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R López Almaraz

Publications and source records attributed to R López Almaraz.

7 recordsLinked to original sources
PubMed2006

[Posterior urethral valves, unilateral vesicoureteral reflux and renal dysplasia (VURD syndrome). Long-term follow-up of kidney function].

Posterior urethral valves, unilateral vesicoureteral reflux and renal dysplasia (VURD syndrome) is an infrequent entity in childhood that has provoked multiple controversies. The shortage of studies that evaluate the long-term outcome in these children prompted up to write the present article. Three patients that met strict criteria for a diagnosis of VURD syndrome were retrospectively reviewed, with special emphasis on several indicators of renal function in these patients at diagnosis and in adulthood. The three patients currently have normal renal function, unlike a large percentage of patients diagnosed with posterior urethral valves with vesicoureteral bilateral reflux. Although the sample is small, our results support the hypothesis of good long-term renal function in affected children.

Adolescent↗
PubMed2006

[Neonatal neoplasms: a single-centre experience].

INTRODUCTION: Malignant tumors are uncommon in the neonatal period and benign tumors may have malignant potential. OBJECTIVES: To describe the neoplasms diagnosed and treated in newborns (</= 28 days of life) in the Hospital Universitario de Canarias and their association with congenital abnormalities and to evaluate prenatal diagnosis of these tumors. PATIENTS AND METHODS: The medical records of patients with neoplasms diagnosed during the neonatal period in the previous 25 years in our hospital were retrospectively reviewed. The variables analyzed were the percentage of neonatal neoplasms among the total number of cancer cases in children aged less than 14 years, their incidence among all the newborns in our hospital, sex, year of diagnosis, age at clinical diagnosis, the presence or absence of prenatal diagnosis, type of tumor (histologic diagnosis), association with syndromes or other congenital anomalies, treatment, and long-term outcome. RESULTS: Of 260 neoplasms diagnosed in our unit from 1980, 16 (6.1 %) were diagnosed in the neonatal period. The incidence of neonatal neoplasms was estimated to be 276.5 per million live births. Males accounted for 43.8 % and females for 56.2 %, with a mean age at diagnosis of 5.5 days (range 1-28 days). Five neonates (31.2 %) had a prenatal diagnosis, 60 % of which were made in the last 7 years of the study period. A further five newborns were diagnosed at the initial neonatal examination. Histologic diagnoses were neuroblastoma (n = 5; 31.2 %), teratoma/ germ cell tumor (n = 4; 25 %), soft tissue sarcoma (one fibrosarcoma of the thigh and two hemangiopericytoma of the back and heart; 18.8 %), and one case each of mesoblastic nephroma, cerebral tumor (ependymoblastoma), melanoma (associated with giant congenital melanocytic nevi), and acute leukemia (associated with Down syndrome). Treatment consisted of surgery alone (n = 10; 62.5 %) and surgery plus chemotherapy (n = 5; 31.2 %); one patient received no treatment. The overall actuarial survival rate was 87.5 %. Sequelae were observed in 33.3 % of survivors. CONCLUSIONS: The neoplasms most frequently diagnosed in the neonatal period were solid tumors, mainly neuroblastoma and teratomas/germ cell tumors; 12.5 % were associated with syndromes or congenital anomalies. In the last 7 years, the prenatal diagnosis of these entities has improved. Most of the neoplasms responded to therapy, mainly surgery, and long-term outcome was favorable.

Female↗
PubMed2006

[Assessment of the immigrant child].

In the last twenty years Spain has turned into one of the principal countries recipients of foreign population. As consequence of this massive entry of people, our country is among the first ones of Europe for interannual increase of population. The concept of immigrant child is very wide and includes minors of very diverse characteristics, as the proceeding from international adoptions, the children coming from developing countries or those that come from other developed countries. The immigrant children do not represent health risk for the autochthonous population, on the contrary, they are in situation of defenselessness for their scanty vaccination coverages, their situation of marginality and the precarious sanitary systems of the countries of origin. At the moment of offering medical paediatric attention to foreign children, we must individualize our actions in conformity with the characteristics of each patient. It is not possible to simplify in one unique protocol the best studies to resolve a problem of health in an immigrant child. The attention of these children implies an overstrain for the pediatrician and the sanitary personnel that receives them, because it is necessary to conquer idiomatic, cultural and social barriers to optimize the level of health of these patients. The syndromic initial description can help to prioritize the studies in each case (according to the most probable diagnoses). The children who return to the native land of their parents meet in a special situation of risk, for not being prepared to resist the attack of pathogen that do not exist or are rare in Spain.

Child↗
PubMed2003

[The role of molecular genetics in childhood cancer].

In the last few years molecular genetic studies of childhood cancer have acquired great importance. Advances in these techniques have increased knowledge of the various genes involved in tumoral development. Genetic alterations can occur in three large groups of genes: oncogenes, tumor suppressor genes, and DNA repair genes. Cytogenetic analyses (karyotyping) are complemented by various molecular techniques, such as fluorescence in situ hybridization (FISH), reverse transcriptase-polymerase chain reaction (RT-PCR) and spectral karyotyping (SKY). These are the most reliable techniques and improve the sensitivity of karyotyping. The present article reviews the most representative and best characterized genes involved in the molecular etiology of childhood cancer, both hematologic malignancies (leukemia and lymphoma) and solid tumors (brain tumors, neuroblastoma, Wilms' tumor, hepatoblastoma, rhabdomyosarcoma, Ewing's sarcoma and retinoblastoma). Molecular techniques have enabled more precise diagnosis as well as identification of new prognostic factors and the development of more effective treatments. These techniques can also be useful in identifying minimal residual disease during and after treatment for leukemias, neuroblastomas and sarcomas, with the aim of predicting recurrence.

Child↗
PubMed2002

[Cutaneous involvement as the form of presentation in B-cell lymphoblastic leukemia/lymphoma].

Primary cutaneous involvement in B-cell lymphoblastic leukemia/lymphoma is rare in childhood. We present the case of an eleven and a half year old girl who, five months prior to being referred to our center, had undergone surgery to remove a small gluteal tumor diagnosed histopathologically as lymphoid proliferation suggestive of large cell lymphoma. On examination the presence of small nodes close to the scar where the tumor had previously been removed was observed. Hemogram revealed 2.7 x 9/l white blood cells with 0.5 x 9/l neutrophils; the remaining series and complementary investigations were normal. Bone marrow aspiration revealed 52 % blastic cells with immunophenotype and morphological characteristics of common (B-cell) acute lymphoblastic leukemia with L2 subtype in the French-American-British (FAB) classification. Ten months after finishing polychemotherapy, the patient is now in complete remission. We would like to highlight that a small slow-growing cutaneous node could be the presenting form of lymphoblastic lymphoma or acute lymphoblastic leukemia.

B-Lymphocytes↗
PubMed2001

[Vertically transmitted bacteremias: to treat or not to treat?].

OBJECTIVE: To analyze the incidence, etiology and management of infants born in 1977 with vertically transmitted bacteremia or suspected early neonatal sepsis. PATIENTS AND METHODS: The total number of newborn infants in this period was 2,365. We revised the clinical histories of the infants diagnosed with bacteremia and classified them into two groups: a) those with vertically transmitted bacteremias, according to the recommendations of the Castrillo Group, and b) those with suspected early onset neonatal sepsis in whom blood culture was positive and analytical data suggested bacterial infection but who showed no clinical symptoms of vertically transmitted sepsis. Birthweight, sex, gestational age, risk factors for neonatal infection, clinical signs and laboratory tests suggestive of bacterial infection and microbiological agents were analyzed. The clinical and analytical evolution of the treated and untreated newborn infants was studied. RESULTS: The newborn infants were diagnosed with vertically transmitted bacteremia (an incidence of 4.2x1,000 live newborn infants) and 17 were diagnosed with suspected early onset neonatal sepsis (7.8x1,000 live newborns). All the infants had risk factors for neonatal sepsis. The most common of them was prolonged membrane rupture (>- 18 hours) due to which sepsis screening was carried out (hemogram, C-reactive protein at 12 and 36-48 hours of life, and blood culture). In both groups the most commonly isolated microorganism was group B streptococcus, which was found in 30% of vertically transmitted bacteremias and in 41.2% of suspected early onset neonatal sepsis. All the newborn infants with suspected sepsis and two with vertically transmitted bacteremia were treated without incident. The remaining eight infants with untreated vertically transmitted bacteremia were followed-up clinically ana analytically for one year, and remained asymptomatic. CONCLUSIONS: The most common microorganism in vertically transmitted bacteremia and suspected early onset neonatal sepsis was group B streptococcus. None of the untreated infants developed late sepsis or meningitis. Our findings suggest that non-treatment of asymptomatic infants with vertically transmitted bacteremias is appropriate as long and close clinical surveillance is maintained.

Age Factors↗