Search PubMed⌕ Search

Biomedical subjects

J G Maksoud

Publications and source records attributed to J G Maksoud.

47 records · Page 3Linked to original sources
PubMedDate not supplied

[Liver transplantation in children: initial experience of the Instituto da Criança of the Hospital das Clínicas of Universidade de São Paulo].

The initial experience at the Instituto da Criança do Hospital das Clínicas--School of Medicine of São Paulo University with liver transplantation in children is presented. A staff experienced in the management of children, including pediatric surgeons, hepatologists, critical care specialists, anesthesiologists, and other has been joined to draw therapeutic protocols. Afterward, more than 100 experimental liver transplant were performed in animals of medium size (dogs and pigs). From September, 1989 to July 1991, 12 liver transplants were performed on 9 children (3 retransplants) ranging in age from 2.5 to 17 years, being 5 boys and 4 girls. The donors had been selected according to the ABO blood group and body weight. Just once a blood A+ recipient received a liver from a blood O+ donor. The regular postoperative immunosuppression consisted of triple therapy with cyclosporin, prednisone and azathioprine. The postoperative stay in the Intensive Care Unit ranged from 3 to 24 days, according to the necessity of ventilatory support. These was no intraoperative mortality, arterial or venous thromboses, or early biliary complications. The overall survival is 78% (7/9). Primary non-function of the graft was the cause of death in two of our children. Although the number of cases is still small our results are comparable to those of the best liver transplant centers in the world.

Adolescent↗
PubMedDate not supplied

[Stability of the mixture of a new fat emulsion with parenteral nutrition solutions].

The stability of the mixture of various parenteral nutrition (PN) solutions with a new fat emulsion containing 50% soybean oil and 50% medium chain triglycerides (MCT) was tested. Five different mixtures were analyzed under transmission electron microscopy 24 hours after the preparation: 1) 10% fat emulsion (FE); 2) FE + PN solution with 5% glucose; 3) FE + PN solution with 12.5% glucose; 4) FE + PN solution with 25% glucose; 5) FE + pure 50% glucose. The pH of each PN solution, fat emulsion and mixture was determined in order to verify if the stability was dependent on the pH of the surrounding medium. The mixture of lipid emulsion with PN solutions did not cause any coalescence of the liposomes or damage to their membranes. However, the addition of 50% glucose to FE coalesced the liposomes, probably due to a decreased pH of the medium (pH = 3.3). We conclude that mixtures of this specific lipid emulsion with PN solutions containing glucose up to 25% are stable for at least 24 hours, and suitable for clinical use in parenteral nutrition.

Drug Combinations↗
PubMedDate not supplied

[Gastroesophageal reflux in children: analysis of 34 consecutive cases].

We studied 34 consecutive children from 6 m to 10 yr presenting gastroesophageal reflux (GER) with or without hiatal hernia. There was a high incidence of stenosis: 28 (80%) children presented with stenosis of the esophagus from mild to severe degree and 20 of them (70%) developed shortened or Barrett's esophagus. This data suggest that in our serie the diagnosis of GER has been delayed or medical therapy has been inadequate or excessively prolonged. The surgical treatment of GER with or without stenosis is the Nissen fundoplication. Our first cases of shortened esophagus were treated by intrathoracic Nissen fundoplication, which was considered an extensive and major risk surgery. Lately, for these cases we have been utilizing the gastro-fundoplication without opening of the chest. This is an easier surgery, through which we could reach good results without serious postoperative complications.

Child, Preschool↗
PubMedDate not supplied

[Compression of esophagus and trachea by aortic arch anomalies in childhood].

From February 1985 to November 1992, 14 children with aortic arch anomalies and tracheal and/or esophageal compression were treated at the Pediatric Surgery Division of the São Paulo University School of Medicine. There were 3 cases of double aortic arch, 3 of right aortic arch with ligamentum arteriosum and 4 of aberrant right subclavian artery. Accurate diagnosis was based only on barium esophagoradiogram and, eventually, tracheobroncoscopy. The surgical approach was made through a left posterolateral thoracotomy that allowed an adequate exposure of the malformations. There was no operative mortality. There were 3 late post-operative deaths, 2 of them caused by chronic pulmonary lesions owing to delayed diagnosis. The other child died from complications of a severe tracheomalacia which became symptomatic only after the corrective surgery. The diagnosis of the aortic arch anomalies should be early suspected in children with undetermined respiratory symptoms and can be easily made basically by esophagoradiogram and tracheoscopy.

Aorta, Thoracic↗