distribution of hepatitis C virus genotypes among the hemodialysis population in the province of Alicante].

UNLABELLED: Hepatitis C virus (HCV) genotypes are irregularly distributed among the different geographic area and groups at risk. OBJECTIVE: To study the different HCV genotypes and subtypes of hemodialyzed patients from Alicante. METHODS: We studied 640 patients on haemodialysis (HD) and we determined the RNA-HCV and the genotypes in the 120 patients with antibodies against HCV (HCV-Ab). We compared the results with the genotypes of 1,370 patients from other groups at risk in the same geographic area. RESULTS: RNA-HCV was not found in the serum in 15% (18/120) of the patients on HD who were HCV-Ab positive. Prevalence of the different genotypes in the 102 patients with positive viral RNA was the following: 1b: 56.8% (58/102), 1a: 19.6% (20/102), 3: 17% (17/102), 2a-2c: 1.9 (2/102), 2b: 0.9% (1/102) 4: 2.9 (3/102), 5: 0.9% (1/102). In conclusion, the genotype 1b was the most frequent in the patients studied in all these areas, and was the same as in the rest of the country. This genotype has been associated with the most severe hepatic disease and poor response to treatment, affecting the prognosis of these patients. The most frequent genotypes in HD in Alicante were 1b, 3 and 1a. HCV genotypes distribution among the HD units was not uniform in the different geographic areas. HCV genotypes distribution in the HD population is similar to other groups at risk from the same geographic area.

Adult↗
PubMed1996

[Are there a neuro-urological symptomatology improvement after spinal cord untethering?].

Changes in bladder behaviour and neurological symptoms were evaluated in 47 patients underwent untethered spinal cord because of tethered cord syndrome secondary to myeloneningocele closure. Patients were located in 3 categories (A < or = 5 years, B = 6-10 years and C > 10 years) in relation to age of treatment. After untethering 77% improved neurologically and the best results were evident in children whose condition was repaired promptly (90%). Urodynamic studies were performed in 33 patients before and after surgery. Fifteen had hyperreflexic bladders, six low complicance and 12 hyperreflexia plus low compliance. After treatment in 6 patients bladder dysfunction improved (18%), hyperreflexia disappeared in 4 and sphinteric resistance increased in 2. In patients with tethered cord syndrome, untethering is recommended treatment in preventing further, sometimes rapid neurologic dysfunction and better results are got in childs whose condition is repaired at an early ages.

Child↗
PubMed1995

Cultured epidermal autograft in the management of critical pediatric burn patients.

We treated 4 patients with CEA at "La Paz" Children's Hospital between July 1992 and September 1993. All of them had acute flame burns. The total body surface area (TBSA) of burn injury ranged from 75% to 85% with an age range of two to five years. Before placement of CEA homografts and biosynthetic materials were used to prepare the wound bed. CEA take ranged from 40% to 90%. One of the children died after polyethylene glycol intoxication when the exposed areas were nearly totally covered. Two more have started rehabilitation therapy and the last patient was grafted just two months ago.

Burns↗
PubMed1995

Immunological aspects of a case of posttransplant lymphoproliferative disorder.

We describe a female renal transplant recipient with cytomegalovirus and Epstein-Barr virus (EBV) infections who developed aggressive polymorphous polyclonal B cell proliferation. She received two courses of OKT3. We found a majority of transformed B cells bearing EBV membrane receptor CR2 and EBV nuclear antigen. Posttransplant lymphoproliferative disorders may be associated with a significant immunological activation, detected in this case by the sudden increase of beta 2-microglobulin and immunoglobulin levels, including immunoglobulin D. These raised levels persisted throughout the short and rapid course of the disease.

Adult↗
PubMed1995

The role of antiphospholipid antibodies in lupus nephropathy.

Although several clinical and morphological changes observed in overt systemic lupus erythematosus have been associated with the presence of antiphospholipid antibodies (aPL), the relation between these antibodies and lupus nephropathy (LN) is not clear. Twenty-three patients with biopsyproved LN were retrospectively studied (average age 28.5 +/- 12.3 years, all women) in order to investigate the relationship between the presence of aPL and clinical and immunobiological data. The average follow-up period was 55 +/- 42 months. The presence of aPL (IgG and IgM) was detected at least once in all patients by ELISA and/or lupus anticoagulant (kaolin time). Seven patients (30.4%) were aPL+, and the remainder aPL-. We did not find differences related to age, period of follow-up, blood pressure and livedo reticularis. However the prevalence of thrombosis, strokes and hemolysis was slightly higher in the aPL+ patients. The levels of antinuclear antibodies or anti-DNA antibodies, immunoglobulins and complement serum levels (C3, C4) were also similar in both groups. In the aPL+ group, proteinuria was significantly higher than in aPL- cases (2.21 +/- 1.5 and 0.91 +/- 1.07 g/24 h, respectively; p = 0.029). The renal histological pattern in both series was similar. However, microthrombosis in the glomerular capillary lumens was more frequent in the aPL+ group. The evolution of renal function was less favorable in aPL+ patients when compared with aPL- patients. We conclude that the presence of aPL in patients with LN is associated with several characteristics of renal impairment which may contribute to its evolution.

Adult↗
PubMed1995

[Problems associated with nephrectomy of transplanted kidneys].

Graft survival is not indefinite and a proportion of the failures must be removed. This study pretend to know the fate of failed renal transplant (RT) in the child, indication for transplant nephrectomy (TN) and morbidity involved. 96 RT were performed between 1985 and september 1994, during this time 31 grafts were lost: 71% immunologic causes, 13% relapse of original disease and 16% other reasons. Mean patient age and weight were 9 years and 27.3 kg, respectively. TN was performed in 28 (29%) and the most common indication was symptomatic rejection after withdrawal of immunosuppression (35.7%). Postoperative complications were diverse, including wound hematoma (13.6%), major hemorrhage (7%), fluid and electrolyte disorders (45.5) and 1 patient died (4.5%). Re-surgical approach was necessary in the 2 patients with major hemorrhage and 50% of the patients were in need of dialysis in the early postoperative. In this paper we appreciated that child with failed renal allograft could need TX in 90% of the cases, mainly because of symptomatic rejection. Furthermore, this procedure is more risky than simple native nephrectomy.

Adolescent↗
PubMed1994

[The usage of thermo-vac facial masks for the treatment of hypertrophic scars in children].

We present the results obtained in the treatment of facial hypertrophic scars in children admitted in the Pediatric Burn Unit of the Hospital Infantil La Paz (Madrid). During the last 30 months 13 patients, with ages ranging from 3 months to 5 years, have been treated. Compared to the elastic pressure masks, rigid masks have yielded better results both on the short and the long term. Rigid masks of Thermo-Vac material turn out to be more comfortable and easier to wear and tolerate than the classical elastic appliances.

Burns↗
PubMed1992

Evolution of lipid profiles in long-term peritoneal dialysis.

Serial lipid profiles of 102 patients starting chronic ambulatory peritoneal dialysis (CAPD) in our renal unit from January 1985 to December 1990 were collected retrospectively. Transient triglyceride elevation was noted during the first two years of CAPD but declined to normal levels even lower than those at baseline by 60 months. Total cholesterol, HDL and LDL cholesterol levels did not change significantly. Lipid-lowering agents were begun in 17 patients before initiating CAPD, 5 of whom achieved lipid profiles warranting cessation of therapy. Five other patients started treatment while on CAPD. No statistical difference in patient mortality was found when patients hyperlipidemic at the initiation of CAPD were compared to their normolipemic counterparts. We conclude that the return to normal plasma triglyceride levels after transient triglyceride elevation during long-term CAPD implies that adaptative mechanisms of triglyceride production in response to chronic glucose overload may ensue.

Adolescent↗
PubMed1992

[Predisposing factors for the development of acute severe tubular necrosis in the immediate post-transplantation period].

Retrospective study on the incidence of severe acute tubular necrosis (ATN), defined as the need for dialysis on the first week post-transplantation ruling out acute rejection or technical complication, in our series of 81 renal transplantations from corpse donor. It includes an evaluation of the influence on severe ATN presentation of parameters such as recipient and donor's age, level of plasma creatinine prior to extraction, whether the corpse had hypotension, duration of both vascular anastomosis and procedure, type of removal (single or multiorgan) and cold ischaemia. We conclude that in our experience, cold ischaemia of the graft is the only determining factor among the cases studied for ATN presentation conditioning a reduced long-term survival of the graft (0.758 vs 0.971 at 18 months: p.05). Peripheral blood typing of corpse donor would allow us to shorten cold ischaemia duration, and thus achieve a low rate of severe ATN (13.6%).

Adolescent↗