PubMed Health⌕ Search

Biomedical subjects

R Calderón González

Publications and source records attributed to R Calderón González.

3 recordsLinked to original sources

[Emergency management of convulsions and prevention of status epilepticus with rectal diazepam administered by parents].

The parents of 17 children with a history of convulsions, were shown how to administer liquid diazepam through the rectum using a 1 mL insulin syringe, in order to alleviate a convulsion at home or any where ever this may occur. Eight of the children had suffered from repetitive and/or prolonged non-temperature related convulsions, four had epileptic status and five had suffered from simple fever related convulsions, complicated in four and in a convulsive status in 1; the number of fever-related convulsions ranged between 1 and 6 per child and those non temperature related ranged from one daily to once a month. The observation of the children was done in an 88 month period (between 1 and nine months per child, averaging 5.2 months). In seven of the children, it was required of the parents to administer rectal diazepam a total of 90 times (fluctuating between 2 and 25 doses per child), with no complications, a dose of 0.5 mg/kg was administered in those patients whose convulsions lasted over 5 minutes or more. In 75 occasions, the convulsion stopped within a period of 2 to 5 minutes, in 12 other times there was a need for repeated dosages and in 2 occasions, a third doses was needed. Only in one occasion was hospital management needed. Therefore, we conclude that the administration of rectal diazepam by parents--at home--is a useful and secure method to prevent prolonged convulsions and the epileptic status; it gives parents security and tranquility using an instrument which can be used in any circumstance therefore reducing anguish and the cost of hospital care.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Rectal↗

[Gilles de la tourette syndrome: clinical spectrum and management].

OBJECTIVE: To present the current concepts of the clinical phenomenology and natural history of Gilles de la Tourette syndrome (GTS), differential diagnosis with other involuntary movements, its pathogenesis and current management. DEVELOPMENT: GTS is a disorder characterized by a spectrum of both motor and sonic tics, and a spectrum of behavioral disorders. There is not a biological marker that confirms or refutes the diagnosis of GTS, so this diagnosis remains purely clinical. It has been found to be present in 1 to 3% of school population. An specific cause for GTS is unknown, though most cases appear to occur on an hereditary polygenetic basis. Observations that drugs increasing dopamine neurotransmission, including levodopa and the dopamine receptor agonist pergolide lessen tics, have called into question the dopamine receptor supersensibility hypothesis. The hypothesis proposing basal ganglia and frontostriatal pathways involvement in the pathophysiology of the disorder is the most likely. Frequently, disruption due to tics is overshadowed by comorbid conditions, like obsessive compulsive behaviors, attention deficit hyperactivity disorder, other behavioral disorders and learning disabilities, so the management should be targeted to them. CONCLUSION: The knowledge about the basic mechanisms and the integral definition of the clinical spectrum of tics and neurobehavioral manifestations, and its natural history in a patient with GTS, allow us to establish a more rational approach for management and prognosis

Behavior Therapy↗

[Autism in tuberous sclerosis].

During the last five years, it has been recognized a very high incidence of autism in children affected by tuberous sclerosis; we believe that this association may be more than just a coincidence and that it may be that the autistic behavior spectrum is related to a great extent, to the anatomic localization of tubers in the frontal and temporoparietal areas. In this study we report our experience with 27 consecutive children, 12 boys and 15 girls with a diagnosis of tuberous sclerosis confirmed by clinical and MRI and or CT findings according to the diagnostic criteria developed by the Diagnosis Criteria Committee of the National Tuberous Sclerosis Association. They were studied during the period of 1988 to 1990. Ages range from 18 months to 16 years (mean: 6.5 years). Twenty-four had epilepsy and were receiving antiepileptic treatment. Seven of the 27 children (25.9 per cent) fulfilled the diagnostic criteria for autistic disorder according to the DSM-III-R. The autistic behavior was evident in all of them by three and half years. The seven children had mental retardation. MRI and CT findings with subependymal calcifications and cortical tubers of frontal and temporoparietal predominance were seen in five of the seven autistic children. In one child, CT was normal and in the other it was not performed. Five were girls and all had West syndrome; two were boys and neither had seizures. Most of the reported cases of children with tuberous sclerosis and autism had experiences West syndrome. In our patients, five of the seven children with autism had west syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗