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Biomedical subjects

J Bosch

Publications and source records attributed to J Bosch.

389 records · Page 22Linked to original sources
PubMedDate not supplied

[Treatment of cerebrospinal fluid shunt infections using the Perrin and McLaurin technique. Analysis of 11 cases].

Eleven patients with shunt infection (SI) of the cerebrospinal fluid in whom the SI was withdrawn and replaced by a new SI system with reservoir and intraventricular and parenteral antibiotic treatment were reported. The diagnosis was made by culture of the components of the SI and, or, the cerebrospinal fluid. In 9 cases the agent was a staphylococcus. The different therapeutic trials to treat SI infections can be summarized as follows: a) replacement of the SI by an external drainage, antibiotics, and reinsertion of the SI when the cerebrospinal fluid was sterilized; b) withdrawal of the SI and placement of a new SI in the same surgical procedure associated with intraventricular and systemic antibiotic treatment; and c) treatment with intraventricular and, or, systemic antibiotics. It has been demonstrated that the surgical approach (a and b) is more effective. In our series the procedure indicated in B was followed by the control of the infection in all cases. The follow-up of the surgical treatment was 1-3 years. The most currently used SI was the ventriculoperitoneal bypass. Their main complications are pseudocysts which are easily recognized by of abdominal echography and frequently revealed SI infection. Diagnosis and treatment of SI infections should take into account the type of complications and the most appropriate collaboration with other clinical departments.

Adolescent↗
PubMedDate not supplied

[Neonatal aortic thrombosis].

A case of aortic thrombosis is reported in a 14 days old newborn after extensive review of the world literature is made. It was secondary to sepsis and hypercoagulability syndrome. Emphasis is placed on the early diagnosis, on the usefulness of the Doppler system when studying the vascular system as a non-invasive method in critically ill pediatric patients; likewise, on the determinant surgical procedure during the initial stages of the establishment of the aortic thrombosis.

Aorta, Abdominal↗
PubMedDate not supplied

[Long-term results of cholesteatoma surgery in children].

In the long-term results, a large percentage of failures of pediatric cholesteatoma surgery (recurrent and residual), as well with the open and closed (ICWT) techniques and motive for the low rates of functional results are a reflection for most authors about the best surgical technique for improving anatomical-functional results. A total of 57 cases of children's cholesteatoma (3-11 years) operated on in a five-year period (1983-1990) with follow-up surgery to 7 years was analyzed statistically. The location of the cholesteatoma in most cases was in the attic and mastoid (72%) with extension to middle ear in 77% and ossicular chain destruction in 80% of cases. In 54% of cases, radical mastoidoepitympanectomy was performed, in 40% mastoidectomy or attico-antrotomy with tympanoplasty and reconstruction of posterior wall with homologous and alloplastic materials, and only in 5.2%, intact canal wall tympanoplasty. Pathological failure (residual + recurrent cholesteatoma) occurred in 17.5% (12.9% with the radical mastoidepitympanectomy, 21% with the reconstructive techniques and 33% with ICWT). The hearing results were better in 17.5% of cases (average 20.2 dB) and hearing loss occurred in 10.5%. At the present time, in most cases the surgical technique used is radical mastoidoepitympanectomy (12.9% of failures).

Child↗
PubMedDate not supplied

[Somatosensory focal seizures as an onset form in adult Moyamoya syndrome].

Moya-Moya disease is a chronic infrequent vasculopathy. Occasionally such abnormalities are found in association with one of many conditions, in these cases the angiographic abnormality should be termed Moya-Moya syndrome rather than Moya-Moya disease. Although in children the usual manifestations are ischemic events and seizures. This clinical presentation is infrequent in adults. We present a 42-years-old man with a 1-month history of recurrent right sided partial somatosensorial seizures, later he presented a left parietal infarction, the angiographic findings were compatible with moyamoya syndrome.

Adult↗
PubMedDate not supplied

[Neonatal infection by Streptococcus agalactiae. Multicenter study in the area of Barcelona, Spain].

BACKGROUND: Streptococcus agalactiae or streptococcus group B (SGB) is the main etiologic agent of early neonatal sepsis. A multicenter study was performed with the aim of determining the incidence and characteristics of this disease in our medium and contribute the design of an adequate prevention protocol. METHODS: Ten hospitals and two primary health care centers were implicated in the study; 103 microbiology confirmed episodes of SGB neonatal sepsis (blood and/or LCR positive) were reported from 1994 to 1996. RESULTS: The incidence of early SGB neonatal sepsis was 1.48/1,000 live births with a mortality of 8.7%. The cultures, for detecting the state of the SGB carrier were performed in only 26 (25%) of the patients. At least one of the factors described for risk of perinatal SGB infection was observed in 46% of the mothers, with the most frequent being prolonged amniorrhea (26%), intrapartum fever (17%), and early delivery (14%). At the time of delivery only 10.7% of the mothers received endovenous antibiotherapy. CONCLUSIONS: From these results the following recommendations have been made: a) detection of SGB carriers by the systematic practice of blood cultures in the last weeks of gestation and b) the administration of intrapartum antibiotic prophylaxis in both early births (< 37 weeks) and in all the SGB carriers should be undertaken. With these measures we aim to decrease the neonatal infections by streptococcus group B.

Adult↗