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Biomedical subjects

F Moazam

Publications and source records attributed to F Moazam.

At least 37 records · Page 2Linked to original sources
PubMed1987

Caustic ingestion and its sequelae in children.

Management of caustic ingestion in children remains a difficult challenge, with the outcome ranging from an asymptomatic state to intractable esophageal strictures. We reviewed the cases of 56 children ranging in age from 10 months to 5 years treated from 1973 to 1984 at the University of Florida. For children seen primarily at our institution, initial management consisted of prompt endoscopy and early institution of steroids and antibiotics. Esophageal burns were confirmed in 37 patients, 21 (56.75%) of whom subsequently had esophageal strictures of varying severity. In seven patients, limited esophageal strictures were managed successfully by dilation, but 14 children with multiple strictures required eventual esophageal replacement. Substernal right colonic interposition was tolerated well by these patients, with few complications, and their growth and development have been satisfactory over follow-up periods ranging from nine months to 13 years. A review of these cases suggests that the character of the ingested caustic material is the most important determinant of the severity of esophageal injury, with preparations containing lye being the most injurious; that in the presence of full-thickness esophageal injury, there is a high potential for stricture formation, regardless of the type of initial management, including early use of steroids; and that multiple esophageal strictures are refractory to dilation, and esophageal replacement should be an early consideration.

Black or African American↗
PubMed1986

Magnetic resonance imaging of bicornuate uterus with unilateral hematometrosalpinx and ipsilateral renal agenesis.

A complex solid and cystic pelvic mass in a young patient was demonstrated by computed tomography (CT) and ultrasound (US). These modalities failed to accurately characterize the solid components as bicornuate uterus and the cystic areas as hemorrhage. Magnetic resonance imaging (MRI) using multislice multiecho spin echo (SE) sequences made it easier to characterize the mass, clearly depicting the abnormality in transaxial and coronal planes and at the same time demonstrating ipsilateral renal agenesis.

Adolescent↗
PubMed1985

Congenital anorectal malformations. Harbingers of sacrococcygeal teratomas.

Since 1973, seven infants treated at the University of Florida, Gainesville, for congenital anorectal anomalies have been found to have concomitant sacrococcygeal teratomas. As anorectal anomalies occur in approximately one in every 5,000 live births and sacrococcygeal teratomas are noted in one in every 40,000 live births, this presentation would suggest a prevalence that precludes a random association. The presence of significant anorectal strictures in these patients resulted in a delay in the diagnosis of the presacral teratomas. As the frequency of malignant change in sacrococcygeal teratomas has been documented to increase proportionately with age, early diagnosis and excision of these lesions is essential. Our experience with these children suggests that the presence of congenital anorectal malformations in infancy should raise the physician's index of suspicion for associated sacrococcygeal teratomas.

Anal Canal↗
PubMed1985

Acute scrotal lesion secondary to barium peritonitis in an infant.

We report on an acute scrotal lesion occurring secondary to barium peritonitis in an infant with a patent processus vaginalis. To our knowledge, this has not been described previously. Treatment of the peritonitis may be sufficient for the scrotal lesion.

Acute Disease↗
PubMed1985

Total lung lavage for pulmonary alveolar proteinosis in an infant without the use of cardiopulmonary bypass.

Pulmonary alveolar proteinosis is a rare disease that usually affects the adult patient, but is now being recognized as a possible cause of neonatal respiratory distress. In the adult patient, whole lung lavage, as described by Ramirez-R in 1965, is considered the most effective therapy for management of this condition. The lavage can be accomplished safely and with relative ease by using a Carlens or Robertshaw tube to isolate and lavage one lung while ventilating the other. The unavailability of a small double-lumen tube makes this procedure impossible in the pediatric age group. Therefore, whole lung lavage has been possible in only a few children in the past with the help of cardiopulmonary bypass to allow simultaneous oxygenation during the pulmonary lavage. Due to the hazards and technical difficulties of cardiopulmonary bypass, total pulmonary lavage can not be considered a practical option in the very small infant. A 15-week-old infant is reported, weighing 2 kg with a diagnosis of pulmonary alveolar proteinosis, who underwent total pulmonary lavage safely on three different occasions without employing cardiopulmonary bypass. A double-lumen Swan-Ganz catheter, introduced transbronchoscopically through the side-arm of a rigid, 3.5-mm Storz bronchoscope was used to isolate and lavage one lung while ventilation to the other lung was maintained through the bronchoscope. A Nellcor oximeter, utilized for transcutaneous monitoring, revealed satisfactory oxygen saturation during the entire pulmonary lavage. The transbronchoscopic lavage was monitored under direct vision with a video monitor, ensuring correct position of the bronchoscope and the catheter at all times.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchoscopy↗
PubMed1984

Total parathyroidectomy and autotransplantation for tertiary hyperparathyroidism in children with chronic renal failure.

An association between chronic renal failure and skeletal deformities in the adolescent patient was first documented by Lucas in 1883. Since then it has been established that the kidneys play a major role in the regulation of calcium, phosphate, and parathyroid hormone, and that chronic renal failure is characterized by profound alterations in the normal metabolic homeostasis of the human body. With the hyperphosphatemia of uremia, compensatory hyperparathyroidism is also a well known complication. Due to these factors, loss of normal renal function ultimately leads to derangement in mineral and bone metabolism resulting in severe skeletal deformities. Reports in the English literature suggest that the changes of renal osteodystrophy are much more pronounced in the pediatric patient, as compared to those in the adult. In the last two decades, renal transplantation has come to be recognized as a satisfactory modality for controlling renal failure and its complications. This procedure is often not available as an option, however, in small patients, especially those under three years of age. The pediatric nephrologist is often forced to manage these patients for long periods with conservative therapy, in an attempt to control the ravages of renal osteodystrophy. The problem becomes unmanageable when the compensatory hyperparathyroidism proceeds to autonomy. When this occurs, despite maintenance of normal serum calcium levels, the renal osteodystrophy progresses rapidly, producing pain, deformities and growth retardation. At this point, the condition is often refractory to medical management and resection of parathyroid tissue remains the only satisfactory modality for control.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic Kidney Disease-Mineral and Bone Disorder↗
PubMed1984

Transcervical myotomy for wide-gap esophageal atresia.

A primary end-to-end anastomosis of the esophagus can be accomplished in the wide-gap esophageal atresia by obtaining extra esophageal length through circular myotomy of the proximal esophageal pouch. However, a very short proximal esophageal pouch may not be accessible through the standard thoracic incision, precluding this procedure. An infant is reported in whom the inaccessible proximal pouch was exteriorized into the neck through a concomitant cervical incision, allowing three circular myotomies to be performed with ease. The proximal esophagus was then reintroduced into the chest cavity and a primary esophagoesophagostomy performed without difficulty.

Esophageal Atresia↗
PubMed1984

Physiology of serum gastrin production in neonates and infants.

Conflicting data exist regarding the physiology of serum gastrin production in neonates and infants, and the response of the neonatal gastric antrum to feeding. Normal neonates and infants underwent serial determination of fasting and postprandial serum gastrin levels from birth to 4 months of age. The mean fasting serum gastrin levels in newborns and infants up to 4 months remained considerably higher than the mean maternal levels, the elevations being statistically significant until 2 months of age. In addition, in the first 2 months of life, there was no evidence of postprandial stimulation of serum gastrin levels 30 minutes following normal feeds consisting of breast milk or commercial formula. At 3 and 4 months of age, the response appears to revert to an adult pattern with statistically significant postprandial elevations following normal feeds (p = 0.003 and p = 0.02, respectively). This study confirms the presence of neonatal hypergastrinemia and reveals a persistence of elevated serum gastrin levels through early infancy. A maturation of the antral gastrin release response with postprandial elevations of serum gastrin levels occurs at approximately 3 months of age.

Age Factors↗
PubMed1984

Inguinal hernias after ventriculoperitoneal shunt procedures in pediatric patients.

The results of this study of 134 patients confirm the increased incidence of previously unrecognized inguinal hernias after ventriculoperitoneal shunting procedures. Infants with intraventricular hemorrhage appeared to be the most susceptible, although associated prematurity may play an additional role. Close observation of infants and children who undergo ventriculoperitoneal shunting is required, to allow early detection and repair of inguinal hernias. Inguinal herniorrhaphy can be performed safely with few or no postoperative complications and no deleterious effects to the VP shunt.

Abdomen↗
PubMed1983

Spontaneous perforation of a colonic duplication.

Alimentary tract duplications are rare anomalies that present with a wide spectrum of clinical manifestations. Mass lesions or obstructive symptoms predominate in infancy, while pain and hemorrhagic complications often herald their recognition in childhood. Spontaneous perforation, a rarely encountered complication, accounted for the acute exacerbation of previously chronic abdominal pain in a three-year-old girl. This case emphasizes the potential for these benign lesions to present with progressive abdominal symptoms and ultimately pressure-induced ischemic perforation.

Child, Preschool↗
PubMed1983

Endotracheal cryotherapy in the treatment of refractory airway strictures.

In 1977 we reported the successful use of endotracheal cryotherapy in the treatment of experimental tracheal strictures. This technique has now been employed in the treatment of 29 refractory airway lesions in 27 patients ranging in age from 3 months to 42 years. The technique utilizes a nitrous oxide cryoprobe measuring 3 mm in diameter and 43 cm in length. The tip of the probe is applied directly to the stricture through the endoscope and cooled to -80 degrees C for 45 seconds. On removal of the probe, the frozen tissue is resected with biopsy forceps. Cryotherapy has successfully relieved the airway strictures in 20 of the 24 lesions in which treatment was completed. The technique of endotracheal cryotherapy has proved helpful in the management of selected patients with refractory airway strictures.

Adolescent↗
PubMed1983

Hepatic artery ligation for hepatic hemangiomatosis of infancy.

Capillary and cavernous hemangiomas of the skin and subcutaneous tissue, usually follow a benign course with enlargement in the first year of life followed by gradual involution. Hemangiomas of the liver, on the other hand, can be responsible for life threatening complications in infancy. The presence of major intrahepatic arteriovenous communications may produce a high output cardiac failure, refractory to intensive medical therapy. Use of radiation therapy and high doses of steroids have proven to be of limited success with a 90% mortality in infants managed with nonoperative therapy. Hepatic artery ligation in such patients may provide dramatic control of the high output failure, with negligible side effects. Two infants are reported in whom bilateral hepatic artery ligation provided prompt control of fulminant congestive failure secondary to hepatic hemangiomatosis, after failure of medical therapy.

Female↗
PubMed1983

Retroperitoneal malignant schwannoma: a case report.

Malignant schwannomas are primary nerve sheath tumors that usually arise from peripheral nerves and only rarely occur within the retroperitoneum. Only 13 instances of this neoplasm occurring in such an anatomic location have been reported in the English literature, and none have been described previously in children. The present report details a case of a retroperitoneal malignant schwannoma in a 14-yr-old child.

Adolescent↗
PubMed1982

Near-total pancreatectomy in persistent infantile hypoglycemia.

To prevent the devastating effects of hypoglycemia on the CNS of the infant, persistent infantile hypoglycemia should be recognized early and treated promptly. To avoid mental retardation, surgical intervention should not be considered as a last resort. When an insulinoma is identified at surgery, subtotal pancreatectomy is adequate in achieving normoglycemia. However, the most common cause of insulin excess in infancy appears to be islet cell hyperplasia or nesidioblastosis, both diffuse processes. In these patients, subtotal pancreatectomy is often ineffective in achieving normoglycemia. Near-total pancreatectomy, retaining the spleen and duodenum, is a safe procedure, well tolerated by infants and children, and should be considered early for the correction of hypoglycemia of infancy that is not readily controlled by medical intervention.

Adenoma↗
PubMed1982

Secretin levels in plasma and tissue of the neonatal swine.

The mean fasting serum secretin level determined in newborn swine was found to be 298.0 +/- (SEM) 5 pg/ml, significantly higher than that in the adult animal. Intraduodenal infusion of 0.1 N HCl produced dramatic elevation of the mean serum secretin level to 2,090 +/- 340 pg/ml. The tissue secretin concentration of duodenal mucosa as well as the molecular species of tissue secretin were found to be identical to that of the adult swine. The mean disappearance half-life of exogenously administered secretin in the newborn swine was significantly prolonged over adult values, to 3.6 min. These data suggest that delayed secretin degradation can be implicated as a factor in the etiology of the hypersecretinemia in the newborn swine.

Animals↗