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Biomedical subjects

S García García

Publications and source records attributed to S García García.

18 recordsLinked to original sources

[Respiratory function in pediatric survivors of malignant neoplasms].

AIM: To evaluate post-treatment pulmonary function in patients with malignant extrapulmonary neoplasia and its relationship with age, type of neoplasty and treatment received. METHODS: Cohort study of 95 pediatric patients after chemotherapy with or without surgery or extrapulmonary thoracic radiotherapy. The patients were in remission without treatment and able to undergo pulmonary function testing. Personal history and exposure to risk factors or toxic habits were evaluated. Clinical examination, chest radiographs, pulmonary gammography, basal and stress pulmometry, forced spirometry, whole body phletismography and carbonmonoxide transfer test were performed. RESULTS: Mean age at diagnosis was 5 +/- 3.3 years. Treatment duration was 2.4 +/- 1.3 years and time without treatment 4.3 +/- 3. 3 years. Thirty-six patients were reviewed two and a half years after the first control. Thirty-nine patients had acute lymphoblastic leukemia and 57 had solid tumors. Sixty percent showed functional restriction due to chest deformity after undergoing chest surgery. The association between functional restriction and radiotherapy (6 patients) did not produce poorer functional results. Forty-three percent showed initial change in TLCO. Nineteen percent showed basal hemoglobin saturation under 93% which in 16% fell after physical exercise. These alterations improved with time. However, restrictive change initially present in 11.5% persisted at the second evaluation. Thoracic surgery was the main cause of thoracic deformity and therefore of restrictive change. The children under 8 years old and those who received longer treatments tended to show the worst TLCO values. The patients with neuroblastoma showed greater restrictive change while the change in TLCO was more frequent in patients with Burkitt s lymphoma and in those treated with cyclophosphamide. CONCLUSIONS: Neither personal or family history of respiratory disease nor the presence of symptoms such as cough served to identify risk of functional change. Restrictive change in pulmonary function was greater in patients who had undergone thoracic surgery. Functional values were worse in patients with neuroblastoma. Pulmonary function should be followed up in pediatric survivors of malignant neoplasia in order to prevent restrictive alterations.

Child↗

[Steroid treatment: risk factor for invasive pulmonary aspergillosis].

To describe the association between invasive pulmonary aspergillosis and steroid treatment in patients with no immunodepression attributable to other causes. We reviewed the case histories of apparently non immunodepressed patients in our hospital with histological diagnoses of invasive pulmonary aspergillosis between 1992 through 1996. Seven patients were identified. Laboratory, clinical and radiological data were collected, as well as type and duration of steroid treatment. Four patients suffered underlying chronic obstructive pulmonary disease, 1 had temporal arteritis, 1 interstitial pulmonary fibrosis and 1 a neurological tumor. All had received steroid treatment for periods varying from several days to 16 months, at varying doses, although the majority of them were treated with 1mg/kg/day. All presented clinical profiles suggestive of pneumonia (5 community acquired and 2 nosocomial). Invasive pulmonary aspergillosis can appear in minimally immunocompromised patients, such as those undergoing steroid treatment and must be suspected whenever pneumonia is seen in patients receiving steroids who do not improve with widespectrum antibiotic treatment.

Adrenal Cortex Hormones↗

[Amino acid changes in blood of children with severe liver disease. The evaluation of differences according to distinct physiopathology].

OBJECTIVE: The aim of this study was to know the serum amino acid profiles in children with terminal hepatic diseases and to assess the differences between the two main physiopathological groups of hepatic damage: cholestasis and cellular necrosis. PATIENTS AND METHODS: We studied twenty-six pediatric patients with severe hepatic diseases admitted to the Pediatric Intensive Care Unit. Patients were divided into two groups according to the predominant hepatic lesion: cellular damage (fourteen children) and cholestasis damage (twelve cases). RESULTS: Overall, there is a significant increase in the aromatic amino acids (AAA) phenylalanine (p < 0.04) and tyrosine (p < 0.0003) and a decrease in the branched-chain amino acids (BCAA) leucine, isoleucine and valine (p < 0.00001), with a reduction in the BCAA/AAA ratio (p < 0.00001). However, we found a significant decrease in glutamine, cysteine, taurine, serine, threonine, tryptophan, total amino acids and essential amino acids, together with higher levels of glutamic acid, ornithine and citrulline, which reflects a more complex metabolic disturbance. The group with cholestatic damage shows very low taurine levels (p < 0.0003). Patients with predominantly cellular damage have higher increases in tyrosine (p < 0.01), phenylalanine and hydroxyproline (p < 0.01). CONCLUSIONS: These findings may help us to better understand the complex physiopathology of amino acid metabolism in different liver diseases. Moreover, the extremely low levels of taurine found prompted us to recommend additional dietary support particularly in children with cholestatic hepatopathy.

Adolescent↗

[Management of colostomies with plug: clinical aspects and patient evaluation].

AIM: To assess the effectiveness of the one-piece disposable plug device Conseal (Coloplast A/S, Espergaerd, Denmark) in colostomy patients, considering clinical and social aspects. PATIENTS AND METHODS: Twenty patients with definitive (perineal-abdominal amputation 17 cases) or transitory (Hartmann in 3 cases) colostomy were studied prospectively. No patient used self-irrigations. All of them completed the study. After obtaining the patient's consent, we analyzed for comfort, leaks, security, easy handling and skin conditions by means of personal interview and clinical examination. RESULTS: Sixteen patients (80%) had previously used conventional colostomy bags, 4 (20%) started to use the plug device during the postoperative period (average 8.7 days). Fifteen patients (75%) preferred to use the plug, whereas 5 (25%) considered the plug was insecure. CONCLUSIONS: Our study suggests that the one-piece disposable plug device improves the quality of life in patients with colostomy, although adequate selection of patients and previous training are mandatory.

Adult↗

[Hepatocarcinoma: a rare form of presentation].

A case of acute abdomen presenting with pain in the right upper abdomen, pyrexia and leukocytosis is presented. At laparotomy, hepatocarcinoma with necrosis and associated acute cholecystitis was found. This is apparently an unusual report of hepatocarcinoma presenting as acute cholecystitis.

Acute Disease↗

[Medical pericarditis: study of 19 cases].

19 cases of medical pericarditis admitted to the PICU from 1978 to 1989 were reviewed, to asses the diagnostic and therapeutical approach. The overall incidence is low, 0.32% of the patients admitted to the PICU in that time period. We have found neither tuberculous nor purulent pericarditis, with a 42% of idiopatic forms. Echocardiography was the best method for syndromic diagnosis. The ethiological diagnosis of pericarditis was made, in most cases, by means of non invasive methods or in association with the underlying disease. The cualitative analysis of the pericardial fluid was not useful for the ethiological diagnosis, therefore, we suggest pericardiocentesis should be performed mainly as a therapeutical tool. There were no correlation between the amount of fluid obtained on the first pericardiocentesis and the later incidence of the pericardial effusion. Biopsy brought no ethiological specificity in the cases it was performed.

Adolescent↗

[Status asthmaticus; experience in a pediatric intensive care unit].

Thirty children presenting status asthmaticus in fifty episodes were studied during a period of three and a half years. All of them showed acute respiratory failure secondary to asthma. The purpose was to evaluate treatment results and complications compared with a previous similar study conducted in our unit. We have noticed that there is a lower number of admissions for SA in our ICU and a different seasonal tendency. Precious treatment of asthmatic crisis selective inhaled beta 2 bronchodilators can prevent the ICU admission of an asthmatic patient.

Adolescent↗

[Three cases of mucolipidosis type III (author's transl)].

Three cases of mucolipidosis type III in three siblins ranging in age from 4 to 10 years are reported. One of them was severely involved; the other two in a lesser degree. The enzymatic studies performed are exposed, together with a discussion and interpretation of the findings. The concepts regarding the group of metabolic diseases among which mucolipidosis is nowadays included are reviewed. Some characteristics of the enzymatic disorder, origin of the disease, are finally commented.

Child↗

[Surgical treatment of congenital cardiopathies in the 1st year of life: experience in 893 treated cases].

We present a study of 893 infants treated surgically, of ages from 30 hours to 12 months old, with a global mortality rate of 23.1%. In 37.6% of the cases, a total correction of cardiopathy was reached, using closed techniques in 25.9% and open-heart surgery in 11.7%. Palliative techniques wer chosen in 62.3% of the patients. The highest mortality corresponds to those patients under one month old (40%), decreasing to 14% in the 7-12 month old group. Surgical indications and techniques used are commented in each group of cardiopathies, making special reference to post surgical care.

Age Factors↗