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J Murcia

Publications and source records attributed to J Murcia.

65 records · Page 4Linked to original sources
PubMed1990

[Infection as a complication of the liver transplant].

Currently, the incidence of one episode of infection after liver transplantation is 83 for 100 and 50 for 100 of them are severe. We have studied 30 patients who underwent liver transplantation, ten of them received a second graft. All patients were treated prophylactic with antibiotics 48 hours and selective bowel decontamination, in 23 we used ganciclovir prophylactic. The incidence of infection was 73 for 100, 40 episodes of bacterial infection, eight fungal and ten viral. The direct relationship of infection and mortality was seen in six patients. We studied different risk factors of infection and we found a correlation between surgical time, prior operations and arterial thrombosis with infections.

Bacterial Infections↗
PubMed1989

[Posterior urethral valves: prognosis related to the initial surgical treatment].

Long-term outcome of 32 boys with severe posterior urethral valves is reviewed. Diagnosis was established during the first month of life in 14 patients, along the first year in another 14 and later in five. Surgical management was, initially, bilateral upper urinary tract diversion (cutaneous ureterostomy or pyelostomy) in 17 patients (Group A), and valve ablation alone or vesicostomy in 15 children (Group B). Eight months was the mean age of patients at initial surgery (40% before the first month of life). The average age for closure of the temporary urinary diversion was 17 months. Eleven patients underwent later unilateral nephrectomy and eighteen antireflux surgical procedures. Follow-up ranged from 1 to 15 years (mean 6 years). Fifteen patients have a Glomerular Filtration Rate (G.F.R.) of more than 80 ml./min./1.73 m2. Eleven (73%) of them underwent early upper urinary tract diversion, and the remaining four (27%) underwent valve ablation or vesicostomy. Two children among the 32 have developed end stage renal disease. Average height and weight posttreatment values were higher in those patients treated with ureterostomy or pyelostomy. The results of our study suggest that renal function improved in patients with early upper urinary tract diversion.

Child, Preschool↗
PubMed1989

[Aspects related to extraction and preservation in 60 cases of liver transplant].

Extraction and preservation are of special interest in any liver transplant program. The viability and correct early function of the graft are determinant factors of the success or failure of the transplant. Application of a restrictive criterion in the acceptance of donor livers has allowed us to achieve an optimal viability (96.7%) in our first 60 cases of liver transplant.

Humans↗
PubMed1989

[Surgical evaluation of a liver transplant program. Experiences with the first 45 cases].

The cumulative experience in liver transplantation since the introduction of cyclosporine A has confirmed its efficacy in the treatment of diverse liver diseases in children and adults. In the present study we review the surgical aspects of 45 transplants performed in 39 patients (17 children and 22 adults). Immunosuppressive treatment consisted of cyclosporine A, steroids and monoclonal antibodies (OKT3) in rejection unresponsive to steroids. The actuarial survival rate one year after transplantation was 74%. In the course of development of the program, the elective use of veno-venous bypass during the anhepatic phase in adults was confirmed as useful. Among pediatric transplantations there were numerous arterial malformations (31.5%) in donor organs, which, with the malformations associated in receptors, made allograft reconstruction difficult. Our results confirm those reported by other groups, as well as the importance of specialized training for this type of intervention.

Adolescent↗
PubMed1987

[Digestive leiomyomas in childhood].

Leiomyoma is a very rare tumor, originating in smooth muscle. During the last 18 year authors treated four of them from 159 digestive tumors. This were located in jejunoileal bowel with occlusion in two cases and bleeding problems in the other two.

Child, Preschool↗
PubMed1985

[Current status of the treatment of congenital diaphragmatic hernia].

50 cases of congenital diaphragmatic hernia were operated during a five year period (1978-82). Authors review surgical and postoperative treatment. Eight cases were treated with pulmonary vasodilators, including tolazoline and dopamine, with very good results. Other cases were treated with hyperventilation. Mortality rate was 30%.

Hernia, Diaphragmatic↗
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↗
PubMed1984

[Tumors in the newborn infant: development and surgical treatment].

From 1970-1982, 70 newborns with different kinds of tumors were studied at "La Paz" Children's Hospital in Madrid. Our review was directed to study sex, site, kind and malignity. This type of neonatal work is uncommon in pediatric literature. We make special emphasis in the follow-up of malignant. tumors. 63% of these tumors were benign ant the remaining were malignant. The overall mortality was 28%.

Carcinoma, Hepatocellular↗
PubMed1984

[Partial splenic embolization in hypersplenism].

Partial splenic embolization is a new procedure in the treatment of hypersplenism in infancy. We have used embolization of the spleen as an alternative to splenectomy in a patient with critical hypersplenism. The patient was a 6 year old girl with portal hypertension. The white blood cell and platelet count returned to normal 24 hours after embolization and tre frequency of bleeding episodes was reduced. There were no splenic abscesses and no other significant complications of the treatment.

Child↗