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Biomedical subjects

J Torres

Publications and source records attributed to J Torres.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

[Epidemiologic and clinical aspects of Helicobacter pylori infection in children].

Worldwide, H. pylori prevalence in children ranges from under 10% to almost 80%. Prevalence is low in developed countries; whereas high prevalence is observed in most developing countries. Documented risk factors for infection include socioeconomic status, household crowding, ethnicity, migration from high prevalence regions, and infection status of family members. H. pylori infection is not associated with specific symptoms in children; although it is consistently associated with antral gastritis, which clinical significance is unclear. H. pylori associated duodenal ulcers are seldom seen in children under 10 years of age. The role of the infection in recurrent abdominal pain is highly controversial. H. pylori-infected children demonstrate a chronic inflammatory cell infiltrate, with a lack neutrophils, as compared with the response observed in adults. The importance of virulence determinants such as cagA and vacA, described as relevant for disease during H. pylori infection, has not been extensively studied in children. Sensitive and specific methods for the detection of H. pylori in children are needed, especially in infant populations where the colonization is in its early phases. Non-invasive, cheap, and simple methods are needed for epidemiologic studies. There is no consensus about criteria for the use of eradication treatment in H. pylori-infected children. Multicenter pediatric studies are needed to solve the many unanswered question on the natural history of H. pylori infection in children, including identification of risk factors for infection, identification of prognostic indicators for the development of gastroduodenal disease later in life, and the host response to infection.

Abdominal Pain↗
PubMedDate not supplied

[Assessment of the nutritional status of elderly patients treated at a home-hospital unit].

GOALS: To establish the nutritional status of our elderly patients, assess the usefulness of the various anthropometric and biochemical parameters as markers of malnutrition and to determine which of the variables studied have the greatest correlation with malnutrition. SCOPE: Home Hospital Unit of the Arnau de Vilanova Teaching Hospital in Lerida. PATIENTS: 57 patients > or = 60 years. Mean admission to our unit: 12.1 days. VARIABLES: Age, sex, groups by treatment complexity, associated pathology, diagnosis, reason for admission, duration of stay in hospital, surgery performed, complications during the stay at the Home Hospital Unit, weight, height, PCT, AC, BMI, albumin, haemoglobin and RTL. RESULTS: Patients of great age present lower levels of serum albumin (p < 0.005), total proteins (p < 0.001), transferrin (p < 0.03), haemoglobin (p < 0.02) and RTL (p < 0.04) than "younger" elderly patients. Serum albumin and haemoglobin are lower in patients in a complicated post-surgical condition (p < 0.04 and p < 0.02, respectively) and this group is the one with the longest stays (p < 0.001). Those patients with hypoalbuminaemia (74.1%) present lower PCT and RTL (p < 0.02) and a longer stay in hospital (p < 0.01) than those with normal levels of albumin in blood. Patients with anaemia (63.3%) present a lower RTL (p < 0.01) and a greater hospitalization time than those without anaemia. Total proteins (p < 0.0001), albumin (p < 0.004), transferrin (p < 0.003) and RTL (p < 0.005) correlate negatively with age. Albumin (p < 0.001), haemoglobin (p < 0.006) and RTL (p < 0.0001) present a negative correlation with length of hospital stay. CONCLUSION: The prevalence of global malnutrition is high (51% moderate-severe). The nutritional status worsens with age. The length of hospitalization increases gradually with age, with deteriation in the nutritional status and with complexity of the treatment provided.

Age Factors↗
PubMedDate not supplied

[Late postoperative apnea in a premature newborn infant].

We report the case of a premature newborn child (36 weeks) who was operated on a teratoma of the sacrum when he was 12 days old and weighed 2,950 g. The patient presented a late postoperative apnea 17 hours after anesthesia. The anesthetic technique consisted of lumbar epidural blockade with 0.33% bupivacaine at a dose of 2.25 ml and superficial inhalation anesthesia with 0.5% isoflurane. Relaxing muscular agents used in this case were succinylcholine (3 mg) for orotracheal intubation and pancuronium bromide (0.3 mg) for maintaining the anesthetic level. The immediate postoperative phase was uneventful but 17 hours after surgery the patient presented apnea, bradycardia (40 beats/min), and marked cyanosis requiring assisted ventilation with bag and mask during 3 min and initial cardiac massage. Recovery of heart rate was immediate and recovery of ventilation was progressive. The patient was treated with caffeine during one week and no relapses occurred. Pneumocardiographic recordings obtained later on revealed sporadic short lasting episodes of apnea (shorter than 15 s) sometimes associated with bradycardia (40 beats/min lower than baseline). There were no apparent intercurrent or precipitating factors for this apnea. We believe that the present clinical picture corresponds to a late postoperative apnea of unknown origin which required reanimation measures and that until present, there are no reported complications of the anesthetic technique that can explain this episode.

Anesthesia, Epidural↗
PubMedDate not supplied

Colonization by Clostridium difficile in hospitalized children: risk factors and typification of the isolated strains.

The frequency of colonization by Clostridium difficile in 273 hospitalized children under 15 years of age was studied. Feces were collected from patients attending the infectious disease service at the Pediatric Hospital IMSS, during a period of 11 months. No colonization was detected in 16 neonates; whereas 10 of 103 children (9.7%) under one year of age, 7 of 84 children (8.3%) from one to five years and 3 of 70 children (4.2%) from five to 15 years of age were colonized. The use of antibiotics and the nutritional state were studied as possible risk factors for colonization. The frequency of colonization was not influenced by the nutritional state, whereas the treatment with antibiotics decreased significantly the colonization in children under one year of age but not in those children over one year of age. In children under one year of age, the cytotoxin was more frequent in cases of diarrhea, and in those over one year no association was found. The 50 strains isolated from these children were classified according to: toxigenicity, sensitivity to antibiotics, phages and bacteriocins. Strains acquired before hospitalization were more toxigenic than those acquired intrahospital. Twelve resistotypes were detected; one of them (V) was more frequent in intrahospital strains. Ten phagobacteriocin types were found, and two of then (D and I) were present only in intrahospital strains. Using this classification scheme, it was found that eight patients were colonized with two different strains at the same time.

Adolescent↗
PubMedDate not supplied

[Anesthesia in insulinoma surgery: report of 18 cases].

We reviewed 18 patients operated on insulinoma during the last 16 years (1974-1990). The previous symptoms, the clinical and biochemical diagnostic procedures, the localization before and during operation, and the medical and surgical treatment are reported. Constant and continuous glucose solution perfusion at the preoperative stage prevented the occurrence of hypoglicemia without interference with the rebound hyperglicemia that follows tumor exeresis. Neuroleptanalgesia with nitrogen protoxide and competitive muscular relaxant agents was satisfactory in all instances. Prevention and treatment of postoperative complications are also discussed in this study.

Adolescent↗
PubMedDate not supplied

[Home oxygen therapy in children with bronchopulmonary dysplasia].

Eight babies with severe bronchopulmonary dysplasia (BPD) were discharged from a private hospital at Santiago, Chile, on a program that provided oxygen therapy at home. Mean gestational age was 27 +/- 2 weeks and mean birth weight was 1,181 +/- 353 g. Discharge was decided after stabilization of arterial PO2 or O2 Sat, PCO2 less than 50 mmHg and adequate weight gain. Prior to discharge parents were trained in O2 administration and cardiopulmonary resuscitation. Oxygen was given at home for a mean of 71 days (range 7 to 339). There were no complications secondary to oxygen therapy. At follow up in only two cases additional hospitalizations were needed, in both instances because of intercurrent respiratory infections. Weight gain between 3d and 50th percentile were seen in all cases. Oxygen therapy at home appears to be a good alternative in the treatment of infants with BPD, and it reduces significantly hospital stay and costs. Both optimal family conditions and adequate support at home are needed.

Bronchopulmonary Dysplasia↗
PubMedDate not supplied

[Changes in blood calcium during liver transplant in children].

We have evaluated the changes in plasma total and ionic calcium levels in twenty hepatic transplantations in pediatric patients. Direct intraoperative monitoring of ionic calcium is fundamental, because its variability is unrelated with total calcium levels; in addition, normal ionic calcium levels contribute to the hemodynamic stability of the patient. Although at the end of the operation total and ionic calcium levels were similar to the postinduction measurement, their values were dissociated in the perianhepatic period. In the anhepatic phase ionic calcium reached its lowest value (1.00 mmol/l) although total calcium increased above postinduction level from 2.13 to 2.46 mmol/l (p less than 0.05). In hepatic transplantation in pediatric patients calcium administration is indicated during the transfusion of citrated blood, being particularly necessary during the anhepatic phase to prevent ionic hypocalcemia.

Adolescent↗
PubMedDate not supplied

Malignant melanoma of the cervix. Report of a case.

A malignant melanoma of the cervix, a rare neoplasm, was found to have an unusual cytologic pattern, similar to that of a leiomyosarcoma. A biopsy sample was diagnosed as cervical malignant melanoma of the spindle cell type. Some neoplastic cells in the tissue contained melanin pigment, whereas none of the abnormal cells in the cervical scrapes, except for an abnormal giant cell, had visible cytoplasmic pigment. The abnormal cells in the cervical scrape specimen were spindle-shaped, as were their nuclei, which is why the cytologic pattern was interpreted as that of a leiomyosarcoma. Evidence from this and previously reported cases shows that malignant melanoma must be considered as a possible source of exfoliated abnormal nonpigmented spindle-shaped cells in a cervicovaginal cell sample.

Cell Nucleus↗