Search PubMed⌕ Search

Biomedical subjects

J A Diez Pardo

Publications and source records attributed to J A Diez Pardo.

6 recordsLinked to original sources
PubMed1995

Ambulatory 24-hour manometric and pH metric evidence of permanent impairment of clearance capacity in patients with esophageal atresia.

Dysphagia and gastroesophageal reflux (GER) probably caused by structural disorganization of the esophagus occur frequently after repair of tracheoesophageal fistula (TEF), and the extent to which they may improve beyond childhood is not known. The aim of the present study is to assess by combined ambulatory 24-hour manometry and pH-metry the esophageal peristaltic activity and acid clearing capacity in adolescents and adults who had been operated on for TEF at birth. Twenty-two patients, aged 17.1 +/- 4.5 years (mean +/- SD), were examined with combined three-channel manometry and two-channel pH-metry followed by endoscopy and biopsy. Although they considered themselves healthy, on careful interrogation, 16 (72%) were found to have dysphagia, 13 (59%) had heartburn, 10 (45%) had foreign body impaction, and 7 (31%) had chronic respiratory tract disease. GER was detected in 12 (54%) patients (5 with histological esophagitis), 10 of whom had a pattern of prolonged nocturnal episodes with very slow clearance. All patients had diminished contractile activity with low-amplitude and short-duration waves that decreased from 0.53 +/- 0.35 waves per minute to 0.28 +/- 0.2 waves per minute during sleep. Propulsive activity was uniformly disorganized, with peristaltic sequences being few (less than 50% overall) and incomplete (above 80%). Finally, the acid-clearing capacity was nil; the proportions of ineffective sequences were above 90% for all periods considered, including sleep and mealtimes. The motor behavior of nonrefluxing and refluxing patients was identical despite the differences in esophageal acid exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Residual cavities after surgery for hepatic hydatid cysts--an ultrasonographic evaluation.

Ultrasonography has made it easier to diagnose precisely hepatic hydatid cysts, but the interpretation of images of residual cavities persisting long after the operation can be difficult. We reviewed the clinical histories of 22 children treated surgically for hepatic hydatid cysts at our hospital (1985-1992) to find clues to the proper attitude toward residual cavities. The children's mean age was 7.4 +/- 2.5 years. Fourteen children had single cysts (11 right and 3 left) and 8 children had multiple cysts, one of them 30 cysts (16 right and 14 left). The mean ultrasonographic diameter of the 44 cysts was 6.1 +/- 3 cm. Cystectomy with partial pericystectomy was performed in every case. Six months after operation, 29 cavities had disappeared, became calcified, or were substituted with fibrous scar tissue. The remaining 15 residual cavities had a mean diameter of 3 +/- 1 cm. The residual cavities exhibited little change at 12 months (2.8 +/- 1 cm), but at 18 months 9 had disappeared, 2 that increased in size and 4 remained the same size. Of these 4 stable lesions, surgery performed in 2 found no cysts and 2 have been followed-up ultrasonographically for 5 years. This short series shows that ultrasonography is useful in the diagnosis and follow-up of residual cavities after surgery for hepatic hydatid cysts. Most residual cavities disappeared by 18 months. In the cavities that persisted, our findings suggest that surgical treatment is justified only when the cyst becomes larger on ultrasonography.

Child↗
PubMed1990

Gastric heterotopy of the biliary tract.

The case of a 12-year-old girl having cholestatic syndrome, due to the presence of gastric tissue in the gallbladder and extrahepatic biliary tract, is reported here.

Bile Duct Neoplasms↗
PubMed1985

Morbid musculoskeletal sequelae of thoracotomy for tracheoesophageal fistula.

The standard surgical approach for tracheoesophageal fistula (TEF) is right dorso-lateral thoracotomy. The late musculoskeletal consequences of the operation have been evaluated only rarely. Two hundred and seventy-seven patients with TEF were operated upon during the past 16 years, 117 of whom were available for long term (3 to 16 year) study. Twenty-nine of the patients had significant musculoskeletal deformities: (1) Twenty-one patients (23.8%) had prominent elevation of the right shoulder or "winged" scapula secondary to partial paralysis of the latissimus dorsi muscle; (2) Eighteen (20%) had marked asymmetry of the thoracic wall from atrophy of the serratus anterior muscle; (3) Nine (10%) had fusion of the ribs, in one of whom major respiratory dysfunction was a consequence; (4) Seven (7.8%) had severe thoracic scoliosis. The deformity was not of sufficient severity to warrant surgical correction but all patients required physiotherapy; (5) In two children (2.2%), fixation of the skin cicatrix to the bony thorax limited the mobility of the ipsilateral shoulder; (6) And finally, in three girls (3.3%), the thoracotomy scar disfigured the right breast leading to mammary maldevelopment in one adolescent. The latter child required plastic release of the entrapped breast. The dorso-lateral thoracic incision for tracheoesophageal atresia may lead to significant musculoskeletal complications and, since other alternatives are available, should be reevaluated as the recommended surgical approach.

Bone Diseases↗
PubMed1980

Apple peel small bowel. A review of twelve cases.

This is a review of 12 cases with apple peel small bowel with agenesis of the dorsal mesentery and intestinal atresia, 11 of them jejunal and 1 duodenal in type who were treated at the Clinica Infantil "La Paz" Madrid over a period of ten years (1969--1979). The associated anomalies, the surgical treatment and the cause of death as well as the etiology and pathogenesis of this malformation are discussed.

Duodenum↗