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V Modesto

Publications and source records attributed to V Modesto.

6 recordsLinked to original sources
PubMed2005

[Evidence-based medicine in Spanish pediatric surgery reports].

INTRODUCTION: Pediatric surgical literature is characterized by a high prevalence of observational studies and a paucity of randomized controlled trial, comparing mainly medical therapies. AIMS: To asses scientific evidence level produced by spanish pediatric surgeons. MATERIAL AND METHODS: Articles reported in Cirugía Pediátrica, surgical reports in Anales Españoles de Pediatría, and reports from spanish authors published in the Journal of Pediatric Surgery, Pediatric Surgery International and European Journal of Pediatric Surgery, from 1997 to 2002. Internal validity was assessed through the critial guides from Sackett, and evidence level was classified through the Oxford Centre for Evidence Based Medicine classification. RESULTS: 94.5% on therapy reports, 61.5% on diagnosis, 83.3% on prognosis and 52.2% on risk factors or etiology, were classified as level 4 (descriptive studies). Only four randomized controlled trials were found, all of them comparing medical therapies (analgesia, antibiotics and surgical stress control). CONCLUSIONS: Our results are similar to those offered by previous reviews, showing up a low level of scientific evidence in most articles. Diffusion of guides on reporting descriptive studies may improve the evidence level of our reports.

Child↗
PubMed1997

[Acute epiglottitis caused by Haemophilus influenzae type b in children: presentation of 21 cases].

BACKGROUND: The aim of this paper is to review the epidemiological, clinical and therapeutical characteristics of Haemophilus influenzae type b (Hib) epiglottitis in children at a time when an efficient and safe vaccination is available. METHODS: The clinical histories of 21 children admitted to Children's Hospital La Fe (1971-1996) with a clinical diagnosis of epiglottitis and isolation of the microorganism in blood cultures (20 cases) and surface culture of the epiglotis (one case) are reviewed. RESULTS: The annual average was 4/100,000 children under 5 years of age. Evolution prior to diagnosis was > 12 hours in 52.4% of the cases. More males were affected (52.4% vs 47.6%). All the children except one (95.2%) were under 5 years of age; 81% were under 3 years of age and 1 child was 6 years and 8 months old. Respiratory distress (100%) and fever > or = 38 degrees C (85.7%) were the most common clinical manifestations. General health was affected in 71.4% of the cases and 66.7% had leucocytosis on admission. The clinical diagnosis was confirmed by direct visualization of the epiglotis in 76.1% of the cases. Hib was isolated in blood culture in 20 cases (95.2%). The strains produced beta-lactamases and were ampicillin-resistant in 57.1%. 19 children (90.5%) required endotracheal intubation. Initial empiric antibiotic therapy was third generation cephalosporins (cefotaxime or ceftriaxone) alone or combined with ampicillin. One child died (4.8%). CONCLUSIONS: Pediatricians must still be aware of this serious infection in order to diagnosis and treat it as early as possible.

Acute Disease↗
PubMed1991

Laparoscopic cholecystectomy: use and preparation for Operation Desert Shield.

While stationed at Winn army hospital, Fort Stewart, Georgia as backfill surgeons during the initial stages of Operation Desert Shield, we performed eight laparoscopic cholecystectomies (LC) over a 2 1/2 week period. Our patients included four active duty soldiers, three dependents, and one retiree. There were no complications. The average hospital stay was 2 days, and the average time to return to duty was 10 days for LC compared to 5 and 30 days, respectively, with standard cholecystectomy (SC). Performing LC whenever possible can return soldiers back to duty in one-third the time and greatly reduce health care costs by reducing the hospital stay.

Cholecystectomy↗