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Biomedical subjects

J Boix-Ochoa

Publications and source records attributed to J Boix-Ochoa.

At least 73 records · Page 4Linked to original sources
PubMed1983

[Physiologic surgery for anomalies of the cardio-hiatal region].

In 11 years (1971-1981) 1.040 cases of anomalies of the cardio-hiatal sector have been controlled in the Children's Hospital of the Social Security of Barcelona, 101 patients were operated. Surgical indication was based on the following facts: size of the hernia, poor clinical evolution with postural treatment, or infants of more than 2 years who also presented a high gastric acidity or a clearly pathological pHmetry, or, lastly, a social cause. We have used a much more physiological technique than that of Nissen, based on the obtention of a large segment of the abdominal esophagus on which changes of pressure existing in the abdominal and thoracic cavities can act, clearly registered in manometric studies effected before and after operation. The few complications observed in this large series of operated children speak clearly in favour of its necessary diffusion and utilization.

Cardia↗
PubMed1982

[Intramural duodenal hematoma: conservative treatment in six cases (author's transl)].

Six cases of intramural duodenal hematoma in children less than seven years old are presented. A review of the literature found 143 cases in patients under 15 years. The etiology is traumatic in most cases, although they have also been described in patients with Schönlein-Henoch purpura or coagulation diseases. Contrast X-rays are fundamental elements for diagnosis. The "spring" sign is very valuable. Patients were conservatively treated, although three of them where operated, one for a hepatic rupture and the two other for presumed appendicitis and intussusception respectively. In none was the hematoma drained. Clinical course was excellent and oral tolerance was achieved between three and seven days. Based on this experience and that obtained in the review of the literature, conservative treatment is recommended for intramural duodenal hematomas, when other associated problems needing a laparotomy have been excluded.

Child↗
PubMed1982

[Appendicular peritonitis: antibiotics and complications (author's transl)].

A retrospective study of the complications and bacteriologic findings in a group of 500 appendectomies in children under seven years is reported. A prospective trial on 64 appendiceal peritonitis revealed that there were no significant differences between two antibiotic policies (clindamycin plus gentamycin vs. cefoxitine alone) in regard to postoperative septic complications. Nevertheless, both policies significantly decreased the number of intraabdominal abscesses as compared with the treatments applied during the years of the retrospective study. No improvement was observed in the number of wound infections.

Abscess↗
PubMed1981

[Pediatric retroperitoneal iliac abscesses (author's transl)].

11 cases of retroperitoneal iliac abscesses are reported in patients under seven years of age. Causes have been: sepsis in 2 cases, lumbar traumatism in 1, perforation of the iliac vein in 1, pararenal abscess in 1, following debridement of iliac adenitis in one child and by appendicular mass in another case. The etiology was unknown in the remaining cases. Gram positive germs such as Staphylococcus and Streptococcus predominated in the exudate cultures. The most important clinical manifestations have been: fever, painful mobilization of the psoas, pain in the iliac fossa, limping and antiallergic scoliosis. Among radiological findings obliteration of the psoas line, mass in the iliac fossa, ureteral displacement and vesical compression were the most outstanding. Breathing x-rays and echography were diagnostic procedures in our cases. Diagnosis and differential diagnosis are commented, together with treatment. Authors consider that surgical debridement and drainage and administration of antibiotics are the ideal therapeutical procedures in these processes.

Abscess↗
PubMed1981

[Total colic aganglionosis (author's transl)].

Eleven cases of total colic aganglionism are presented in a series of 130 patients with Hirschsprung's disease. Five patients survived, four were operated according to the Duhamel-Roviralta technique and the fifth according to the simpre procedure of Duhamel. Two others, also operated using the Duhamel-Roviralta technique died, one in the immediate postoperatory period and the other at three months due to hepatitis. The four remaining cases died, two after having effected the ileostomy and two due to the inability of applying an immediate solution because the results of the biopsies were lacking. Death was due to septic processes in the immediate postoperatory period. Advantages of the Duhamel-Roviralta operation makes it the selected technique for the greater part of cases, due to its' quickness and simplicity.

Child↗
PubMed1981

[Thoracic and abdominal trauma in children: study of 122 cases (author's transl)].

Authors present a review of patients under 7 years of age affected with thoracic and/or abdominal trauma not due to birth injuries, observed in the period 1966-1979. In these 122 patients, they observed 154 injuries, including 63 abdominal, 58 renal, 28 thoracic and 5 vertebral. Automobile accidents, falls and penetrating injuries, in this order are the etiological factors. Six patients died due to brain injuries (66%) and the rest of septic and hemorrhagic shock. Authors observed a high incidence of multiple injuries involving thehead, skeleton, abdomen and chest and the importance of recognizing these coexisting injuries to improve the prognosis. Finally, they point out that the pediatric surgeon's function is not only to treat the patient but to prevent the injuries through interdisciplinary meetings.

Abdominal Injuries↗
PubMed1980

Masculinization of a female fetus by Krukenberg tumor during pregnancy.

A case of fetal masculinization resulting from a Krukenberg tumor in a pregnant woman is reported in a newborn infant with a sexual ambiguity of the external genitals, of the feminine pseudohermaphrodite type. She also had an incarceration of both ovaries and tubes in a right inguinoscrotal hernia that was surgically corrected.

Disorders of Sex Development↗
PubMed1980

Management of primary testicular tumors in children.

Between 1966 and 1977, 16 primary testicular tumors (PTT) were treated at the Social Security Children's Hospital in Barcelona. Treatment consisted of resection of the testis, vas deferens and spermatic vessels followed, when the peroperatory biopsy revealed malignancy, by para-aortic lymphadenectomy in 11 of the 13 patients with primary malignant testicular tumors (PMTT). Retroperitoneal radiation therapy was given to patients with positive paraaortic nodes. Chemotherapy was given to all patients with the PMTT. 77.0% of the thirteen patients with PMTT are alive from 1 to 11 yr after surgery. 81.3% of the 16 patients with 13 malignant and 3 benign tumors are alive.

Child↗
PubMed1980

Twenty-four hour exophageal pH monitoring in gastroesophageal reflux.

Twenty-four hour pH esophageal monitoring has been studied in 123 children with gastroesophageal reflux (GER) with ages ranging between 6 mo to 6 yr. The technique is described and the scoring system modified to evaluate gastroesophageal reflux in these patients. For the first time the normal patterns are presented in pediatrics (n = 20). The results obtained in 103 patients are presented, divided into pre- and post-nonoperative and surgically treated groups. The test is more objective, has greater precision, sensitivity, and reliability than contrast studies, endoscopy, acid perfusion or acid reflux tests. The study seems to indicate that esophagitis depends more on the duration of the reflux than on the number, for which the concept of esophageal acid clearance is of paramount importance. The prone position generally lessens the number of refluxes but in this position the esophageal acid clearance is altered. With a greater knowledge and more experience in this technique, we would be able to identify children at risk to develop severe complications, control them and aid in the selection of those patients requiring surgical intervention.

Child↗
PubMed1980

[Lipomeningocele].

In a revision of 473 spina Bifida cystica, 19 lumbosacral lipomas during the last 13 years is presented. It corresponds to a 4,01% of total cases. The results are commented pointing out the embryology, symptomatology and diagnostic. The treatment is surgical before symptomatology appear. It is very important early surgery for the risk is very low if we compare it with the serious neurologic symptoms that can be established. Tumor must be exirpated as much as possible, liberalizing the medullar adherences that avoid its free ascend. All surgical cases presented an intramedullar communication and compresion. Only three of them, under 3 months of life, are not operated. Postsurgery evolution is satisfactory.

Humans↗
PubMed1979

[Peutz-Jeghers syndrome. comments on a new case (author's transl)].

Authors report a new case of Peutz-Jeghers syndrome which is the earliest of the 20 cases published in our country. Out of 450 rectoscopies carried out in their hospital, they found 64 patients with polyps in the rectum and sigma, and in only one case this was associated with pigmentation on the lips establishing the diagnosis of Peutz-Jeghers syndrome. A review of the literature and comments on pathogenesis, hereditary aspects, clinical signs, prognosis and treatment are made.

Child, Preschool↗
PubMed1978

[Pulmonary gas exchange in newborns with congenital diaphragmatic hernia (author's transl)].

In 20 newborns with congenital diaphragmatic hernia the state of the pulmonary function was studied through the blood gas values (PO2 and PCO2 on breathing air and 100% oxygen spontaneously or with mechanical ventilation). The group of survivors presented a normal or slightly altered pulmonary function, whilst in the group that died the pulmonary function was severely altered. Up to now, and in accordance with the results obtained, none of the proposed hypothesis (pulmonary atelectasis, extra-pulmonary right-to-left shunt, pulmonary hypoplasia) explain this alteration in a satisfactory manner. From the prognostic point of view, if the levels of gases are spontaneously normal or with administration of oxygen and/or assisted, ventilation a level of PO2 higher than 230 and of PCO2 lower than 70 is obtained, prognosis is excellent. If these levels are not obtained the prognosis is nearly always fatal and the value of the intervention questionable.

Blood Gas Analysis↗
PubMed1977

Haemangiomas of the parotid gland in children.

The authors present the case histories of 40 intraparotid haemangiomas, in 11 of which they achieved healing after radical surgical treatment (parotidectomy). Since 1971, the authors have adopted a conservative approach (not surgical), seeing that most of the cases involute spontaneously up to complete healing. None of the 29 cases treated conservatively has undergone exacerbations of the process, after the age of 6-9 months. No emergency surgical operations were required.

Child, Preschool↗
PubMed1977

Surgical or conservative treatment in hiatal hernias in children: a new decisive parameter.

The authors have investigated the role of gastric acidity in the evaluation of cardiohiatal anomalies. Results are given of maximal gastric acid (MAO) investigations made in 155 children. Children in whom postural therapy failed and those with an ulcerlike syndrome have much higher MAO values than does the group who responded well to postural therapy and to a control group. Hyperacidity indicates a high probability of a poor response to postural therapy. Therefore measurement of gastric acidity is advisable in all patients with hiatus hernia, and early surgical therapy should be recommended in those with hyperacidity.

Child↗